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Biomedical subjects

A Lechi

Publications and source records attributed to A Lechi.

At least 127 records · Page 7Linked to original sources
PubMed1984

Distribution of ceftazidime in ascitic fluid.

The pharmacokinetics of ceftazidime were investigated in eight normal subjects and eight patients with ascites after intravenous administration of 1 g of the drug. Samples of blood and ascitic fluid were collected for 6 h after dosage, and urine samples were collected for 24 h. Pharmacokinetic data were calculated by using a one-compartment model. The apparent volume of distribution and half-life of elimination (t1/2 beta) in patients with ascites were approximately three times those in normal subjects. In contrast, renal clearance was greater in the normal subjects. With respect to ascites, the mean area under the concentration-time curve was 95.3 +/- 38.3 micrograms X h/ml. The mean ratio of the area under the concentration-time curve for ascitic fluid to that for plasma was 69.9% (+/- 38.2). These data show that ceftazidime rapidly diffuses into the peritoneal space, in which concentrations greater than 10 micrograms/ml were present for at least 6 h.

Adult↗
PubMed1984

Accidental poisoning with deadly nightshade berries: a case report.

A case of acute accidental poisoning with deadly nightshade (Atropa belladonna) berries is reported. The patient was an elderly but healthy man who soon recovered. On the one hand, the clinical picture looked similar to that of delirium tremens; on the other, there were myoclonic jerks and signs of extrapyramidal involvement to suggest the onset of subacute dementia. The electroencephalogram findings confirmed those already reported during experimentally induced intoxication after ingestion of atropine in man.

Aged↗
PubMed1984

Reduction of the antihypertensive effect of captopril induced by prostaglandin synthetase inhibition.

The effects of prostaglandin synthetase inhibition by indomethacin on blood pressure and hormonal variations induced by captopril were studied in eight patients with essential hypertension and in six nonhypertensive subjects. Captopril antihypertensive effect and captopril-induced plasma renin increase were almost totally abolished by a short-term administration of indomethacin (50 mg t.i.d.). These results support the hypothesis that prostaglandins contribute to the antihypertensive effects of ACE inhibitors. It may be of clinical importance that anti-inflammatory drugs that inhibit PG-synthetase can also blunt the antihypertensive action of ACE inhibitors.

Adult↗
PubMed1983

[The effect of dopaminergic stimulation and inhibition on the urinary excretion of aldosterone and kallikrein in spontaneously hypertensive rats].

The effect on the electrolyte balance of a dopaminergic agonist (bromocriptine) and an antagonist (metoclopramide) and their effect on renal aldosterone and kallikrein excretion were investigated. Ten normotensive Wistar rats and ten spontaneously hypertensive rats (SHR-Wistar Kioto) were treated with BCR (4 mg/Kg weight b.i.d.) for 4 days; after a week of pharmacological wash-out they received MCP (0,5 mg/Kg weight b.i.d.) for 4 days. Before and after treatment and at the 2nd and 4th day of each treatment diuresis, urinary excretion of aldosterone, kallikrein, sodium, potassium and proteins were measured. During the 24-hour urine collections the rats were kept in separate metabolic cages with free access to food and water. Kallikrein urinary excretion was lower in SHR than in normotensive rats under basal conditions (p 0.05); urinary sodium, potassium, proteins and sodium/potassium rate were also reduced in SHR. After treatment with bromocriptine a further reduction in urinary kallikrein excretion was observed in SHR. After MCP all the parameters were unchanged both in normotensive rats and in SHR, but SHR showed a significant correlation between aldosterone and kallikrein excretion (p less than 0,001); in this condition it seems that in SHR the control exerted by aldosterone on kallikrein excretion is greater than the one exerted by dopamine. It may indicate a defect of the natriuretic and vasodilator dopaminergic system in spontaneously hypertensive rats.

Aldosterone↗
PubMed1983

The effect of amantadine on arousal and EEG patterns in Creutzfeldt-Jakob disease.

In recent years, Creutzfeldt-Jakob disease (CJD) has been supposed to be of viral origin, and amantadine hydrochloride has been suggested as therapy because of its proved antiviral action. We studied nine patients with CJD (confirmed at autopsy in seven). Four were treated with amantadine hydrochloride, in dosages ranging from 3.5 to 15 mg/kg/day for an average period of 32 days. The clinical evolution of their disease was compared with that in five patients receiving only supportive maintenance therapy. The length of survival from the onset of clinical care did not differ significantly between the two groups. Nevertheless, a transient improvement in wakefulness and mentation was observed in three patients treated with amantadine, and EEG changes were observed in two, consisting above all of a reduction in the slow-wave activity and the periodic discharges (PDs). Amantadine administered intravenously did not induce any short-term changes in the PDs or the cyclic alternating pattern.

Aged↗
PubMed1983

Neuronal loss in the basal nucleus of Meynert in progressive supranuclear palsy.

