Search PubMed⌕ Search

Biomedical subjects

A Mussi

Publications and source records attributed to A Mussi.

At least 109 records · Page 6Linked to original sources
PubMed1986

Cellular and humoral factors in borderline hypertension.

In this article, we review the data about Na+ and K+ lymphocyte content in young subjects with borderline hypertension. These data indicate that many borderline subjects have an abnormally high lymphocyte Na+ content (Nai) and that their pressor response to stress and exercise is directly related to Nai. Lymphocyte K+ content (Ki) is increased in about 50% of borderline subjects. Subjects in whom Ki is high, in comparison with those having a normal Ki, have a lower Nai and lower diastolic blood pressure. This suggests that these subjects have an activation of some compensatory mechanism, possibly an increase in sodium pump function. A humoral factor causing an increase in Nai was detected not only in the plasma from essential hypertensives, but also in the plasma from borderline subjects and from normal subjects with familial hypertension having high Nai. This indirect evidence of a plasma factor impairing Na+ transport was confirmed by direct measurements of the plasma ability to inhibit Na+/K+ adenosine triphosphate. Moderate short-term dietary salt restriction reduces Nai and, proportionally, pressor response to stress. In the long-term, resting blood pressure is also reduced. Dietary K+ supplementation reduces pressor response to handgrip but not resting blood pressure. Intralymphocytic Na+ content is a good predictor of future sustained hypertension, since subjects with normal Nai do not develop hypertension within 5 years, whereas subjects with high Nai develop hypertension in 31% of cases. These subjects also have an altered pressor response to mental stress and do not respond to the low-salt diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibody Formation↗
PubMed1986

Predictors of stable hypertension in young borderline subjects: a five-year follow-up study.

Forty-four young subjects with borderline hypertension underwent a 5-year follow-up. At the first examination their intralymphocytic Na+ (Nai) was measured before and after 1 month of a low-salt diet. Blood pressure and heart rate were recorded at rest (baseline), during mental arithmetic, and after the test (recovery). After 5 years, no subject with normal Nai developed hypertension, and, furthermore, subjects with normal Nai had no increase in blood pressure values. Thirty-one percent of subjects with high Nai developed hypertension. Subjects developing hypertension were characterized by a high pressor response to mental stress and by an increase in recovery diastolic blood pressure in comparison with baseline diastolic blood pressure. Sixty percent of the subjects whose recovery diastolic blood pressure was at least 6% higher than baseline developed hypertension. Eighty percent of subjects whose Nai was not reduced after the diet became hypertensive. Nai and diastolic blood pressure were unrelated at the first examination; however, a significant correlation was found between Nai recorded at first examination and diastolic blood pressure recorded after 5 years. It is concluded that Nai is a good predictor of future blood pressure in borderline subjects and that subjects with normal Nai have a very low risk of developing high blood pressure.

Adult↗
PubMed1986

Influence of captopril on intracellular ions--a possible mode of action.

The effects on intra- and extracellular Na+ and K+ (Nai, Ki; Nae, Ke) of 2 months treatment with captopril or hydrochlorothiazide given alone or in combination were assessed in 47 hypertensive patients. Before therapy, diastolic blood pressure was directly related to Nai and to Nai/Ki and inversely to Ki. The correlation coefficient was even higher when Ki/Ke was considered instead of Ki alone. Treatment with captopril induced a decrease in Nai, no change in Ke and an increase in Ki and Ki/Ke. Hydrochlorothiazide induced a decrease in Nai, in Ke and in Ki but an increase in Ki/Ke. The Nai decrease was maximal in patients receiving the combination of captopril and hydrochlorothiazide. In these subjects Ke was not reduced and Ki was still increased. The percent reduction in diastolic blood pressure induced by captopril was significantly related to the percent increase in Ki/Ke whereas the reduction induced by hydrochlorothiazide was best related to the decrease in Nai/Nae. These data suggest that blood pressure is related to the Ki/Ke ratio and that any increase in this ratio could produce a fall in blood pressure. This phenomenon can be explained by the Ki/Ke ratio being an important factor in determining membrane potential and thus arterial smooth muscle tone.

Adult↗
PubMed1985

Surgical treatment of primary lung cancer and solitary brain metastasis.

