[Critical review of transfusion activity in general surgery. Proposed application of a program of autotransfusion].
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Biomedical subjects
Publications and source records attributed to L Romano.
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To investigate the role of lipid peroxidation in human cataract, malondialdehyde, a breakdown product of lipid peroxidation, was measured in clear and cataractous lenses from normal subjects, and in cataractous lenses from diabetics and from subjects with severe myopia. The cataractous lenses contained more malondialdehyde than did clear lenses and the level was higher in diabetes and severe myopia than in the idiopathic forms. This indicates that lipid peroxidation may be involved in the development of senile cataract and, as a direct consequence of retinal damage, also in the pathogenesis of cataract in diabetes and in severe myopia.
The pH dependence of sulfate transport through the red cell membranes of ten mammalian (nucleated and non-nucleated) species was studied by measuring tracer exchange. The characteristic maximum of the sulfate transfer system, observed previously in the red cells of man and a number of other mammalian red cell species was found to be present in all species investigated. Although the volumes of the red cells of the various species differ by no more than a factor of 2 and the ratios of volume/surface even less, the rate constants at the respective maxima vary from 0.33 x 10(-2) min-1 (beef) to 15.50 x 10(-2) min-1 (eagle), i.e. about 45 fold. This suggests that either the number of anion transport molecules per cell and/or the turnover numbers of the individual transport molecules show considerable variations.
The authors have investigated the oxidative state of glutathione in red blood cells (RBC) and plasma from patients affected by chronic renal failure (CRF) and from age-matched healthy subjects. RBC-reduced glutathione (GSH) levels were significantly lower in CRF patients than in healthy subjects. Oxidized glutathione (GSSG) levels in plasma from CRF patients were higher than in plasma from controls. GSSG levels in RBC were similar in both groups. No differences were noted in GSH plasma levels between patients and controls. The GSSG/GSH ratios in RBC were similar in the two groups; on the contrary, the GSSG/GSH ratio in plasma was significantly higher in CRF patients. High levels of GSSG in plasma could exert two important effects on RBC: (1) inhibition of glucose-6-phosphate dehydrogenase activity, with a consequent alteration of the glutathione system; (2) GSSG easily reacts with hemoglobin to produce hemoglobin-glutathione mixed disulfides, with a consequent protein aggregation and precipitation. In vitro experiments have shown that RBC from CRF patients easily lyse when incubated with their same plasma, but not when incubated in saline buffer. Our results seem to demonstrate that plasma from CRF patients contains various oxidants which could affect the integrity of the glutathione system in RBC. This alteration could play a role in the pathogenesis of anemia in uremic patients.
Seven patients with OSAS were studied during nocturnal sleep in order to assess the trend of PAP throughout apneas and to identify factors possibly associated with such a trend. All patients underwent a polysomnography including the monitoring of PAP and esophageal pressure. While intravascular PAP decreased during apneas and increased at the resumption of breathing, transmural PAP values (ie, corrected for intrathoracic pressure swings) showed a trend toward a progressive increase throughout apneas and toward a decrease once ventilation had been resumed. The measurement of transmural values allowed a reliable assessment of PAP changes occurring during apneas, and different degrees of such changes shown by different patients may be related to a host of factors relevant to wakefulness and sleep, including individual responsivity to hypoxic stimulus.
Magnetic Resonance (MR) imaging was employed to evaluate musculoskeletal pathoanatomy, and proved to be extremely useful in characterizing knee pathology. Between October 1986 and November 1987, 24 patients with suspected traumatic ligament injuries were examined with high resolution MR imaging in the RMRC diagnostic center, Naples, with a 0.5 T superconducting magnet (5000 Magniscan CGR) using a surface coil and a 500/28 (repetition time: TR: ms/echo time: TE-ms), 1200-1600/35-105 spin-echo pulse sequence. Nineteen patients with positive MR imaging exams underwent diagnostic and/or therapeutic arthroscopy. Arthroscopy confirmed MR diagnosis in the whole of cases. In 6 patients with negative MR findings no arthroscopy followed and the patients' successful outcome confirmed the accuracy of MR negative predictive value. Such results prove MR imaging to have a high diagnostic accuracy in the evaluation of acute joint injuries of the knee. Moreover, MR imaging--an uninvasive screening technique--appears to have high potentials for the evaluation of those cases where diagnostic arthroscopy is not required.
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Reduced (GSH) and oxidized (GSSG) glutathione levels in arterial and venous rabbit red blood cells (RBC) and plasma are reported. No significant differences were noted between arterial and venous erythrocytes GSH and GSSG content. Plasma GSH levels were found to be the same in both arterial and venous samples. Contrarily, the concentrations of GSSG were higher in venous than in arterial plasma. These findings cannot be attributed solely to the increased RBC oxidative activity that occurs in the venous system. The phenomenon may reflect the oxidative state present in other tissues and may thus be a harbinger of differences in GSH content.
