PubMed Health⌕ Search

Biomedical subjects

A Beltrami

Publications and source records attributed to A Beltrami.

14 recordsLinked to original sources
PubMed2006

Comparison of clinical and pathological staging and long-term results of liver transplantation for hepatocellular carcinoma in a single transplant center.

Liver transplantation (OLT) is a treatment for hepatocellular carcinoma (HCC) superimposed on cirrhosis provided that the disease meets defined criteria. The aim of the study was to evaluate our experience with respect to clinical and pathological staging and long-term results. From 1996 to 2005, 50 patients underwent OLT for HCC including 43 men (86%) and seven women (14%) of median age 57 years (range 37 to 67). All patients fulfilled the Milan criteria. The HCC diagnosis was based on preoperative imaging and alpha-fetoprotein levels; no tumor biopsy was performed. Upon histological examination of the resected specimens, we discovered 6 (12%) incidentalomas and 8 (16%) cases of no HCC. Finally we had 42 "true" HCC. Twenty-six patients (52%) have been downstaged and 10 (20%) upstaged by preoperative imaging; 15% were pT1, 45% were pT2, 27% pT3, and 13% pT4a. Twenty-six percent of cases exceeded the Milan criteria. One patient (pT4a) with microvascular invasion died of pulmonary metastases at 14 months after transplantation. No HCC recurrences within the liver have been encountered at a median follow-up of 20 months (range 0 to 80 months). Overall the estimated 1-, 3-, and 5-year survival rates were 83%, 77%, and 72%, respectively. One-, 3-, and 5-year estimated survival rates were 87%, 75%, and 75% for pT1, and pT2, and 75%, 67%, and 67% for pT3 and pT4a, respectively (P = .99). Based on our experience OLT for HCC has long-term results comparable to those without HCC despite the presence of a significant number of cases exceeding the Milan criteria upon pathological staging.

Adult↗
PubMed2006

De novo malignancies after kidney and liver transplantations: experience on 582 consecutive cases.

De novo malignancies after transplantation are a growing problem of solid organ transplant recipients, due to longer survival follow-up under chronic immunosuppression. The aim of this study was to analyze a population of 582 consecutive kidney (n = 382) and liver (n = 202) transplant recipients, who survived at least 12 months after transplantation, at a single transplant center for the development of de novo cancers. The incidence of de novo malignancies was 7% after both renal and liver transplantation. The median elapsed time from transplant to the diagnosis of de novo malignancy was 45 months (range 3 to 220) months for kidney and 37 months (range 12 to 101 months) for liver transplants. Skin cancers were the most common within renal recipients, while gastroenteric cancers were more frequently encountered in liver transplants. Oropharyngeal and upper digestive tract tumors were always associated with a history of chronic alcohol consumption in liver recipients. Liver transplant recipients treated for acute rejection had a worse cancer prognosis than patients without rejection 1- and 2-year survivals 83% and 63% versus 36% and 17% (P = .026). The estimated 1- and 2-year survival rates for all types of de novo malignancies were 79% and 66%, including 64% and 51% for solid organ tumors versus 89% and 89% for skin cancers and posttransplant lymphoproliferative disorder (PTLD) (P = .17) in renal transplants and 70% and 42%, including 57% and 28% for solid organ tumors versus 85% and 64% for skin cancers and PTLD (P = .43) in liver transplants respectively.

Cadaver↗
PubMed1991

Clinical correlation between diabetic and non diabetic patients with myocardial infarction.

We have studied 130 patients with diabetes mellitus and 455 patients without. All the patients were consecutively admitted to our Coronary Care Unit with their first myocardial infarction. We have observed a higher incidence of heart failure, in-hospital mortality, atrial fibrillation, conduction abnormalities, and post-infarction angina among diabetics. Nevertheless, diabetic patients do not show evidence of larger infarcts than those without diabetes. In our patients the higher mortality among diabetics is related to an increased occurrence of left ventricular failure. Moreover, post-infarction ischemic episodes are more common compared with non diabetics. Since infarcts in diabetics do not seem to be more extensive than in non diabetics, we suggest, in accordance with others, that the poorer outcome among diabetic patients with AMI could be related to an underlying cardiac dysfunction of diabetics in addition to coronary artery diseases.

Adult↗
PubMed1989

T-lymphoblastic lymphomas expressing the non-disulfide-linked form of the T-cell receptor gamma/delta: characterization with monoclonal antibodies and genotypic analysis.

