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Biomedical subjects

C Vergani

Publications and source records attributed to C Vergani.

At least 19 recordsLinked to original sources
PubMed1995

Videothoracoscopic staging and treatment of lung cancer.

Videothoracoscopy, routinely performed as the initial step of an operation, opens interesting opportunities for both the operative staging and treatment of lung cancer. Videosurgical maneuvers ensure thorough exploration of the cavity, thus avoiding unnecessary exploratory thoracotomies, confirming resectability of the lesion by open or, in selected cases, by a direct video-assisted approach. We report our experience of 155 patients submitted to videothoracoscopic operative staging between October 1991 and January 1994. Videothoracoscopic operative staging showed unresectability in 13 patients (8.3%) due to preoperatively unexpected (10 patients) or suspected conditions (3 patients). The remaining 142 patients were divided by staging of the lesion and general conditions into three groups. Group A consisted of 13 elderly patients with small peripheral tumor who could not tolerate lobectomy and who underwent thoracoscopic wedge resection. Group B consisted of 63 patients with peripheral clinical T1 N0 or T2 N0 tumor. Fifty-two lobectomies and 4 pneumonectomies were carried out thoracoscopically. Seven conversions to thoracotomy were necessary due to technical problems. The postoperative course was uneventful in 51, 5 had prolonged air leakage, and a bronchial fistula developed in 1 because of positive-pressure postoperative ventilation. Group C consisted of 66 patients with stage II or IIIa neoplasm. Thoracotomy after thoracoscopy proved unresectability in 4, whereas 62 were submitted to a radical pulmonary resection. In the literature the incidence of exploratory thoracotomies for conditions missed by preoperative staging still remains high. After adoption of videothoracoscopic operative staging we reported a 2.6% exploratory thoracotomy rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

[Changes in the compliance of the radial artery in normotensive subjects with familial hypercholesterolemia].

BACKGROUND: Recent studies have shown that in normotensive hypercholesterolemic subjects endothelial dependent dilatation of arterioles is impaired. METHODS: We studied the effects of hypercholesterolemia on arterial compliance in normotensive subjects of both sexes, with a normal serum cholesterol (n = 8, total serum cholesterol = 209 +/- 7 mg/dl, means +/- SEM), an elevated serum cholesterol (n = 8, 285 +/- 8 mg/dl) and familial hypercholesterolemia (n = 8, 393 +/- 20 mg/dl). All subjects were normotensive and devoid of clinical and laboratory evidence of atherosclerotic lesions. The mean age of the 3 groups was 46.7 +/- 2.5, 51.5 +/- 2.9 and 49.8 +/- 2.9 years respectively. In hypercholesterolemic subjects use of hypolipidemic drugs was stopped 2 months before the study. Arterial compliance was measured from the radial artery by an echo-tracking device capable of providing radial artery diameter and, with the addition of a Finapres device, diameter/pressure and compliance/pressure curves continuously over the systolic-diastolic blood pressure range. RESULTS: Mean arterial pressure was similar in the three groups (84.5 +/- 6.1, 79.8 +/- 2.4 and 73.1 +/- 4.4 mm Hg). Arterial compliance was similar in normocholesterolemic and non familial hypercholesterolemic subjects but it was strikingly reduced (50%) in familial hypercholesterolemic subjects. The reduction was even more evident following prolonged local ischemia because while in the first two groups arterial compliance increased after ischemia, in familial hypercholesterolemia no increase occurred. CONCLUSIONS: Thus, familial hypercholesterolemia is accompanied by a striking CONCLUSIONS: Thus, familial hypercholesterolemia is accompanied by a striking reduction in radial artery compliance, i.e. a marked increase in arterial wall stiffness. This may increase the traumatic effect of blood pressure on the arterial wall, favouring atherosclerosis. The lack of compliance alterations in non familial hypercholesterolemia suggests that this hemodynamic disturbance either occurs when serum cholesterol is more markedly increased or it has a genetic origin.

Analysis of Variance↗
PubMed1994

Videothoracoscopic excision of mediastinal masses: indications and technique.

