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Biomedical subjects

P Pugliese

Publications and source records attributed to P Pugliese.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Dissection of the ascending aorta complicated by acute myocardial infarction in a patient with Marfan's syndrome and anomalous origin of the left circumflex artery. Description of a case].

Acute myocardial infarction is a rare complication of ascending aortic dissection; it is usually due to the coronary ostium involvement. The authors describe an unusual case with anomalous left coronary origin too; they suggest that, due to this combination, the aneurysmatic area pushes the anomalous coronary artery, causing acute myocardial infarction.

Adult↗
PubMed1993

Relationship between respiratory burst and adhesiveness capacity in elderly polymorphonuclear cells.

Polymorphonuclear cell (PMN) activation was assessed in 30 aged donors, in terms of either adherence to different substrates or superoxide anion (O2-) generation by adhering and suspended cells in response to several agonists. Results showed that PMN in suspension from elderly individuals displayed a phorbol 12-myristate 13-acetate (PMA)-triggered O2- responsiveness which overlapped that seen in the younger counterpart, while a significant decrease of respiratory burst was observed in the presence of formyl-methionyl-leucine-phenylalanine (FMLP). Moreover, in spite of a normal nylon fiber adhesiveness, aged individuals exhibited a reduced PMN adherence to foetal calf serum (FCS)-coated plastic surfaces by using either PMA or FMLP as stimulant. However, elderly adhering cells produced higher amounts of O2- than homologous neutrophils in suspension. Cell pretreatment with anti-CD11b, anti-CD11c and anti-CD18 antibodies led to a further inhibition of PMN adhesion to FCS-coated plates. By contrast, under the same experimental conditions, O2- generation from adhering cells was reduced by using anti-CD18 antibody only. Altogether, these findings provide additional evidence for an imbalance of PMN-mediated functions in the elderly.

Adult↗
PubMed1990

Senile dementia, Alzheimer type: a distinct entity in the immunosenescence?

Since previous data have provided conflicting results on immunoresponsiveness in senile dementia, Alzheimer type (SDAT), we evaluated the immune function in groups of SDAT patients and aged and young donors. In comparison to the younger subjects, SDAT and aged subjects did not exhibit significant differences in lymphocyte surface markers. Both groups of aged donors showed decreased B cell polyclonal responsiveness in a nonspecific T cell-driven B lymphocyte differentiation system. The use of an antigen-specific induction assay revealed an imbalance of T helper (Th) or T suppressor function in the elderly, while SDAT individuals were characterized by decreased Th activity. At the same time, aged individuals manifested an impairment of leukocyte-inhibiting factor (LIF) and lymphocyte-derived chemotactic factor production; a selective deficit of LIF release was seen in SDAT. Finally, elderly individuals displayed a decline of polymorphonuclear cell (PMN)-mediated functions and monocyte phagocytosis; only a decrease in PMN response was observed in SDAT. These results reveal discrepancies in impaired immune responses between SDAT and aging.

Adult↗
PubMed1989

Thermal properties of young red blood cells are indicative of an age-dependent regulation of membrane-skeleton interaction.

The effects of red blood cell (RBC) age on membrane thermal properties have been investigated by using a 16-nitroxide stearic acid spin probe. We detected in unfractionated and most dense cells (2% fraction of circulating cells) a thermal transition at 40 degrees C that in young cells (1% fraction) was lowered at 33-35 degrees C. Spectrin seems to be directly involved in the transition detected in both young and unfractionated cells, as showed by the disappearance of the breaks after low salt extraction of spectrin. A further indication for a role of spectrin in this transition comes from its characteristic thermal unfolding above 40 degrees C. However, young cells did not show changes either in the thermal unfolding of spectrin or in the distribution of spectrin dimer, tetramer, and high oligomeric forms. These data rule out that spectrin of young RBC is modified in its thermal properties and indicate that young cells may have a different spectrin-membrane interaction. Treatment of unfractionated ghosts with an antibody specific for a fragment of the 10K domain of protein 4.1, which is fully competent for the spectrin-actin binding, produced an evident lowering of the transition temperature. The same antibody did not affect the thermal transition of young ghosts. Our results suggest that spectrin-membrane interactions may be regulated during RBC lifespan.

