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Biomedical subjects

P Bruno

Publications and source records attributed to P Bruno.

At least 55 records · Page 3Linked to original sources
PubMed1998

Steal phenomenon from mammary side branches: when does it occur?

BACKGROUND: The hemodynamic significance of patent mammary graft side branches is still controversial. This study was designed to evaluate the potential for flow steal of patent mammary side branches in different hemodynamic conditions. METHODS: Echo-Doppler measurement of mammary graft flow was performed at rest and after dipyridamole-induced coronary vasodilatation in 10 patients with angiographic demonstration of evident mammary graft side branches (study group) and in 10 matched control patients (control group). Concomitant thallium-201 myocardial scintigraphy was performed to assess the adequacy of mammary flow to the myocardial oxygen demand. Patients of the study group were also submitted to flow evaluation in condition of selective muscular or combined systemic and coronary relaxation. RESULTS: No difference in mammary flow and adequacy to myocardial oxygen demand was detected between patients of the study and control groups both at rest and after dipyridamole infusion. In patients with patent side branches the systolic-to-diastolic flow ratio was maintained in case of combined coronary and peripheral vasodilatation, whereas selective muscular relaxation led to an increase in the systolic and a reduction in the diastolic flow. CONCLUSIONS: Flow steal from patent mammary graft side branches is possible only in case of selective muscular vasodilatation. As this situation is unlikely to occur in the clinical setting, the potential for flow steal of mammary side branches in cardiac surgery patients seems to be minimal.

Case-Control Studies↗
PubMed1998

Characterization and applications of human epidermis reconstructed in vitro on de-epidermized derma.

In recent years in vitro models have been developed to avoid the use of animals in cutaneous toxicological studies. Submerged human keratinocyte cultures in vitro could be so far employed as an alternative to animal testing and a good correlation between skin irritation and cytotoxicity has been demonstrated. Nevertheless, these submerged cultures are lacking in the stratum corneum which acts as a barrier to chemical toxicity, so that this type of culture is far from the in vivo situation. A better alternative method seems to be the use of in vitro reconstructed skin at the air-liquid interface that closely resembles the in vivo situation. In this work, in a first step we have characterized human epidermis reconstructed in vitro on de-epidermized derma (DED) after a two-week air exposure. Human skin reconstituted in vitro on DED was histologically similar to the in vivo skin. A stratified epidermis including the stratum corneum was obtained. The presence of basal lamina as well as of various important markers for epidermal differentiation (involucrin, K10 keratin, and filaggrin) were revealed. In a second step we have tested the cytotoxic and morphological effects of four surfactants on our model. A good rank correlation has been shown to exist between the irritation potency of surfactants on our model and reported ocular irritancy in vivo. From our results, in vitro reconstituted human skin could represent an attractive model for irritancy testing and could be an in vitro replacement for animal testing.

Child, Preschool↗
PubMed1998

Integrated approach for revascularization in multivessel coronary artery disease and porcelain aorta.

We report two cases in which combined beating heart revascularization of the left anterior descending artery (LAD) and percutaneous angioplasty of the non-LAD target arteries were adopted after the intraoperative detection of porcelain aorta and impossibility to complete surgical revascularization. This type of strategy preserves the benefits of surgical LAD grafting and complete revascularization and results in a simple and low-risk technical procedure in an otherwise challenging setting.

Aged↗
PubMed1997

Palliative coronary artery surgery in patients with severe noncardiac diseases.

Eight patients with severe systemic pathologies and refractory angina unsuitable for angioplasty were submitted to palliative surgical revascularization without the use of cardiopulmonary bypass and limited to the culprit vessels. Complete relief from angina was achieved in all patients without postoperative mortality and morbidity.

Aged↗
PubMed1997

Promoter-dependent synergy between glucocorticoid receptor and Stat5 in the activation of beta-casein gene transcription.

