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Biomedical subjects

A Perrone

Publications and source records attributed to A Perrone.

At least 55 records · Page 3Linked to original sources

Prevalence, clinical features, and acute course of atypical myocardial infarction.

Ninety-four consecutive patients (60 men and 34 women; mean age 68.5 +/- 11.5 years) with acute myocardial infarction (MI) were investigated retrospectively, in order to evaluate the prevalence, clinical features, and short-term course of the atypical forms (symptoms other than chest pain). An atypical MI was found in 30 patients, with a prevalence of 32% (95% confidence limits 27-36%). It was most prevalent in women above sixty-five years old (P < 0.05). Abdominal pain, paroxysmal dyspnea, and pulmonary edema were the most frequent symptoms (33%, 17%, 13%, respectively). No differences were observed between typical and atypical MI in regard to risk factors (hypercholesterolemia, arterial hypertension, diabetes mellitus, cigarette smoking) and history of MI, cerebrovascular disease, peripheral vascular disease, or chronic lung disease. Significantly fewer patients with atypical MI had a history of angina pectoris (P < 0.05). No differences were observed in regard to previous medication, except for antiarrhythmic drugs, more often used by atypical patients (P < 0.05). Location and severity of MI (as judged by ECG and peak levels of creatine kinase in the serum) were similar in both subgroups, as were the complications (34% typical and 50% atypical) and death rate (12.5% and 16.7%, respectively). In conclusion, atypical MI is not less severe than typical. This emphasizes the need for a high suspicion index in many different clinical settings, but particularly (although not exclusively) in elderly females, in the presence of abdominal pain or otherwise unexplained paroxysmal dyspnea.

Aged↗

Human hepatoma cells expressing MHC antigens display accessory cell function: dependence on LFA-1/ICAM-1 interaction.

Malignant transformation of human hepatocytes is often accompanied by an increased expression of major histocompatibility complex (MHC) molecules, but whether this phenomenon is related to an enhanced immunogenicity remains unknown. In this study, we tested the capacity of a series of human hepatoma cell lines to induce proliferation of allogeneic T cells in primary mixed lymphocyte tumour cultures (MLTC). These cell lines were positive for class I molecules, whereas class II molecule expression was either constitutive or inducible by treatment with interferon-gamma (IFN-gamma). We found that HA22T/VGH cells expressing class II molecules constitutively stimulated high proliferative responses of purified CD4+ T lymphocytes, whereas class II-negative Li7A cells stimulated CD4+ T-cell responses only when induced by treatment with IFN-gamma. HA22T/VGH and Li7A cells also exerted a significant stimulatory activity for purified CD8+ T cells whereas HepG2 cells, in which MHC class II molecules are neither constitutive IFN-gamma-inducible, were unable to induce CD4+ and CD8+ T-cell proliferative responses. Phenotypical analysis revealed that HA22T/VGH and Li7A expressed high levels of intracellular adhesion molecule-1 (ICAM-1) and experiments with blocking monoclonal antibodies (mAb) demonstrated that this molecule played a key role in mediating the co-stimulatory function of hepatoma cells. In addition, HA22T/VGH cells were found to produce mRNA for interleukin-1 (IL-1) beta and IL-6, while Li7a only produced IL-1 beta, yet both these cytokines were found to play a small part, if any, in T-cell co-activation. On the whole, these results show tht hepatoma cells expression MHC antigens and ICAM-1 are able to deliver signals necessary for activation of resting CD4+ and CD8+ T cells and suggest that they may actively participate in the anti-tumour immune response.

Antigen-Presenting Cells↗

[Internal hernias. Description of 2 cases].

The authors describe two cases of recent observed internal-hernia, regarding in the first case the right para-duodenal dimple, and in the second a mesenteric breach. They report the clinic presentation and the diagnostic and therapeutic approach compared with the data deriving from the international literature. A complete clinical classification of the internal-hernia is illustrated showing the different clinical signs. The respective symptomatology that in the initial phases of this pathology is not too evident, shows that the internal hernia should always be held in due consideration at the moment of diagnosis because the consequent mortality due to complications such as intestinal-gangrene is rather high.

Aged↗

[Extraperitonealization of the liver in the Chilaiditi syndrome].

The Chilaiditi syndrome or viscero hepato diaphragmatic interposition is a rare anomaly. The authors describe one case they observed. Even if it is often asymptomatic, it may manifest also by recurrent sub-occlusion or occlusion. Only a few patients need corrective surgical operation. The operation of choice is hepatic extra-peritonealization, which after replacement of the dislocated gastroenteric tract, brings the superior face of the liver again into direct contact with the related diaphragmatic dome.