A morphometric study of the basal nucleus of Meynert (bnM) has been performed in a 70-year-old man with a 4-year history of pathologically confirmed progressive supranuclear palsy (PSP). An important neuronal loss (52%) was demonstrated in the bnM. This finding has not been previously documented with morphometric methods in PSP, but the involvement of the bnM is well known in other related conditions, i.e., Parkinson's disease, Alzheimer's disease, and Parkinson-dementia complex of Guam. Our findings yield support to the view that the involvement of the bnM, a nucleus with complex connections with various subcortical structures and diffuse cholinergic projections on the neocortex, could play an important role in the physiopatholog of subcortical dementia.

Aged↗
PubMed1983

Serum pancreatic enzyme alterations in acute viral hepatitis.

In a group of 167 patients with acute viral hepatitis (AVH), 11 with type A hepatitis, 125 with type B and 31 type non A, non B, the following enzymes were studied: serum amylase (S-AMY) and its isoenzymes (pancreatic and salivary type), urinary amylase (U-AMY), serum lipase (S-TGL) and serum immunoreactive trypsin (i-TRY). In all groups of patients, in the acute phase of illness, a significant increase in S-AMY was observed, in particular in hepatitis type B and non A, non B (p less than 0.001). An increase in U-AMY excretion was recorded in patients with type A hepatitis. S-TGL levels were significantly higher in all groups, especially in patients with type A hepatitis. i-TRY was only slightly higher in patients with hepatitis A and non A, non B. S-AMY isoenzymes showed a peculiar pattern: the pancreatic type (2) of isoamylase was found to be prevalent in 66% of patients with AVH while in controls the salivary type (1) was prevalent in most cases. Pancreatic enzyme alterations correlated neither with laboratory hepatic function tests nor with the clinical syndrome. These results suggest that a pancreatic injury is not uncommon in AVH, although it is seldom severe.

Acute Disease↗
PubMed1983

A discrepancy between the effects of a single oral dose of captopril on blood pressure, plasma renin activity, and serum angiotensin-converting enzyme levels.

The effects of a single oral dose (100 mg) of the angiotensin-converting enzyme (ACE) inhibitor, captopril (SQ 14,224), on blood pressure (BP), plasma renin activity (PRA), plasma aldosterone (PA), and serum ACE were investigated in 18 patients with essential hypertension (EH) and in 4 with renovascular hypertension (RVH). in most patients, SQ 14,225 caused a significant reduction of BP during the subsequent 6 h, particularly in RVH patients. A significant correlation between basal PRA levels and BP reduction was observed only by considering all the patients together. After ACE blockade, a significant increase of PRA was observed in RVH and in normal-renin EH patients, but not in EH patients with lower PRA. Maximal serum ACE inhibition (over 50%) occurred after 2 h but diminished after 4 h and 6 h, whereas the BP decrease persisted for 6 h. After 3-day treatment with indomethacin (six patients) captopril's antihypertensive action was blunted, despite a reduction of baseline PRA levels and of captopril-induced PRA elevation. The antihypertensive effects of SQ 14,225 in low-renin EH patients, the lack of effect of ACE blockade on renin secretion in these patients, and the reduction of the antihypertensive effects of SQ 14,225 after indomethacin refute the interpretation of purely angiotensin-related antihypertensive mechanism.

Administration, Oral↗
PubMed1983

Megalencephaly with formation of Rosenthal fibers in symmetric subependymal gliomatous proliferations: clinicopathologic report.

Clinical and neuropathologic observations are reported concerning a girl with retarded psychomotor development accompanied with a steady increase in the volume of the cranium and brain, tetraparesis, and a serious epileptic syndrome resulting in death at the age of 13 years. The neuropathologic study revealed a marked megalencephaly and the presence of two bilateral and symmetric areas of atypical glial proliferation, corresponding with the optostriatal groove, with endoventricular protrusion: in this region the histologic findings gave evidence of a tapetum of Rosenthal fibers. Discussion is focused on the observed neuropathologic aspects in relation to the various diagnostic hypotheses: Alexander's disease, primary megalencephaly associated with astrocytomas or reactive gliosis, or megalencephaly associated with subependymal hamartomas.

Brain↗
PubMed1982

Clinical evaluation of labetalol alone and combined with chlorthalidone in essential hypertension: a double-blind multicentre controlled study.

In a multicentre, double-blind, crossover, placebo-controlled study, the antihypertensive effect of labetalol 100 mg and chlorthalidone 10 mg, given alone or in combination, has been assessed in 32 hypertensive patients. The combination had a greater effect in reducing blood pressure than did its separate components. This was particularly evident after exercise. Heart rate increased during chlorthalidone therapy, decreased during labetalol therapy, and a summation effect was observed during treatment with the combination. In most cases additivity was observed, as no interaction between the single components was observed, except for heart rate after exercise, and for diastolic blood pressure in the upright position. No interaction was observed either in the biochemical indices or in the clinical side-effects.

