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Biomedical subjects

C Romeo

Publications and source records attributed to C Romeo.

At least 37 records · Page 2Linked to original sources

Pleuropulmonary blastoma: long-term survival and literature review.

BACKGROUND AND PROCEDURE: Pleuropulmonary blastoma (PPB) identifies different types of pulmonary tumors in the pediatric age. It is extremely uncommon and is known to have a very poor prognosis, with only few cases surviving after 10 years follow-up. Our experience with such a patient and long-term follow-up (12 years) is therefore of interest. She was a 2-year-old girl admitted with a history of respiratory distress and underwent a left thoracotomy. The tumor was removed and after 1 month a polychemotherapy course was started using dactinomycin and vincristine for 6 months. The patient remains disease-free 12 years after the operation. CONCLUSIONS: The biologic behavior of the tumor is considered unpredictable, and for this reason much effort has been expended in trying to identify prognostic factors. The preoperative size of the mass (size <5 cm) in our patient, its complete excision, and the histologic aspects might be helpful in identifying favorable prognostic factors.

Child, Preschool↗

Neonatal oxidative liver metabolism: effects of hydrogen peroxide, a putative mediator of septic damage.

BACKGROUND/PURPOSE: Surgical neonates are at risk for sepsis and liver dysfunction. These complications are more common in preterm neonates and in those who receive total parenteral nutrition. Elevated levels of reactive oxygen species (eg, hydrogen peroxide) have been reported in these "at-risk" patients and may be the mediators of liver impairment via their effect on oxidative energy metabolism. The aim of this study was to test the hypothesis that elevated levels of hydrogen peroxide (H2O2) impair neonatal liver oxidative energy metabolism. METHODS: An in vitro model to test this hypothesis was developed in hepatocytes isolated from neonatal (11-day to 15-day) rats. The cells, respiring on palmitate (0.5 mmol/L in 2% bovine serum albumin), were exposed to H2O2. Oxygen consumption was measured polarographically. In experiment A, H2O2 was added to the cell preparation at different concentrations (0.5 mmol/L, 1 mmol/L, 1.5 mmol/L, 2 mmol/L) to assess the effect on oxygen consumption. In experiment B, H2O2 (2 mmol/L) was added to hepatocytes in the presence of inhibitors of mitochondrial respiration to define the site of action of H2O2. In experiment C, electron microscopy was performed on hepatocytes after incubation with 1 mmol/L and 2 mmol/L of H2O2. RESULTS: In experiment A, H2O2 significantly reduced hepatocyte oxygen consumption at 1.5 and 2 mmol/L. In experiment B, in the presence of inhibitors of mitochondrial respiration, myxothiazol (inhibitor of substrate oxidation), and oligomycin (inhibitor of adenosine triphosphate (ATP) synthase), no further inhibition by H2O2 occurred, indicating that the effect of H2O2 was intramitochondrial and affecting the synthesis of ATP. In experiment C, microscopic alterations of mitochondria were noticed exclusively in hepatocytes incubated with 2 mmol/L H2O2. CONCLUSIONS: Results of this study demonstrate that H2O2 impairs neonatal liver oxidative metabolism. H2O2 probably directly inhibits ATP synthase. The authors hypothesize that H2O2 may play a role in the biochemical pathogenesis of liver dysfunction associated with sepsis. Identification of the precise target site of H2O2 may be valuable in directing therapy in septic neonates.

Adenosine Triphosphate↗

A role for mucosal immunity in resistance to HIV infection.

In a recent, thought-provoking novel by Elizabeth McCracken (The Giant's House. Avon Books, New York, 1997), two characters discuss love and its impossibilities. One brashly claims to be "immune to love", explaining the concept to his perplexed interlocutor, "...people become immune to love like they become immune to any disease. Either they had it bad early in life, like chicken pox and that's that; or they keep getting exposed to it in little doses and build up an immunity; or somehow they just don't catch it, something in'em is born resistant. I'm the last type. I'm immune to love and poison ivy". (p. 275) (E. McCracken, The Giant's House. Avon Books, New York, 1997). Substitute the words 'HIV infection' for 'love' and this intriguing metaphor summarizes the state of the art working hypotheses for the phenomenon of resistance to HIV infection in HIV-exposed individuals who, against all odds, do not seroconvert. These hypotheses will be discussed hereafter and particular emphasis will be placed upon a possible role for mucosal immunity in this phenomenon.

