Renal-retinal diabetic syndrome.
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Diabetes Mellitus, Type 2↗
Biomedical subjects
F Giordano
Publications and source records attributed to F Giordano.
Effects on respiratory function of the head-down position and the complete covering of the face by drapes during insertion of the monitoring catheters in the cardiosurgical patient.
BACKGROUND: We evaluated the effect on the respiratory gas exchange of the 30 degrees head-down position and the complete covering of the face by sterile drapes. These are used to cannulate the internal jugular vein and position the pulmonary artery catheter in the cardiosurgical patient. During the two manoeuvres, 20 coronary patients and 10 patients with end-stage heart disease were supplied with oxygen (FiO2 =0.4) by a Venturi mask, while 20 coronary patients breathed room air. The arterial blood samples to measure oxygen (PaO2) and carbon dioxide (PaCO2) tension and oxygen saturation (SaO2) were analysed by a blood gas system. RESULTS: The contemporary application of the head-down position and the drapes over the face significantly increased PaO2 and SaO2 in all the patientssupplied with oxygen. Without the head-down position, leaving the drapes over the face, did not significantly change the two parameters in the coronary patients supplied with oxygen, but induced a significant increase in PaO2 and SaO2 in the patients with end-stage heart disease. In the coronary patients that were breathing room air, PaO2 and SaO2 were stable throughout the study. CONCLUSIONS: We conclude that the 30 degrees head-down position and the complete covering of the face by drapes does not interfere with respiratory gas exchange and can be safely performed in coronary patients supplied with oxygen or breathing room air and in patients with end-stage heart disease supplied with oxygen (FiO2 of 0.4).
Journal Article↗
In vitro and in vivo evaluation of oral systems for time and site specific delivery of drugs (Chronotopic technology).
This paper reports the in vivo and in vitro evaluation of an oral system for time and/or site specific drug delivery prepared according to Chronotopic technology. The proposed device consists of a drug containing core coated by a hydrophilic polymeric layer, which determines the delay in release onset. By applying an outer gastroresistant film, and by properly modulating the delay duration, a colon-specific release can be achieved. The obtained results show that the proposed delivery system is capable of releasing drug after a programmed time (time-specific release) and of targeting the colon (site-specific release) when an external gastroresistant film is applied on units coated with an appropriate amount of a hydrophilic retarding polymer.
Adult↗
Crystal forms of piroxicam pivalate: preparation and characterization of two polymorphs.
This study investigates the polymorphism of piroxicam ester with pivalic acid. Two crystal modifications were prepared by recrystallization from toluene (form 1) and ethyl acetate (form 2). Data regarding preparation conditions, solid state properties, and physicochemical characterization of two polymorphs by means of FT/IR spectroscopy, X-ray diffractometry on powder, and thermal analysis are reported. Heat of fusion rule and thermodynamic formulas consistently indicate an enantiotropic stability relationship of forms 1 and 2 with a calculated transition point (32 degrees C) near the ambient temperature. The phase diagrams of each polymorph with piroxicam were also investigated in order to gain information about the thermal behavior of their solid mixtures. Liquidus curves calculated by the Schröder-Van Laar equation from fusion enthalpies and temperatures were found to agree satisfactorily with experimental results obtained by first heating runs with differential scanning calorimetry.
Anti-Inflammatory Agents, Non-Steroidal↗
Structural characterization of two polymorphic forms of piroxicam pivalate.
The crystal and molecular structures of two polymorphs of piroxicam pivalate are presented and discussed. A peculiarity of the high melting (154 degrees C) polymorph is the association of piroxicam pivalate molecules as centrosymmetric dimers by hydrogen bonding. Two centrosymmetrically related N-H...N hydrogen bonds maintain the dimer structure involving the amido nitrogen atom as donor and the pyridine nitrogen atom as acceptor. Molecular association of this type does not occur in the crystal structures of drugs belonging to the oxicam class of nonsteroidal antiinflammatory drugs. Two distinct conformations coexist in the crystal of the low melting polymorph (136 degrees C) with differing hydrogen bonding arrangements within domains of the crystallographically independent molecules. The occurrence of different molecular conformations (conformational polymorphism) associated with different hydrogen bonding schemes in discrete domains is an unusual structural feature. Structural data for the two polymorphs are also correlated with the relevant infrared spectra. Computer-generated X-ray powder diffraction patterns for the two polymorphs of piroxicam pivalate are in very good agreement with the experimental ones, thus confirming the validity of the single-crystal X-ray models.
