Biomedical subjects

Antonio Romano

Publications and source records attributed to Antonio Romano.

18 recordsLinked to original sources

PubMed2006

Anterior chamber depth measurement before and after photorefractive keratectomy: comparison between IOL master and Orbscan II.

PURPOSE: To measure the anterior chamber depth (ACD) with 2 different devices before and after photorefractive keratectomy (PRK). DESIGN: Noncomparative case series. PARTICIPANTS: One hundred forty-three eyes of 143 patients who had undergone PRK with refractive errors ranging from -13.13 diopters (D) to +7 D (mean, -3.67+/-3.58) were analyzed. METHODS: The ACD values preoperatively and at 1, 3, and 6 months postoperatively were measured with the Orbscan II and IOL Master. The results were analyzed using the Pearson correlation. MAIN OUTCOME MEASURE: Anterior chamber depth. RESULTS: The instruments showed good agreement between the measurements before and after surgery. A significant decrease between the preoperative and 1-month postoperative measurements was found in the ACD measured from the epithelium with Orbscan II (P<0.01) and IOL Master (P<0.01). A nonsignificant decrease with both IOL Master (P>0.01) and Orbscan II (P>0.01) was found between 3 and 6 months after surgery. The ACD measured from the endothelium using the Orbscan II showed a significant difference only between the 3- and 6-month follow-up data (P<0.01). CONCLUSIONS: The 2 devices showed good agreement, and the changes detected postoperatively seem to be related not only to corneal thinning but also to anterior segment remodeling.

Adolescent↗

PubMed2006

Evidence for a functional genetic polymorphism of the human retinoic acid-metabolizing enzyme CYP26A1, an enzyme that may be involved in spina bifida.

BACKGROUND: CYP26A1, together with CYP26B1 and CYP26C1, are key enzymes of all-trans retinoic acid (RA) inactivation and their specific and restricted expression in developing embryos participate in the fine tuning RA levels. As RA is a critical regulator of gene expression during embryonic development, the imbalance between the synthesis and degradation of RA during embryogenesis could contribute to malformations and developmental defects. METHODS: A PCR-single strand conformation polymorphism (PCR-SSCP) strategy was developed to screen for CYP26A1 sequence variations that could affect the enzyme expression and/or activity and applied to DNA samples from 80 unrelated Caucasians, comprising 40 French healthy volunteers and 40 Italian patients with spina bifida. The consequence of the 1-bp deletion identified in the coding sequence was investigated by an in vitro functional assay using COS-7 cells. RESULTS: A total of 7 polymorphisms were identified, comprising 1 nucleotide deletion in the coding sequence (g.3116delT) that results in a frameshift and consequently in the creation of a premature stop codon. The g.3116delT mutation is of particular interest because it was identified in a patient with spina bifida and likely encodes a truncated protein with no enzymatic activity, as demonstrated by our preliminary in vitro data. CONCLUSIONS: Despite the fact that our findings could not show any evidence that the CYP26A1 genetic polymorphism has implications in the pathogenesis of spina bifida, this work represents the first description of a functional genetic polymorphism affecting the coding sequence of the human CYP26A1 gene.

Animals↗

PubMed2005

Adult T-cell acute lymphoblastic leukemia: biologic profile at presentation and correlation with response to induction treatment in patients enrolled in the GIMEMA LAL 0496 protocol.

