Biomedical subjects
Publications and source records attributed to G Basile.
201 cases of hydatid cysts observed in 1964-1984 are analysed. This is followed by a report on 100 cases of hepatic cysts with details of the patients' sex, age, symptoms and occupation. Finally the surgical treatment adopted in response to the site and dimensions of the cysts is described in detail.
An ultrastructural and stereologic study was performed on sympathetic ganglia collected at surgery from eight diabetic patients, seven age-matched non-diabetics and six subjects with glucose intolerance. All patients underwent surgery because of arteriosclerosis obliterans. Volume density (Vv) and mean thickness (tau) of the satellite cell layer were found to be significantly higher in diabetics (P less than .001 and P less than .002, respectively) than in the other two groups, between which no difference was found. Vv and tau of the endothelial basal lamina were found to be increased in the diabetic and glucose-intolerance groups at a low level of significance (P less than .05). Satellite cells are thought to exhibit a close similarity to Schwann cells. Ultrastructurally, cytoplasmic edema, increase of subcellular organelles and lipid inclusions were consistently observed in satellite cells from diabetic patients. The results suggest that there may be a metabolic impairment of these cells in diabetes.
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Acute cholecystitis is a non-rare disease, the incidence of which was increasing in the last years parallel to biliary lithiasis, which in 90% of cases is the first cause of such pathology. From the anatomopathological standpoint, we distinguish three types of acute cholecystitis: catarrhal, suppurative and gangrenous. The most frequently remarked symptom is ache at right hypochondrium. Only in 30% of cases cholecyst can be palpated, in form of ovoid mass; typical is the positiveness of Murphy's manoeuvre; constant is fever, but not subicterus. The introduction of new methods of ascertainment, exempt from any risks, simple to be performed and remarkably careful, made the diagnostics of acute cholecystites easier: parietal cholecystotomography, hepato-biliary scintigraphy, echotomography (first approach investigation), computerized axial tomography and laparoscopy almost always succeed in dispelling doubts. By using more than one of these investigations, a diagnostic accuracy, touching on 100%, can be reached. The differential diagnosis should be placed with: peptic ulcer, acute pancreatitis, acute appendicitis, gonococcus perihepatitis, virus hepatitis, acute pyelonephritis, right basal pneumonia. The complications an acute cholecystitis can occur are: perforation (localized, in free peritoneum or in a hollow organ), choleperitonaeum, necrosis of hepatic parenchyma, acute pancreatitis. Due to the possible arising of such complications, the mortality unfortunately is not indifferent (5%), especially in patients already weakened by other chronic diseases. Still discussed is the question as to when performing operation. In fact, there are three trends: intervention in immediate emergency, in postponed emergency, or in remote time (preceded by a medical treatment). The Authors prefer the intervention in postponed emergency, as, in their experience, they remarked the poor effectiveness of the delay medical treatment, also involving a greater difficulty in the technical execution of the intervention and a longer stay in hospital. From 1973 up to 1983, 241 cases of acute cholecystitis (158 women and 83 men) were hospitalized at the First Aid Surgical Centre of the Catania University. Eight patients refused the surgical intervention. The remaining 233 underwent, depending upon the seriousness of the affection, the associated diseases and the different reactiveness to the medical treatment, operation: in immediate emergency (26.1%); in postponed emergency (67.8%; in remote time (6.1%). The mortality was 2.2%, with the lowest percentage in the second group.
Cytochrome c synthetase has been solubilized from yeast mitochondria using Triton X-100 and fractionated with ammonium sulfate. Use of this partially purified enzyme has permitted us to isolate a quantity of iso-1-cytochrome c formed from 125I-labeled apocytochrome c and hemin in the presence of a NADPH-generating system. Visible absorption spectra (pH 8.0 or 5.0) including alpha, beta, and Soret bands and their molar absorption coefficients of this enzymatically synthesized cytochrome c in the oxidized and reduced states are the same, within experimental error, as those of native cytochrome c. Pyridine ferrohemochrome (pH 13) of the synthesized species also exhibits the same alpha and beta bands as those of iso-l-cytochrome c and similar to those reported for heme peptides of cytochrome c. If only one or no thioether bond were formed between the two vinyl side groups of heme and the cysteine residues of apocytochrome c, all these alpha and beta bands would have shifted to red (Pettigrew, G. W., Leaver, J. L., Meyer, T. E., and Ryle, T. E. (1975) Biochem J. 147, 291-302). Thus, two thioether bonds appear to be formed to link heme to apocytochrome c by cytochrome c synthetase, completing information of the three-dimensional structure of cytochrome c.
Cytochrome c synthetase in yeast mitochondria catalyzes the formation of a yeast cytochrome c-like species from the apoprotein and hemin (Basile, G., DiBello, C., and Taniuchi, H. (1980) J. Biol. Chem. 255, 7181-7191). To test the specificity of this enzyme, 125I-labeled horse apocytochrome c was incubated with the yeast mitochondrial fraction in the presence of hemin, NADPH, and an ethanol extract of the postmitochondrial fraction. A radioactive 125I-labeled cytochrome c-like species was formed in yields of up to 26%. This 125I-labeled species is indistinguishable from horse cytochrome c by ion exchange chromatography (under the conditions which allow separation of horse and yeast cytochrome c), resistance in its reduced form to digestion by trypsin, resistance against autoxidation, reduction by cytochrome b2, and generation of the apoprotein after treatment with silver sulfate and dithiothreitol. With unlabeled horse apoprotein and [59Fe]hemin, the yield of a [59Fe-labeled horse cytochrome c-like species was up to 7% with respect to the apoprotein incubated. The yield of the 59Fe-labeled species was not altered by the addition of unlabeled FeCl3. Conversely, synthesis of the 59Fe-labeled species was not detectable after incubation of yeast mitochondria with unlabeled horse apoprotein, unlabeled hemin, and 59FeCl3. The formation of both 125I- and 59Fe-labeled cytochrome c-like species was sensitive to heat. Thus, we conclude that cytochrome c synthetase catalyzes direct bonding of heme (or hemin) to the apoprotein. Since the amino acid sequences of horse and yeast cytochromes c differ considerably, cytochrome c synthetase may recognize only a limited region(s) of the apoprotein.