Aged↗

[Bouveret's syndrome: unusual variety of biliary ileum].

The authors report one case of Bouveret's syndrome that come to their observation. Physiopathology, clinic and diagnosis are discussed. After the method of stone removal they emphasized the surgical procedure in one stage with enterotomy and stone-removal, cholecystectomy and repair of biliary fistula.

Aged↗

[Lumbar hernia of Grynfeltt's quadrilateral space. Apropos a case].

The authors discuss a case of Grynfeltt's quadrilateral lumbar hernia in an 85-year-old patient. These rather rare hernias can be classified as Grynfeltt's hernias of the superior lumbar space, as Petit's inferior lumbar space and as diffused hernias concerning the whole hip. In our case this hernia was located in the superior lumbar space and it was delimited on the upper part by the 12th rib and by the serratus posterior-inferior muscle; in the lower part by the internal oblique muscle and by the lumbar quadratus muscle. Surgical treatment was effected by plastic surgery with synthetic material put in the extra-peritoneum space and fixed by serum-muscular stitches. Postoperative control effected after a month from the operation proves a good keeping of the plastic surgery reconstruction with total disappearance of the hernia.

Aged↗

Oxygen administration increases plasma digoxin-like substance and renal sodium excretion in chronic hypoxic patients.

Despite the absence of cardiac or renal pathologies, edema and mild hyponatremia may often occur in patients affected by chronic obstructive pulmonary disease (COPD). Therefore, it has been suggested that hypoxia may influence the release of different hormones regulating renal sodium handling. To evaluate the effect of hyperoxia and O2 removal on plasma digitalis-like substance (DLS) levels, 9 patients affected by COPD and 7 normal subjects were studied. After 1 h in supine position, O2 was administered for 3 h by a tight-fitting face-mask. Blood samples for plasma DLS were taken at time 0, 60, 180 min and then for 3 h after O2 removal. In normal subjects, plasma DLS did not vary after O2 administration (from basal values of 162.25 +/- 8.59 to 107.75 +/- 6.65 pg/ml at 180 min; NS), and O2 removal (143.7 +/- 16.87 pg/ml after 3 h from O2 removal; NS). On the contrary, in patients affected by COPD, plasma DLS levels increased during O2 administration (from basal values of 138.98 +/- 8.31 to 202.14 +/- 8.21 pg/ml at 180 min; p < 0.05), and returned to baseline levels (142.59 +/- 8.28 pg/ml) 3 h after O2 removal. In the same patients, DLS increase was accompanied by a rise in Na+ excretion (from 0.08 +/- 0.01 at time 0 to 0.16 +/- 0.02 mEq/min after 3 h of O2 administration; p < 0.05). In conclusion, our findings showed an oxygen-related increase in plasma DLS levels and in urinary Na+ excretion in patients affected by COPD. This phenomenon could promote Na+ urinary loss during prolonged O2 therapy in these patients and should be taken into account in their management.

Blood Proteins↗

Renal sodium excretory function during acute oxygen administration.

To evaluate the effect of O2 administration and O2 removal on renal Na+ excretion, 12 hypoxemic eucapnic patients affected by chronic obstructive pulmonary disease (COPD) and 9 normal subjects were studied. After 1 h in the supine position, O2 was administered for 3 h by a tight-fitting face-mask. Urine and blood samples for renal Na+ excretion evaluation were taken at times 0, 60 and 180 min. After O2 removal both the blood and the urine samples were taken again for a further 3 h. In normal subjects, urinary Na+ excretion did not vary after both O2 administration and removal. On the contrary, in patients affected by COPD renal Na+ excretion significantly increased during O2 administration (from basal values of 0.08 +/- 0.01 to 0.17 +/- 0.02 mEq/min at 180 min, p < 0.05), and returned to baseline levels (0.13 +/- 0.03 mEq/min) after 3 h from O2 removal. The basal fractional excretion of filtered Na+ was significant lower in hypoxemic patients than in normal subjects (0.72 +/- 0.3% in patients with COPD vs. 0.95 +/- 0.7% in normal subjects, p < 0.05), while, at the end of O2 administration, it became higher in patients with COPD than in controls (1.62 +/- 0.4% in patients with COPD vs. 0.89 +/- 0.5 in control subjects, p < 0.001). In conclusion, our findings showed an oxygen-related increase of both the urinary Na+ excretion and the fractional excretion of filtered sodium in patients affected by COPD.

Carbon Dioxide↗

Normalization of depressed natural killer activity after interferon-alpha therapy is associated with a low frequency of relapse in patients with chronic hepatitis C.

