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Biomedical subjects

A Stella

Publications and source records attributed to A Stella.

At least 127 records · Page 7Linked to original sources

Traumatic dissection in an inflammatory aneurysm.

Primary dissections of the abdominal aorta are rare (0.4-4% of aortic dissections) and in most cases are traumatic (accidental or iatrogenic) in origin. The authors describe a case of iatrogenic dissection of the abdominal aorta following arteriography. The macroscopic and histological appearance of the aortic wall was compatible with an inflammatory aneurysm. In this type of aneurysm and in the presence of aortoiliac atherosclerosis, aortic catheterization carries a risk of aortic wall dissection.

Aortic Dissection↗

Interactions between the sympathetic nervous system and atrial natriuretic factor in the control of renal functions.

We studied neural influences on the renal actions of atrial peptides in anaesthetized cats by comparing the response to atrial natriuretic factor (ANF) infusion in the innervated kidney and in the contralateral surgically denervated kidney. During ANF infusion arterial pressure decreased, the heart rate did not change and blood flow to both kidneys increased slightly. Vascular conductances became slightly but significantly higher in the denervated kidneys than in the controls. In both kidneys, the glomerular filtration rate increased transiently and significantly. Inhibition of renin release was more prompt and larger in the innervated than in the denervated kidneys. ANF infusion caused a significant increase in sodium and water excretion from both the innervated and denervated kidneys. However, the diuretic and natriuretic effect in the innervated kidneys, although proportionally greater than that in the denervated kidneys, was of shorter duration and subsided after 20 min of ANF infusion. Efferent renal nerve activity did not change during the initial 10 min of ANF infusion but thereafter increased progressively and significantly. We conclude that the effects of atrial peptides on renin release and excretory functions are influenced by renal nerve activity.

Animals↗

Cancer family syndrome: cytogenetic investigations, in vitro tetraploidy, and biomarker studies in a large family.

Fifty-five members of a family with the cancer family syndrome (CFS) were investigated for the following potential biomarkers for cancer proneness: (1) cytogenetics of peripheral blood lymphocytes and skin fibroblasts; (2) in vitro tetraploidy of dermal fibroblast monolayer cultures; (3) quantitative serum immunoglobulin determinations; (4) study of genetic linkage with respect to eight blood group markers including Kidd. Biological specimens were obtained from 14 patients affected with cancer, 21 subjects at risk, and 20 healthy subjects. None of the markers tested in this family, in order to identify a biomarker for the status of CFS gene carrier, was found to be useful. Our search for linkage to other biological markers (DNA RFLPs and NK cells) is in progress.

Adult↗

Depressed level of natural killer cells in cancer family syndrome.

Individuals from kindred with cancer family syndrome (CFS) have an increased genetic risk for the development of adenocarcinoma of the colon as well as of several other organs. Previous studies have suggested that this high occurrence of adenocarcinoma in this as in other hereditary neoplastic syndromes may be correlated to an underlying abnormality in immunological tumor surveillance. In attempt to define a marker that might identify individuals within CFS kindred at risk of developing cancer, we determined natural killer (NK) cell number and NK cell function in affected and healthy members of a CFS family. We studied 13 cancer-affected patients, 20 unaffected but "at-risk" subjects, 20 healthy subjects and 26 normal individuals matched to the patients with colon cancer on the basis of sex and age. We determined the number of NK cells and their function concurrently, using a monoclonal antibody and a 51Cr-release assay with K562 as target cells. We found that the number of NK cells was significantly (P = 0.00004) reduced in cancer patients as compared with healthy subjects and normal controls. Of the 20 at-risk individuals 9 had levels lower than the norm, while 11 showed normal-values. Consequently, the mean percentage of NK cells of this group does not differ either from that of normal subjects or from that of cancer patients. Mean NK cell function was lower in cancer patients than in healthy members of the CFS family but the differences were not statistically significant. Therefore, the mean NK cell function per single cell, expressed as a ratio between cytotoxicity (LU) and the number of NK1-positive cells, resulted paradoxically in an increase when compared with that of normal subjects. The possible mechanisms for this dichotomy were examined.