Steroid hormone receptors and Stat factors comprise two distinct families of inducible transcription factors. Activation of a member of each family, namely the glucocorticoid receptor by glucocorticoids and Stat5 by prolactin, is required for the efficient induction of the expression of milk protein genes in the mammary epithelium. We have studied the mode of interaction between Stat5 and the glucocorticoid receptor in the activation of beta-casein gene transcription. The functional role of potential half-palindromic glucocorticoid receptor-binding sites mapped previously in the promoter region was investigated. beta-Casein gene promoter chloramphenicol acetyltransferase constructs containing mutations and deletions in these sites were tested for their responsiveness to the synergistic effect of prolactin and dexamethasone employing COS-7 cells or HC11 mammary epithelial cells. Synergism depended on promoter regions containing intact binding sites for the glucocorticoid receptor and Stat5. The carboxyl-terminal transactivation domains of Stat5a and Stat5b were not required for this synergism. Our results suggest that in lactogenic hormone response elements glucocorticoid receptor molecules bound to nonclassical half-palindromic sites gain competence as transcriptional activators by the interaction with Stat5 molecules binding to vicinal sites.

Animals↗
PubMed1997

Torsion during saccades between tertiary positions.

We systematically studied the effect of saccade direction and saccade starting position on the velocity profile of the saccade. Saccades were made between targets placed at optical infinity by dichoptic presentation. This arrangement was chosen to evoke conjugate eye movements. Eye movements were recorded binocularly, including torsion. Horizontal and vertical movements of the eyes are strongly correlated (r > or = 0.95) during the saccade, torsional movements are much less so (r approximately 0.67). Listing's law would predict that the three-dimensional versional velocity of the eye would be located in a plane that is tilted out of Listing's plane by an amount that depends on the saccade's starting position (half angle rule). Taking together all saccades that started from the same initial position a plane could be fitted through the velocity vectors. However, this plane was tilted less relative to Listing's plane than predicted by the half angle rule. The deviation was especially large for the yaw component of the tilt (56% of predicted). For the pitch component the prediction was better (81% of predicted). In addition, we find that the torsional velocity during the fast "intrasaccadic" part of the motion can be unequal in the two eyes. The implications for three-dimensional models of saccadic control are discussed.

Humans↗
PubMed1997

Conventional left atrial versus superior septal approach for mitral valve replacement.

BACKGROUND: This study was designed to evaluate the safety and effectiveness of the superior septal approach for routine mitral valve replacement. METHODS: One hundred forty-six consecutive patients undergoing mitral valve replacement at our institution were randomly assigned to undergo the procedure using either the conventional left atriotomy or the superior septal approach. Postoperatively and during the follow-up, 12-lead electrocardiography, 24-hour Holter monitoring, and transthoracic and transesophageal echocardiography were performed in all patients. RESULTS: The cardiopulmonary bypass and cross-clamp times were significantly higher in the superior septal group. No significant difference in blood loss was found between the two groups, and no residual atrial septal defect was found in patients in whom we used the superior septal approach. The maintainance of sinus rhythm at late follow-up and the incidences of postoperative arrhythmias and newly developed atrioventricular block were not significantly different between the two groups. CONCLUSIONS: The use of the superior septal approach to the mitral valve is not associated with a greater incidence of rhythm disturbances or other complications. Because this approach provides optimal exposure of the valve and the subvalvular apparatus, it has been routinely adopted for use in patients undergoing mitral valve replacement at our institution.

Adult↗
PubMed1997

Unusual right coronary artery anomaly with major implication during cardiac operations.

We report a case in which an unrevealed high origin of the right coronary artery (almost 4 cm above the left coronary sinus) led to major complications during a routine atrial septal defect closure. We stress that, in absence of preoperative coronary angiography, coronary artery anomalies should always be considered and minimal ascending aorta manipulation and antegrade/ retrograde myocardial protection should be recommended.

Adolescent↗
PubMed1997

Relative orientation of primary positions of the two eyes.

We evaluated the relative orientations of the displacement planes of the two eyes under various conditions: fixations of nearby targets, of far targets and targets presented dichoptically at optical infinity. We show that disparity driven vergence is not always required to rotate the primary positions. We find that eye orientation during fixation of far targets is idiosyncratic. We found a bimodal distribution ranging from null to about 30 deg of the relative exorotations of the two primary positions. By contrast, the difference of primary positions' orientation of the two eyes was, for targets at optical infinity, stable and similar across subjects. However, the displacement planes of the two eyes did not coincide, but were exorotated by 4.3 deg on average, even though horizontal vergence was close to zero. We discuss our results with reference to current models of binocular three-dimensional control.

