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Biomedical subjects

C Finelli

Publications and source records attributed to C Finelli.

At least 37 records · Page 2Linked to original sources

[Microsurgery and laser surgery in conservative operations on the ovary. Experimental research].

In this study we compared two different conservative surgery techniques performed on 12 ovaries of female rabbits: microsurgery and CO2 Laser surgery. After the surgical procedure all the animals were investigated by a Laparotomy to evaluate the post-operative adhesion formation. Histological examinations were performed on 6 ovaries, to evaluate the possible damage to the ovarian parenchyma. We did not find significant differences between the two methods employed, particularly for the adherence formation and the parenchymal thermic damages: no post-operative adhesions were detected respectively in 3 ovaries operated on by microsurgery and 5 by laser surgery; slight adhesions were present in 2 ovaries treated with microsurgery and in 3 with laser surgery; 3 ovaries treated with microsurgery and 2 with laser surgery showed moderate adhesions. Only 2 ovaries treated with microsurgery presented severe adhesions.

Animals

[Tubo-ovarian transplantation in the treatment of sterility. Experimental research].

Microsurgical transposition of fallopian tube and ovary has the potential of being an efficient therapeutic treatment in patients with tubal sterility. The Authors present their experience of microsurgical adnexal transplantation in rabbit by two different techniques: the first procedure by microvascular anastomosis of the ovarian vessels, the second one without vascular pedicle. Function is evaluated at various time after grafting by: exploratory laparotomy on day 30 to establish whether circulation to the grafts was still maintained; macroscopic and microscopic examination of ovaries and fallopian tubes. The microvascular techniques prove highly reliable in terms of immediate vascular patency rate but it is disappointing that 50% of the autografts has failed with blocked vessels by day 30. Perhaps this is due to the difficult techniques in anastomosing the ovarian vessels of small caliber. In spite of these outcomes the vascularized autografts were viable and functional after transplantation in contrast with the non-vascularized tubo-ovarian grafts which all failed. This experience encourages to believe that the microsurgical technique could be employed for homograft transplantation in woman with extensive ovarian and tubal damages.

Anastomosis, Surgical

Ticlopidine lowers plasma fibrinogen in patients with polycythaemia rubra vera and additional thrombotic risk factors. A double-blind controlled study.

Thirty-seven patients affected by polycythaemia rubra vera (PRV) and with at least one additional thrombotic risk factor (overt vascular disease, diabetes mellitus, treated hypertension, smoking habit, plasma hyperviscosity, hyperfibrinogenemia) were enrolled in a double-blind randomized placebo-controlled study, and 18 were given ticlopidine 250 mg, b.i.d., for 60 days. All the patients had previously been submitted to cytoreduction, and PRV was under control in all cases at the start of the study. During the study, the haematological parameters were controlled every 15 days, and venesection was performed if haematocrit was greater than 46%. Whole blood viscosity, at low and high shear rates, plasma viscosity, and fibrinogen were measured on days 0 and 60. In the ticlopidine group, we recorded a significant 13.14% reduction of the mean fibrinogen level after treatment (390 +/- 63 vs. 449 +/- 97 mg/dl, p less than 0.01). All the other haemorheological parameters were not significantly modified by ticlopidine treatment, nor were there significant modifications recorded in the placebo group. Our study shows that ticlopidine may reduce a probable thrombotic risk factor (hyperfibrinogenemia) in PRV patients.

Aged

Myelofibrosis with myeloid metaplasia: clinical and haematological parameters predicting survival in a series of 133 patients.

The prognostic value of 12 clinical and haematological parameters, recorded at diagnosis, in myelofibrosis with myeloid metaplasia (MMM) was retrospectively analysed in a consecutive series of 133 patients followed for a minimum of 60 months. Multivariate analysis showed that the following features were associated with a significantly shorter survival: (1) short period of time (less than 13 months) between first symptoms and diagnosis; (2) anaemia (haemoglobin less than 10 g/dl); (3) leucocyte count greater than 12 x 10(9)/l; (4) peripheral blood granulocyte precursors greater than 10%. Age, splenectomy and percentage of peripheral blood metamyelocytes were found significantly to affect survival only from univariate analysis, whereas sex, size of spleen, thrombocytopenia and thrombocytosis were of no prognostic significance. These data suggest that a more intensive chemotherapy might be useful for younger patients with bad prognostic factors at diagnosis.