Adolescent↗

DST in chronic pain patients not suffering from major depression.

The relationship between chronic pain and depression is complex, and nonorganic chronic pain has been hypothesised (at least in some cases) as the expression of an underlying affective disturbance. Postdexamethasone cortisol nonsuppression was assessed in two groups of patients with chronic organic (n = 43) and nonorganic (n = 20) pain, none of them suffering from a major depressive disorder. Non-suppression occurred in 16.3% of the organic group and 20% of the nonorganic one. No difference emerged between the two groups for mean postdexamethasone cortisol values. The DST test results did not suggest the existence of a close relationship between chronic pain and major depressive disorder; however, a wider relationship between chronic pain and affective disturbances, at least in a subgroup of patients, cannot be ruled out.

Adult↗

Neural control of renin release.

Among the major mechanisms controlling the renal release of renin, renal nerves are known to exert a direct stimulating action on juxtaglomerular cells that is mediated by beta-adrenoceptors. Activation of the renal nerves also exerts an important permissive role in order to amplify and possibly accelerate responses to stimuli affecting the vascular and macula densa mechanisms. Reduction of renal perfusion pressure, intravenous infusion of furosemide, and captopril administration cause a greater increase in renin release from innervated kidneys than from denervated kidneys. A complex interaction between neural and non-neural mechanisms in the control of renin secretion is suggested. Efferent renal nerve activity controlling the renin secretion rate is mainly under the inhibitory influence of vagal afferent fibers originating from the cardiopulmonary region. Recent experiments have demonstrated that a similar reflex tonic inhibition of renin secretion is also exerted by renal afferent fibers.

Humans↗

Role of the renal nerves in the natriuretic response to vasopressin infusion.

The present study was designed to determine whether renal nerves influence the natriuretic response to an infusion of vasopressin. Experiments were performed on anaesthetized rats in which the response to vasopressin of the innervated kidney was compared with that of the contralateral surgically denervated kidney. During the vasopressin infusion the natriuretic effect was evident in both kidneys and was proportionally greater in the innervated kidney than in the denervated one. Efferent renal nerve activity, recorded in three additional animals, decreased during the vasopressin infusion. Our data demonstrate that the natriuretic response of the innervated kidney is larger than that of the denervated kidney, probably because of an associated decrease in efferent renal nerve activity.

Animals↗

Angiotensin converting enzyme inhibition and renin release from the kidney.

Experiments were performed in anaesthetized cats, to determine whether renal nerves interfere with the negative feedback action of angiotensin II (Ang II) on renin release. The increase in renin release from the innervated kidney in response to captopril-induced inhibition of Ang II generation was compared with the response of the contralateral denervated kidney. Renin release was measured before (control), and 5, 15 and 30 min after the beginning of captopril infusion (1 mg/kg priming dose followed by 1 mg/kg per h for 30 min intravenously), and 60 min after the end of the infusion. During the captopril treatment renin release from both kidneys increased, but after 15 and 30 min the increase in renin release from the innervated kidneys was significantly larger than that observed in the denervated kidneys. After the captopril infusion was stopped, renin release from both kidneys returned towards control values. These results could not be explained on the basis of the changes in renal haemodynamics, excretory functions and efferent renal nerve activity observed during the captopril infusion. The data suggest that the renal nerves influence the changes in renin release caused by captopril by increasing the sensitivity of juxtaglomerular cells to the negative feedback action of Ang II.

Angiotensin II↗

Traumatic amputation of the upper limb: replantation of the arm.