Aging↗
PubMed1988

Direct visualization of aorto-coronary bypass grafts by two-dimensional echocardiography: a new clinical application.

An attempt was made to assess noninvasively the patency of aorto-coronary bypass grafts by two-dimensional echocardiography (2-D echo) in 21 patients who underwent myocardial revascularization. Fifteen patients had one graft while the other six had two grafts. All 21 patients underwent angiography 6-18 months after operation. A day before angiography a 2-D echo was performed with the aim of visualizing the bypass grafts. In 18 patients with 23 grafts (13 with 1 graft and 5 with 2 grafts) it was possible to visualize the tract of the graft by 2-D echo; 16 were judged patent on 2-D echo and confirmed by selective angiography, while 5 grafts were considered occluded both on 2-D echo and angiography. The other 2 grafts were considered to be occluded on 2-D echo but angiographic control displayed their patency. In 3 patients 2-D echo failed to visualize grafts that were patent angiographically. These data must be considered preliminary and need validation in a larger number of patients. However it is reasonable to conclude that 2-D echo has a reliable capacity to predict graft patency. Such an application may be of value in sequential control of patients with aorto-coronary bypass surgery, especially when combined with other clinical and/or technical data.

Adult↗
PubMed1988

Cell-mediated immune response in patients with type IIa, type IIb and type IV primary hyperlipoproteinaemia.

Plasma lipoproteins inhibit immune function. Polymorphonuclear cell (PMN) and monocyte activities, and pokeweed mitogen (PWM)-driven B cell differentiation in patients with type IIa, type IIb and type IV primary hyperlipoproteinaemia were evaluated. Evidence is provided for a selective impairment of these functional capacities in type IIa and type IIb hyperlipoproteinaemic patients, while immune responsiveness is unaffected in type IV primary hyperlipoproteinaemia. The data suggest a specific immune dysfunction in patients with type IIa and type IIb primary hyperlipoproteinaemia.

Adult↗
PubMed1987

[Late aortic dissection after aortic valve substitution. Considerations on 5 operative cases].

This study analyses the clinical course of five patients who developed acute ascending aortic dissection 45.8 months (17-87 months) after aortic valve replacement (AVR) and underwent reoperation in our Department. All except one had aortic insufficiency with mild dilatation of the ascending aorta. No evidence of aortic wall degeneration was present at the time of AVR. Prostheses implanted were: Hancock 2, St. Jude 2, Bjork-Shiley 1. Associated procedures (coartectomy, coronary artery by-pass) were carried out in two patients. The dilated aorta was managed at the first operation by longitudinal resection in 3 of them. Emergent aortic dissection repair was performed: in 3 cases with composite graft according to the Bentall procedure, in one case with non valved dacron conduit and in the last case with teflon patch. Histological examination of the dissected aortic wall showed elastic fiber degeneration like cystic medial necrosis. Three patients survived surgical repair and are doing well at 22.4 months of mean post-operative follow-up. Surgical strategy of this complication is discussed; particular emphasis is given to the method of treatment of ascending aorta dilatation during AVR.

Adult↗
PubMed1985

[Sudden and fatal malfunction of a Björk-Shiley prosthesis in mitral position due to rupture of the ventricular bracket and disk embolization].

Mechanical complications of prosthetic valves are increasing. The following report describes a case of fracture of a Björk-Shiley mitral prosthetic strut with dislogment of the valve occluder into the thoracic aorta. At the reoperation a new prosthesis was implanted but the patient died of acute heart failure. The diagnosis of valve disfunction must be made non invasively, because the time required for cardiac catherization usually constitutes a lethal delay. The only hope for survival is prompt surgical treatment.

Adult↗
PubMed1984

Posterior enlargement of the small annulus during aortic valve replacement versus implantation of a small prosthesis.

Twenty-two patients with a small aortic annulus were identified among 196 consecutive patients undergoing aortic valve replacement (AVR). The 11 patients in Group 1 underwent posterior enlargement aortic annuloplasty, and the 11 in Group 2 received a small aortic prosthesis (less than or equal to 21 mm). The two groups were unselected. Core hypothermia, cardioplegia, and local cooling were employed for all operations. Isolated AVR was performed in 3 patients in each group. In Group 1, the mean increase in diameter of the annulus was 4.82 mm, which resulted in a mean area increase of 169.91 mm2 (51.7%). Mean aortic cross-clamp times were 140.4 minutes and 93.5 minutes in Groups 1 and 2, respectively. There were 2 operative deaths in Group 1, and 1 operative and 1 late death in Group 2. Mean follow-up was 26.5 months for Group 1 and 43.4 months for Group 2. No thomboembolic or bleeding episodes have been recorded. Considerations and conclusions are offered from the study of this small series of patients.

