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Biomedical subjects

P Stella

Publications and source records attributed to P Stella.

15 recordsLinked to original sources

[Budd-Chiari syndrome in children: case report].

This work aims at describing a particular case of Budd-Chiari syndrome in a ten-year-old girl. In our patient, the subjective and objective features of this disease, which is already rare during childhood, are associated with a well-assessed polyposis in the blind intestine (intestinum caecum). In our opinion, a possible connection between these two pathological events, a connection unheard of in the literature so far, is an interesting issue to be dealt with in this case report. The follow-up of our patient took place at the Pediatric Hospital of the University of Rome "La Sapienza" and lasted an overall period of 6 months. The girl was hospitalized twice and she underwent a large number of radiological and laboratory tests. The therapy consisted only of medical treatment and support measures. Liver transplant is regarded as the only chance to obtain a full recovery, but it has not yet been performed on our patient. It is by comparing those researches carried out on similar cases with the outcome of our personal study, that we come to the conclusion that, as for our patient, the Budd-Chiari syndrome can be classified as an idiopathic syndrome. Moreover, the fact that this syndrome and the polyposis of caecum occur at the same time in a patient can probably be considered as a coincidence.

Budd-Chiari Syndrome

Detection of the low molecular weight heparin component of ITF 1300 in urines after intranasal administration to dogs.

GAGs were purified from urine of dogs after intranasal administration of 40 mg/kg ITF 1300. The electrophoretic patterns of urine GAGs in acidic buffer showed the presence of heparin together with chondroitins, heparan sulfate, and hyaluronic acid. The heparin present in urines was purified using chondroitinase ABC, and its purity was tested by electrophoresis in acidic buffer. The sample obtained was characterized by 13C-NMR, showing the same characteristic signals of the heparin starting material.

Administration, Intranasal

Erythrocyte Na+,K+,Cl- cotransport and kidney function in essential hypertension.

OBJECTIVE: To determine whether essential hypertensive patients with high Na+,K+,Cl- cotransport (COT) display alterations of some indices of kidney tubular reabsorption similar to those observed in Milan hypertensive (MHS) rats, which have high COT in both erythrocytes and kidney tubular cells, and hypertension caused by a primary increase of tubular reabsorption. DESIGN: Two sets of experiments were performed. First, renal function in two subgroups of hypertensive patients (one with 'high' and one with 'normal' COT was compared with that in normotensive controls. Secondly, the natriuretic and diuretic effects of a single oral dose of frusemide (25 mg) were analysed in six high- and in six normal- COT hypertensive patients. RESULTS: Compared with normotensives and with normal-COT hypertensives, high-COT hypertensives had lower fractional uric acid excretion and plasma renin activity with similar glomerular filtration rate and urinary sodium and potassium excretion. COT was negatively correlated with fractional uric acid excretion in the essential hypertensive patients but not in the normotensives. The diuretic natriuretic response to frusemide was much higher in high- than in normal-COT hypertensives. CONCLUSION: These results are consistent with the hypothesis that patients with high COT have abnormal renal handling of sodium similar to that observed in MHS rats.

Adult

Heritability estimate of erythrocyte Na-K-Cl cotransport in normotensive and hypertensive families.

Na-K-Cl cotransport was measured in 209 essential hypertensive patients (EH) and in 114 normotensive controls (NT). The distribution of Na-K-Cl cotransport was bimodal in EH and unimodal in NT. The EH with higher Na-K-Cl cotransport values had increased passive permeability to Na in fresh erythrocytes and increased Li-Na countertransport compared to NT. Li-Na countertransport was significantly increased in the EH as a whole, but the increase was accounted for by some EH individuals with elevated Na-K-Cl cotransport values. A simple biometric analysis of the Na-K-Cl cotransport was performed for 287 individuals of 86 families with different prevalence of hypertension (neither parent hypertensive, 39 families; one, 31 families; or both, 16 families). Na-K-Cl cotransport was not correlated between spouses, but was correlated highly significantly between the average value of the two parents (mid-parent) and offspring. The polygenic additive heritability (h2) was about 50% for all families considered together. It increased slightly for the hypertensive families analyzed alone (no significant correlation was found, and hence genetic heritability, in the normotensive families). Finally, after applying arbitrary cut-off points to the Na-K-Cl cotransport values, segregation analysis showed that some major gene, recessive for the high allele, also contributes to the phenotypic value of Na-K-Cl cotransport.

Alleles

Relations between hypertension and glomerulosclerosis in first-generation hybrid rats of the Milan strains.

In the Milan hypertensive rats (MHS) glomerulosclerosis is less evident than in the normotensive strain (MNS). To clarify whether this pattern is due to a 'protective effect' of increased afferent arteriolar tone or to a different mechanism, we studied 12 first-generation hybrids (F1), 4 parental MHS and 4 parental MNS rats. Four-micrometer sections were stained with hematoxylin, Mallory's trichrome stain and periodic acid-Schiff reaction. The blood pressure of the F1 rats was only slightly higher than that of the MNS so that very probably renal vascular resistances were similar. The F1 rats had low proteinuria (23.3 +/- 2.7 mg/24 h) like the MHS (25.3 +/- 4.8), and few damaged glomeruli per section (18.5 +/- 1.2), again like the MHS (18.7 +/- 1.1). MNS had higher proteinuria (363.8 +/- 111.6; p less than 0.01 vs. MHS and F1) with a greater number of damaged glomeruli (51.4 +/- 4.5; p less than 0.01 vs. MHS and F1). The difference in afferent arteriolar resistance is not implicated in glomerulosclerosis.

