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Biomedical subjects

A Monaco

Publications and source records attributed to A Monaco.

At least 19 recordsLinked to original sources
PubMed1999

A randomized comparison of trapidil (triazolopyrimidine), a platelet-derived growth factor antagonist, versus aspirin in prevention of angiographic restenosis after coronary artery Palmaz-Schatz stent implantation.

The aim of the study is to assess the safety of trapidil in the setting of coronary stenting and to evaluate its efficacy in reducing angiographic in-stent restenosis. One hundred eighteen patients undergoing Palmaz-Schatz stent implantation were randomly assigned to receive antiplatelet therapy using either aspirin (325 mg/d) or trapidil (400 mg/d), in combination with ticlopidine (500 mg) for the first month. At entry, both groups were comparable with regard to clinical, angiographic, and procedural characteristics. At 6-month angiographic follow-up, >50% restenosis occurred in 15 of 52 lesions (28.8%) of the aspirin group and in 14 of 47 lesions (29.8%) of the trapidil group (P=not significant, NS). At 6-month clinical follow-up, there was no difference in the two groups in the rate of adverse events (2.0% vs. 2.1%, P=NS), medication side effects (4.0% vs. 4.2%, P=NS), and peripheral vascular complications (4.0% vs. 4.2%, P=NS). In conclusion, treatment with trapidil seems to be associated with a similar incidence of stent restenosis and adverse cardiac events as compared to aspirin and could be a valuable alternative to aspirin in the setting of coronary stenting.

Aged↗
PubMed1999

[Temporomandibular disorders in pediatric age].

In this work the authors consider TMJ disorders in children, evaluating the epidemiological, etiopathogenetic and diagnostic aspects compared to the TMJ pathology in adults and with reference to recent literature. In order to achieve a better understanding of TMJ disorders in children and to promote an appropriate prevention and therapeutic approach, four questions are raised: 1) What are the signs and the symptoms of TMJ disorders during the growth? 2) What factors are associated with TMJ disorders? 3) What is the prognostic meaning of the signs and the symptoms? 4) What is the importance of TMJ disorders in a protocol which considers treatment needs and priority?

Adolescent↗
PubMed1998

Homology models for the PERB11 multigene family.

BACKGROUND: PERB11 is a multicopy polymorphic gene family found in association with HLA Class I genes within the major histocompatibility complex (MHC). Although its function is unknown, PERB11 has sequence similarities to HLA Class I and other related proteins. To explore the possible functional roles for PERB11, homology models have been constructed using both HLA Class I and Class I-like protein structures as templates. RESULTS: The models show that PERB11.1 appears to have an unusual distribution of charged residues that potentially give the molecule a distinct polarity. Furthermore, a cluster of negatively charged residues in the traditional P2 site may form a novel binding site for a positively charged ligand such as a metal ion or complex. Other charged residues line the floor and walls of the cleft and are able to form salt bridges, reminiscent of the closed cleft of the Class I-like mouse neonatal Fc receptor structure. The closely related PERB11.2 family has a different arrangement of charged residues in the cleft, but these residues are still able to form salt bridges. Unlike HLA Class I, the majority of polymorphic positions in the PERB11 family occur outside the cleft and on the surface of the molecule. CONCLUSIONS: Homology models for PERB11 suggest that the structure is capable of associating with beta2 microglobulin or a similar molecule. Furthermore, not all of the potential glycosylation sites suggested by the PERB11 sequences appear viable. Importantly, the models suggest that the molecule has a less accessible cleft than HLA Class I and is not, therefore, able to bind peptides. Other small ligands, including metal ions, might be bound, however.

Amino Acid Sequence↗
PubMed1998

Expression of B7 co-stimulatory molecules and CD1a antigen by alveolar macrophages in allergic bronchial asthma.

