[Methyldiazepinone (Noan) in ophthalmologic surgery].
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Adult↗
Biomedical subjects
A Messina
Publications and source records attributed to A Messina.
Determination of argininosuccinate lyase in human serum by ion-pair reversed phase liquid chromatography.
A new assay for argininosuccinate lyase based on the separation of the enzymatic reaction mixture components by an ion-pair reversed phase mechanism is reported. The determination of enzyme activity is performed after direct injection by UV detection of the fumarate formed. The chromatographic analysis time is 8 min and a detection limit of 0.4 U/L is achieved. The HPLC method is highly accurate, sensitive and precise. The simple procedure makes this method suitable for the routine determination of ASAL activity in human serum samples.
Arginine↗
CT of Nissen's fundoplication.
The aim of this work is to describe the computed tomographic (CT) anatomy in patients who underwent Nissen's fundoplication. Forty patients (mean age = 61 years) with peptic esophagitis (nine cases), refractory gastroesophageal reflux (11 cases), and hiatal hernia (20 cases) were studied. Examinations were performed by third-generation CT equipment, with patients in the prone position after the ingestion of gastrovison and barium paste. In 34 patients, the examination demonstrated anatomical variations related to surgery, that is, the presence of a soft tissue mass at the level of the distal third of the esophagus. In four patients, a functional incompetence of the fundoplication (three cases) and a recurrent hiatal hernia (one case) were demonstrated. Our results suggest a possible application for CT study in postoperative follow up of patients who undergo Nissen's fundoplication, complementary to endoscopy and functional exams.
Case-Control Studies↗
AO 1535 inhibits O2- production by human macrophages.
AO 1535 is a semisynthetic monoglycosylceramide derived from O-glycosilated sphingosine, with a chemical structure similar to the glycolipids present in many mammalian tissues. In the epidermis monoglycosylceramides contribute to consolidate the structure of cutaneous layers. It has been recently shown that sphingosine and its derivatives are potent inhibitors of Protein kinase C, and block the 'respiratory burst' of phagocitic cells. In macrophages, like in neutrophils, the reactive oxygen intermediates are produced by a membrane associated enzymatic complex, NADPH-oxidase, which is activated by Protein kinase C. This study demonstrates that AO 1535 is able to inhibit the production of reactive oxygen intermediates in human monocytes and macrophages stimulated by phorbol ester and chemotactic tetrapeptide, suggesting a potential clinical application of AO 1535 in the treatment of inflammatory dermatoses.
Cells, Cultured↗
Expression of ornithine decarboxylase gene in elderly human monocytes.
The proliferative capacity of the immune system is impaired in elderly subjects and the expression of various genes involved in cell cycle progression is reduced in PHA stimulated lymphocytes during the aging process. Macrophages play a fundamental role in the immune system response. It has recently been demonstrated that the process of macrophage activation is accompanied by a rapid, transient rise of ornithine decarboxylase (ODC) mRNA levels. In fact, the ODC gene seems to be involved in macrophage activation and differentiation. The authors demonstrated that the steady-state levels of ODC mRNA and the correlated superoxide anion production are lower in the monocytes of elderly subjects with respect to those in young subjects used as control. These results confirmed the impaired immune function of the elderly.
Journal Article↗
Effects of TRH on the immune system of newborn rats.
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Animals↗
Visual outcome after excimer laser refractive surgery in adult patients with amblyopia.
