Biomedical subjects
Publications and source records attributed to G Bianchi.
The authors report a case of arteriomegaly and underline the importance of a correct diagnosis. A review of the literature, in fact, confirms the incidence of the disease is higher than usually believed. Therefore, a complete diagnostic evaluation is necessary to recognize the disease and assure the adequate treatment.
A working group of ten rheumatology institutes (UNIREUM) was formed in Italy to promote multicenter therapeutic studies on rheumatoid arthritis. The Functional Disability Index (FDI) of the Health Assessment Questionnaire (HAQ) was chosen as a measure of disability. This paper reports the results of a multicenter study to validate an Italian translation of the instrument and to assess its reliability and validity. Two questions were modified to achieve cross-cultural equivalence. Back-translation into English showed agreement with the American instrument. Reproducibility was high: the test-retest correlation coefficient was 0.989 and ranged from 0.81 to 0.99 for the centers taken separately. Validity was confirmed by a correlation coefficient of 0.95 between the patient self-attributed and the physician-attributed FDI scores. We conclude that our Italian version of the HAQ FDI is a reliable and valid self-administered instrument.
Biliary Cystadenoma are rare benign neoplasms that occurs mainly in young women. Clinical features includes abdominal pain and biliary obstruction. The diagnosis is for clinical features and radiologic method, but require the pathological report. The treatment is surgical. We report a 30 years old woman, with biliary obstruction and radiological findings of a neoplasm located in the left hepatic duct, that was surgically removed. The pathological report was a biliary cystadenoma. We discuss the clinical radiological and pathological tindings.
Surgical infections represent one of the main causes of postoperative morbidity and mortality, especially in emergency surgery, with negative consequences on health costs. The Authors examined 2002 cases of emergency admission for surgical pathologies at the I Surgical Department of the University of Rome ¿La Sapienza¿ from 1987 to 1992. Overall septic complications were 13,7%, with a mortality rate of 1,2%. The Authors underline the lack in Italy of either an accurate system for monitoring septic complications or a useful method for data collection. At last the attention is focused on the main causes of septic complications, their diagnosis and treatment.
The ingestion or introduction of foreign bodies is a common situation in emergency surgery. The patients who usually ingest foreign bodies for different reasons are children, psychotics, alcoholics, prisoners and old people. The authors analyzed 65 cases observed in the I Institute of Surgery of the University of Rome "La Sapienza": 45 males and 20 females. Both the anal introduction and ingestion may be accidental or voluntary. The incidence of complications is estimated about 5 to 7%. The authors underline the opportunity of a conservative removal through endoscopic procedures especially for intraesophageal corps. This procedure is recommended to reduce morbidity and mortality rates, as well as hospitalization and social costs.
Under certain conditions, natural killer (NK) cells accumulate rapidly at extrahematic sites. In an effort to define the mechanisms underlying the recruitment of NK cells in tissues, we investigated their ability to adhere and transmigrate across endothelial cell (EC) monolayers. A considerable proportion of NK cells adhered to EC and about 30-40% of the adherent NK cells transmigrated across EC. NK cells were 2-3 times more efficient than resting T cells. Exposure of NK cells to IL-2 and IL-12 augmented their adhesive ability, while IL-4 had an inhibitory effect. mAb directed against CD18 and CD11a inhibited binding and migration of NK cells across resting or IL-1-activated EC, whereas anti-CD11b and Cd11c did not. Using IL-1-activated EC, it was found that anti-VLA-4 and anti-VCAM-1 mAb utilized in concert with anti-CD18 significantly reduced adhesion and transmigration. The CS-1 peptide of fibronectin (which recognizes VLA-4), when used in concert with anti-CD18 and anti-VCAM-1 (but not anti-VLA-4), caused a small, but significant increase in inhibition. Thus, LFA-1 and VLA-4 are crucial determinants of the adhesive and migratory interaction with the vascular endothelium.