BACKGROUND: Lung allergen recognition that takes place in the airways of asthmatic subjects is still a controversial matter. OBJECTIVE: We hypothesized that a rapid allergen recognition process requires the presence, at the mucosal surface, of professional APC, such as B7+ alveolar macrophages (AM) and/or CD1+ dendritic cells, which usually have a lower expression in the normal human lung. METHODS: Studies were performed on bronchoalveolar lavage (BAL) fluid collected from 10 untreated allergic subjects and 10 adult normal volunteers. Further controls consisted of five untreated pulmonary sarcoidosis (PS) and four extrinsic allergic alveolitis (EAA) individuals. To ascertain whether T helper 2-type cytokines or allergen influence B7 and CD1 antigen expression, in vitro studies were carried out using unprimed (naive) cord blood plastic-adherent monocytes. RESULTS: Cytofluorymetric analysis revealed that AM from asthmatics, unlike those from normal subjects or patients with PS or EAA, overexpressed B7-2, CD1a and, to a lesser extent, B7-1 surface molecules. Immunohistochemical studies confirmed the presence of CD1+ dendritic cells in the BAL fluid from asthmatic subjects. On in vitro cultured naive cord blood monocytes both purified Dermatophagoides pteronyssinus allergen and T-cell cytokines, i.e. IL-4 and granulocyte macrophage colony-stimulating factor, induced surface expression of B7-2 and CD1a receptors, whereas they had no appreciable effect on that of B7-1 membrane molecule. CONCLUSIONS: Taken together, these findings support the proposal that airways of atopic individuals are equipped with professional APC that synergize with allergen-specific T cells for the recognition of intact allergens. When the recognition process takes place, asthmatic symptoms could develop in genetically susceptible individuals.

Adolescent↗
PubMed1998

[Dissolution of acute stent thrombosis by abciximab bolus].

Abciximab, REOPRO, a potent inhibitor of platelet aggregation via glycoprotein IIb/IIIa inhibition, has shown to be effective in the prevention of short and long-term complications of percutaneous coronary interventions. Very few reports on the role of this drug in the setting of acute stent thrombosis have been published. We report 1 case of the effectiveness of REOPRO in the complete lysis of stent thrombus with reperfusion of the coronary vessel and its collaterals. This case suggests an important role of platelets in the setting of acute stent thrombosis and a thrombolytic effect of REOPRO.

Abciximab↗
PubMed1998

[Safety, feasibility and efficacy of a new single-wire stent in the treatment of complex coronary lesions: the angiostent].

The angiostent is a single wire, flexible, highly radiopaque, balloon expandable stent. To evaluate the feasibility and safety of the deployment of this new stent, we report the clinical and procedural results of 70 procedures performed in 51 native coronary arteries of 48 patients, with objective evidence of ischemia. The target lesion was located in the left anterior descending artery in 18 (36%) cases, in the circumflex artery in 16 (31%) cases and in the right coronary artery in 17 (33%) cases. Mean reference vessel diameter was 3.2 +/- 0.4 mm and the minimal luminal diameter was 0.4 +/- 0.3 mm, with a mean diameter stenosis of 86 +/- 10%. Type B2 and C lesions were encountered in 56% of the cases. More than one angiostent was implanted in 14 vessels and multiple stenting was accomplished with the use of different stents in 8 coronary arteries. No major complications were reported. The post-procedural minimal luminal diameter was 3.2 +/- 0.4 mm with a mean diameter stenosis of 1.4 +/- 3.7%. In 25 cases (49%) major side branches raised from the stented segment and in all but one remained patent. In conclusion, the implantation of the angiostent is safe, feasible and effective, as it can be easily deployed at the lesion site, used for the treatment of complex lesions and preserves the patency of jailed side-branches.

Anticoagulants↗
PubMed1998

[Endothelin-1 variation in the coronary circulation during angioplasty with a stent implant].