Adult↗
PubMed1982

Anderson-Fabry's disease: neuropathological and neurochemical investigation.

A clinical, neuropathological and neurochemical study of a case of Anderson-Fabry's disease is described. The clinical course mainly consisted of repeated ictus with major involvement of the CNS. The neuropathological examination is dominated by severe alterations in the cerebral vessels due to glycolipid deposits on the walls, with reduction or occlusion of the lumen. This is correlated with secondary ischaemic foci scattered throughout the cortex as well as through the white matter. In addition, the cells of the cerebral cortex, thalamus, basal ganglia, amygdala, cerebellar and olivary nuclei show a marked accumulation of lipofuscin. Biochemical examination reveals a threefold increase in galactolipids due to the specific alpha-galactosidase deficiency. Cholesterol is reduced secondarily to ischaemic myelin damage. Glycosaminoglycans uronic acid is increased in cytosol and membrane-bound fractions which could be related to reactive gliosis. Glycoprotein sugars show a decrease in N-acetyl-neuraminic acid and fucose as well as an increase in hexosamines and hexoses in membrane-bound fraction, while in cytosol fraction all sugars are increased. This suggests that the alpha-galactosidase deficiency can alter not only the glycolipid but also the glycoprotein metabolism, resulting in a higher presence of hexosamines and hexoses-rich glycoproteins.

Amygdala↗
PubMed1982

Contribution of four markers of tubular proteinuria in detecting upper urinary tract infections. A multivariate analysis.

The presence of tubular involvement, as a marker for the detection of urinary tract infection (UTI) site, was examined in 19 patients with pyelonephritis and in 15 patients with cystitis or asymptomatic bacteriuria. The urinary excretion of four markers of tubular proteinuria, beta 2-microglobulin (beta 2M), lysozyme (LZ), lactic dehydrogenase isoenzyme V (LAD-5) and N-acetyl-beta D-glucosaminidase (NAG), was investigated. LAD-5 appeared particularly valuable for the early detection of upper UTI. However, the overall diagnostic accuracy appeared to be further strengthened using, besides LAD-5, one additional variable. A set of simple and noninvasive biochemical tests on urine samples can reliably help to identify the site of UTI.

Acetylglucosaminidase↗
PubMed1982

The kinetics of cefuroxime in ascitic and pleural fluid.

Adequate drug concentration at the infection site is a very important objective of antibiotic therapy. In this study we investigated the pharmacokinetics of the new methoximine, cefuroxime, in peritoneal and pleural fluids in 16 patients. After a 1-g dosage of cefuroxime, its concentration reaches a peak in ascitic fluid within 4-5 h. With a 2-g dose the peak level is reached in 2-3 h. After 5 h, cefuroxime concentration in ascites exceeds that in serum. Cefuroxime diffuses readily into the peritoneal space, where high concentrations (8-10 mcg/ml) are maintained for at least 6 h. Data on the kinetics in pleural fluid also seem to show high antibiotic diffusion rates, even if concentrations are never as high as those in blood at the same time following 1 g i.v. These favorable kinetic properties are probably due to low serum protein binding and to slow renal excretion.

Ascitic Fluid↗
PubMed1981

Progressive supranuclear palsy in the course of subclavian steal syndrome.

A 70-year-old man manifested during four years a progressive clinical picture consisting in palsy of gaze, axial rigidity, disorders of standing and gait, dysarthria, dysphagia. Neuroradiological investigations demonstrated proximal thrombosis of the left subclavian artery with subclavian steal. At necropsy, degenerative changes in several areas of the basal ganglia and brain stem, with presence of globose neurofibrillary tangles, were found, consistently with the pathologic pattern of the Progressive Supranuclear Palsy (PSP). The association of PSP and subclavian steal syndrome has not been previously reported, to our knowledge. We hypothesize that chronic ischemia, due to subclavian steal syndrome, in the vertebral basilar system and its watershed versus carotid system may have favoured the appearance, in these same areas, of the changes of the PSP.

Aged↗
PubMed1981

On the pathology of meningiomas. A study of 412 cases.

Some pathological features of tumors arising primarily in the meninges are discussed on the basis of 412 surgically treated meningiomas during the period running from 1964 to 1978. Cases of meningeal sarcomas were not considered. Except for a few cases, pathology and clinical course have been generally in agreement. The incidence of histological types like meningotheliomatous, fibroblastic, angioblastic or atypical meningiomas has been verified in relation to sex, age and intracranial or spinal conventional locations. The problem of recurrencies has been studied either comparing the histological features with the first observation or comparing histopathological types with location and details of surgical procedure. Additional criteria like uni or multifocal origin of the tumors and histological features of the peri-lesional tissues, often harbouring small meningiomatous nests, have been taken into account.

Brain Neoplasms↗