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Biomedical subjects

A Ferrari

Publications and source records attributed to A Ferrari.

At least 37 records · Page 2Linked to original sources
PubMed2000

Polycystic ovary syndrome: evidence for reduced 3 beta-hydroxysteroid dehydrogenase gene expression in human luteinizing granulosa cells.

In a preview study we found that luteinizing granulosa cells from follicles of patients with polycystic ovary syndrome (PCOS) have a reduced capacity to synthesize progesterone in vitro. Because the 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4-isomerase (3 beta-HSD) is an important enzyme for the biosynthesis of progesterone, the reduced capacity of PCO luteinizing granulosa cells to synthesize progesterone in vitro may be due to reduced 3 beta-HSD gene expression. A reverse transcriptase polymerase chain reaction for 3 beta-HSD was performed and the relative intensity of signals for 3 beta-HSD was evaluated using computer-assisted densitometry. Cells from polycystic ovaries expressed less 3 beta-HSD in follicles < or 10 mm (p < 0.05) and in follicles > or 16 mm (p < 0.05) than cells from normal ovaries. Furthermore, after human chorionic gonadotropin stimulus (50 ng/ml), cells from polycystic ovaries expressed less 3 beta-HSD in follicles > or = 16 mm (p < 0.01) than cells from normal ovaries. The data show that there is a specific change in the gene expression of 3 beta-HSD in PCO granulosa cells resulting in a suppressed capacity to secrete progesterone.

3-Hydroxysteroid Dehydrogenases↗
PubMed2000

Treatment versus no treatment of transient hyperprolactinemia in patients undergoing intracytoplasmic sperm injection programs.

The aim of our study was to investigate the effect of increased plasma prolactin levels on oocyte and fertilization rate in patients undergoing in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI) treatment. We identified 135 patients with transient or borderline hyperprolactinemia, measured in the mid and late follicular phase and in the mid-luteal phase of the cycle before ovarian stimulation. The patients were assigned to either the no treatment group (76 patients) or the treatment group (59 patients). The treated group underwent treatment with cabergoline or bromocriptine before ovarian stimulation, until there was a decrease of plasma prolactin levels, and the therapy was continued also during the ICSI programme. Both groups received a gonadotropin-releasing hormone (GnRH) agonist and were subsequently stimulated with follicle-stimulating hormone (FSH) up to the day of human chorionic gonadotropin (hCG) administration. The untreated group needed a significantly lower number of FSH ampoules than the treated group to reach the day of hCG administration (38.1 +/- 18.2 versus 43.9 +/- 28.5; p < 0.05). No correlation was found between the two groups on the peak estradiol level achieved, the progesterone level at hCG administration and the numbers of oocytes retrieved. The number of oocytes with superior morphology (87.9% versus 80.4%; p < 0.05), the fertilization rate (70.8 +/- 28.0 versus 60.8 +/- 28.5; p < 0.03), and the mean number of embryos transferred (3.6 +/- 1.6 versus 3.2 +/- 1.5; p < 0.05) were significantly higher in the patients whose hyperprolactinemia was left untreated. In conclusion, we found that transient hyperprolactinemia is positively associated with ICSI outcome, in particularly with oocyte quality and fertilization rate.

Adult↗
PubMed2000

[The usefulness of the association of clinical probability, rapid plasma measurement of D-dimer, compression echography of the lower limbs and echocardiography in the diagnosis of acute pulmonary embolism].

BACKGROUND: The aim of this study was to investigate the diagnostic utility of clinical probability, rapid plasma D-dimer assay, compression ultrasonography (CUS) and transthoracic echocardiography (TTE) in patients with suspected pulmonary embolism. METHODS: One hundred forty consecutive outpatients with suspected pulmonary embolism were enrolled in a prospective trial. We evaluated sensitivity, specificity, positive and negative predictive value of a combination of clinical probability, D-dimer, CUS and TTE using perfusion lung scan and pulmonary angiography as a combined gold standard for determining the presence or absence of pulmonary embolism. Clinical probability was assessed in accordance with the PIOPED criteria. The D-dimer (Nycocard) level was considered as abnormal > 0.3 mg/l, the CUS if incompressibility of the leg veins was showed, and the TTE if right ventricular dilation was present, in the absence of chronic pulmonary disease. The combination of these tests was considered consistent with the presence of pulmonary embolism if D-dimer plus CUS and/or TTE showed abnormal results. A pulmonary embolism was excluded if D-dimer and CUS showed normal findings or a low clinical probability was associated with normal findings of CUS and TTE. RESULTS: One hundred eleven patients were evaluated. Pulmonary embolism was present in 45/111 (40%) patients. The combination of tests showed positive findings in 39/39 patients with pulmonary embolism, negative findings in 47/50 without pulmonary embolism and non-diagnostic results in 22/111 (20%) patients (95% confidence interval--CI 12-28%). There were three false positive and no false negative results. Sensitivity and specificity were 100 and 94% respectively (95% CI 92-100% and 87-100%); positive and negative predictive values were 93 and 100% (95% CI 85-100% and 93-100%). None of these tests, separately, showed enough sensitivity and specificity. CONCLUSIONS: The combination of clinical probability, D-dimer, CUS and TTE was highly accurate to confirm or rule out pulmonary embolism.

