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Biomedical subjects

C Orlandi

Publications and source records attributed to C Orlandi.

At least 19 recordsLinked to original sources

Abnormal uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile in a primary cardiac lymphoma.

Abnormally high uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile (99mTc-SESTAMIBI) in the right ventricle and in the septum was observed in a 47-year-old woman initially presenting with dysarthria and left hemiparesis. Endomyocardial biopsy demonstrated a high-grade malignant non-Hodgkin's lymphoma. Complete remission was achieved by combined cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy and radiotherapy of the heart and mediastinum. The post-remission single photon emission tomography (SPET) 99mTc-SESTAMIBI study showed a homogeneous distribution pattern, in agreement with echocardiography computed tomography and magnetic resonance imaging. Increased uptake of 99mTc-SESTAMIBI, a myocardial perfusion agent, has been observed in some benign and malignant tumours. It may prove to be useful in the diagnosis and follow-up of malignancies.

Antineoplastic Combined Chemotherapy Protocols

[Propofol, fentanyl, nitrous oxide: useful and current combination?].

The introduction of use of propofol in the anesthetists' pharmacopoeia has reinvigorated the research for a totally intravenous anaesthesia, for which the Authors propose a diagram. However, in experience related to the supplementary use of N2O, in virtue of its analgesic power, demonstrates yet another utility, permitting an easier anesthetical administration with minor consumption of intravenous drugs.

Adult

Evaluation of circulating tumor necrosis factor-alpha in patients with gynecological malignancies.

TNF-alpha levels in sera from patients with gynecological cancers were evaluated by ELISA and compared with those of patients with benign ovarian cysts or of anonymous healthy donors. Patients with cervical and endometrial carcinoma and with benign ovarian cysts showed levels of TNF-alpha similar to those of healthy donors. In contrast, significantly increased levels of TNF-alpha were found in patients with ovarian carcinoma, regardless of the stage of disease.

Biomarkers, Tumor

A multifaced DNA ploidy analysis to determine ovarian carcinoma aggressiveness.

A microfluorometric DNA study was conducted on isolated cells from 64 fragments of ovarian epithelial tumors. Data analysis considered the DNA content of the main stemline and the prevalence of cells in the different compartments of the DNA ploidy histogram in relation to the mitotic activity index and the histologic architecture. Main stemlines were found remarkably stable in different parts of the same tumor. Peridiploid (1.8c to 2.2c) stemlines were found both in well-differentiated and in poorly differentiated tumors. However, low aneuploid (2.2c to 3.0c) stemlines were mostly found in nonsolid tumors and high ploidy (3.2 to 5.04 c) stemlines were prevalent in solid tumors. A comparative analysis between DNA ploidy parameters and mitotic activity was useful to evaluate the expanding modalities of neoplastic cell populations. This analysis revealed that several tumors accumulate an excessive amount of heteroploid cells and others an excessive amount of G2 cells. Yet, most neoplastic cell populations vary from slow to rapidly growing patterns without relevant abnormalities in their ploidy graphic profiles. No relationship was found between stemline ploidy and histologic architecture compared with expanding modalities. These findings indicate that multifaced criteria combining features such as main ploidy, graphic profile, mitotic rate, and histologic architecture measured on one or more microsamples of the same tumor may help to objectively estimate the aggressiveness reached by the neoplastic cells at the time of clinical presentation.

Carcinoma

Constrictive effect of serotonin on visible renal arteries: a pharmacoangiographic study in anesthetized dogs.

Serotonin (5HT) has been implicated in the pathogenesis of several arterial disorders. Experimental intrarenal infusion of 5HT has produced initial decreases, and later sustained increases in total renal blood flow in the dog, and flow limiting renal artery spasm in other species. We assessed renal angiographic responses to 5HT infused into one renal artery of nine dogs before and after treatment with indomethacin (I). On blinded assessment of arteriograms, 5HT-induced narrowing was detected (p less than 0.001), and the effect was accentuated by I (p less than 0.001). Ketanserin (K), a 5HT-2 receptor antagonist, reversed the arteriographic vasoconstrictor effect of 5HT in five I-treated dogs (p less than 0.05). Linear cortical defects and decreased contrast intensity were seen in the nephrogram phase during 5HT infusion after I. This appearance resembled the arteriographic findings in hemorrhagic shock, suggesting profound impairment of renal cortical perfusion. This study suggests that 5HT constricts visible renal arteries via interaction with the 5HT-2 receptor, and that this in vivo effect is modified by arterial synthesis of vasodilator prostaglandins in the anesthetized dog.

Angiography

Plasma concentrations of atrial natriuretic factor and hemodynamics in pregnancy-induced hypertension.