Mediastinal masses are generally excised through wide thoracotomies or median sternotomies. These lesions are often benign, usually asymptomatic, discovered incidentally, and relatively easy to resect. For these reasons, a minimally invasive approach is appropriate. Videothoracoscopy allows an optimal exploration of the pleural cavity and a panoramic view of the mass. Dissection is usually easy to perform, and the mass can be extracted from the thorax through a trocar incision or through a limited "utility thoracotomy." To avoid possible tumor seeding, the mass is inserted in a plastic bag before extraction. From September 1991 to January 30, 1994, 20 mediastinal masses (6 thymomas, 2 thymic cysts, 1 hyperplastic thymus, 1 fibrous tumor of the mediastinum, 2 pleuropericardial cysts, 2 thoracic teratomas, 2 large thoracic lipomas, 3 neurogenic tumors, and 1 bronchogenic cyst) were removed through such a minimally invasive approach. Eighteen patients had an uneventful postoperative course. Two patients hemorrhaged in the immediate postoperative period, and repeat thoracoscopy was done. In 1 patient, electrocoagulation of a bleeding intercostal artery controlled the hemorrhage. In the other, the source of bleeding could not be found, and removal of the clots and irrigation of the cavity stopped the hemorrhage. Further data and long-term follow-up are necessary, but videothoracoscopy offers a new, less invasive approach for the management of noninvasive mediastinal masses.

Adult↗
PubMed1994

Tracheal sleeve pneumonectomy for bronchogenic carcinoma.

For a long time, primary tumors arising less than 2 cm distal to the carina have presented a contraindication to surgical excision. Tracheal sleeve pneumonectomy technique allows carinal resection and reconstruction but still carries considerable postoperative complications. From 1983 to 1992 we performed 27 right tracheal sleeve pneumonectomies and one left. Fourteen patients had N0 nodes, nine had N1, and five had N2. No anastomotic complications, either fistula or stenosis, were observed. Successful outcome depends on meticulous attention to surgical details and careful anaesthetic management with a new ventilation tube. One patient died on the twenty-second postoperative day from myocardial infarction. Complications included pneumonia (one), vocal cord paresis (two), and pleural empyema without bronchial fistula (one). Conservative treatment allowed complete recovery from all complications. There are seven patients alive at 4 years after operation and one at 5 years. Six patients have been disease-free for between 1 and 32 months. Two patients died free of disease at 13 and 42 months. Two patients died of mediastinal recurrence and 10 of distant metastases within 6 and 54 months.

Adult↗
PubMed1993

Expression and alternative splicing of fibronectin mRNA in human diploid endothelial cells during aging in vitro.

Different mRNAs for fibronectin arise from the variable processing of a single primary transcript. We used ribonuclease protection assay to investigate the changes occurring in fibronectin expression and the alternative splicing of mRNA precursor during aging in vitro of human diploid endothelial cells. Senescent endothelial cells release more protein and contain 4-5-fold more fibronectin mRNA than young cells. The pattern of alternative splicing of fibronectin mRNA, with the EDA and the CS1 segments largely included (35% and 77%, respectively) and the EDB segment undetectable, correlates well with previous studies at the protein level both in vitro and in vivo. No changes in the splicing pattern of fibronectin mRNA precursor were detected during endothelial cellular senescence. The increased expression of fibronectin in senescent cells may be a result of the activity of interleukin-1 alpha, which is overexpressed in senescent endothelial cells. It could be also important in vivo during aging and in atherosclerotic lesions.

Alternative Splicing↗
PubMed1993

Major pulmonary resections: pneumonectomies and lobectomies.

We report on our experience in 20 patients who underwent major thoracoscopic pulmonary resections between October 1991 and November 1992. These consist of 2 left pneumonectomies, 17 lobectomies, and 1 segmentectomy. The indications were strictly limited to benign pulmonary diseases and stage I (TNM) primary lung cancer. A hilar lymphadenectomy was performed in all cases of malignancy. Our surgical technique is described. Our findings demonstrate the feasibility of performing major video-assisted thoracoscopic pulmonary resections, even though the definite role of this procedure in the management of lung cancer must still be defined.

Female↗
PubMed1993

Videothoracoscopic excision of a mediastinal thymoma.

The authors have applied the advances in optics, endotelevision monitoring, and instrumentation that have led to the development of videoendoscopic abdominal surgery to performing major excisional procedures in the thorax. A videothoracoscopic technique for the removal of a mediastinal thymoma is described. The procedure was done on a 24-year-old woman suffering from a benign lymphoepithelial thymoma of the mediastinum. The mediastinal mass was mobilized under videolaparoscopic guidance and extracted from the thorax through a small (4 cm) inframammary incision. The postoperative course was uneventful, and the patient experienced minimal postoperative pain. She was discharged on the 3rd postoperative day with excellent functional and cosmetic results and resumed normal activity 4 days later.

Adult↗
PubMed1992

Association of a polymorphism in the Apo AI gene promoter with hyperalphalipoproteinemia.