Acute Disease↗
PubMed2000

[A cardiac embolic stroke due to malposition of the pacemaker lead in the left ventricle. A case report].

Misplacement of a permanent pacemaker lead has been described in several locations but rarely in the left ventricle. Less commonly, as described in our report, malposition may occur when the lead perforates the interatrial septum and extends across the left atrium and through the mitral valve into the left ventricle. The actual incidence of this pacemaker complication is unknown. Consequences may include perforation and systemic or cerebral thromboembolic events. We report the case of a patient with unintentionally misplaced left heart pacemaker lead admitted for neurological symptoms consistent with embolic stroke. The patient was on aspirin when symptoms occurred. The lead misplacement was not recognized at the time of implantation. Pacing threshold was normal. A 12-lead electrocardiogram showed right bundle branch block configuration paced complexes. By two-dimensional and transesophageal echocardiography, the pacemaker lead was carefully evaluated. The pacemaker lead crossed the interatrial septum, the left atrium, the mitral valve to be implanted in the left ventricular endocardium. To avoid the risk of future embolization, it was felt that the lead should be removed and right ventricular pacing established, once anticoagulation treatment was initiated. Successful percutaneous lead replacement was accomplished without sequelae. Measures to avoid lead misplacement are suggested.

Electrodes↗
PubMed2000

Quality assurance system using ISO 9000 series standards to improve the effectiveness and efficacy of the Headache Centre.

The ISO 9000 series has been adopted as a reference standard and operating system for a Quality Assurance project involving all the units of the Polyclinic of Modena, within which the Headache Centre operates, to guarantee a clearly-defined standard of service to the client and the promotion of continuous quality improvement. The implementation of the quality system, which necessitated analysis and description of the process of headache diagnosis and treatment currently being applied, highlighted those aspects that did not conform with the quality objective, primarily, the long waiting list for admission. Since ready accessibility is a basic requisite for the quality of health care services, a new organisational set-up was introduced, and is still in place, with the aim of enabling patients who are really in need to be admitted to the Headache Centre without undue delay.

Headache↗
PubMed1999

Synovial sarcoma: report of a series of 25 consecutive children from a single institution.

BACKGROUND: The role of postoperative radiotherapy and adjuvant chemotherapy in the treatment of synovial sarcoma remains to be determined. PROCEDURE: Twenty-five children were treated during a 23-year period with a multimodality approach. All of them had resection of the primary tumor (three amputations), followed by surgical retreatment in eight. Postoperative radiotherapy was delivered to 16 patients and adjuvant chemotherapy was given to 22. RESULTS: At the time of the report, 19 patients were alive and without evidence of disease. Six developed distant metastases (one associated with local recurrence); five of them died of their disease and one was alive in complete remission at 4 years from relapse. With a median follow-up of 9 years (range 2-23), the survival and the event-free survival at 5 years were 80% (SE 8.2) and 74% (SE 9.2), respectively. All relapsing patients had been classified as T2B. CONCLUSIONS: Multimodality treatment yielded satisfying survival results using limb-preserving surgery in most cases. Tumor size > 5 cm and invasiveness, which defined stage T2B, were the most important predictors of poor outcome. Evaluation of the role of adjuvant chemotherapy and radiotherapy awaits prospective studies, even if T2B patients, as well as children having nonradical surgery, seem worth managing by adjuvant treatments.

Adolescent↗
PubMed1999

An analysis of urban collisions using an artificial intelligence model.

Traditional studies on road accidents estimate the effect of variables (such as vehicular flows, road geometry, vehicular characteristics), and the calculation of the number of accidents. A descriptive statistical analysis of the accidents (those used in the model) over the period 1992-1995 is proposed. The paper describes an alternative method based on the use of artificial neural networks (ANN) in order to work out a model that relates to the analysis of vehicular accidents in Milan. The degree of danger of urban intersections using different scenarios is quantified by the ANN model. Methodology is the first result, which allows us to tackle the modelling of urban vehicular accidents by the innovative use of ANN. Other results deal with model outputs: intersection complexity may determine a higher accident index depending on the regulation of intersection. The highest index for running over of pedestrian occurs at non-signalised intersections at night-time.

