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Biomedical subjects

D Leone

Publications and source records attributed to D Leone.

At least 19 recordsLinked to original sources
PubMed1998

Multicenter trial comparing tramadol and morphine for pain after abdominal surgery.

Seventy patients (40 male, 30 female), mean (SD) age 60.8 +/- 13.7 years were treated with parenteral morphine (10 mg/1 ml ampul) or tramadol (100 mg/2 ml ampul) to verify their analgesic effects in pain following abdominal surgery. The multicenter trial followed an open, controlled experimental design between patients, randomized within the centers. The drugs were given by intramuscular injection, as requested by patients, starting in the postoperative period when pain was more than 70 mm, assessed on a visual analog scale. Patients were allowed up to six ampuls of tramadol or morphine in the 24-h trial but in the first 4 h, if they asked for supplementary analgesic, only diclofenac (75 mg in a 3-ml ampul) was allowed. Both test drugs gave rapid and constant pain relief. After the first dose, pain intensity was reduced 36.2% with tramadol, and 51% with morphine; the pain-free interval was similar for both treatments. The quality of sleep and the number of hours of sleep the night after surgery were similar for both groups. Tramadol was tolerated better, giving rise to no untoward reactions; with morphine there was one case of mild respiratory depression. In abdominal surgery, therefore, tramadol given by intramuscular injection has postoperative analgesic activity similar to morphine, but is better tolerated.

Abdominal Pain↗
PubMed1998

[Evaluation of continuous measurement of cardiac output with thermodilution in critical patients].

BACKGROUND: A new pulmonary artery catheter and monitor for continuous cardiac output measurement (CCO), based on thermodilution principle, has been recently developed. Aim of our study was to evaluate the new system by comparing data obtained with the CCO with the standard bolus thermodilution method (TD). METHODS: Nineteen patients admitted in a medical intensive care unit were studied. In each patient 6 daily measurements of cardiac output (CO) were recorded using both the CCO and the TD. The parallel monitoring was continued for 48 h; 12 pair determinations were obtained in each patient with a total of 228. RESULTS: Total CO ranged from 2.6 L/min to 10.6 L/min. The regression coefficient was 0.94. The bias of all measurements was 0.03 (SD: +1.22-1.16). The mean relative error was 1.52% +/- 29.9. Modifications in temperature or variations in heart rate did not change the agreement between the two techniques. CONCLUSIONS: Our results confirm that CCO, although does not have all the characteristics of an ideal monitoring system, can be considered extremely useful and safe.

Adult↗
PubMed1997

Long-term adrenalectomy can decrease or increase hippocampal dentate gyrus volumes.

Male and female Long-Evans adult rats were adrenalectomized and sacrificed 6 weeks later to determine whether dentate gyrus damage would differ in females and males. A subset of adrenalectomized rats of both sexes had significantly reduced dentate gyrus volumes compared to the same sex SHAM operated rats. The remainder of the male and female adrenalectomized rats which did not have clear dentate gyrus damage had significantly larger dentate gyrus volumes compared to the same sex SHAM rats. The dentate gyrus volumes of all adrenalectomized rats were significantly correlated with two indices of residual hormonal levels (Na+/K+ ratios and body weight gain 6 weeks after surgery), indicating that endogenous corticosterone levels may be a determining factor in the response of the dentate gyrus to adrenalectomy. These dentate gyrus volumetric changes could not be attributed to tissue shrinkage as there were no changes in CA3 volumes in any of the groups. These results suggest that long-term adrenalectomy can result in either increased or decreased dentate gyrus volumes and that the adrenal steroid levels of each individual adrenalectomized rat may be the factor determining the direction of the dentate gyrus volumetric response.

Adrenal Glands↗
PubMed1997

A new fast-moving variant causing erythrocytosis and mild hemolysis: Hb Gàmbara [beta 82(EF6)Lys-->Glu].

