Biomedical subjects
L Giuliani
Publications and source records attributed to L Giuliani.
[Diagnostic and therapeutic problems of renal hydatidosis].
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Testosterone sulphation and glucuronidation in the human liver: interindividual variability.
Presystemic sulphation and glucuronidation at OH-C17 limits the bioavailability of testosterone; the aim of this investigation was to describe the variability in testosterone sulphation and glucuronidation rates in the human liver. Liver samples were obtained from 61 women and 40 men of similar age (mean 53 and 55 years, respectively) submitted to surgery. The mean rate of testosterone sulphation was significantly (P = 0.002) higher in men (22.4 pmol/min/mg) than in women (17.5 pmol/min/mg), was not age-dependent, followed bimodal distribution and varied over 7-fold in men and women. There was a weak, but significant negative correlation (r = -0.380; P = 0.003), between the rate of testosterone glucuronidation and age in the liver of women but not in that of men. The mean rate (pmol/min/mg) of testosterone glucuronidation was 155 (men) and 105 (women) (NS) and varied over 20-fold. When the rate of testosterone glucuronidation was expressed on the basis of g liver equivalent, the mean estimates were significantly (P = 0.003) greater in men (3323 pmol/min/g) than in women (1841 pmol/min/g). The present findings are consistent with the view that the hepatic activities of sulphotransferase and glucuronosyltransferase are higher in men than in women and that they vary in the human liver.
Ritodrine sulphation in the human liver and duodenal mucosa: interindividual variability.
The beta2-adrenoceptor agonist ritodrine has a bioavailability of 30% due to its presystemic metabolism and sulphation is an important metabolic route. The interindividual variability in the rate of ritodrine sulphation in 100 specimens of human liver and duodenum is reported. The final concentrations of ritodrine were 2 mM (duodenum) and 20 mM (liver). The mean estimates of ritodrine sulphation rate were 490 pmol x min(-1) x mg(-1) (duodenum) and 140 pmol x min(-1) x mg(-1) (liver). There was a 4-5-fold variation within +/- 2 SD units in the hepatic and duodenal rates of ritodrine sulphation. Statistical analysis revealed the presence of at least two subgroups of ritodrine sulphation. In the liver, 30% and 70% of the population fell into two subgroups with the mean estimates of ritodrine sulphation rate of 114 and 149 pmol x min(-1) x mg(-1), respectively (P < 0.05). In the duodenum, 25% and 75% of the population fell into two subgroups and the mean estimates of ritodrine sulphation rate were 332 and 538 pmol x min(-1) x mg(-1), respectively (P < 0.05). The rates of ritodrine and 4-nitrophenol sulphation correlated highly in the liver (r = 0.865; P < 0.001) and the rates of ritodrine and dopamine sulphation correlated highly (r = 0.914; P < 0.001) in the duodenum. In both tissues, the rates of ritodrine and (-)-salbutamol sulphation underwent a similar extent of variation and correlated highly. The intrinsic clearance of ritodrine sulphation was over one order of magnitude higher in the duodenum than in the liver suggesting that the duodenum is an important site of ritodrine sulphation.
Uridine 5'-diphosphoglucuronic acid (UDPGLcUA) in the human fetal liver, kidney and placenta.
The endogenous concentration of uridine 5'-diphosphoglucoronic acid (UDPGLcUA), the endogenus substrate of UDP-glucuronosyltransferase, was measured in the human fetal and adult liver and kidney and in the placenta. The concentrations (mumol/Kg wet weight) of UDPGLcUA were 59.4 +/- 11.3 (fetal liver), 301 +/- 119 (adult liver), 11.9 +/- 3.2 (fetal kidney), 17.4 +/- 3.0 (adult kidney), 17.8 +/- 1.8 (mid-term placenta) and 17.0 +/- 1.7 (term placenta). UDPGLcUA is present in the human fetal liver at a concentration 5-fold lower than in the adult liver indicating a potential limiting factor for glucuronidation ind the human fetus.
Delayed allergy to aminopenicillins: clinical and immunological findings.
Aminopenicillins are the most used beta-lactam antibiotics. Morbilliform or maculopapular rashes are rather frequent during therapy with aminopenicillins. The pathogenesis of these reactions is often due to a cell-mediated allergy. The aim of this work is to characterize patients with cell-mediated allergy to aminopenicillins and to identify alternative beta-lactam drugs that can be safely administered to these patients. We studied 27 subjects affected by cell-mediated allergy to aminopenicillins. The diagnosis was made on the basis of positivity of patch tests with aminopenicillins. These patients then underwent an allergological evaluation (skin and patch tests, oral and/or intramuscular challenge tests) with a wide spectrum of beta-lactam antibiotics. Our work highlights the following main characteristics of cell-mediated allergy to aminopenicillins: time elapsing between drug administration and onset of symptoms of about 2 days; the maculopapular rash and delayed appearance of urticaria/angioedema were the most typical symptoms (82.8 percent of cases); a cross-reactivity with aminocephalosporins is usually absent, or it is limited to cephalexin (in our study, in fact, just 3 out of 20 patients challenged with cephalexin showed a positive oral challenge test); all the beta-lactams, other than aminopenicillins, are well tolerated. Patch tests represent a specific diagnostic tool with a good predictive value of identifying alternative drugs that can be safely administered to patients with beta-lactam allergy. Our patients could tolerate other beta-lactam drugs after a complete allergological evaluation. On the basis of our study, cell-mediated allergy to aminopenicillins should be considered a well-defined nosologic entity.