Between 1996 and 2000, 90 newly diagnosed adult patients with T-acute lymphoblastic leukemia (T-ALL) were registered in the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) Leucemia Acuta Limfoide (LAL) 0496 protocol. Cases were centrally processed for morphology, immunophenotype, cytogenetics, molecular biology, and multidrug resistance (MDR). Twenty-two patients were females and 68 were males. Four percent of cases were pro-T, 47% pre-T, 39% cortical T, and 10% mature T-ALL. Fifty-six percent of patients with pro-T + pre-T-ALL achieved complete remission (CR) compared with 91% for cortical + mature cases (P = .002). CD34 expression was associated with a significantly lower CR rate: 54% versus 84% (P = .009). Thirty-one (36.5%) of 85 patients had an abnormal karyotype, the most common abnormality (15%) being a partial del(6q). The cytogenetic profile did not impact on CR achievement. MDR1 function, present in 26% of cases, correlated significantly with CR achievement (P = .004). A highly significant (P = .001) difference in CR rate was observed between patients who did not express the CD13/CD33/CD34 antigens and were MDR functionally negative (96%) compared with patients positive for at least one of these markers (57%). Multivariate analysis showed an impact on CR achievement for CD33 expression and MDR1 function. An extensive biologic workup of adult T-ALL cases at presentation is recommended in order to design tailored therapeutic strategies aimed at improving CR rates.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2005

Reliability of a new correcting factor in calculating intraocular lens power after refractive corneal surgery.

PURPOSE: To test the reliability of a corneal radius correcting factor (R factor) in calculating intraocular lens (IOL) power in eyes that developed cataract after refractive surgery and compare it with the clinical history (CHM) and double-K (DKM) methods. SETTING: Department of Ophthalmology, Second University of Naples, Naples, Italy. METHODS: Nineteen eyes from the literature that underwent cataract extraction and IOL implantation after refractive surgery were used to compare actual postoperative and expected refractive errors utilizing the R factor, CHM, and DKM. Intraocular lens powers were calculated with 3 formulas: SRK/T, Hoffer Q and Holladay 1. The differences were evaluated with the Wilcoxon test and Spearman correlation. RESULTS: With the R factor SRK/T and Holladay 1 formulas gave the best results; 16 (84.2%) and 17 (89.5%) eyes were within +/-2 diopters (D) of emmetropia. With CHM, the best results were obtained using the SRK/T and Holladay 1 formulas; with both formulas 12 (63.2%) eyes were within +/-2 D of emmetropia. With DKM, the best results were obtained using SRK/T and Holladay 1 formulas; with both formulas 10 eyes (52.63%) were in the range of +/-2 D from emmetropia. CONCLUSIONS: The R factor can be used with the SRK/T or Holladay 1 formula because this method seems comparable or superior to DKM and CHM.

Cataract Extraction↗

PubMed2005

Minimization of immunosuppression with thymoglobuline pre-treatment and HCV recurrence in liver transplantation.

Induction with thymoglobuline, a potent anti-thymocyte polyclonal antibody, has been recently reported to allow minimization of postoperative immunosuppression in organ transplantation. The relationship with recurrence of hepatitis C virus (HCV) after liver transplantation (LTx) has never been investigated. We report here on the outcome in 22 HCV+ patients receiving thymoglobuline pre-treatment and minimal immunosuppression after LTx. Patient survival and acute rejection rates were good, and remarkably low dosages and levels of immunosuppression were achieved with thymoglobuline, without exposing patients to an elevated risk of rejection. A progressive weaning of the primary immunosuppressor was also possible in the majority of patients without complications. The HCV recurrence rate was similar to what is reported in the literature, although lower HCV-RNA viral loads were obtained with thymoglobuline, with a mild histologic course. Although our results need to be validated in large cohort studies, our experience shows that minimization of immunosuppression with thymoglobuline is effective in protecting against rejection and demonstrated a positive impact on HCV recurrence that deserves further investigation.

Adult↗

PubMed2004

Intermittent inflow occlusion in living liver donors: impact on safety and remnant function.

