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Biomedical subjects

F Franchi

Publications and source records attributed to F Franchi.

At least 91 records · Page 5Linked to original sources
PubMed1992

[Arrhythmogenicity in left ventricular hypertrophy in mild to moderate arterial hypertension].

BACKGROUND: Several studies have evidenced that hypertensive patients (pts) with left ventricular hypertrophy (LVH) have an increased incidence of malignant ventricular arrhythmias and sudden death. The purpose of our study was to investigate the prevalence of risky ventricular arrhythmias in uncomplicated hypertensive pts (untreated during last 10 days) in comparison with normotensive ones. In this context, not only the value of left ventricular mass index (LVMI) was taken into account, but also the type of LVH and the related functional behaviour. PATIENTS AND METHODS: 59 untreated mild to moderate essential hypertensives (EH), without symptoms or signs of coronary artery disease, were classified in 3 groups: normal (i.e. without hypertrophy) EH (NEH: 12 pts, 6 M and 6 F, mean age +/- SD 52 +/- 10 yrs), concentric hypertrophic EH (CEH: 30 pts, 15 M and 15 F, mean age +/- SD 59 +/- 10 yrs), and eccentric hypertrophic EH (EEH: 17 pts, 7 M and 10F, mean age +/- SD 60 +/- 10 yrs), according to echocardiographic measurements. Values and duration of arterial hypertension were comparable among the groups. A normotensive, age-matched group was studied as control (C: 21 pts, 11 M and 10 F, mean age +/- SD, 57 +/- 10 yrs). 24-hour Holter electrocardiographic monitoring (ECG-H) and Signal-Averaged electrocardiography (SAECG) were performed seeking to identify the arrhythmogenic risk. Echocardiographic analysis was accomplished by means of a computerized system: LVMI, ratio of LV wall thickness to LV internal radius (relative wall thickness = RWTh), systolic velocity of circumferential fractioning (VCFs), peak of LV relaxation rate (pLVRr) and peak-systolic stress (pSS) were evaluated. RESULTS: Normal LV systolic function was generally found, but both NEH and EEH groups showed a significant reduction in pLVRr in comparison with C and CEH groups (mean values +/- SD: 3.52 +/- 1,3 and 3.40 +/- 0.9 vs 4.92 +/- 0.4 and 4.27 +/- 1.4 sec-1, respectively, p < .05 for both). pSS was significantly higher in EEH and NEH than in CEH and C (mean values +/- SD: 149 +/- 42 and 157 +/- 66 vs 116 +/- 28 and 122 +/- 15 10(3) dynes/cm2, respectively; p < .05 for both). At ECG-H, EEH had a prevalence of potentially malignant ventricular arrhythmias (PMVA: ventricular extrasystoles > or = 30/h; ventricular couplets, > or = 2 episodes/24h, or triplets, > or = 1 episode/24h; R on T), significantly larger than in C (35.3% vs 4.8%, p < .05) and almost significantly larger than in NEH and CEH (8.3% and 10%, respectively). No differences in LVMI were found between EEH with or without PMVA. In respect of functional LV behaviour, the former group showed lower values of VCFs (2.33 +/- 0.6 vs 3.71 +/- 1.32 sec-1, (p < .005) than the latter group. At SAECG, the EEH exhibited again a greater prevalence of abnormal findings than C (35.3% vs 0%, p < 0.5). No correlations were found between ECG-H and SAECG abnormalities, nor between the latter group and LVMI or LV functional indexes. Among pts showing a more pronounced impairment of diastolic function (pLVRr < 4 sec-1), EEH exhibited the highest prevalence of both PMVA (50%) and late potentials (41%). CONCLUSIONS: Our data suggest that uncomplicated mild to moderate essential hypertension may be associated with higher risk of ventricular arrhythmias, particularly when cardiac involvement is characterized by eccentric LVH. On the contrary, in this stage of hypertensive disease, LVMI as well as LV function do not seem to influence the ventricular arrhythmogenesis. The clinical importance of these findings is uncertain, and further studies are needed.

Adult↗
PubMed1992

Retroperitoneal seminoma secondary to 'burned out' testicular tumor in an acromegalic patient.

We report a case of an acromegalic patient with a retroperitoneal seminoma secondary to a testicular tumor which had completely disappeared. Testicular ultrasonography did not show any pathological mass and histological examination indicated that the normal testis had been totally replaced by fibrous tissue, without neoplastic cells. Our patient had high levels of growth hormone (GH) and prolactin (PRL), both hormones with high immunostimulating effect, and an increase of interleukin-2 receptor-positive lymphocytes, a finding supporting enhanced immunological activity. Thus, we cannot exclude that the immunological pattern of this acromegalic patient may have played some role in the tumoral destruction.