Chemokines↗

Surgical anatomy of the mediastinum.

After a short description of mediastinal anatomy and embryology, the authors illustrate the division of the mediastinum, based on criteria of either surgical anatomy or radiological anatomy. Lastly, they discuss the topographical distribution of the mediastinal masses in anterior, visceral, and posterior compartments of the mediastinum.

Humans↗

A morphometric and ultrastructural study of the changes in the lamina propria in adolescents with varicocele.

OBJECTIVE: To verify if changes in the lamina propria and its components, reported in adults with varicocele, are already present in adolescents with idiopathic varicocele, using a morphometric and ultrastructural study. MATERIALS AND METHODS: Twenty testicular biopsies from adolescents (mean age 15.6 years) were obtained during surgery for left idiopathic varicocele; five testicular biopsies from adolescents (mean age 16 years) undergoing surgery for hydrocele or inguinal hernia were used as controls. Biopsy specimens were processed for light and transmission electron microscopy; the sections were evaluated morphometrically using computerized image analysis. RESULTS: Morphometric and ultrastructural examination of the testes with varicocele showed an increased thickness in the lamina propria, caused principally by an increase in the extracellular matrix components, and deep invaginations towards the germinal epithelium. CONCLUSION: There is detectable damage of the lamina propria in adolescents affected by left idiopathic varicocele, although not as well developed or as severe as in adults.

Adolescent↗

The neonatal management and surgical correction of urinary hydrometrocolpos caused by a persistent urogenital sinus.

OBJECTIVE: To define the neonatal management and ultimate surgical correction via the anterior sagittal transanorectal approach (ASTRA) in cases of neonatal urinary hydrometrocolpos associated with a persistent urogenital sinus (UGS). PATIENTS AND METHODS: We report three patients with UGS (with no ambiguous genitalia) and urinary hydrometrocolpos in whom prenatal ultrasonography showed cystic dilatation of the pelvis. Two patients were temporarily treated with intermittent vaginal catheterization and antibiotic prophylaxis, and in one a cystostomy was necessary to temporarily drain the urine. At the age of 6-8 months the patients underwent reconstructive surgery of the UGS via the ASTRA, under a previous protective colostomy. RESULTS: The mean (range) age of the patients at the last follow-up was 18.7 (8-32) months. A good cosmetic result was obtained in all patients. The vagina was dilated briefly with no anaesthesia in each patient. Patients had normal faecal control after the colostomy was closed and none had urinary incontinence. CONCLUSIONS: When possible, intermittent vaginal catheterization permits sufficient temporary drainage of the urinary hydrometrocolpos associated with a persistent UGS. Subsequent ASTRA allows good exposure of the UGS, assuring the preservation of the anorectal innervation and of the sphincteric mechanism.

Colostomy↗

The effect of a tyrosine kinase inhibitor on endotoxin mortality and splenocyte mediator production in the neonatal rat.

