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Biomedical subjects

G Romano

Publications and source records attributed to G Romano.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Evaluation of epidermal growth factor receptor, carcinoembryonic antigen and Lewis carbohydrate antigens in human colorectal and liver neoplasias.

The expression of LewisY related carbohydrate antigens and the content of epidermal growth factor receptor (EGF-R), the carcinoembryonic antigen (CEA) and the alpha-fetoprotein (AFP) in colorectal and liver tumors were determined. These included 30 large bowel adenocarcinomas (7 colon, 6 sigma, 5 caecum, 12 rectum), 12 hepatocellular carcinomas and 6 liver metastases. Histologically normal tissue excised along with the tumors were used as controls. All plasma membranes studied showed specific EGF binding, and tumor plasma membranes had an EGF receptor level higher than that of the normal counterpart. However, EGF-R was positive in only a few tumors, and no correlation between clinical stages and grades of differentiation was observed. Cytosol CEA was higher in tumors than in normal counterparts. Tissue AFP and CEA content was different in liver hepatocellular carcinomas and in liver metastases. They are good markers to differentiate between primary and secondary liver neoplasias. The LewisY and related carbohydrate antigens, evaluated by the reactivity of the tissues to monoclonal antibody MAb B3, are expressed in liver metastases from colorectal adenocarcinoma. MAb B3 failed to react with hepatocellular carcinomas and with peritumoral liver tissues obtained from both metastatic and primary tumor lesions. These data suggest that immunoblotting with MAb B3 may be useful to obtain more information on liver carcinomas. Furthermore, MAb B3 or CEA armed with toxin in the form of recombinant immunotoxin or linked to a radionuclide can be useful in new treatments of metastatic lesions, such as immunotherapy, radioimmunotherapy and radioimmunoguided surgery.

Adenocarcinoma↗
PubMedDate not supplied

[The nutrition of the elderly surgical patient].

The key concepts regarding nutrition of elderly patients prior to surgery are outlined. The main metabolic changes that occur during surgical stress, paying special attention to the characteristics of elderly patients, are described. Lastly, the caloric-energy intake required by postoperative geriatric patients is evaluated and the methods of food intake compared to the benefits obtained are analysed.

Aged↗
PubMedDate not supplied

Mechanisms of cell transformation by Herpesvirus saimiri.

Herpesvirus saimiri is a virus capable of inducing oncogenic transformation of T lymphocytes of New World primates and immortalizing human T cells in vitro. T lymphocytes immortalized by H. saimiri demonstrate functional biological responses to their antigens. Therefore, H saimiri-induced transformation of T cells emerges as a very powerful tool of T-cell biology. The mechanism of this transformation remains to be elucidated. However, it is apparent that H. saimiri proteins Tip and StpC are crucial for T-cell transformation. Potential mechanisms mediating the effects of Tip and StpC, as well as the possible role of other H. saimiri proteins, are discussed in this review.

CD2 Antigens↗
PubMedDate not supplied

Measurement of reabsorption by single segments of the human nephron.

A widely diffused method to measure the reabsorption by single segments of the nephron in humans is based on water diuresis (WD), assuming that the peak urine flow rate approximates proximal delivery (PD). However, back-diffusion of an unknown volume of solute-free water (CH2O-BD) from lumen to the interstitium even in the absence of antidiuretic hormone (ADH) introduces a significant error in the estimate of PD. We herein describe an improved method that more precisely estimates the rates of segmental reabsorption. It is based on the assumption that the volume back diffusing during WD will not be subtracted when the hypertonicity of the interstitium is dissipated during the action of furosemide (F); hence, it will be estimated by the difference in urine flow rates measured before (V) and at the peak effect of F (Vf), such that CH2O-BD = Vf - V. Therefore, Vf (the urine flow rate during F) is assumed to directly measure PD of filtrate to the distal tubule (DT) during maximal WD. Adding CH2O-BD to the free water excreted during baseline WD (CH2O) yields the total volume (CH2O-T) of solute-free water formed: CH2O-T = CH2O + CH2O-BD. Therefore, the solute-free water generated by the ascending limb of Henle's loop (CH2O-HL) can be separated from that formed by the convoluted DT (CH2O-DT), since the latter is the only free water formed and excreted during F. Therefore CH2O-DT = CH2Of. Subtracting CH2Of from the total yields the free water formed by Henle's loop: CH2O-HL = CH2O-T - CH2Of. A suitable modification of this method allows the estimation of CH2O-HL even during maximal antidiuresis (AD). The present paper describes the theory, discusses its assumptions, the experimental validation by micropuncture experiments in rats, the results in humans, in health and disease, by simple experiments carried out at the bedside. The data show that this new method represents a significant improvement in accuracy with respect to former techniques to estimate segmental reabsorption, and that it can be suitably used to disclose the pathophysiologic derangements of the nephron in a number of diseases.