In the present study, we found that human recombinant interferon-alpha (rIFN-alpha) given at a dose of 3 x 10(6) units thrice weekly for three months, and 1.5 x 10(6) units thrice weekly for the next three months, was able to restore depressed natural-killer (NK) activity to normal values in 12 out of 21 chronic hepatitis C patients positive for anti-HCV antibodies. In all of these patients, NK normalization was still sustained after three months from suspension of therapy. Eighteen patients also showed a normalization of the alanine aminotransferase (ALT) level by the end of treatment (responder patients), independently of changes in NK activity. No significant improvement in either NK activity or aminotransferase levels was seen among 20 untreated patients. In 8 responder patients (1 with normalized and 7 with low NK activity), ALT levels returned to pre-therapy values within three months after suspension of rIFN-alpha administration (relapse). We found that patients who normalized NK activity had a lower frequency of relapse as compared to patients with low NK activity by the end of treatment (p > 0.01). Immunofluorescence analysis of biopsy-derived liver tissue revealed that rIFN-alpha was able to induce strong MHC class I antigen expression on hepatocytes of treated patients, but this was not related to the clinical course.

Adult↗

Ag-NOR protein distribution correlates with patient survival in stage I endometrial adenocarcinoma.

The relationship between argyrophil nucleolar organizer region (Ag-NOR) protein quantity and prognosis was studied in 33 cases of stage I endometrial adenocarcinoma. Ag-NOR protein quantity was measured by image analysis in silver-stained sections from paraffin-embedded samples of curettings. Patients had a minimum 10-year follow-up. Only 2 out of 25 patients exhibiting a mean Ag-NOR protein area of less than 3 microns2 died of cancer, whereas 5 of the 8 patients with a mean Ag-NOR protein area of more than 3 microns2 died of the disease. The present results demonstrate that the Ag-NOR protein value is closely related to patient survival in stage I endometrial carcinoma and that it is a reliable prognostic indicator in this type of carcinoma.

Adenocarcinoma↗

Enhanced release of atrial natriuretic factor during exercise-induced myocardial ischaemia in patients after acute myocardial infarction.

To determine whether acute myocardial ischaemia induced by dynamic exercise can lead to changes in plasma levels of atrial natriuretic factor, we performed symptom-limited bicycle electrocardiographic tests in 20 males with recent acute myocardial infarction and in 8 control males. Ten patients developed exercise-induced myocardial ischaemia and 10 patients did not. There were no significant differences between the two groups with regard to age, site of myocardial infarction, urinary sodium, atrial sizes, radionuclide left ventricular ejection fraction, workload, baseline and peak-exercise heart rate, baseline and peak-exercise rate-pressure product, duration of exercise. Also baseline atrial natriuretic factor concentrations were similar in both groups (ischaemic patients: 34.51 +/- 15.73 pg/ml; nonischaemic patients: 27.17 +/- 8.74 pg/ml, NS), while peak-exercise atrial natriuretic factor concentrations were higher in patients with exercise-induced myocardial ischaemia (112.31 +/- 35.5 pg/ml) than in the others (80.46 +/- 23.43 pg/ml) (P less than 0.05). After 15 minutes of recovery, plasma atrial natriuretic factor levels were still raised only in the ischaemic patients (63.3 +/- 15.44 pg/ml, P less than 0.01), returning to baseline after 30 minutes in both groups. In control subjects, the behaviour of atrial natriuretic factor resembled that of the patients without exercise-induced ischaemia, with a significant increase at peak-exercise (from baseline levels of 23.1 +/- 10.5 pg/ml to peak-exercise levels of 91.3 +/- 14.5 pg/ml, P less than 0.0005) and a rapid return to baseline levels after 15 minutes of recovery (28.5 +/- 10.6 pg/ml, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[The role of angiography in cryptogenic submesocolic digestive tract bleeding].

Three cases of chronic gastrointestinal bleeding are described; the Authors emphasize the important role of mesenteric arteriography in establishing site and nature of bleeding. The review of international literature shows a success rate between 41 and 73% of cases studied with this method after negativity of other diagnostic procedures.

Adolescent↗

Immunology of hepatocellular carcinoma.

The immune surveillance theory continues to remain a powerful force in cancer research and therapy despite the varying degrees of enthusiasm from both its supporters and critics. The role of both specific and non-specific immune responses in the host's defense against hepatocellular carcinoma is presented as well as the possibilities of immune-system manipulation for the prevention and therapy of this tumour.

Antibodies, Monoclonal↗