Tyrosine kinases mediate cellular signal transduction to endotoxin. A class of tyrosine kinase inhibitors, the tyrphostins, have been shown to protect mice from endotoxin-induced lethality. Neonatal rats and mice have been shown to be uniquely susceptible to lethal endotoxic shock. In our study, the effect of a lipophilic tyrphostin, AG 556, on endotoxin-induced neonatal and adult mortality and in vitro neonatal splenic cell thromboxane (TxB2), tumor necrosis factor-alpha (TNF-alpha), and nitric oxide (NO) production were examined. Neonatal rats (<24 h old) were administered tyrphostin (100 microg subcutaneous) 2 h before an approximate LD50 dose of Salmonella enteritidis endotoxin (.024 mg/kg/intracardiac). There was a significant decrease in mortality in the animals pretreated with 100 microg of tyrphostin (29% mortality in the treated group, n = 41 versus 53% in the vehicle control group, n = 40; p < .05). Also in adult rats tyrphostin (5 mg/kg intraperitoneal) 2 h before endotoxin (10 mg/kg intravenous) significantly improved survival (50% drug treated versus 84% in control, n = 12/group; p < .05). Adherent neonatal splenic cell mediator production of TxB2, TNF-alpha, and NO (measured by nitrite) in tyrphostin pretreated splenic cells were compared with endotoxin-stimulated splenic cells in vitro. The studies (n = 4) demonstrate an increase (p < .05) in the production of TxB2, TNF-alpha, and NO in the endotoxin- (10 microg/mL) stimulated adherent splenic cells compared with basal. Tyrphostin pretreatment (10, 20, 50 microM) produced a dose-dependent decrease (p < .05) in endotoxin-stimulated TxB2 and TNF-alpha production. NO production was not significantly reduced. In conclusion, tryphostin appears to have a protective effect on mortality in both adult and neonatal rat endotoxic shock. Tyrphostin decreased specific mediator production in stimulated neonatal cells. Thus, inhibition of signal transduction pathways of endotoxin activation by tyrosine kinase inhibition may provide an effective approach to treat endotoxic shock in the neonate.

Animals↗

T cell activation induced by novel gain-of-function mutants of Syk and ZAP-70.

The Syk family tyrosine kinases play a crucial role in antigen receptor-mediated signal transduction, but their regulation and cellular targets remain incompletely defined. Following receptor engagement, phosphorylation of tyrosine residues within ZAP-70 and Syk is thought to control both kinase activity and recruitment of modulatory factors. We report here the characterization of novel mutants of ZAP-70 and Syk, in which conserved C-terminal tyrosine residues have been replaced by phenylalanines (ZAP YF-C, Syk YF-C). Both mutant kinases display a prominent gain-of-function phenotype in Jurkat T cells, as demonstrated by lymphokine promoter activation, tyrosine phosphorylation of potential targets in vivo, and elevated intracellular calcium mobilization. While the presence of p56-Lck was required for ZAP YF-C-induced signaling, Syk YF-C showed enhanced functional activity in Lck-deficient JCaM1 Jurkat cells. Our results implicate the C terminus of Syk family kinases as an important regulatory region modulating T cell activation.

Amino Acid Sequence↗

Luteinizing hormone-releasing hormone is a primary signaling molecule in the neuroimmune network.

The brain-pituitary-reproductive axis and the brain thymus-lymphoid axis are linked by an array of internal mechanisms of communication that use similar signals (neurotransmitters, peptides, growth factors, hormones) acting on similar recognition targets. Moreover, such communication networks form the basis and control each step and every level of reproductive physiology. This presentation highlights the extent to which endocrine, neural, glial, or immunologically competent cells may achieve their specific functions using common mechanisms, but employing them to different degrees. In particular, this work will focus on LHRH, the chief hormone orchestrating reproductive events. Within the thymus LHRH plays a unique role of immunomodulator, contributing to the sex-dependent changes in immune responsiveness during the estrous-menstrual cycle as well as pregnancy. From the recent cloning and sequencing of lymphocyte LHRH, the expression of LHRH receptor mRNA in lymphocyte, the transduction mechanisms involved, and the steroidogenic sensitivity of the intralymphocyte LHRH system. It would appear that this peptide may act as an immunological response modifier in the brain-pituitary-lymphoid-gonadal axis. The interplay between neuronal, endocrine, and immune compartments is further emphasized in the study of LHRH-astroglial interactions. Astrocytes are able to manufacture a wide variety of signaling agents and can secrete immunoregulatory molecules that influence immune cells, as well as the glial cells themselves. Astroglia and the immortalized hypothalamic LHRH (GT1-1) neurons communicate with an array of mechanisms, via soluble mediators as well as cell-to-cell contacts. Manipulation of astroglial-derived cytokines and nitric oxide (NO) in GT1-1 neuron-astroglia cocultures, underscores a potential cross-talk between different intra/inter-cellular mediators in the dynamic control of LHRH release. Further studies aimed to disclose at a biochemical and a molecular level such bidirectional, informative network will give us new insights into more general issues concerned with the malfunction of the neuroendocrine-immune axis.