Crystallization↗
IgA nephropathy complicating diabetic glomerulosclerosis.
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Diabetes Mellitus, Type 2↗
The use of beta-cyclodextrin as a pelletization agent in the extrusion/spheronization process.
The use of beta-cyclodextrin for the preparation of pellets by the extrusion/spheronization process is described for different formulations and processing conditions. Sieve analysis and friability tests were performed to assess the physical and technological characteristics of pellets. Satisfactory products were obtained with beta-cyclodextrin contents up to 90% by weight.
Cyclodextrins↗
Solitary fibrous tumour of the submandibular gland.
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Biomarkers↗
Use of the ARPE-19 cell line as a model of RPE polarity: basolateral secretion of FGF5.
PURPOSE: To determine the polarity of fibroblast growth factor 5 (FGF5) secretions from retinal pigment epithelium (RPE) cells and to examine the viability and utility of the ARPE-19 cell line as a model for the study of RPE polarity. METHODS: Influenza infection and adenovirus-mediated gene transfer were used to deliver and express genes encoding influenza hemagglutinin (HA), p75-NTR (a neurotrophin receptor), low-density lipoprotein (LDL) receptor (LDLR), and FGF5 in confluent monolayers of ARPE-19 cells. The localization of HA, p75-NTR, and LDLR was determined by confocal microscopy. Domain selective biotinylation assays were used to quantitatively determine the polarities of p75-NTR and LDLR. The secretion of FGF5 into the apical and basal media of ARPE-19 cultures was examined by immunoblot analysis of conditioned media. RESULTS: Hemagglutinin and p75-NTR were found to be localized on the apical surface of infected and transduced ARPE-19 cells. In contrast, LDLR was associated preferentially with the basolateral membrane of ARPE-19 cells. Biotinylation studies indicated that 84% of p75-NTR was present on the apical surface, and 79% of LDLR was basolaterally polarized. Over the course of 6 hours, more than 90% of the total secreted FGF5 protein accumulated in the basolateral media. CONCLUSIONS: ARPE-19 cells exhibit a polarized distribution of cell surface markers when examined by either confocal microscopy or surface-labeling assays. This indicates that the ARPE-19 cell line is a valid model for studies of RPE cell polarity. FGF5, a secreted protein normally produced by RPE cells, is accumulated preferentially in the basal media after only 6 hours, suggesting that it is vectorially secreted from the basolateral surface of ARPE-19 cells.
Basement Membrane↗
Study of the complexation behaviour of gliclazide with partially methylated beta-cyclodextrin in solution and solid state.
The complexation of Gliclazide (GL) with a partially methylated beta-cyclodextrin was studied. Phase-solubility and (1)H NMR spectroscopy were employed to investigate the complexation behaviour in solution and to demonstrate the complexation in liquid medium with the participation of both azabicyclooctyl and tolyl moieties of GL in the inclusion process. Solid systems prepared by kneading, co-grinding and spray drying have also been checked, using DSC and HSM, for assessing the formation of the inclusion compound. Experimental evidence of the complexation between drug and cyclodextrin was reported for the co-ground and spray-dried systems.
Journal Article↗
Nuclear magnetic resonance investigations of the inclusion complexation of gliclazide with beta-cyclodextrin.