PURPOSE: To evaluate the visual and refractive outcome in adult patients wi th refractive and anisometropic amblyopia treated with photorefractive keratectomy. METHODS: An interventional non-comparative study was performed on 50 consecutive patients with amblyopia treated with photorefractive keratectomy. Sixty-eight eyes of 18 participants with bilateral refractive amblyopia and 32 participants with unilateral anisometropic amblyopia were studied. The photorefractive keratectomy was performed with MEL 70 G-Scan excimer laser. Follow-up was 1, 3, 6, and 12 months after the treatment. The mean outcome measures were uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BCVA), refraction, and corneal transparency. RESULTS: In 64.7% of eyes, the UCVA at 12 months after the treatment was better than or equal to their preoperative BCVA. A total of 82.4% of eyes improved their BCVA one or more lines. No eye lost lines of BCVA, 17.6% remained unvaried, 50% gained one line, 20.6 % gained two lines, and 11.8% gained three lines of BCVA. The number of lines gained correlated strongly with diopters of anisometropia between eyes (p<0.01). The mean sphere changed from -5.62+/-3.37 D to -0.47+/-1 D, mean cylinder varied from -2.36+/-1.57 to -0.18+/-0.41 D, and the spherical equivalent varied from -6.82+/-3.1 to -0.45+/-1.08 D. No clinically significant haze was observed. CONCLUSIONS: Excimer laser refractive surgery appears to be a safe and efficient procedure in the treatment of ametropic and anisometropic amblyopia in adults. Adult patients with anisometropic and refractive amblyopia could benefit from the refractive treatment with significant improvement of the visual acuity.
Adult↗
[Longitudinal shortening of the extensor proprius in neglected mallet-finger].
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Adult↗
[The Dialysis Outcomes and Practice Patterns Study (DOPPS): results of the Italian cohort].
BACKGROUND: The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international prospective, longitudinal, observational study examining the relationship between dialysis unit practices and outcomes for hemodialysis (HD) patients in seven developed countries France, Germany, Italy, Spain, United Kingdom, Japan and the United States. Results of the DOPPS in Italy are the subject of this report. METHODS: A national representative sample of 20 dialysis units (21 in Germany) was randomly selected in each of the European DOPPS countries (Euro-DOPPS). In these units, the HD in-center patients were included on a facility census, and their survival rates continuously monitored. A representative sample of incident (269 in Italy, 1553 in the Euro-DOPPS) and prevalent (600 in Italy, 3038 in the Euro-DOPPS) patients was randomly selected from the census for more detailed longitudinal investigation with regard to medical history, laboratory values and hospital admission. RESULTS: Comparing the Italian and Euro-DOPPS cohorts we found comparable mean age for prevalent patients (61.4 vs. 59.5 yrs), but incident patients were older in Italy. Italian prevalent patients had less cardiovascular disease, more satisfactory nutritional status and more frequent use of native vascular access. These data were associated with a comparable mortality (15.7 vs. 16.3 deaths/100 patient yrs), but morbidity was lower in Italy. Kt/V levels were comparable in the two cohorts (1.32 vs. 1.37), but 35% of Italian patients showed a Kt/V below the recommended target. Moreover, hemoglobin levels were below 11 g/dL in 60% of Italian patients. CONCLUSIONS: The DOPPS results bring to light several positive aspects and the opportunity for further possible improvements for Italian patients, but at the same time highlight some critical points that could represent a risk for dialysis quality.
Aged↗
[The prevalence of serum anti-hepatitis C virus antibodies in hemodialyzed patients].
Hepatitis C virus (HCV) is responsible for a high percentage of cases of transfusional hepatitis and is often considered the etiological agent of numerous cases of non-A, non-B hepatitis in which parenteral transmission has not been documented. Patients undergoing hemodialysis are at risk for HCV infection. We used an immunoenzymatic method and confirmatory test (neutralization test) to determine serum anti-HCV antibody positivity in order to identify the factors associated with increased risk of HCV infection. We studied 63 hemodialyzed patients from eastern Sicily and compared the mean dialytic age and transfusion case history in positive and negative groups. 17.4 percent of the patients were anti-HCV positive. Mean dialytic age was significantly higher in the anti-HCV positive group. On the contrary no significant differences regarding transfusion case history or number of units of blood transfused were seen in the two groups. Our study confirms that hemodialyzed patients are at risk for HCV infection. This risk seems to increase with dialytic age. The lack of correlation between HCV and transfusion case history suggests that it may be a hospital-acquired infection.