Animals↗

A possible role of the plasmalemmal cytoskeleton, nitric oxide synthase, and innervation in infantile hypertrophic pyloric stenosis. A confocal laser scanning microscopic study.

In reference to a possible neuropathy in the pathogenesis of infantile hypertrophic pyloric stenosis (IHPS), previous studies have described alterations in peptidergic transmission while others have recently attributed an important role to nitrinergic activity. Little attention has been given to the organization of the extracellular matrix (ECM) and the constituent cytoskeleton and subsarcolemma of the pyloric smooth-muscle cell. To study a possible relationship between neuronal and muscular elements in IHPS, 9 biopsies from patients with IHPS and 5 biopsies of normal pylorus were examined using immunohistochemical techniques with regard to the distribution of nerve cells and fibers (bNOS and PGP 9.5) and the ECM (laminin) and cytoskeleton (talin, vinculin, dystrophin, alpha-smooth iso-actin, desmin) components of the pyloric muscle. Our results showed anti-protein gene product 9.5 and b-nitric oxide synthase immunoreaction respectively reduced or absent in nerve fibers with a positive reaction inside the ganglion cells. An uneven distribution of the ECM component laminin was evident, together with a negative immunoreaction to talin and dystrophin. The imunolocalization of vinculin, alpha-smooth iso-actin, and desmin was similar to the controls. Our findings suggest that there is a close relationship between the nerve and muscle elements in the pathophysiology of IHPS and that non-alteration of some elements of cytoskeleton organization can play an important role in regaining pyloric function after pyloromyotomy.

Cytoskeletal Proteins↗

[Developmental changes of cardiac mechanics during fetal and postnatal life. Diagnostic role of Doppler echocardiography].

The advent of fetal echocardiography combined with Doppler technology gave the clinicians the possibility to evaluate and clarify the main aspects of fetal and postnatal circulatory physiology. From the end of cardiogenesis to the end of gestation the developmental changes of the fetal myocardial structure, ventricular function and circulatory physiology have all been studied. Also the physiological features of the transitional circulation in the first postnatal period, as well as the developmental changes in the morphology and function of the neonatal ventricles can be assessed by Doppler echocardiography. This review is divided in two parts. In the first one we will briefly discuss the contractile properties of the fetal myocardium, the cardiac performance and dynamics of the fetal circulation; in the second one we will consider the physiological aspects of the transitional circulation, the structural features of the immature neonatal myocardium, as well as the developmental changes of the myocardial mechanics as shown by Doppler ultrasound.

Age Factors↗

Purification of a fatty acid-stimulated protein-serine/threonine phosphatase from bovine brain and its identification as a homolog of protein phosphatase 5.

An arachidonic acid-stimulated Ser/Thr phosphatase activity was detected in soluble extracts prepared from rat pituitary clonal GH4C1 cells, rat or bovine brain, and bovine heart. The enzyme activity was purified to homogeneity from bovine brain as a monomer with a Mr of 63,000 and a specific activity of 32 nmol of Pi released per min/mg of protein when assayed in the presence of 10 microM phosphocasein in the absence of lipid. Arachidonic acid stimulated activity 4-14-fold, with half-maximal stimulation at 50-100 microM, when assayed in the presence of a variety of phosphosubstrates including casein, reduced carboxamidomethylated and maleylated lysozyme, myelin basic protein, and histone. Oleic acid, linoleic acid, and palmitoleic acid also stimulated activity; however, saturated fatty acids and alcohol or methyl ester derivatives of fatty acids did not significantly affect activity. The lipid-stimulated phosphatase was identified as the bovine equivalent of protein phosphatase 5 or a closely related homolog by sequence analysis of proteolytic fragments generated from the purified enzyme. When recombinant rat protein phosphatase 5 was expressed as a cleavable glutathione S-transferase fusion protein, the affinity-purified thrombin-cleaved enzyme exhibited a specific activity and sensitivity to arachidonic acid similar to those of the purified bovine brain enzyme. These results suggest that protein phosphatase 5 may be regulated in vivo by a lipid second messenger or another endogenous activator.

