[The cardiologist face to face with pulmonary embolism].
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Cardiology↗
Biomedical subjects
F Greco
Publications and source records attributed to F Greco.
[Congenital abnormalities of the temporal bone. Clinical picture and therapeutic indications].
The embryology of the ear and the different congenital anomalies depending on the arrest in development at a particular embryologic date are reviewed. The historical and the actual attitude towards surgical correction is discussed. The classification system, the evaluation and patients selection, the timing of auricular reconstruction and atresiaplasty, the preoperative evaluation, the patient and parents counselling, the surgical technique, the complications and alternative techniques are discussed.
Craniofacial Abnormalities↗
Experimental Determination of Drop Shape in Slow Steady Shear Flow.
Theoretical predictions for the 3D shape of a Newtonian drop immersed in a Newtonian fluid under slow flow have been available for a long time (C.E. Chaffey and H. Brenner, J. Colloid Interface Sci. 24, 258 (1967); J.M. Rallison, J. Fluid Mech. 98, 625 (1980)). The predictions contain four scalar coefficients, given in terms of the viscosity ratio of the component fluids. In this work, experimental values of such coefficients were measured for the case of two Newtonian fluids in simple shear flow. The experiments were carried out in a parallel plate apparatus, equipped with video-enhanced microscopy, and the measurements were performed by image analysis techniques. The results were also compared to theoretical calculations and provide the first complete assessment of shape predictions for the case of Newtonian fluids. Copyright 1999 Academic Press.
Journal Article↗
Pyrrolo[3,2-c]quinoline derivatives: a new class of kynurenine-3-hydroxylase inhibitors.
A series of pyrrolo[3,2-c]quinoline derivatives were synthesised and evaluated as inhibitors of selected enzymes of the kynurenine pathway. 7-Chloro-3-methyl-1H-pyrrolo[3,2-c]quinoline-4-carboxylic acid (7a) was found to be a relatively potent and selective inhibitor of kynurenine-3-hydroxylase (KYN-3-OHase). A molecular modelling study showed a good superimposition of 7a with PNU-156561 and kynurenine the natural substrate of KYN-3-OHase.
Animals↗
Elastic fibers of musculoskeletal tissues in bovine Marfan syndrome: a morphometric study.
Bovine Marfan syndrome has all the major pathognomonic, clinical, and pathological features of the human syndrome. To further explore the alterations characterizing Marfan syndrome, musculoskeletal tissues from affected and healthy cattle were subjected to histochemical and histomorphometric analysis. Our findings demonstrated reduced elastic fiber content in the periosteum, capsule, interosseous ligament, and flexor tendons of the metatarsophalangeal joint of affected cattle. The elastic properties of a tissue are supplied by elastic fibers in the extracellular matrix; therefore, their reduced content in articular tissues suggests that these fibers could be functionally incompetent to withstand normal stress, causing a predisposition to joint laxity and dislocation. Moreover, perichondrial-periosteal membranes, which are made of collagen and elastic fibers, are known to affect the growth process of the long bones. The decrease in the number of elastic fibers in these membranes could result in reduced restraint of skeletal growth and explain some skeletal abnormalities of Marfan syndrome (i.e., dolichostenomelic habitus).
Animals↗
N,N-dicarboxymethyl chitosan as delivery agent for bone morphogenetic protein in the repair of articular cartilage.
Bone morphogenetic protein (BMP), associated with N,N-dicarboxymethyl chitosan, is used to induce or facilitate the repair of articular cartilage lesions. This association is intended for the synergistic potentiation of the respective biological effects. Data show that BMP-7 enhances the in vivo proliferation of cells with chondrocytes phenotype in the articular environment, leading to partial healing of the articular surface of the lesions. N,N-dicarboxymethyl chitosan is found to be useful as a molecular carrier or drug delivery agent.
Animals↗
Successful treatment of right heart thromboemboli with IV recombinant tissue-type plasminogen activator during continuous echocardiographic monitoring: a case series report.
BACKGROUND AND STUDY OBJECTIVE: Echocardiographic detection of right heart thromboemboli (RHTE) during pulmonary embolism (PE) shows an uncommon but life-threatening event. The treatment of this condition is not well established. The aim of our study is to evaluate the efficacy and safety of recombinant tissue-type plasminogen activator (rt-PA) in treating RHTE. METHOD: We performed a transthoracic echocardiogram within (mean +/- SD) 120+/-45 min from onset of symptoms on 30 consecutive patients with proven massive PE. Seven patients (23%) showed RHTE, four patients (57%) had cardiogenic shock; and all patients showed echocardiographic features of acute cor pulmonale. The seven patients with RHTE received an IV infusion of 100 mg rt-PA over a period of 2 h with continuous echocardiographic monitoring. RESULTS: We observed complete RHTE lysis at 45 to 60 min from the onset of rt-PA infusion and significant reductions at 2 h in the following: 14% in right ventricle (RV) end-diastolic diameter (reduction, 40.8 to 35 mm; p < 0.01); 12% in RV/left ventricular ratio (reduction, 0.83 to 0.73; p < 0.01); and 17% in tricuspid regurgitant flow velocity (reduction, 3.5 to 2.9 m/s; p < 0.01). The interventricular septal and RV wall motions improved. An excellent clinical outcome was achieved rapidly in all patients. No adverse events were recorded. CONCLUSIONS: We demonstrated the rapid, effective, and safe action of rt-PA in RHTE resolution and an improvement in pulmonary perfusion. Our data confirm the important role of an early, systematic echocardiographic approach in order to detect RHTE quickly in patients with suspected massive PE.
