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Biomedical subjects

A Izzo

Publications and source records attributed to A Izzo.

At least 37 records · Page 2Linked to original sources

Insulin-like growth factor binding protein-3 reduction in follicular fluid in spontaneous and stimulated cycles.

OBJECTIVE: To investigate serum and follicular fluid insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) behavior in spontaneous and in superstimulated cycles. DESIGN: Estradiol, GH, IGF-I, and IGFBP-3 were evaluated in serum and in follicular fluid during spontaneous and stimulated cycles. SETTING: Department of Obstetrics and Gynecology, University of Naples, Naples, Italy. PATIENT(S): Ninety-two patients with regular menstrual cycles and tubal and/or male factor infertility undergoing treatment with an IVF program. INTERVENTION(S): The superstimulated IVF program uses leuprolide acetate suppression followed by hMG in a sequential manner in the subsequent cycle. After sufficient follicular development, hCG was administered, followed 34-36 hours later by oocyte retrieval. MAIN OUTCOME MEASURE(S): Growth hormone, IGF-I, and IGFBP-3 were assayed by RIA and immunoradiometric assay techniques. RESULT(S): Growth hormone levels in serum and in follicular fluid were higher after FSH-stimulated cycles than after physiologic cycles. Serum and follicular fluid IGF-I did not change during physiologic and FSH-stimulated cycles. Serum IGFBP-3 decreased only in FSH-stimulated cycles. Levels of IGFBP-3 in follicular fluid were lower than serum levels in late follicular phase both in physiologic and in FSH-stimulated cycles. CONCLUSION(S): Reduction of IGFBP-3 is an important mechanism allowing a larger local availability of free IGFs, which modulate the response of follicles to gonadotropin stimulation. This effect is amplified in stimulated cycles.

Adult↗

[The influence of left systolic ventricular function on right ventricular function after an acute myocardial infarct].

The aim of this study was to assess the interaction between left ventricular and right ventricular systolic function after acute myocardial infarction (AMI). The study population comprises 27 normal subjects and 71 patients assessed at predischarge (12 +/- 7 days) after AMI and divided into two subgroups, 24 with inferior AMI and 47 with non inferior AMI. The three groups were comparable for sex, age, heart rate and blood pressure. Right ventricular function was evaluated by two-dimensional assessment of tricuspid annular plane systolic excursion (TAPSE) and by Doppler analysis of right ventricular outflow tract. Left ventricular systolic function was evaluated by two-dimensional determination of ejection fraction and wall motion score index, and by Doppler analysis of left ventricular outflow tract. The overall AMI population showed reduced TAPSE, velocity-time integral (both p < 0.05) and peak velocity (p < 0.005) of right ventricular outflow tract, prolongation of Q-S2 interval and increase of pre-ejection period/acceleration time ratio (both p < 0.05) in comparison with normals. These alterations were accompanied by a decrease of left ventricular ejection fraction and increase of wall motion score index. (p < 0.0001) The changes of right ventricular indexes were confirmed in patients with inferior AMI who had also lower left ventricular ejection fraction (46 +/- 9%). Functional parameters of the right ventricle were not significantly modified in patients with non inferior AMI who had greater left ventricular ejection fraction (53 +/- 8.6%). In the overall AMI population, and in particular in inferior AMI, we found univariate relations between time-velocity integrals of left ventricular and right ventricular outflow tract and between left ventricular ejection fraction and TAPSE. Only in inferior AMI creatinkinase peak was related to time-velocity integral of right ventricular outflow tract (r = -0.59, p < 0.01). In conclusion, the magnitude of right ventricular systolic impairment developing after left ventricular AMI depends on the degree of left ventricular dysfunction, likewise by changes of hemodynamic load imposed to the right ventricle. AMI location and, only in inferior AMI, infarct extension participate in determining this dysfunction.

Analysis of Variance↗

Influence of nighttime blood pressure on left atrial size in uncomplicated arterial systemic hypertension.