Incubation of the 125I-labeled apoprotein, prepared from 125I-labeled iso-1-cytochrome c, with a yeast mitochondrial fraction in the presence of hemin, NADPH, and an extract of the postmitochondrial fraction at 32 +/- 1 degree C for 30 min has resulted in formation of cytochrome c-like species in yields of up to 35%. This radioactive synthesized species contains a functional group which responds to reduction with ascorbate and oxidation with K3Fe(CN)6 in that it is resistant in the reduced form and susceptible in the oxidized form to trypsin action in a manner characteristic of native cytochrome c. The functional group cannot be removed from the protein by cold HCl-acetone or 8 M urea treatment. The reduced form of the synthesized species exhibits resistance against autoxidation and the oxidized form can be reduced also by cytochrome b2. The synthesized species exhibits the same compact hydrodynamic volume of native cytochrome c. Treatment with silver sulfate followed by incubation with dithiothreitol converts the synthesized species to the original apoprotein as judged by an increase in the hydrodynamic volume. Thus, the synthesized species is indistinguishable from the original labeled iso-1-cytochrome c by these measurements; i.e. the synthesized species consists of the apoprotein to which heme is covalently attached through the thioether bond(s). The active factor of the mitochondrial fraction is heat-labile. The synthetic activity is strongly dependent on pH with a maximum approximately at pH 7.0. Hemin (or heme) appears to be required for this synthesis. The postmitochondrial fraction is inactive by itself. However, its addition markedly increases the synthetic activity. This factor is heat-stable, soluble in 80% methanol (or 75% ethanol), and insoluble in ethyl ether or ethyl acetate. Addition of NADP(H) (or NAD(H)) also increases the synthetic activity, the reduced form being more effective than the oxidized form. The postmitochondrial factor and the pyridine nucleotides appear to enhance the effect of each other. Thus, it seems that cytochrome c or a cytochrome c-like species is formed from the apoprotein and heme (or hemin) by an enzyme, cytochrome c synthetase, present in mitochondria.
Increased urinary excretion of free amino acids is a sign which requires determination of the underlying cause. Physiological aspects of tubular transport with emphasis on the role played by transport proteins or carriers are briefly discussed. Subsequently we present a resumptive classification. In prerenal hyperaminoaciduria the urinary excretion of amino acids just reflects the error in amino acid metabolism. Depending on tubular reabsorption of the amino acid involved in the metabolic error three types can be distinguished: the overflow, the competitive and the non-threshold hyperaminoacidurias. Renal hyperaminoaciduria can either be specific for individual or group-related amino acids, or generalized involving all amino acids. With the exception of classical cystinuria the various hyperaminoacidurias have more theoretical than clinical importance. Generalized hyperaminoaciduria is always a symptom of severe tubular disturbance which can be produced by various metabolic diseases, intoxications or deficiency states. Finally we present our experience in the treatment of cystinuria with mercaptopropionyl-glycine.
The authors report their experience with flexible intramedullary nailing in the treatment of some fractures of the femur and humerus during childhood. The series goes back 2 years, with 16 patients treated, and 2 years follow-up for 10 of them. The method used took two variations into consideration: that of multiple bundle nailing, and that of two secant arc nails. Flexible intramedullary nailing presents a consistent series of advantages, that are divided into advantages of a biological (physiological consolidation), mechanical (flexible stability), and practical (comfort for the patient) nature. The authors believe that the advantages divided into relative and absolute have a very relevant weight.
BACKGROUND: Purpose of the study was to evaluate indications and efficacy of Dacron prostheses in the treatment of incisional hernias. METHODS: The study has been carried out in a retrospective way; mean follow-up has been 20 months. Surgical setting has been the Institute of Emergency Surgery at the University of Catania, where about 500 abdominal operations are performed every year. Thirty patients affected by incisional hernias have been considered (mean age 66.8 years). In 12 patients the Mayo technique was performed, whereas a Dacron prosthesis was placed in 18 patients. Other than early postoperative complications, patients have been followed by periodical clinical exams in order to find out possible recurrences as well as other late complications. RESULTS: Among 18 patients treated with insertion of Dacron prosthesis no infection, recurrence, bowel fistula, haematoma or dislocation have been observed. Only in one case an intestinal occlusion secondary to adhesions between prosthesis and bowel has occurred; in this patient a new operation has been necessary to remove the prosthesis. CONCLUSIONS: Considering that prostheses have been used in large incisional hernias or in patients with a weak abdominal wall, the high successful percentage (94%) obtained suggests the use of Dacron prostheses which guarantee long stability and minimum risk of recurrences.
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Two non familial cases of pseudoachondroplasia are reported. The patients, observed at 4 years and 6 months and 5 years respectively, show short-limb dwarfism with disproportionated long trunk and with normal head and face. Flattening of vertebral bodies with biconvex deformity and short tubular bones with irregular epiphyses and metaphyses are the major radiographic features. In these patients to state the type of genetic transmission is very arduous, as the genetic heterogeneity of the pseudoachondroplasia.
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