Accidents, Traffic↗
PubMed1999

The use of Matrigel at low concentration enhances in vitro blastocyst formation and hatching in a mouse embryo model.

OBJECTIVE: To determine the effect of Matrigel at a low concentration on the growth of mouse embryos in culture. DESIGN: Randomized case-control study of mouse embryos. SETTING: An academic research environment. ANIMALS: Mouse embryos. INTERVENTION(S): Embryos were cultured in Quinn's or Celbio's human tubal fluid (HTF) enriched with 1.5% bovine serum albumin and 0.8% liquid Matrigel. Each HTF was compared with the same medium devoid of Matrigel. Afterward, Quinn's and Celbio's HTF, both containing Matrigel, were compared directly. Embryos were cultured in four-well dishes, and their morphology and viability were assessed at 96 hours. MAIN OUTCOME MEASURE(S): Level of interleukin-1alpha in media collected at the end of culture. RESULT(S): In both types of HTF, the presence of Matrigel allowed a larger number of embryos to reach the blastocyst stage and to hatch; blastocyst morphology also was improved. These positive effects were enhanced in Quinn's HTF: embryos cultured in its Matrigel-enriched version secreted a higher level of interleukin-1alpha than those in Celbio's HTF plus Matrigel and also showed a better morphology. CONCLUSION(S): In the mouse embryo model, Matrigel improves culture conditions in terms of both embryo viability and morphology, and these effects are enhanced in Quinn's HTF.

Animals↗
PubMed1999

Effect of consumption of a ready-to-eat breakfast cereal containing inulin on the intestinal milieu and blood lipids in healthy male volunteers.

OBJECTIVE: To investigate the effect of a breakfast cereal containing inulin on blood lipids and colonic ecosystem in normolipidemic young men. SETTING: Department of Food Science and Microbiology,University of Milan, Italy. SUBJECTS: Twelve healthy male volunteers, age 23.3 +/- 0.5 y, body mass index (BMI) 25.7 +/- 1.2 kg/m2 (mean +/- s.e.m.). INTERVENTIONS: Subjects consumed daily, for three periods of four weeks, 50 g of a rice-based ready-to-eat cereal (placebo) and the same cereal containing 18% inulin (test) in substitution of their habitual breakfast, then returned to the habitual diet (wash-out). They followed no other dietary restrictions. RESULTS: No changes in body weight, dietary habits, faecal and bile acid output, faecal short-chain fatty acid (SCFA) and faecal pH, were observed at the end of each period, whereas plasma total cholesterol and triacylglycerols significantly decreased at the end of test period by 7.9 +/- 5.4 (P < 0.05) and 21.2 +/- 7.8% (P < 0.005) respectively. Meal glucose tolerance test (MTT) resulted in the same incremental area under the curve for both cereals (IAUC test 124 +/- 35; placebo 118 +/- 33 mmol x min/l, ns). Inulin markedly enhanced breath H2 excretion (IAUC test 280 +/- 40; placebo 78 +/- 26 ppm x h, P < 0.005), as well as faecal concentration of L-lactate. Total facultative anaerobes significantly decreased after test, and bifidobacteria increased after correction for total anaerobes (P < 0.05). Changes in blood lipids were negatively correlated with bifidobacteria counts and positively with secondary bile acid excretion (P < 0.05). CONCLUSIONS: Inulin seems to have a lipid lowering potential in normolipidemic men possibly mediated by mechanisms related to colonic fermentation.

Adult↗
PubMed1999

Elevated serum progesterone on the day of HCG administration in IVF is associated with a higher pregnancy rate in polycystic ovary syndrome.