The aim of the study was to determine the relations of 24-h blood pressure (BP) and its different phases with left atrial size. A total of 130 subjects (mean age 46 years) not taking cardiac drugs were studied by M-mode and Doppler echocardiography and ambulatory BP recording. Subjects (excluding those with coronary artery or valvular heart disease, heart failure, or diabetes) were classified into two groups: 25 normotensives and 105 hypertensives (history of antihypertensive treatment and office diastolic BP > 90 mm Hg). The two groups were comparable in terms of sex, age, and heart rate, whereas body mass index, (P < .01), office BP, average 24-h BP, and average daytime and nighttime BP (all P < .00001) were higher in hypertensives. Hypertensives also had increased left atrial dimension, left atrial dimension/aortic root ratio (both P < .001), and left ventricular mass (LV) indexed for height (P < .0001). Positive correlations of left atrial dimension were found with office BP, average 24-h, average daytime and nighttime systolic and diastolic BP, LV mass index, and Doppler-derived E/A ratio. In a multivariate model that included potentially confounding factors, only body mass index (standardized beta coefficient = 0.41, P < .00001), average nighttime diastolic BP (beta = 0.33, P < .00001), and male sex (beta = 0.18, P < .01) were independent predictors of left atrial size in the pooled population. In conclusion, left atrial size is more closely related to ambulatory, rather than office, BP measurements, and high average nighttime BP is a powerful marker of left atrial enlargement in arterial hypertension.

Adult↗

Intestinal function in mice with small bowel growth induced by glucagon-like peptide-2.

Glucagon-like peptide-2 (GLP-2) stimulates small intestinal growth through induction of intestinal epithelial proliferation. To examine the physiology of GLP-2-induced bowel, mice were treated with GLP-2 (2.5 micrograms) or vehicle for 10 days. Small intestinal weight increased to 136 +/- 2% of controls in GLP-2-treated mice, in parallel with 1.4 +/- 0.1- and 1.9 +/- 0.5-fold increments in duodenal RNA and protein content, respectively (P < 0.05-0.001). Similarly, the activities of duodenal maltase, sucrase, lactase, glutamyl transpeptidase, and dipeptidyl-peptidase IV (215 +/- 28% of controls; P < 0.001) were increased by GLP-2. Oral or duodenal administration of glucose or maltose did not reveal any differences in the ability of GLP-2-treated mice to absorb these nutrients, possibly because of decreases in expression of the glucose transporters sodium-dependent glucose transporter-1 (SGLT-1) and GLUT-2. In contrast, absorption of leucine plus triolein was increased after duodenal administration in GLP-2-treated mice (P < 0.01-0.001). Finally, GLP-2 did not alter other markers of intestinal or pancreatic gene expression, including levels of mRNA transcripts for ornithine decarboxylase, multidrug resistance gene, amylase, proglucagon, proinsulin, and prosomatostatin. Thus induction of intestinal growth by GLP-2 in wild-type mice results in a normal-to-increased capacity for nutrient digestion and absorption in vivo.

Animals↗

Circulating and tissue forms of the intestinal growth factor, glucagon-like peptide-2.

Glucagon-like peptide-2 (GLP-2) has recently been identified as a stimulator of intestinal epithelial growth, prompting the development of RIA and HPLC methodologies to study this peptide in more detail. A GLP-2-specific antiserum (UTTH-7) was developed that recognizes amino acids 25-30 of human and rat GLP-2-(1-33). UTTH-7 cross-reacts with N- and C-terminally modified forms of GLP-2, proglucagon, and the major proglucagon fragment. Analysis of rat ileal extracts demonstrated the presence of GLP-2-(1-33) as well as significant amounts of GLP-2-(3-33) (16 +/- 7% of total GLP-2). The level of total immunoreactive GLP-2 in plasma from fasted rats was 700 +/- 71 pg/ml, and this increased 3.6-fold (P < 0.001) in 24-h fed rats. HPLC analysis demonstrated the presence of both GLP-2-(1-33) and GLP-2-(3-33) in plasma from fasted rats, with increments in both peptides in plasma from fed rats. Immunoreactive GLP-2 increased in plasma from human subjects 2 h after a meal, rising from 851 +/- 230 to 1106 +/- 211 pg/ml (P < 0.05); 15 +/- 4% of this immunoreactivity was accounted for by the presence of intact GLP-2. HPLC showed the presence of both GLP-2-(1-33) and GLP-2-(3-33) in plasma from fed humans. Incubation of human GLP-2-(1-33) with the enzyme dipeptidylpeptidase IV resulted in liberation of GLP-2-(3-33), whereas replacement of Ala2 with Gly2 prevented this cleavage. Thus, while GLP-2-(1-33) is a major circulating and tissue form of GLP-2, GLP-2-(3-33) is a significant component ofimmunoreactive GLP-2 in both intestine and plasma.

