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Biomedical subjects

M Costantini

Publications and source records attributed to M Costantini.

At least 127 records · Page 7Linked to original sources
PubMed1986

Biochemical and immunohistochemical evidence that in cartilage an alkaline phosphatase is a Ca2+-binding glycoprotein.

A glycoprotein that exhibits alkaline phosphatase activity and binds Ca2+ with high affinity has been extracted and purified from cartilage matrix vesicles by fast protein liquid chromatography. Antibodies against this glycoprotein were used to analyze its distribution in chondrocytes and in the matrix of calcifying cartilage. Under the light microscope, using immunoperoxidase or immunofluorescence techniques, the glycoprotein is localized in chondrocytes of the resting zone. At this level, the extracellular matrix does not show any reaction. In the cartilage plate, between the proliferating and the hypertrophic region, a weak immune reactivity is seen in the cytoplasm, whereas in the intercolumnar matrix the collagen fibers appear clearly stained. Stained granular structures, distributed with a pattern similar to that of matrix vesicles, are also visible. Calcified matrix is the most stained area. These results were confirmed under the electron microscope using both immunoperoxidase and protein A-gold techniques. In parallel studies, enzyme activity was also analyzed by histochemical methods. Whereas resting cartilage, the intercellular matrix of the resting zone, and calcified matrix do not exhibit any enzyme activity, the zones of maturing and hypertrophic chondrocytes are highly reactive. Some weak reactivity is also shown by chondrocytes of the resting zone. The observation that this glycoprotein (which binds Ca2+ and has alkaline phosphatase activity) is synthesized in chondrocytes and is exported to the extracellular matrix at the time when calcification begins, suggests that it plays a specific role in the process of calcification.

Alkaline Phosphatase↗
PubMed1985

Analgesic treatment in acute myocardial infarction: a comparison between indoprofen and morphine by a double-blind randomized pilot study.

On the basis of the results of an earlier study, showing that i.v. indoprofen induced no clinically significant changes in hemodynamic parameters of patients with acute myocardial infarction (AMI), a double-blind randomized trial was carried out in 40 AMI patients to evaluate the analgesic activity of 400 mg i.v. indoprofen in comparison with 10 mg i.m. morphine hydrochloride. Pain severity was recorded before and at several intervals within 24 h after drug administration. The average analgesic response was prompt and progressive up to the 6th hour in both treatment groups, with no significant difference between drugs in various pain descriptors. However, the proportion of responding patients in indoprofen group was greater than in morphine group at all observation times, indicating a significant difference (p less than 0.05) in favor of indoprofen. In view of its good tolerability, i.v. indoprofen is worth considering in early AMI as an alternative to morphine in those patients in whom non-opiate analgesia might be preferable.

Adult↗
PubMed1985

[Multiplexed peroperative mapping in unstable rhythm disorders].

Since the introduction and development of mapping methods in clinical practice, some arrhythmias can now be treated surgically. We studied an automatized method of epicardial mapping necessitating only a single ventricular complex for the definition of epicardial activation; the signal was acquired from 35 monopolar electrodes spread out over the whole of the ventricular epicardium or concentrated in the zone of epicardial break through to localise its site more accurately. The acquisition, elaboration and tracing of these maps were performed with a computer; the activation can be presented as isochrones or isopotentials. The main value of this method of automatic mapping is the possibility of studying irregular arrhythmias whose potentials are difficult to obtain beat manually. This method has already been applied to 21 patients with ventricular tachycardia unresponsive to medical treatment and referred for surgery.

Arrhythmias, Cardiac↗
PubMed1984

A simple procedure for freezing and storing lymphocyte panels in trays.

Lymphocytes from different donors may be frozen in Terasaki trays by a simple procedure. This method provides the tissue typing laboratory with a readily available panel that can be routinely used to test for lymphocytotoxic antibodies sera from patients waiting for kidney transplant, transplanted patients and polytransfused individuals. The advantage of this procedure is that expensive programmed freezing apparatus is not required.

Blood Preservation↗
PubMed1983

Recognition of donor fibroblast antigens by lymphocytes homing in the human grafted kidney.

