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G D'Angelo

Publications and source records attributed to G D'Angelo.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Role of laboratory monitoring in oral anticoagulant therapy].

The aim of oral anticoagulant therapy is to administer an amount of drug such that, without the induction of severe hemorrhagic complications, thrombi will not develop, or any existing thrombus will stop growing and resolve. For the laboratory control of oral anticoagulant therapy, the prothrombin time is used universally as the primary measurement. The expression of the prothrombin time as "percentage coagulation activity" or "ratio" is not useful as international measures of oral anticoagulant intensity because they are thromboplastin dependent. With the conversion of the "ratio" in International Normalized Ratio, at present it is possible to give a universal measure of oral anticoagulant intensity. It is important to underline that the application of the International Normalized Ratio to situations other than oral anticoagulant monitoring is not useful. Moreover there are other important factors contributing to the imprecision of the International Normalized Ratio: the imprecision of the International Sensitivity Index, the biological variation of the International Normalized Ratio. New approaches to oral anticoagulant therapy and its management are being explored. Immunologic assays have been developed with potential responsiveness to minimal warfarin-induced anticoagulant effects. Use of antibody reagents are in progress to document the clinical usefulness of the methods for monitoring oral anticoagulant therapy.

Administration, Oral↗
PubMed1993

[Oxidative stress in patients undergoing general anesthesia].

The alterations in the normal biological oxide-reductive balance can be due both to an increase of the plasmatic concentration of the free radicals and to the less of the protective mechanism. These conditions lead to damage to cellular structure by the mechanism of lipoperoxidation, particularly in the liver, in the kidney and in the central nervous system. In this study we have studied the lipoperoxidative effects of the use of anesthetic drugs.

Anesthesia, General↗
PubMed1992

Cytogenic characterization of primary refractory anemia.

Refractory anemia (RA) is the only myelodysplastic syndrome (MDS) devoid of quantitative marrow diagnostic criteria. The diagnosis rests mainly on the subjective identification of qualitative abnormalities according to the French-American-British criteria (FAB) involving one or more bone marrow hematopoietic cell lineages. The occurrence of nonrandom chromosome abnormalities remains the hallmark of the disease and the only means of investigation which confirms the disease objectively. With the purpose in mind to further characterize RA among MDS, we have undertaken a prospective high resolution banding chromosome analyses of bone marrow cells in patients with primary refractory anemia (PRA) with the aim of defining a cytogenetic phenotype and of assessing the clinical relevance of clonal abnormalities at initial diagnosis. Of 39 patients consecutively referred for chromosome analyses with a diagnosis of RA according to the FAB criteria, 27 patients had PRA and fulfilled our criteria for adequate chromosome analyses. Median age was 68 years. Fourteen of 27 patients (52%) had clonal chromosomal abnormalities at diagnosis. None of the patients showed a complex karyotype; 9/14 (64%) had a mixture of normal and abnormal cells. Interstitial or terminal deletions, involving chromosomes 5, 6, 7, 9, 11, 12, and 20, were found in 11/14 (79%) of the patients. Comparison of survival between patients with and without abnormalities showed no difference. The presence of clonal abnormalities did not predict transformation to acute myeloblastic leukemia (AML) nor was it associated with poor survival. In this study, patients with PRA were found to have a predominant pseudodiploid karyotypic pattern characterized by interstitial and/or terminal deletions as opposed to derivatives, specific and non-specific balanced translocations, or other structural and numerical abnormalities. We were unable to reveal any prognostic significance to the presence of these clonal abnormalities at initial diagnosis.

Adult↗
PubMed1991

Quantification of mitral regurgitation: comparison between transthoracic and transesophageal color Doppler flow mapping.

We reviewed transthoracic (TTE) and transesophageal (TEE) echocardiograms of 100 consecutive patients: 63 male, 37 female, mean age 50 years (range 16-83 years), 32 with neoplastic disease, 18 aortic disease, 28 mitral valve disease, and 22 with other diseases. Absence or presence of mitral regurgitation (defined as mild, moderate, or severe) was assessed. TEE showed mild mitral regurgitation in 26 patients where TTE was negative. The overall estimate of regurgitant lesion severity was concordant at TEE and TTE in 64% of cases. The overall estimate of regurgitant lesion severity was also greater by one grade in 1% of cases at TTE, and in 35% of cases at TEE. Maximal digitized jet areas were 3.60 +/- 6.35 cm 2 at TTE and 3.04 +/- 3.79 cm 2 at TEE (P = NS). Correlation was r = 0.69 (TEE = 0.41 TTE + 1.55; P less than 0.001). TEE yielded a higher prevalence of mitral regurgitation than TTE with a trend toward greater overall estimate of mitral regurgitation at the semi-quantitative analysis. TTE and TEE showed similar mean results at the quantitative assessment of maximal jet areas. However, a highly significant random variability was observed in quantifying mitral regurgitation at TEE.

