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Biomedical subjects

R Gallo

Publications and source records attributed to R Gallo.

At least 91 records · Page 5Linked to original sources
PubMed1995

Aortic valve replacement with freehand autologous pericardium.

Fifty-one patients with a mean age of 31.2 years underwent aortic valve replacement with glutaraldehyde-treated autologous pericardium. Pure aortic regurgitation was present in 28 (54.9%), stenosis in 9, and mixed disease in 14. Simultaneous mitral valve repair was done in 17 patients and replacement in 1. There were no hospital and two late deaths. Three patients required reoperation because of failure of the pericardial valve as a result of infective endocarditis in two (5 and 31 months after operation) and commissural tear at 8 months in another. One patient underwent reoperation at 24 months because of failure of the mitral valve repair. The pericardial aortic valve, which had 2+ regurgitation since the first operation, was also replaced. Macroscopic and microscopic examination findings in the excised pericardium were excellent. No thromboembolic events have been detected and no patient received anticoagulation therapy except one after mitral valve reoperation and replacement with a mechanical valve. The actuarial survival was 84.53% +/- 12.29% at 60 months, freedom from failure of the aortic reconstruction 83.83% +/- 8.59%, and freedom from any event 72.59% +/- 12.79%. Doppler echocardiographic study at most recent follow-up showed a mean gradient of 12.56 +/- 8.10 mm Hg and mean regurgitation on a scale from 0 to 4+ of 0.80 +/- 0.66. Although the maximum follow-up is only 5 years, the results obtained so far encourage us to continue replacing the aortic valve with stentless autologous pericardium.

Adolescent↗
PubMed1995

Aortic valve replacement with autologous pericardium: surgical technique.

The surgical technique of aortic valve replacement with freehand glutaraldehyde-treated autologous pericardium is described. Forty-nine patients underwent this procedure without hospital mortality and no thromboembolic episodes without anticoagulation. Three patients underwent reoperation: for infective endocarditis in two; and tear of one commissure 8 months after surgery in another. This technique because of its excellent hemodynamics and low thrombogenicity might be a valid alternative particularly in patients with a small aortic annulus.

Adolescent↗
PubMed1995

Lichen planus presenting with erythema-multiforme-like bullous lesions in a patient with systemic scleroderma.

A patient with systemic scleroderma is described who developed a cutaneous eruption of papules and vesicobullae. Over time, the latter turned into papules. The histopathological and immunofluorescence features of the papular lesions were unequivocally those of lichen planus, while those of the bullous lesions reminded of erythema multiforme. Histologically, erythema multiforme shares common features with lichenoid reactions, such as necrotic keratinocytes. Our case suggests that erythema multiforme and lichen planus may coexist or succeed each other as different stereotype immune reactions against the same antigen(s) within the epidermis.

Blister↗
PubMed1995

[Course of peripheral arterial diseases].

During January and November 1983 we examined 230 patients by means of doppler evaluation for suspect of peripheral arterial disease. We identified 105 subjects with peripheral arterial disease. During September and November 1993 we tried to convoke again all 230 subjects. Altogether we followed 215 subjects (95 with peripheral arterial disease and 120 without). Sixty-three patients died and we analysed the cause of death. Forty-seven out of 95 patients (49.5%) with peripheral arterial disease died and only 16 out of 120 subjects (13.3%) without peripheral arterial disease. Twenty-five out of 47 deaths (53.2%) happened among the patients with peripheral arterial disease. Age, severity of peripheral arterial disease (measured by ankle-arm pressure ratio) and the presence of a carotid bruit were associated with death. The natural history of peripheral arterial disease has been characterized by a worsening of the intermittent claudication in 52.1% of patients but only 18.6% presented a progression toward a superior class of the Fontaine classification. In conclusion, the peripheral arterial disease, despite his apparently benign course, represents a clinical event that must not be overlooked, because the risk of cardiovascular mortality is high. The measurement of ankle-arm pressure ratio allows a good definition of the severity of peripheral arterial disease and therefore represents a valid prognostic criterion.

Aged↗
PubMed1994

Detection of immunoglobulin G to measles virus, rubella virus, and mumps virus in serum samples and in microquantities of whole blood dried on filter paper.

Immunity to measles virus, rubella virus, and mumps virus was determined by EIA in serum samples and in dried whole blood specimens spotted on Whatman filter paper (5 mm in diameter). Both specimens were obtained from each patient by venepuncture and finger prick. Ten microliters of whole blood is enough to detect antibodies to these three different viruses. The comparison of the results obtained by EIA from 227 serum and whole blood samples have demonstrated close agreement: 98.6% for measles virus, 99.1% for rubella virus, and 96.0% for mumps virus. Moreover, 96 whole blood samples can be tested in a microtiter plate and can be stored at room temperature for 15 days or at +4 degrees C for several months. Therefore, whole blood dried on filter paper is a convenient alternative method for collecting and transporting specimens, it is easier and safer than venepuncture, and could be used for large-scale epidemiological studies, especially in newborns. This method could solve the problem of sampling, especially in young children, and could simplify studies of vaccine efficacy.

