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Biomedical subjects

C Romanini

Publications and source records attributed to C Romanini.

276 records · Page 16Linked to original sources

Modulation of vascular reactivity after acute calcium antagonist administration in pregnant women moderately sensitive to angiotensin infusion.

Intracellular calcium is hypothesized to mediate vascular reactivity to infused angiotensin in pregnancy, which is increased in women at risk for subsequent development of gestational hypertension or preeclampsia. We infused scalar doses of angiotensin II in pregnant women at risk for hypertension and observed the possible modulation of vascular responsiveness after the administration of a calcium antagonist, in 38 women sensitive to moderate doses (greater than 10 and lower than 64 ng/kg/min). Results were correlated to perinatal outcome. Women moderately sensitive to angiotensin, in which an enhancement of the effective pressor dose after calcium antagonist administration occurred, showed a significant increase of bad perinatal outcomes. The modulation of the pressor test to infused angiotensin by calcium antagonist administration would reveal an activation of intracellular free calcium, and may be used as a second-line screening test.

Angiotensin II↗

Functional platelet modifications induced by oral magnesium supplementation in normotensive and hypertensive pregnancy.

Platelet functionality alterations have been correlated to the onset of hypertension in pregnancy and oral Mg++ supplementation has been clinically postulated to counteract such alterations. We, therefore tested the effect of 4 weeks oral Mg++ pyrrolidone carboxylate supplementation on platelet function. Forty-eight pregnant women were enrolled in the study at the beginning of the third trimester (30-32 weeks). Twenty women were preeclamptic, while 28 remained normotensive and served as controls. All the women received 360 mg/day magnesium pyrrolidone carboxylate for 4 weeks. DPH fluorescence, Na+/K(+)-ATPase and Ca(++)-ATPase activity, intracellular free Ca++ concentrations were determined prior and after the 4-weeks supplementation. Oral Mg++ supplementation significantly increased platelet DPH fluorescence in both normotensive and preeclamptic women. In normotensive pregnant women, it also significantly increased the activity of Na+/K(+)-ATPase, the activity of Ca(++)-ATPase and reduced the concentration of intraplatelet free Ca++. In hypertensive pregnant women, Mg supplementation increases Na+/K(+)-ATPase activity and decreases intracellular free Ca++; this, in turn, contributes to reducing the activity of Ca(++)-ATPase. Magnesium supplementation to preventing hypertension in pregnancy seems to have a consistent biochemical and clinical background.

Administration, Oral↗

Prediction of gestational hypertension by cosinor analysis of second trimester blood pressure.

OBJECTIVE: We evaluated the efficacy of cosinor analysis of blood pressure (BP) at the second trimester in predicting the subsequent development of gestational hypertension. STUDY DESIGN: We performed the cosinor analysis of BP in 313 normotensive non-proteinuric nulliparous women at the second trimester. We followed the pregnancy up to delivery and recorded the subsequent occurrence of gestational hypertension (sGH). We compared data from this group of 33 patients with those from the 280 women with uncomplicated normotensive pregnancy. We used the ANOVA to compare the means, statistical significance was assessed at p < .05. RESULTS: Diastolic MESOR of women with uncomplicated pregnancy was significantly lower than the GH patients, although both groups were definitely normotensive at the time of the recording. (Diastolic: Controls M = 62.2 +/- 1.5, A = 5.1 +/- 0.7, O = 14:07, p = .0001; sGH M = 73.5 +/- 6.2m, A = 5.9 +/- 1.1, O = 14:48, p = .003; Systolic: Controls M = 108.3 +/- 2.2, A = 5.2 +/- 0.7, O = 15:00, p = .0001; sGH M = 122.4 +/- 2.1, A = 4.1 +/- 0.8, O = 15:59, p = .01) We did not find any other significant difference among the population-mean cosinors. The most sensitive cutoff of diastolic blood pressure MESOR proved to be 68 mmHg.

Adult↗

Tissue and serum metalloproteinase (MMP-2) expression in advanced ovarian serous cystoadenocarcinomas: clinical and prognostic implications.

OBJECTIVE: The object of this study was to analyse the tissue and serum metalloproteinase (MMP-2), an enzyme which degrades the basement membrane collagen type IV, as a potential marker useful in prognostic evaluation and clinical monitoring of the follow-up, in patients with advanced ovarian serous cystadenocarcinoma. MATERIALS AND METHODS: Tissue MMP-2 expression was determined in 21 FIGO stage III ovarian serous cystadenocarcinomas treated with primary surgery and adjuvant chemotherapy, and compared to 10 cystadenomas used as controls. Retrospective analysis of clinical data allowed the comparison of accepted prognostic factors to tissue MMP-2 expression for impact on disease-free survival. In fourteen out of 21 patients, serum MMP-2 levels were also analysed. RESULTS: Compared to cystadenomas, the tissue MMP-2 expression was significantly (P < 0.001) higher in serous cystadenocarcinomas. A significant relationship was observed between tissue MMP-2 and disease-free survival (P = 0.0003), independently of tumor architectural grade, lymph nodal status and residual disease after debulking surgery. Recurrence risk in patients whose carcinomas had a tissue MMP-2 > or = 29% was significantly higher than that in patients whose carcinomas demonstrated lower tissue MMP-2 expression (P = 0.004). Serum MMP-2 levels correlated with tissue staining, and also expressed a significant relationship with disease-free survival (P = 0.002). CONCLUSIONS: Tissue MMP-2 seems to be a prognostic indicator in patients with FIGO stage III ovarian serous cystadenocarcinoma, significantly correlated with recurrence risk and apparently independent of tumor architectural grade, lymph nodal status, and residual disease after debulking surgery. An interesting relationship was observed between tissue staining and MMP-2 serum levels.