Our study compared 84 patients with polycystic ovary syndrome (PCOS) with 84 control patients who had normal ovaries and who were matched for the main determinants of success in in-vitro fertilization (IVF) and embryo transfer. Serum concentrations of oestradiol and progesterone on the day of human chorionic gonadotrophin (HCG) injection were significantly higher in PCOS than in normal patients (oestradiol 2016 +/- 1.8 pg/ml versus 1456 +/- 40.9 pg/ml, P < 0.01; progesterone 1.6 +/- 0.1 ng/ml versus 1.2 +/- 0.1 ng/ml, P = 0.03). Furthermore despite oocytes from PCOS patients having a reduced fertilization rate compared with normal patients (61.8 +/- 4.1% versus 73.5 +/- 4.3%, P = 0.03), the differences in pregnancy rate (22.6 versus 19%) and miscarriage (31.5 versus 18.7%) were not statistically significant. In PCOS patients, a critical breakpoint was identified at serum progesterone concentrations of 1.2 ng/ml on the day of HCG injection. The PCOS patients with progesterone > or = 1.2 ng/ml showed a higher pregnancy and miscarriage rate than PCOS patients with progesterone < 1.2 ng/ml (26.6 versus 17.9%, P < 0.01; and 41.7% versus 14.3%, P < 0.01 respectively). These findings suggest that premature progesterone production does not have an adverse effect on pregnancy rate in PCOS, but on the contrary, may be a predictor for success in IVF/embryo transfer.

Adult↗
PubMed1999

Human albumin enhances expression of vascular endothelial growth factor in cultured human luteinizing granulosa cells: importance in ovarian hyperstimulation syndrome.

Ovarian hyperstimulation syndrome (OHSS) is a severe complication of ovarian stimulation for assisted reproductive techniques. Clinical manifestations are massive extravascular fluid accumulation and haemoconcentration. Vascular endothelial growth factor (VEGF) has been demonstrated to mediate the development of OHSS. Intravenous albumin at the time of oocyte aspiration has been suggested as an effective prophylactic treatment against the occurrence of severe OHSS. Here it is reported that in cultured human luteinizing granulosa cells, VEGF mRNA expression was enhanced by human albumin and maximum expression was observed in cultured granulosa cells obtained from patients with serum oestradiol concentrations >2000 pg/ml on the day of human chorionic gonadotrophin injection (P < 0. 05).

Albumins↗
PubMed1999

Evidence that a functional fertilin-like ADAM plays a role in human sperm-oolemmal interactions.

Fertilin is a protein initially identified in guinea pig spermatozoa; it is the prototype of a larger family of conserved, proteins designated as a disintegrin and a metalloproteinase (ADAM). These heterodimers which consist of alpha and beta subunits, containing metalloproteinase-like and disintegrin-like domains, appear to play a role in mammalian fertilization. Peptides derived from the disintegrin domains of two ADAMs, fertilin and cyritestin, interfere with gamete adhesion and sperm-egg membrane fusion in non-human species. It has been suggested that fertilin-beta binds to an oolemmal integrin, and it is proposed that the tripeptide FEE (Phe-Glu-Glu) is the integrin recognition sequence in human fertilin-beta. We evaluated whether fertilin beta plays a role in human fertilization by studying the effects of a linear octapeptide containing the FEE sequence, SFEECDLP, and a scrambled octapeptide with the same amino acids, SFPCEDEL, on the incorporation of human spermatozoa by human zona-free eggs. The effects of G4120, a potent RGD-containing (Arg-Gly-Asp) thioether-bridged cyclic peptide which blocks both fibronectin and vitronectin receptors, and the relationship between FEE- and RGD-receptor interactions on sperm-egg interactions were also studied. The FEE-containing peptide, but not the scrampled peptide, inhibited sperm adhesion to oocytes and their penetration, over the range 1-5 microM. The inhibition induced by SFEECDLP was reversible and occurred only in the presence of peptide itself. The G4120 peptide exhibited 10-fold less inhibitory effects on sperm adhesion and penetration than did SFEECDLP. When combined, SFEECDLP and G4120 exhibited strong inhibition of both adhesion and penetration at concentrations that individually had been ineffective, suggesting co-operation between the two receptor-ligand interactions during fertilization. We propose that a fertilin-like molecule is functionally active on human spermatozoa and that its interaction with an oolemmal integrin receptor plays a role in fertilization in humans.

ADAM Proteins↗
PubMed1999

Renal distal tubular handling of sodium in central fluid volume homoeostasis in preascitic cirrhosis.