Adult↗
PubMed1994

Pulmonary autograft for aortic valve replacement in rheumatic disease--an ideal solution?

The use of pulmonary autograft for aortic valve replacement (Ross procedure) offers an excellent option for the younger patient with its potential for growth and long term viability. We report our experiences of 61 patients with a mean age of 17.0 years undergoing Ross procedure over a four year period. Rheumatic disease was the cause of aortic valve disease in 48 (79.0%) patients. Mitral valve surgery was required in 18 (29.5%) patients. There was no hospital death, endocarditis or thromboembolism in the series. There was one late death from non-cardiac cause and three (4.9%) reoperations. Two of the reoperations were for progressive autograft regurgitation whilst the third was for mitral valve repair failure. Echocardiographic profiles of 37 of these patients followed beyond six months after surgery show a tendency towards progression of the autograft regurgitation. The long term effects of rheumatic disease on the transplanted valves remain to be evaluated.

Adolescent↗
PubMed1993

A new expandable intracoronary tantalum (Strecker) stent: early experimental results and follow-up to twelve months.

A new radiopaque balloon expandable tantalum stent was tested in the coronary arteries of sheep. A total of 28 stents with a diameter of 2.0 to 3.8 mm were successfully deployed. The stent to coronary artery diameter ratio was 1.1-1.2:1. The animals were heparinized with 100 U/kg of heparin but did not receive antiplatelet drugs. Coronary angiography that was performed 10 minutes after stent implantation showed 100% patency with no side-branch occlusion. Four sheep died within 2 hours of stent implantation, and pathologic studies showed thrombosis of the smaller sized stents: 2 mm (n = 2), 2.8 mm (n = 1), and 3.2 mm (n = 1); three fourths of the sheep had two stents implanted. An oversized stent caused coronary rupture and cardiac tamponade in one other sheep. Follow-up study protocol included coronary angiography before animal sacrifice and pathologic studies within 48 hours (n = 11), 2 weeks (n = 1), 3 months (n = 2), 5 months (n = 1), 10 months (n = 7), and 12 months (n = 1). At 3 to 12 months of follow-up the coronary stent was completely covered with a layer of neointima, and there was no angiographic evidence of coronary stenosis and patent side branches. According to histologic examination, the neointima had nonuniform thickness (20 to 330 microns) and consisted of smooth muscle cells and some collagen. At 7 months of follow-up one of seven stents had angiographic (20%) and pathologic evidence of stenosis, which was secondary to thrombus. The tantalum device is easily deployed technically and notable for its excellent fluoroscopic visibility and flexibility. Thrombosis with a tantalum stent remains a problem, and therefore the larger diameter stents > or = 3.2 mm, antiplatelet drugs, and anticoagulation therapy are indicated for human studies. Implantation of multiple coronary stents increases the risk of stent thrombosis. The long-term, mild neointimal thickness and the patency of the stent and side branches are encouraging.

Animals↗
PubMed1993

Automatic analysis of high resolution atrial activation in mitral valve stenosis.

High resolution P-waves of 28 patients having a mean age of 45 years and affected by isolated mitral valve stenosis (nine of whom showed paroxysmal atrial fibrillation) have been compared with those obtained from 30 healthy subjects about 35 years old. Our primary aim was to characterize the signal-averaged P-wave in mitral valve stenosis. Parameters which differed between the two groups in time domain analysis were the P-wave duration, the abscissa of the maximum positive voltage amplitude, the peak-to-peak amplitude and the integrated voltage-time product, which turned out to be greater in the patient class than in the healthy set; furthermore, in the frequency domain analysis, amplitudes in the range from 37 to 60 Hz were greater in healthy subjects than in patients. A successive analysis carried out to predict those patients with mitral valve stenosis who are at risk of developing paroxysmal atrial fibrillation showed that the P-wave duration and the amplitudes (in the range 60-106 Hz) were the most distinctive parameters, but, unfortunately, without any significant difference with respect to those of patients with mitral valve stenosis alone. Finally, some correlations between the age, the P-wave duration and the left atrial diameter of patients, were revealed to exist only in patients affected by episodes of atrial fibrillation.

Adult↗
PubMed1993

Bullous eruption with circulating pemphigus-like antibodies following interferon-alpha therapy.

Two patients with classic Kaposi sarcoma developed bullous lesions and pemphigus-like 'anti-intercellular-substance' antibodies when treated with interferon-alpha (IFN-alpha). In one of them direct immunofluorescence was consistent with pemphigus/pemphigoid features. The immunoprecipitation test showed no specific bands. The mechanism by which IFN-alpha may induce the production of anti-intercellular-substance antibodies is discussed.

Aged↗
PubMed1993

New prosthetic ring for aortic valve annuloplasty.

Aortic valve repair is recently receiving more attention. To broaden the indications for this procedure a prosthetic annuloplasty ring has been developed and tested in animals. Thirty-two sheep underwent implantation of such a ring in the pulmonary (14) and aortic (18) positions. In the 12 survivors followed for a maximum of 200 days the ring was found epithelialized and free from thrombus. One ring was dehiscent; no haemolysis was detected. It is concluded that a small clinical study is warranted.

Animals↗