Adolescent↗
PubMed1991

With regards to the presence of iron granules in plasma cells.

We report on the occasional presence of iron granules in plasma cells in two male patients respectively 64 and 71 years old, both with excessive drinking habits. One patient also had liver cirrhosis. In both patients the bone-marrow biopsy showed a macrocytic anemia without megaloblasts. We refer the morphologic data because the cases reported are not many and the presence of iron granules in plasma cells was a curious and rare aspect. The most important feature appearing from the data issued is the gap concerning both the source and mechanism that cause this phenomenon. Some investigations have suggested that the plasma cell iron is located in mitochondria, others have noted that iron granules were located between the Golgi region and the rough endoplasmic reticulum. Moreover, the morphologic data are not related to the number of plasma cells in the bone-marrow and there is no causal relation between alcoholic abuse and plasma cell iron. The first problem is common, the second is rare.

Aged↗
PubMed1991

[Osteoid osteoma of the limbs: the clinical aspects and diagnostic problems].

The authors report their experience in the treatment of "osteoid osteoma", drawing attention to the great clinical polymorphism of this affection. They also demonstrate the reliability of a preliminary systematic study with bone scan and CT, which are indispensable to early diagnosis and correct surgical procedure.

Adult↗
PubMed1990

Sequence of sites on ATP-citrate lyase and phosphatase inhibitor 2 phosphorylated by multifunctional protein kinase (a glycogen synthase kinase 3 like kinase).

Multifunctional protein kinase (MFPK) phosphorylates ATP-citrate lyase on peptide B on two sites, BT and BS, on threonine and serine, respectively, inhibitor 2 on a threonyl residue, and glycogen synthase at sites 2 and 3. The phosphorylation sites BT and BS of ATP-citrate lyase are dependent on prior phosphorylation at site A whereas site A phosphorylation is decreased by prior phosphorylation at sites BT and BS. To study the MFPK recognition sites and the site-site interactions, the amino acid sequences of ATP-citrate lyase peptide B and inhibitor 2 were determined and compared to each other and to glycogen synthase sites 3-5. The sequence of the tryptic peptide containing the two phosphorylation sites of peptide B is -Phe-Leu-Leu-Asn-Ala-Ser-Gly-Ser-Thr-Ser-Thr(P)-Pro-Ala-Pro-Ser(P)-Arg-, and the sequence of the MFPK phosphorylation site of inhibitor 2 is -Ile-Asp-Glu-Pro-Ser-Thr(P)-Pro-Tyr-. This inhibitor 2 site is identical with the site phosphorylated by glycogen synthase kinase 3/FA. These results suggest that at least some of the sites phosphorylated by MFPK (BT of ATP-citrate lyase, Thr 72 of inhibitor 2, and sites 3b and 4 of glycogen synthase) contain a Ser/Thr flanked by a carboxyl-terminal proline. However, as MFPK did not phosphorylate a series of peptides containing the -X-Thr/Ser-Pro-X- sequence, this minimum consensus sequence is not sufficient for phosphorylation by MFPK.(ABSTRACT TRUNCATED AT 250 WORDS)

ATP Citrate (pro-S)-Lyase↗
PubMed1990

Arthroscopic surgery of the shoulder.

Arthroscopy of the shoulder is well established as a diagnostic procedure. It carries a greater degree of accuracy than conventional imaging techniques and in addition allows the assessment of instability and the degree of mechanical derangement inside the joint. Arthroscopic surgical procedures in the shoulder are in the developing stage. Arthroscopic acromioplasty for impingement syndrome has been shown to be a safe, effective procedure and probably better than conventional surgery. In the older patient, arthroscopic debridement of the rotator cuff is very effective at relieving pain. Arthroscopic surgery for removal of loose bodies and of a torn glenoid labrum would be the current recommended procedure rather than open surgery. Other rapidly developing areas of potential benefit are in the arthroscopic stabilisation of the dislocating shoulder and synovectomy of the shoulder in rheumatoid arthritis and other synovial conditions. The role of arthroscopy in the frozen shoulder is not clearly established although certainly it is the diagnostic tool of first choice in this condition.

