Sutureless everted extra-anal technique for preservation of the sphincter after excision of tumours of the distal rectum.
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Anal Canal↗
Biomedical subjects
M Coppola
Publications and source records attributed to M Coppola.
When a snake bites.
Primary care physicians may be required to treat snake-bitten patients and must differentiate between venomous and nonvenomous snakes. The chief distinguishing characteristics of venomous snakes are fangs and a single row of subcaudal anal plates. The physiologic effects of snake venom are on the cardiovascular, hematologic, and neurovascular systems. The snake-bitten patient first needs supportive treatment and stabilization. Then, the physician must establish whether envenomation has occurred, grade it, and monitor edema around the bite. Local treatment, broad-spectrum antibiotics, and tetanus prophylaxis should be used for all envenomation grades. The decision to administer antivenin therapy should be made on clinical grounds and the envenomation grade. Its use, however, can lead to anaphylaxis and anticomplement reactions.
Anti-Bacterial Agents↗
Neoplastic transformation of C3H 10T1/2 cells: a study with fractionated doses of monoenergetic neutrons.
As most occupational and environmental exposures to ionizing radiation are at low dose rates or in small dose fractions, risk estimation requires that the effects of the temporal distribution of dose are taken into account. Previous in vitro studies of oncogenic transformation, as well as in vivo studies of carcinogenesis induced by high-LET radiation, yielded controversial results concerning the presence of an inverse dose-rate effect. The present study tested the influence of one scheme of dose fractionation of monoenergetic neutrons on neoplastic transformation of C3H 10T1/2 cells. Neutrons of 0.5, 1.0 and 6.0 MeV were used. Cells were exposed to doses of 0.25 and 0.5 Gy, given acutely or in five fractions at 2-h intervals. The acute and fractionated irradiations with each energy were done on the same day. No significant difference between the two irradiation modes was found for both cell inactivation and neoplastic transformation at all energies. These results are in agreement with our data for fractionated fission-spectrum neutrons from the RSV-TAPIRO reactor.
Animals↗
Neutron-induced tumors in BC3F1 mice: effects of dose fractionation.
An experimental study of the biological effectiveness of multifractionated low doses of high-LET radiation was carried out using BC3F1 male mice. They were treated with whole-body irradiation with five equal daily fractions of fission neutrons to yield cumulative doses of 0.025, 0.05, 0.10, 0.17, 0.25, 0.36, 0.535 and 0.71 Gy at the RSV-TAPIRO reactor (mean neutron energy 0.4 MeV, in terms of kerma, y D = 51.5 keV/microns, dose rate 0.004 Gy/min) and were followed for their entire life span. The statistical method described by Peto et al. (IARC Monograph, Suppl. 2, 1980) to establish the existence of a carcinogenic effect in long-term animal experiments was applied to the data sets. This analysis was done for myeloid leukemia and for the presence of selected solid tumors. Myeloid leukemia was absent in the control group and was rarely found in irradiated animals. However, a positive significant trend was found in the dose ranges 0-0.17 Gy and higher. Epithelial tumors were induced at doses from 0.17 Gy on. Tumor occurrence was evaluated further as final incidences with age adjustment for the differences in mortality rates. Survival and incidence data for selected classes of tumors after 0.17, 0.36 and 0.71 Gy were compared with those from a previous experiment at corresponding doses given acutely (dose rate between 0.05 and 0.25 Gy/min). This indicated no marked overall influence of the time regimen of neutron irradiation on survival and tumor induction.
Aging↗
Post-dural-puncture headache: characteristics, management, and prevention.
Post-dural-puncture headache is a common complication after both diagnostic and therapeutic procedures. Prompt recognition of the clinical syndrome, followed by supportive and corrective actions, can decrease the morbidity in those afflicted. The most useful preventive measure during dural puncture in adult patients is the use of smaller cannulae with the bevel aimed parallel to the long axis of the spine.
Adolescent↗
Three primitive reflexes in HIV-1-infected individuals: a possible clinical marker of early central nervous system involvement.
