Search PubMed⌕ Search

Biomedical subjects

A Giangrande

Publications and source records attributed to A Giangrande.

At least 55 records · Page 3Linked to original sources
PubMed1992

Bone mineral and aluminum concentrations in patients undergoing CAPD.

CAPD results in continuous peritoneal transfer of hormones and minerals involved in the pathogenesis of renal osteodystrophy (RO). Moreover, although CAPD patients seem to have better control of serum phosphate concentration than hemodialysis patients, the need for aluminum-containing phosphate binders (ACPB) may still be present. In a prospective study meant to investigate the evolution of RO, we obtained 79 bone biopsies in 29 uremic patients (20 male, 9 female; age 25-59, mean 46). Of these, 22 were obtained at the beginning of treatment, 24 after 24 months, 23 after 36 months and 10 after 60 months. All patients were treated with CAPD (Viaflex, Baxter 2-2.5 L x 4-5 bags/day; Ca(++) + 3.5, Mg(++) 1.5 mEq/L) as the first modality of therapy and received oral calcitriol, aluminum hydroxyde and/or calcium carbonate and magnesium hydroxyde in order to maintain serum calcium (Ca) and phosphorus within the normal range. Qualitative bone histology, bone Ca and magnesium (Mg) (Flame atomic absorption spectroscopy) and aluminum (Al) concentration (Graphite furnace atomic absorption spectrometry) were determined. CAPD achieves a good control of RO as indicated by the tendency toward a decreased incidence of mixed osteodystrophy and predominant hyperparathyroid bone disease and improvement of osteoid lesions. A defective Ca content of bone is persistent in the observed period and positively correlated to bone Mg concentration. An increased level of Al was shown in the serum and bone. The highest bone Al content was found among patients with predominant osteoid bone disease. Also in CAPD, patients consuming ACPB are at risk of bone Al accumulation despite the low Al levels in the dialysate.

Adult↗
PubMed1992

Factors affecting chronic renal failure progression: results from a multicentre trial. The Northern Italian Cooperative Study Group.

In order to evaluate the prognostic factors concerning the rate of progressive deterioration of renal function, we made an inductive analysis of the behaviour of 456 patients in a multicentre, formal prospective trial aimed at clarifying the possible role of protein restriction in retarding the progression of chronic renal insufficiency (CRI). The main clinical and laboratory findings in patients whose plasma creatinine (PCr) levels doubled in comparison with baseline randomization values or who needed dialysis within 24 months after onset of the study were compared with those of the other patients. In addition, independently of the assigned diet, we tested the main variables that might affect CRI progression (sex, systolic and diastolic blood pressure, change in body weight, hematocrit, calcium-phosphate product, proteinuria, protein catabolic rate, total cholesterol and triglycerides). We used multiple regression analyses and also plotted the mean values of these parameters in each patient against an estimate of the deterioration of chronic renal failure based on the difference between the final and the initial reciprocal of the PCr and the creatinine clearance (CCr) levels. A descriptive analysis of the behaviour of PCr in the three CRI groups and in the four underlying diseases groups was made. PCr levels at entry, underlying disease and proteinuria were prognostic factors for CRI progression. The increase in PCr was 0.0102 mg/dl/month in patients with nephrosclerosis, 0.0203 mg/dl/month in interstitial nephropathy, 0.0360 mg/dl/month in glomerulonephritis and 0.0704 mg/dl/month in polycystic kidney disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Prospective, randomised, multicentre trial of effect of protein restriction on progression of chronic renal insufficiency. Northern Italian Cooperative Study Group.