Basement Membrane↗

Increased serum 72 KDa metalloproteinase in serous ovarian tumors: comparison with CA 125.

72 KDa metalloproteinase (MMP-2) is an enzyme present in neoplastic cells and also in normal fibroblasts. It specifically cleaves type IV collagen, and therefore may play a critical role in tumor invasion and metastasis mechanisms. The aim of the present study was to determine serum levels of MMP-2 in serous ovarian tumors, and compare these with serum levels of CA 125. Ten primary ovarian serous cystadenocarcinomas, 5 borderline tumors, and 10 serous cystadenomas, all treated with primary surgery, were recruited from our series of serous ovarian tumors, and studied. Patients' serum samples were obtained before surgery, and the MMP-2 levels were measured by the substrate capture enzyme-linked immunosorbet assay. The analysis of serum MMP-2, gave values significantly higher in cystadenocarcinomas than in borderline tumors and cystadenomas (one way analysis of variance, P < 0.001); in particular, serum MMP-2 was significantly correlated to the MMP-2 immunostaining of the tumor (Spearman correlation, r = 0.82, and P < 0.001). An arbitrary cutoff of the median value of normal adult female samples (0.22 units) was chosen, and all except for one patient with cystadenocarcinoma was shown to have serum MMP-2 levels above the cutoff value, with 90% sensitivity, 70% specificity, and a 75% positive predictive value (50% of Cohen's Kappa); on the other hand, CA 125 showed 80% sensitivity, and a 73% positive predictive value. The association of serum MMP-2 with CA 125 increased sensitivity to 100% in patients with cystadenocarcinoma, with 70% persisting specificity and a 77% positive predictive value (54% of Cohen's Kappa). Serum MMP-2 levels were found to be significantly increased in patients with cystadenocarcinoma in comparison with borderline tumors and cystadenomas, showing a direct relationship with tissutal MMP-2 expression in serous ovarian tumors. Although our results were preliminary, they clearly suggested that serum MMP-2 may be an interesting diagnostic marker for cystadenocarcinomas.

Adult↗

Ras p21 immunostaining in early stage squamous cervical carcinoma: relationship with lymph nodal involvement and 72 kDa-metalloproteinase index.

BACKGROUND: Ras p21 expression seems to be associated with aggressiveness of neoplastic growth and metastatic potentially in human solid tumors. In our series of early-stage squamous cervical carcinoma, we evaluated ras p21 expression with respect to lymph nodal involvement; the aim was to analyse the ras p21 immunostaining as potential marker of lymphatic spread, and investigate the relationship between ras p21 expression and 72 kDa-metalloproteinase immunostaining. PATIENTS AND METHODS: 46 patients with FIGO stage I squamous cell cervical carcinoma, who had undergone primary radical surgery with systematic pelvic and paraaortic lymphadenectomy (Piver's type III) at the Institute of Gynecologic and Obstetrics, Ancona University, were recruited from our series of 59 consecutive cases, and included the study. Any characteristic that could be relevant for prognosis was recorded such as: histologic grade of differentiation, tumor size, lymphatic spread, or adjuvant radiotherapy. Immunohistochemical staining was performed using the avidin-biotin peroxidase complex method (LSAB, Dako, Copenhagen, Denmark). Monoclonal antibody anti-pan ras (Ab-1) (Oncogene Science) and affinity purified rabbit anti-72 kDa-metalloproteinase antibody were used. Positivity for ras p21 was evaluated by semiquantitative analysis, while 72 kDa-metalloproteinase staining was expressed as the percentage of positive cells per 10(3) counted neoplastic cells (index). RESULTS: The expression of ras p21 was observed in 31 patients (67%) with FIGO stage I squamous cervical carcinoma. No connection was found between ras p21 expression and tumor size (P = 0.2), or histologic grade (P = 0.9), while a significant relationship was observed with respect to lymph nodal status (p = 0.048). By analysing 72 kDa-metalloproteinase immunostaining, ras p21 positive carcinomas showed significantly higher 72 kDa-metalloproteinase index than the negative ones (mean + standard deviation, 23.3% + 7.7% and 13.8% + 5.1% respectively, and P < 0.001). CONCLUSIONS: Though the relatively small size of our series does not allow any definitive conclusion, a significant relationship between ras p21 expression and risk of lymphatic spread was detected in early-stage cervical carcinoma. ras p21 positivity seems to be an indicator of neoplastic aggressiveness and lymphatic spread, and is associated with significantly higher expression of 72 kDa-metalloproteinase.

Adult↗