Three cases of T-lymphoblastic lymphomas (T-LL) expressing the T cell antigen receptor gamma delta (TCR gamma delta) are reported. All of them were CD3+/beta F1-/TCR delta 1+. Moreover, neoplastic cells reacted with the delta TCS1 monoclonal antibody (MoAb) which binds to the non-disulfide-linked form of the TCR gamma delta, but not with the BB3 MoAb which recognizes the disulfide-linked form of the TCR gamma delta. All cases showed a stage II cortical phenotype, eg, TdT+/CD1+/CD3+/CD5+/CD7+; two of them coexpressed CD4/CD8, while the other was CD4+/CD8-. Two cases were positive for CALLA and CD25. Immunogenotypic analysis showed evidence of T beta and C gamma 2 gene rearrangements in all three cases and immunoglobulin (Ig) gene rearrangements in two cases. Two patients presented with an anterior mediastinal mass and the third with a solitary inguinal lymphadenopathy. We suggest that these cases of TCR gamma delta+ T-LL may be derived from the small population (approximately 0.5%) of CD3+ cortical thymocytes which, in the normal human thymus, express the delta TCS1-reactive, non-disulfide-linked form of the TCR gamma delta.

Antibodies, Monoclonal↗
PubMed1986

[Intra-sinus echo: demonstration using direct intracavitary recording of the sinus potential].

The authors searched for intra-sinusal echos during electrophysiological investigation of 53 patients (41 men, 12 women, average age: 61 +/- 12 years). Cycles of sinus echos were recorded in 8 patients (15 per cent). The period during which sinus echos could be recorded was 125 ms (average 40.6 +/- 34 ms). Indirect assessment of sinus node function in patients with sinus echos was normal (corrected sinus node recovery time, estimated atrio-sino atrial conduction times using Narula's technique). A valid and reproducible direct recording of the sinus node potential was only possible in one patient. In this case the echo cycles were provoked by stimulation periods of between 440 and 320 ms (echo zone of 120 ms). All the echos obtained were preceded by a sinus node potential with a different duration and morphology to that observed during basal sinus cycles (respective sino-atrial conduction times 105 and 115 ms). In this patient we were also able to induce sinus echos after a single extrastimulus during the spontaneous rhythm. the echo zone was 130 ms and with a shorter coupling interval (310 ms) two successive sinus echos were recorded. The demonstration of intrasinusal echos by direct recording of the sinus node potential supports the experimental data of Allessie and Bonke on isolated right atrial tissues of the rabbit. Improvements in the technique of endocavitary direct recording of the sinus node potential in man should complete this data by showing the possibility of sinoatrial tachycardias due to reentry.

Action Potentials↗
PubMed1985

Mexiletine action on the specialized tissues of the human heart.

Electrophysiological properties of mexiletine (3 mg/kg i.v.) were studied in fifteen patients with various degrees of abnormalities in the specialized conduction system. Sinus cycle length was decreased in all patients; sinus node recovery time was increased in all patients, but the increment was not statistically significant. Atrial and atrioventricular (AV) nodal refractoriness were not modified. The relative refractory period of the His-Purkinje system was reduced in patients with normal intraventricular conduction on the surface electrocardiogram; no changes were noted in five patients with intraventricular conduction delay. In two patients, in whom AV nodal refractory period curves showed antegrade dual AV nodal pathways, mexiletine increased refractoriness of the fast pathway. This report points out that the drug is effective against arrhythmias sustained by a reentry mechanism, not only in the ventricles, but also in the AV node.

Aged↗
PubMed1985

[Sinus node electric activity in prolonged atrial pauses in subjects with the sick sinus syndrome].

Sinus node electrogram (SNE) was recorded in 15 patients with sick sinus syndrome (SSS) in which prolonged atrial pauses were observed. The aim of this study was clarify the physiopathological mechanisms underlying atrial pauses as well as to evaluate the sensitivity of sinoatrial conduction time (SACT) directly measured on SNE and of SACT estimated with the indirect Strauss method with respect to the detection of SSS. The following results were obtained: Sinus electrical activity was recorded during atrial pauses (greater than or equal to 2 basic sinus cycle length) in all the 9 patients in which the pauses spontaneously occurred and in the 2 patients in whom the pauses of 2860 and 3190 msec were induced by atrial pacing. In one of these latter two patients, moreover, a complete electrical desynchronization was observed. In the remaining 4 patients in whom, pauses (greater than or equal to 3 sec) were induced by carotid sinus massage of in 3 no sinus electrical activity was detected on SNE while in 1 advanced sinus node desynchronization was observed. Direct sinoatrial conduction time was abnormally prolonged in 6 patients with SSS and indirect sinoatrial conduction time in 9 patients.