Age Factors↗
[Malignant gliomas: current status and therapeutic prospectives].
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Antineoplastic Agents↗
Immunization in vitro of mouse spleen cells in different cultural conditions.
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Animals↗
[Magnetic resonance in the study of inflammatory diseases of the pancreas].
The role of diagnostic imaging modalities in pancreatic inflammatory diseases is to assess gland damage and peripancreatic tissue involvement. The artifacts related to breathing and to peristaltic movements can be partially resolved with the optimization of acquisition parameters, which allows MRI to be suggested for the assessment of pancreatic inflammatory conditions. Sixty-nine patients with pancreatic inflammatory diseases (20 acute and 49 chronic pancreatitis cases) were examined. MRI was performed with a 0.5-T superconductive magnet and T1- and T2-weighted spin-echo (SE) sequences. In 4 of 20 acute pancreatitis patients image quality was poor. MRI in acute pancreatitis demonstrated glandular edema, intraparenchymal necrosis and the extent of peripancreatic fluid collections; in chronic pancreatitis MRI depicted glandular atrophy and Wirsung duct dilatation and detected the presence of pseudocysts. Even though its spatial resolution is lower than that of CT, MRI can provide useful pieces of information in inflammatory diseases of the pancreas, much more so after the introduction of Fast SE sequences and of fat-saturation techniques which are likely to make MR examinations of the pancreas more widely used.
Acute Disease↗
[Effects of adrenergic stimulation on transmembrane transport of Na+ in patients with essential hypertension].
BACKGROUND: It has been studied whether an adrenergic stimulation induced by the cold pressor test (CPT) could influence the behaviour of the transmembrane transport systems of sodium in hypertensive subjects compared to a normotensive control population. MATERIALS AND METHODS: Twenty-two hypertensive subjects (average age 43.2 +/- 5.7 years), with normal weight, without signs of cardiovascular and metabolic diseases, underwent the cold pressor test. The dynamic behaviour of sodium erythrocytic transport systems and plasmatic norepinephrine was evaluated basally, at the third minute during the cold pressor test and 20 minutes after the end of the test. The same test was carried out in a control population made up of 20 normotensive subjects (average age 41.9 +/- 4.8 years), selected on the basis of the absence of any cardiovascular or metabolic pathology and without family history of arterial hypertension. RESULTS: The cold pressor test did not cause significant changes in the sodium transmembrane transport systems in normotensive subjects, while in the hypertensive subjects a significant reduction was observed, during the test, in the total efflux of sodium and in the sodium/potassium pump, respectively from 2636 +/- 296 mumol/l/red blood cells/hr to 2032 +/- 178 mumol/l/red blood cells/hr (p < 0.0001) and from 2156 +/- 149 mumol/l/red blood cells/hr to 1610 +/- 101 mumol/l/red blood cells/hr (p < 0.0001); the intraerythrocytic sodium increased from 6.5 +/- 1.0 mmol/l/cells to 7.2 +/- 1.1 mmol/l/cells (p < 0.04) and the passive permeability decreased from 0.039 +/- 0.004 hr-1 to 0.018 +/- 0.006 hr-1 (p < 0.0001). During cold pressor test the increase in the plasma norepinephrine levels was correlated to the reduction in the total efflux of sodium (r = -0.60; p < 0.003) and in the sodium/potassium pump (r = -0.59; p < 0.003) only in hypertensive subjects. CONCLUSIONS: Our data show that an adrenergic stimulation, induced by the cold pressor test, is able to significantly influence the behaviour of transmembrane fluxes of sodium in hypertensive subjects, and it causes an inhibitory effect on the sodium/potassium pump and an increase in the intraerythrocytic sodium. Such data show the existence in hypertensive subjects of an interrelationship between adrenergic activity and sodium transport systems that could cooperate in causing and/or in maintaining the hypertensive syndrome.