The formation of the gliclazide-beta-cyclodextrin (GL-beta-CD) inclusion compound has been studied in the liquid state by phase solubility techniques and by 1H and 13C NMR spectroscopy. From the initial straight portion of the solubility curve (Bs type), the value of the apparent stability constant (Kc) was calculated as 1094 M(-1). The nuclear magnetic resonance studies confirm that GL yields a complex with beta-CD in aqueous medium, which is mainly due to the penetration of the azabicyclooctyl group of GL into the cavity of beta-CD. The study of the monodimensional nuclear Overhauser effect (NOE) of the H3 proton of CD has shown that the tolyl group also interacts with CD, but to a lesser extent than the azabicyclooctyl moiety. Finally, the application of the continous variation technique confirmed the 1:2 drug:CD stoichiometry of the complex.
Cyclodextrins↗
Pulmonary lymphangioleiomyomatosis and renal papillary cancer: incomplete expression of tuberous sclerosis?
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Adult↗
[Squamous carcinoma of the gallbladder. Anatomo-clinical study of a case with reference to oncogene expression].
Squamous cell carcinoma of the gallbladder is a rare tumor with an ill-defined clinical course. We report a case of pure squamous carcinoma of the gallbladder with a rapidly fatal outcome. The tumor cells were positive for oncogenes P53, c-Erb B2 and Ki 67. This feature has no comparison with other reported cases of squamous carcinoma of the gallbladder but it is in accordance with oncogene expression in adenocarcinomas.
Carcinoma, Squamous Cell↗
Phorbol myristate acetate-induced hypertrophy of neonatal rat cardiac myocytes is associated with decreased sarcoplasmic reticulum Ca2+ ATPase (SERCA2) gene expression and calcium reuptake.
The decreased expression of the sarcoplasmic reticulum Ca(2+)-ATPase associated with cardiac hypertrophy was investigated in cultured neonatal rat cardiac myocytes. Northern blot analysis indicated a significant 55-60% decrease in Ca(2+)-ATPase mRNA levels and after 12 and 24 h of treatment with the phorbol ester phorbol myristate acetate (PMA). Myocytes treated with the phorbol ester for 80 h showed a significant 34% decrease (relative to vehicle-treated control cells) in the levels of Ca(2+)-ATPase protein, and a significant 38% increase in the levels of alpha-sarcomeric actin, as assessed by Western blot analysis using specific antibodies. Immunocytochemistry of myocytes treated for 72 h with the phorbol ester revealed a hypertrophied cell morphology, and showed a marked decrease in Ca(2+)-ATPase staining intensity. Contractile calcium transients were evaluated through the use of indo-1. It was found that the t1/2 for the decline of calcium transient was significantly prolonged by PMA treatment (0.51 +/- 0.15) when compared to controls (0.38 +/- 0.17, P < 0.001). Treatment of myocytes with endothelin-1 also led to a 35% decrease in sarcoplasmic reticulum Ca(2+)-ATPase mRNA levels. It is concluded that phorbol ester treatment of neonatal rat cardiac myocytes induces similar changes in Ca(2+)-ATPase mRNA levels. It is concluded that phorbol ester treatment of neonatal rat cardiac myocytes induces similar changes in Ca(2+)-ATPase gene expression as observed in vivo in the hypertrophied and failing heart. The observed prolongation in t1/2 for [Ca2+]i decline might be due to the observed depressed levels for sarcoplasmic reticulum Ca(2+)-ATPase in PMA treated cells.
Animals↗
Effects on renal function of a continuous infusion of nifedipine during cardiopulmonary bypass.