Endothelin-1 (ET-1) is an endothelium-derived mediator with vasoconstrictive and mitogenic activity which stimulates vascular smooth muscle cell proliferation. The aim of this study was to evaluate ET-1 production during percutaneous transluminal coronary angioplasty (PTCA) and elective stent implantation. We hypothesized that the additional vessel wall trauma induced by stent deployment might be associated with a greater production of ET-1. To this end, ET-1 levels were measured in 18 patients undergoing PTCA and stenting (12 with left anterior descending coronary artery stenosis and 6 with circumflex artery lesion). The sampling sites were the coronary ostium and coronary sinus in basal conditions (before the procedure), during first balloon inflation, and 5, 20, 60 min after the end of first balloon inflation. At baseline, ET-1 levels were higher in the coronary sinus than in coronary ostium (1.58 +/- 0.22 vs 1.29 +/- 0.20 pg/ml, p < 0.001). During first balloon inflation, ET-1 coronary sinus levels significantly diminished with respect to the basal levels (1.08 +/- 0.32 vs 1.58 +/- 0.22 pg/ml, p < 0.001). Further significant variations of ET-1 levels were not detected neither following the first balloon inflation nor after stent deployment. In conclusion, the culprit lesion seems to produce most of ET-1 circulating in the coronary tree. This is demonstrated by higher ET-1 levels in the coronary sinus compared to coronary ostium at baseline, and even more by the significant ET-1 reduction in the coronary sinus during first balloon inflation. Despite our expectations, we did not detect any significant ET-1 increase during stent deployment.

Aged↗
PubMed1997

Postoperative GnRH analog treatment for the prevention of recurrences of uterine myomas after myomectomy. A pilot study.

Sixty-five patients with uterine myomas were studied after surgery to investigate the effect of periodic GnRH analog treatment on the prevention of recurrences. A group of patients was treated by leuprolide acetate depot 3 months a year for 3 years. At the end of treatment, these patients showed a significantly reduced uterine volume and myoma recurrence rate as compared to untreated patients. A role of GnRH analogs in the clinical prevention of myoma recurrence could be suggested.

Adult↗
PubMed1997

Managing recurrent vulvovaginal candidiasis. Intermittent prevention with itraconazole.

OBJECTIVE: To evaluate the efficacy of one-day, intermittent, monthly prophylaxis with 400 mg itraconazole in the management of recurrent vulvovaginal candidiasis. STUDY DESIGN: In a randomized trial, 57 patients and 57 controls with recurrent vulvovaginal candidiasis were assigned either to receive one-day monthly itraconazole prophylaxis for six months or no treatment. Clinical and mycologic evaluations were carried out 3, 6 and 12 months after enrollment. RESULTS: During the first six months of follow-up, the rate of symptomatic recurrences was 36.4% (20/55) among the treated women and 64.2% (34/53) in the controls. The mean time +/- SEM to symptomatic recurrence was 149 +/- 6 days among patients receiving prophylaxis and 120 +/- 6 days in the controls (P = .003 by log-rank test). These differences disappeared almost completely after the cessation of intermittent prophylaxis. In fact, the proportion of patients still asymptomatic after one year of follow-up was 38.9% (21/54) among treated women and 28.8% (15/53) in the controls (P = .83 by Fisher's exact test). CONCLUSION: One-day monthly, intermittent itraconazole prophylaxis reduced the rate of recurrence in patients with recurrent vulvovaginal candidiasis, but the beneficial effect of itraconazole was lost within a few months after cessation of prophylaxis.

Adult↗
PubMed1997

[Renal angiolipoma associated with bilateral double ureter. A clinical case].