Acromegaly↗
PubMed1991

Low levels of the anticoagulant activity of protein C in patients with chronic renal insufficiency: an inhibitor of protein C is present in uremic plasma.

Twenty-nine of 54 uremic patients had low levels of protein C measured as anticoagulant activity, contrasting with normal levels measured as amidolytic activity or antigenic concentration. We demonstrate that this discrepancy is due to the presence of a soluble plasma inhibitor that interferes specifically with the anticoagulant activity of activated protein C. The inhibitor does not interfere with other coagulation assays. It is resistant to diisopropylfluorophosphate, high temperatures and repeated freezing and thawing. It can be dissociated from protein C by anti-protein C antibodies or by dialysis in vitro and in vivo. It binds to positively charged resins and can be eluted with high salt concentrations without losing its inhibitory capacity. The inhibitory effect is correlated with plasma creatinine levels and fluctuates with time.

Adult↗
PubMed1991

Cancer-associated hemolytic-uremic syndrome with spontaneous resolution. A case report.

A case of cancer-related hemolytic-uremic syndrome is reported. The patient presented a spontaneous recovery, which is unusual in this clinical picture. Mitomycin C is regarded as responsible for this toxic event in most cases. The case history reported here is discussed in relation to dose and scheduling of mitomycin C, and a safe maximum dosage is suggested.

Antineoplastic Agents↗
PubMed1991

5-Fluorouracil (FU) with folinic acid (FA) and mitomycin C (MMC) in the adjuvant treatment of colorectal carcinoma. Part I. Evaluation of toxicity.

Ninety-six patients with colorectal cancer (stage B2-C) were randomized to the control arm or to receive adjuvant chemotherapy with folinic acid, FU and MMC. Ninety-three patients are evaluable. The median follow up is 12 months. The average time between surgery and the start of therapy is 28 days. Toxicity is evaluable in 36 of 41 treated patients. Four patients (10%) failed to complete the projected treatment due to toxicity. Toxicity observed in 208 courses of therapy was mostly gastrointestinal and hematological. No cases of treatment related death or cancer-associated hemolytic uremic syndrome (C-HUS) were reported. The average relative dose intensity (rDI) of the projected treatment was 82.6%. Our study is ongoing and further patients are required to achieve statistically significant results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

5-Fluorouracil (FU) and mitomycin C (MMC) in the management of colorectal carcinoma. Part II. In vitro activity of the two drugs in short-term tumor cultures.

Eighty-seven colorectal adenocarcinomas from untreated patients were investigated by short term tumor cultures to test in vitro sensitivity to 5-fluorouracil and mitomycin C. This study reports the preliminary results of a multistep program aimed at the prospective clinical application of the assay. At present this in vitro experience was performed in parallel with a clinical trial carried out with the same drugs. The in vitro activity of the two anticancer agents is in agreement with the response rate reported in monochemotherapy; our data would suggest an increase of responses using the combination of fluorouracil and mitomycin in comparison to single drug therapy. A low cosensitivity rate and a high number of cases sensitive to one drug but resistant to the other, account for the use of this test as screening of active drugs in the individual patient.

Adenocarcinoma↗
PubMed1991

Blunted growth hormone (GH) responsiveness to GH-releasing hormone in obese patients: influence of prolonged administration of the serotoninergic drug fenfluramine.

The aim of the present study was to ascertain if reduced central serotoninergic activity might contribute to the well-known blunted growth hormone (GH) response to GH-releasing hormone (GHRH) in obese patients. Thus, we studied the effect of prolonged stimulation of the serotoninergic system by fenfluramine (FF; 60 mg twice daily for 7 days) on GHRH-induced GH release in nine obese and seven normal subjects. In controls, GHRH (100 micrograms intravenously [IV]) injection increased GH levels from 2.3 +/- 1.8 (+/- SE) to 18.5 +/- 2.8 mU/L, P less than .002. FF administration enhanced both basal and GHRH-stimulated GH levels (peak, 38.4 +/- 8.3 v 6.9 +/- 2.6 mU/L, P less than .002). This response was significantly higher (P less than .02) than in pretreatment. In obese patients, GH responsiveness to GHRH was slight (peak, 7.1 +/- 2.0 v 0.6 +/- 0.18 mU/L, P less than .01) and lower (P less than .01) than in controls. FF administration did not affect this response. In controls, the enhanced FF-induced GH release after a maximal dose of GHRH indicates that serotoninergic activation influences GH secretion and that the mechanism involved is independent of endogenous GHRH. In obese patients, we found a blunted GH responsiveness to GHRH that was not affected by FF, thus supporting the hypothesis that the serotoninergic control on GH release is impaired.

Adult↗
PubMed1991

Therapy of advanced acute myeloblastic leukemia with cytarabine and interleukin 2.