Acute arterial obstruction of the limbs represents one of the most frequent events in Emergency Surgery. In 95% of the cases, the cause has to be searched in embolus parting from the heart in patients with rheumatic or fibrillary disease. Currently the two therapeutic methods used for peripheral arterial obstruction are thrombolytic therapy and surgical dysobstruction using Fogarty's catheter. The Authors compare the two methods on the basis of their experience in 129 cases underlying how the thrombolytic therapy (Urokinase, Streptokinase) should be instituted in the early hours from presentation of symptoms, otherwise, the possibility of revascularization will heavily drop. Better results are obtained by positioning a catheter under radiologic guide for intra-arterial infusion. The Authors also believe that up-to-date the surgical approach with Fogarty's catheter represents one of the best procedures, either for its feasibility of for the costs of the thrombolytic therapy. Furthermore, the thrombolysis may be not complete, and account for possible haemorrhagic complications.
BACKGROUND/AIMS: Oxygen free radicals might play a role in the pathogenesis of tissue damage in many pathological conditions, including liver diseases where antioxidant tissue systems are reduced. The leading mechanism of free radical toxicity is the peroxidation of membrane phospholipids. Lipoperoxide hydrolysis produces aldehydes -the most represented being malondialdehyde-which reacts with thiobarbituric acid and whose concentration is considered a marker of lipid peroxidation. MATERIALS AND METHODS: We developed a fast and cheap HPLC method for measuring malondialdehyde concentration in plasma using a 3 mm C18 Baker column (4.6 x 50 mm). Thiobarbituric acid-reacting substances were eluted isocratically with a mobile phase containing methanol/KH2PO4 (35/65), and detected fluorometrically. The whole analysis lasts 2.5 minutes. The fasting levels of thiobarbituric acid-reactive substances were measured in 30 non-smoking blood donors and in 45 patients with liver cirrhosis. RESULTS: In control subjects they were on average 0.84 [SD 0.41] mumol/L and were increased to 1.59 [SD 1.23] mumol/L in patients with cirrhosis, where they inversely correlated with hepatocellular function. CONCLUSIONS: The method compares favorably with previous techniques in terms of cost and analytical time. It can be used for serial measurement of plasma lipoperoxide concentrations in response to oxidative stress or following drug administration. Our preliminary data confirms the presence of an oxidative stress in cirrhotic patients. Normal lipoperoxide levels in subjects with very advanced disease may be due to polyunsaturated fatty acid deficiency and/or enzyme defects.
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The Authors report a case of blunt renal trauma in a nine-year-old boy. Clinical and therapeutic approaches are discussed in the light of a wide review of the literature.
The Authors point out how AEFs represent a serious complication of aortic vascular surgery. Special attention is given to the diagnostic and therapeutic approach, also supported by a wide review of the literature.
Human essential hypertension is a polygenic disease whose phenotypic expression is modulated by the environment. Though the kidney could play a major role in the initiation and maintainment of hypertension, many questions remain open. Rat models of primary hypertension provided the substantial information with experiments on kidney cross-transplantation showing that at least a portion of hypertension could be transplanted with the kidney in all strains where such experiment has been carried out. Data consistent with those of rats have also been obtained in humans. Many abnormalities in kidney function and cell membrane on transport have been described in hypertensive rats and humans but the logical sequence of events going from a genetic-molecular abnormality to a cellular abnormality which causes hypertension via a modification of kidney function is difficult to prove. We established this sequence in Milan hypertensive rats using a variety of experimental techniques such as the study of isolated kidney and renal cell function, cell membrane ion transport, cross-immunisation with membrane proteins, molecular biology, genetic crosses and manipulation. Such study led to the identification of a polymorphism in the cytoskeletal protein adducin and to the demonstration of its role in blood pressure control. Recently, alpha-adducin variants have been associated to both human primary hypertension and salt sensitive hypertension. Finally, recent findings strongly support the hypothesis that adducin variants may affect kidney function by modulating the overall capacity of the tubular epithelial cells to transport ions through both a modification in the assembly of actin cytoskeleton, and a modulation of sodium pump activity.
The Authors present an original case record simplified for urgency and emergency, with the aim to allow a quick and exact framing of the "acute" and consequently with a great saving of time. This is possible also thanks to the simple but efficacious graphic representation of the human body and his main districts. Moreover, it is possible to report data in a computerized system.
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