Adult

Changes in myocardial mitochondrial respiration after ligation of the coronary artery in pigs.

After ligation of the left coronary artery, porcine cardiac mitochondria were isolated by homogenizing the tissue and treating the myofibrillar pellet with nagarse. When compared with unligated controls, the ischemic myocardium showed decreases in phosphocreatine (to 41%), ATP (to 56%) and in the mitochondrial respiratory control index (to 69% and 78% as measured with glutamate and succinate respectively). No changes were found in the corresponding P/O ratios. Similar results were obtained upon separation of the mitochondria into two main fractions by a density gradient technique, though only one of these fractions showed a fall in succinate-supported respiration. The results suggest that ischemia decreases the NADH-dehydrogenase activity of cardiac mitochondria.

Adenosine Diphosphate

Influence of age on oxidative damage in mitochondria of ischemic and reperfused rat hearts.

Hearts from rats aged 3 months and 24 months respectively were isolated and subjected to a brief ischemia. The extent of myocardial injury, measured by release of creatine phosphokinase into coronary effluents and by developed tension, was greater in the young rats than in the old when compared with their corresponding non-ischemic controls. The amount of peroxidation, measured in the isolated mitochondria using the malondialdehyde method, was also greater in the younger rats. In contrast, when mitochondria from non-ischemic hearts were incubated for 20 minutes in a medium containing FeCl3, NADPH and ADP, known to generate hydroxyl radicals, significant peroxidation (together with a decrease in respiratory control indices) was obtained only from mitochondria isolated from the older rats. If, as the in vitro results suggest, the mitochondria of the old rats are not less sensitive to peroxidative attack, the difference between the effects of ischemia in the two age groups may be due to a lower rate of formation of reactive species of oxygen or to a greater anti-oxidative cytosolic capacity in the hearts of older rats. Alternatively, the overall oxidative stress following ischemia may be due to the effects of different radicals which target different parts of the mitochondrial membrane.

Aging

Cyclosporin A in the treatment of CLL associated PRCA and bone marrow hypoplasia.

Three patients (1 PRCA-T-CLL, 1 PRCA-B-CLL, 1 B-CLL aplasia) were treated with cyclosporin A (CS-A). Patient no 1 had relapsed during steroid therapy and the remaining two patients had been resistant to conventional immunosuppression. CS-A produced in all cases a prompt remission (within 1-4 weeks) of bone marrow failure. Mild reversible renal toxicity was the only side-effect noted. CS-A might be tried in every case of CLL-associated bone marrow failure.

Adult

Stromal cells in primary myelofibrosis: ultrastructural observations.

The bone marrows of five patients with primary myelofibrosis at different stages of the disease have been studied. In the myelofibrotic bone marrow, associated with "reticulum cells", two other cell types have been identified, namely fibroblast-like and myofibroblast-like reticulum cells, as well as a spectrum of transitional forms. Our findings suggest that reticulum cells may represent a reserve stromal cell pool (i.e. primitive reticulum cells) able to modulate themselves and to transform differently according to functional requirements. Some suggestions regarding the functional significance of fibroblast-like and myofibroblast-like reticulum cells in primary myelofibrosis are suggested.

Biopsy

Deficiency of autologous mixed lymphocyte reaction in patients with idiopathic autoimmune hemolytic anemia.

Alterations in the autologous mixed lymphocyte reaction (autologous MLR) have been reported in many autoimmune diseases and in diseases with a derangement of T regulatory function. We have studied autologous MLR in 10 patients with idiopathic autoimmune hemolytic anemia (IAHA). All patients had decreased autologous MLR which averaged 4,106 +/- 1,332 cpm (SEM) compared to 12,153 +/- 4,166 cpm for simultaneously studied controls. A marked decrease in phytohemagglutinin response and an imbalance of T-cell subsets were also observed. These findings suggest a possible abnormality of T immunoregulatory function in IAHA patients.

Adult

[Polycythemic hyperviscosity syndromes].