Renal angiomyolipoma is a rare renal tumor usually associated with tuberous sclerosis, a syndrome characterized by adenoma sebaceum, mental insufficiency and epilepsy. The authors present a rare case of renal angio-myolipoma associated with bilateral double ureter, in a young male patient not affected by tuberous sclerosis. Histologically, the angiomyolipoma is defined by the presence of smooth muscular cells, new formed vessels and fat. Clinical diagnosis requires the utilization of various imaging techniques, like intravenous pyelogram, ultrasonic scan, CT scan, and FNA (Fine Needle Aspiration). In the histopathologic diagnosis of angiomyolipoma the use of immunohistochemical techniques with different antibodies has been helpful, for the necessity to differentiate angiomyolipoma from other epithelial tumors, as renal cell carcinoma and sarcomatous neoplasms. As for as treatment is concerned, the indication for surgery is still maintained by two factors not affected by these diagnostic improvements: tumor size and presence of symptoms. Tumor size is an important predictive growth factor of the tumor. In the absence of symptoms a close follow-up with ultrasonographic scan may be indicated, keeping in mind the possible presence of a synchronous renal cell carcinoma. Hemorrhage can be a fatal complication of renal angiomyolipoma, requiring emergency surgery or embolization.

Adult↗
PubMed1997

[Indices of treatment needs in orthodontics: the applicability of the DAI (Dental Aesthetic Index)].

The objective assessment of esthetic impairment and relative psychosocial handicap for unacceptable dental aspect (useful for characterizing the need of treatment), could be satisfied by an index that measures each individual's occlusal trait and the psychological impact of the same. An index with these characteristics was suggested by Cons and Jenny, already since 1985. This is an index (DAI: Dental Aesthetic Index) designed specifically to measure dental esthetics, based on esthetic standards socially defined and focused through an extensive and finalized search. Therefore this index assesses the social acceptability of the dental appearance based on the public perception of dental esthetics. The authors, in this work, indicate as measuring the objective traits of occlusion and arriving to final score trough simple calculation. This score provides severity levels of esthetic, psychologic and functional impairment relative to dental aspect in examination.

Dental Health Surveys↗
PubMed1997

[Use of Valtrac in digestive surgery. Initial clinical experience].

Stapling instruments are being currently used for digestive or colorectal anastomoses with definite advantages. The authors report their initial clinical experience about BAR utilization to restore intestinal continuity after upper digestive and colorectal resections. The authors have been carried out 20 anastomoses on 18 patients: 11 males and 7 females. Eleven (61.1%) of them were affected with malignant neoplasms and in 9 cases were performed an urgency procedure. The colorectal and jejunal-jejunal anastomoses were performed, respectively, in 8 cases; gastric-jejunal and ileo-colic anastomoses, respectively, in 2. The satisfactory results obtained seem to demonstrate that the biofragmentable anastomotic ring constitutes a "safe" method of bowel junction of the whole digestive apparatus.

Adult↗
PubMed1996

Increased allergen-specific, steroid-sensitive gamma delta T cells in bronchoalveolar lavage fluid from patients with asthma.

OBJECTIVE: To test the hypothesis that allergen-specific, steroid-sensitive gamma delta T lymphocytes are increased in bronchoalveolar lavage fluid of patients with asthma. DESIGN: Case series. SETTING: The outpatient allergy services at the University of Perugia, Perugia, Italy. PATIENTS: 12 untreated atopic patients (6 children and 6 adults) with mildly symptomatic chronic asthma were studied. Bronchoalveolar lavage fluid from 10 healthy non-smoking volunteers and age-matched children with cystic fibrosis (n = 5) or anatomic malformation of the airways (n = 4) served as control samples. INTERVENTION: Three patients received treatment with deflazacort, 60 mg twice daily, for 1 week. MEASUREMENTS: CD3+, CD4+, and CD8+ T cells from patients and controls were examined by two-color flow cytometry for coexpression of V delta 1 and V delta 2 isoforms of the gamma delta T-cell receptor. In vitro pulmonary gamma delta T-cell proliferation in response to a specific allergen, the apoptotic death of these cells after incubation with 10(-7) M dexamethasone, and bronchoalveolar lavage fluid T-lymphocyte composition before and after 1 week of deflazacort therapy were evaluated in 3 Dermatophagoides pteronyssinus-sensitive patients. RESULTS: The proportion of gamma delta T lymphocytes, primarily CD4+ or CD4- CD8- cells, was higher in asthmatic patients than in controls (P < 0.05 by one-way analysis of variance). Most lung gamma delta CD4+ lymphocytes expressed the gamma delta T-cell receptor V delta 1 chain. These cells proliferated in response to allergen stimulation, underwent steroid-induced apoptosis in vitro, and disappeared after systemic steroid treatment. CONCLUSIONS: Allergen-specific, steroid-sensitive gamma delta T cells may be one of the cellular components involved in the airway inflammation that characterizes allergic bronchial asthma.