Clamping of the portal triad accomplishes complete inflow occlusion. This maneuver is commonly used during liver surgery to minimize blood loss but is not widely used in living donors undergoing resection for liver transplantation. We compared outcomes in living donors who underwent resection with and without inflow occlusion. We reviewed data on 2 nonsimultaneous living liver donor cohorts. The first 20 donors (group 1) underwent resection without inflow occlusion. In the next 15 donors (group 2), inflow occlusion was used during parenchymal transection, using cycles of 10-15 minutes occlusion and 6 minutes reperfusion. In donors, we recorded type of resection; ischemia times; blood loss; transfusions; peak ALT, AST, bilirubin, and INR in the first 5 days; hospital length of stay (LOS), and major complications. In recipients, we recorded peak ALT. In group 1, 19 of 20 donors underwent right hepatectomy. In group 2, 8 donors underwent right hepatectomy, and 7 donors had left lobectomies. Total ischemic time ranged from 16-49 minutes (mean, 31 +/- 9 minutes). In group 1, two donors received a total of 5 U of allogeneic blood. In group 2, no donor required transfusion. Mean peak ALT was significantly higher in group 1 (521 +/- 336 U/L) than group 2 (322 +/- 162 U/L; P = 0.03). Mean INR was significantly higher in group 1 (1.8 +/- 0.2) vs. group 2 (1.5 +/- 0.2; P = 0.001). There were 4 major complications in group 1 (incisional hernia, transient liver failure, biliary stricture, and biliary leak) and no major intraoperative or postoperative complications in group 2. Mean LOS was significantly longer in group 1 (7.9 +/- 2.9 days) than group 2 (6.2 +/- 1.1 days; P = 0.04). Mean peak ALT in recipients trended lower in group 2. In conclusion, inflow occlusion was associated with reduced blood loss and less ischemic injury to hepatic remnants in the donors and the grafts in the recipients. These benefits were associated with a diminished incidence of major complications and shorter LOS. Inflow occlusion should be an essential part of living donor hepatectomy.

Adult↗

PubMed2004

Reliability of the IOLMaster in measuring corneal power changes after photorefractive keratectomy.

PURPOSE: To test the accuracy of the IOLMaster (Carl Zeiss) in detecting corneal power changes after photorefractive keratectomy (PRK). SETTING: Department of Ophthalmology, 2nd University of Naples, Naples, Italy. METHODS: Two hundred twenty-five consecutive eyes that had PRK (mean -5.13 diopters [D] +/- 2.98 [SD] [range +0.25 to -16.25 D]) were analyzed. The data included preoperative and postoperative (1, 3, and 6 months) subjective refraction and computerized keratometry. Statistical analysis was performed to determine the correlation between the changes in the subjective refraction at the corneal plane and the changes in keratometry. RESULTS: The mean difference between the changes in refraction and the measured corneal changes was 0.75 +/- 1.13 D (range -3.84 to +7.68 D) at 1 month, 0.92 +/- 1.10 D (range -0.87 to +7.93 D) at 3 months, and 0.75 +/- 0.98 D (range -1.70 to +3.85 D) at 6 months. The difference was significant (P<.001). CONCLUSION: Automated keratometry provided by the IOLMaster did not accurately reflect the effective refractive changes after PRK, particularly in eyes that had a high dioptric treatment.

Adult↗

PubMed2004

Living donor liver transplantation with left liver graft.

Small-for-size syndrome in LDLT is associated with graft exposure to excessive portal perfusion. Prevention of graft overperfusion in LDLT can be achieved through intraoperative modulation of portal graft inflow. We report a successful LDLT utilising the left lobe with a GV/SLV of only 20%. A 43 year-old patient underwent to LDLT at our institution. During the anhepatic phase a porto-systemic shunt utilizing an interposition vein graft anastomosed between the right portal branch and the right hepatic vein was performed. After graft reperfusion splenectomy was also performed. Portal vein pressure, portal vein flow and hepatic artery flow were recorded. A decrease of portal vein pressure and flow was achieved, and the shunt was left in place. The recipient post-operative course was characterized by good graft function. Small-for-size syndrome by graft overperfusion can be successfully prevented by utilizing inflow modulation of the transplanted graft. This strategy can permit the use of left lobe in adult-to-adult living donor liver transplantation.