The distribution of a polymorphism due to an Adenine to Guanine transition in the ApoAI gene has been studied in 136 women and 108 men, through amplification of the promoter region of the gene and allele-specific oligonucleotide hybridization. The allelic frequencies for the A allele were 0.10, 0.14 and 0.27 in women and 0.08, 0.17 and 0.14 in men for the lowest decile, intermediate group and the highest decile of HDL-cholesterol levels, respectively. Statistical analysis showed that the A allele was associated with high HDL-cholesterol levels in women, but not in men.

Alleles↗
PubMed1992

High density lipoproteins: physiopathology and clinical relevance.

On September 13-14 1991 a Symposium on High Density Lipoproteins: Physiopathology and Clinical Relevance was held in Bellagio (Italy). This Symposium was aimed at discussing various aspects of HDL from epidemiology to the most recent advances in the understanding of HDL metabolism and factors (diets, drugs) affecting their levels.

Coronary Disease↗
PubMed1992

Free radicals promote modifications in plasma high-density lipoprotein: nuclear magnetic resonance analysis.

The behavior of high-density lipoprotein (HDL) after free-radical-mediated oxidation was studied by incubating plasma HDL with chemical oxidizing systems (Cu++) in conditions similar to those used for low-density lipoprotein (LDL) chemical oxidation. Nuclear magnetic resonance (NMR) spectroscopy (1H and 31P) was used to evaluate the degree of oxidation and to characterize the oxidized products. The almost complete loss of polyunsaturated systems together with an appreciable decrease in choline peak demonstrates large-scale HDL-lipid degradation. The appearance of epoxide systems on fatty chains and the identification of oxidized cholesterol derivatives as cholesterol 5 alpha,6 alpha-epoxide, 5 beta,6 beta-epoxide, 7-keto, and 25-hydroxy confirm this picture. Phospholipid analysis indicates an alteration of the phospholipid profile in lyso-phosphatidylcholine (Lyso-PC) production and the disappearance of phosphatidylethanolamine (PE). This study shows that HDL is extensively degraded although there are no large variations in the classical oxidative monitors, lipid hydroperoxide (LPO) and thiobarbituric acid reactive substance (TBARS). Our results suggest that HDL is significantly modified when submitted to an oxidative process.

Cholesterol↗
PubMed1992

Antioxidant activity of ubiquinone-3 in human low density lipoprotein.

The ability of ubiquinone-3, a short chain ubiquinone homologue, to prevent Cu2+ induced oxidation of human low density lipoprotein was investigated. The results are as follows: in the presence of ubiquinone-3 the extent of peroxidation, as determined by the formation of thiobarbituric acid reactive substances, was only one third of that found in its absence; the quinone can also prevent the fragmentation of apolipoprotein B-100 and the increase of the net negative surface charge of the particle.

Apolipoprotein B-100↗
PubMed1992

Videoendoscopic pulmonary lobectomy for cancer.

A videothoracoscopic right lower pulmonary lobectomy is reported. The excision was done in a 71-year-old man suffering from an adenocarcinoma of the right lower lobe, with an apparent absence of lymphnodal and systemic metastasis. The procedure has been performed using four 10-mm cannulas and a minimal inframammary thoracotomy (4 cm) by inserting a chip camera linked to the thoracoscope and connected to external monitors. The lobar hilar structures were dissected and then sutured-divided with Endo-GIA R shots. The specimen was extracted through the minimal thoracotomy. The postoperative course was uneventful with minimal postoperative pain, and the patient was discharged after complete surgical recovery with excellent functional and cosmetic results. This procedure in selected patients is a new and promising possibility in chest videoendoscopic surgery.

Adenocarcinoma↗
PubMed1991

Tissue-specific splicing pattern of fibronectin messenger RNA precursor during development and aging in rat.

Fibronectin isoforms are generated by the alternative splicing of a primary transcript derived from a single gene. In rat at least three regions of the molecule are involved: EIIIA, EIIIB, and V. This study investigated the splicing patterns of these regions during development and aging, by means of ribonuclease protection analysis. Between fetal and adult rat, the extent of inclusion of the EIIIA and/or EIIIB region in fibronectin mRNA varied according to the type of tissue analyzed; but the inclusion of the V region, and in particular the V25 alternative variant, was significantly higher in all fetal than in adult tissues. These data suggest a crucial role of the V25 variant, possibly related to its interaction with the alpha 4 beta 1 integrin receptor during development. On the other hand, during aging, the only significant change observed in the splicing pattern was a decrease in the EIIIA variant in brain. The high inclusion levels of the EIIIA and EIIIB regions in young adult brain suggest that these segments may play an important role in differentiated brain tissue. The decreasing levels of inclusion of the EIIIA segment in brain fibronectin mRNA during aging may be an age-related marker with functional consequences.

Aging↗