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Biomedical subjects

M Rusca

Publications and source records attributed to M Rusca.

At least 55 records · Page 3Linked to original sources
PubMed1996

Leiomyosarcoma of the superior vena cava.

Leiomyosarcoma of the superior vena cava is exceptional. A case in a 52-year-old man is described. A treatment by means of neoadjuvant chemotherapy, operation, and adjuvant radiotherapy was performed. This aggressive treatment has permitted the patient to obtain a relatively long survival with a good quality of life.

Chemotherapy, Adjuvant↗
PubMed1996

[The use of the pleural tent in superior lobectomies].

Persistent pleural space must be considered a possible complication after lung resection surgical treatment. Although in most cases the evolution is favourable, the authors suggest the use of the "pleural tent" technique, that compared to others thoracoplasty procedures offers some advantages. A short historical review of the thoracoplasty techniques is presented together with a detailed description of the above-mentioned technique.

Humans↗
PubMed1996

An original application of plasma expanders: heart-lung preservation.

The lack of an ideal heart-lung preservation solution is one of the principal factor that limits the wide spread of transplantation. The aim of this work was to investigate the efficacy of Haemaccel (HM) on isolated human pulmonary artery endothelial cells comparing its effects with those of University of Wisconsin (UWS). Subcultures of HPAEC were inoculated at the density of 5,000 cells per cm2 in 9 cm2 well-plates. Cells were incubated with HM and UWS for 6 hrs at 10 degrees C. Cellular viability was analysed by the total protein content (cytotoxicity index) and by the rate of protein synthesis (metabolic index). The results showed that HM and UWS did no show a significant differences in the toxicity when compared with the control; on the contrary, HM seems to determine a less inhibitory effect on cellular metabolism permitting a more rapid cellular metabolic recovery than UWS. Thus, HM appears to be more suitable for the preservation of isolated HPAEC than UWS.

Adenosine↗
PubMed1996

Mediastinoscopy, thoracoscopy and left anterior mediastinotomy in the diagnosis of N2 non small cell lung cancer.

The preoperative diagnosis of the involvement of the N2 lymph nodes is very important in patients with NSCLC for the most appropriate treatment. The classical diagnostic techniques for mediastinal exploration, mediastinoscopy and left anterior mediastinotomy, have been recently integrated by videothoracoscopy. FromJanuary 1993 to April 1994 186 patients with NSCLC suitable for surgery, were observed in our Department. 18 patients (9%) had CT evidence of N2 disease. In 10 cases the sites of the nodal enlargement were the right paratracheal station (#2 according to Naruke) and the right tracheobronchial station (#4), in 4 the subcarinal station (#7), in 2 the subaortic (#5) and in the remaining 2 cases the paraaortic station (#6). 14 mediastinoscopies were performed to investigate the stations 2,4 and 7,2 videothoracoscopies for station 5 and 2 left anterior mediastinotomies for station 6. The histological diagnosis was obtained in all cases without intraoperative or postoperative complications. Because the sequence chemotherapy-surgery seems to obtain the best results in the treatment of N2 disease the preoperative diagnosis of nodal involvement is of outstanding importance. Until recently mediastinoscopy and anterior left mediastinotomy were considered the standard techniques to explore mediastinum, now also videothoracoscopy has been introduced. In our experience, the integration of all the above techniques allowed a complete study of each suspect N2 site. Particularly the videothoracoscopy is very useful to safely biopsy under direct vision the aortic window lymph nodes.

Biopsy↗
PubMed1996

Morphological changes of human pulmonary-artery endothelial cells after 12-hours hypothermic storage in organ-preservation solutions.

Pulmonary endothelial cells are known to be fundamental for lung preservation and one of the most serious limiting factors observed during transplantation is the stress to which these cells are subjected. On this premise, strenuous efforts should be made to select and employ the preservation solution best able to prolong ischemia time and thus prevent cytotoxic effects. The aim of this study was to identify the solution with minimum toxicity on endothelial cells. For this purpose, we analysed the noxious effect of solutions such as Euro Collins (ECS), Belzer (UWS) and Low-potassium Dextran (LPD) on endothelial cells after 12 hours of incubation at 10 degrees C. For each solution, we examined the modifications produced on the nuclei, mitochondria and cellular wall of human pulmonary-artery endothelial cells by transmission electron microscopy and recorded the results on an ultrastructural grading scale. As regards morphological alterations incompatible with cell life, the most cytotoxic solution proved to be ECS. UWS and LPD, on the contrary, appeared to preserve cells relatively well, and no perceptible difference was observed between the two solutions. In conclusion, it is interesting to note that although ECS is widely used for lung preservation, the results of our study indicate that a 12 hours at 10 degrees C in this solution may exert adverse effect on pulmonary endothelial cells.