From 1970 to 1985, 13 patients were treated as a result of an upper limb traumatic sub-amputation. Three of them were younger than 15 years and another one was only 3 years old at the time of the trauma. All the elements involved in the treatment of the lesions are described. When it was possible, an end-to-end anastomosis was used for the repair of arteries and veins. Otherwise, when the loss of tissue was marked, a saphenous vein graft was used. The fracture was treated, when possible, with an intramedullary fixation, surely less traumatizing for soft tissues than a plate. The repair of the nerve was at times simultaneous at other times delayed. The followup has shown a good functional restoration of the limb and of the joints affected by the trauma and a normal development of the patients in terms of age.

Adolescent↗

Electron microscopy of lipid deposits in human atherosclerosis.

The filipin probe associated with tannic acid stain was used to study intra- and extracellular lipids in surgically removed human atherosclerotic lesions (n = 20). In particular, intimal thickenings, fatty streaks and fibrolipidic plaques have been investigated by using mainly transmission and scanning electron microscopy. In the intimal thickenings, the lipid deposits were mainly localized in the subendothelial space as homogeneously sized particles (40-140 nm) and more heterogeneous uni-multilamellar vesicles (35-700 nm). Intermediate lipid forms were also observed. In the fatty streaks, the lipid deposits were intracellular and mainly observed in cells with a monocyte/macrophagic phenotype. Lipid inclusions, lipid lysosomal bodies and intracellular cholesterol crystals very similar to those observed in experimentally induced atherosclerosis were documented. In the fibrolipidic plaque the lipid deposits were found both in the intracellular and in the extracellular compartments. Lipids accumulated within arterial macrophages and smooth muscle cells, usually as lipid droplets. Clusters of lipoprotein-like particles (50 nm in diameter) as well as larger uni-multilamellar lipids (700 nm) with an occasional compound appearance were particularly observed bound to elastic tissue and collagen fibers. These morphological observations outline the complexity of lipid metabolism in the various histological aspects of human atherosclerosis.

Aged↗

Endothelial injury in human atherosclerosis.

A light and electron microscopic investigation (scanning and transmission electron microscopy) was performed on 51 human atherosclerotic carotid lesions. The purpose of this study was to establish whether features of endothelial injury such as those described in animals occur in man and whether these features can be related to specific stages of human atherosclerosis. Irrespective of their histological appearance the atherosclerotic lesions were covered with endothelium which showed non-specific changes in cell shape and size. However, all complicated lesions appeared denuded. Moreover, a peculiar interaction of endothelium with monocytes and lymphocytes as well as blood components (e.g., fibrin and lipoproteins) was observed in intimal thickenings, fatty streaks and uncomplicated plaques. The surface exposure of macrophage-derived foam cells was seen on florid fatty lesions. Large areas of the arterial surface lacking any endothelial coverage were characteristic of complicated plaques. They appeared to be a consequence of the arterial wall degeneration with an associated failure in endothelial repair.

Arteriosclerosis↗

Evaluation of hypertensive patients by means of captopril enhanced renal scintigraphy with technetium-99m DTPA.

One-hundred five hypertensive patients underwent conventional renal scintigraphy followed 2 or 3 days later by Captopril-enhanced renal scintigraphy, performed 1 hr after premedication with 50 mg of Captopril per os. All patients were then submitted to renal arteriography, performed within 15-30 days. Fifty-five patients had no renal artery stenosis, 29 had unilateral disease, and 21 bilateral. Overall, 34/37 patients were diagnosed by the provocative test as having at least one renal artery affected by a stenosis greater than 50%. Of those with no stenosis (n = 55) or stenosis less than 50% (n = 13) only two cases were falsely positive. Thus sensitivity was 92% and specificity 97%. For single kidney identification with stenosis greater than 50%, sensitivity of renal scintigraphy after Captopril administration was 94% and specificity 98%. Captopril enhanced renal scintigraphy is thus suggested as the first test to be performed in hypertensive patients referred for renal scintigraphic studies. Only those cases with equivocal results require a baseline study for better assessment.

Adult↗