[Acid-base balance and blood viscosity during the initial stage of myocardial infarct].
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Biomedical subjects
Publications and source records attributed to G Caimi.
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We evaluated leukocyte rheology, expressed as leukocyte filtration, polymorphonuclear (PMN) membrane fluidity and cytosolic Ca2+ concentration in subjects with acute deep venous leg thrombosis (DVT). In 14 subjects with leg DVT we examined the leukocyte filtration [unfractionated, mononuclear cells (MN), PMNs], PMN membrane fluidity and PMN cytosolic Ca2+ concentration. Subsequently, we evaluated the same PMN variables after in vitro chemotactic activation with 4-phorbol-12-myristate-13-acetate. At baseline, we observed a significant difference in the filtration of unfractionated and MNs and in PMN cytosolic Ca2+ concentration. After PMN activation, a significant variation, greater in DVT subjects, was present in PMN filtration at 5 and 15 min. In normals, no variation was present in PMN membrane fluidity or cytosolic Ca2+ concentration after activation, while in subjects with DVT we found a significant variation in both PMN parameters. These results underline that there is a systemic leukocyte functional alteration in DVT.
The effects of 10 days' treatment with 500 mg/day ticlopidine on the filterability of red blood cells in suspension and on the microviscosity of the red blood cell membrane was evaluated in 11 patients with vascular atherosclerosis. The results show ticlopidine to be effective in influencing the rheological measures of red cell filterability and membrane microviscosity: filterability was increased and microviscosity was decreased. Ticlopidine also decreased the extent of fluorescence polarization. These results are discussed regarding possible mechanisms of action of ticlopidine.
Ten patients with myotonic muscular dystrophy (MD) were examined by auditory event-related potentials (P300 ERPs), spirometric and blood gas analyses: arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2) and arterial oxygen saturation (SaO2). The aim of the study was to analyse the frequency of ERP abnormalities in this disease and to determine whether the neurophysiological evidence of cognitive impairment might be related to the ventilatory function abnormalities frequently described in MD. The mean P300 latency was significantly altered in MD patients compared with controls; P300 latencies did not correlate with spirometric parameters, blood gas values or with age, age at onset, duration or clinical status of the disease. This study provides neurophysiological evidence of cognitive impairment in MD patients. The cognitive deficits are not related to alveolar hypoventilation and appear to be a non progressive feature of the disease.
States of hyperinsulinemia with insulin resistance are frequently associated with proliferative tissue abnormalities, via stimulation of DNA synthesis and cell proliferation through the IGF-1 receptor. Such elements of metabolic syndrome (hyperinsulinemia/insulin-resistance, obesity, type 2 diabetes mellitus, hypertension, dyslipidemia) are explored in a population of 125 women (n. 50 with histologically confirmed diagnosis of breast cancer, Group A; n. 50 with benign breast pathology, Group B; n. 25 with no breast pathology, Group C, controls), affering to a Center for the prevention of breast cancer, in order to investigate for an eventual relationship between these pathologies. The prevalence of type 2 diabetes mellitus, hypertension, dyslipidemia, was higher in group of women affected by breast cancer vs. benign breast pathology and controls. This finding is in agreement with the hypothesis of the interrelationship of hyperinsulinism/insulin resistance with the growth-related abnormalities of breast cancer.
In a group of 12 subjects (5 men, 7 women) with vascular atherosclerotic disease (VAD) and in a group of 17 subjects (9 men, 8 women) with VAD and with non-insulin dependent diabetes mellitus (NIDDM) we evaluated the red cell membrane individual phospholipids and their relationships with the erythrocyte membrane fluidity. Examining the group of non diabetic subjects with VAD, it is evident that no difference is present between normals and this group regarding individual phospholipids; in this group is present a slight correlation between the erythrocyte membrane fluidity (expressed as Iex/Im ratio) and phosphatidylethanolamine only. Examining the group of VAD subjects with NIDDM it is evident that between normals and this group a significant difference is present for phosphatidylcholine and phosphatidylserine; in this group no relationship is evident between red cell membrane individual phospholipids and Iex/Im ratio.
The main physiopathologic and therapeutic aspects of diabetic ketoacidosis have been considered. Of the former, we have underlined the enzymatic and hormonal aspects and especially carbohydrate metabolism regulation and the destination of the fatty acids inside the liver cell. Regarding the therapeutic aspects, we have examined insulin therapy, rehydration and administration of potassium. The iatrogenic complications which can be caused by incorrect treatment have also been evaluated.
In this research we evaluated the red blood cell deformability using the Filtrometer MF4. Our study includes a group of 44 diabetics and a group of 20 normal controls. Since we used only paper filters, the reading, made on four channels on the same sample, lasted 83' at the end of which we examined: SL80%, SL60%, SL50%, SL40%, SL20% (values of the trigonometric tangent of the alpha angle, i.e., the angle that the geometric tangent at the curve in predetermined points forms with the t axis); T50 (time employed to filter 50% of the sample); MinT (time employed to reach residual blood volume). Examining the trend of the SL values it is evident that the filtration curve is different between normals and diabetics and not between diabetics subdivided for vascular complications.