Animals↗
PubMedDate not supplied

Analysis of 4-ABP-DNA adducts and p53 alterations in urinary bladder carcinoma.

BACKGROUND: Activated intermediates of 4-aminobiphenyl (4-ABP) are able to covalently interact with DNA to form adducts. There is a large body of evidence indicating that carcinogen-DNA adduct formation can be one of the cancer initiating mechanisms. MATERIALS AND METHODS: (4-ABP)-induced DNA damage in association with p53 overexpression and mutations were evaluated in specimens of urothelial bladder cancers from 106 patients. RESULTS: 4-ABP-DNA adduct levels resulted higher in smokers compared to non smokers, with a borderline statistical value. p53 nuclear overexpression was related to tumor grading, while no significant correlation with stage, 4-ABP-DNA adducts, smoking habit, and disease recurrence could be observed. Concerning molecular analysis, p53 point mutations were found in 17 of 106 cases (16%) and mutational pattern was significantly associated both with higher grade and stage, but no correlation was found with disease recurrence. CONCLUSIONS: These results suggest that other sources, in addition to tobacco smoke, may contribute to 4-ABP-DNA adducts formation in bladder tissue and that p53 expression/mutation cannot be considered a prognostic factor in bladder cancer.

Aminobiphenyl Compounds↗
PubMedDate not supplied

Epstein-Barr virus (EBV)-induced long-term proliferation of CD4+ lymphocytes leading to T lymphoblastoid cell lines carrying EBV.

We have previously demonstrated that Epstein-Barr virus (EBV) strain B95.8 can infect and initiate a partial transcriptional program in both CD4+ and CD8+ lymphocytes (Guan, M. X., R.-D. Zhang, B. Wu, and E. E. Henderson. 1996. J. Virol. 70:7341-7346). Experiments were undertaken to determine whether EBV infection can alter the growth potential of T lymphocytes. Peripheral blood lymphocytes were separated into populations consisting of 99.8% CD4+ and 98.6% CD8+ T lymphocytes by FACS. Infection of these populations with EBV resulted in blastogenesis in both CD4+ and CD8+ populations. Clones were established from the CD4+ population in the presence of interleukin-2. Two of these clones expressed the T cell surface markers CD3 and CD4 and carried the EBV genome. One lymphoblastoid cell line (LCL) had a mixture of CD4+ and CD19+ cells. The T-LCLs harboring the EBV genome in circular form and transcribed mRNA transcripts corresponding to BZLF1, BRLF1, BMLF1, and EBER-1 and -2. Immunofluorescence demonstrated EBNA in the nucleus of T rosette-positive lymphoblasts with an absence of viral capsid antigen expression. In situ hybridization for EBER showed nuclear and cytoplasmic staining in B95.8 cells, whereas EBV-carrying T-LCLs only showed nuclear staining. These results demonstrate that EBV can both infect and induce growth transformation of T lymphocytes, supporting a direct role for EBV in AIDS-related, EBV-associated T cell lymphomas. A better understanding of the EBV transcriptional program during EBV-induced T cell transformation could directly lead to adoptive T cell therapeutic strategies and/or more effective antiviral chemotherapy for EBV-associated T cell lymphoma.

Base Sequence↗
PubMedDate not supplied

Current understanding of AIDS pathogenesis.

From the mid 1990s, considerable progress has been achieved in understanding the biology of the human immunodeficiency virus type 1 (HIV-1), and the pathogenesis of the acquired immunodeficiency syndrome (AIDS). However, these achievements are still not sufficient to indicate the reasons for failure of the host immune response in suppressing HIV-1 infection and why the immune system collapses at the end of the clinical latency period, followed by progression to the terminal course of the disease. A more complete view of the dynamics of AIDS pathogenesis may greatly facilitate the development of novel and ambitious therapeutic interventions, that are needed to counteract the onset of HIV-1 variants resistant to current antiretroviral treatments, to ensure affordable therapy programs for developing countries, and, in the long term, to eradicate the virus from patients and to confer protective immunity to HIV-1 infection.

HIV Infections↗
PubMedDate not supplied

Evaluation of 8-hydroxydeoxyguanosine in human oral cells: the importance of tobacco smoke and urban environment.

The DNA adduct 8-hydroxydeoxyguanosine (8-OHdG) has been widely used as a sensitive biomarker for oxidative damage. To investigate the role of environmental factors on oxidative DNA damage formation, the level of 8-OHdG was determined in oral cells from 109 healthy volunteers by an immunohistochemical method. A statistically significantly higher content of 8-OHdG was detected in oral cells from smokers (111 +/- 55, n = 38) compared with non smokers (78 +/- 48, n = 71), (p < 0.01). Moreover, subjects living in an urban area showed a higher level of oxidative damage with respect to those living in a countryside-suburban area (99 +/- 53, n = 58 vs. 78 +/- 51, n = 51), (p = 0.03). No significant association was detected between 8-OHdG in oral cells and other variables such as passive smoke, oral infections, alcohol or vitamin intake and grilled food consumption. This work suggests that tobacco smoke and environmental exposure to pollutants lead to a measurable increase of oxidative damage in oral cells and confirms that the immunoperoxidase method is an appropriate approach for epidemiological analyses.

