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Biomedical subjects

C Romanini

Publications and source records attributed to C Romanini.

At least 109 records · Page 6Linked to original sources
PubMed1995

Natural killer cell activity in patients with invasive cervical carcinoma: importance of a longitudinal evaluation in follow-up.

OBJECTIVE: To analyze longitudinally the basal natural killer cell activity in patients with invasive cervical carcinoma, the natural cytotoxicity was related to the most important known prognostic factors, and evaluated with respect to the clinical outcome of cervical disease. MATERIALS AND METHODS: Forty-six patients with histologically proven invasive cervical carcinoma treated and followed at the Institute of Gynecology and Obstetrics, Ancona University, Salesi Hospital, were consecutively recruited from 1989 to 1992 and included into the study. For immunologic investigation, natural killer cell activity and peripheral blood T-lymphocyte subsets were tested before primary treatment and during the follow-up period, every 6 months. Natural killer activity was determined by target cell retention of the fluorescent dye carboxyfluorescein diacetate; the K 562 cell line was used as target cells. RESULTS: A significant inverse relationship was observed between natural killer activity and disease stage (p = 0.001); patients with stage IV disease had the lowest level of natural cytotoxicity. The reduction of natural cytotoxicity was not accompanied by any alteration of lymphocyte distribution. The longitudinal analysis showed an increase of natural killer activity after surgical removal of the tumor, persisting during the follow-up, but all the 9 patients who recurred showed, at the time of disease recurrence, a significant decrease of their natural cytotoxic potential. CONCLUSION: Natural killer cell activity seems to be a functional index of immune status, significantly related to the stage and the clinical outcome of disease.

Adenocarcinoma↗
PubMed1995

The human umbilical vein in normal, hypertensive and diabetic pregnancies: immunomorphological and ultrastructural evidence.

Mother-fetus exchanges at the placental level are found to be altered in women affected by hypertensive or diabetic pregnancies following the onset of microenvironmental, circulatory, trophic or tissue disorders. Our aim was therefore to assess the alterations occurring within the umbilical cord, particularly its venous endothelial component and underlying smooth muscle layer, using transmission (TEM) and scanning electron microscopy (SEM) and immunohistochemical analyses. Immunohistochemical data appear to support the ultrastructural evidence for an activated state of these vascular structures, in both conditions (hypertension and diabetes). Furthermore, mainly during diabetic pregnancies, extracellular matrix molecules such as tenascin and fibronectin also quantitatively increase at the vein wall level. The umbilical cord seems to be a structure capable of responding actively to abnormal microenvironmental conditions which seriously threaten the health of the fetus and also the mother herself.

Cell Adhesion Molecules↗
PubMed1995

Nodal immune reactivity in FIGO (International Federation of Gyn-Ob) Stage I endometrial carcinoma: relationship with myometrial invasion.

BACKGROUND: To evaluate T lymphocyte subsets in pelvic and paraortic lymph nodes, in patients with FIGO stage I endometrial carcinoma at different degrees of myometrial invasion and with lymphovascular space invasion. The aim was to define an eventual modulation of regional immune reactivity useful in the therapeutic approach of the disease. METHODS: Twenty-two women with FIGO stage I endometroid adenocarcinoma were consecutively recruited and selected for immunological study. All the patients underwent primary surgery characterized by radical hysterectomy (Piver's type III) with bilateral salpingo-oophorectomy and systematic pelvic plus paraaortic lymphadenectomy. Lymphocyte tipization was performed by Beckton Dickinson monoclonal antibodies (CD4, CD8, CD56 and CD16) immunohistochemically in frozen-sections (immune assay on lymph nodes). For statistical evaluations. Student's t test and one way analysis of variance were used. RESULTS: Significantly higher percentages of CD4+ lymphocytes were found in pelvic than in paraaortic lymph nodes; however, by analyzing T lymphocyte content in the different pelvic nodal groups, we also observed significantly higher percentages of CD16+ and CD56+ cells in obturator nodes when compared to iliac stations. A significant increase of CD16+ and CD56+ cell percentages was then defined with respect to myometrial involvement and lymphovascular space invasion, in pelvic nodes. CONCLUSIONS: From our results, we could not define any clinical importance of nodal lymphocyte distribution in patients with early stage endometrial carcinoma; however, the observed nodal immune reactivity in presence of myometrial invasion seems interesting, with or without lymph vascular space involvement as possible expression of neoplastic systemic diffusion.