Adult↗
PubMed1984

[The sinus node electrogram in the evaluation of atrial pauses].

The aim of this study was to establish the electrophysiological mechanism of atrial pauses, defined as a sudden lengthening of atrial cycle greater than or equal to 10% of its basal value. The sinus node electrogram (SNE) was recorded during electrophysiological study in 20 subjects. Satisfactory recordings of 64 pauses were obtained, 25 of which were spontaneous, 16 were induced by short periods of atrial pacing (AP) in normal subjects, whereas 23 atrial pauses were induced with the premature stimulation method. The basal sinus cycle and the one during the spontaneous pauses were measured from the upstroke slope on the SNE. The electrically induced pauses of the sinus cycle were measured from the artifact of the stimulus to the upstroke slope of the SNE of the first post-pacing beat. We have found that: 1-spontaneous atrial pauses correspond to a moderate slowing of the sinus cycle and to a depression of the sinoatrial conduction occasionally up to a second degree sinoatrial block. Only in subjects with sick sinus disease, the atrial pauses are induced by depression of the sinus automatism; 2-in normal subjects the AP results in a sinoatrial conduction delay; 3-the single extrastimulus regularly produces a moderate increase of the sinoatrial conduction time with variable but minimal effects on the sinus node automatism.

Cardiac Pacing, Artificial↗
PubMed1982

[Direct measurement of sinoatrial conduction time in man. Correlation with sinus cycle length].

Recent reports have shown that it is possible to record sinus node potential (SNP) using a transvenous electrode catheter technique in animals and in man. We applied similar techniques to record sinoatrial activity in 24 normal subjects and in 6 patients with sick sinus syndrome. We used bipolar recordings, with one interelectrode distance of 1 cm, low-pass filters of 0.1-50 Hz and high-amplification (up to 100 microV/cm). Validation of the source of the sinus node electrograms (SNE) was obtained by using ad hoc criteria. Like SNE recorded in animals, human SNE shows a smooth, low-frequency upstroke slope that begins before and merges into atrial activation. Sinus node potential is separated from preceding T wave by an isoelectric plateau. In 24 subjects with normal sinus node function, the directly recorded sinoatrial conduction time (D-SACT) was 82.9 +/- 17.9 msec. Correlation with the SACT estimated by Narula's method was excellent (r = 0,84). In 12 patients with sinus arrhythmia on SNE, SACTs were directly measured as were the associated P-P intervals. When SACT at each sinus cycle length (SCL) was plotted against SCL for all subjects grouped together, the average change of SAT per 100 msec change of SCL was 15 msec. In 6 patients with sick sinus syndrome, D-SACT was 150.4 +/- 67.4 msec. When SACT at each SCL was plotted against SCL, the average change of SACT per 100 msec change of SCL was 39 msec. In the same patients the SACT estimated by Narula's method was 129 +/- 17 msec.

Electrocardiography↗
PubMed1978

Placebo effect in the treatment of angina pectoris.

The interference of placebo effect in the treatment of angina pectoris has been studied in a group of patients with stable angina pectoris, selected on the basis of normal electrocardiogram at rest and a pathologic ergometric electrocardiographic test. It was found that the patients could be divided, according to the results of the exercise test, into two groups: placebo responders and place-bo-non-responders. The anti-anginal effect of beta-blocking agents has been clearly demonstrated only in the placebo-non-responders group. No statistically significant effect of beta-blocking agents was observed in the placebo-responders group. This result shows that it is necessary, in double blind trials, at first to separate placebo-responders from placebo-non responders. Otherwise the correct evaluation of a drug can be modified by the placebo-responders group.

Adult↗
PubMedDate not supplied

[The relationship between systolic time intervals and the electrocardiographic pattern in essential hypertension (author's transl)].

Systolic time intervals at rest and after exercise were studied in 56 patients with essential hypertension. The patients were divided into groups according to the presence or absence at rest of electrocardiographic patterns of left atrial hypertrophy, and left ventricular strain. An impaired left ventricular function was shown, at rest and after exercise, in patients who had an electrocardiographic pattern of "left ventricular strain".

Adult↗