A child with acute myelogenous leukemia who relapsed three months after an allogeneic bone marrow transplant received intermediate-dose cytarabine followed by interleukin 2 (IL-2). Complete remission was achieved after the first cycle of IL-2. Five more combined cycles of cytarabine and IL-2 were given over the next year, during which remission has persisted. IL-2 therapy affected serum tumor necrosis factor (TNF), interferon gamma (IFN gamma) and soluble IL-2 receptor (sIL-2r) levels. In vitro cytotoxicity against leukemia cell lines and recipient leukemia cells was also increased.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Effect of energy substrate manipulation on tumour cell proliferation in parenterally fed cancer patients.

The effects of isocaloric carbohydrate-based vs. fat-based total parenteral nutrition (TPN) regimens on cancer cell proliferation and host nutritional status were evaluated in 27 patients with tumours of the gastro intestinal tract consecutively assigned to receive for 14 days: a glucose-based (A) or a lipid-based (B) TPN formula, or an oral diet (C) isocaloric and isonitrogenous to A and B. Cancer cell replication rate was evaluated by thymidine labelling index (LI) on tumour samples before and at the end of each nutritional regimen. The number of replicating cells increased by 32.2% in patients receiving regimen A. LI decreased by 24.3% in patients given regimen B. LI values were slightly increased (+15%) in patients maintained on regimen C. Nutritional status remained within normal limits. None of the LI changes observed between and within the three arms of the trial were found to be statistically significant. Thus we failed to prove that glucose consistently stimulates or lipids inhibit tumour proliferation despite a trend in this sense.

Journal Article↗
PubMed1991

Restoration of immune functions after chemotherapy.

A paradigmatic case in which anticancer chemotherapy could paradoxically lead to immune restoration is reported. A patient with hairy cell leukemia was unsuccessfully treated with alpha-interferon. Treatment had to be withdrawn because of unusual toxicity and therapy with cytotoxic drugs had to be administered. Not only did the anticancer agents produce a complete remission of the disease, but the immunological profile of the patient improved. This case report raises the problem of the interference of chemotherapy with the immune system in cancer patients.

Antineoplastic Agents↗
PubMed1991

Cell kinetics of gastrointestinal tumors after different nutritional regimens. A preliminary report.

Forty-four cases of different untreated gastrointestinal tumors were studied with regard to cell kinetic activity. As a pilot experiment, we also determined the 3H-TdR Labeling Index (LI) in 28 patients in basal conditions and after 15 days of nutritional manipulation with prevalently lipid-based or glucose-based feeding to ascertain whether selective nutritional regimens could affect tumor proliferation. Preliminary results from this study indicate that a kinetic perturbation is induced in tumor cells by nutritional manipulation. Lipid-based feeding seems to produce effects similar to those of chemical or physical anticancer agents, thus suggesting a possible supporting role of nutritional manipulation in cancer treatment strategy.

Aged↗
PubMed1991

Naloxone does not modify fenfluramine-induced prolactin increase in obese patients.

OBJECTIVE: To evaluate whether the supposed physiological interaction between serotoninergic and opioidergic pathways in the modulation of PRL release is preserved in human obesity, a pathological condition in which these two systems are greatly impaired. DESIGN: According to a single-blind randomized procedure, three tests were performed: test A (oral placebo + saline infusion over 5 hours), test B (fenfluramine, a well known serotoninergic drug, 60 mg orally + saline infusion over 5 hours) and test C (fenfluramine at the same dose + naloxone, an opiate receptor antagonist, infusion over 5 hours at a dose of 3 mg/h). PATIENTS: Ten obese women (body mass index 34.4 +/- 2.3 kg/m2, mean +/- SE) and ten normal-weight sex and age-matched subjects (body mass index 22.3 +/- 2.4 kg/m2) volunteered for the study. MEASUREMENTS: At each test, blood samples for PRL determination were collected in basal conditions (time 0) and every hour for 5 hours. Plasma PRL was determined by radioimmunoassay. RESULTS: In controls, naloxone significantly reduced the clear-cut PRL increase induced by fenfluramine. In obese patients, serotoninergic stimulation caused an increment in PRL levels similar to that in the controls, but opioid receptor blockade by naloxone did not affect this response. CONCLUSIONS: These findings confirm that there is a physiological relationship between the serotoninergic and the opioidergic systems in the control of PRL secretion and show that this interaction is not present in obese subjects. Our data provide indirect proof of the functional impairment of these two systems in human obesity.

Adolescent↗
PubMed1991

Vaginopathic and proteolytic Candida species in outpatients attending a gynaecology clinic.

