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Biomedical subjects

A Pacifico

Publications and source records attributed to A Pacifico.

85 records · Page 5Linked to original sources

Measurement of cardiac output without right heart catheterization: reliability, advantages, and limitations of a left-sided indicator dilution technique.

This study was done to determine the accuracy and reliability of cardiac output measurements by the injection of indocyanine green into the left ventricle, with simultaneous sampling from a systemic artery. In 40 patients (18 men, 22 women, aged 34 to 74 years), cardiac output was measured in close temporal proximity by (a) standard indicator dilution (right atrium-to-pulmonary artery thermodilution in 11, pulmonary artery-to-systemic artery indocyanine green in 29) and (b) left ventricle-to-systemic artery indocyanine green. There was excellent agreement between the two techniques (r = 0.98, SEE = 0.12 liters/minute). In 28 of the patients, cardiac output also was measured by ascending aorta-to-systemic artery indocyanine green. In these individuals, this technique yielded results that were disparate from those obtained by standard indicator dilution (difference between standard indicator dilution and left ventricle-to-systemic artery indocyanine green = 0.18 +/- 0.13 [mean +/- SD] liters/minute; difference between standard indicator dilution and ascending aorta-to-systemic artery indocyanine green = 0.72 +/- 0.55 liters/minute; p less than 0.001), and in 22 of the 28, the ascending aorta-to-systemic artery indocyanine green cardiac outputs were greater than those obtained by standard indicator dilution. Thus, cardiac output can be measured accurately by injecting indocyanine green into the left ventricle, with simultaneous sampling from a systemic artery, but it cannot be quantified reliably by introducing indicator into the ascending aorta. The left ventricle-to-systemic artery indocyanine green technique can be used in patients undergoing only left heart catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Plasma lipids and lipoproteins pattern in beta-thalassemia major.

We studied serum lipids and lipoproteins in 20 patients with beta-thalassemia major, under high transfusion programme and regular chelation therapy, and in 20 control subjects. Total cholesterol, HDL-cholesterol, HDL2-and HDL3-cholesterol, apolipoprotein A and B levels were significantly lower in patients with Cooley's anemia, whereas free cholesterol, triglycerides and the HDL-/HDL3-cholesterol ratio did not differ in the two groups. We think that liver damage plays an important role in determining the altered lipoprotein pattern in beta-thalassemia major. However, other factors may contribute to cause such lipid changes.

Adolescent↗

[Changes in HDL subfractions in patients with type I diabetes mellitus before and after metabolic control].

In order to further investigate the behaviour of high density lipoproteins in diabetes mellitus, we studied HDL subclasses, HDL2 and HDL3, in 10 patients with newly detected, untreated insulin-deficient diabetes before starting insulin treatment and after getting a good metabolic control. We used the extractive method of Abell to determine HDL-cholesterol after LDL and VLDL precipitation with polyanions and HDL3-cholesterol after HDL2 precipitation with dextransulphate 15,000 m.w. After insulin therapy, we observed a significant increase in HDL-cholesterol and a decrease in serum triglycerides. Only HDL2-cholesterol, but not HDL3-cholesterol, raised; moreover, we found a significant inverse relationship between HDL-cholesterol (and also HDL2-cholesterol) and triglycerides. So, we think that an increase of lipoprotein lipase activity, owing to insulin treatment, could account for our results.

Adolescent↗

[Post-heparin lipase activity in beta-thalassemia major: preliminary data].

We studied serum lipids and post-heparin triglyceride lipase activities in 8 patients with Beta-Thalassaemia Major, under high transfusion programme and regular chelation therapy and in 8 control subjects. Total cholesterol and HDL-cholesterol were significantly lower in patients with Cooley's anaemia, whereas triglyceride levels did not differ in the two groups. Post-heparin triglyceride lipase activities were determined according with the method of Krauss et A1. using glyceryl-tri-(1-14C)oleate as substrate and NaCl to inactivate the extrahepatic lipase. These enzymatic activities (both hepatic and extrahepatic) resulted significantly lower in thalassaemic patients. We suppose that the decreased levels of these enzymatic activities could play a role in determining the decrease of HDL-cholesterol that we observed in our thalassaemic patients.

Adolescent↗

[HDL2 and HDL3 cholesterol in hepatic cirrhosis].