Adenocarcinoma↗
PubMed1995

Transdermal estradiol and medroxyprogesterone acetate in hormone replacement therapy are both antioxidants.

We have evaluated the effects of the different components of hormone replacement therapy (HRT) on the production of free radicals in platelet membranes from menopausal women. The study included 12 women in menopause for at least 6 months to a maximum of 4 years. First, the effect was determined of progestin only during the administration of 20 mg/day medroxyprogesterone acetate for 5 days. The peroxide production level was measured on day 0 and day 5. The second set of experiments was carried out in the first month of cyclic HRT with transdermal estradiol 50 micrograms/day from day 1 to day 25 and medroxy-progesterone acetate from day 13 to day 25. In this experiment, the peroxide level was evaluated on days 0, 12 and 25. A significant reduction of peroxide level was observed after oral medroxyprogesterone acetate administration. During HRT, we observed a similar reduction in lipid oxidation at the peak of the estrogen effect, and a further decrease with the administration of medroxyprogesterone acetate. It is concluded that reduction of lipid peroxidation during HRT is not only due to estrogens, but also depends upon the combined action of sex steroids. This observation justifies not only the combined regimen (estrogens plus progestin) in HRT, but also the positive effects of progestins alone on patients who cannot use estrogens.

Administration, Cutaneous↗
PubMed1995

Umbilical veins in dichorionic twins. A morpho-functional assessment.

Investigations on singleton and twin pregnancies show different functional behaviour on maternal-fetal relationship. In some ways twin pregnancies may be considered at risk and they may develop associated pathologies such as hypertension. The aim of this work was to evaluate the morpho-functional behaviours of umbilical cord veins in twin and singleton gestations to better understand the role of these extra-embryonic tissues in the regulation of pregnancies. The umbilical cords were studied from singleton pregnancies and from dichorionic twin pregnancies. Biochemical and morphological investigations were carried out. A significant decrease in the anisotropy values was observed in endothelial cells from twins compared with singletons. Our ultrastructural data show immaturity features at the vein vessel wall level in twins. Furthermore, immunohistochemical investigations showed a lower degree of expressivity concerning adhesion molecules such as ICAM-1 and ELAM. Morphogenetic extracellular glycoproteins like fibronectin and tenascin seem over-expressed in twin pregnancies. Our morpho-functional data well testify the lower maturation degree of umbilical cord veins in twins with respect to singletons.

Anisotropy↗
PubMed1995

The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy.

OBJECTIVE: To show that intrauterine anesthesia is a reliable method for reducing pain associated with endocavitary procedures. DESIGN: A prospective, randomized, double-blind study. SETTING: The Department of Obstetrics and Gynecology, Tor Vergata University of Rome, Rome, Italy. PATIENTS: Forty-five patients undergoing diagnostic hysteroscopy (n = 27) or hysteroscopy and endometrial biopsy (n = 18). INTERVENTIONS: Five milliliters of 2% mepivacaine or saline solution were injected transcervically into the uterine cavity before performing the procedures. MAIN OUTCOME MEASURES: Evaluation of pain reduction on a visual analogue scale. RESULTS: Pain expectation and pain reported were reduced during and after the procedures. CONCLUSION: Topical anesthesia effectively reduces pain during hysteroscopy and endometrial biopsy.

Anesthesia, Local↗
PubMed1995

Hysteroscopically detected asymptomatic müllerian anomalies. Prevalence and reproductive implications.

OBJECTIVE: To assess the prevalence of uterine anomalies and relative reproductive function in 322 women with abnormal uterine bleeding (AUB) evaluated by diagnostic hysteroscopy. STUDY DESIGN: Uterine contours were classified as septate/bicornuate, arcuate or normal on the basis of hysteroscopy. A complete medical history was obtained from all the subjects; it included a questionnaire on menstrual characteristics, reproductive history and pregnancy outcome. Cumulative birth rates, frequency of spontaneous abortion, preterm delivery, malpresentation and mode of delivery in patients with normal and abnormal uteri were compared using life table analysis, the log-rank test and chi 2 analysis. RESULTS: Arcuate, septate/bicornuate and unicornuate uteri were observed in 6.5%, 3.7% and 0.3% of women, respectively. Although 24-month pregnancy rates and monthly fecundability rates were similar in women with and without müllerian anomalies, the 36-month cumulative live birth rate was significantly lower in women with a septate/bicornuate uterus. Overall, women with uterine malformations showed a significantly higher miscarriage rate (P < .05) and a significantly lower term delivery rate (P < .05) than women with a normal-shaped uterus. CONCLUSION: Diagnostic hysteroscopy in women with AUB detected a 10% prevalence of uterine anomalies, which were associated with a significantly higher incidence of spontaneous abortion and lower cumulative live birth rates.