Non-pregnant, non-diabetic outpatients were examined for the presence of pathogenic vaginal yeasts to determine if a correlation existed between a specific yeast and clinical disease. Yeasts were isolated as single vaginal species from 186 of 228 subjects with clinically diagnosed candidal vaginitis, as well as from 122 out of 380 asymptomatic, age-matched controls. Apart from Candida albicans and C glabrata, other prevalent species were C krusei, C parapsilosis and Saccharomyces cerevisiae which accounted for 9.2%, 6.0% and 5.4%, and 9.0%, 2.4% and 19.7%, of yeasts from patients and carriers, respectively. Only C albicans and C parapsilosis were significantly more common in those with vaginitis. Only the isolates of these two species secreted aspartyl proteinase in vitro, and the amount of the enzymes secreted by the isolates from patients was significantly higher than that secreted by the isolates from carriers. These two species consistently produced vaginal infection in pseudoestrus rats, whereas none of the non-proteolytic species tested (C glabrata, C krusei, and S cerevisiae) colonised the vagina in these rats. Proteinase secretion correlated with experimental vaginal infection; it could also be a reliable factor for distinguishing clinically active infection from asymptomatic fungal carriage.

Adult↗
PubMed1991

Effect of right atrial stimulation on both atrial pressure and atrial natriuretic peptide release in essential hypertension.

UNLABELLED: Several reports indicated a direct relationship between atrial pacing and atrial natriuretic peptide (ANP) blood levels, but few controlled hemodynamic studies have been reported. In particular, the relationship between increase in heart rate, release of ANP and increase in right atrial pressure (RAP) are still uncertain. Moreover, the effect of accelerated heart rate on ANP secretion in patients with essential hypertension has not yet been fully elucidated. For this, we studied 12 untreated essential hypertensive (EH; WHO stage I-II) and 10 age-matched normotensive subjects (NO) as control by right atrial stimulation (parasinusal site) in consecutive steps of 110, 130 and 150 b.p.m., each step lasting for 5 min. Both before and during stimulation at each pacing rate (after 5 min) RAP and systolic blood pressure (SBP) were measured and blood was drawn from the right atrium for ANP measurements (radioimmunoassay method). During stimulation we observed significant differences in the ANP release in comparison to the initial values: at 130 (p less than 0.05) and at 150 b.p.m. (p less than 0.01) in EH; at 150 b.p.m. (p less than 0.005) in NO. RAP and SBP did not differ significantly at each pacing rate from initial values both in EH and NO. No significant differences in ANP and RAP were found between EH and NO. IN CONCLUSION: (a) ANP release increases in both EH and NO, even if beginning at 130 in EH and at 150 b.p.m. in NO; (b) in both EH and NO, there is no relationship between RAP or SBP values and ANP secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial Natriuretic Factor↗
PubMed1991

Long-term intramuscular administration of thyrotropin-releasing hormone tartrate in patients with cerebrovascular disease: effects on the pituitary-thyroid axis.

We studied the effects of long-term (30 days) refracted daily intramuscular administration of 4 mg TRH tartrate (TRH-T) on the pituitary-thyroid axis in 20 euthyroid patients affected by cerebrovascular disease (CVD). All subjects were assayed for T4, T3, FT4, FT3, TSH and TBG plasma levels before treatment (D0), after 15 and 30 treatment days (D15, D30), and after a 15-day washout (D45). In addition, TSH response to 200 micrograms intravenous TRH was assessed at D0, D30 and D45. We observed a significant increase in T4, FT4 and FT3 levels in the face of decreased TSH concentrations. A blunted TSH response to TRH bolus persisted at D30. These data demonstrate that the down-regulation mechanism may be partially overcome in vivo when thyrotrophs are chronically exposed to pharmacological TRH-T doses and that TSH pattern is mainly due to the negative feedback of thyroid hormones, even though pituitary TSH reserves may become depleted. Furthermore, prolonged TRH-T administration does not produce hyperthyroidism in euthyroid CVD patients.

Aged↗
PubMed1991

Fractional incorporation of radionucleotides, a marker of in vitro tumor cell chemosensitivity in colorectal cancer.

Working with the antimetabolic chemopredictivity assay on short term cultures we evidenced a correlation between in vitro chemosensitivity of colorectal cancer and fractional incorporation of radionucleotides. Four different drugs (5-FU, mitomycin C, 4'-iododeoxydoxorubicin and ruboxyl, a nitroxyl derivative of daunorubicin) were tested on 102 tumor cultures. The extent of 3H-TdR and 3H-UdR incorporation into DNA and RNA in the related control cultures was in relationship with the chemosensitivity of the tumor. Along with the labeling index this simple metabolic-kinetic trait may gain a role for the screening of tumor phenotypes sensitive to chemotherapy.

Antineoplastic Agents↗