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Biomedical subjects

H Valensise

Publications and source records attributed to H Valensise.

At least 55 records · Page 3Linked to original sources
PubMed1994

The relationship of clinical-pathologic status and adjuvant treatment with natural killer cell activity in stage I and II endometrial carcinoma.

OBJECTIVE: The aim of our study was to evaluate the basal immune reactivity in patients with locally advanced endometrial carcinoma, and the immune modulating effect of adjuvant treatment in cancer population randomized to endocrine or radiation therapy. MATERIAL AND METHODS: Forty-three patients with FIGO stage I and II endometrial carcinoma, treated with primary radical surgery, were randomly selected to receive endocrine (medroxy-progesterone acetate 30 mg weekly and Tamoxifen 300 mg weekly, given consecutively) or radiation adjuvant treatment (external beam photon treatment of the whole pelvis, with an average total dose of 3680 cGy rad). The immune assay included the evaluation of natural killer cell activity by target cell retention of the fluorescent dye carboxyfluoresceyn diacetate, using sensitive cell line K 562. The immunological monitoring was performed before surgery, and then before, during, and after adjuvant treatment. Nine patients, who refused any adjuvant treatment, were recruited as controls. RESULTS: Patients, matched for age and demographic characteristics, with locally advanced endometrial carcinoma had significantly lower mean values of natural killer activity than in healthy controls; the decrease of natural cytotoxicity was significantly related to the depth of myometrial invasion. The adjuvant treatment was associated with a significant immune modulation: patients in endocrine therapeutic regimen showed an increase of natural killer activity, while patients in radiation therapy had a reduction; in the control group there was no significant modification of natural cytotoxicity during negative follow up. CONCLUSIONS: Natural killer cell activity of peripheral blood is significantly reduced in local advanced endometrial carcinoma patients. The natural cytotoxicity evaluation, as a function of therapeutic modality, may be useful in establishing a relationship between adjuvant treatment and immune status in endometrial carcinoma.

Adenocarcinoma↗
PubMed1993

Second-trimester uterine artery flow velocity waveform and oral glucose tolerance test as a means of predicting intrauterine growth retardation.

The absence of a rise in maternal serum glucose level during the course of a 3-h glucose tolerance test was noted in pregnancies that resulted in growth-retarded infants. It was postulated that this response to an oral glucose load, in association with increased impedence to uterine artery blood flow, as demonstrated by color flow Doppler waveforms, could select the pregnancies at greater risk of developing intrauterine growth retardation. One hundred and four uncomplicated primigravidae and 88 multigravid women considered to be at high risk of developing intrauterine growth retardation were monitored longitudinally from the 24th week of gestation. The right and left uterine artery resistance indices (RI) were measured at 24 weeks by means of pulsed Doppler with color flow imaging, and the results were averaged. The following week, an oral glucose tolerance test (OGTT) was performed. Serum glucose was measured immediately prior to the ingestion of 100 g glucose, and again after 60, 120 and 180 min. The OGTT results were classified as normal, impaired glucose tolerance, gestational diabetes mellitus, and flat. This last result was indicated by a less than 20% rise in serum glucose compared to the fasting value.A notch in the uterine artery waveform and/or an RI greater than 0.58 (> 2 SD above the mean) was found in 39 (20.3%) women. A flat response to the OGTT was seen in 31 (16.1%) cases. Of the 16 women in whom both a high RI and a flat OGTT response curve were demonstrated, 15 (93.7%) delivered low-birth-weight babies due to intrauterine growth retardation. Eight of these 16 women developed hypertension. In the group with a flat OGTT response curve but normal uterine artery RI, two of the 15 women (13.3%) had growth-retarded babies. The positive predictive value of an increased RI with a flat OGTT response curve was 94%, while the predictive values of each individual method were 62% and 55%, respectively, for development of intrauterine growth retardation.Increased resistance to blood flow in the uteroplacental circulation in conjunction with a flat response curve to an oral glucose load might identify a group of pregnant women at risk of having a growth-retarded infant with or without the development of hypertension.

Journal Article↗
PubMed1993

Doppler velocimetry of the uterine artery as a screening test for gestational hypertension.