Adenosine↗
PubMed1996

Electromyographic evaluation of the spared serratus anterior after postero-lateral thoracotomy.

Postero-lateral thoracotomy is the standard access in thoracic surgery, and can be carried out dividing or preserving the serratus anterior muscle. This last method, besides its advantages, is still a matter of discussion, in fact traction has been claimed to cause severe muscular damage equal to section. We have studied 20 patients (16 males and 4 females, mean age 63 years), who underwent postero-lateral thoracotomy sparing the serratus anterior, after 6 months from surgery, both clinically and by means of electromyography (EMG), to evaluate the functional status of the spared muscles. In 4 cases (20%) there wasn't any neurogenic damage nor clinical evidence of winging scapula; 3 cases (15%) had medium neurogenic damage. The remaining 13 (65%) cases had a medium neurogenic damage and only one patient showed a winging scapula, neverthless being able to lift the arm to shoulder level. Our data confirmed that retraction during surgery does not damage the serratus anterior, leaving a functionally valid muscle.

Aged↗
PubMed1995

Methodology for the assessment of lung protection. Human pulmonary artery endothelial cell preservation using haemaccel.

This investigation was designed to show an original methodology for the assessment of lung preservation and to analyze the efficacy of a low potassium polygelin solution (haemaccel [HM]) on isolated human pulmonary artery endothelial cells. The effects of HM were compared with those of low potassium dextran (LPD), Belzer (University of Wisconsin [UWS]), and Euro-Collins solutions. The viability of the endothelial cultures was assessed by means of both total protein content and recovery of metabolic cellular function expressed as the protein synthesis rate after 6 hr and 16 hr of incubation at 10 degrees C. Our results failed to show any significant difference in the total protein content for HM, LPD, and UWS, both after 6 and 16 hr of incubation; however, the Euro-Collins-preserved sample revealed a significant drop in this parameter as early as 6 hr after the start. This finding was regarded as a clear indication of cellular cytotoxicity. In contrast, the metabolism recovery capacity of the cells varied significantly between HM and UWS at 6 hr and among HM, LPD, and UWS at 16 hr; at 6 hr, however, no significant difference was observed between HM and LPD. In conclusion, HM appears to exert a more significant effect on human pulmonary artery endothelial cell metabolism recovery than do the other fluids, thus suggesting its suitability as a long-term pulmonary perfusate.

Cell Division↗
PubMed1995

A new extracellular type solution for lung preservation: "in vitro" comparison with Beltzer, low potassium Dextran and Euro-Collins solutions by means of human lung fibroblasts.

UNLABELLED: The attempt to synthesise efficacious solution to prolong lung preservation is, at present one of the most interesting challenges in transplant research. Recently, several issues emphasise the central role of ionic composition of lung-flush solutions, underlining, however, that colloid-free solutions are clearly detrimental. We have been studying a complex extracellular type solution (SPAL UP) synthesised to minimise the pathological events that occur during both preservation and reperfusion period. We report the results of toxicity of SPAL UP on normal human fibroblasts obtained from foetal lung (WI-38). WI-38 cells were seeded at 1.4 x 10(4)/cm2 in disposable plastic 12-well plates. After 3 days, cells were incubated in SPAL UP, Beltzer (UWS), Low Potassium Dextran (LPD) and Eurocollins (ECS) solutions for 6 hours at 10 degrees C. Cellular viability was evaluated by the rate of protein synthesis exploiting the incorporation of 35S-Methionine (2 microCi/ml) in growth medium with 10 mM unlabelled Methionine during 30 minutes incubation at 37 degrees C. The results were expressed as nmol. 35S-Methionine/mg of proteins/minute, and presented as means +/- SD of data of three (n = 3) well for each solution studied. RESULTS: the viability at time 0 before incubation (considered as control) was 1.65 +/- 0.1; after hypothermic preservation the data were respectively as follow: SPAL UP 0.51 +/- 0.09; UW 0.24 +/- 0.02; ECS 0.19 +/- 0.01; LDP 0.19 +/- 0.05. CONCLUSIONS: in this "in vitro" model SPAL UP solution provides a significantly (p < 0.05) better cell preservation than regular UW, ECS and LPD solutions.

Adenosine↗
PubMed1995

Ultrastructural damage of the pulmonary endothelial cell after storage in lung preservation solutions. Comparison between Belzer and Euro-Collins solutions.

