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Biomedical subjects

R Bellomo

Publications and source records attributed to R Bellomo.

At least 235 records · Page 13Linked to original sources
PubMed1991

Clinical spectrum of cryptogenic organising pneumonitis.

Cryptogenic organising pneumonitis (bronchiolitis obliterans organising pneumonia) is an uncommon condition that often responds to steroids. It is characterised clinically by constitutional symptoms, pathologically by intra-alveolar organising fibrosis, and radiologically by patchy pulmonary infiltrates. Its full clinical spectrum and course are only partially described and understood. Six patients are described, seen over three years, with considerably diverse clinical and radiological presentations (two had diffuse lung infiltrates, two had peripheral lung infiltrates, and two had localised lobar involvement) and with very varying severity of disease (two with a life threatening illness, three with appreciable subacute constitutional symptoms, and one with mild symptoms). It is concluded that cryptogenic organising pneumonitis can present in various ways. A set of diagnostic criteria are proposed which will help in the recognition of this syndrome, which is probably underdiagnosed.

Aged↗
PubMed1991

[The modified Shouldice inguinal hernioplasty. A clinical contribution].

The Authors present their personal experience in the surgical treatment, using the Shouldice modified method, of 85 cases of patients suffering from inguinal hernia. The rarity of general and local complications and the relatively low percentage of relapse, if compared with other surgical methods, testify to the validity of this technique.

Adult↗
PubMed1990

In vitro expansion of CD3/TCR- human thymocyte populations that selectively lack CD3 delta gene expression: a phenotypic and functional analysis.

Highly purified CD1-3-4-8- human thymocytes were obtained by panning techniques combined with cell depletion with antibody-coated magnetic beads. Most of these cells expressed cytoplasmic CD3 antigen, as assessed by mAbs known to react with the CD3 epsilon chain. After culture with low doses of PMA (0.5 ng/ml) and subsequent addition (at 24 h) of recombinant interleukin 2 (rIL-2; 100 U/ml) cells underwent extensive proliferation (40-60-fold of the initial cell input after 2 wk). The majority of the proliferating cells were CD3-TCR-. The remaining cells (5-40%) were represented by CD3+ TCR gamma/delta+ (BB3- A13+) cells. Further removal of CD3+ TCR-gamma/delta+ cells resulted in highly purified CD3- populations that further proliferated in culture with no substantial phenotypic changes. When CD3+ thymocytes were cultured under the same experimental conditions, only CD3+ TCR-alpha/beta+ cells could be detected, thus indicating that PMA did not affect the surface expression of the CD3/TCR complex, but rather induced preferential growth of CD3- thymocytes. Surface marker analysis of cultured CD3- thymocytes showed that they were homogeneously CD7+, whereas low proportions of cells expressed CD2 and CD8 antigens. Among the natural killer (NK) cell markers, CD56 was highly expressed by all cells, whereas CD16, CD57, CD11b, NKH2, and GL183 were absent. Importantly, these cells were different from peripheral NK cells, as 80-95% of them expressed cytoplasmic CD3 antigen. Functional analysis revealed a strong cytolytic activity against both NK-sensitive (K562) and NK-resistant (M14, Daudi) human target cells. In a redirected killing assay against the Fc gamma R+ P815 cells, mAbs specific for triggering molecules including CD3, CD2, and CD16 failed to augment target cell lysis, while a strong cytolytic effect was induced by PHA. In addition, PHA alone or in combination with PMA induced tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) (but not IL-2) production by CD3- thymocytes. Cloning of fresh CD1-3-4-8-thymocytes in the presence of PMA and rIL-2 resulted in CD3-CD56+ clones that displayed a pattern of cytolytic activity and lymphokine production similar to that of the polyclonal populations. Northern blot analysis of transcripts coding for CD3/TCR molecules revealed the presence of CD3 zeta, epsilon, and gamma transcripts, while CD3 delta was undetectable. Mature transcripts for both gamma and delta TCR chains could be detected, whereas no TCR-alpha mRNA and only a truncated (1.0 kb) form of TCR-beta mRNA were revealed.(ABSTRACT TRUNCATED AT 400 WORDS)

Antigens, CD↗
PubMed1990

[Clinical contribution to the knowledge of retroperitoneal tumors of the pelvic excavation].