Adult↗
[Effect of beta blockade on the erythrocyte transport of Na+: evaluation during stimulation by cold pressure test in patients with essential hypertension].
Several studies have shown in essential hypertension alterations of the transmembrane red blood cells sodium fluxes, as an involvement, especially in the early phases, also of the adrenergic system. In this study we evaluated the behaviour of red blood cells fluxes of sodium before, during and after the cold pressor test, a method used also to evoke an adrenergic stimulation, in twenty hypertensive subjects, 14 males and 6 females, with an average age of 43.2 +/- 5.7 years, with normal weight and without cardiovascular complications and metabolic diseases. The behaviour of the Na+ total efflux (Na+ TE), of the Na+/K+ pump, of the Na+K+ cotransport (Na+/K+ CT), of the Na+/Li+ counter transport (Na+/Li+ Cnt), of the Na+ passive permeability (Na+ PP), of the intracellular Na+ (I Na+) and of the plasmatic noradrenaline (NE) was evaluated basally, at the third minute during cold pressor test (CPT) and 20 minutes after the end of the test. The test, which the same method, was repeated after a 30 day treatment with propranolol at the dose of 240 mg/day in three daily administrations. The beta-blockade caused, besides the reduction of both the systolic and diastolic pressure values, a significant increase in the Na+/K+ CT (from 248 +/- 41 to 314 +/- 71 mmol/l/cells/h, p < 0.001) and a decrease in the Na+ PP (from 0.039 +/- 0.004 to 0.023 +/- 0.007 hr-1, p < 0.00001), probably directed towards the reduction of the accumulation of intracellular Na+, that could compete, among the other mechanisms, with the anti-hypertensive action of the beta-blockers. The CPT caused, before the beta-blockade, a significant depression of the Na+/K+ pump (from 2057 +/- 149 to 1610 +/- 101 mmol/l/cells/h, p < 0.00001) and of the Na+ TE (from 2640 +/- 397 to 2032 +/- 179 mmol/l/cells/h, p < 0.00001) inversely correlated to the levels of NE (r = -0.60, p < 0.003), with a consequent increase in I Na+ (from 6.2 +/- 0.6 to 7.5 +/- 1.5 mmol/l/cells, p < 0.001), showing how the adrenergic activation in hypertensive subjects is able to interfere with the systems of transmembrane transport with an inhibitory attitude, that is expressed by an increase in the levels of I Na+. The beta-blockade was able to outweigh the depression of the Na+/K+ pump (from 1843 +/- 584 to 1728 +/- 640 mmol/l/cells/h, p: ns) and the reduction of the Na+ TE, preventing the accumulation of I Na+ (from 6.3 +/- 1.6 to 6.6 +/- 1.3 mmol/l/cells, p: ns). Such data show an increased susceptibility of the Na+ transport systems to the adrenergic stimuli in hypertensive subjects with a tendency to favor the accumulation of I Na+ and that the beta-blockade is able to antagonize the effects, with a maintenance of the intracellular levels of Na+.
Adrenergic beta-Antagonists↗
[Cholangiopancreatography with magnetic resonance in the assessment of pancreatic ducts].
We investigated MR cholangiopancreatography (MRCP) findings in patients with pancreatic conditions, which are mainly diagnosed based on US and CT morphologic findings. Sixty-three patients were submitted to MRCP using a .5T magnet. MRCP was performed with non-breath-hold fat-suppressed 3D turbo spin echo sequences (TR = 3000 ms, TE = 700 ms, ETL = 128, NEX = 6) with 3 min acquisition time. For better depiction of Wirsung duct and secondary ducts in the last 11 patients, a high resolution technique with a 128 x 256 matrix, 8 NEX and 8 min 36 s acquisition time was developed. MRCP images were studied both on MIP reconstructions and on single slices as well as T1- and T2-weighted TSE axial images. The diagnosis was compared with endoscopy, percutaneous procedure or CT findings in all cases. A hypointense focal mass was observed on T1-weighted TSE images in 39 pancreatic carcinoma patients (100%) and parenchymal atrophy was shown in 13 patients (33%); a sudden obstruction of the Wirsung duct was observed in 16 cases (41%) with homogeneous dilatation in 11 cases (28%). A tapered appearance of the distal Wirsung duct was demonstrated in 19 chronic pancreatitis patients, with diffuse patchy signal changes in 12 patients (63%); bead-like appearance of the Wirsung duct was shown in 6 cases (32%) and pseudocysts in 7 cases (37.3%). MRCP is the only imaging method demonstrating pancreatic conditions between carcinoma and pancreatitis, similarly to ERCP.
