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Biomedical subjects

A Pierangeli

Publications and source records attributed to A Pierangeli.

At least 73 records · Page 4Linked to original sources
PubMed1987

Antigenic and biochemical characterization of poliovirus type 2 isolated from two cases of paralytic disease.

Three isolates of poliovirus type 2 were obtained from rectal and pharyngeal swabs of two patients with paralytic poliomyelitis from Southern Italy (1981/1983). Neither one of the patients had received oral poliovirus vaccine, although a systematic vaccination campaign is conducted in the area. Neutralization tests with strain-specific antisera and analysis of the structural proteins by SDS-PAGE indicated that the three isolates were typical Sabin-like poliovirus type 2. Moreover, neutralization assays by means of a panel of well-characterized monoclonal antibodies indicated that the three isolates carried an antigenic mosaic where both wild-type and Sabin-specific epitopes were represented. The T1 fingerprints of the RNA of the three isolates diverged slightly from the standard Sabin reference map. A comparison of the oligonucleotide fingerprints of the viruses isolated from the pharynx and the feces of one patient indicated that mutations appeared as early as during replication in the intestinal tract.

Antibodies, Monoclonal↗
PubMed1987

[Supravalvular aortic stenosis. Analysis of a surgical series of 8 patients].

Supravalvular aortic stenosis (SAS) is an unusual form of progressive left ventricular outflow tract (LVOT) obstruction, frequently associated with others vascular and physical anomalies. Between July 1980 and July 1986 eight such patients have been operated upon. In seven patients patch aortoplasty (according to McGoon or Doty technique) relieved the stenosis; in one, a two years old boy, with associated severe hypoplasia of the ascending aorta and aortic arch, a left ventricle (LV) - abdominal aorta valved conduit was associated to aortoplasty. One patient died in the operating room with a severe anterior myocardial infarction; seven patients are in good clinical condition at a mean follow-up of 32 months. The aortic supravalvular gradient was dramatically reduced in all patients according with Doppler echocardiography. In our mind, patients with SAS would benefit from an early surgical repair, because of progressive involvement of the aortic valve, coronary arteries and LV. The surgical technique is strictly related to the anatomical situations. Per and postoperative management should rely on the pathophysiology peculiar to this malformation (especially about coronary perfusion). Taking care to these points, the surgical results at a mid term follow-up are now very satisfactory in this cardiac malformation.

Adolescent↗
PubMed1987

[Atrial fibrillation in patients after aortocoronary bypass. Correlation with electrophysiologic properties evaluated intraoperatively].

An electrophysiologic study (EPS) has been performed before and after cardioplegia in 50 patients (pts) who underwent a coronary by-pass graft intervention (CBPG) in order to investigate the possible mechanism explaining the frequent episodes of paroxysmal atrial fibrillation (PAF) complicating the early follow-up and the possible role of the type of caval cannulation. Twenty-five pts underwent a separate caval cannulation and twenty-five only cannulation of the inferior vena cava. EPS has been performed before (34 degrees C) and after cardioplegia (37 degrees C). PAF complicated the 15 days early follow-up of 32% of the pts; 24% of the pts operated with 1 cannula and 40% of the operated with 2 cannulae respectively (N.S.). The pts with AF had an high percentage of splitting of the atrial signals during atrial premature stimulation (77% vs 5%, p less than 0.002) and a significant dispersion of the conduction times between high and low right atrium (36 +/- 21 vs vs 11 +/- 14 msec, p less than 0.002). In conclusion PAF has an high incidence in the early follow-up of CABG operation and occurs independently of the type of caval cannulation. The presence of a major dispersion of intra right atrial conduction together with an high incidence of fractionizing potentials already before cardioplegia in the pts with AF suggests that the atria with intrinsic conduction delays can be per se predisposed to develop atrial tachyarrhythmias during the early follow-up.

Atrial Fibrillation↗
PubMed1987

[Transposition of the great vessels with interventricular defect and stenosis of the left ventricular efflux channel: anatomical correction by the intraventricular repair technic].