Aged↗
[Thrombolytic treatment of type A right atrial thrombi].
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Coronary Thrombosis↗
Short stature, brachydactyly, nail dysplasia, and mental retardation: further observation of the Tonoki syndrome.
We studied a patient with microcephaly, short stature, type B brachydactyly, nail dysplasia, skeletal anomalies, and mental retardation. The mother of the propositus has brachydactyly of thumbs and a similar physiognomy without mental retardation. This appears to be another observation of the Tonoki syndrome, a distinct autosomal dominant or X-linked clinical entity.
Adolescent↗
4-Phenyl-4-oxo-butanoic acid derivatives inhibitors of kynurenine 3-hydroxylase.
Kynurenine 3-hydroxylase (KYN 3-OHase) is a key enzyme in the kynurenine pathway of tryptophan degradation and its inhibition may be an effective mechanism for counteracting neuronal excitotoxic damage. We present here a new class of inhibitors derived from a structure-activity relationship (SAR) study of the benzoylalanine side-chain of 1. 2-hydroxy-4-(3,4-dichlorophenyl)-4-oxobutanoic acid (8) and 2-benzyl-4-(3,4-dichlorophenyl)-4-oxo-butanoic acid (10) emerged as the most interesting derivatives. Enantiospecific synthesis for both enantiomers of 8 and diastereomeric salt resolution for those of 10 were successfully applied.
Animals↗
Mobilization, collection, and characterization of peripheral blood hemopoietic progenitors after chemotherapy with epirubicin, paclitaxel, and granulocyte-colony stimulating factor administered to patients with metastatic breast carcinoma.
BACKGROUND: As single agents, both paclitaxel and epirubicin in combination with cytokines can mobilize peripheral blood progenitor cells (PBPCs). The authors have demonstrated previously that the combination of epirubicin and paclitaxel is very active against metastatic breast carcinoma and tolerated by patients. METHODS: Twenty-one patients with metastatic breast carcinoma received epirubicin 90 mg/m2 in combination with paclitaxel 200 mg/m2 given as a 3-hour infusion, and granulocyte-colony stimulating factor (G-CSF) starting 24 hours after chemotherapy to mobilize PBPCs. An immunophenotypic analysis for CD3, CD4, CD8, CD 19, CD33, CD34, and CD38 antigen expression was performed on apheresis products. Eighteen patients underwent high dose chemotherapy and were engrafted with PBPCs primed with paclitaxel, epirubicin, and G-CSF. RESULTS: The median number of circulating CD34+ cells at peak was 70/microL; in the patients less heavily pretreated, it was 106.7/microL. The mean number of CD34+, CD34+/CD33-, and CD34+/CD38- cells/kg collected per apheresis was 6.3 x 10(6), 2.0 x 10(6), and 0.18 x 10(6), respectively. The mean number of CD34+ cells/kg per apheresis was 7.8 x 10(6) when the preleukapheresis CD34+ cell count was more than 50/microL and 0.9 x 10(6) when the CD34+ cell count was less than 50/microL. The mean number of CD3+, CD4+, and CD8+ cells/kg collected per apheresis was 90 x 10(6), 50 x 10(6), and 30 x 10(6), respectively. CONCLUSIONS: Epirubicin plus paclitaxel in combination with G-CSF mobilizes PBPCs, including more primitive progenitors capable of supporting myeloablative treatment. Moreover, the mononuclear cells collected in this study contained high levels of cytotoxic effector cells suitable for ex vivo manipulation to augment the antitumor effect.
Adenocarcinoma↗
Reflex sympathetic dystrophy associated with deep peroneal nerve entrapment.
Reflex sympathetic dystrophy (RSD or causalgia) has been rarely reported in children. We now report a 10-year-old boy with RSD in whom we performed extensive ancillary investigations including thermography, bone scintigraphy and dermo-echography. The clinical, laboratory and ancillary studies reported here highlight the profound focal acquired autonomic disturbance in this disorder. The patient presented a compression of the deep peroneal nerve at the inferior extensor retinaculum in the affected limb. Surgical decompression lead to rapid improvement of the patient's condition. Peripheral nerve decompression should be considered as a possible treatment of RSD in children, particularly those that are refractory to conservative maneuvers.
Causalgia↗
Reversible palsy of the hypoglossal nerve complicating infectious mononucleosis in a young child.
We report a 7-year-old boy with serologic evidence of active Epstein-Barr virus (EBV) infection who developed transient unilateral hypoglossal nerve palsy, with complete recovery within 21 days. This is, to our knowledge, the youngest reported patient with isolated hypoglossal nerve palsy in the context of EBV infection. Acute EBV infection should be considered early in the evaluation of children with twelfth nerve palsy in order to avoid extensive ancillary testing.