Animals

[A case of uterine leiomyosarcoma in a young patient].

The authors, after a short review of the literature, report a clinical case observed by them. They describe a case of unsuspected uterine leiomyosarcoma diagnosed after a miomectomy and they discuss the question about therapeutic management.

Adult

Genetic polymorphism of Na-K cotransport in essential hypertension.

Erythrocyte Na-K cotransport is high and genetically correlated to hypertension in Milan hypertensive strain (MHS) rats. In man there is a substantial overlap of individual values between essential hypertensives and controls. However, the findings in rat strains with different types of genetic hypertension suggest that Na-K cotransport studies may throw light on the different pathogenetic mechanisms of the human disease. In 28 normotensive and 22 hypertensive families the midparent-offspring correlation of Na-K cotransport values was significant only in hypertensive families (r = 0.48) and not significant in normotensive ones (r = 0.06), indicating genetic polymorphism for its phenotypic expression only in the hypertensives. In 189 essential hypertensives and 109 normotensives carefully selected from a population-based screening in order to exclude uneven sampling bias, analysis for the bimodality of the distribution of Na-K cotransport clearly showed that normotensives are distributed unimodally and hypertensives bimodally, with nadir of the distributions at about 450 mumols (1 RBC/h). Dividing the hypertensives according to Na-K cotransport value, the high Na-K cotransport subgroup has lower fractional percent excretion of uric acid and plasma renin activity. These data suggest that the high Na-K cotransport subgroup has peculiar characteristics of greater proximal tubular reabsorption (lower fractional excretion of uric acid) that may cause body volume expansion (lower plasma renin activity).

Biological Transport, Active

[Radiological diagnosis of Meckel's diverticulum].

Seven patients with clinically suspected Meckel's diverticulum were examined. The symptoms of Meckel's diverticulum are variable, ranging from mild recurrent or severe acute gastrointestinal bleeding to intestinal obstruction and acute peritonitis. The authors evaluate the diagnostic results and suggest guidelines to choose the most appropriate radiological procedures, according to the clinical pattern: barium meal, enteroclysis and scintigraphy (99mTc) in patients with mild bleeding; mesenteric angiography in case of severe bleeding. The possibility of false negatives and positives is then discussed.

Acute Disease

Reliability of IL Monarch ion-selective electrode module for sodium, potassium, and chloride measurements.

We evaluated the IL Monarch random-access centrifugal analyzer for measurement of Na+, K+, and Cl- by an indirect potentiometric method. For different concentrations of control material, the total precision (CV) ranged between 0.82% and 1.14% for the three electrolytes; linearity was acceptable within a range of 103 to 215 mmol/L for Na+, 1.6-15.25 mmol/L for K+, and 80-173 mmol/L for Cl-. Data correlated well with those by flame photometry for Na+ and K+ and with those by coulometry for Cl-, both for various biological materials--sera, urines, dialysis fluids--and commercial control materials from various producers. Stability of the potentiometric signal was acceptable: daily variations were 0.2 mV for Na+, 0.05 mV for K+, and 0.03 mV for Cl-. Accordingly, we conclude that the system supplies reproducible and accurate results while being easy to use and requiring little maintenance. The use of indirect potentiometry offers results consistent with those obtained with traditional methods, and easily interpretable by clinical staff. However, better information about the actual ion activity in the tested sample for certain pathologies such as hyperlipemia and dysproteinemia could be obtained by methods involving direct potentiometry.

Centrifugation

[Radiological assessment of Crohn disease].

Fifty-eight consecutive cases of patients affected by Crohn's disease, with ileum (23/58), colon (10/58) and ileo-colic (25/58) involvement were studied. A good overall sensitivity was reached by the radiological procedures employed (barium meal, barium enema, enteroclysis). Enteroclysis is proposed as a second-step method for the study of ileum involvement, because it provides a quite precise assessment of disease stage and extent. Some criteria for a rational use of current radiological procedures in the follow-up of both surgically and medically treated patients are proposed. Moreover it is suggested that better coordination of anatomo-radiological and clinical aspects could improve the therapeutic approach and prognostic judgement in such cases.

Colitis

Radiological aspects of cancer of the esophagus.

The role radiology plays in the study of cancer of the esophagus (CE) involves three different diagnostic steps: identification of CE; staging of CE and postoperative follow-up. This study comprises 117 cases of CE, all surgically confirmed: in 57/117 CE, resection of the neoplasm with subsequent reconstruction of the digestive tract proved possible; in the remaining 60/117 non-resectable CE, a Celestin prosthetic tube was positioned. The radiological diagnosis was correct in 92.3% of the cases, the diagnostic error (9/117: 7.7%) being mainly due to under-diagnoses (6/9) rather than false negatives (3/9). Conventional radiology provided satisfactory results in the staging of CE. Among the postoperative complications in the 57 resected patients, fistulae (13/57) and mediastinal abscesses (1/57) were early complications, whereas stenosis of the anastomosis (5/57) and neoplastic recurrences (3/57) were late complications. The possible role of diagnostic delay in the poor prognosis of CE, as well as its possible causes, are discussed in this paper.

Diagnosis, Differential