8-Hydroxy-2'-Deoxyguanosine↗
PubMedDate not supplied

[Perforated duodenal diverticulum: report of a case].

After the colon, the duodenum is the most common site of diverticula. Duodenal diverticula can be divided into two types: intraluminal or extraluminal. The latter are more frequent, with a prevalence ranging from 0.6 to 27% in relation to the diagnostic methods utilized. Females are more often affected than males. About 70-75% of extraluminal duodenal diverticula are located in a circular area centred around the ampulla of Vater within a radius of 2-3 cm; these are defined as periampullary or juxtapapillary. Perforation is the rarest type of complication and can simulate different clinical conditions. CT plays a fundamental role in diagnosis also in relation to the different diverticular topography. Perforation is an indication for emergency surgery. The authors describe the clinical case of a duodenal diverticulum containing the outlet of the papilla, complicated by perforation; CT showed retroduodenal fluid and free air. Emergency surgery with an external biliary drainage, naso-biliary probe, and a diverticulo-jejunostomy on a Roux-en-Y defunctionalised loop, resolved the condition.

Adult↗
PubMedDate not supplied

[Functional results of colorectal and coloanal anastomosis with and without pouch].

In the last two decades one of the main targets of anorectocolonic surgery has been to develop sphincter saving procedure able to achieve good results with acceptable five-years survivals, optimal local control of the diseases and low rate of local cancer recurrence. Partially the development of new operative techniques such as low colorectal and coloanal anastomoses with or without pouch, the TME operation and the nerve sparing procedure have reach this target. In fact, often after these operations we can observe a functional syndrome called "Post Anterior Resection Syndrome". The basis of this syndrome have to researched in anatomical and physiological alterations that followed a reconstructive operation. It is characterized by frequency and fragmentation of the stool, feeling of incomplete evacuation, tenesmus and urgency. Fecal continence may be compromised to different levels: usually with alteration limited to soiling and impaired control of flatus, occasionally with loss of liquid stool, rarely with loss of solid stools. The anorectal function will be altered for long time following the surgical procedure and the stabilization of functional results may require 1-3 years. On the basis of these considerations, the authors examine the etiopathogenesis and clinical presentation of the "Post Anterior Resection Syndrome", suggesting some expedients to prevent the functional problems. Analysing our experience and a wide specific bibliography, they also underline the indispensable point to achieve a good functional results after a reconstructive procedure. The author conclude asserting that the absence of these points have to be carefully valued because, in these situations, a simply colostomy is able to guarantee a better quality of life that a colorectal/coloanal anastomoses with or without pouch but associated to functional problems.

Anal Canal↗
PubMedDate not supplied

[Non-toxic multinodular goitre: which surgery?].

AIM OF THE STUDY: Evaluation of total thyroidectomy, subtotal thyroidectomy and lobectomy in the management of multinodular non-toxic goitre. MATERIALS AND METHODS: 225 patients: 101 total thyroidectomies, 64 sub-total thyroidectomies, 29 lobo-hystmectomies. Hemorrages, recurrent nerve palsies, post-operatory hypocalcemias, clinical and ultrasonographic relapses, undesired effects of ormonal therapy and hypothyroidism after partial resection (considered risk factor for recurrence) have been pointed out. RESULTS: All three procedures showed a low incidence of recurrent nerve palsy; lobectomy didn't show post-operatory hypocalcemia, that appeared respectively in 26.6% and 23% after sub-total and total thyroidectomy. Recurrence's percentage in patients followed-up, was 18.2% after lobectomy and 12.2% after sub-total thyroidectomy, but in that group we observed 46.9% of hypothyroidism (vs. 9.1% after lobectomy) and 8.6% of undesired effects of therapy. Reoperations showed inferior laringeal palsy and post-operatory hypocalcemia significantly more elevated. DISCUSSION: Compared to lobectomy, total thyroidectomy showed higher risk of hypoparathyroidism; compared to subtotal thyroidectomy, it showed on all occasions less incidence of complications. Endocrinological follow-up is easier after total thyroidectomy. CONCLUSIONS: According to our results, we deem the indications for lobectomy have to be limited to the patients having solitary nodule, undoubtedly benign, without familiarity or other environmental risk factor of goitre.

Adult↗
PubMedDate not supplied

[Our trend in conservative surgery in differentiated carcinoma of the thyroid].