New technique of anatomical correction of transposition of the great arteries (TGV) with ventricular septal defect (VSD) and pulmonary stenosis (PS) without using a prosthetic conduit was reported by Lecompte in 1982. We analyse our recent experience with this procedure in three patients and we describe the main advantages and the wide surgical indications with reference to the Rastelli procedure.

Abnormalities, Multiple↗
PubMed1986

The use of absorbable suture: morphological findings in a newborn three months after coarctation repair.

The macroscopic and histological findings in a case of surgical repair of aortic coarctation in a newborn, performed using polydioxanone, a monofilament absorbable suture material, are reported. The persistence of suture material three months after surgery, the lack of severe inflammatory changes, calcification and elastic disruption of the arterial wall, confirm previous experimental data. For these characteristics, the use of polydioxanone in the repair of aortic coarctation in newborns is suggested, in order to avoid recoarctation, the most frequent complication of this surgical therapy.

Absorption↗
PubMed1985

[Aortic coarctation with hypoplasia of the arch: description of a new surgical technic].

The aortic coarctation is frequently associated with aortic arch tubular hypoplasia, especially in early infancy. The treatment in one time of both lesions is mandatory in these cases. We propose therefore a new surgical technique: after resection of the isthmic coarctation and appropriate cutting of both ends, the anastomosis is widely extended in the concavity of transverse aortic arch, beyond the hypoplastic region. We discuss the advantages of this technique over the classic end-to-end anastomosis, patch graft and subclavian flap angioplasty.

Aorta, Thoracic↗
PubMed1985

[Clinical and hemodynamic results after aneurysmectomy and coronary revascularization].

To assess the effects of left ventricular aneurysmectomy (l.v.a.) on left ventricular function (l.v.f.), a prospective clinical and hemodynamic study has been performed in nineteen patients (pts) operated on from 1979 to 1983. There where no operative deaths and only one late death during follow-up. A significant improvement in NYHA class was observed in 68% of the pts, 16% worsened, and the clinical status in the remaining 16% was unchanged. Hemodynamic data showed an increase in e.f. (33 +/- 12% to 43 +/- 10%; p less than 0.001), a reduction of the percentage of the abnormally contracting left ventricular segments (66 +/- 23% to 57 +/- 23%; p less than 0.05) and no significant changes of left ventricular end diastolic pressure. Revascularization index (nr. of bypassed vessels/nr. of stenotic vessels) and graft patency rate were low (0.57 and 0.72 respectively). No significant relation was noted between clinical and hemodynamic findings in the postoperative study. We conclude that l.v.a. is associated with an improvement of l.v.f. (mainly in e.f. and segmental wall contractility) and of clinical status of the pts but without a direct relation between these two parameters.

Adult↗
PubMed1982

[Importance of metabolic disorders and endocardial viability ratio in the prognosis of open-heart operations. Experimental study of the pig heart protected by potassium cardioplegia in hypothermia].

The aim of this study was to investigate the protective efficacy of potassium cardioplegia in general moderate hypothermia, in five pigs, after 90 minutes of myocardial ischemia induced by extracorporeal circulation (ECC) and aortic clamping. The behaviour of subendocardial supply demand ratio (DPTI/TTI), of CSBF (coronary sinus blood flow) and numerous hemodynamic parameters was evaluated in addition to lactate myocardial metabolism changes, at rest, after 90 minutes of total ECC and during a 60 minutes reperfusion period. The reperfusion period included two phases: during the first (15-20 minutes) the animals were in ECC with unclamped aorta; spontaneous circulation was instituted during the second one (40 minutes). A marked increase in CSBF was observed at aortic clamp removal during the first phase (post ischemic reactive hyperemia). Coronary sinus lactate release was also noted, probably due to wash-out of previously sequestered acid metabolites during aortic clamping (90 minutes). At the onset of the second phase a depressed left ventricular performance and low DPTI/TTI values were shown. A rapid return (20 minutes) to normal values of this parameter was then noted. DPTI/TTI normalization results strictly correlated to the progressive improvement in myocardial performance. Hypothermic potassium cardioplegia seems therefore to prevent the irreversible myocardial damage and favour a fast recovery of cardiac function.

Animals↗