Hb Gàmbara is a new hemoglobin variant with abnormal beta chains that has been found in three out of four members of a family of Lombardy origin (Gàmbara, Brescia, Northern Italy). The affected subjects led a normal life, but they had modest erythrocytosis and mild (compensated) hemolysis with slight splenomegaly. Their abnormal hemoglobin was about 52% of the total hemoglobin, and was shown to be stable by the isopropanol test. Whole blood P50 of the proband was 19.3 Torr, Bohr effect was decreased (-0.25), as well as the molar ratio between the 2,3-diphosphoglycerate level and total hemoglobin of erythrocytes (0.68). The purified abnormal hemoglobin was characterized by an altered oxygen affinity, low n-factor, chloride, and 2,3-diphosphoglycerate effects. The Bohr effect was about 40% of the normal control. The abnormal hemoglobin moved faster than Hb A at alkaline electrophoresis, and split into two fractions, probably due to the formation of hybrid tetramers (alpha 2 beta A beta X). The reversed phase high performance liquid chromatogram from the tryptic digest of the aminoethylated abnormal beta chain subunits indicated the presence of an extra peptide, beta T-9, 10, replacing the individual peptides beta T-9 and beta T-10. Finally, the proband's DNA, drawn from a suitable segment of the beta structural gene (exon 2), revealed a nucleotide sequence carrying the heterozygous mutation AAG-->GAG at codon 82. This led to a Lys-->Glu substitution at position 82(EF6) of the beta chain.

Electrophoresis↗
PubMed1996

Evaluation of brain perfusion with high resolution single photon emission tomography in the diagnosis of brain death.

Nuclear Medicine studies performed with tomographic acquisition and tracers such as Technetium-99m hexamethyl-propyleneamine oxime (99mTc-HMPAO) are able to assess cerebral blood flow. A case is reported of a patient with a large intracranial tumor, of possible pituitary origin, with a clinical and electroencephalographic suspicion of brain death. The patient had endocrinous-metabolic impairments for a history of impotence, since 18 months, and diabetes insipidus with a urine output of 350 ml/hr in the first 24 hours from the clinical suspicion of brain death. Due to the endocrinous-metabolic impairments, according to Italian law, it was necessary to confirm the diagnosis of brain death by performing a study able to assess cerebral blood flow. A single Photon Emission Tomography (SPET) scan was performed after the intravenous administration of 99mTc-HMPAO using a high resolution, brain dedicated device. No tracer uptake was evident in cerebral, cerebellar and brain stem structures. The cerebral blood flow study by SPET confirmed the diagnosis of brain death and made the organ transplant possible in a short period of time. High resolution SPET studies are useful to confirm the diagnosis of brain death when there are factors that can influence clinical and electroencephalographic signs, reducing time to authorise the organ explant.

Adult↗
PubMed1994

[Results of early external ventricular diversion in posthemorrhagic ventricular dilatation in the newborn].

OBJECTIVE AND DESIGN: The authors report the outcome of early treatment with long-term external ventricular drainage (EVD) of progressive post-hemorrhagic ventricular dilatation (PPHVD), following peri-intraventricular hemorrhage (PIVH) in a population of preterm newborns. SETTING: Neonatal Intensive Care Unit (NICU) of a Children's Hospital. PATIENTS: Twenty-one preterms of 29.6 +/- 2.4 weeks of gestational age, weighing at birth 1443 +/- 445 g, mechanically ventilated, submitted to early EVD because of PPHVD following PIVH of III (n 11) e IV (n 10) grade. METHODS: PPHVD was diagnosed on the basis of US and TC findings. An external liquoral drainage suitable, for its technical characteristics, to be maintained for a long period of time and peculiar anesthesiologic, intra and postoperative treatments were utilized. RESULTS: EVD was placed at 21 +/- 5.8 days of life and maintained for 40 +/- 16 days. In all cases reduction of ventricular size was observed. One case (5%) developed liquoral infection and recovered with antibiotic therapy. No obstruction or dislocation of the ventricular catheter occurred. During EVD 3 patients (14%) died because of respiratory complications. After the normalization of cerebrospinal fluid (CSF), a "permeability test" was performed to assess the canalization of the liquoral system. Seven patients (33.5%) underwent ventriculo-peritoneal shunt (VPS) and 11 (52.5%) became shunt-free. CONCLUSIONS: Our results indicate that long-term use of EVD has a low risk of complications, avoids the need for transcutaneous tips and allows monitoring of CSF characteristics. Furthermore EVD protects the brain from liquoral hypertension, while waiting for a possible recurrence of natural CSF circulation, and is associated with a low number of definitive VPS.