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Investigations carried out on 43 diabetic not ketoacidotic patients (32 women and 11 men) showed that the percentage of glycosylated hemoglobins (GHb) is significantly (p less than 0.01) inversely related to the intra-erythrocytic concentration of 2,3-DPG and to the calculated P50. Preliminary data from a prospective study suggest that the inverse relationship could be referred to the degree of control of the disease. In poorly controlled diabetes, where at the highest percentages of GHb the lowest levels of 2,3-DPG are found, less oxigen can be delivered to peripheral tissues.
Blood viscosity factors and some metabolic parameters were estimated in thirty-eight insulin-treated diabetics. The evaluation was carried out on admission and after eight weeks of controlled therapy. From this study it follows that blood viscosity factors do not permit us to distinguish, at these two stages, diabetics with complications from diabetics without while there is this possibility at the initial observation in diabetics subdivided for sex. Furthermore there are no significant variations, except for the haematocrit, of the average of blood viscosity factors and metabolic parameters at the initial and final observation. Very interesting is the negative relation between the Vrbc, parameter which studies the erythrocyte deformability, and the red cell 2,3-diphosphoglycerate (2,3-DPG) that seems more evident in diabetics with complications. Contrary to what has been reported in literature no relation between Vrbc and glycosylated haemoglobin (GHb) is present.
We evaluated, during an exercise test, the leukocyte flow properties, the polymorphonuclear leukocyte (PMN) membrane fluidity and PMN cytosolic Ca2+ content in normals, in subjects with previous acute myocardial infarction (AMI) and in subjects previously submitted to a aortocoronary by-pass. Leukocyte flow properties were evaluated using the St. George filtrometer. Examination of the PMN membrane fluidity was effected employing the probe TMA-DPH; while evaluation of the PMN cytosolic Ca2+ content was carried out using the probe Fura 2-AM. At baseline, in both cardiopathic groups a significant difference in PMN filtration parameters and in PMN cytosolic Ca2+ content was evident compared to normals. In normals, at peak of exercise, there was an evident reduction of mononuclear filtration parameters, while during recovery a slight increase of the PMN cytosolic Ca2+ content was observed. In subjects with previous AMI and in subjects with aortocoronary by-pass, however, we observed, at peak of exercise, a decrease of the mononuclear filtration parameters, a reduction of the PMN membrane fluidity and an increase of the PMN cytosolic Ca2+ content. In both groups, the changes in PMN membrane fluidity and cytosolic Ca2+ content remained during recovery. The trend of the PMN membrane fluidity and cytosolic Ca2+ content found in the cardiopathic subjects during the exercise test suggest the PMN activation may be more evident in these subjects.
In subjects with essential hypertension we evaluated, respectively, the red cell membrane protein lateral mobility (obtained marking intact red blood cells with pyrene-3-maleimide (3-PM)), the erythrocyte membrane fluidity (obtained marking intact erythrocytes with 10-(1-pyrene) decanoic acid), the red cell membrane transverse fluidity gradient (obtained marking intact red blood cells with a set of fatty acid fluorescent probes (2-AP, 6-AS, 9-AS, 12-AS)), the platelet membrane fluidity (obtained marking intact and unstimulated platelets with 1,6-diphenyl-1,3,5-hexatriene (DPH) and with 1-(4-(trimethylamino)phenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH)) and the polymorphonuclear membrane fluidity (obtained marking intact and unstimulated polymorphonuclear cells with TMA-DPH). From the obtained data it is evident that: (1) red cell membrane protein lateral mobility does not distinguish normals from hypertensives; (2) erythrocyte membrane fluidity and red cell membrane transverse fluidity gradient clearly discriminate normals from hypertensives; (3) platelet membrane fluidity differentiates normals from hypertensives only when DPH is used as fluorescent probe; (4) polymorphonuclear membrane fluidity does not distinguish normals from hypertensives. Our results show that in essential hypertension a different behaviour of the membrane dynamic properties in the circulating blood cells is evident.
The aim of the study was to evaluate the polymorphonuclear leukocyte (PMN) membrane fluidity and PMN cytosolic Ca2+ content in several clinical conditions: diabetes mellitus, vascular atherosclerotic disease (VAD), chronic renal failure (CRF), essential hypertension (EH). In 13 subjects with insulin-dependent diabetes mellitus (IDDM), in 24 subjects with non-insulin-dependent diabetes mellitus (NIDDM), in 42 VAD subjects, in 23 VAD subjects with NIDDM, in 15 subjects with CRF and in 12 subjects with EH, we determined the PMN membrane fluidity, obtained marking unstimulated PMN cells with fluorescent probe 1-[4-(trimethylamino)phenyl]-6-phenyl-1,3,5-hexatriene (TMA-DPH), and considering the fluorescence polarization degree, and the PMN cytosolic Ca2+ content, obtained marking unstimulated PMN cells with the fluorescent probe Fura2-AM and considering the ratio between the Fura2-Ca2+ complex and the unchelated Fura 2 fluorescence intensity. From the obtained data it is evident that PMN membrane fluidity does not distinguish normals from IDDM subjects, NIDDM subjects, VAD subjects with and without NIDDM, CRF subjects and hypertensives. PMN cytosolic Ca2+ content, in comparison with normal controls, is significantly increased in VAD subjects (p < 0.01), in VAD subjects with NIDDM (p < 0.001), in CRF subjects (p < 0.001) and in hypertensives (p < 0.05). No correlation was found between PMN membrane fluidity and PMN cytosolic Ca2+ content. The study of these PMN parameters can be useful in the understanding of the role of leukocytes in the vascular damage that characterizes these clinical conditions.
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