Amino Acid Sequence↗

Segmental up-regulation of transforming growth factor-beta in the pathogenesis of primary megaureter. An immunocytochemical study.

OBJECTIVE: To examine the maturational-delay hypothesis of primary megaureter (PM), i.e. that the condition arises by a segmental maturational delay of the ureteric wall that can resolve spontaneously within the first year of life, using comparative immunocytochemistry of ureters resected from infants and from homologous pre-natal ureters. MATERIALS AND METHODS: Seventeen distal urinary tracts were obtained from children with PM who were referred for surgery (aged 6 months to 8 years, mean 2.1 years). These were compared with ureteric buds obtained from 11-week-old human and 11- to 38-week-old calf fetuses. The samples were immunostained using a monoclonal antibody specific for transforming growth factor beta (TGF-beta). RESULTS: The histological appearances of the narrowed ureteric segments from patients under 18 months old were like the fetal ureteric buds at 26-38 weeks of gestation. Positive TGF-beta immunoreactions were detected in the longitudinal muscle layer in the ureter from patients 6-12 months old. Such reactions weakened progressively in those patients older than 1 year, becoming negative in all children older than 3 years. The TGF-beta immunolabelling in resected ureters was closely similar to that in fetal ureters from 20 to 26-week old calves. CONCLUSIONS: From these results, PM should be ascribed to a segmental developmental delay of the terminal ureter arising at about 20 weeks of gestation, with a possible pathogenetic involvement of autocrine TGF-beta overexpression.

Animals↗

[Preoperative staging of colorectal neoplasms: importance of the echo-endoscopy].

The A. A., after having confirmed how the timely diagnosis of cancer of the Sigma-Rectum section is the result a complicated and articulate diagnostic iter, describe the advantages of using the ultrasonography-endoscopy. Therefore they relate their experience, comparing the outcome of this research with that of the TC images and above all with the histo-pathological surveys on the removed sechions. They conclude affirming that a higher percentage of the diagnostic care is a clear evolution in the correct pre-operating stage of these neoplasias.

Aged↗

Luteinizing hormone-releasing hormone (LHRH) receptors in the neuroendocrine-immune network. Biochemical bases and implications for reproductive physiopathology.