Doppler ultrasound was used to study the main uterine artery flow velocity waveforms in an unselected population of 272 primiparous women at 22 weeks' gestation. The incidences of subsequent complications were as follows: gestational hypertension alone, 4.4%; intrauterine fetal growth retardation alone, 4%; and gestational hypertension with intrauterine growth retardation, 3.6%. The flow velocity waveform was considered abnormal when the resistance index in the uterine artery was greater than 0.58. This identified 9.5% of the population as 'at risk' and predicted either of the above outcomes with an overall sensitivity of 74% (kappa index, 0.72). The sensitivity of prediction for gestational hypertension alone was 50% while for proteinuric gestational hypertension it was 88%. The best result was obtained for the prediction of pregnancies affected by both gestational hypertension and intrauterine growth retardation, where the sensitivity was 100%.

Journal Article↗
PubMed1992

Amiodarone treatment in pregnancy for dilatative cardiomyopathy with ventricular malignant extrasystole and normal maternal and neonatal outcome.

Amiodarone treatment in pregnancy might be difficult to handle because of the long half-life of the drug (14-28 days up to 2 months) and because it reduces maternal and neonatal thyroid activity. Although short-term use in pregnancy has been described in cases of fetal supraventricular tachycardia, there are few reports on the chronic use of the drug. In this paper we describe our experience with amiodarone treatment in two pregnant sisters with familial dilatative cardiomyopathy and ventricular malignant extrasystole. Prolonged administration of amiodarone (400-200 mg/die) since the beginning of pregnancy did not have any adverse effects; maternal and neonatal thyroid function was normal, as was the neurological and motor development of the neonates.

Adult↗
PubMed1992

Magnesium pyrrolidone carboxylate infusion reduces angiotensin II pressor response in pregnant women at risk for hypertension.

OBJECTIVE: Our objective was to investigate the possible restoring action of magnesium on vascular sensitivity to angiotensin II in pregnancy. STUDY DESIGN: We studied intraplatelet free calcium and the pressor response to angiotensin II in 10 primigravid women (28 to 32 weeks' gestation) at risk for pregnancy induced hypertension on the basis of altered uteroplacental blood velocity waveforms at 20 weeks' gestation, before and after the infusion of 1 gm of magnesium pyrrolidone carboxylate. After the effective pressor dose was achieved or a maximum of 32 ng/kg per minute was reached, we infused 1 gm magnesium pyrrolidone carboxylate and repeated the test. Intraplatelet free calcium was measured by means of fluorescent probes at the beginning and the end of both tests. RESULTS: Six women were classified as refractory to angiotensin II and four as sensitive (effective pressor dose < 10 ng/kg per minute). After magnesium pyrrolidone carboxylate infusion, the four sensitive women became refractory and the effective pressor dose was significantly enhanced to 32 in all six refractory women. Intracellular free calcium increased significantly during the first angiotensin II infusion, whereas after magnesium pyrrolidone carboxylate administration it did not change significantly. CONCLUSIONS: Magnesium pyrrolidone carboxylate enhances the vascular refractoriness and intracellular free calcium mediates the pressor response to angiotensin II in pregnancy.

Adult↗
PubMed1992

Lymphocyte subset in HPV infection.

The outcome of HPV infection and its progression to neoplastic disease may be conditioned by the immune status of patients. In the present study we observed the systemic lymphocyte subset, with particular regard to NK cells and NK activity in 7 patients with HPV infection. The lymphocyte phenotypes in peripheral blood were studied using a panel of monoclonal antibodies, while NK activity was evaluated as percentage of lysis of K 562 target cells. We noticed a significant decrease of basal NK activity especially in patients with HPV 16-18 infection (p less than 0.001), without any difference in the absolute number of these cells.

Adolescent↗
PubMed1992

Paget's disease of the vulva: advantages of demolitive surgery.

Four patients with vulvar Paget's disease were analysed retrospectively. In all cases the clinical manifestation was typical, with pruritus and visible lesion. None of the cases had a palpable cutaneous or subcutaneous mass but at the histologic exam a minimally invasive Paget's disease was detected. Treatment consisted of total vulvectomy and subsequent new reconstructive time; only one patient with clinically localized disease was treated with simple vulvectomy. Postoperative complications were minimal, thanks to the reconstructive time that assured a rapid recovery of the surgical injury and reconstruction of the urethral and vaginal meatuses. In all cases we obtained the complete removal of the lesion (negativity of resection margins), except in one case that was also the only one to have a recurrence after 40 months. The patients have been followed for an average of 58 months. Considering the results, we suggest demolitive surgery with subsequent reconstructive time in the treatment of vulvar Paget's disease.

Aged↗
PubMed1992

Immuno-biologic integration for therapeutic approach in ovarian carcinoma.