Cerebral Hemorrhage↗
PubMed1993

Mucopolysaccharidosis: thickening of dura mater at the craniocervical junction and other CT/MRI findings.

Cranial CT and/or MRI imaging of 8 patients with mucopolysaccharidosis (MPS) was retrospectively evaluated. Two patients had MPS IH, 1 had MPS IS, 1 had MPS IVA and 4 had MPS IV. CT and MRI showed thickening of dura mater at the cranio-cervical junction, causing narrowing of the subarachnoid space, in all the patients examined. Spinal cord compression was detected in 4 patients. Other findings were: white matter alterations, mild to severe hydrocephalus, skull dysplasia and odontoid dysplasia. White matter alterations were evident as large areas and as multiple dispersed spots of prolonged T1 and T2 value. Reduced gray/white matter contrast was demonstrated on T2-weighted MRI images. It is important to examine the cranio-cervical junction carefully for thickening of dura mater in all patients with mucopolysaccharidosis examined by CT or MRI, because of the generally progressive clinical course of MPS. In patients with symptomatic cord compression, surgical intervention should be considered.

Adolescent↗
PubMed1992

[Mucopolysaccharidoses: evaluation of the cranium by computed tomography and magnetic resonance].

Cranial CT and/or MRI examinations were performed in 8 patients affected with mucopolysaccharidosis. Two patients were affected with mucopolysaccharidosis IH,1 had mucopolysaccharidosis IS, 1 had mucopolysaccharidosis IV A and 4 presented mucopolysaccharidosis VI. CT and MRI showed white matter changes consisting of symmetric and diffuse hypodense areas on CT, large areas and multiple spots of prolonged T1 and T2 value on MRI. Reduced gray/white matter contrast was demonstrated on T2-weighted sequences. Furthermore, CT and MRI showed thickening of the dura mater at the cranio-cervical junction, which caused subarachnoid space narrowing in all patients. Spinal cord compression was detected in 4 patients. Additional findings were mild to severe hydrocephalus, skull dysplasia and odontoid dysplasia. Owing to the progressive clinical course of all mucopolysaccharidosis, the authors stress the importance of a careful study of the cranio-cervical junction in all the patients with mucopolysaccharidosis examined by CT or MRI in order to demonstrate essential thickening of the dura mater. In the patients with symptomatic cord compression, surgery should be considered.

Adolescent↗
PubMed1992

[Usefulness of the prevention of oxygen radical damage in the critical patient using the parenteral administration of reduced glutathione in high doses].

A hyperproduction of Oxygen Free Radicals (FRO) is frequently observed during stress, anoxia, hyperbarism and may worsen the clinical conditions of intensive care patients. The hyperproduction of FRO may be reduced by antioxidants. The glutathione (GSH) is frequently associated with organic antioxidant protective systems. Forty patients receiving a continuous infusion of 70 mg/Kg/die of GSH were compared with forty patients not receiving GSH; the patients in both groups were randomized for age, sex, and pathology. Some parameters which are indirect indexes of FRO hyperproduction were chosen: ethane in the expired air, plasma malondialdehyde, fibrinopeptide A and C5 activated complement fraction, also the erythrocyte membrane deformability was investigated. The results obtained in the group receiving GSH were compared with the control group and a significative difference was found indicating a reduced FRO production. These interesting results need more trials in order to confirm a real GSH involvement in the antioxidant organic protection. In any case the supplementation with antioxidants in the therapy of intensive care patients can be regarded as an interesting means to improve their clinical conditions.