Arthroscopy↗
PubMed1990

[Serum paraprotein in a patient with chronic lymphatic leukemia].

We report a case of chronic lymphocytic leukemia associated with paraproteinemia which proved to be a complete immunoglobulin IgM lambda. This case is reported because the process of cellular differentiation exposed to intrinsic or extrinsic stimulation may undergo morphofunctional variations which lead to the formation of plasma cells with extremely high secretionary capacities during the course of chronic lymphocytic leukemia.

Humans↗
PubMed1990

[Color Doppler identification of early diastolic turbulence in the left atrium in patients with mitral valve insufficiency: persistence of regurgitation or inertia phenomenon?].

Color Doppler flow mapping represents the most recent non invasive diagnostic tool for the visualization of intracardiac blood flow. By using the color Doppler flow mapping technique, two independent observers identified the persistence of turbulence in early diastole inside the left atrium in a selected group of 8 patients (3 F and 5 M) with mitral insufficiency. All the patients had moderate or severe mitral insufficiency, due to dilated cardiomyopathy and/or ischemic cardiomyopathy and/or valvular disease. The persistence of early diastolic turbulence inside the left atrium was documented and confirmed by using 30 degrees color sector images, which show the highest possible frame rate. The frame by frame analysis facilitated the identification of two simultaneous flow velocities during early diastole, after the mitral valve was open. The first flow was anterograde and was coded as a red signal; it flowed from the mitral valve into the left ventricle and represented early diastolic left ventricular filling. The second flow was retrograde, and was coded as a blue mosaic signal, due to turbulent aliased jet, extending from the mitral valve into the left atrium, away from the transducer. The interpretation of these two dimensional color Doppler findings is uncertain. We believe, however, that these turbulent velocity signals which persist in early diastole and flow from the mitral valve into the left atrium are probably caused by inertial blood flow due to the impact of regurgitant mitral jets during the previous systole.

Adult↗
PubMed1990

[Zinc-protoporphyrin determination in patients with sideropenic anemia and insufficient erythropoiesis].

We have measured erythrocyte Zinc-Protoporphyrin and serum ferritin in 125 subjects: 100 seemingly healthy controls, 17 with sideropenic anemia and 8 with erythropoietic insufficiency (sideropenia without anemia). Erythrocyte Zinc-Protoporphyrin was measured using Protofluor Z (Helena--Lab.) and serum ferritin was tested with immunoenzymatic technics. Patients with sideropenic anemia showed erythrocyte Zinc-Protoporphyrin values higher than controls, whereas serum ferritin was significantly lower than controls. Patients with erythropoietic insufficiency also showed erythrocyte Zinc-Protoporphyrin values higher than controls with statistical significance whereas the decrease of serum ferritin was not significant. Our study showed that Zinc-Protoporphyrin, in conjunction with serum ferritin, is a very useful test for evaluation of iron storage.

Adult↗
PubMed1990

[Acquired idiopathic sideroblastic anemia with cyclic hypereosinophilia of unclear significance. A case report].

We considered the case of an eighty-three-years-old woman who was admitted to Somma Lombardo Hospital, because of the presence of an acquired sideroblastic idiopathic anaemia accompanied by a cyclic hypereosinophilia of undefined significance. The case is reported both because references about sideroblastic idiopathic anaemia with hypereosinophilia of undefined significance are rare in the literature and because it may support the hypothesis that hypereosinophilia ensues from the myelodysplastic syndrome. Therefore it is possible that when diagnosing acquired sideroblastic idiopathic anaemia, not only thrombocytopenia, but hypereosinophilia has to be considered as an unfavourable prognostic marker for early appearance of acute non-lymphoid leukemia.

Aged↗
PubMed1989

Interobserver and echo-angio variability of two-dimensional colour Doppler evaluation of aortic and mitral regurgitation.