We studied one hundred and six neurologically asymptomatic HIV-1-seropositive patients, mostly drug abusers, in various stages of HIV-1 infection to evaluate the frequency of three primitive reflexes: snout, palmomental, and glabellar. We also examined one hundred HIV-1-seronegative drug abusers and one hundred healthy heterosexual individuals. We observed the presence of one or more primitive reflexes in 41% of HIV-1-seropositive subjects, in 8% of HIV-1-seronegative drug abusers and in 3% of healthy individuals. We elicited more than one primitive reflex in 22% of patients, but never among the subjects of the two control groups. The associations of multiple reflexes were significantly more frequent in the most severe CDC stages. Our observations suggest that including evaluation of primitive reflexes in a standard neurologic examination may be useful in screening for early non specific cerebral dysfunction in neurologically asymptomatic HIV-1-seropositive subjects.
Acquired Immunodeficiency Syndrome↗
Antiphospholipid antibodies and cerebrovascular disease.
Antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) are regarded as important risk factors for ischemic stroke and transient ischemic attacks in young subjects. In fact the interaction of these antibodies with phospholipid may impair the coagulation system at several steps, promoting thrombosis. A variety of therapeutic strategies including corticosteroids, immunosuppressive drugs, antiplatelet agents and anticoagulants have been prescribed in stroke patients with aPLs, but the efficacy of these drugs has not been established yet.
Antibodies, Antiphospholipid↗
Presence of papova-like viral particles in cerebrospinal fluid of AIDS patients with progressive multifocal leukoencephalopathy. An additional test for "in vivo" diagnosis.
An "in vivo" diagnosis of progressive multifocal leukoencephalopathy (PML), a neurological opportunistic viral infection in AIDS patients, can be made only by brain biopsy. In order to identify viral particles, we examined the cerebrospinal fluid (CSF) of 15 AIDS patients with focal neurological signs by electron microscopy using negative staining technique. In 2 out of 3 patients with clinical and neuroradiological presumptive diagnosis of PML, the CSF examination revealed papova-like viral particles. Our results support the hypothesis that the severe cell-mediated immunodeficiency reactivates papovavirus from a latent state in the brain, leading to PML. Therefore, the CSF study by negative staining might be a useful test for an "in vivo" diagnosis of PML.
Acquired Immunodeficiency Syndrome↗
Venomous snakes of southwest Asia.
This report provides a brief description of the venomous snakes encountered in Southwest Asia, as well as a brief review of the clinical implications of envenomation from each animal. Specific therapy for snake envenomation in the United States is somewhat controversial, and it is no less controversial with animals from this region. The most logical approach probably combines medical management with antivenom when available, and surgical intervention when clearly indicated due to elevated compartment pressure or massive tissue necrosis. Antivenom is available for all species except W aegyptia (in vitro only) and Atractaspis species. Antivenom for V palaestinae may be used for Atractaspis envenomation (Tables 2 and 3).
Animals↗
Relapsing polychondritis: an unusual cause of painful auricular swelling.
Auricular pain, redness, and swelling are usually the result of infectious cellulitis. However, relapsing polychondritis is another cause of this symptom complex and is the result of an autoimmune phenomenon. It presents with inflammation and destruction of both articular and nonarticular cartilage, with the external ear and joint cartilage most often involved. Although usually indolent with multiple acute exacerbations, relapsing polychondritis can be rapidly fatal if the airway or cardiovascular system is involved. We present a case of relapsing polychondritis initially mistaken for auricular cellulitis. The clinical manifestations and course of relapsing polychondritis are reviewed, along with the emergency department management.
Acute Disease↗
The dose-response relationships for tumor induction after high-LET radiation.
This paper presents a review of several studies conducted in our laboratory to examine the carcinogenic effects in mice of high-LET radiation and, for comparison, of low-LET reference radiation. For some specific end-points the following conclusions can be formulated: i) the dose-response curves for myeloid leukemia and malignant lymphoma can be interpreted in terms of induction and inactivation; in particular, the data confirmed that a linear dependence of the induction on dose is adequate to describe the response to fission neutrons, while a pure quadratic dependence is consistent with the experimental data for low-LET radiation; ii) in the liver, a marked age-dependence was demonstrated for radiation-induced tumors with a much higher susceptibility in young than in old mice; also for these tumors the dose-effect curves can be described by a linear and a quadratic relationships for high- and low-LET radiation, respectively; iii) data on ovarian tumor induction suggested threshold-like dose responses: these peculiar shapes as well as the absence of a clear radiation quality dependence of the curves are difficult findings to explain using a simple model of radiation action, and they might better be related to a non-stochastic effect of hormonal imbalance following irradiation.