BACKGROUND/AIMS: Patients with preascitic liver cirrhosis have an increased central plasma volume, and, for any given plasma aldosterone concentration, they excrete less sodium than healthy controls. A detailed study of the distribution of sodium reabsorption along the segments of the renal tubule, especially the distal one, is still lacking in preascitic cirrhosis. METHODS: Twelve patients with Child-Pugh class A cirrhosis and nine control subjects (both groups on a normosodic diet) were submitted to the following investigations: (a) plasma levels of active renin and aldosterone; (b) four hour renal clearance of lithium (an index of fluid delivery to the loop of Henle), creatinine, sodium, and potassium; (c) dopaminergic activity, as measured by incremental aldosterone response to intravenous metoclopramide. RESULTS: Metoclopramide induced higher incremental aldosterone responses, indicating increased dopaminergic activity in patients than controls, which is evidence of an increased central plasma volume (+30 min: 160.2 (68.8) v 83.6 (35.2) pg/ml, p<0.01; +60 min: 140.5 (80.3) v 36. 8 (36.1) pg/ml, p<0.01). Patients had increased distal fractional sodium reabsorption compared with controls (26.9 (6.7)% v 12.5 (3. 4)% of the filtered sodium load, p<0.05). In the patient group there was an inverse correlation between: (a) absolute distal sodium reabsorption and active renin (r -0.59, p<0.05); (b) fractional distal sodium reabsorption and sodium excretion (r -0.66, p<0.03). CONCLUSIONS: These data suggest that in preascitic cirrhosis the distal fractional tubular reabsorption of sodium is increased and critical in regulating both central fluid volume and sodium excretion.

Adult↗
PubMed1999

Serum levels of alpha-tocopherol in hypertensive pregnancies.

OBJECTIVE: Assess alpha-tocopherol serum levels in a population of pregnant women affected by different hypertensive disorders. METHODS: Alpha-tocopherol serum levels were determined by high-pressure liquid chromatography in 177 third-trimester pregnant women: 63 affected by gestational hypertension, 69 by preeclampsia, 26 by chronic hypertension, and 19 normotensive controls. In 39 out of the 158 hypertensive patients, pregnancy was complicated by intrauterine growth retardation (IUGR). RESULTS: Alpha-tocopherol serum levels did not show any significant difference among gestational hypertensive, preeclamptic, chronic hypertensive patients, and controls. A significant reduction of alpha-tocopherol levels was observed when we compared patients with IUGR and patients with a normally grown fetus. Such significant reduction was maintained when we analyzed the different classes of hypertension. CONCLUSIONS: The reduction of antioxidant nutrients and, in particular, of alpha-tocopherol is not a feature of preeclampsia and seems better correlated with the presence of placental insufficiency, rather than maternal disease.

Female↗
PubMed1999

Cytogenetic and molecular characterization of T-cell acute lymphoblastic leukemia as a second tumor after anaplastic large-cell lymphoma in a boy.

We report a case of acute T-cell lymphoblastic leukemia which developed in a boy 8.5 years after successful treatment for anaplastic large-cell lymphoma. Cytogenetic and molecular characterizations of the second tumor were performed. The cytogenetic investigation revealed a complex pattern of karyotypic alterations, including double minutes, ring chromosomes, and a duplication of the p21-32 region of chromosome 1. The microsatellite DNA analysis excluded rearrangement or deletion of the TAL1 gene in the tumor cells; rearrangements of the MLL gene were excluded by Southern blot analysis. To the best of our knowledge, this is the first report of T-cell lymphoblastic leukemia arising after treatment of CD 30+ anaplastic large-cell lymphoma. The different T-cell receptor rearrangement evidenced in the two tumors indicates that this second malignancy most likely emerged de novo, but was plausibly related to the previous radiation and chemotherapy.

Child↗
PubMed1999

Presence of urokinase-type plasminogen activator receptor in urine of cancer patients and its possible clinical relevance.

High levels of urokinase-type plasminogen activator receptor (uPAR) are expressed in various types of cancer. Recent studies showed that cancer patients may have increased levels of soluble (s)uPAR in their serum. In the present study, we show that urine samples from healthy volunteers contain measurable amounts of suPAR. suPAR/creatinine levels from healthy controls showed only little variation over the day and were even stable during a month of continued monitoring. Importantly, urinary suPAR/creatinine levels were highly correlated with serum suPAR concentrations. Urinary suPAR levels were elevated in patients with different types of cancer. Interestingly, part of the urinary suPAR seemed to be present in a cleaved form, as has been found in tumor tissue extracts. Together with the recently established, cell migration-promoting effect of certain cleaved fragments of suPAR, the present data suggest that the measurement of urinary suPAR and/or its cleaved forms might have clinical implications.

Adult↗
PubMed1999

Sacro-coccigeal teratoma: antenatal diagnosis and management.

We report a case of sacro-coccygeal teratoma (ScT) in a 29 years old primigravida at 19 weeks of gestation. Ultrasonographic evaluation in antenatal management of these abnormalities is discussed. The main sonographic criteria appear to be two: dimension and rapid growth of the tumour. Cariotype must be performed to exclude aneuploidy, frequently associated.

Abortion, Induced↗