A human transplanted kidney, surgically removed because of untreatable chronic rejection, was used as the source of lymphocytes (K-L) of recipient origin that were expanded with interleukin-2 (IL-2), and of kidney fibroblasts (K-F) of donor origin that were maintained as an established line. Cytotoxicity assays were performed using K-L and peripheral blood lymphocytes (PBL) as effectors, and K-F and donor PBL as targets. From the results the following conclusions can be drawn: (1) cytotoxic lymphocytes, presumably involved in the process of chronic graft rejection, home in the kidney (from which they can be recovered) but are not detected in the circulation; (2) cytotoxic lymphocytes can be generated from peripheral lymphocytes by mixed lymphocyte culture (MLC) and further expansion in vitro with IL-2 (MLC-L); and (3) although both K-L and MLC-L are cytotoxic toward K-F, the former are not cytotoxic toward donor PBL. This suggests that although MLC-L recognize antigens shared by K-F and PBL, K-L recognize antigens specific for K-F only. These results, if confirmed, indicate that antigens not present on PBL, and possibly tissue-restricted are important in graft rejection. Thus, while monitoring transplanted patients, a lack of cytotoxicity in the recipient PBL may be misleading because the relevant cytotoxic effector cells may have disappeared from the periphery and the appropriate antigenic target may be absent on donor PBL.

Adolescent↗
PubMed1983

[Post-infarct ventricular tachycardia. Electrophysiological aspects, endocardial and epicardial electromapping and surgical therapy].

Seven patients (6 men and 1 woman), aged 45-67 years, with previous myocardial infarction and recurrent sustained ventricular tachycardia (VT), refractory to medical treatment, underwent encircling endocardial ventriculotomy, according to a modified Guiraudon's technique, associated with surgical resection of ventricular aneurysm. Before surgery all patients underwent electrophysiologic study, to evaluate the modalities of onset and interruption of VT; endocardial mapping at multiple sites was carried out in order to define the site of origin of VT and the sequence of endocardial activation: during VT in 5/5 patients the earliest activation occurred in the left ventricle at mid septum (2 cases), in the low (1 case) and high (1 case) septal regions and in the latero-basal region (1 case); the arrhythmias always originated at the border between fibrous and viable tissue. Intraoperative mapping was carried out from 18-29 points of the epicardial surface, both in sinus rhythm (7 cases) and during VT in the 6 patients in whom the arrhythmia was inducible with electrical stimulation. During sinus rhythm fragmented electrical activity of low voltage and prolonged duration was recorded from the epicardial surface of the aneurysm in all cases; during VT the site of earliest activation was localized in the low posterior (3 cases), high lateral (2 cases) and high posterior (1 case) regions of the left ventricle. Intraoperative endocardial mapping during VT confirmed the site of origin of the arrhythmia, as determined by preoperative mapping, in the 3 cases in whom it was performed. In all cases encircling endocardial ventriculotomy around the area of earliest activation or, when the origin of VT was not precisely determined, along the border zone of the aneurysm, was associated with conventional surgical procedures (aneurysmectomy: 6 cases; incision-suture: 1 case; aorto-coronary bypass: 1 case; mitral valve replacement: 1 case). One patient died in the early post-operative course with a low-output syndrome. During a follow-up of 6-35 months, one patient died two months after surgery because of intractable heart failure; the remaining patients are alive and well, with no recurrence of VT; none of them required antiarrhythmic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1982

[HLA and Huntington chorea].

Twenty-three patients with documented Huntington's Chorea were typed for 54 HLA antigens belonging to A, B and C loci. The control group was constituted by 124 healthy subjects of the same ethnic background. Patients and controls were typed with the same antisera. In this study no significant differences in the distribution of HLA antigens between the two groups were found. These data indicate that Huntington's Chorea is not associated with any of HLA antigens serologically determined. However, these findings do not exclude the possibility that other genes, whether or not related to MHC, could be responsible of the family inheritance of the disease.

Adult↗
PubMed1981

[Schizophrenia and HLA antigens].

38 schizophrenic patients (21 hebephrenics and 17 paranoids) and 124 healthy subjects were matched for HLA antigens. HLA typing was determined by the microdroplet lymphocyte toxicity method developed by Terasaki of UCLA. In order to detect 47 HLA antigens as many as 118 antisera were used. No significant differences in HLA typing were found between the two groups. However, the separate evaluation of HLA antigens of hebephrenic schizophrenics did not give any statistical significance, as well. The authors discuss these findings in the light of previous studies on the topic.

Adolescent↗
PubMedDate not supplied

Treatment of esophageal achalasia with laparoscopic Heller myotomy and Dor partial anterior fundoplication: prospective evaluation of 100 consecutive patients.

