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Biomedical subjects

P Bobbio

Publications and source records attributed to P Bobbio.

At least 37 records · Page 2Linked to original sources
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

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↗
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

Some questions about Eurocollins solution used for lung preservation.

Currently, Eurocollins' (EC) solution (high-potassium concentration) is the most widely clinically used pulmonary perfusate. However, recently, experimental studies have reported an increase of the lung ischemic period using low-potassium solutions. The purpose of our study, is to investigate the influence of the EC ionic composition and the effect of hyperosmolarity due to the glucose concentration on isolated alveolar type II epithelial cells. Pneumocytes type II were isolated from pathogen free Wistar rats using the modified Dobbs' method. Cells were incubated for 6 hours at 4 degrees C in EC, Collins (CL) and Ringer Lactate (RL) solutions. After that, cellular viability was evaluated by analysis of the protein synthesis assay by measuring the 35 S methionine uptake during an incorporation period of one hour at 37 degrees C (picomol 35 S met/mg proteins/h). Mean +/- standard deviation and Student "t"-test were used for data presentation and results comparison. Cellular viability at time 0 (control) before cellular incubation was 3.93 +/- 0.38. After 6 hours at 4 degrees C the results were respectively as follows: EC = 2.16 +/- 0.13; CL = 2.63 +/- 0; RL = 3.21 +/- 0.04. Our results suggest that the low-potassium extracellular type solution (RL) shows a protection on isolated type II epithelial cells statistically significant (p < 0.05) if compared with EC solution. Moreover CL solution, that has the same ionic composition EC but without glucose, presents a less cytotoxic effects on incubated cells than EC, confirming a deleterious influence of solution hyperosmolarity.

Animals↗
PubMed1994

[Tumors of the thoracic wall. Our experience].

Chest wall tumors are rare being less than 1% of all the neoplasms. While the treatment of benign tumor and of solitary metastatic is standardized, the therapy of the primary malignant is not the same for all the authors. From January 1980 to December 1993 46 patients affected by chest wall neoplasms, 29 men (63%) and 17 women (37%), mean age of 51 yrs. (range 31-77 yrs.), were treated surgically. For benign tumors only resection was performed while for malignant and metastatic tumors after the resection the reconstruction was performed respectively: in 11 cases with Marlex mesh, in 1 case with the omentum, in 2 cases with Marlex and Methyl Methacrylate. Muscle transposition was performed in 1 case with pectoralis major covering a Dura Mater prosthesis. We have no peroperative death and no complications in 37 (80%) patients. Minor complications in 9 cases; in 1 case the sternal prosthesis was removed for infection. The median follow up was of 40.50 months. Actually the 48% of patients with primary and metastatic tumor are alive. From our results we conclude that the wide radical resection with reconstruction when necessary is the treatment of choice for the tumors of the chest wall.

Adult↗
PubMed1993

Contralateral spontaneous pneumothorax after single lung transplantation for fibrosis.

The authors report the treatment of a case of contralateral spontaneous pneumothorax during single lung transplantation. This is a unusual complication that must be treated to avoid life-threatening problems. There is no consensus of opinion on therapeutic procedures. This work underline the success obtained with a simple thoracostomic drainage.

Adult↗
PubMed1992

[Videothoracoscopic treatment of spontaneous pneumothorax].

In the period between May and October 1992 we have admitted in our department 14 patients (M/F: 11/3) with recurrent spontaneous pneumothorax, being the entity more than 40% in 8 of them. All the patients were treated with video-assisted thoracoscopic pleurectomy, beginning from the 2nd to the 6th rib, completing by abrasing the further ribs below. Whenever the causative bullae or blebs were found, those were resect using and endoGIA. At the end of the procedure a pleural drain (no. 24) was positioned and maintained on suction until a complete lung reexpansion was ensured for at least a couple of days. Neither postoperative nor delayed complications and no recurrences have been observed. Our results of such an approach, once indicated the pleurodesis for the treatment of spontaneous pneumothorax, are undoubtedly encouraging both for the technical simplicity and the reduction in hospitalization time.

Adult↗
PubMed1992

[Videothoracoscopic wedge resections of the lung].

The recent development in thoracoscopic instrumentation has widely improved their surgical applications so to allow lung resection whether for diagnostic of therapeutic purpose. From June to December 1992, we performed 14 segmental atypical lung resections in 12 patients. The indications were: recurrent spontaneous pneumothorax due to bullae or blebs in 7 cases, solitary peripheric lung nodule in 6 cases, for diagnostic purposes in suspicious interstitial lung disease in one case. Lung resection were carried out using stapling device (EndoGIA). In the cases of solitary lung nodule, the frozen section confirmed the presence of metastases in 4 subjects and thus it was proceeded towards an exploratory mini-thoracotomy (3 cm long) so to allow a further palpatory video-assisted evaluation of the lung surface. The remaining 2 patients were diagnosed to have hamartomas. The wedge resection in the patient with interstitial lung disease allowed diagnosis of sarcoidosis. There were no postoperative complications, nor deaths. Video-thoracoscopic lung wedge resections are indicated for treating bullae and blebs while performing pleurectomy for spontaneous pneumothorax, for removing benign and metastatic peripheral lung nodules. The procedure is substantially diagnostic in case of interstitial lung diseases. It's important to underline that the therapeutic value of thoracoscopic approach for metastatic lung nodules has not proved to be less or more efficient than the thoracotomy one and for this reason further investigations are required.

Adenocarcinoma↗
PubMed1992

[Videothoracoscopy in diagnosis and treatment of chronic pleural effusions].

Thoracoscopy is the most important method for the diagnosis, and in particular cases for the treatment, of chronic pleural effusion of unknown aetiology. The Authors report their experience of 4 cases, 2 males and 2 females, that underwent a thoracoscopy from June to December 1992. The method was done in 3 cases in general anesthesia and in one case in local anaesthesia.

Aged↗