In order to further investigate plasma lipoproteins abnormalities secondary to serious liver damage, we studied plasma lipids and lipoproteins, and in particular HDL subfractions (HDL2, HDL3), in 12 patients with cirrhosis of the liver and in 12 sex, age and weight matched healthy volunteers. Enzymatic methods were used to determine total cholesterol and triglycerides, while the extractive method of Abell et al. was used for the determination of HDL-cholesterol levels after LDL and VLDL precipitation with polyanions (MnCl2 and Na-heparin) and of HDL3-cholesterol values after HDL2 precipitation with dextran-sulphate 15,000 m.w. Total cholesterol and HDL-cholesterol levels were significantly lower in cirrhotic patients compared to normal subjects. We must emphasize that only HDL3-cholesterol was decreased in cirrhotics, whereas HDL2-cholesterol values were normal or high. We suggest that a diminished activity of hepatic triglyceride lipase might account for the decrease in HDL3-cholesterol in liver cirrhosis.

Aged↗

Cholinergic receptor control mechanisms for L-dopa, apomorphine, and clonidine-induced growth hormone secretion in man.

The effect of pirenzepine, an anticholinergic agent, on GH release induced by L-dopa (500 mg po), apomorphine (0.75 mg sc), and clonidine (0.150 mg iv) administration was studied in a group of normal men. Pirenzepine, a cholinergic muscarinic antagonist, completely blocked the GH rise induced by dopamine- and adreno-receptor stimulation. In contrast, the PRL-inhibiting action of L-dopa was not modified by the cholinergic antagonist. The data suggest that acetylcholine and its receptors are important regulators of the neurosecretory mechanisms that control GH secretion in man.

Adult↗

Participation of cholinergic muscarinic receptors in glucagon- and arginine-mediated growth hormone secretion in man.

To investigate the participation of cholinergic receptors in glucagon- and arginine-induced GH and PRL secretion, glucagon (1 mg, sc) and arginine (30 mg over 30 min) were administered to a group of normal subjects. On a different occasion, both tests were repeated after premedication with 40 mg pirenzepine, a muscarinic blocker, given iv 5 min before the test substances. Pirenzepine completely suppressed the glucagon- and arginine-induced GH rise in all subjects. The PRL response to arginine was not altered by pirenzepine. The results suggest that cholinergic muscarinic receptors regulate the GH response to glucagon and arginine in man.

Adult↗

T cell hybrids with arsonate specificity. I. Initial characterization of antigen-specific T cell products that bear a cross-reactive idiotype and determinants encoded by the murine major histocompatibility complex.

T cell hybrids have been constructed between the BW5147 thymoma cell line and A/J splenocytes from mice suppressed with the p-azophenylarsonte hapten. Three independently derived cloned lines have been chracterized. Each secretes or sheds a 62,000-dalton antigen-specific product bound by rabbit antisera directed against the arsonate cross-reactive idiotype. In addition, each of the antien-specific molecules contains determinants encoded within the I region of the murine major histocompatibility complex. Peptide mapping analysis indictes that, whereas these molecules are remarkably similar, each is individually distinct in primary structure. The availability of cloned T cell lines that produce antigen-specific idiotype-positive I region-containing products should facilitate a more thorough dissection of the interrelationships of T-B interctions in the arsonate idiotypic system.

Animals↗

Study of A- and B-cell function in beta-thalassemia major.

Hepatic and pancreatic damage owing to iron overload is often present in patients with beta-thalassemia major. In order to investigate B-cell function and hepatic insulin clearance in these patients, under a high transfusion program and regular chelation therapy, we studied the glucose (BG), insulin (IRI) and C-peptide (CPR) response and the CPR/IRI ratio after OGTT in 27 patients with Cooley's anemia and in 10 sex- age- and weight-matched healthy subjects; we also studied BG and IRI levels after IVGTT in 9 beta-thalassemic patients and in 9 control subjects. Furthermore, BG, CPR, IRI and glucagon (IRG) response to arginine infusion were evaluated in 5 thalassemic patients with normal OGTT and in 5 age-, sex- and weight-matched normal children, in order to assess pancreatic A-cell function, too. OGTT and IVGTT were normal in the patients with beta-thalassemia major. Plasma IRI level 30 min after an oral glucose load and the insulinogenic index for cumulative intervals were significantly lower in thalassemics after OGTT, whereas the insulin response and insulinogenic index were normal following i.v. glucose. No significant difference was observed for the CPR/IRI ratio during OGTT between thalassemics and normal subjects. Finally, BG, CPR, IRI and IRG levels were similar in the thalassemic patients and in healthy children both fasting and following arginine infusion. Our data suggest that patients with beta-thalassemia major, under a high transfusion program and regular chelation therapy, may have normal glucose tolerance and normal hepatic insulin clearance in spite of iron overload in pancreas and liver. Insulin response to oral glucose was lower than the one to IVGTT, probably because of diminished secretion of the gastrointestinal hormones which stimulate insulin release.

Adolescent↗