In this article we report our experience in 100 consecutive achalasia patients who were treated with laparoscopic Heller myotomy and Dor antireflux fundoplication, with particular regard to the technical problems encountered, the learning curve, and the long-term follow-up. The operation was completed laparoscopically in 94 patients, with a median operative duration of 150 minutes, and a continuous steady reduction in the operating time from the first patients to the last. In six patients the operation was completed through "open" access. Postoperative complications were recorded in six cases. Follow-up was completed in all 100 patients, with a median follow-up of 24 months. Overall, actuarial life-table analysis showed a probability of 90% that patients would be symptom free over a 5-year period. Radiologic assessment showed a significant reduction in the esophageal diameter, and manometry showed a significant reduction in the lower esophageal sphincter resting pressure and residual pressure. Twenty-four-hour pH monitoring showed postoperative reflux in 6.9% of the patients. Persistent dysphagia or chest pain was reported by eight patients, which constituted treatment failures. Seven of these eight patients were eventually treated with multiple pneumatic dilatations, which were successful in six cases. It was concluded that laparoscopic Heller myotomy with Dor fundoplication is a feasible and effective treatment for achalasia, with an actuarial success rate of 90% at 5 years.

Adolescent↗
PubMedDate not supplied

Standards for oesophageal manometry. A position statement from the Gruppo Italiano di Studio Motilità Apparato Digerente (GISMAD).

Manometry is an important tool in the diagnosis of oesophageal motility, disorders, but proper instruments and methods are needed to obtain useful clinical information. The authors reviewed the minimal technical requirements, operative aspects, which information the final report should contain as well as indications and contraindications of the text itself. Technical requirements: At least a three-channel, multiple-lumen catheter perfused with a pneumo-hydraulic capillary infusion system which ensures deltaP/deltaT>150-200 mmHg/sec.; data should be recorded at a sampling rate of > or =8 Hz to study the oesophageal body and lower oesophageal sphincter; lower oesophageal sphincter tonic (pressure) and phasic activity (relaxations) and oesophageal body amplitude and peristaltic activity should be recorded. The final report must contain the patient's details, the indication for the test and a manometric diagnosis. Indications for manometry: Dysphagia (after ruling out any organic pathology); non- cardiac chest pain (after ruling out any cardiopulmonary involvement); systemic collagenosis (to investigate oesophageal involvement); gastro-oesophageal reflux disease (if surgery is planned). Contraindications are limited to: pharyngeal or upper oesophageal obstructions, oesophageal bullous disorder, cardiac conditions in which vagal stimulation may not be tolerated, severe coagulopathy and patient non-compliance.

Equipment Design↗
PubMedDate not supplied

Assessing psychological distress in cancer patients: validation of a self-administered questionnaire.

BACKGROUND: Screening for psychological distress in cancer patients is important, considering the high prevalence of psychiatric disorders responsive to treatment. The aim of this study is to test the psychometric properties of the Psychological Distress Inventory (PDI), a 13-item self-administered questionnaire developed to measure psychological distress in cancer patients. PATIENTS AND METHODS: The PDI was tested in three samples of 434 cancer patients. In the first sample (n = 102) it was administered with the State Trait Anxiety Inventory (STAI) and with the Eysenck Personality Questionnaire (EPQ). Its validity as a screening method for psychiatric disorders was evaluated through a clinical interview in the second sample (n = 107). The third sample (n = 225) provided information on the ability of the PDI to discriminate among patients in different clinical phases of disease and allowed an estimate of the prevalence of psychiatric disorders in these groups of patients. RESULTS: A 0.88 alpha coefficient was obtained in the whole study sample. The correlations with the STAI scales were > 0.70. A positive correlation with neuroticism (r = 0.59) and a negative correlation with extroversion (r = -0.34) was observed. In the second sample, 67 patients (62.6%) received a psychiatric diagnosis according to the ICD-X criteria. The mean PDI scores were significantly lower for the 40 patients with no psychiatric diagnosis (mean 24.5) as compared with the 49 patients with adjustment disorders (mean 36.4) and with the 12 patients with depressive disorders (mean 40.8). The area under curve, estimated through a Receiver-Operating Characteristics analysis, was 0.88. A cut-off of 29 was associated with a 75% sensitivity and a 85% specificity. In the third sample, the lowest PDI scores were in patients with no evidence of disease (mean 24.7, 95% CL 23.0-26.4) as compared to patients undergoing antineoplastic treatment (mean 30.9, 95% CL 28.9-32.9) and to patients under palliative therapy (mean 36.0, 95% CL 34.0-37.9). The estimated prevalence of patients with psychiatric disorders in these three groups were respectively 5.0, 56.6 and 98.8%. CONCLUSIONS: Our results suggest that the PDI is a reliable and valid tool for measuring psychological distress in cancer patients and to detect psychiatric disorders through a screening procedure.

Adult↗