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Biomedical subjects

A Angelini

Publications and source records attributed to A Angelini.

At least 19 recordsLinked to original sources

Evaluation of four different methods for platelet freezing. In vitro and in vivo studies.

This report describes our experience with various techniques for the freezing of platelet-rich plasma, removed from the final product after leukapheresis procedures performed on 14 hematological patients. A total of 194 platelet units were frozen for subsequent autologous transfusion, by the following four methods: (1) 6% dimethyl sulfoxide (DMSO); (2) a combination of 5% DMSO/6% hydroxyethyl starch; (3) 3% glycerol; (4) 5% glycerol/4% glucose. Each technique was evaluated by measuring the percentage of platelet recovery, malondialdehyde (MDA) production, and lactate dehydrogenase release. To investigate the safety and therapeutic effectiveness of the previously frozen platelets, in vivo comparison of four platelet freezing methods was made in 8 thrombocytopenic patients, using corrected platelet increment (CCI), determined at 24 h. Our in vitro results indicate that the cryopreservation with 6% DMSO, without controlled cooling rate, provides significantly (p less than 0.05) greater platelet recovery (75%) as compared to other systems. The decrease of MDA production and the increase in plasma lactate measured after the thawing process was less in the DMSO-frozen units than in the other platelet units. When platelets, cryopreserved by this method, were subsequently transfused into patients, a significantly better CCI (greater than 5,000/microliters) was obtained. In our series, 6 patients were entirely supported with frozen autologous platelets. It appears from this study that a better understanding of the physical and biochemical events occurring during the freezing process will improve platelet cryopreservation, allowing a more systematic use of frozen platelets in the support of thrombocytopenic patients.

Adolescent

Relationship between plasma and hepatic cytosolic levels of ornithine decarboxylase (ODC) and thymidine kinase (TK) in 70% hepatectomized rats.

Ornithine decarboxylase (ODC) and thymidine kinase (TK) are enzymes important for DNA synthesis, a process that is critical for cell renewal and regeneration. As such, they already have been used as surrogate markers of regeneration in tissue. In the present study, the activity of these two enzymes in plasma of rats and regenerating hepatic tissue following a 70% hepatectomy were determined. The results demonstrate that the changes in these enzyme activities in plasma reflect the changes obtained in the liver tissue. Thus, blood levels of ODC and TK can be used as a less invasive and nondestructive means of monitoring the regenerative response of the liver and possibly other tissues.

Animals

Density gradient separation of hematopoietic stem cells in autologous bone marrow transplantation.

Recently, the principles of density gradient cell separation have been transferred to the marrow fractionation, and the Ficoll technique by using a COBE 2991 blood cell processor has been developed and widely employed as well. This method is particularly useful in view of a chemical antineoplastic purging intended for autologous marrow transplantation. Forty marrows, which derived from patients suffering with leukemia and lymphoma, were fractionated with Ficoll on a COBE machine and in vitro purged with Mafosfamide at a dose of 50 micrograms/ml/1 x 10e7 MN cells. The density gradient separation enables to reduce the initial volume to 10%, the contaminating RBC to less than 1%, the total nucleated cells to 25% (greater than 80% of MNC) sparing about 80% of the CFU-GM. After purging, the surviving hemopoietic progenitor cells were 2.5%. The clinical effects of the fractionated purged cells were studied in 11 autotransplanted patients and compared with 14 transplants performed with untreated buffy-coat marrow derived cells. Ficoll cells produced less adverse effects at the time of reinfusion, while, as expected, the time of hematopoietic recovery was delayed in these patients (mafosfamide treated cells). These results confirm the usefulness of the gradient density cell separation to reduce the side effects of the DMSO and to make reliable the Mafosfamide purging manoeuvre, preventing the interference of contaminating RBC aldehyde dehydrogenase.

Bone Marrow Transplantation

[The anatomicofunctional picture of the atherosclerotic lesion].

The natural history of atherosclerotic disease is characterized by a first asymptomatic phase, when the lesion develops and a second one, the more dramatic symptomatic phase, when the mature plaques, which represent the progression of the early lesions, and their complications produce a wide range of clinical phenomena. After 1 year of age all children show changes in coronary arterial wall, consisting of cell proliferations, which may be considered as precursors of atherosclerosis. These cells migrate from the tunica media of the coronary artery, proliferate, may synthetize connective tissue and lose the ability to degrade plasma lipoproteins. As a consequence, they may be laden of cholesterol, which accounts for fatty streaks. Later on, near 25% of 15-20 year old children are found to be affected by silent non-obstructive coronary atherosclerotic plaques, which consist of raised lesions, the fibrous plaque, made up of frequently lipid laden cells and fibrous tissue. The lesion-prone area is chiefly the proximal anterior descending coronary artery at the site where the worst precursors of atherosclerosis are usually detected. The medial coat of the vessel retain at this stage a good thickness, which accounts for the vasoreactivity of the coronary artery in youths and young-adults. The trigger in the cascade of dynamic events which lead to the advanced lesions remains a mystery. The plaque is not a static immutable structure, but is subjected to growth with consequent stenosis of the lumen and continuing modification and remodelling which involve all the 3 coats of the arterial wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging

Comparison of five methods for concentrating progenitor cells in human marrow transplantation.