Adult↗

PubMed2003

Mesalazine-associated benign intracranial hypertension in a patient with ulcerative colitis.

PURPOSE: To report a case of benign intracranial hypertension related to mesalazine use. DESIGN: Observational case report. METHODS: A 23-year-old-woman with sudden visual loss, headache, and a history of ulcerative colitis treated with mesalazine underwent ophthalmologic examination, echography, magnetic resonance imaging, and lumbar puncture. RESULTS: The examinations disclosed benign intracranial hypertension that resolved when mesalazine was discontinued and recurred when the drug was restarted. CONCLUSIONS: We recommend periodic ocular fundus examination for patients undergoing long-term therapy with mesalazine, especially if decreased vision, headaches, or neck stiffness are present, to avoid potentially severe complications of intracranial hypertension

Adult↗

PubMed2002

Expulsive hemorrhage before phacoemulsification.

A 65-year-old white man who was scheduled for cataract extraction experienced a sudden increase in intraocular pressure (IOP) with flattening of the anterior chamber immediately after the anterior capsule incision. The eye was sutured, and because no decrease in pressure was noted, surgery was postponed. The presence of the cataract prevented ophthalmoscopic examination. Echographic examination revealed a hemorrhagic choroidal detachment with involvement of the ciliary body. The patient was examined regularly until the choroidal detachment disappeared 4 weeks later. He then had uneventful phacoemulsification and intraocular lens implantation.

Aged↗

PubMed2002

Scleral buckling technique without retinopexy for treatment of rhegmatogeneous: a pilot study.

PURPOSE: To evaluate the role of retinopexy in the surgical management of primary rhegmatogenous retinal detachment (RD) without proliferative vitreoretinopathy. The primary outcome was retinal attachment, and secondary outcomes were visual acuity results and complications. METHODS: A randomized controlled trial including 60 patients with RD caused by a break or a group of breaks no larger than one clock hour. Thirty eyes received no retinopexy (group 1), and 30 eyes received transscleral cryotherapy (group 2). An encircling buckle was placed in all eyes. In eyes with posterior breaks, segmental buckles were also added. In some eyes, subretinal fluid drainage or anterior chamber paracentesis and/or intravitreal air bubble injection was performed. RESULTS: No differences were found between the groups in terms of the preoperative clinical variables evaluated: age; sex; axial length; lens status; type, number, and location of breaks; extension of detachment; and macula status. There were no differences in the surgical procedures performed. The reattachment rate in group 1 was 90%, and in group 2, it was 87% (a difference that was not significant [P = 1.00]). Final visual acuity improved by two lines or more in 22 patients in group 1 and in 20 patients in group 2 (P = 0.317). CONCLUSIONS: Our results indicate that primary rhegmatogenous RD can be successfully treated with scleral buckling without retinopexy.

Adult↗

PubMed2002

Diagnosing nonimmediate reactions to penicillins by in vivo tests.

BACKGROUND: Maculopapular and urticarial rashes are nonimmediate manifestations common during penicillin treatment; the former often represent cell-mediated hypersensitivity. Our objectives were to assess the incidence of allergy in adults reporting nonimmediate manifestations during penicillin therapy and to evaluate the diagnostic potential of patch tests, delayed-reading skin tests and challenges in such cases. METHODS: We used prick and intradermal tests as well as patch tests with penicillin determinants, ampicillin, amoxicillin and any other suspect penicillins. We also performed challenges with the suspect antibiotics. RESULTS: Such antibiotics were aminopenicillins in 93.1% of 259 patients, most of whom had suffered from maculopapular rashes followed by piperacillin (4.2%). Three subjects displayed immediate skin test positivity. Ninety-four subjects showed patch test and delayed intradermal test positivity to the culprit penicillin (90 to aminopenicillins and 4 to piperacillin) and were considered as having had delayed hypersensitivity reactions. Five of the 8 subjects who displayed delayed intradermal test positivity and patch test negativity to the suspect penicillin underwent challenges, 2 reacted positively to the responsible aminopenicillin. Among the remaining 154 with negative results in allergologic tests, 125 agreed to undergo challenges; only 3 reacted. In all, 98 patients -- 93 of whom had experienced maculopapular rashes -- displayed delayed hypersensitivity (94 to aminopenicillins and 4 to piperacillin). CONCLUSIONS: Both patch and intradermal tests are useful in evaluating nonimmediate reactions to penicillins, particularly maculopapular rashes. Patch test and delayed intradermal positivity together indicate delayed hypersensitivity. Intradermal testing appears to be slightly more sensitive than patch testing.