Adolescent↗
PubMed1984

[Isolated straddling tricuspid valve. Presentation of 2 cases operated on successfully].

During the period May 1977-September 1983 in the Department of Cardiac Surgery of Massa Hospital two patients with isolated straddling tricuspid valve were studied with cardiac catheterization and selective angiocardiography and subsequently underwent surgical correction. The first patient, a 38-month-old white boy presented with "complete straddling" according to Bharati and Lev classification; the second, a 39-month-old white boy presented with "peripheral straddling". In both cases at surgery the ventricular septal defect was closed with a Teflon patch, sparing the chordae tendinae and the "straddling" papillary muscle. Both patients survived operation. The first one developed a complete atrioventricular (A-V) block with a ventricular rate which never was below 80 beats/min, during the 30 days of in-hospital observation. No permanent pacemaker was therefore inserted. The follow-up controls (39 and 79 months respectively) shows both patients to be hemodynamically and functionally well.

Child, Preschool↗
PubMed1983

Successful repair of delayed rupture of the left ventricular wall after mitral valve replacement. Report of two cases.

Rupture of left ventricular wall (LVWR) following mitral replacement (MVR) is rare (0.5 to 7.3% of all MVR). Two "types" of LVWR have been recognized and attributed to technical errors during MVR and/or to co-existing unfavourable conditions. The two types are precisely located, and appear "early" during operation, at discontinuation of cardiopulmonary bypass (CPB). Miller et al. have described a "third type" LVWR which depends primarily on local conditions, is located between the other two and occurs "late". Successful repair is rare. The outcome is favourably influenced by intraoperative recognition. This paper reports two LVWRs "type III" which occurred among 282 MVR (0.7%) done in our Department since 1977. Both were successfully repaired respectively 12 (and again 48) and 15 hours after MVRs. To the best of our knowledge these are the only cases of successful repair of a "type III" LVWR reported in the literature. On the basis of this experience some considerations are presented.

Aged↗
PubMed1982

[Ostium secundum type of interatrial septal defect associated with cleft mitral valve].

Eight patients (7 females and one male) ranging in age from 6 to 30 years (mean 11.2 years), with secundum-type atrial septal defect (o.s. ASD) and cleft mitral valve (CVM) were surgically corrected at the Cardiac Surgery Department of Massa Hospital (Massa-Italy) from 1974 to 1981. All patients were studied with non invasive diagnostic techniques and with cardiac catheterization and angiography. All had mitral regurgitation of variable degree. On the ECG, there were P and QRS wave abnormalities but no superior quadrant QRS axis deviation suggestive of endocardial cushion defect. At operation the cleft(s) was found in variable positions: on the anterior leaflet in 4 cases and on the posterior leaflet in four. In two cases there was a double cleft. Correction was accomplished in 5 cases with direct repair of CVM, associated with various types of anuloplasty and in 2 cases anuloplasty only was done, without suturing the cleft. The septal defect was closed by direct suture in one case and with a Dacron patch in the remaining seven. There was one early death in the first 24 hour post-operatively. The seven surviving patients have been followed for a period of time ranging between 2 and 93 months (mean 29 months). No survivor has been re-evaluated by cardiac catheterization and cineangiography. No patient shows clinical or non-invasive evidence of residual mitral regurgitation behind grade I (slight). We conclude that: 1) the CVM associated with o.s. ASD cannot be securely diagnosed preoperatively with the common diagnostic techniques, even when producing severe mitral regurgitation, except perhaps by B-mode echocardiography; 2) the CVM (part of the spectrum of endocardial cushion defect malformations) in no cases was associated with the typical ECG or angiocardiographic abnormalities; 3) the CVM associated with o.s. ASD should always be repaired because, compared to the CVM that occurs with endocardial cushion defects, its site and regurgitation characteristics are variable, and simple ASD closure may not be sufficient.

Adolescent↗