Child↗
[Renal artery stenosis in pediatric age. Clinical and instrumental observations of two patients].
Two male patients, four and six years old, affected with monolateral renal artery stenosis are reported. One of them presented recurrent facial nerve palsy, while the other was affected by renal calculosis. The diagnostic suspicion was confirmed by arteriography. They were submitted respectively to aortorenal bypass and nephrectomy, with blood pressure normalization.
Angiography↗
Surgical treatment of atherosclerotic lesions of subclavian artery: carotid-subclavian bypass versus subclavian-carotid transposition.
BACKGROUND: The aim of this retrospective study is to analyze the short and long term results of two different surgical treatments in patients with subclavian lesions: common carotid-subclavian artery bypass (CSB) versus transposition of subclavian artery on the common carotid artery (SCT). METHODS: From 1981 until 1995, 40 non randomized patients with symptomatic subclavian steal underwent 20 CSBs and 20 SCTs. Risk factor rates were equally balanced in the two groups. Surgery was carried out routinely under general anesthesia, with electroencephalic continuous monitoring. Patency of revascularization was assessed by physical examination, brachial blood pressure determinations, ultrasound sonography and angiography whenever recurrence of symptoms developed or when the function of repair was in doubt. Patients were examined every year. In Spring 1996 (range 9-189 mos, average 7 years) a general clinical-instrumental follow-up was performed. RESULTS: In the short term (<30 days) mortality was 5%: one death (5%) for pulmonary embolism in a patient with CSB and one for myocardial infarction in a patient with SCT. The early thrombosis rate was 5% (1 CSB and 1 common carotid artery distal to a patent SCT). During follow-up 10 patients (25%) died and 6 were lost. The six-year actuarial patency rate was 100% for SCT and 66% for CSB. Moreover there were 3 thromboses of the vertebral artery homolateral to patent CSBs. CONCLUSIONS: In conclusions SCT should be considered the surgical technical choice for the treatment of proximal subclavian artery lesions.
Adult↗
Quantitative analysis of anaerobic metabolism in resting anoxic muscle by 31P and 1H MRS.
31P and 1H MRS high resolution measurements at 4.7 T were carried out in isolated frog (Rana esculenta) gastrocnemius muscle during anoxia to assess, using reference compounds, the concentration of high energy phosphates (approximately P = phosphocreatine (PC) plus adenosinetriphosphate (ATP)), inorganic phosphate (P(i)), phosphomonoesters (PME) and lactate (La): Two sets of measurements were performed, with (p) and without (up) muscle IAA poisoning and the time course of the metabolite concentration changes was described. The rate of phosphocreatine hydrolysis during the first phase of anaerobiosis, when no lactate is accumulated in either case, appears to be greater in p than in up preparations. This finding can be explained with the sizeable accumulation of phosphomonoesters (PME) in the former. The efficiency of anaerobic glycolysis, i.e. the approximately P/La ratio, recalculated taking into account also PME changes, was found to be 1.48 +/- 0.28, a value higher than that obtained by previous chemical measurements and close to the maximum stoichiometric approximately P/La value. Hence, the in vivo substrate of glycolysis, in the resting anoxic frog gastrocnemius, appears to be almost exclusively glycogen.
Adenosine Triphosphate↗
Application of NMR microscopy to the morphological study of the silkworm, Bombyx mori, during its metamorphosis.
Zero (ZQ) and double (DQ) quantum 2D chemical shift selective and spin-echo 3D NMR imaging at microscopy resolution, has been applied to the morphological study of silkworm, Bombyx mori, during its metamorphosis. Attention had been focused on the evolution of the internal structure of the insect during its postembryonal life occurring through the larval, pupal and adult development. A major objective of this work was the characterization of the silk glands, responsible for the synthesis and secretion of fibroin and sericin, through the changes of distribution and mobility of water, by imaging the water protons during postembryonal life stages. Moreover, alanine deriving from silk gland proteins was imaged during the last life stage of Bombyx mori.
Animals↗
An experimental study in X-ray spectroscopy of the zirconium (Ca-PSZ) - bone interface. Microanalytic evaluation of the osteogenetic response.
Ultrastructural difractometric and chemical evaluations of calcium partially stabilized zirconium (Ca-PSZ) implants were performed in an in vivo study on animals in order to evaluate its biological behaviour. The chemical-morphological investigations demonstrated the presence of an osteogenetic activity at the bone-biomaterial interface. The new-osteogenesis was preceded by the formation of a loose connective tissue around the implants. This mesenchymal-type tissue without a capsular organization, allowing modulation of the mechanical forces to which the implant is subject, could be considered a positive event in the osteogenetic process and not a sign of future failure of the implant. Finally, microanalytical investigations carried out on non-implanted and implanted Ca-PSZ tools suggested that the surface of this ceramic material does not undergo modification once it has been inserted in the biological environment (12 months).
Journal Article↗