Two cases of primitive retroperitoneal tumors of the pelvic excavation have been reported: a neurinosarcoma and a liposarcoma. Particular, this work emphasizes the rarity of the neurinosarcoma in that seat, the atypical clinical presentation, the complex diagnostic researches performed and the problems of the differential diagnosis. In the diagnosis of these neoplasms, the Authors emphasize, the main role performed by the "classic" radiology and its most recently acquired means as (ECO, TAC, EMR). These can give precise informations about the seat and the size of the neoplasms and especially, about it's relationship with the adjacent tissues. By using these new means, other examinations some what dangerous, can be avoided. The Authors conclude that from the therapeutical point of view, surgery is still the main weapon against these neoplasms, even if sometimes it is demolishing and does not sensibly improve the prognosis. Surgery can be associated with radiotherapy and/or chemotherapy.

Aged↗
PubMed1990

[Aneurysm of the left gastric artery. Clinical contribution and review of the literature].

The extra-visceral aneurysms of the gastric arteries are very rare and their diagnosis occurs mostly in the presence of haemoperitoneum and shock due to their rupture. Through echography and selective arteriography a right diagnosis can be made before a rupture. The treatment is surgical with good results but treatment with embolisation through arteriography is preconized. Two cases treated in emergency are reported.

Aged↗
PubMed1990

Clearance of vancomycin during continuous arteriovenous hemodiafiltration.

The clearance of vancomycin during therapy with continuous arteriovenous hemodiafiltration (CAVHD) has been measured in vivo. Vancomycin clearances (n = 16) were 0.636 +/- 0.269 L/h (10.5 +/- 4.46 ml/min). Effective drug clearances were proportional to ultrafiltrate volumes, reflecting convective clearance. Clearances of vancomycin on CAVHD were approximately twice the values seen with continuous arteriovenous hemofiltration. These data allow construction of a dosing schedule for vancomycin therapy in patients receiving renal support via CAVHD.

Acute Kidney Injury↗
PubMed1990

Continuous arteriovenous haemodiafiltration: optimal therapy for acute renal failure in an intensive care setting?

We report the results of continuous arteriovenous haemodiafiltration (CAVHD) treatment in 12 critically ill intensive care patients with acute renal failure (eight males, four females - mean age 60.9 years - range 47 to 76) (APACHE II score 28.8, range 18-37). All patients were oligoanuric or had a rising creatinine (greater than or equal to 100 microM/L per day). Vascular access was obtained by Scribner shunt or wide-bore femoral arterial and venous cannulae. At the beginning of CAVHD therapy the mean plasma urea was 38 mM/L (SE 4.5, 95% confidence interval (CI) 25.1 to 75.6 mM/L) and the mean creatinine was 604 microM/L (SE 70, 95% CI 450-756 microM/L). After 72 hours of therapy, despite oligoanuria, urea concentration had fallen to a mean of 15.7 mM/L (SE 2.4, 95% CI 12.5-22.9 mM/L) and the creatinine concentration to 297 microM/L (SE 25, 95% CI 243-351 microM/L), respectively. The mean ultrafiltrate volume was 441 mL/hr (SE 33, 95%, range 50-1050 mL/hr). There were no complications related to the extracorporeal circuit, the filter, anticoagulant therapy, electrolyte status or changes in patients' haemodynamic state. Excellent biochemical control of azotaemia was uniformly achieved during CAVHD therapy. Five patients (41.6%) survived to be discharged from the Intensive Care Unit. CAVHD is a simple, safe and effective continuous renal replacement therapy. CAVHD offers technical advantages over alternative therapy while providing equivalent or better biochemical control of azotaemia and volume status in critically ill patients with acute renal failure.

Acute Kidney Injury↗
PubMed1984

Differential effects of steroids on leukocyte-mediated glomerulonephritis in the rabbit.