Adult↗
PubMed1996

Comparative mapping on the mouse X chromosome defines a myotubular myopathy equivalent region.

The gene for X-linked myotubular myopathy (MTM1) has been localized to a 300-kb critical region in human Xq28 between IDS and GABRA3. As part of an effort to clone this gene, we developed a YAC contig on the mouse X Chromosome (Chr) which includes loci homologous to those within the human MTM1 critical region. The murine contig consists of 18 YACs and spans 2.5-3.0 Mb. We have aligned the human and murine physical maps by isolating conserved mouse genomic fragments, including CpG islands and trapped exons. We believe that the simultaneous isolation of genes from both mouse and human and continued comparative mapping will prove helpful in the eventual identification of MTM1 and other genes in the region.

Animals↗
PubMed1996

The impact of oral contraception on chlamydial infection among patients with pelvic inflammatory disease.

The prevalence of oral contraceptive use in association with chlamydial pelvic inflammatory disease (PID) and the presence of anti-chlamydial IgG and IgA in a population of 144 hospitalized and outpatient subjects with a standard diagnosis of PID was studied. The rates of chlamydial PID and IgA detection were 15.3% (22/144) and 13.9% (20/144), respectively. After stratification for age, number of pregnancies, and lifetime sexual partners, the rates of chlamydial PID (odds ratio = 0.30, 95% CI = 0.10 - 0.89) and IgA detection (odds ratio = 0.23, 95% CI = 0.07 - 0.73) were lower among previous or current oral contraceptive users than in women who had never used birth control methods. Analyses of linear trend indicated a negative association between increasing duration of exposure to hormonal contraception and anti-chlamydial IgG and IgA. This study confirms that among patients with chlamydial PID, the frequency of oral contraceptive use is lower than that in patients with PID of other etiology. Serologic studies suggest a possible relationship between hormonal contraception and changes in immune response or susceptibility to chlamydial infection.

Adolescent↗
PubMed1996

OKT3 prophylaxis in renal grafts with prolonged cold ischemia times: association with improvement in long-term survival.

The data on patients participating in two randomized, prospective studies with similar immunosuppressive regimens were updated and combined to evaluate the long-term effects of OKT3 according to cold ischemia time (< or = or > 24 hr). Among 159 patients in the OKT3 and 153 in the cyclosporine A (CsA) group, 8 and 12 deaths occurred, respectively (P = NS). In patients with cold ischemia > 24 hours, OKT3 prophylaxis resulted in a lower mean number of rejection episodes per patient than did CsA prophylaxis within one year (mean +/- SEM: 0.87 +/- 0.11 vs. 1.35 +/- 0.14, respectively; P = 0.008) and within five years (1.07 +/- 0.12 vs. 1.49 +/- 0.15, respectively; P = 0.032). In contrast, rejection incidences in patients with cold ischemia < or = 24 hours was not significantly different in the two groups. In all study patients, there was a trend towards higher graft survival rates in the OKT3 group versus the CsA group (at 5 years, 73% vs. 66%, respectively; P = 0.182). Among recipients of kidneys with cold ischemia times > 24 hours, OKT3 patients had significantly higher graft survival than CsA patients at two years (84% vs. 64%, respectively) and at five years (71% vs. 56%, respectively; P = 0.045). Significant differences were not observed in recipients of kidneys with cold ischemia times < or = 24 hours. In conclusion, patients receiving renal grafts with long cold ischemia times strongly benefit from OKT3 prophylaxis.

Adult↗