Plasma values of atrial natriuretic factor (ANF) were evaluated in 31 women with pregnancy-induced hypertension (PIH) and 31 normal pregnant women at the same age of gestation. In 27 women with PIH and 27 normal pregnant women forearm venous tone (FVT) was evaluated by Strain Gauge Plethysmography. Forearm vascular resistance (FVR) was measured as the ratio of mean blood pressure (MBP) to forearm blood flow. In addition Cardiac Index (CI) by means of transthoracic electrical bioimpedance and total peripheral vascular resistance (TPR) (with the Frank Equation) were also measured. In comparison with the normal pregnant women, the women with PIH had similar values of hematocrit (as an index of plasma volume) and significantly higher levels of FVR and TPR, while ANF plasma values did not differ significantly. Subdividing the women with PIH in relation to the presence of proteinuria (greater than or equal to 0.3 g/l), those with proteinuria, in addition to significantly higher levels of FVR and TPR, had significantly higher levels of FVT than normal pregnant women, while ANF plasma values were higher even though the difference was only near the level of significance. Hypertensive women with proteinuria also had higher values of FVT than hypertensive women without proteinuria. By means of multiple regression ANF did not show any significant correlations with hematocrit or sodium excretion. Hypertension with proteinuria seems to represent a more severe form of the disease in which, in addition to the probable influence of other factors such as the renin-angiotensin and prostaglandin systems, a greater increase in peripheral sympathetic tone than in hypertension alone appears to be present, causing a reduction in venous compliance in addition to the elevation in FVR and TPR, with increase in central blood volume and atrial stretch. This may explain the higher ANF plasma levels in these patients in comparison with normal pregnant women, even though the absence of a significant correlation of ANF with hematocrit and the fact that ANF increase was only near the level of significance may suggest a change in the relation between ANF secretion and atrial volume receptors in pregnancy either normal or complicated by hypertension. ANF does not seem to play an important role in water and sodium excretion in PIH probably because of the presence of very high plasma levels of hormones such as aldosterone, progesterone and oestriol which, together with renal prostaglandins, seem to be involved in diuresis and natriuresis in pregnancy.

Adult

Early scintigraphic detection of experimental myocardial infarction in dogs with technetium-99m-glucaric acid.

Recent data have generated some interest in technetium-99m-(99mTc) glucaric acid as an in vivo viability marker. We studied 99mTc-glucaric acid retention in canine models of myocardial ischemia (20-min occlusion of the LAD/40-min reperfusion), acute myocardial infarction (MI) (90-min LAD occlusion/3-hr reperfusion), and chronic MI (90-min occlusion and either 48-hr or 10-day reperfusion). Regional myocardial blood flow was measured by radiolabeled microspheres. No preferential uptake of glucaric acid was observed in ischemic but viable myocardium. The compound showed high affinity for necrotic myocardial tissue for several days following injury. The preferential uptake in infarcted tissue disappeared by 10 days following injury. This study shows that 99mTc-glucaric acid acts exclusively as a marker of necrosis in canine models of MI. Technetium-99m-glucaric acid may have clinical utility in early cardiac imaging of myocardial infarction and in differentiating recent from old injuries.

Animals

Maternal and fetal prolactin in pregnancy-induced hypertension.

In plasma from 35 women with pregnancy-induced hypertension (PIH) and 35 normal pregnant women both at 39 weeks of gestation, plasma prolactin levels were measured at 8.30 a.m. (PRL1) and 9.30 a.m. (PRL2) under basal conditions. At delivery umbilical cord blood samples were taken for measurement of fetal prolactin (PRLF). PRL1 and PRL2 were higher in women with PIH, but no significant relations were found between PRL1/PRL2 and blood pressure. PRLF did not differ when infants of mothers with PIH and infants of normal pregnant women were compared, but PRLF had a significant direct independent relation with PRL2. The latter relation may be due to the increase in placental oestrogens during pregnancy, which stimulate both the maternal and fetal hypophyses and their prolactin secretion. PRLF did not show any relation with neonatal morbidity, but PRL1 showed a significant direct relation with the Apgar score at 5 min.

Adult

In vivo demonstration of enhanced arterial constrictor response to serotonin following focal endothelial cell loss.