A multicentre, prospective trial was organised to clarify the role of protein restriction in the progression of chronic renal insufficiency (CRI). 456 adult patients were assigned either a low-protein diet (0.6 g/kg body weight daily; n = 226) or a "normal" controlled-protein diet (1.0 g/kg daily; n = 230) and were stratified into three groups (A-C) with increasing baseline plasma creatinine concentrations. Each patient was followed up for 2 years or until an endpoint (a doubling of the baseline plasma creatinine or a need for dialysis) was reached. The difference between the diet groups in cumulative renal survival defined by these endpoints (27 low-protein, 42 controlled-protein) was of borderline significance (p less than 0.06). The difference in renal survival between the low-protein and controlled-protein diet groups was of borderline significance in group A (0 vs 4 endpoints), significant in group B (10 vs 21 endpoints; p less than 0.025), and not significant in group C. There were no differences among the diet groups or subgroups in mean plasma creatinine concentrations, creatinine clearance, the slope of the plasma creatinine reciprocal, or mean blood pressures. Compliance was good in the controlled-protein group but poor for the low-protein diet: the difference in protein intake between the groups was substantially less than that required by the protocol. However, there was no correlation between the progression of renal failure and protein catabolic rate. These findings offer little, if any, support to the hypothesis that protein restriction retards CRI progression: careful medical care and a "normal" controlled protein intake also allow very slow progression of CRI.

Actuarial Analysis↗
PubMed1991

Sgs-3 chromatin structure and trans-activators: developmental and ecdysone induction of a glue enhancer-binding factor, GEBF-I, in Drosophila larvae.

The transcription of the Drosophila melanogaster 68C salivary gland glue gene Sgs-3 involves the interaction of a distal and a proximal regulatory region. These are marked in vivo by a specific chromatin structure which is established sequentially during development, starting early in embryogenesis. The distal region is characterized by a stage- and tissue-specific DNase I hypersensitive site. A stage- and tissue-specific factor, GEBF-I, binds in this region and is missing in 2B5 mutant larvae which lack Sgs-3 transcripts. This binding involves the simultaneous interaction with two distinct DNA sequences which induces conformational changes in the protein. Salivary glands acquire competence to respond to ecdysone in the mid-third larval instar, whereafter the hormone rapidly induces both the GEBF-I protein and Sgs-3 transcription.

Age Factors↗
PubMed1991

A multicenter, selection-adjusted comparison of patient and technique survivals on CAPD and hemodialysis.

Four hundred and eighty CAPD and 373 HD patients started regular dialysis treatment between 1981 and 1987 in 6 dialysis centers. The CAPD patients were 6 years older, on average, than the HD patients and had more complicating conditions (43.3% with 3 or more coexisting risk factors versus 28.9% with coexisting complications). The 7-year patient survival rate was not significantly different. Cox's proportional hazards regression showed that age, cardiovascular disease, cerebrovascular disease, peripheral vascular disease, diabetes, malignancy and multisystem disease had significant adverse effects on patient survival. After correcting for the influence of these factors, no significant differences in patient survival were seen. However, after 53.5 years of age, the increase in the risk of death was significantly higher in HD than in CAPD patients. Technique survival was significantly different in the 6 centers and was better for HD than for CAPD. There was no statistically significant difference between CAPD and HD technique survival when peritonitis was eliminated as a cause of failure. Based on this 7 year analysis, CAPD would appear to be an excellent alternative to HD.

Female↗
PubMed1990

Genes involved in the development of the peripheral nervous system of Drosophila.

The development of the peripheral nervous system (PNS) requires the activity of a number of genes. The neurogenic and the proneural genes are necessary in the earliest phase; their mutations lead to hyperplasia and partial or total elimination of the PNS respectively. Some of these mutations also affect other developmental processes. Other mutations affect later events: cut transforms one type of sensory organ into another; numb alters the fate of the components of a single sensory organ. We will describe the effects of the best studied mutations on PNS development and discuss the possible role of the wild type genes.

Animals↗
PubMed1989

Regulatory elements and interactions in the Drosophila 68C glue gene cluster.