Adolescent↗

PubMedDate not supplied

Correlation between automated and subjective refraction before and after photorefractive keratectomy.

PURPOSE: To ascertain whether autorefractometry after photorefractive keratectomy (PRK) provides results that are comparable with subjective refractometry. METHODS: The refractions of 159 eyes before and 1 month after PRK were determined with both automated and subjective refractometry, and the results of the two methods were compared. RESULTS: Before PRK, subjective spherical equivalent refraction ranged from -15.25 to +0.25 D (mean -5.30 +/- 2.64 D) and automated spherical equivalent refraction ranged from -16.13 to -0.50 D (mean -6.10 +/- 2.74 D), with good correlation (r2 = 0.965) between the two methods. One month after PRK, subjective spherical equivalent refraction ranged from -1.63 to +3.50 D (mean +0.98 +/- 0.78 D) and automated spherical equivalent refraction ranged from -2.50 to +3.00 D (mean +0.36 +/- 0.96 D) with poor correlation (r2 = 0.401). CONCLUSION: Autorefractometry is less reliable in eyes after PRK, and consequently software changes are recommended for overcoming this problem.

Adult↗

PubMedDate not supplied

Anterior corneal surface after Nidek EC-5000 multipass and multizone photorefractive keratectomy for myopia.

PURPOSE: To evaluate the correlation between the presence of irregularities in corneal ablation and the number of ablation zones with multipass and multizone photorefractive keratectomy (PRK). METHODS: The differential maps obtained from corneal topography performed before and 1 month after PRK in 62 eyes that had undergone PRK with the Nidek EC-5000 excimer laser were assessed for irregularities. PRK treatment ranged from -1.00 to -16.00 D (mean -5.25 +/- 2.72 D), and the number of zones ranged from one to five. RESULTS: Of 62 differential maps, 27 had an irregular pattern according to the Hersh classification, with a non-significant correlation with the number of treatment zones (chi2 = 5.09, P >.1). CONCLUSION: Our results suggest that corneal topography irregularities arising from multizone PRK were not related to the amount of treatment or to the number of ablation zones.

Adult↗

PubMedDate not supplied

A new method of calculating intraocular lens power after photorefractive keratectomy.

PURPOSE: To find a method of calculating intraocular lens (IOL) power that may be independent of preoperative data, in eyes that have developed a cataract after refractive surgery. METHODS: Prior to and 1 month after PRK, the SRK/T formula was used to calculate IOL power in 88 eyes of 65 patients with a preoperative spherical equivalent refraction between -16.25 to +0.25 D (mean -5.39 +/- 3.19 D). IOL power was calculated by utilizing the spherical equivalent refraction as target both before and after PRK. Utilizing the postoperative corneal radius measurement (R2), an underestimation of the IOL power was found. For this reason, the mean postoperative corneal radius (R3) that gave the same IOL power found before surgery was calculated for each patient. The R3/R2 ratios were plotted against the axial eye length and a linear regression formula was used to calculate R2 correcting factors that gave the new corneal radius (R4). Patients were divided into classes according to axial eye length, and the mean R3/R2 ratios for each class were calculated and used to recalculate the new mean radius (R5). IOL power for emmetropia was calculated in all patients by utilization of R3, R4, R5, the historical method, and the "true corneal power" method. RESULTS: Within +/-0.50 D from the IOL power calculated with R3, R4 gave 35 (39.3%) IOLs, while R5 gave 40 (45.5%) IOLs; the clinical history method gave 24 (27.3%) IOLs and "true corneal power" gave 23 (26.1%) IOLs, with a statistically significant difference P<.001). CONCLUSIONS: Our theoretical method, based on correlation between axial eye length and corneal radius correcting factors, may represent an effective method of calculating IOL power after PRK, especially if the history of the patient is unknown.