Algorithms↗
PubMed1997

Increased concentrations of renin, aldosterone and Ca125 in a case of spontaneous, recurrent, familial, severe ovarian hyperstimulation syndrome.

We report for the first time increased concentrations of aldosterone and renin in a case of spontaneous, recurrent, familial, severe ovarian hyperstimulation syndrome (OHSS). High concentrations of Ca125 were also found. Our patient was a 26 year old woman, gravida 2, para 1, affected by severe OHSS, who denied having ever consumed any ovulation drug. Both the patient and her only sister had suffered from a similar condition in their previous pregnancies. The patient was treated with i.v. fluid therapy. Paracentesis was performed on one occasion. The patient was dismissed after 25 days in good condition. Blood count and blood chemistry confirmed the severity of the clinical picture. We conclude that spontaneous OHSS, although very rare, may have been underestimated so far. It can be recurrent and may also be familial. The intra-ovarian prorenin-renin-angiotensin system may play a role in its aetiopathogenesis.

Adult↗
PubMed1997

[Minithoracotomy myocardial revascularization: results of early angiographic control].

AIM OF THE STUDY: Minimally invasive direct coronary artery by-pass (MIDCAB) has been proposed as an alternative technical solution in different clinical settings. However, a systematic angiographic study of the results obtained using this new technique has not been published yet. This paper summarizes our preliminary angiographic results with MIDCAB. MATERIALS AND METHODS: From January 1995 to January 1997, 56 patients underwent MIDCAB. All patients were followed up regularly and underwent stress myocardial scintigraphy. A postoperative angiographic control was performed in 48 patients (87.2% of the total) at a mean postoperative interval of 1.7 +/- 2 months. RESULTS: One patient died in hospital. Five patients required further surgery using conventional techniques (either surgical or percutaneous). In 41/48 patients (85.4%), the mammary artery graft and the left anterior descending artery (LAD) were normal. In two cases, we found an anastomotic stenosis, in two cases there was a LAD lesion distal to the anastomosis (at the application site of the stay sutures), one case showed an anastomotic stenosis associated with a distal LAD stenosis, one case had a mammary graft occlusion and one case showed a thrombus-like image in the LAD proximal to the anastomosis. CONCLUSION: Systematic angiographic follow-up of MIDCAB patients seems mandatory in order to evaluate the effectiveness of the technical solutions utilized and to optimize various aspects of this new procedure.

Adult↗
PubMed1997

[Use of arginine in intruterine growth retardation (IUGR). Authors' experience].

BACKGROUND: Asymmetrical intrauterine growth retardation (IUGR) represents a foetal mechanism, consequent to placental insufficiency, due to many factors: genetic, vascular, malformative. At present, no therapy is really efficient. The aim of this study was to evaluate the efficacy, in these pathological conditions, of the use of L-arginine. This amino-acid improves GH-RH incretion, with consequent increase of plasmatic GH influencing somatic growth. L-arginine moreover, is the obligatory precursor for nitric oxide (NO) enzymatic synthesis (Endothelial-derived relaxing factor). NO helps the prolapse of smooth musculature and, consequently, the improvement of placental blood circulation. METHODS: On the basis of the double activity of NO, vasodilatation and GH-RH induction, 43 pregnant women have been treated suffering from IUGR, diagnosed by ultrasonic examination an by evaluation of Doppler velocimetry values, from 30th week of gestation, administering L-arginine (Bioarginina, 6 g per os/day). Periodically, USG and Doppler velocimetry examinations were performed to evalue foetal growth and possible increase of peripheral vessels resistance. RESULTS: 32 patients improved the clinical course of pregnancy: 19 recovered the whole retardation; 9 only one week; 4 had premature delivery after 36 weeks with foetal weight coincident with gestational age. CONCLUSIONS: The positive results suggest the prosecution of clinical studies in order to attempt the achievement of an effective pharmacological treatment of IUGR.

Amino Acids↗