Adult↗

Regional diastolic function in normotensive versus hypertensive subjects: comparison using Doppler myocardial imaging.

BACKGROUND: Pulsed Doppler myocardial imaging (DMI) is a new technique that makes it possible to obtain an on-line quantitative assessment of wall motion in different myocardial segments through sample-volume placement. Therefore, this tool is suitable for identifying changes in regional diastolic function in uncomplicated arterial hypertension. In this study, we examined standard Doppler-derived indexes of global left ventricular diastolic function and regional diastolic parameters obtained by pulse-wave DMI in a population of hypertensive patients, comparing them with the indexes found in a control group of normotensive subjects. METHODS: Thirty-six patients with uncomplicated hypertension and 10 normotensive subjects (all males) underwent a complete Doppler echocardiographic examination and a pulsed DMI assessment of 4 different myocardial segments: basal and middle septum, basal and middle lateral wall. RESULTS: The 2 groups were comparable in age and heart rate, but body mass index, systolic and diastolic blood pressure and left ventricular mass index were higher in hypertensives. All of the transmitral diastolic measurements were impaired in hypertensives, without any difference in the Doppler indexes of global systolic function. While there were no changes in the regional systolic measurements, most of the DMI parameters for diastolic function changed significantly in all 4 of the segments examined, with a greater statistical difference at the basal and middle septum. We found a relationship between the number of segments involved in the diastolic dysfunction (ie with peak velocity E/A < 1) and the degree of impairment of the transmitral E/A ratio solely in the hypertensive population. CONCLUSIONS: DMI is a useful tool for distinguishing left ventricular diastolic function in hypertensive patients and it provides information about the extent and degree of diastolic impairment in different myocardial segments. The basal and middle septum present more evident diastolic alterations. Minor but significant changes can be identified at the basal and middle lateral walls. The higher the prevalence of the myocardial segments involved in diastolic dysfunction, the greater the impairment of the global diastolic function of the left ventricle will be.

Analysis of Variance↗

Involvement of NMDA receptor mechanisms in jaw electromyographic activity and plasma extravasation induced by inflammatory irritant application to temporomandibular joint region of rats.

The aim of this study was to examine the possible role of N-methyl-D-aspartate (NMDA) receptor mechanisms in responses induced by the small-fibre excitant and inflammatory irritant mustard oil injected into the temporomandibular joint (TMJ) region of rats. The effects of the non-competitive NMDA antagonist MK-801 were tested on the mustard oil-evoked increases in electromyographic (EMG) activity of the masseter and digastric muscles and Evans Blue plasma extravasation. Five minutes before the mustard oil injection, MK-801 or its vehicle was administered systemically (i.v.), into the third ventricle (i.c.v.), or locally into the TMJ region. Compared with control animals receiving vehicle, the rats receiving MK-801 at an i.v. dose of 0.5 mg/kg (n = 5) showed a significant reduction in the incidence and magnitude of EMG responses as well as in the plasma extravasation evoked by mustard oil; MK-801 at an i.v. dose of 0.1 mg/kg (n = 5) had no significant effect on plasma extravasation or on the incidence and magnitude of EMG responses but did significantly increase the latency of EMG responses. An i.c.v. dose of 0.1 mg/kg (n = 5) or 0.01 mg/kg (n = 5) had no significant effect on plasma extravasation or incidence of EMG responses but did significantly reduce the magnitudes of the masseter EMG response; the 0.01 mg/kg dose also significantly increased the latency of the digastric EMG response. The magnitudes of both the masseter and digastric EMG responses were also significantly reduced by MK-801 administered into the TMJ region at a dose of 0.1 mg/kg (n = 5) but not by 0.01 mg/kg (n = 5); neither dose significantly affected the incidence of EMG responses or the plasma extravasation. These data suggest that both central and peripheral NMDA receptor mechanisms may play an important role in EMG responses evoked by the small-fibre excitant and inflammatory irritant mustard oil, but that different neurochemical mechanisms may be involved in the plasma extravasation induced by mustard oil.