Adult↗

PubMedDate not supplied

Correlation of changes in refraction and corneal topography after photorefractive keratectomy.

PURPOSE: To establish which corneal power evaluation measured with corneal topography correlates best with refractive changes after photorefractive keratectomy (PRK) for myopia. METHODS: Two hundred fifty-one consecutive eyes of 171 patients who had PRK for myopia ranging from -14.80 to -0.50 D (mean -5.43 +/- 2.978 D), calculated at the corneal plane, were included in the analysis. Data included preoperative and postoperative (1, 3, and 6-mo) subjective refraction and videokeratography with a Keratron Scout (Optikon 2000). Statistical analysis was performed to determine the correlation between the change in subjective refraction at the corneal plane and changes in six corneal power measurements: best fit sphere, simulated keratometry (Sim K), corneal apex, and center of the pupil (last two evaluated for axial and meridional curvatures). RESULTS: The closest correlation between subjective refraction change and corneal power measurement during the three follow-up evaluations was found with Sim K (R2 = 0.904; 0.889; 0.854) and best fit sphere (R2 = 0.919; 0.909; 0.872), whereas the other measurements showed poor correlation with the different curvatures. CONCLUSIONS: The best fit sphere corneal topography parameter correlated best with the refractive changes, primarily for low treatment amounts, whereas it showed a clear-cut underestimation in eyes that had undergone high dioptric treatments.

Adult↗

PubMedDate not supplied

Axial eye length evaluation before and after myopic photorefractive keratectomy.

PURPOSE: To test the accuracy of a new device (IOL Master; Carl Zeiss, Jena, Germany) in detecting axial eye length changes after photorefractive keratectomy (PRK). METHODS: Pre- and postoperative (1, 3, and 6 months) subjective refraction and axial eye length measurements were performed in 184 consecutive eyes that underwent PRK with the Nidek EC5000 excimer laser (Nidek Technologies, Gamagori, Japan) to treat refractive errors from +0.25 to -16.25 diopters (D) (mean: -5.12 +/- 3.01 D). RESULTS: The axial eye length measurements ranged from 22.51 to 31.32 mm (mean: 25.61 +/- 1.47 mm) before PRK; from 22.39 to 31.10 mm (mean: 25.48 +/- 1.43 mm) 1 month after PRK; from 23.17 to 31.14 mm (mean: 25.61 +/- 1.36 mm) 3 months after PRK; and from 23.36 to 29.68 mm (mean: 25.58 +/- 1.35 mm) 6 months after PRK. Preoperative and 1-month postoperative data showed a statistically significant difference (P<.001), whereas no significant difference was found between 1 and 3 months (P=.0137) or 3 and 6 months (P=.2422). CONCLUSIONS: The IOL Master showed a decrease in the axial eye length measurement larger than the theoretical ablation depth and the difference increased as the correction became higher.

Adolescent↗

PubMedDate not supplied

An unusual intaocular foreign body.

An unusual foreign body in a 60-year-old man with ocular siderosis is described. A surgical needle was found in the eye after magnetic resonance imaging was performed for cerebral ischemia. As a general precaution in patients who have undergone any kind of surgery, it might be better to perform a plain x-ray before performing magnetic resonance imaging to identify such foreign bodies.

Eye↗