Twenty patients with carcinoma of the lung and a brain metastasis have undergone combined lung and brain surgery, which was synchronous in five. There were no operative deaths. Survival from the first surgical intervention was less than one year (3-10 months) in four patients (20%), one to two years in four (20%) and more than two years (26-66 months) in five patients (25%). Seven patients (35%) are alive and well after an average period of three years and three months (15-66 months). Actuarial survival at five years is 33.6%. All patients had severe neurological symptoms and 18 (90%) had a complete remission. Our experience and data reported in the literature point to the effectiveness of combined lung and brain surgery in prolonging symptom free survival in patients with lung cancer and solitary brain metastasis.

Adult↗
PubMed1985

Comparison of two automatic devices and the standard mercury sphygmomanometer in hypertensive patients.

The standard mercury sphygmomanometer (SMS) and two automatic blood pressure recording devices, Dinamap 845 (D) and Sentron (S), were compared by means of a randomized 3-period cross-over experiment. Both devices recorded diastolic BP lower than SMS, on average and for most individual patients. Systolic BP was similar for SMS and S, and slightly lower for D, with variations for individual patients. A second study failed to detect effects of the physician's presence when BP was measured, whereas the difference between D and SMS was substantially confirmed.

Blood Pressure↗
PubMed1985

Modifications of intra- and extracellular sodium and potassium. A possible mechanism for the antihypertensive action of captopril and hydrochlorothiazide.

Forty-four essential hypertensive patients were studied during placebo and after 2 months of the following treatments: hydrochlorothiazide 25 mg once daily (group 1); captopril 50 mg twice daily (group 2); hydrochlorothiazide + captopril (group 3). Blood pressure, serum sodium and potassium (Nae, Ke) and intralymphocytic sodium and potassium (Nai, Ki) were measured before and after treatment. During placebo, diastolic blood pressure was directly related to Nai (r = -0.84) and inversely related to Ki (r = -0.81). The correlation was even greater when the Ki:Ke ratio was considered instead of Ki alone (r = -0.91). Hydrochlorothiazide reduced Nai, Ke and Ki. Captopril induced a decrease in Nai, an increase in Ki and no change in Nae or Ke. The association of the two drugs caused a reduction in Nae and Nai and an increase in Ki. All three treatments caused an increase in Ki:Ke ratio which was proportional to the decrease in the blood pressure. While the antihypertensive effect of hydrochlorothiazide seems to be more related to Nai:Nae reduction, the effect of captopril seems to be more related to the increase in Ki:Ke ratio. The results of our study suggest that hyperpolarization of arterial smooth muscle cells, induced by a Ki:Ke ratio increase, along with a reduction in Nai:Nae, might play a role in the antihypertensive effect of captopril and hydrochlorothiazide.

Adult↗
PubMed1985

Antihypertensive efficacy of two low dosages of hydrochlorothiazide in patients treated with captopril.

Twelve patients with essential hypertension (diastolic blood pressure, greater than 90 mmHg) after four weeks of treatment with captopril (50 mg BID) were randomly divided into two groups and treated with 12.5 mg and 25 mg of hydrochlorothiazide OD, in addition to captopril, in a crossover experimental design. Each dosage of hydrochlorothiazide was given for four weeks, with a two-week placebo washout period intervening. Both dosages of hydrochlorothiazide caused significant reductions in blood pressure. Eighty percent of patients achieved a diastolic blood pressure less than 90 mmHg during combination therapy, independent of the dose of diuretic. None of the patients reported significant side effects, and no changes were observed in routine biochemical analysis during treatment. In patients not completely controlled by captopril alone, a once-daily dosage of 12.5 mg of hydrochlorothiazide proved as effective as a 25-mg once-daily dosage. The smaller dosage could result in fewer unwanted metabolic effects induced by diuretic administration.

Adult↗
PubMed1984

Results of en bloc resections for lung cancer.

The results of en bloc resection carried out in 33 patients with lung cancer involving the chest wall are described. Microscopic examination of the lung specimen revealed large cell anaplastic carcinoma in 14 cases, squamous carcinoma in 10, adenocarcinoma in 5, microcytoma and fibrosarcoma in 2 cases respectively. The 5 year survival, calculated according to the actuarial method, was 32%, only slightly lower than the 5 year overall survival observed in our survey. The long-term prognosis was essentially related to the presence of lymph node metastases, which were found to occur at a late stage of the clinical evolution.

Actuarial Analysis↗
PubMed1980

[Association of secondary short esophagus and adenocarcinoma of the esophagogastric junction].