Enrichment of bone marrow (BM) aspirates is an important prerequisite prior to in vitro treatment or cryopreservation. In this regard, we have analyzed the results obtained on 190 BM processed by the following 5 techniques: HES sedimentation with centrifugation; COBE 2991 blood cell processor; Ficoll/hypaque (F/H) gradient centrifugation; Continuous flow cell separator (CS 3000 Fenwal); Semicontinuous blood cell separator (Dideco T 90). Each procedure was evaluated by measuring the recovery of nucleated marrow cells (NC), mononuclear cells (MNC), committed progenitor cells (CFU-GM), the reduction of BM volume and the removal of red blood cells (RBC) and polymorphonuclear cells (PMN). The results of this comparative study show that F/H gradient on a COBE 2991 cell washer provides the most efficient system for purifying a MNC fraction (89% recovery) from unwanted cells (RBC less than 2% and PMN less than 2%) in a very small volume (98% reduction) with a good recovery of CFU-GM (80%).

Bone Marrow Transplantation

Cluster-like headache and head injury: case report.

This appears to be the first report of cluster-like headache secondary to post-traumatic subdural hematoma. A 39 year old man consulted us for cluster-like headáche on the right side following an injury to the right frontotemporal region some 45 days before. A CT scan revealed a chronic subdural hematoma in the right frontotemporal region. We discuss the possible relationship between the head injury and the headache and suggest the value of CT scanning in patients with cluster headache.

Administration, Rectal

Coronary arterial wall and atherosclerosis in youth (1-20 years): a histologic study in a northern Italian population.

Based on the working hypothesis that coronary atherosclerosis begins in childhood, a histologic study was carried out on the subepicardial coronary arterial tree of 100 young persons (1-20 years), who had died from causes unrelated to the cardiovascular system. These subjects were natives of a well-defined geographic area in northern Italy, namely the region of Veneto. Intimal proliferations (musculo-elastic and fibro-elastic layers) were observed in 95.3% of the coronary arterial segments in the age group between one and five years. The more distal the coronary segments examined, the lesser was the intimal thickening. Raised mature fibrous plaques were detected in 23 segments from 15 patients (2 from subjects aged between six and 10 years; 4 between 11 and 15 years, and 9 between 16 and 20 years). Single vessel disease was present in 9, double vessel disease in 4 and triple vessel disease in 2 cases. The site most involved by plaques was the proximal part of the left anterior descending coronary artery. Only one plaque was of sufficient dimensions to be considered stenotic (50% luminal reduction). Plaques were rarely sudanophilic, and all seemed to arise in relation to previous intimal thickening. No qualitative nor quantitative sexual differences were observed. These data give rise to much concern, and one consistent with a recently observed occurrence of sudden coronary death in young people from the same geographic area.

Adolescent

Immunoscintigraphy in the follow up of patients with ovarian cancer.

Our case series concerns eight patients affected by epithelial cancer of the ovary. The immune scintigraphical examination with B 72.3-I-131 monoclonal antibody was carried out as a follow-up after surgical therapy with chemo- and/or radio-therapy. The results were compared with traditional diagnostic methods (CT, pelvic echography etc.). The immunoscintigraphy confirmed the presence of local relapses in seven patients, correlating positively with the results of conventional enquiries. The conclusions, although relating to a limited number of cases, are satisfactory and seem to indicate important diagnostic possibilities to the end of follow-up in patients affected by ovarian cancer.

Adult

Evaluation of azlocillin-amikacin combination for empirical therapy of infection in febrile neutropenic patients.

We have evaluated the azlocillin-amikacin combination, given at a daily dose of 200 mg/kg and 15 mg/kg respectively, in the treatment of 62 consecutive febrile granulocytopenic patients (less than 500 PMN/microliters) affected by hematological disease. The effectiveness of the treatment was assessed in 60 patients, 44 (73%) of whom responded within 96 hours from the beginning. 36 of the responders showed microbiological and clinical infections, 2 had clinically documented pneumonia and 6 a possible infection. No improvement was obtained in 16 patients; 7 of whom suffered from clinical and microbiological infection, 2 from pulmonary mycosis, 4 from possible infection and 3 from doubtful infection. Seven of these patients subsequently responded to a proven antibiotic treatment, while only one of the remaining responded to a second-line empirical antibiotic schedule. These results suggest that the combination of azlocillin-amikacin was able to overcome about two-thirds of the infections, representing an effective remedy for the empiric treatment of febrile neutropenic patients.