Animals↗

Prevalence of NIDDM and impaired glucose tolerance in Italy: an OGTT-based population study.

To provide complete prevalence data on diabetes mellitus in Italy (diagnosed and undiagnosed), a population survey was performed in the Health District of Cremona, a representative area of the Po river (north Italy). The survey is characterised by particular attention being paid to methodology, non-responders being investigated for possible selection biases affecting diagnosed and undiagnosed diabetes prevalence estimations. Out of a population aged 44 years or older from three municipalities, a random sample of 3097 subjects was selected to undergo an oral glucose tolerance test. In addition, past medical history, clinical and laboratory data were collected. A total of 1797 subjects participated (58%), and information on known diabetes status was obtained for 2618 persons (85%), also including 826 interviewed non-participating subjects. Overall rates were age-standardised according to the 1991 Italian census. Overall prevalence and 95% confidence interval of diagnosed diabetes was 8.5% (6.9-10.1) in males and 7.9% (6.7-9.3) in females over the age of 44 years; previously undiagnosed diabetes was 2.5% (1.4-3.6) in males and 3.4% (2.1-4.7) in females; glucose intolerance was 7.7% (5.7-9-7) in males and 8.9% (7.0-10.8) in females. Total diabetes prevalence above age 44 years, developed-world age, and sex standardised, was 10.7%. This study provides the first reliable prevalence estimation of impaired glucose tolerance, diagnosed and undiagnosed diabetes in Italy, according to World Health Organization criteria, and one of the few figures for Southern Europe. The role of body mass index on both prevalence of diabetes and cluster of cardiovascular risk factors is considered, with implications for prevention.

Age Factors↗

Intraluminal excretion of PAF, lysoPAF, and acetylhydrolase in patients with ulcerative colitis.

PAF-acether (PAF) is a phospholipid synthesized by numerous inflammatory cells. PAF can produce several pathological changes in various organs, especially in the colon. In animals PAF causes colonic ulceration and inflammation, which are similar to the anatomic lesions seen in human ulcerative colitis. The aim of this study was to measure in vivo colonic production of PAF in active ulcerative colitis using a modified colonic perfusion method. Ten patients with active ulcerative colitis and six control patients were investigated. A colonic segment was continuously perfused with a buffer and the liquid was recovered 20 cm distally, after a 45-min period of equilibration, at 20-min intervals. PAF, lysoPAF, and acetylhydrolase were measured in the colonic samples. PAF and lysoPAF outputs were significantly higher in patients with active ulcerative colitis compared to controls patients. There was a significant correlation between colonic PAF output and, respectively, macroscopic mucosal lesions and myeloperoxidase colonic output. We thus conclude: (1) the colonic perfusion method allows in vivo study of the metabolism of PAF during ulcerative colitis and could also be used to study the efficiency of PAF antagonists in UC; and (2) colonic production of PAF is increased during ulcerative colitis and correlated to local injury and inflammation. Whether or not PAF plays a role in the pathogenesis of ulcerative colitis remains open for further investigations.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗

A paradoxical inhibition of androgenic hyperproduction by a Sertoli-Leydig cell tumour ovary.

A 17 year old woman was evaluated for amenorrhoea and severe hirsutism (Ferriman-Gallway index = 31). Pelvic ultrasound demonstrated a right unilateral ovarian mass (6 x 5 cm), whereas the computed tomography for the adrenal gland was normal. Endocrinological findings revealed normal concentrations of oestradiol, progesterone, dihydroepiandrosterone sulphate, cortisol, prolactin, follicle-stimulating hormone, luteinizing hormone and adrenocorticotrophic hormone (ACTH). Total testosterone, free testosterone, androstenedione and 17-hydroxy-progesterone concentrations, already elevated at basal conditions, did not increase after an ACTH test, whereas they decreased significantly after dexamethasone administration and increased after a human chorionic gonadotrophin test. Of all the tumour markers investigated, tissue polypeptide antigen and alpha 1-fetoprotein showed an increase in concentration. Selective venous ovarian catheterization indicated the presence of an androgen-producing tumour in the right ovary. The histopathological diagnosis was consistent with a Sertoli-Leydig cell tumour ranking between an intermediate and a poor grade of differentiation, with heterologous elements characterized by mucinous epithelium of the gastro-intestinal type. An endocrine evaluation performed postoperatively showed a normalization of all serum pathological hormones and tumour markers studied. Some particular aspects were focused on and discussed.