Case-Control Studies↗
PubMed1994

Ductus venosus velocity waveforms in appropriate and small for gestational age fetuses.

The objective of this study was to evaluate differences in ductus venosus velocity waveforms between appropriate and small for gestational age fetuses by using a new index based on the ratio between systolic and atrial peak velocities. Ductus venosus velocity waveforms were cross-sectionally recorded in 164 appropriate for gestational age fetuses at 16-42 weeks of gestation and in 97 small for gestational age fetuses free from structural and chromosomal abnormalities between 24-36 weeks of gestation. Small for gestational age fetuses were divided according to the Doppler findings in arterial peripheral vessels: group A (n = 33), normal ratio between umbilical artery and middle cerebral artery Pulsatility Indices; group B (n = 41), umbilical artery/middle cerebral artery ratio > 95th centile but presence of end diastolic flow in umbilical artery; group C (n = 23), umbilical artery/middle cerebral artery ratio > 95th centile and absence of end diastolic flow in umbilical artery. Eighteen small for gestational age fetuses (10 from group B and 8 from group C) were also serially studied until delivery due to fetal distress. Ductus venosus velocity waveforms were recorded at the level of its origin from umbilical vein and the ratio between systolic and atrial peak velocities (systolic/atrial ratio) calculated. In appropriate for gestational age fetuses, systolic/atrial ratio values significantly decrease with gestation. No significant differences were found in systolic/atrial ratio between appropriate for gestational age fetuses and group A small for gestational age fetuses while, after correction for gestational age, significantly higher values were found in group B (P < or = 0.01) and group C (P < or = 0.001) fetuses. Among these fetuses, those with systolic/atrial ratio above the 95th confidence interval showed a poorer perinatal outcome. No relationships were found between systolic/atrial ratio and Pulsatility Index values from fetal arterial peripheral vessels, while a positive relationship was found with the percentage reverse flow in inferior vena cava. In fetuses serially followed, the systolic/atrial ratio progressively increased approaching the onset of abnormal fetal heart rate patterns. The systolic/atrial ratio allows the evaluation of ductus venosus hemodynamics in small for gestational age fetuses and this index may be useful in the monitoring of such fetuses.

Aorta, Thoracic↗
PubMed1994

A biochemical-morphological study on microvillus plasma membrane development.

The microvillus plasma membrane of the human placental syncytiotrophoblast at term has been extensively studied, while little is known about the characteristics of its development. The aim of the present work was to compare functional and structural properties of this membrane at early and term gestational age. Ten normal term placentas (40 weeks) and ten placentas at 10 weeks of gestational age were studied. The Na+/K+-ATPase activity is significantly decreased in the syncytiotrophoblast plasma membrane obtained from term placentas as compared to the early ones, with significant variation of maximum velocity (Vmax). The microviscosity, evaluated by the P parameter of DPH and Sn parameters of 5- and 16-NS, is increased in the term placentas compared to the early placentas. This alteration is accompanied by an increased cholesterol to phospholipids ratio in term placentas, while there is a decreased unsaturated to saturated fatty acid ratio. As follows from morphological studies, an increased mean diameter in the E face was observed in the term placenta with respect to the early placenta. The distribution factor DF, which indicates the particle aggregation state, decreased in the E face in the term placenta as compared to the early one. The present biochemical morphological study shows that a deep modification of the membrane is at the basis of the syncytiotrophoblast plasma membrane development.

Female↗
PubMed1994

Does measurement of amniotic fluid index detect changes in amniotic fluid volume after second-trimester amniocentesis?

The objective of this study was to establish whether variations of amniotic fluid volume induced by second-trimester amniocentesis could be detected by serial measurements of amniotic fluid index. A total of 130 singleton pregnancies undergoing second-trimester amniocentesis for genetic indications were considered. Amniotic fluid index was measured at three different time intervals: 30-60 min before amniocentesis, immediately after the procedure, and 60 min after the procedure. Serial measurements were obtained either by a single operator (n = 55) or by the three independent operators (n = 75). Significantly lower amniotic fluid index values were demonstrated immediately after amniocentesis when compared with the pre-amniocentesis and subsequent measurements in the study design with both the single and multiple operators. No statistically significant changes were found between the first amniotic fluid index measurements and those obtained 1 h after amniocentesis. These results suggest that second-trimester amniocentesis induces a temporary decrease of amniotic fluid volume detectable by serial amniotic fluid index measurements, no longer evident 1 h after the procedure.