Colour Doppler flow mapping (CD) has proved to be a very sensitive and specific means of diagnosing valvular regurgitation and obtaining a rapid semiquantitative estimation of the severity of regurgitation itself. We tried to compare a semiquantitative evaluation of aortic and mitral regurgitation, without time-consuming calculations of regurgitant jet areas, with the conventional visual semiquantitative angiographic estimation. We have also evaluated in detail the interobserver variability of this type of semiquantitation. Two independent observers (OB) have reviewed CD studies of a selected group of 47 consecutive patients who underwent both cineventriculography and aortography for aortic regurgitation (AR) and/or mitral regurgitation (MR), then graded as mild, moderate or severe. At CD, AR and MR were classified as present or absent and graded as mild, moderate or severe. The following interobserver percentage agreements were noted for AR presence or absence, AR grade, MR presence or absence, MR grade, respectively: 96%, 83%, 96%, 83%. Likewise, the respective echo-angio agreements were 90%, 58%, 80%, 70%. Agreement was significant (P less than 0.001) in all cases. Thus, good interobserver and echo-angio agreement was found in the CD assessment of AR and MR. However, under- or overestimation of CD vs. angio was noted in several cases (mostly by one grade). Underestimation of CD vs. angio was 27% for AR and 18.5% for MR; overestimation of CD vs. angio was 15% for AR and 11.5% for MR. CD has proved to be a useful technique not only for the qualitative but also for the semiquantitative evaluation of aortic and mitral regurgitation, as assessed in the same subjects, with good interobserver agreement.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve Insufficiency↗
PubMed1989

Translocation (1;5)(q23;q33) in adult acute non-lymphocytic leukemia.

Chromosome banding studies carried out on bone marrow cells from a 57-year-old white caucasian male with an M1 acute non-lymphocytic leukemia (ANLL) revealed an unbalanced translocation involving chromosomes 1 and 5 [der(5)t(1;5)(q23;q33)] as part of complex abnormalities in 76% of the cells analyzed. This chromosomal abnormality is the first to be reported in an adult patient with acute non-lymphocytic leukemia. A review of previous reports on translocations involving the juxtaposition of the 1q23----qter DNA segment to other chromosomes suggests that this new translocation may be specifically involved with abnormal myeloid proliferation.

Bone Marrow Cells↗
PubMed1989

Chronic B-cell lymphocytosis.

Persistent elevation of lymphocyte counts is usually associated with a malignant monoclonal lymphoproliferative disease. Over the last 8 years, amongst patients investigated in our center for undetermined persistent lymphocytosis, a diagnosis of malignant lymphoproliferation was excluded in 6 cases as studies of surface membrane immunoglobulin light chains showed that they presented a polyclonal expansion of their B-lymphocyte pool. All patients were young-to-middle aged women presenting peculiar immunohematologic findings characterized by 1) persistent (2-7 yr) elevation of lymphocyte counts (4-14 x 10(9)/l), 2) presence of characteristic binucleated B cells on peripheral blood smears, 3) a normal bone marrow histology, 4) a polyclonal increase of serum IgM with low-to-normal IgG and IgA levels. Histologic examination of the spleen in 2 patients and lymph nodes in 1 showed a benign follicular lymphoid hyperplasia. The evolution was benign in every case. We suggest that chronic polyclonal B-cell lymphocytosis is a distinct clinicopathologic entity that should not be confused with malignant lymphoproliferative disorders.

Adult↗
PubMed1989

Scanning electron microscopy of the small intestine mucosa in children with celiac disease after long-term dietary treatment.

Jejunal mucosal specimens from twenty children with celiac disease were studied by light microscopy (LM), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) after one year of dietary treatment. An ultrastructural morphometric study was performed in five patients who had an intestinal permeability (IP) test. Seventeen patients were tested for serum antigliadin antibodies (AGA). In ten children, in whom LM showed partial villous atrophy, SEM and TEM examination confirmed the lesion. In the second group (10 children) with normal morphology at routine LM, SEM showed lesions of variable degree in 70% of cases. The morphological ultrastructural investigation showed good correlation with the immunological and functional data (IP test): ultrastructural damage of the jejunal mucosa after one year of a gluten-free diet was found in patients with positive serum AGA and an abnormal IP test. Furthermore, the morphometric study of the ultrastructural alterations allowed a quantitative, closer correlation between morphological and functional data. Our results suggest: 1) SEM and TEM investigations offer additional and more complete information on celiac patients, over LM alone. 2) The morphometric evaluation of the ultrastructural alterations highlights quantitative and reproducible correlations between morphological and clinical data, not strengthened by the subjective, qualitative study.

Adolescent↗