Biomedical subjects
Publications and source records attributed to A Colombo.
Hepatic hydrothorax is a complication of hepatic cirrhosis which frequently conditions respiratory insufficiency. Traditional therapy is almost always inefficacious. The paper reports four cases which were successfully treated using pleurodesis with sterile talc. Treatment was simple with no major complications. At the 6-month check-up no cases of recurrent pleural effusion were observed.
The authors describe a case of coronary angioplasty on a distal Left Main coronary lesion. The left coronary tree was protected by the left internal mammary connected to left anterior descending artery. The procedure was performed using the "kissing balloon" technique, with a single guiding catheter. Immediate angiographic result and one-year follow-up have been excellent.
We describe a case of percutaneous transluminal coronary angioplasty in which we implanted a balloon expandable Palmaz-Schatz stent into a high-grade restenosed lesion at the origin of the left internal mammary graft.
Actin was localized in the four subacrosomal bulges (Camatini et al., Eur. J. Cell Biol. 45:276-281, 1987), which characterize the sperm head of rabbit spermatozoa (Phillips, J. Ultrastruct. Res. 38:591-604, 1972), and in the postacrosomal region (Welch and O'Rand, Dev. Biol. 109:411-417, 1985; Camatini et al., Eur. J. Cell Biol. 45:276-281, 1987). Specific antibodies and indirect immunogold labelling on testis Lowicryl K4M sections and spermatozoa cryosections were used to study the distribution of calmodulin and a spectrin-like protein. This protein was also present close to the shaping membranes of the head. The results presented suggest a membrane-cytoskeletal role of actin, spectrin, and calmodulin.
A computerized database for documenting drug use in pregnancy was set up on a personal computer. Summaries of the information available from the literature on more than 700 drugs taken during pregnancy have already been entered and are currently in use. This reliable, cheap, handy, and personal system (the first available on the topic) may be a potentially useful instrument not only for drug consultation services, but for individual physicians, too.
OBJECTIVE: To study the possible role of the immune system in the pathogenesis of endometriosis. DESIGN: A cytotoxicity assay by 51Cr release was performed to determine the lymphocyte cytotoxic response toward endometrial targets and an erytroleukemic cell line (K562). SETTING: The assays were performed in an academic research environment. PATIENTS, PARTICIPANTS: Twenty-five control women and 25 patients with endometriosis were selected on the basis of laparoscopic examination. INTERVENTIONS: The lymphocyte cytotoxic activity was evaluated separately on endometrial stromal and epithelial cells after 4 hours' incubation. MAIN OUTCOME MEASURE: The study was designed to determine, in controls and endometriosis patients, the lymphocyte-mediated cytotoxicity toward stromal and epithelial cells of endometrium. RESULTS: The lymphocyte response in the presence of stromal cell antigens was significantly lower (P less than 0.02) in disease-affected women when compared with that obtained in controls (2.89 +/- 0.87 and 7.64 +/- 1.66, respectively). In contrast, when the same assay was performed on K562 cells, no difference was observed between endometriosis patients and controls. CONCLUSIONS: These data suggest that an altered immune recognition might be one of the pathogenic mechanisms of endometriosis. Moreover, they indicate that this is not a general phenomenon but is specific for the endometrial target.
This paper outlines the clinical and CT scan features of a subtype of global aphasia, characterized by an extreme loss of communicative abilities, verbal as well as nonverbal. Three to four weeks after a left hemisphere stroke, 17 patients were completely unable to communicate with people addressing them. Though there were differences in their willingness to interact with the environment, they were characterized by complete loss of speech output and by inaccessibility to any kind of message, whether given verbally or through gestures. Patients who survived were reassessed 6 and 12 mos later and half of them were still found in a state of complete communicative isolation. The remainder had somewhat improved, but remained globally aphasic. The attempt to find a CT scan basis for this picture was disappointing. Only 35% of patients had a lesional pattern in agreement with the traditional view that ascribes global aphasia to the involvement of Broca's and Wernicke's areas. The location of lesion in the other cases spanned from anterior cortical damage, to posterior cortical damage, to deep nuclei damage and none of the lesions that have been proposed to account for subcortical global aphasia was consistently observed.
Early diagnosis of HIV infection in the child of an HIV-infected mother may be difficult as HIV-specific immunoglobulin (Ig) G antibodies are transmitted to the fetus transplacentally. In an attempt to provide a new, simpler tool for early identification of HIV-infected children we analysed the HIV-specific IgG subclass pattern during the first year of life. One hundred and one samples were collected from 35 children born to HIV-seropositive mothers, among whom 18 seroreverted during follow-up and 17 were HIV-infected (two P1 and 15 P2 according to the Centers for Disease Control classification). Serum HIV-specific IgG3 was detectable at least in one sample in 26 out of 35 children. All 17 HIV-infected children showed persistently detectable specific IgG3, both with stable or progressive disease. Out of the 18 uninfected children who seroreverted during follow-up, nine were HIV-specific IgG3-negative when first tested and nine lost HIV-specific-IgG3 within 28 weeks after birth. The correlation of the serological results with clinical information and any other diagnostic tool on each child suggests that the clearance of specific-IgG3 antibodies heralds seroconversion in uninfected passive antibody-carrier children. This observation provides the basis for a new, simple and effective method for early diagnosis of HIV infection in children born to seropositive mothers.