Adolescent↗
PubMed1991

Expression and functional characterization of a soluble form of vascular cell adhesion molecule 1.

Vascular cell adhesion molecule 1 (VCAM1) is a leukocyte adhesion molecule induced on human endothelium in vitro and in vivo by inflammatory stimuli. A truncated cDNA for VCAM1 was constructed, stably expressed in Chinese Hamster Ovary (CHO) cells, and the secreted recombinant soluble form of VCAM1 (rsVCAM1) purified to homogeneity by immunoaffinity chromatography. Immobilized rsVCAM1 is a functional adhesion protein, and selectively binds only VLA4-expressing cells, including human B and T lymphocytes, NK cells, and certain lymphoblastoid cell lines. T cell subset analyses indicate preferential binding of CD8+ memory cells. rsVCAM1 should prove valuable for the further study of the role of VCAM1 during inflammatory and immune responses in vivo.

Amino Acid Sequence↗
PubMed1991

Posttranslational modifications of rat proenkephalin overexpressed in Chinese hamster ovary cells.

Rat proenkephalin was overexpressed in Chinese hamster ovary cells using the dihydrofolate reductase-coupled genetic amplification method. About 2 mg purified protein could be obtained from 250 ml conditioned medium; multiple successive harvests could be obtained from the same roller bottle. Degradation of proenkephalin released into the conditioned medium was reduced significantly in the presence of 2% fetal bovine serum. Forty-eight percent of recombinant proenkephalin was glycosylated; glycosylation could be entirely prevented by the addition of tunicamycin. Two-dimensional isoelectric focusing experiments showed that recombinant proenkephalin exhibited considerable charge heterogeneity, with two major unglycosylated isoelectric forms and six or seven glycosylated isoelectric forms. The estimated isoelectric points of the major unglycosylated proenkephalins were 6.0 and 6.1, while glycosylated proenkephalins ranged in pI from 5.7-6.1. Some of this isoelectric heterogeneity is due to phosphorylation; [32P] orthophosphate was readily incorporated into serine residues within newly synthesized proenkephalin.

Animals↗
PubMed1990

Molecular analysis of atypical beta-thalassemia heterozygotes.

This paper reviews the molecular pathology of a heterogeneous group of beta-thalassemia heterozygotes which may be referred to as atypical beta-thalassemia. This group includes four different categories of heterozygous beta-thalassemia, which are characterized, respectively, by (1) normal MCV and MCH; (2) normal Hb A2; (3) normal MCV, MCH, and Hb A2 and imbalanced globin chain synthesis only or, (4) the presence of clinical manifestations. The first group is represented by a limited proportion of double heterozygotes for alpha- and beta-thalassemia. The second group includes two categories. One category is double heterozygotes for delta- and beta-thalassemia with the delta-thalassemia mutation in cis or in trans to beta-thalassemia. A number of delta-thalassemia mutations which produce this phenotype by interacting with beta-thalassemia have been described. The other category within the second group is heterozygotes for some mild beta(+)-thalassemia mutations. Within the third group, conclusive evidence for a mutation within the beta-globin gene cluster producing the silent beta-thalassemia phenotype has been obtained solely for a C----T substitution at -101 within the CACCC box of the beta-globin gene. Possible candidates are the complex rearrangements (-T, +ATA; -T, +ATATA) found at position -530 from the cap site. In the group of thalassemic hemoglobinopathies, a series of mutations mostly located in the third exon and producing elongated or truncated molecules have been recently reported. Most of the mutations are silent at the protein level, produce inclusion bodies in peripheral erythrocytes, and show a dominant transmission pattern or occur sporadically.

Codon↗
PubMed1981

[Use of potassium canrenoate in cardiosurgery].

The influence of canrenoate of potassium, a new injectable antialdosteronic, on serum, urinary and intraerythrocyte ionograms has been evaluated as part of a random controlled study on patients submitted to ECC heart surgery. The results show that the drug maintains correct ionic homoestasis and gradualises and potentiates diuresis, in association with furosemide. The possible clinical implications of these results are discussed.

Adult↗