Animals↗
[Reconstruction after pancreaticoduodenectomy for cancer: Whipple-Child vs Traverso-Longmire technique (a National questionnaire 1990 on data of 1,095 cases of surgery)].
The Authors report the results of a National multicentric experience in 1.095 cases of pancreaticoduodenectomy for cancer. In order to evaluate the reliability of pyloric preservation mortality, morbidity, and functional results are discussed.
Duodenum↗
Neutron carcinogenesis in mice: a study of the dose-response curves.
Several experimental studies have been conducted with the objective to improve our knowledge of the types of dose-response relationships for radiation carcinogenesis in mice exposed to single acute doses. The experimental results on tumor induction have already been published and are here summarized with emphasis on the dependence on radiation quality, age at irradiation, and sex. These data indicate that the bone marrow, liver, and ovaries of the mice tested have an appreciable susceptibility to radiation carcinogenesis. However, the shape of the dose-response relationship depends on the tissue exposed. The data also confirm that a linear relationship is adequate for a conservative description of the dose-effect curves after exposure to low dose of neutrons, while a purely quadratic dependence is not inconsistent with the experimental data obtained using low-LET radiation. Other information which stems from the present analysis is that the susceptibility to radiation induction of liver tumor by fission neutrons decreases in old age. Finally, the experimental data on induction of ovarian tumors suggest a threshold-like dose response.
Aging↗
Chromosome aberrations and radiosensitizers.
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Chromosome Aberrations↗
Absence of a dose-fractionation effect on neoplastic transformation induced by fission-spectrum neutrons in C3H 10T1/2 cells.
We have investigated the effect of fission-spectrum neutron dose fractionation on neoplastic transformation of exponentially growing C3H 10T1/2 cells. Total doses of 10.8, 27, 54, and 108 cGy were given in single doses or in five equal fractions delivered at 24-h intervals in the biological channel of the RSV-TAPIRO reactor at CRE-Casaccia. Both cell inactivation and neoplastic transformation were more effectively induced by fission neutrons than by 250-kVp X rays. No significant effect on cell survival or neoplastic transformation was observed with split doses compared to single doses of fission-spectrum neutrons. Neutron RBE values relative to X rays determined from data for survival and neoplastic transformation were comparable.
Animals↗
Ratio of acentrics to dicentrics in human lymphocytes exposed to X rays and misonidazole.
A 0.8 mM concentration of misonidazole was added to human blood samples before exposure to graded X-ray single doses, in order to investigate the dependence of the frequency ratio of acentrics to dicentrics, produced in lymphocytes, on treatment with radiation, the substance and the combination of the 2 agents. The results confirm the findings of a previous experiment carried out using sodium iothalamate, showing that this ratio is markedly influenced by the relative action of the physical and the chemical agents, especially at low radiation doses, because of the enhancement of the frequency of acentrics, and not of dicentrics, caused by the presence of the drug compared to the spontaneous level.
Cells, Cultured↗
Age-related susceptibility of mouse liver to induction of tumors by neutrons.
The induction of liver tumors has been studied in BC3F1 male mice after acute whole-body irradiation with fission neutrons and X rays, given at different ages. In prenatally irradiated mice, a small effect is seen after doses of 0.3 to 2.1 Gy of X rays, and a more pronounced effect is found after neutron doses of 0.09 to 0.62 Gy. At 3 months of age the animals show a higher incidence after X-ray doses from 2 Gy, and for neutrons from 0.17 Gy. At 19 months of age, liver tumors are rarely induced by either type of radiation. These findings are confirmed by the statistical analysis of trend. The possibility of deriving dose-response relationships for liver tumors was also investigated. In the dose ranges where the risk appears to increase as a function of the increase in dose, the data points for neutrons were well fitted by a linear expression. A pure quadratic relationship best fitted the X-ray data. Using these expressions, the RBE for neutrons was 28 at 0.09 Gy for prenatal irradiation and 13 at 0.17 Gy for irradiation at 3 months. This suggests the existence of a risk of developing liver tumors after exposure to radiation, and fetal liver seems to be particularly sensitive to neoplastic transformation. This risk may be negligible at low doses (less than 1 Gy) of low-LET radiation, or with exposure at older ages.
Aging↗
[Intra-operative echographic exploration of the hepatobiliopancreatic system].
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Bile Ducts↗