OBJECTIVES: To evaluate the effects on renal function of continuously administered nifedipine during cardiopulmonary bypass (CPB) in patients undergoing cardiac surgery. DESIGN: The study was prospective, randomized, and controlled. SETTING: The study was performed in the Department of Anesthesia and intensive care unit of a regional hospital in Italy. PARTICIPANTS: Thirty-four patients scheduled for elective coronary artery surgery; all patients had preoperative renal and hemodynamic function within normal limits. INTERVENTIONS: The patients were randomly divided into two equal groups: nifedipine and control. Twenty patients were included in the study: 10 patients in the nifedipine group (group A) and 10 patients in the control group (group B). In group A, nifedipine was continuously administered during CPB at an infusion rate ranging from 0.24 to 0.59 micrograms/kg/min to maintain the mean systemic arterial pressure (MAP) between 60 and 70 mmHg. In group B, increases of MAP above 70 mmHg were treated with IV boluses of urapidil (5 mg). MEASUREMENTS AND MAIN RESULTS: Renal function was studied using creatinine clearance (CRCL), determined before, during, and after the operation, and the glomerular filtration rate (GFR) was measured the day before and after the operation by plasma and urine clearance of 51-chromium edetic acid (51Cr-EDTA). Hemodynamic monitoring was performed using a pulmonary artery catheter. In comparison with preoperative determinations, CRCL and GFR values increased significantly after CPB (p < 0.001) and after the operation (p < 0.01) in the patients treated with nifedipine, whereas the two parameters showed a small and not significant reduction at the same times in the control patients. Hemodynamic function was well maintained in all patients throughout the study. CONCLUSIONS: It is concluded that, besides the maintenance of adequate hemodynamics, a continuous infusion of nifedipine during CPB can be an additional therapeutic tool to protect renal function in cardiac surgical patients.
Aged↗
Sarcomatoid carcinomas: pathological and histopathogenetic considerations.
Malignant tumors with a mixed phenotype are a controversial field of pathology. In this article the morphological aspects and the immunohistological characterization of sarcomatoid carcinomas are presented. These uncommon neoplasms show both carcinomatous and sarcomatous features, and have been described in the past under a variety of different names causing great uncertainty about their classification and histogenesis. They can occur in various anatomical sites and exhibit a wide range of microscopic appearances, but some features are quite characteristic and are found in many cases. Morphological "transition" between carcinomatous and sarcomatous tissue, and detection of epithelial characteristics by electron microscopy or immunohistochemistry in the sarcomatous component, are very peculiar features of these neoplasms, providing both helpful clues for pathological diagnosis and important insights into histogenesis. Here a unifying histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcomatoid tissue is proposed and supporting literature data from both experimental systems and clinicopathological observations are reviewed and discussed.
Carcinoembryonic Antigen↗
Nosocomial outbreak of Aspergillus fumigatus infection among patients in a renal unit?
Aspergillus fumigatus is present in the environment worldwide and it is only able to infect debilitated or immunodepressed subjects. Nosocomial outbreaks of A. fumigatus infection have been associated with hospital reconstruction. Spores are released into the environment and are inhaled by immunodepressed patients housed in nearby Medical Units. Specific clinical syndromes are allergic bronchopulmonary aspergillosis and invasive pulmonary aspergillosis with characteristic radiological features. Invasive A. fumigatus infection is commonly fatal, even if promptly diagnosed and treated. Three consecutive cases of A. fumigatus infection occurred in debilitated patients housed in our Renal Unit while building renovation near the Unit was being performed. Two of these patients died and pulmonary and diffuse aspergillosis was found on postmortem examination. The third patient, highly suspected to be infected with Aspergillus, was aggressively and successfully treated with liposomal amphotericin B. Our experience suggests that fungal infections have gained increasing prominence in clinical medicine and they must be considered in chronic debilitated patients including dialysis patients, and that liposomal amphotericin B represents an important advance in the treatment of aspergillosis.
Aged↗
A physiochemical approach to the investigation of the stability of trimethoprim-sulfamethoxazole (co-trimoxazole) mixtures for injectables.
The stability of the trimethoprim/sulfamethoxazole (1:5, w/w) combination suitable for administration by injection was investigated to determine the nature of solid phases that can separate after dilution with infusion fluids. Phase-solubility analysis was performed on the binary system in water and in buffered aqueous media (pH 7 and 9), thus allowing a comprehensive picture of solid-solution compositions. Commercial samples of this combination were tested for solid phases separating after dilution with various infusion fluids. The interaction between trimethoprim and sulfamethoxazole, forming a 1:1 molecular compound with low solubility in water, is mainly responsible for the physicochemical properties of mixtures of these drugs in solution. Other solid phases (i.e., trimethoprim monohydrate and sulfamethoxazole emihydrate) can separate on long-term standing of solutions, depending on the value of the pH of the medium and the fluid used for dilution.
Calorimetry, Differential Scanning↗