Adolescent↗

[Predictive value of various echocardiographic parameters of systolic and diastolic function in the development of congestive heart failure after infarction].

To evaluate the predictive value of systolic and diastolic left ventricular (LV) function parameters, in the development of congestive heart failure (CHF) after acute myocardial infarction (AMI), 48 patients (mean age 56.2 +/- 10.4 years) were studied with two-dimensional and Doppler echocardiography (2D echo) in the acute phase (36 +/- 12 hours) and after 6 months of follow-up. The following parameters have been evaluated: LV wall motion score-index; peak velocity of early diastolic filling (E); peak velocity of filling during atrial systole (A); the ratio A/E; percent of LV filling contributed by atrial systole (A%). During follow-up 10 patients (Group B; 21%) developed symptoms and/or signs of CHF, while 38 patients (Group A; 79%) did not. In the patients who developed CHF 2D echo showed a depressed contractile function (mean value of wall motion score-index 3.08 +/- 0.45 versus 3.53 +/- 0.32 of Group A; p < 0.001) and a marked impairment of filling during atrial systole: A/E = 1.89 +/- 0.80 versus 1.07 +/- 0.35 (p < 0.001); A% = 52.2 +/- 9.9 versus 39.1 +/- 8.4 (p < 0.001). The multivariate analysis showed that the ratio A/E, A% and the wall motion score-index are the only variables that may predict the development of CHF. This capacity has been confirmed also considering the cut-point as conditional variables (A/E > 1.4; A% > 45%; score-index < 3.1). Our results demonstrate that a combined evaluation by 2D echo of systolic and diastolic LV function parameters allowed a better stratification of patients at risk of developing CHF after an AMI.

Adult↗

An Italian population-based study of the prevalence of diabetes: some methodological aspects.

The aim of the present study, which is part of a larger population survey, is to provide an Italian estimate of the total prevalence of diabetes taking into account the fraction of known diabetes among the non-responders. The study consists of a population survey. Out of the population aged over 40 ys. of two municipalities, Casalbuttano and Vescovato, in the Health District of Cremona, a random sample of 2,229 subjects was selected to undergo an OGTT. In addition, a series of anamnestic, clinical, and laboratory data were collected for each individual. Overall response rate was 63%. Prevalence of known diabetes was 7.8% (6.5%-9.1%, 95% CI), (F = 7.9%, M = 7.6%). The comparison between responders and the telephone-interviewed non-responders showed an unpredictable and age- and sex-dependently varying frequency of known diabetes, even if the overall differences were not statistically significant. This suggests that, to avoid biases, many efforts should be spent to collect information about diabetes also for non-responders. Prevalence of unknown diabetes was 3.2% (2.2%-4.2%, 95% CI), (F = 4.0%, M = 1.8%) and total diabetes was 10.9% (9.3%-12.5%, 95% CI) (F = 11.9%, M = 9.4%). In contrast to other countries, the relationship between unknown and known diabetes was less than 1 to 2, and the proportion of unknown diabetes was almost negligible below the age of 70. A positive family history and a lower level of triglycerides were associated with awareness of the disease (p = 0.0005 and p = 0.006, respectively), thus suggesting different behaviour towards one's own health between known and unknown diabetic subjects.

Adult↗

[Use of triptorelin in the medical treatment of uterine myoma].