UNLABELLED: The preservation of the lung for transplantation for a long period is still a problem not solved. Euro-Collins (EC) and Belzer (UW) solution are the most widely used. The aim of this work is to analyse the direct influence of both EC and UW solutions on endothelial cells of human pulmonary artery by means of an ultrastructural analysis. The arteries were obtained from 3 patients that underwent pneumonectomy and prepared with the no touch technique. The arteries were divided in 15 specimens and preserved in EC and UW solution at 4 degrees C for 6 and 10 hours. The specimens were fixed in osmic acid veronal buffer 1% and embedded in Durcupan. Ultrastructural examination was done with transmission electron microscopy (TEM) and the influence of the solutions was evaluated using a grading scale with scores ranging from 0 to 4 that express the damages of the cellular wall, mitochondria and nuclei. The data are expressed as mean +/- standard deviation (n = 5). Student's t-test was used for statistical comparison between the solutions. RESULTS: after 6 hours of preservation in EC and UW the scores were 5.2 +/- 0.45 and 4.8 +/- 0.84 (p = 0.373) while after 10 hours were respectively 8.2 +/- 0.84 and 6.8 +/- 0.84 (p = 0.029). In conclusion our experimental model suggests that there are no significant differences between EC and UW after hypothermic 6 hours preservation while endothelial cells are better preserved after 10 hours in UW solution.

Adenosine↗
PubMed1995

[Tracheal and main bronchial disruptions after blunt chest trauma].

Tracheobronchial disruption is one of the less common injury associated with blunt thoracic trauma and the diagnostic evaluation is often misleading. Early diagnosis and repair of these injuries are essential to minimize the risk of patient's death and his future respiratory performances. Mechanisms of injury, clinical presentation, diagnosis and management of 5 our patients are reviewed. The good results achieved encourage an aggressive approach in these disruptions that can be life threatening.

Adolescent↗
PubMed1994

Single lung transplantation in the rabbit: an alternative proposal for the study of preservation devices.

The authors report their standard protocol for single lung transplant in New Zealand rabbit, the anaesthesiological approach consisted of a premedication with Ketamine 35 mg/kg i.m., Atropine sulphate 0.25 mg/kg s.c. and Fentanil 0.1 mg/i.m.; a jugular vein was cannulated and the anaesthesia was carried out administering Ketamine 10-15 mg/kg every 20 min., plus Fentanil 0.1 mg every 30 min. The rabbit was intubated through a tracheostomy, curarized and room air was administered using an appropriate ventilator device. The heart-lung en bloc removal from the donor was performed through a midline sternotomy. The left lung was then separated leaving an adequate cuff of left atrium inclusive of right pulmonary veins which were ligated using a 7-0 thread the graft prepared in this way was then preserved by putting it into the perfusion solutions. The recipient rabbit, after anaesthesia, underwent left pneumonectomy through a left toracotomy the bronchial anastomoses was first performed, followed respectively by the arterial and the atrial sutures. The controlateral pulmonary artery was then clamped and sequential arterial samples were taken from descending aorta previously cannulated to obtain arterial gases tests. The recipient rabbit has been followed up this way no more than 2 hour time, than it was sacrificed.

Anesthesia↗
PubMed1994

Haemmaccel, a key for lung preservation?

Several and different solutions have been used for lung preservation but, at present, fluids and solutions are quite alike. In the last years extracellular type solutions have been progressively tested in experimental researches and have shown a better protection vs intracellular one. In this research we have studied the effect of a low-potassium solution normally used as plasma expander (Haemmaccel, HM) on isolated foetal human fibroblasts (WI-38). HM has been compared with Belzer solution (UWS) after 16 hrs incubation at 10 degrees C and low-potassium solutions with dextran 2% and 5% after 6 hrs and 16 hrs incubation at 10 degrees C. Wi-38 cells have been seeded at the density of 9x10(4)/cm2 onto plastic well plates. Cellular viability was measuring using the rate of protein synthesis through the incorporation of 3H leucine in growth medium during a 1 hr incubation at 37 degrees C. The results were expressed as nmol 3 H leu/mg of proteins/minute and presented as means +/- SD; the comparison has been performed by the one way variance analysis test. After 16 hrs incubation at 10 degrees C HM preserves WI-38 cells significantly better than UWS. Comparing HM with LPD 2% and 5% a significant difference both at 6 hrs and at 16 hrs was observed. Our preliminary in vitro results confirm that low-potassium solutions are less toxic on isolated lung cells than intracellular one. Polygelin contained in HM could be considered a suitable colloidal substance that determine a better preservation if compared with Low-Potassium Dextran solutions.

Culture Techniques↗