Arterial sensitivity to vasospasm was assessed prior to and 2 weeks following a 15-min period of external compression of the superficial femoral artery in dogs. Compression was achieved by placing a plastic cuff around the artery to produce a 40-60% reduction in the artery cross-sectional area. An additional six dogs were used to assess morphologic changes produced in the artery immediately and at 2 weeks after compression. Angiography following intraarterial infusions of serotonin (10 and 30 micrograms/min), norepinephrine (0.1 microgram/min), ergonovine (20 micrograms/min), and the thromboxane mimic U-46,619 (0.1 microgram/min) demonstrated a specific sensitivity to serotonin 2 weeks after the 15-min application of external arterial compression. The serotonin response was antagonized by the specific serotonin (5-HT2) receptor antagonist, ketanserin. Scanning electron microscopy of the acutely injured luminal surface revealed loss of endothelium and deposition of platelets. Patchy areas with intact endothelium and migrating leukocytes were located within the denuded sites. Two weeks after constrictor placement, the compressed area appeared as a raised or semiraised lesion in which the orientation and shape of the luminal cells were distinctly delineated from the adjacent noninjured segments. However, the luminal cells appeared to be endothelium that had regrown over the previously denuded area. The results of this study demonstrate, in an in vivo model, an enhancement in serotonin-mediated vasoconstriction following intimal injury and repair and support the suggestion that endothelial damage or dysfunction may play a role in the pathophysiology of arterial spasm.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5

Autonomic nervous system and microcirculation in diabetes.

In order to evaluate the occurrence of sympathetic impairment of skin microvascular control in diabetes, we evaluated the spectral analysis of forearm skin laser-Doppler fluctuations in nine insulin-dependent diabetic subjects and in 21 controls of similar age. Low-frequency oscillations (around 0.1 Hz) were significantly lower in diabetics than in controls (2.333 +/- 0.340 (mean +/- SEM) units vs. 3.486 +/- 0.093 units, P less than 0.001), whereas no significant differences were found between the two groups regarding high-frequency respiration-related oscillations. These results suggest that the loss of rhythmicity in diabetic subjects is selectively related to low-frequency oscillations, mostly under sympathetic control, and is likely to be dependent on autonomic abnormality.

Adult

Proliferative and lipid metabolism response to balloon angioplasty in canine renal arteries.

The mechanisms responsible for reocclusion after percutaneous transluminal angioplasty are still poorly understood. The effects of angioplasty on arterial morphology, deoxyribonucleic acid (DNA) synthesis (3H-thymidine incorporation) and lipid metabolism (14C-oleate incorporation) were studied in renal arteries of 24 male mongrel dogs. Balloon-dilated (identified by Evans blue dye accumulation) and adjacent normal arterial segments were collected 90 min and 2, 5 and 14 days after the procedure. The immediate vascular response was endothelial cell denudation and platelet accumulation. Two weeks after angioplasty, healing of the luminal surface by "endothelial-like" cells, mild smooth muscle cell proliferation and an angiogenic response with capillary growth into the media were observed. DNA synthesis was increased in balloon-dilated segments at day 5 compared with adjacent nonballoon-dilated artery. This increase in DNA synthesis persisted in the 2 week postangioplasty segments. Additionally, angioplasty produced both quantitative and qualitative changes in arterial lipid synthesis. The most dramatic change was an increase in sterol esterification that was apparent as early as 90 min after angioplasty; the change persisted through day 5 but diminished toward baseline by day 14. Angioplasty-induced alterations of arterial metabolism parallel aspects of the atherogenic process and may be involved in the pathogenesis of postangioplasty reocclusion, particularly in the presence of additional risk factors, such as hyperlipemia.

Angioplasty, Balloon

Hypochondriacal fears and beliefs in pregnancy.

Illness attitudes were evaluated in 26 pregnant women and 26 control subjects matched for sociodemographic variables, by means of a self-rating scale, on 3 different occasions. For each trimester of pregnancy, women displayed more hypochondriacal fears and beliefs and conviction of disease (disease phobia) than normal controls. In the third trimester, they also reported more fear of dying and bodily preoccupations. The findings should alert physicians to ask their pregnant patients whether they are preoccupied with fear of dying, or are concerned that they suffer from an undiagnosed physical illness, or dread a specific illness such as cancer or heart disease. Hypochondriacal fears and beliefs are liable to affect well-being and the health attitudes of pregnant women. If properly recognized, they may effectively be treated.

Adult

Regional cerebral blood flow and distribution of [99mTc]ethyl cysteinate dimer in nonhuman primates.

Increases in regional cerebral blood flow have been described in a variety of cerebral pathologic states, including stroke and seizure disorders. The usefulness of technetium-99m-labeled cysteinate dimer as a marker in the measurement of regional cerebral blood flow was tested in five cynomolgus monkeys. To expand the range of blood flow to beyond the normal limits, 40 mg/kg i.v. of the carbonic anhydrase inhibitor acetazolamide was administered. Regional cerebral blood flow in all five monkeys was measured using radiolabeled microspheres (before and after acetazolamide) and the marker (after acetazolamide) in 60-70 samples from 12 brain regions. Acetazolamide significantly increased the mean +/- SEM regional cerebral blood flow measured using microspheres from 0.56 +/- 0.21 to 1.71 +/- 0.9 ml/min/g (p less than 0.01 for each region). A significant positive correlation was found between regional cerebral blood flow values calculated using microspheres and the marker after normalizing the values to those in the cerebellum (r = 0.773, p less than 0.0001). The mean +/- SEM regional cerebral blood flow determined using the marker in a single monkey (1.21 +/- 0.04 ml/min/g) did not differ significantly from that determined in the same monkey using microspheres (1.13 +/- 0.04 ml/min/g). These data support the potential use of this new brain perfusion imaging agent to assess regional cerebral blood flow over a clinically relevant range of blood flows.