The case of a 39-yr-old male with adenocarcinoma which arose on short oesophagus secondary to congenital hiatal hernia is reported. The patient was treated by oesophagogastric resection and intrathoracic anastomosis. After a short analysis of the literature, the infrequent incidence of hiatal hernia and the rarity of secondary short oesophagus are considered and the association in question is attributed to chance.

Adenocarcinoma↗
PubMedDate not supplied

Comparison of three devices for measuring blood pressure.

Blood pressure measurement with two automatic devices, Dinamap 845 and Sentry, was compared with the standard mercury sphygmomanometer, by means of a 3-period crossover experiment. Both automatic devices read diastolic pressure considerably lower than the mercury sphygmomanometer (about 7 mmHg on average); agreement was better for systolic pressure. Device differences in individual patients were often much higher. To assess the patient's emotional pressor response during manual measurement, Dinamap was used to monitor blood pressure before, during and after measurement with the mercury sphygmomanometer. No rise in pressure was found. It is concluded that the three devices can often give different values, and that the physician's involvement cannot explain these differences.

Blood Pressure↗
PubMedDate not supplied

Spontaneous release of leukemia inhibitory factor and oncostatin-M is increased in supernatants of short-term organ cultures from lesional psoriatic skin.

Several cytokines are increased in psoriatic skin, mainly at the lesional level. Some of these mediators seem to be very important in the pathogenesis of psoriasis since they are thought to stimulate keratinocyte proliferation and/or to drive the inflammatory changes associated with psoriasis. Among the proinflammatory modulators, hematopoietins, which are a family of cytokines sharing a receptor component (the gp130 subunit), have been under intensive investigation in recent years. The hematopoietin family includes interleukin-6 (IL-6), interleukin-11 (IL-11,) leukemia inhibitory factor (LIF), oncostatin-M (OSM), granulocyte colony-stimulating factor (G-CSF), ciliary neurotrophic factor (CNTF) and cardiotrophin. Amounts of two of these molecules, IL-6 and IL-11, have been found to be increased in psoriatic lesions. The present study adds new information concerning the spontaneous release of two hematopoietins, namely LIF and OSM, in 48-h culture supernatants of lesional and nonlesional skin punch biopsies from psoriatic patients and normal subjects. The cytokine determinations were performed using commercially available ELISA kits. The results are expressed as picograms per milligram of tissue, after weight normalization. The levels of LIF released by lesional skin (median 2.4 pg/mg, range 0.05-13.4 pg/mg) were significantly higher than from nonlesional (median 0.4 pg/mg, range under detection limit (UDL)-4.4 pg/mg; P = 0.001) and normal skin (median 0.4 pg/mg, range UDL-0.9 pg/mg; P = 0.005). The OSM levels were also significantly higher in supernatants of lesional skin (median 0.9 pg/mg, range 0.4-5.2 pg/mg) than in supernatants of nonlesional (median 0.2 pg/mg, range UDL-0.8 pg/mg; P = 0.001) and normal skin (median 0.1 pg/mg, range UDL-0.4 pg/mg; P = 0.0001). In addition, interleukin-8 (IL-8), a cytokine involved in the pathomechanisms of psoriasis, showed a similar behaviour when measured in the same samples. Lesional skin showed a median value of 752.5 pg/mg, range 98.8-2063.8 pg/mg, nonlesional skin a median value of 58.3 pg/mg, range UDL-1252.5 pg/mg (P = 0.007) and normal skin a median value of 44.6 pg/mg, range UDL-176.7 pg/mg (P = 0.004). No significant differences were found between nonlesional and normal skin for the three molecules analyzed. Taken together with the fact that at least two other hematopoietins (namely IL-6 and IL-11) are also increased in supernatants of lesional psoriatic skin, these data point to a possible involvement of the hematopoietins in inflammatory processes associated with psoriasis.

Adult↗
PubMedDate not supplied

Influence of bulla volume on postbullectomy outcome.