We reviewed studies on the developmental regulation of the 68C glue gene cluster of Drosophila melanogaster. Extensive transformation analyses of Sgs-3 have shown that four regions necessary for normal expression can be distinguished. The first(+10 to -50) contains the transcription start site and TATA motif. This region can be replaced functionally by corresponding sequences from the hsp70 gene, but it is sensitive to point mutations in the TATA sequence. The second region (-50 to -98) contains more than one upstream sequence that, in combination with the other elements, leads to stage and tissue-specific expression. The third region (centered at -600) contains an element that enhances transcript levels some 20-fold. The final region (between -1.65 and -2.35 kb) contains elements having modest (twofold to threefold) effects on expression, one of which is contained in the coding sequences of Sgs-7, a second member of the cluster.

Animals↗
PubMed1989

Induction and repression of the Drosophila Sgs-3 glue gene are mediated by distinct sequences in the proximal promoter.

The normal developmental expression of the Drosophila salivary gland secretion protein gene Sgs-3 requires the interaction of a distal and proximal regulatory element. A deletion/replacement analysis of the proximal promoter in stably transformed lines shows that induction of an Sgs-3/Adh fusion gene is normal if sequences from +10 to -50 are replaced by those of the hsp70 gene. Sequences between -98 and -50 are necessary for this expression but there is internal redundancy within this region as two distinct upstream sequences of 18 and 22 bp respectively are sufficient for stage- and tissue-specific expression, albeit at reduced levels. A point mutation at -53 eliminates the ecdysone-mediated repression of the Sgs-3 promoter at pupariation. We report mosaicisms of expression within the salivary gland for a number of stably transformed lines.

Animals↗
PubMed1989

Drosophila Sgs3 TATA: effects of point mutations on expression in vivo and protein binding in vitro with staged nuclear extracts.

The Drosophila salivary gland secretion protein gene, Sgs3, has a consensus TATA sequence and gives rise to abundant stage and tissue-specific transcripts. Two TATA point mutations (TAAA and TAGA) reduce transcript levels approximately 50-fold when assayed in transgenic flies. This effect is reflected in vitro, in DNase I footprint and gel retardation assays where we observed TATA-probe-specific complexes that are not seen with TAAA, TAGA or non-specific probes. The binding patterns observed when using nuclear extracts from 0-2- and 0-20-h embryos (Sgs3 inactive) differ from those seen with extracts from third instar salivary glands (Sgs3 active). There are also differences in in vitro binding when using an hsp70 TATA fragment, previously shown to substitute in vivo for the Sgs3 TATA sequence, as probe. Together these observations suggest the possibility that more than one TATA box factor may be present in these extracts. We conclude that a wild-type TATA motif is crucial for the binding of a TATA box factor and all subsequent interactions with other factors bound to the proximal and distal regulatory sequences that are necessary for the normal expression of Sgs3.

Animals↗
PubMed1989

Hyperparathyroidism does not influence the abnormal primary haemostasis in patients with chronic renal failure.

Patients with chronic renal failure suffer from secondary hyperparathyroidism and have greatly increased blood concentrations of intact parathyroid hormone (PTH) and PTH fragments. Thus PTH has been regarded in the last few years as a uraemic toxin possibly responsible for many clinical manifestations of the uraemic syndrome including a tendency to prolonged bleeding. Since PTH inhibits platelet aggregation 'in vitro', the possibility that hyperparathyroidism of uraemia plays a role in the pathogenesis of uraemic bleeding has been considered. Clinical data to support this possibility is not available so far. In this study we have correlated the skin bleeding time, the best clinical marker of uraemic bleeding tendency, with serum concentrations of intact PTH or PTH fragments in 40 patients with chronic renal failure undergoing chronic haemodialysis. Since the skin bleeding time is known to be influenced by packed cell volume (PCV), we also considered two distinct groups of uraemic patients on the basis of their PCV values. The results indicated that bleeding time does not correlate with serum concentrations of intact PTH or PTH fragments. Also, no correlation has been found between PTH values and blood concentrations of calcium, phosphorus, magnesium and hydroxyproline. It is concluded that elevated PTH values in renal-failure patients do not contribute to uraemic platelet defect, as reflected by the skin bleeding time.