It seems apparent that the brain-pituitary-reproductive axis and the brain-thymus-lymphoid axis are linked by an array of internal mechanisms of communication that use similar signals (neurotransmitters, peptides, growth factors, hormones) acting on similar recognition targets. Moreover, such communication networks form the basis and control of each step and every level of reproductive physiology. This work has focused on the LHRH system, a primary central and peripheral clock of both neuroendocrine and immune functions. From the initiation of a sexually organized response, the detection of sexual odors, and the induction of mating behavior, extrahypothalamic and hypothalamic LHRH orchestrates the neuroendocrine modulation of gonadotropin secretion, while its expression within the ovary directly controls specific events such as follicular atresia. The presence of LHRH receptors in oocytes clearly anticipates a potential action of the decapeptide during the process of fertilization and/or implantation. Within the thymus and other peripheral immune organs, LHRH plays a unique role of immunomodulator, contributing to the sex-dependent changes in immune responsiveness during the estrous-menstrual cycle as well as pregnancy. The reciprocity of the neuroendocrine-immune signaling systems is further supported by the ability of sex steroids to modulate thymus-dependent immune functions via direct effects on specific target genes involved in the development of sex dimorphism and sex-dimorphic immune responses, including the downregulation of immune response observed during pregnancy. Such cyclic changes in immune responsiveness could have a physiological implication, such as the decrease or suppression in cell-mediated immunity observed in the postovulatory phase of the cycle and in pregnancy, respectively, and might play a role during the implantation process and the establishment of pregnancy. In this context, the ability of corticosterone to directly inhibit both GR transcript levels as well as a cell-mediated immune response within the thymus, and the modulation of such an inhibitory effect by the sex steroid hormone milieu, may offer an explanation and a molecular mechanism whereby stress may be deleterious for reproduction, also via immunomodulation. On the other hand, hormonally mediated alterations in immunity might also have a pathological implication in sexually related immune diseases. For example, in mouse and humans, lupus erythematosus is more prevalent in females and estrogen accelerates the disease process, while menstruation is known to exacerbate idiopathic thrombocytopenia purpura. Sex steroid hormone milieu might also have a role in controlling the stress response through immunomodulation. Within the placenta, an intricate network of signaling systems controls a delicate interplay between the neuroendocrine hormones, growth factors, and cytokines that are susceptible to play a major local role in the processes of implantation and the establishment and completion of pregnancy. The neuroendocrine and immunomodulatory role of LHRH continues well after parturition because the presence of LHRH-like material within the mammary gland and milk participates in the physiological modulation of hypophyseal, gonadal, and immune functions of the pups. Such a significant role played by the hypothalamic peptide in the modulation of immune responsiveness would indicate LHRH as the signal conveying information to both neuroendocrine and immune cells, with the role of informing and then transducing the messages into appropriate biological responses.(ABSTRACT TRUNCATED)

Amino Acid Sequence↗

[Responsibility of incomplete retinal photocoagulation in the indication of vitrectomy in proliferative diabetic retinopathy].

PURPOSE: We report an epidemiologic study about prophylactic photocoagulation of ischaemic diabetic retinopathy in order to avoid proliferative stage and severe vitreous haemorraghe. METHODS: We studied retrospectively 42 eyes of 32 diabetic patients who underwent a vitrectomy in 1993. For each patient several items were analyzed: nationality, sex, age, type, duration and clinical course of diabetes, and other risk factors. Slit lamp and ocular fundus examination were noted; in particular lens, iris and vitreoretinal framework. RESULTS: Almost all patients had an inadequate laser photocoagulation: in 26 eyes (62%) it was insufficient or non-existent, uncomplete in 12 eyes (29%), and non confluent for 18 eyes (43%). Only four eyes have had complete and confluent panphotocoagulation. CONCLUSION: Photocoagulation appears to be the priority therapy to avoid most severe complications of proliferative diabetic retinopathy. Laser photocoagulation must be started from preproliferative retinopathy, confluent on the useless ischaemic retinal areas, and dense elsewhere.

Adult↗

Cleavage at a V(D)J recombination signal requires only RAG1 and RAG2 proteins and occurs in two steps.

Formation of double-strand breaks at recombination signal sequences is an early step in V(D)J recombination. Here we show that purified RAG1 and RAG2 proteins are sufficient to carry out this reaction. The cleavage reaction can be divided into two distinct steps. First, a nick is introduced at the 5' end of the signal sequence. The other strand is then broken, resulting in a hairpin structure at the coding end and a blunt, 5'-phosphorylated signal end. The hairpin is made as a direct consequence of the cleavage mechanism. Nicking and hairpin formation each require the presence of a signal sequence and both RAG proteins.

Amino Acid Sequence↗

[Left ventricular remodelling at 3 months from a first transmural infarct: the effect of physical activity and of the patency of the necrotic artery on changes in volume and segmental kinetics].