OBJECTIVE: To quantify the contribution of the resected volume and the presence of associated, functionally significant emphysema to the postoperative improvement of pulmonary function after resection of giant lung bullae. DESIGN: Patients undergoing elective surgery for giant bullae who had had complete pulmonary function and radiographic studies performed were reviewed retrospectively. SETTING: All 25 patients underwent surgery at the thoracic surgery unit of the University of Pisa, Pisa, Italy. METHODS: Pulmonary function was assessed before and 12 months after surgery. On the chest radiograph, the location of bullae, and the signs of compression and emphysema were evaluated. The radiographic total lung capacity (TLC(x-ray)) and the volume of bullae were measured according to the ellipse method. Postoperatively, functional and radiographic changes were analyzed. The percentage change in forced expiratory volume in 1 s (Delta FEV(1)%) after surgery was the main outcome measure. The influence of factors related to emphysema and bulla volume on the functional improvement postbullectomy was assessed by stepwise multiple regression. RESULTS: Before surgery, the TLC(x-ray) overestimated the TLC measured by nitrogen washout, with a mean difference between the two measurements of 1.095 L. A close relationship was found between the TLC(x-ray) and the plethysmographic TLC (n=6; r=0.95). After surgery, dyspnea lessened (P<0.05) and FEV(1) increased (P<0.01). Statistically, the radiographic bulla volume was the single most important factor determining the Delta FEV(1)% (r=0.80, P<0.0001). CONCLUSIONS: These findings suggest that the preoperative size of bullae is the most important contributor to the improvement in ventilatory capacity after bullectomy, and that it is possible to predict the expected increase of postoperative FEV(1) from preoperative bulla volume.

Adolescent↗
PubMedDate not supplied

Modulation of neoangiogenesis in bronchial preneoplastic lesions.

We have previously demonstrated that vascular count significantly increases in the preneoplastic lesions of the bronchial tree, starting from very low levels in the normal epithelium to a significantly higher number of microvessels in moderate dysplastic lesions and in situ carcinomas. Vascular endothelial growth factor (VEGF) protein expression has shown to be strictly associated with neovascularization both in human cancer and in various type of preinvasive lesions. A number of studies have demonstrated that mutant p53 is involved in the regulation of angiogenesis, and immunohistochemical detection of the p53 protein is associated with p53 gene mutations. In this study we looked for possible correlation between p53 protein detection, VEGF expression and vascular count in a series of preneoplastic and neoplastic lesions of the bronchial tree in order to investigate the angiogenic pattern and its genetic control in the early steps of bronchial cancer development. Twenty-four retrospective bronchial lesions with different grades of dysplasia and a case of normal bronchial epithelium were analysed. Surgical specimens removed from patients either confirmed, or suspect for lung carcinoma were stained immunohistochemically for CD34, VEGF, and p53. There were significant increases in microvascular density (MVD), VEGF, and p53 expression from normal bronchial epithelium through moderate dysplasia to in situ carcinoma to invasive cancer and these factors were significantly associated with moderate dysplastic lesions. A statistically significant difference was observed in MVD between hyperplastic-metaplastic, moderate dysplastic lesions and in situ carcinoma. A similar pattern was also observed for VEGF and p53 protein expression but no significant difference was observed between moderate dysplastic lesions and in situ carcinoma with regard to VEGF protein expression. The association between MVD, VEGF expression, p53 mutations and preinvasive lesions of the bronchial tree suggests that neoangiogenesis is early in non-small cell lung cancer (NSCLC) development and that p53 may have an important role in promoting angiogenesis in this human model of carcinogenesis.

Bronchi↗
PubMedDate not supplied

Mediastinal goitres: when the transthoracic approach?

The correct surgical approach to mediastinal goitre is not always well defined. We reviewed why and when our patients required a transthoracic approach. From 1979 to 1998, on 7.480 patients who underwent thyroid surgery in our hospital, 374 (5%) had a goitre whose greater bulk was inferior to the thoracic inlet; 43 patients of these last ones (11%) required a transthoracic approach. General anaesthesia was performed in all patients and orotracheal intubation was selective in 11 cases (double lumen tube of Carlens). In 34 cases, the first approach was a cervicotomy, followed by sternotomy in 23 cases or right posterolateral thoracotomy in 11 cases. Three patients underwent a sternotomy and 6 a thoracotomy only. We had neither perioperative mortality nor major complications. The mean hospital stay was 5 days. Mean goitre weight was 430 g and on average the greater diameter was 13 centimetres. The removal of a substernal goitre can be difficult and risky via the cervicotomy only. A transthoracic approach is often required in the case of greater secondary, primary and recurrent mediastinal goitres.

Adult↗
PubMedDate not supplied

Intrapleural BCG in postsurgical stage I non-small cell lung cancer.

In a randomized trial comparing intrapleural bacillus Calmette-Guérin (BCG) with placebo in postsurgical stage I non-small cell lung cancer, BCG-treated patients (n = 17) showed a non-significant overall improvement of 5-year and median survival and disease-free interval, but an increased rate of recurrence of cancer compared with control patients (n = 17).

Adjuvants, Immunologic↗