The effects of steroids on the development of injury in two models of experimental glomerulonephritis (GN), (one mediated by neutrophils, the other by macrophages) were compared. The neutrophil-associated lesion [initiated by heterologous antiglomerular basement membrane (GBM) antibody] was characterized by the development of an exudative endocapillary GN with heavy neutrophil accumulation [mean, 6.9 neutrophils/glomerular cross section (N/GCS) +/- 2.9 SD], minor macrophage infiltration [7.9 macrophages/glomerulus (M/G) +/- 2.2 SD] and heavy proteinuria (1905 mg/24 hr +/- 520 SD). Steroid-treated (methylprednisolone, 2 mg/kg/12 hr i.v.) rabbits developed a marked monocytopenia, mild neutrophilia, and significant reduction in glomerular macrophage accumulation (0.3 M/G 0.02 SD). However, neutrophil accumulation (6.1 N/CGS +/- 2.5 SD), histological appearances, and proteinuria (1820 mg/hr +/- 490 SD) were unaffected. The macrophage-associated model of GN was induced by passive autologous rabbit anti-sheep IgG 15 hr after the injection of a subnephritogenic dose of the same anti-GBM antibody. The glomerular lesion was characterized by a diffuse endocapillary proliferative GN with heavy macrophage infiltration (54 M/G +/- 8 SD), insignificant neutrophil accumulation (0.8 N/GCS 0.02 SD), and the regular development of proteinuria (420 mg/24 hr +/- 80 SD). Steroid-treated rabbits developed a mild neutrophilia and a significant monocytopenia associated with abrogation of glomerular macrophage accumulation (2.3 M/G +/- 0.8 SD). This was associated with the prevention of the development of GN and proteinuria (22 +/- 9.5 SD). Thus, steroids produce monocytopenia and prevent glomerular macrophage accumulation and associated injury whereas neutrophil accumulation and injury is unaffected. These data suggest steroids may have widely varying effects on the outcome of leukocyte-associated experimental GN depending on the nature of the infiltrating cells.

Animals↗
PubMed1983

[Polygraphic findings in bird-like face syndrome with favorable spontaneous evolution].

The syndrome characterized by acquired micrognathia, hypersomnia and periodic apneas during sleep is a rare consequence of mandibular underdevelopment. The pathogenesis is ascribed to incomplete obstruction of the upper airways associated with a hypoexcitability of the respiratory center. Tracheostomy, with the placement of a permanent tracheal cannula, has proved to be the only treatment producing clinical remission of the syndrome. Polygraphic findings were described in a case spontaneously recovered of hypersomnia and periodic apneas with acquired micrognathia due to a bilateral mastoiditis occurring in early childhood. In this patient three polygraphic recordings were carried out during diurnal and nocturnal sleep; another night sleep was recorded after a spontaneous improvement. In the early three recordings there is a prevalence of light sleep over slow-waves sleep and REM sleep is reduced in nocturnal sleep. There is a lot of periodic apneas during sleep stages. During apneas we observe an increase of heart frequency in NonREM sleep and a decrease in REM sleep. In the recording after clinical recovery we observe an improvement of sleep parameters and a disappearing of apneas in NonREM sleep. A temporary hyposensibility of respiratory centers is considered to be a possible interpretation of clinical and polygraphic improvement.

Disorders of Excessive Somnolence↗
PubMed1981

Smooth pursuit eye movements among storage battery workers.

Eleven male workers in a battery storage plant with lead and erythrocyte protoporphyrin blood actual levels greater than 50 and 100 micrograms %, respectively, and 18 male controls without lead exposure were tested by a clinical pendular eye tracking test (PETT). Each worker underwent a series of lead absorption measurements including blood lead, urinary lead, erythrocyte protoporphyrin, delta-aminolevulinic acid dehydratase activity, and urinary delta-aminolevulinic acid. The SPEMs were evaluated by an eye tracking technique. The subjects followed a horizontally moving target which, in the form of a luminous spot on a dark background, was projected onto a screen placed 1 m from the subject. The maximum predicted eye movement velocity during tracking was about 30 degrees/s. Skin electrodes were applied on the outer canthi of both eyes and SPEM were plotted on a polygraph, recording both the actual eye movements and the corresponding first derivative. Our findings suggest that lead workers display a disorder of motor coordination of SPEMs system, and the PETT is useful, when associated with biochemical data, to evaluate the degree of subclinical damage of nervous system during lead poisoning.

Adult↗