Variable levels of bcl-2, bcl-x and bax mRNA in bladder cancer progression.
We investigated the expression of the anti-apoptotic genes bcl-2 and bcl-X and the pro-apoptotic gene bax in bladder tumors and normal samples from urinary bladder, using RT-PCR analysis. Bcl-2 mRNA was not detected in any of the normal samples, while it was found expressed in 66% of the low stage tumors and in 100% of the high stage tumors. Bax expression had an inverse progress, being present in 62% of the normal tissues examined, in 16% of the low stage tumors and in 14% of the high stage. Bcl-X gene expression was quite variable among all samples (37% in normal tissues, 50% in the low stage tumors and 14% in the high stage). bcl-X mRNA was only found in the isoform bcl-XL, with anti-apoptotic functions, whereas no sample expressed the isoform bcl-XS, which is known to suppress bcl-2 functions. Most samples expressing bcl-2 did not express bcl-X, and vice versa. These results, besides confirming the potential role of these genes in the pathogenesis of low stage bladder cancer strengthen the hypothesis concerning their possible interaction in the progression of disease.
[Basedow's disease and atypical ophthalmologic signs].
The authors report a case of BASEDOW's disease discovered with CT scan. The beginning was uncommon, characterized by orbital pains associated with optic neuropathy without any other signs of hyperthyroidism.
[Tasks and functions of the hospital pharmacy service].
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[Monodose aztreonam in the prevention of infection after extracorporeal shockwave lithotripsy. Theoretical premises].
A series of 905 patients suffering from renal calculosis and treated with ESWL is considered and the indications for antibiotic treatment with prophylactic or prolonged aztreonam reviewed: 1) for calculi with sterile urine or occasionally infected with I.S.T. less than 200, monodose prophylaxis is certainly advantageous; 2) for calculi with sterile urine or occasionally infected with I.S.T. between 200 and 500, prolonged antibiotic cover is useful; 3) for calculi with chronic infection or with I.S.T. greater than 500, prolonged target antibiotic therapy is necessary; 4) aztreonam is an effective drug for both monodose prophylaxis and for cover treatment. In more complex cases, an antibiogram indication is necessary.
[Antibiotic prevention with aztreonam in urologic surgery in children].
In a group of 51 children aged 3 days-17 years old, 40 were given operative 8 endoscopic and 3 percutaneous surgery, while all received antibiotic prophylaxis with Aztreonam (Squibb Azactam) for the prevention of surgical infections. Preoperative uroculture revealed sterile urine in all 51 but 49 needed excretory catheters at various levels: urethral, pyelic. Drug treatment was started preoperatively at the time of narcosis and continued until catheter removal. Aztreonam was chosen for its anti-Gram negative action and absence of toxicity as reported in the literature. Urine cultures at the end of treatment and 7 days later revealed sterile urine in 49 (96%) of the children, while 2 presented asymptomatic infection by Gram positive bacteria. No significant side effects definitely attributable to the drug were encountered.
[Renal cancer embolization with isobutyl-2-cyanoacrylate. Experimental study and first clinical applications (author's transl)].
Isobutyl-2-cyanoacrylate (IBC) is an acrylic monomer which quickly polymerizes in contact with blood. It has been rarely used as an embolic material and never in embolization of renal cancer. The authors report their experience on the use of this substance as embolic material, based on an experimental study in the rat and on two human cases of renal cancer, where a preoperative transcatheter embolization was performed. IBC revealed as a substance which can produce a very efficient and lasting embolization. No complications were observed.
[The Saralasin test in the diagnosis of renovascular hypertension. Personal experience].
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[Treatment of bladder hemorrhages due to inoperable pelvic cancers by embolization of the hypogastric arteries (author's transl)].
Transcatheter embolization of the hypogastric arteries has become more and more widely used in the management of bladder hemorrages due to inoperable pelvic cancers. It is a not shocking technique for the patient, without major complications. However, if its immediate results can be defined as very good, its long-term effects are not well known. The purpose of this paper is to describe the Authors' experience on this matter, which is based on 9 cases of transcatheter embolization of the hypogastric arteries. The patients were followed for at least 1 year or, in some cases, until their death.
[The index of tuberculization in school children of Trento. Preliminary results].
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[Tuberculin tests of school children in Trento province].
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[Cavernous hemangioma of the mediastinum. (Apropos of a case in the pediatric age)].
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[Wide abdominothoracic approach for a tumor on the superior pole of a horseshoe kidney; supra and subumbilical median and anterolateral oblique thoraco-phrenic laparotomy (author's transl)].
The development of a tumor on the superior pole of a horseshoe kidney is an event which, although rare, still presents the surgeon very specific problems related to the anatomy of the malformation. The presence of a parenchymal pons, the multiplicity and anomalies in the origin of arteries are all factors to be taken into consideration in the selection of a surgical procedure. It is of particular importance that the approach be very wide in order to combine the advantages of the trans-peritoneal approach with that of the thoraco-phrenic laparotomy. One case is presented, and the surgical solution is discussed.