Journal Article↗
PubMed1994

Transverse cerebellar diameter in small-for-gestational-age fetuses: pregnancy dating is possible only when growth retardation is secondary to uteroplacental insufficiency.

The objective of this study was to establish whether measurement of the transverse cerebellar diameter to determine gestational age differs in small-for-gestational-age fetuses with normal or abnormal Doppler velocity waveforms. Our secondary objective was to compare the efficacy of measurement of transverse cerebellar diameter with that of femur length in pregnancy dating among small-for-gestational-age fetuses. A total of 107 small-for-gestational-age fetuses with established dates and free from structural and chromosomal abnormalities were considered for this study. According to the Doppler results, fetuses were divided into two groups: group A (n = 64), with normal Doppler values as expressed by a ratio of pulsatility indices between the umbilical artery and middle cerebral artery of 95th centile. Measurements of transverse cerebellar diameter and femur length were compared to previously established 95th centile prediction intervals. In both groups of small-for-gestational-age fetuses, the values for transverse cerebellar diameter were lower than in normally grown fetuses after normalization for gestational age. The difference was more evident in group A (p <or= 0.001) than in group B (p <or= 0.05). Only 68.7% of transverse cerebellar diameter values of group A fetuses fell within the normal limits for gestation, while this occurred in 90.6% of group B fetuses. When compared to the femur length, the transverse cerebellar diameter measurement appeared to be better for predicting gestational age in both groups of small-for-gestational-age fetuses (p <or= 0.001). However, this measurement may be used to estimate gestational age only in small-for-gestational-age fetuses with abnormal Doppler findings.

Journal Article↗
PubMed1994

Fetal cardiac and extracardiac flows preceding intrauterine death.

Extracardiac and cardiac flow velocity waveforms were recorded in a severely growth-retarded fetus 1 day and a few hours before fetal death. At the first scan, the typical Doppler patterns of a growth-retarded fetus were found, but the brain-sparing effect was lost at the last examination and a huge tricuspid insufficiency was demonstrated.

Journal Article↗
PubMed1994

Pregnancy induced hypertension: a role for peroxidation in microvillus plasma membranes.

It has been recently hypothesized that in PIH a placental oxidant-antioxidant imbalance might cause the release of lipoperoxidation products into the circulation, with subsequent damage of endothelial cell membranes. In this hypothesis the endothelial cell and further increase in circulating lipoperoxide levels, which are by themselves able to induce smooth muscle constriction and increased pressor responsiveness to angiotensin II. In order to investigate this issue, we studied the basal content of lipid peroxides in terms of malondialdehyde (MDA) in the syncytiotrophoblast plasma membranes (SPM) from PIH women. Moreover, we investigated the susceptibility to peroxidation of SPM using an in vitro oxidative stress as a tool to verify the predisposition to the in vivo development of peroxidation products. The fatty acid composition of the membranes was also analyzed. Microvillus membrane lipoperoxide concentrations were significantly increased in PIH women (62.8 +/- 7.6 ng MDA/mg prot) compared with healthy pregnant subjects (37.6 +/- 4.8 ng MDA/mg prot; p < 0.01). The formation of TBARS under the action of phenylhydrazine was significantly greater in PIH women (90.3 +/- 7.4 mmol MDA/mol cholesterol) than in normal pregnant subjects (68.6 +/- 6.4 mmol MDA/mol cholesterol; p < 0.01). In PIH microvillus membrane we also observed a significant increase of the content of polyunsaturated arachidonic acid. The increased susceptibility to oxidative stress of SPMs from PIH women might be due either to reduced antioxidant systems or to an abnormality of the lipid composition of the membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Human hypertensive placenta contains an increased amount of Na,K-ATPase with higher affinity for cardiac glycosides.