Adult↗
PubMed1988

Analysis of a DNase I-hypersensitive site in transgenic Drosophila reveals a key regulatory element of Sgs3.

We have undertaken chromatin studies on transformed Drosophila strains carrying DNA sequences modified in the region of the DNase I (EC 3.1.4.5)-hypersensitive sites -750 and -600 base pairs upstream from the Sgs3 start site. Although both sites are developmentally specific, modifications in the -750 site have little or no effect on Sgs3-encoded transcript levels, whereas either deletion or replacement of sequences at the -600 site causes an important reduction in transcript levels. The element associated with the -600 site enhances Sgs3 transcription when displaced with respect to the start site. This combined approach has defined sequence elements necessary both for normal transcript levels as well as the chromatin structure characteristic of Sgs3 activity in vivo.

Animals↗
PubMed1988

Particle migration from haemodialysis circuit: electron microscopy and microprobe analysis.

It has been recognized that storage inflammation in organs of uraemic patients is due to silicone particle migration from tubing segments of the haemodialysis circuit to blood. Nevertheless, iatrogenic storage of foreign material containing Si has been also observed in long-term dialysis patients which, in our Unit, used only PVC or PU-PVC tubings. The origin and the nature of the particulate has been investigated in vivo and in vitro on bioptical samples as well as on cuprophan dialyser and PVC tubing eluates. This study carried out by means of TEM, SEM and microprobe EDS revealed the presence of variously shaped material and particles containing Si in bioptical samples and in eluates. Si containing contaminants were not demonstrated in eluates filtered in absence of the dialyser. This result suggests that leachable products can result from the dialyser and that such release can be an additional risk for uraemic patients.

Electron Probe Microanalysis↗
PubMed1987

The Drosophila sgs3 gene: an in-vivo test of intron function.

An intronless Drosophila melanogaster sgs3 "glue" gene from the Formosa strain was constructed and inserted by P element transformation into a strain carrying an sgs3 variant that produces a larger mRNA and protein. By comparing both the RNAs and proteins produced by the two alleles we show that the intron has no detectable effect on sgs3 expression.

Animals↗
PubMed1987

Sps-3 transcript levels are determined by multiple remote sequence elements.

The region from 1.4 to 2.7 kb upstream of Drosophila melanogaster gene Sgs-3 is responsible for a 10-fold increase in Sgs-3 transcript levels in the third instar larval salivary gland. This region includes the related Sgs-7 gene from the 68C glue gene cluster as well as 400 bp of its 5' sequences. We show that two elements are involved, each contributing a modest 3-fold effect. One of these includes Sgs-7 transcribed sequences some 2.3 kb upstream of Sgs-3, although Sgs-7 transcription is not involved. Although important for the overall levels of Sgs-3 expression, they are clearly not strong, viral-like enhancer elements. We propose that many position effects observed in P element transformation studies are the consequence of insertion in the vicinity of similar elements dispersed throughout the genome and having modest effects on transcript levels.

Animals↗
PubMed1985

Percutaneous ethanol injection of parathyroid tumors under US guidance: treatment for secondary hyperparathyroidism.

In 12 patients with secondary hyperparathyroidism, 13 parathyroid tumors detected with the use of sonography and confirmed by fine-needle aspiration biopsy were treated by percutaneous injection of absolute ethanol under ultrasonographic guidance. Indications for this procedure were recurrence of parathyroid tumors after previous subtotal surgery, high surgical risk, or refusal of surgery. Significant volume reductions were recorded for the larger glands; in the smaller ones, structural changes were observed as well. Clinical and biochemical therapeutic effects were obtained in most cases of single hyperplastic glands treated. Percutaneous alcoholic ablation of enlarged parathyroid glands can be used in cases of secondary hyperparathyroidism when surgery is contraindicated or problematic; it can also improve responsiveness to medical therapy, delaying the need for surgery.

Adult↗