Magnetic Resonance Imaging (MRI) has been applied to musculoskeletal pathoanatomy and has proved to be useful in the detection and characterization of knee pathology. Thirty-two acutely injured knees and 8 normal knees were examined. The images were obtained in the Diagnostic Centre RMRC of Naples on a 0.5 T superconductive magnet system, using a surface coil and a spin-echo pulse sequence (SE 600/28 ms). The examined limb was immobilized and bent at 8-10 degrees, extrarotated for the examination of the anterior cruciate ligament (ACL) only. Images were obtained on a 256 x 256 matrix and had a 2 or 4-mm thickness. MRI clearly showed all the anatomical structures. The anterior and posterior cruciate ligaments (ACL and PCL) and the patellar ligament were shown by sagittal SE images through the intercondylar notch; the tibial and fibular collateral ligaments (TCL and FCL) were evaluated on coronal SE images; the articular capsula and menisci on axial transverse SE images. Objective criteria for ACL and PCL tears were: lack of continuity of the signal and change in signal intensity; in meniscal pathology, menisci with small linear regions of increased signal or with grossly truncated shape were interpreted as tears. Preliminary results of this study indicate that MRI together with clinical evaluation may be an useful non-invasive procedure in the assessment of acute injuries of the knee.
The comment we are reporting refers to an exceptional form of acute intestinal invagination of the infant. It is question of a total ileocecocolic invagination in which the hump invaginated part came to lodge to the superior part of the rectal ampulla. The treatment was a radio-surgical one and the operative follow-up without any complications.
Duovent activity was compared with placebo in a double-blind study carried out in 20 children, aged between 5 and 14 years, suffering from bronchial asthma. The experiment lasted 2 weeks. The patients were divided into two groups. In the 1st week, group I was treated with Duovent and group II with placebo, in the 2nd week vice versa. There was no reduction in cough or dyspnea in subjects treated with placebo, and only a slight increase (not significant) in peak expiratory flow (PEF). In the subjects treated with Duovent, there was a clear reduction in cough and dyspnea and a significant increase in PEF. The effect of the drug was still evident after 8 h, and it was well tolerated without side effects. The high number of additional sprays required during the placebo period was further evidence of the therapeutic efficacy of Duovent, which in almost all cases met the daily therapeutic requirements of the small patients. Duovent appears to be an effective drug in the treatment of bronchial asthma in children, both clinically and functionally.
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Dansylation of the red blood cell membrane inhibits monovalent anion transport as measured by means of 36C1 and enhances divalent anion transport as measured by means of 35SO4 (Legrum, Fasold and Passow (1980) Hoppe-Seyler's Z. Physiol. Chem. 361, 1573-1590 and Lepke and Passow (1982) J. Physiol. (London) 328, 27-48). In the present work the effect of dansylation on phosphate equilibrium exchange was studied over the pH range where the ratio between monovalent and divalent phosphate anions varies. At high pH, phosphate equilibrium exchange was enhanced; at low pH, exchange was inhibited. The pH maximum of phosphate equilibrium exchange, seen at pH 6.3 in untreated ghosts is now replaced by a plateau. The inverse effects of dansylation on the rates of exchange at high and low pH suggest that both monovalent and divalent phosphate anions are accepted as substrates by the anion transport protein. A tentative attempt to obtain a quantitative estimate of the ratio of monovalent and divalent phosphate transport indicates that in the untreated red cell membrane over the pH range 7.2-8.5 the transport of HPO42- is negligible compared to the transport of H2PO4-.
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A case-control study was performed from January '80 to February '83 in a group of children aged 3 months to 4 years. The aim of this study was to check possible relationships between immunization with anti-diphtheria-tetanus or anti-poliomyelitis vaccine and serious neurological complications. Twenty-nine cases of neurological illness were investigated among children hospitalized in G, Gaslini Institute (Pediatric Hospital) of Genoa. The diagnosis of admission was "coma" or "generalized convulsions". Two matched controls were chosen among children hospitalized in the same Institute with diagnosis different from coma or convulsions. The controls were chosen on the basis of their age (+/- 6 months), date of hospitalization (+/- 1 months) and sex. Furthermore 58 additional controls, represented by non-hospitalized children living in the same area, were selected on the basis of age and sex. The statistical analysis did not show any relationships between immunization with anti-diphtheria-tetanus or anti-poliomyelitis vaccine and severe neurological illness.
Anion transport in the trout red blood cell is mediated by a membrane protein that selectively binds dihydro-4,4'-dithiocyanostilbene-2,2'-disulfonic acid (3H2DIDS) and that forms on sodium dodecyl sulfate (SDS)-polyacrylamide gel electropherograms a band with the same diffuse structure at the same location as the band 3 protein of the mammalian red blood cells. There exists a linear relationship between binding of H2DIDS to this protein and the inhibition of anion equilibrium exchange. At maximal inhibition about 8 X 10(6) molecules/cell are bound to the protein. The kinetics of anion transport in the trout red blood cell differ from those of mammalian red blood cells. In addition to a H2DIDS-sensitive component of sulfate transport there exists a considerable H2DIDS-insensitive component with a relative magnitude that decreases with increasing temperature. At 23 degrees C, it amounts to about 25%. The temperature dependence of the H2DIDS-sensitive component is about 15 kcal/mol instead of 32 as in human red blood cells. Cl- transport increases with increasing pH. Above pH 7.4, the rate of transport becomes too fast to be measurable with either inhibitor stop or filtration technique. SO2-4 transport is nearly pH independent over the pH range 6.5 to 7.8 and the net entry of SO2-4 in exchange against intracellular Cl-, as followed in the absence of CO2, is accompanied by little if any proton uptake. Net proton uptake becomes measurable only at temperatures above 40 degrees C. Possibly at lower and more physiological temperatures, the band 3 protein in the red blood cell of the trout accomplishes part of the SO2-4 movements without cotransporting protons.
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