The "in vitro" cell growth of 14 ovarian carcinomas was evaluated and related with the clinical-pathologic stage (FIGO) and grade of histologic differentiation of disease, with the patients' immunological pattern and with the relapse and survival rates. We identified 4 different patterns of "in vitro" cell growth (P1, P2, P3 and P4). Their correlation with the clinical-pathologic stages of disease as well as with the recurrence and survival rates was strong: 75% of recurrences in pattern P3 and 100% in pattern P4, while tumours with patterns P1 and P2 did not relapse. Similar results were obtained for survival, in fact 2 of the 3 patients who died from disease had cell growth pattern P4, and the other a P3. A significant correlation was found with basal natural killer cell activity of peripheral blood lymphocytes too: in patients with P1 neoplasia the basal NK cell activity was significantly higher (p < 0.05) while it was significantly lower (p < 0.05) in patients with P4 neoplasia in comparison with the others. We conclude that the "in vitro" biological behaviour of ovarian neoplasia can be regarded as prognostic factors even if patients' basal NK activity represents the most significant prognostic element, directly related to the recurrence rate (p = 0.002).

Adolescent↗
PubMed1991

Modifications induced by gestational hypertension on platelet calcium transport.

Several studies have recently demonstrated that the platelets of subjects affected by essential hypertension have, in their basal state, an elevated cellular calcium content. Such data appear particularly interesting with regard to gestational hypertension (GH). Supposing that the intracellular calcium may be involved in the regulation of blood pressure we have studied the cytosolic calcium concentration, Na+/K(+)-ATPase activity, Ca(2+)-ATPase activity, fluidity, and the cholesterol/phospholipid (C/P) molar ratio of the plasma membranes in platelets from 20 normotensive pregnant women and 20 women affected by mild gestational hypertension without pharmacological treatment, near term. We observed an increased Ca(2+)-ATPase activity and a decreased Na(+)K(+)-ATPase activity in GH compared to the controls, accompanied by an increased Ca2+ intraplatelet concentration in the same patients. The fluidity and the C/P molar ratio were also increased. Our study gives indirect support to the hypothesis, supposing a reduced Na+/K(+)-ATPase activity which might cause increased intracellular Na+ content and decreased Ca2+ efflux through the Na+/Ca2+ exchange. However, out data can not rule out the other hypotheses explaining the increased cellular Ca2+ content. The present data indicate that GH is accompanied by a membrane structural abnormality that alters its physical state and modifies the membrane-related cellular functions.

Biological Transport, Active↗
PubMed1991

In vitro effect of magnesium on the Na/K-ATPase isolated from human placenta.

Magnesium (Mg) is an activator of many cellular processes, among which is cation transport. An imbalance of cation transport may be involved in several diseases, as well as during pregnancy. Since the action of Mg in vivo in preventing gestational diseases is known, as well as its role in vitro on some cation transport activities, we studied the action of increasing concentrations of Mg on the activity of the enzyme Na/K-ATPase isolated from placental tissue of six normotensive women, at term. Incubation in a medium with increasing concentrations of Mg resulted in a significant activation of the enzyme, which was related to Mg concentration. The study demonstrates the action of Mg in vitro on isolated enzymes, and suggests the use of enzyme purification as a model for the study of cation transport in pregnancy.

Dose-Response Relationship, Drug↗
PubMed1991

Effect of magnesium-deficient diet on cation transport in pregnant rabbits.

The imbalance of cation transport is considered to play an important role in the development of hypertension, and this also applies to hypertension during pregnancy. Magnesium (Mg) is one of the factors that regulate cation transport across the cell membrane. We therefore studied the effect of a magnesium-deficient diet on the activity of erythrocyte Na/K-ATPase and Mg-ATPase from six pregnant rabbits and compared the results to those obtained from six controls on a normal diet. None of the rabbits on the deficient diet developed hypertension or intrauterine growth retardation; nevertheless the activity of both enzymes was significantly reduced compared to the group on the normal diet. Since the reduced activity of these enzymes can determine sodium or calcium retention in the cell, Mg deficiency could be the basis of the onset of some forms of hypertension in pregnancy.

Animals↗
PubMed1991

Telephonic transmission of cardiotocographic recordings from a remote facility to an obstetric unit.

The Authors describe their experience in telephonic transmission of cardiotocographic recordings. With a Corometrics 116 and 410 unit installed in a remote facility, 61 CTG recordings were tele-transmitted and received by a Toshiba personal computer. The concordance between original and transmitted CTG record was excellent and a very low percentage of signal loss during transmission (3.2%) was found. The advantages of telephone transmission of CTG in peripheral areas are stressed.