OBJECTIVE: Aim of this perspective study was to assess in patients (pts) with a recent first transmural myocardial infarction (MI) the influence of a physical training, of MI location and of the patency of the infarct-related coronary artery on the modification of the left ventricle volumes and wall motion score. METHODS: One hundred and four consecutive pts with a first transmural MI without clinical contraindication (heart failure, moderate or severe mitral regurgitation, severe postinfarction angina, claudication or severe orthopedic problems) were randomly assigned to a rehabilitation group (A) and to a control group (B). Ten days after acute MI all pts underwent a coronary angiography. A complete echocardiographic examination was performed 10 and 90 days after MI, and an ergometric evaluation 20 and 90 days after MI. Ventricle volumes, ejection fraction (EF) and wall motion score were calculated by a two-dimensional echocardiogram. Thirteen pts (12.5%) were excluded from the study because of the bad quality of the echocardiographic images. There were 8 dropouts (7.8%) due to bypass surgery or to coronary angioplasty. Of the 83 pts who have concluded the study 46 (55%) belonged to the Group A and 37 (45%) to the Group B. Thirty-six had anterior MI (20 Group A), 41 inferior MI (22 Group A) and 6 lateral or posterolateral MI (4 Group A). RESULTS: At the base-line the ventricular volumes, the EF, the wall motion score and the Total Work Capacity (TWC) were not different in the two groups. Three months after the MI the pts of the Group A demonstrated, in comparison with the controls, a reduction of left ventricle end-diastolic volume index (EDVi 75.4 +/- 18.1 ml/m2 vs 85.3 +/- 27.9 ml/m2; p < 0.05) and an increased TWC (7146 +/- 3566 Kgm vs 4494 +/- 2728 Kgm; p < 0.001). In the Group A the comparison of the base-line data with those observed 3 months later showed a reduction of the EDVi from 81.9 +/- 16 to 75.4 +/- 18.1 p < 0.05, of the end-systolic volume index (ESVi) from 43.6 +/- 11.9 to 38.1 +/- 14 ml/m2, p < 0.05, of the wall motion score from 6.7 +/- 2.3 to 5.5 +/- 2.9 p < 0.05 and a great increase of the TWC (from 4483 +/- 2407 Kgm to 7146 +/- 3566 Kgm; p < 0.0001). No parameter in the Group B showed any significant modification in the same period. The tendency to reduce the volume and improve the physical performance with exercise training was greater in the inferior MI (ESVi from 41.3 +/- 12.3 to 34.7 +/- 11.6 ml/m2, p = 0.07 - TWC from 4652 +/- 2446 to 8115 +/- 3954 Kgm, p < 0.001) than in the anterior MI (ESVi from 445.8 +/- 10.7 to 42.1 +/- 17.2 ml/m2, p = ns - TWC from 4085 +/- 2103 to 5829 +/- 2256 Kgm, p < 0.05). When comparing pts with an occluded infarct-related coronary artery with TIMI grade 0-2 flow with those with a patent one (TIMI grade 3 flow), no significant differences in any considered parameter except for the collateral vessels score were found (1.48 +/- 0.97 vs 0.29 +/- 1.64 p < 0.05). After 3 months 20 pts presented larger EDVi compared to the baseline, and compared to the 34 pts with a smaller EDVi, they had a higher serum myocardial enzymatic peak (LDH 2035 +/- 1423 vs 1346 +/- 683 p < 0.01, CK 3096 +/- 2339 vs 2099 +/- 1520, p < 0.05) an inferior collateral score (0.47 +/- 0.77 vs 0.67 +/- 1.98, p < 0.01) and they mainly belonged to the Group B (55%). Twenty pts had an initial EF < or = 40% (range 22-40%): 5 of the 6 pts of this group, who increased the EDVi after 3 months belonged to the Group B while 9 of the 10 pts who reduced it belonged to the Group A. CONCLUSIONS: Intensive physical training during the 3 months following a first transmural MI significantly improves the physical performance, reduces the ventricle size and improves the wall motion score. Such improvement could not be found in the control group and is not related to the patency of the culprit coronary artery. The pts with an inferior MI tended to gain a major advantage from the physical activity than the pts with an anterior

Aged↗