Acetazolamide

Search for herpes simplex virus 2 and human papillomavirus genetic expression in vulvar neoplasia.

Specimens from vulvar carcinomas and vulvar intraepithelial neoplasia (VIN) of various degrees were analyzed for the presence of herpes simplex virus 2 (HSV 2) and human papillomavirus (HPV) genetic information. A search for the HPV 16 E6 protein as well as the HSV 2 antigenic determinant LA1 and ICSP 11/12 protein was carried out with an immunoperoxidase assay on 12 vulvar carcinomas and 6 VINs. Seven invasive cancers and four VINs were screened for the presence of homology to HPV 16 DNA and HSV 2 DNA transforming sequences with Southern blot hybridization. We used specimens from labial tumors and from normal vulvas and cervixes as controls. The preliminary results showed that one vulvar carcinoma and two VINs contained HPV 16 DNA. Four vulvar carcinomas expressed the E6 protein, while all the VINs were negative. Homology to HSV 2 DNA transforming sequences was detected in one vulvar cancer but not in any VIN cases. Positivity to HSV 2 ICSP 11/12 was observed in 33.3% of VIN cases and 75% of invasive cancers. HSV 2 LA1 antigenic determinant was expressed in 33.3% of VIN and 66.6% of cancer cases.

Adult

Relationship between phasic changes in human skin blood flow and autonomic tone.

Heart rate beat-to-beat oscillations synchronous with respiration and blood pressure waves, have been found to be a marker of sympathovagal interaction in man and animals. Oscillations of heart rate, respiration, and cutaneous blood flow were simultaneously recorded to assess the relationship between autonomic nervous control and cutaneous circulation in a group of 21 healthy subjects and in a group of 6 healthy patients after brachial plexus anesthesia and consequent sympathetic blockade. In the first group, changes in posture were employed to modify autonomic tone. Relative changes in cutaneous blood flow were recorded by laser-Doppler flowmetry. Spectral analysis techniques (cross-correlation) were used to quantify the relationship between oscillations common to the recorded signals. A standing maneuver induced a significant decrease of the cross-correlation between respiratory and heart rate fluctuations (from 4.93 +/- 0.16 to 4.44 +/- 0.16 a.u.; P less than 0.001), and a significant increase of the cross-correlation between heart rate and skin blood flow fluctuations (from 0.64 +/- 0.31 to 1.33 +/- 0.21 a.u.; P less than 0.001), but did not modify the cross-correlation between respiratory and skin blood flow fluctuations (from 2.87 +/- 0.15 to 3.04 +/- 0.14 a.u.; NS). After the standing maneuver the maximum correlation between heart rate and skin blood flow was always due to oscillations in the range of 0.1 Hz (or 10-sec period), similar to the oscillations described in large arteries. Sympathetic blockade reduced significantly the cross-correlation between heart rate and skin blood flow (P less than 0.001). These results suggest that the cross-correlation between skin blood flow and heart rate at 10-sec period fluctuations can be used as an index of the influence of the autonomic tone on skin blood circulation.

Adolescent

Psychosomatic assessment of hirsute women.

Psychiatric illness, psychological distress and illness behavior were investigated in 30 hirsute women and 30 nonhirsute healthy control subjects matched for sociodemographic variables. The majority of patients showed a good psychological adaptation to illness: they did not report significantly more anxiety, depression, and abnormal illness behavior than controls. One-sixth of the patients, however, suffered from a clinically meaningful affective disorder. Further, hirsute patients displayed significantly more hostility and irritable mood than controls (p less than 0.01).

Adult

Hypochondriacal symptoms in pregnancy.

Illness attitudes were evaluated in 26 pregnant women and 26 control subjects matched for sociodemographic variables, by means of a self-rating scale, on three different occasions. In each trimester of pregnancy, women displayed more hypochondriacal fears and beliefs and conviction of disease (disease phobia) than normal controls (p less than 0.001). The findings should alert physicians to ask their pregnant patients whether they are preoccupied with fear of dying, or are concerned that they suffer from an undiagnosed physical illness, or dread a specific illness such as cancer or heart disease. Hypochondriacal fears and beliefs are liable to affect the well-being and health attitudes of pregnant women. If properly recognized, they may effectively be treated.

Female