Cardiotocography↗
PubMed1990

Effects of behavioural states on cardiac output in the healthy human fetus at 36-38 weeks of gestation.

Doppler velocity waveforms from atrioventricular valves were recorded in 20 healthy fetuses at 36--38 weeks of gestation during both behavioural states 1F (quiet sleep) and 2F (active sleep). No significant changes were found in the ratios between the velocities during early passive ventricular filling and active ventricular filling (E/A ratios) at the level of both mitral and tricuspid valves when the measurements obtained during states 1F and 2F were compared. Moreover, during state 2F the left ventricular output increased and the right ventricular output decreased, resulting in a marked modification of the right to left cardiac output ratio. Our data suggest a redistribution of cardiac output in favour of the left side of the heart during state 2F.

Blood Circulation↗
PubMed1989

Calcium and sodium transport in gestational hypertension.

The enzymatic activities of Na+/K+ ATPase and Ca2+ ATPase were determined on erythrocyte membranes from 9 normotensive and 9 gestational hypertensive pregnant women near term. A reduction in the activity of the Na+/K+ ATPase and a relative increase in the activity of the Ca2+ ATPase were found in the hypertensive patients, possibly due to a conformational alteration of erythrocyte membranes. This observation supports the possible role of the transmembrane cation transport in the pathogenesis of gestational hypertension.

Adult↗
PubMed1989

Umbilical cord blood rheology in relation to maternal disease and fetal hypoxia.

Erythrocyte aggregation was studied in 60 samples of cord blood taken at delivery from neonates whose mothers suffered from hypertension or diabetes in pregnancy or from neonates who showed hypoxia during labor. Erythrocyte aggregation significantly increased in the cord blood of neonates who suffered from hypoxia during labor, and in neonates from hypertensive and diabetic mothers. The effects of maternal disease or intrapartum hypoxia may therefore stimulate fetal erythropoiesis and cause major changes in cord blood rheology.

Erythrocyte Aggregation↗
PubMed1989

Tryptophan availability and fetal behavioral states.

Behavioral state instability in growth-retarded fetuses might be related to a decrease in serotonine production. Tryptophan maternal and cord blood values after elective cesarean section have been investigated by means of high performance liquid chromatography in 20 growth-retarded fetuses due to pregnancy-induced hypertension (PIH) and 20 normal pregnancies as control group. The feto-maternal ratio of tryptophan is significantly higher in normal fetuses than in PIH growth-retarded fetuses (p less than 0.001). Behavioral states have been determined 1 week and just before cesarean section. Values of 1F, 2F, 3F and 4F differ in the 2 groups (p less than 0.001). A higher percentage of non-coincidences (p less than 0.001) and state interruptions (p less than 0.001) is found in PIH fetuses. A significant correlation is demonstrated between the increase of non-coincidences and decrease in the feto-maternal Trp ratio (p less than 0.001).

Female↗
PubMed1989

Morphological development of the human placenta in normal and complicated gestation: a quantitative and ultrastructural study.

In order to evaluate the structural potentialities of the placenta, we analyzed placentas in the following conditions: normal full term gestation, hypertensive status, twin pregnancy and abortion at 8-12 weeks of gestation, comparing cell structures, surface organization and tissue reaction. We quantitatively evaluated (1) the arborization of the placental villous tree, and (2) the microvillous density per unit of surface area, paralleling these data with ultrastructural and immunohistochemical features. In early gestation (8-12 weeks of pregnancy) the limited degree of branching of placental villi parallels a reduced number of clefts per unit of surface area (0.7/1,000 microns2), if compared with controls (2.7/1,000 microns2). In the full term twin placenta, the number of furrows is 2.26/1,000 microns2: this value reflects a low arborization potentiality, testifying to a low placental maturity. On the contrary, a high branching of the placental villous tree is present at term in hypertension. In this gestational condition, the number of sulci of 3.1/1,000 microns2 reveals a compensatory attitude of the placenta, aiming to sustain the impaired fetal-maternal metabolic interchange. In all these cases, syncytiotrophoblastic microvilli are reduced in number in comparison with the normal placenta, and this is likely to be an expression of a low trophoblastic maturation degree. The placenta is a barrier with a highly specialized function that conditions fetal outgrowth, and microenvironmental modifications are promptly faced by this structure through morphofunctional modulations.

Female↗