Adult↗
[Cerebral hemorrhage induced by low-dose streptokinase: a pharmacologic paradox? Report of a clinical case].
A case of an important intracranial hemorrhage after a low dose (approx. 500,000 UI) of streptokinase in a 60 year-old woman suffering from myocardial infarction is presented. Clinical, electrocardiographic, echocardiographic, lab and tomographic findings are described. The authors suggest a pharmacokinetic mechanism which could be responsible of a "paradox effect" (a powerful and dangerous effect of the drug when given in low dose) and they wonder whether in case of allergic reactions should it be better not to stop the infusion of the thrombolytic drug and be more liberal with the "symptomatic" drugs. Tha patient is still alive and the clinical conditions slowly progressing.
Cerebral Hemorrhage↗
[Biliary complications of liver transplant. Role of cholangiography with magnetic resonance].
INTRODUCTION: Orthotopic liver transplantation is considered the treatment of choice in several hepatic conditions. The five-year patient survival rate is approximately 75%, thanks to progress in both surgical techniques and postoperative medical treatment. Biliary complications are one of the commonest causes of failure and their prompt identification is difficult due to their insidious clinical pattern and to the poor predictive value of a negative US examination. To date, invasive contrast cholangiography (endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography) may be the only way to identify anatomic abnormalities and it is therefore a necessary examination when biliary obstruction is suspected. The aim of our work was to assess the possible role of MR cholangiography in late biliary complications of liver transplanted patients. MATERIAL AND METHODS: Twenty-three liver transplant recipients (11 men and 12 women, mean age: 51.1 years) were submitted to MR cholanglography using non-breath-hold, fat-suppressed three-dimensional turbo spin echo sequences, (TR = 3000 ms, TE = 700 ms, ETL = 128). Our patients presented with clinical, laboratory and US patterns doubtful for biliary obstruction. The diagnostic confirmation was obtained at percutaneous transhepatic cholangiography (four cases), endoscopic retrograde cholangiography (eight cases), T-tube cholangiography (one case) or clinical follow-up (ten cases). RESULTS: No biliary tract abnormalities were detected at MR cholangiography in 11 cases. Twelve strictures were diagnosed in eleven patients (9 anastomotic, two nonanastomotic/intrahepatic and one nonanastomotic/extrahepatic, with associated anastomotic and nonanastomotic strictures in two cases). MR cholangiography correctly defined the stricture site and the dilation of the bile ducts above in all cases, with optimal correlation with contrast cholangiographic findings. The common bile duct below the stricture was visible in 9 of 10 patients with extrahepatic strictures on MR cholangiography and in 8 of 10 patients on contrast cholangiograms. The distal common bile duct was missed on both MR cholangiography and diagnostic percutaneous transhepatic cholangiography in a patient only. The strictures were correctly graded in 8 of 10 patients, with two cases of overestimation. Other findings were a 1-cm stone proximal to the obstructed common bile duct, multiple intrahepatic stones in another case and common bile duct kinking at the anastomosis. CONCLUSIONS: MR cholangiography is a useful imaging method in the follow-up of liver transplant recipients which can assess the biliary obstruction and therefore permit to limit the use of invasive procedure only for interventional purposes.
Biliary Tract Diseases↗