AIM OF THE STUDY: Report as contribution to the controversy between supporters of total thyroidectomy versus "less than total" thyroidectomy. MATERIALS AND METHODS: 42 patient operated on over six years; 35 treated with total thyroidectomy, 7 with lobohystmectomy. RESULTS: In the patients who underwent total thyroidectomy we observed recurrent nerve lesions in 5.7%, hypoparathyroidism in 14.3% and 1 lymph nodal relapse (it was a cancer stay III); in patients who underwent lobohystmectomy, we observed 1 temporary recurrent nerve palsy (14.2%) and 1 lymph nodal relapse (14.2%). DISCUSSION: The choice between total thyroidectomy and lobohystermectomy depends upon different goals: reduction in risk of relapse in total thyroidectomy, to minimize complications in lobohystmectomy. In our series the risk of lymph nodal relapse seems to depend more on biological characters of the tumour than surgical tech of lymphadenectomy; however, this occurrence does not change prognosis. CONCLUSIONS: In our experience, potential multifocality of the disease, low risk of hyatrogenic lesions and easy postoperatory management make total thyroidectomy the our preferred technique. Informed consensus is mandatory in order to involve the patients to the best choice.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

[Predictive and diagnostic factors of malnutrition in hemodialysis patients].

The relationship between malnutrition and inflammation is by now well established. IL-6 and, probably, other proinflammatory cytokines (mainly IL-1 and TNF) may represent the link between these two entities since these interleukins may promote loss of appetite, muscle protein breakdown and reduced hepatic synthesis of "negative" acute phase proteins like albumin, prealbumin and transferrin. IL-6 also stimulates up to 1000 fold the hepatic synthesis of "positive" acute phase proteins, mainly C-reactive Protein (CRP) and Serum Amyloid A. The association between CRP and cardiovascular mortality in the general population, as well as in haemodialysed uraemic patients, is well established. These crucial interrelationships have modified the interpretation of serum albumin concentration in the diagnosis of malnutrition; a reduced serum albumin concentration, in fact, in the presence of high CRP values should point towards a diagnosis of inflammation, though the inflammation may often induce weight loss or a condition of malnutrition. After switching most patients to a more biocompatible dialysis membrane and improvement of the quality of the dialysis fluid (by adopting hydrophobic filters at the water entry of dialysis devices and bicarbonate powder cartridges) nephrologists have focused their attention on other sources of inflammation (e.g. artificial vascular protheses, presence of infected thrombi, Clamidiae, Helicobacter Pilori, dental granulomas etc.). Starting from these assumptions the diagnosis of malnutrition, once focused mainly on serum albumin reduction, must be based on other parameters (clinical history of body mass wasting, dietary and anthropometric assessment, subjective global assessment, bioimpedance analysis etc.). All these investigations, however, must be examined together to obtain suitable information on the risk of malnutrition in dialysis patients. A comprehensive approach to malnutrition-inflammation in dialysis patients is the object of the present nephrology conference.

Acute-Phase Proteins↗
PubMedDate not supplied

Is diabetes mellitus a risk factor for HCV infection?

The aim of this study was to investigate whether or not the diabetes mellitus may be considered a risk factor for the HCV infection. The HCV seroprevalence was evaluated in 254 diabetic subjects, whose anamnestic data and risk factors are known, in comparison to 223 first-time blood donors, carefully age- and gender-matched. The statistical analysis showed that the studied groups belonged to the same population (Mann-Whitney U test) and that there were no significant differences between cases and controls as regards HCV prevalence (Yates corrected chi 2 test). The obtained data underline the importance of the control group selection, especially in the studies considering age-related pathologies. The authors disprove type 2 diabetes as a risk factor for the HCV infection and consider that this is a valid hypothesis only when the hepatitis C was unknown and not adequate prevention was used.

Adult↗
PubMedDate not supplied

Long-term follow-up after endoscopic biliary stent placement for bile duct strictures from laparoscopic cholecystectomy.

BACKGROUND/AIMS: The outcome of endoscopic biliary stent insertion for postoperative bile duct stenosis was retrospectively evaluated. METHODOLOGY: Fifty-seven patients with biliary stenosis from laparoscopic cholecystectomy were included from February 1992 to January 2000. One to three stents were inserted for an average of 12.4 months, with stent exchange every 3 months to avoid cholangitis caused by clogging. RESULTS: Successful stent insertion was achieved in 43/57 (75.4%) patients. Stent insertion failed in 10 patients with complete and in 4 patients with incomplete biliary obstruction. Early complications occurred in 4 patients. Late complications occurred in 5/43 patients. Five patients experienced recurrence of stenosis. CONCLUSIONS: Endoscopic treatment should be the initial management of choice for postoperative bile duct stenosis.

Adult↗