Following the introduction of GnRH analogue drugs the medical treatment of uterine myomatosis has been proposed. The use of these compounds in fact causes a reduction in mean plasma levels of 17-beta-estradiol which is reflected in the target tissue of myomas. Using this hormone-dependence as a starting Tryptoreline point, the study examined the volumetric changes induced by LH-RH agonist analogue, Tryptoreline, administered to a group of 15 selected patients. The results are encouraging: in all cases there was a marked reduction of tumour volume ranging between 30 and 40%. The therapeutic effect, however, gradually wore off following the suspension of treatment. For this reason, the use of this analogue should be reserved for premenopausal or younger patients for the treatment of menometrorrhagic episodes, or as a preoperative therapy in order to limit blood loss during surgery.

Adolescent↗

Dysmenorrhoea and sports activities in adolescents.

Primary or essential dysmenorrhoea is a painful syndrome which precedes by a few hours or accompanies the menstrual flow, present above all in adolescents. The aim of the present work is to evaluate the incidence of dysmenorrhoea in adolescents who practice sports. We examined two groups of athletes who practised sport in their adolescent period: 1) first population of athletes (483 subjects): women who had begun their activity before menarche (Group A: 261 subjects) and athletes who had started some years after the menarche (222 subjects); and in this latter group before (Group B1) and after (Group B2) the beginning of sports activity. 2) Second population (281 subjects) comprising: Group C (169 adolescents) comprised women who took part in sport only now and then; Group D (112 women) whose activity was of an athletic type. Comparing the percentage of dysmenorrhoea it emerges: 1) that dysmenorrhoea is present in a lower percentage in subjects in Group A (68.19%) in respect to women in Group B; 2) that in a considerable number of girls in Group B it was observed that there was a regression or an improvement in the pain symptomatology after the beginning in athletic activity; 3) dysmenorrhoea was much less in the more intense the sports activity (Groups C and D). From these data it can therefore be seen that athletic activity of almost any type or level has a positive influence on the dysmenorrhoea symptom, while it does not produce the same effect on other characteristics of the cycle, indeed, in some cases they were worsened.

Adolescent↗

[Arteriectasis: a forgotten chapter].

In 1942, Leriche described the first "dolichomégaartères" (or "arteriomegaly" according to the definition subsequently proposed by Anglo-Saxon researchers). We detected 199 cases of arteriomegaly (16.29% of cases examined) during a review of 1,221 translumbar arteriographies of the lower limbs performed from 1980 to 1985 in the vascular radiology department of our hospital. The percentage of associated aneurysms was 33.16%. The possible dysplastic pathogenesis of the affection and the differential diagnosis with atherosclerosis and other vascular affections found in connective tissue diseases is noted. Histopathology showed dystrophic lesions of the media and especially of the elastic fibers as well as occasional associated venous lesions and a familial basis. The peripheral symptomatology was acute, pseudoembolic and severe as revealed by ischemia and cyanosis. There was no collateral circulation. Medical treatment consisted especially in anti-coagulant and hypervolemic hemorrheologic therapy during ischemia. Ultrasonography enabled us to monitor the regular, systematic course of arteriomegaly, to make the diagnosis initially, to measure the exact size of the arteries, to observe the morphology of the wall and, moreover, to determine the presence or not of megaveins capable of reinforcing the dysplastic genesis of arteriomegaly.

Dilatation, Pathologic↗

Sex-education needs and interests of high school students in a rural New York county.

Seventy-five boys and 88 girls from three high schools in a rural county of New York state took a sex-education quiz and were asked to describe their sexual and contraceptive experiences and sex-education interests. Consistent with most previous research, nonvirgin teenagers who earned better grades on the sex-education quiz failed to use more effective contraceptives than nonvirgins who had performed poorly on the quiz. There was a striking similarity among students' descriptions of sex-education interests, regardless of their gender, previous enrollment in a health course, or experience with sexual intercourse. Very few teenagers (9%) were completely satisfied with their high school's current sex-education program. The majority (57%) wanted to learn more about contraceptives and venereal disease prevention, either as the primary focus of their sex-education curriculum or in combination with other topics such as sexual values, the biology of reproduction, and information about the human body. Many adolescents (19%) seemed confused about their sex-education needs and described a vague interest in everything sexual. Only 2% of the students thought sex education should provide them with erotic information or techniques for increasing sexual pleasure. The remaining students wished that their sex-education courses would give them additional information solely about sexual values (5%) or the biology of reproduction and knowledge about the body (8%).

Adolescent↗