Packed red cell volume (VPRC) and total blood volume chiefly affect oxygen transport to tissues and produce the syndrome of polycythemic hyperviscosity. Several studies have demonstrated that a raised VPRC increases the blood viscosity and, under a measured pressure, decreases the flow rate in a capillary tube. Reduced flow results in a less effective tissue perfusion. The oxygen transport at different values of VPRC is shown by an inverted arc-like curve: at normal VPRC levels the oxygen transport is optimal. Hypervolemia affects oxygen transport to tissues: at the same VPRC values, hypervolemic patients have a better oxygen transport. In polycythemia vera (PV), hypervolemia may partially reduce the damage due to the increased blood viscosity. However, in some local areas where fixed vessel diameter (from arteriosclerosis) limits the increased blood flow, hyperviscosity may result in a local tissue ischemia. A relative iron deficiency with associated microcytosis due to venesection frequently occurs in PV. It is also associated with a delayed red blood cell filtration which may contribute to hyperviscosity. When thrombocytosis is present, the risk of thrombotic complications is furthermore increased. We report symptoms and signs at the onset in a series of 80 patients affected by PV. All patients have a minimum follow-up of 4 years. We also report the course of the illness, the treatment effectiveness (venesection, dibromomannitol) on clinical symptoms, the survival curve with analysis of prognostic factors at the onset and the causes of death.

Aged

The validity of informant reports in assessing the severity of dementia: evidence from the CAMDEX interview.

The evaluation of a patient's mental state, overall clinical profile and behavioural disturbance in the process of diagnosing dementia requires at least two sources of information: the patient and the informant. Since the severity of the dementia may interfere with the subjective perception of these disorders, it is important to evaluate the consistency between these two sources of information and the clinical and psychometric evaluation made by the physician. Accordingly, in this study five behavioural areas, derived from the semi-structured interview schedule provided by the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX, i.e., Sleep, Depressed Mood, Everyday Activity, Memory and Global Mental Functioning) have been tested on the patient and his/her informant. Eighty dementia patients (mean age = 74 years) and their informants participated in the study. The dementia group was subdivided into two levels of severity according to DSM-IIIR criteria: 41 with mild dementia and 39 with moderate dementia, respectively, matched for age and schooling. The rating of impairment was found to increase along with the severity of dementia in all the above-mentioned areas, except for sleep. However, the source of information per se significantly influenced the evaluation of memory functioning. Moreover, the significant interaction between the two factors considered indicates that memory functioning is evaluated quite differently by the patients and the informants, as only in the assessment made by the latter group did the impairment increase in parallel with severity of dementia. Finally, whereas none of the subjective measures recorded in the patients were significantly correlated with their test scores, the correlations between the informant memory appraisals and patient test results proved to be significant. The present findings confirm the validity of informant reports in assessing cognitive and memory disorders in early-stage dementia, as well as in distinguishing patients with mild from those with moderate dementia.

Aged

Effect of in vivo treatment with rh GM-CSF on in vitro growth of haematopoietic progenitors in patients with myelodysplastic syndromes.

BACKGROUND: Recombinant (r) human (h) granulocyte/macrophage colony stimulating factor (rh GM-CSF) has been shown to increase the number of peripheral blood (PB) neutrophils, eosinophils and monocytes in myelodysplastic syndromes (MDS). The aims of this study were: 1) to evaluate the effect of rh GM-CSF therapy on the in vitro growth of granulocyte-erythroid-macrophage-megakaryocyte colonies (CFU-GEMM), erythroid colonies (BFU-E), and granulocyte-macrophage colonies (CFU-GM) in patients with MDS; 2) to assess in these patients, while they are being treated in vivo with rh GM-CSF, the possible additive effect of rh IL-3 and rh G-CSF on the in vitro growth of haematopoietic progenitors. METHODS: The in vitro growth of CFU-GEMM, BFU-E and CFU-GM was studies in 10 myelodysplastic (MDS) patients, before and after in vivo administration of rh GM-CSF. RESULTS: After rh GM-CSF administration, the number of CFU-GM increased in all standard risk MDS patients. In 2 out of 5 cases, this effect was more pronounced and persisted up to 30 days after the end of rh GM-CSF treatment. On the other hand, the number of CFU-GEMM and BFU-E was substantially unchanged. When rh GM-CSF, rh G-CSF and rh IL-3 were added in vitro alone or in combination as the source of colony stimulating activity, no significant increase of the CFU-GM colony number was noticed. CONCLUSIONS: Rh GM-CSF therapy appears useful for increasing the number of peripheral blood granulocytes and of marrow CFU-GM in standard-risk MDS patients. High-risk MDS patients are far less responsive to rh GM-CSF treatment, probably reflecting a more aggressive and/or advanced disease.

Colony-Forming Units Assay