Placentas of women suffering from pregnancy-induced hypertension (PIH) were found to contain a greater amount of Na,K-ATPase molecules, estimated from anthroyl ouabain binding, than normotensive individuals. Both the microsomal fraction of placental cells and purified Na,K-ATPase showed an increased affinity for the specific inhibitor ouabain which, in the case of the microsomes, bound with a dissociation constant of 0.9 nM as compared with 3.4 nM in the controls. Likewise, the dissociation constant of the ouabain complex with purified Na,K-ATPase was about 3.5 times lower in the hypertensive patients. The differences are apparently caused by a different microenvironment of the ouabain-binding site, as reflected in the quantum yield of bound anthroyl ouabain. If an endogenous digitalis-like factor is present in the body fluids to regulate Na,K-ATPase activity, the present results render its role quite plausible.

Adult↗
PubMed1994

Influence of neoadjuvant polychemotherapy on natural killer cell activity in patients with locally advanced cervical squamous carcinoma.

Peripheral blood natural killer (NK) cell activity against K562 tumor line was monitored in 16 patients with locally advanced squamous cervical carcinoma (II and III FIGO stages) during neoadjuvant polychemotherapy (cisplatin at 80 mg/m2 and bleomycin at 30 mg/m2). There was a significant progressive decrease in NK activity during the three cycles of antiblastic treatment (P = 0.008) without significant depletion of NK cell (CD56 and CD16 monoclonal antibody positive cell percentage and absolute number). A significant relationship was shown between basal NK activity levels and response to polychemotherapy; in fact, nonresponder patients had a significantly lower mean value of NK activity before polychemotherapy than responders (P = 0.044). In conclusion, NK activity declines as a result of antiblastic therapy; although polychemotherapy reduces tumor spread, its antineoplastic action may be affected by this decreased immune reactivity.

Adult↗
PubMed1994

Natural killer cell activity in stage I endometrial carcinoma: correlation with nuclear grading, myometrial invasion, and immunoreactivity of proliferating cell nuclear antigen.

The purpose of this study was to examine the relationship between natural killer cell activity and biological behavior of tumor, expressed by architectural (FIGO) and nuclear grading, depth of myometrial invasion, and proliferating cell nuclear antigen (PCNA) index in patients with endometrial carcinoma. Forty patients with FIGO stage I endometrial carcinoma, treated with radical surgery, were included in this retrospective study. At the time of diagnosis, natural killer cell activity of peripheral blood was evaluated against K562 target tumor cells and correlated with architectural and nuclear grading, depth of myometrial invasion, and PCNA index of the tumor. Natural killer activity diminished with increasing nuclear grade of the tumor (P = 0.004); similarly, natural cytotoxicity decreased with myometrial invasion: for stages IC and IB endometrial carcinoma, the mean values of natural cytotoxicity were significantly lower than stage IA disease (P = 0.0001). Natural killer activity was significantly correlated with PCNA immunostaining of the tumor (r = -0.8). It is concluded that the natural immune reactivity seems to be related to the pathologic features of early stage endometrial carcinoma, showing a significant reduction in presence of nuclear pleomorphism and/or myometrial invasion, and also an inverse relationship with PCNA index.

Adult↗
PubMed1994

Chromosomal abnormalities in fetuses with absent end-diastolic velocity in umbilical artery: analysis of risk factors for an abnormal karyotype.

OBJECTIVE: Our purpose was to evaluate the incidence and patterns of chromosomal abnormalities in fetuses with absent end-diastolic velocity in umbilical artery and to analyze maternal and fetal factors associated with abnormal karyotype. STUDY DESIGN: One hundred ninety-two fetuses of known karyotype with absent end-diastolic velocity in the umbilical artery at a gestational age > 20 weeks were considered. The following potential risk factors were analyzed in a multiple logistic regression model: maternal age, gravidity, parity, gestational age at diagnosis, presence of gestational hypertension and preeclampsia, presence of fetal malformations, different biometric measurements, head/abdominal circumference ratio, amniotic fluid volume, and several Doppler index values calculated from uterine arteries, fetal heart, and fetal peripheral arteries and veins. RESULTS: Sixteen cases had an abnormal karyotype. In two cases a triploidy was present, whereas the remaining 14 cases had autosomal aberrations. The risk factors statistically significantly and independently associated with the presence of an abnormal karyotype were maternal age > 35 years, gestational age at diagnosis < 27 weeks, presence of multiple malformations, and absence of gestational hypertension and preeclampsia. All the fetuses with an abnormal karyotype but one were correctly identified by at least one risk factor. CONCLUSIONS: An abnormal karyotype is present in 8.3% of fetuses with absent end-diastolic velocity in umbilical artery and is associated with maternal and fetal risk factors. The knowledge of these factors may be useful in the management of such fetuses.

Abnormalities, Multiple↗