Adolescent

Factors influencing the presence or absence of acute coronary artery thrombi in sudden ischaemic death.

Sudden ischaemic death results either from an episode of acute myocardial ischaemia consequent upon coronary thrombosis or from an arrhythmia arising within a scarred left ventricle. Very different proportions of these two groups have been reported in both clinical studies in resuscitated subjects with out-of-hospital ventricular fibrillation, and in necropsy series. In 168 cases of sudden death due to ischaemic heart disease coming to necropsy 73 (43.5%) had mural intraluminal coronary thrombi, 50 (29.8%) had occlusive intraluminal thrombi, and 45 (26.7%) had no intraluminal thrombi, giving a ratio of 2.7:1 for those with and without coronary thrombosis. Single vessel disease, the presence of acute infarction at autopsy and prodromal symptoms were positively associated with the presence of coronary thrombosis. Conversely, the presence of old myocardial infarction at necropsy, a known clinical history of ischaemic heart disease and triple vessel disease were associated with the absence of acute thrombosis. The reported variation in the incidence of coronary thrombi in sudden ischaemic death can be largely explained by selection of subjects with those clinical characteristics which are positively or negatively associated with coronary thrombosis.

Acute Disease

Early hematopoietic reconstitution after autologous transplantation with blood-derived stem cells in a patient with advanced lymphoma.

A 30-year-old man with advanced non-Hodgkin lymphoma underwent repeated leukaphereses for harvesting blood-derived hemopoietic stem cells. Collection was started 8-10 days after the end of L-VAMP therapy (3 cycles). Nine procedures were performed and a total of 65.4 x 10(9) mononuclear cells (0.87 x 10(9)/Kg) were collected, processed, cryopreserved and stored in liquid nitrogen. The yields of CFU-GM, BFU-E and CFU-GEMM were respectively 964 x 10(4) (12.4 x 10(4)/Kg), 249 x 10(4) (3.2 x 10(4)/Kg) and 798 x 10(4) (10.4 x 10(4]. The patient received a myeloblative regimen consisting of fractionated total body irradiation (1200 cGy) and cyclophosphamide (120 mg/kg) followed by infusion of his own thawed cells. Early trilineage hematopoietic recovery was first observed on day +8; 1 x 10(9)/l WBC were reached on day +11, 0.5 x 10(9)/l PMN on day +13 and 50 x 10(9)/l platelets on day +11. Course was uneventful and the patient was discharged from hospital on day +21. Eight months after transplant the patient is in continuous unmaintained complete remission with normal blood cell counts. This reports suggests that complete and sustained engraftment can be achieved with peripheral stem cells recruited after "soft" chemotherapy.

Adult

Ultracytochemical localization of guanylate cyclase in early human placenta.

Previous biochemical and cytochemical studies have indicated that in human term placenta the enzyme guanylate cyclase (GC) is associated mostly with the cytosolic fraction of homogenates and localized on the syncytiotrophoblast microvillous border. In the present study we have shown cytochemically the GC particulate form in early human placenta using guanylyl-imidodiphosphate [Gpp(NH)p] as substrate and NaN3 as activator. In samples of placental villi taken from the 6th to 12th week of pregnancy, the GC reaction product was always found on the apposing Langhans cytotrophoblast and syncytiotrophoblast plasma membranes. Furthermore, GC was present on cells in mitosis of the Langhans cytotrophoblast. From the 11th week GC was also visible on basal plasma membranes of Langhans cytotrophoblast and on endothelial cells of fetal capillaries. In samples of human term placenta GC was detectable on the syncytiotrophoblast microvillous border. This suggests a shift of enzyme localization during pregnancy.

Female

The morphology of the normal aortic valve as compared with the aortic valve having two leaflets.

We studied 30 normal aortic valves and 64 aortic valves with only two leaflets to examine their morphologic components. The components of the aortic valve are the leaflets, the sinuses, and the interleaflet triangles. The first part of our study shows the relationship of these component parts of the normal aortic valve to the other cardiac structures. The second part shows a wide variation in the architecture of valves having two leaflets. Having produced criteria for the number of sinuses and the number of leaflets, we discovered that previous criteria used in the definition of valves with two leaflets are inadequate when the whole valvular complex is considered. Only seven valves in the study have two leaflets supported by two sinuses. The evidence points to the other valves having started with three leaflets but becoming bicuspid during either intrauterine or postnatal life.

Adult