The case of a patient showing bilateral ophthalmoplegia with proximal limb weakness, severe dysphagia and short stature, without family history, is described. The diagnosis of Kearns-Sayre syndrome was excluded because of the absence of pigmentary retinopathy and of all other common manifestations except short stature. The analysis of mitochondrial DNA of the patient's muscle revealed a deleted form accounting for 65% of the total mitochondrial DNA. The deletion, undetectable in the mitochondrial DNA of peripheral blood leukocytes, was apparently indistinguishable from that already described by others in a far more severe form of classic Kearns-Sayre syndrome.
The normal values of the systolic time intervals (STI) in children and their possible relationship with heart rate have not been studied thoroughly. From a group of 9760 healthy school-children 10-12 years old, 488 subjects of both sexes were randomly selected in order to measure the STI and calculate the respective indices. The final population study was composed of 479 children, 249 males and 230 females, aged from 10/1 to 12/2 years/months (mean age 11/1 +/- 0/4 years/months). In each child, the following STI were measured: total electromechanical systole (Q-S2), left ventricular ejection time (LVET), mechanical systole (S1-S2), preejection period (PEP), PEP/LVET ratio and isovolumic contraction time (ICT). For each parameter, the regression equation with heart rate was calculated using a linear model and was verified if a real difference existed between linear regressions of males and females. Moreover, for each parameter, the index from the respective regression equation was calculated as well as its normal value and the standard deviation. Finally, the diastolic time (% diastole) and its correlation with heart rate were calculated. Our results demonstrate that in children, a close correlation exists between the STI and heart rate, although less striking than in adults; only the PEP/LVET ratio appears independent from heart rate, as in adults. The % diastole versus heart rate non-linear relationship shows the same behaviour as in adults. Finally, in agreement with other authors, our results show that in childhood the relationship between the STI and heart rate behaves alike in males and females.
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A prospective study analyzed the prevalence and severity of dysmenorrhea, intermenstrual pain and deep dyspareunia in relation to morphologic features of peritoneal disease in 73 consecutive women with endometriosis but no associated pelvic pathology, previous pelvic surgery or hormonal treatment. All underwent their first laparoscopy for chronic pelvic pain at the First Department of Obstetrics and Gynecology, University of Milan, Milan, Italy, between 1986 and 1989. Gynecologic pain symptoms were evaluated with a verbal score and visual analog scale. Peritoneal lesions were classified as typical (black nodules, yellow-brown patches, stellate scars), atypical (clear vesicles, clear or red papules, red polypoid lesions) or mixed. When the three types of lesions were considered together, a statistically significant association was observed only with deep dyspareunia (P less than .01). Moreover, a significantly higher prevalence of deep dyspareunia was revealed in patients with typical versus atypical lesions (P less than .01) and in those with mixed versus atypical lesions (P less than .05). Fresh, papular, atypical lesions exposed to peritoneal fluid might cause functional pain, whereas "old," black nodules immersed in infiltrating scars might provoke mainly organic pain.
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We report a case of balloon catheter rupture with subsequent entrapment during percutaneous transluminal coronary angioplasty. The presence of a calcified, distal lesion is believed to have prevented withdrawal of the broken catheter. A nonsurgical retrieval technique, using a second dilation system, was used to free the catheter.
To investigate the effects of complete and incomplete revascularization on the response to exercise, 25 patients underwent symptom-limited exercise testing with continuous assessment of gas exchange a mean of 5 +/- 4 days prior to and 18 +/- 12 days following percutaneous transluminal coronary angioplasty. All antianginal medications were discontinued for testing. Revascularization was considered complete if all stenoses were reduced to less than 50% diameter (13 patients), and incomplete if one or more stenoses remained (12 patients). Consistent improvements in ST-segment depression were observed after angioplasty at matched submaximal exercise levels (mean range 0.5-0.8 mm; p less than 0.05), and were accompanied by a reduction in angina. Significant increases in heart rate and systolic blood pressure were observed at peak exercise following angioplasty in both groups. Gas exchange variables were significantly improved at maximal exercise, with a similar increase in oxygen uptake observed in both groups following angioplasty (mean increase 3.3-3.7 ml/kg/min; p less than 0.01). Thus, incomplete revascularization following coronary angioplasty resulted in hemodynamic, electrocardiographic, symptomatic, and gas exchange responses to exercise that were comparable to complete revascularization.
A case of spinal epidural haematoma diagnosed by means of Gadolinium-DTPA-enhanced MR imaging is described. The sensitivity of this recent technique is underlined.
We report the entire course of a case of thrombosis of the venous sinuses, very probably caused by contraceptive pill use, documented by MR imaging. MRI appears to be the examination of choice in such cases.