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Biomedical subjects

D Romano

Publications and source records attributed to D Romano.

At least 19 recordsLinked to original sources

Fertility rate evaluation by laparoscopic approach in the experimental animal.

PURPOSE OF INVESTIGATION: The aim of the present study was to evaluate the effect of laparoscopic insemination (LAP) and natural mating (NM) on fertility rate in experimental animal (Ovis Aries Comisana) during the month of June. METHODS: For the experiment, 97 ewes were used. Laparoscopic insemination was performed with the frozen semen of three different Romanov rams: Laparoscopic insemination I (n = 24); Laparoscopic insemination 2 (n = 26); and laparoscopic insemination 3 (n = 28), and natural mating was performed with two different Ovis Aries Comisana rams with proven fertility: Natural mating I (n = 10); Natural mating 2 (n = 9). Estrus was synchronized with fluorogestone acetate impregnated intravaginal sponges (40 mg, 14 days). Pregnant mare serum gonadotrophin (Folligon, Intervet International) at a dose of 400 UI was given intramuscularly at sponge removal. Artificial insemination was carried out 60 hours after the removal of the sponges in the laparoscopic insemination groups. RESULTS: The mean pregnancy rate at ecographic diagnosis performed at about 36 days from sponge removal for the laparoscopic insemination and natural mating groups were respectively, 62.8% and 78.9% with no significant difference. CONCLUSION: The mean fertility rates for the LAP and NM groups were 56.0 and 73.4, respectively, with no significant difference.

Animals↗

Ovine fetal growth curves in twin pregnancy: ultrasonographic assessment.

PURPOSE OF INVESTIGATION: The fetal-lamb model is a fundamental tool for developing clinical applications for the treatment of human fetal pathology (e.g., open fetal surgery). Accurate estimation of gestational age is important to avoid size-related problems during surgery. METHODS: To evaluate the effect of twinning on ovine fetal growth, we followed seven twin pregnancies in Comiso ewes from mating through parturition. Fetal growth indexes (muzzle-occipital and mean abdominal diameters, abdominal circumference, femoral and humeral length) were measured weekly using perimammary ultrasonography and analyzed with a linear quadratic regression model based on natural logarithms of each parameter and fetal age. RESULTS: The model explained > 90% of the variability observed, with determination coefficients of 95% (femoral length, abdominal circumference), 94% (abdominal diameter, humeral length), and 89% (muzzle-occipital diameter). CONCLUSION: Mean birth weight was lower than that reported for singleton fetal lambs, as it is in bigeminal pregnancies in humans, despite the uterine and placental differences between these two species. With the exception of slightly earlier growth deceleration, curves for head and long-bone growth resembled those for singleton ovine fetuses. Ovine fetal growth patterns (like those of humans) in singleton and twin pregnancies are similar.

Abdomen↗

Complementary therapy for severe Rh-alloimmunization.

PURPOSE OF INVESTIGATION: This report describes successful treatment, using invasive and noninvasive techniques, of a 36-year-old woman (gravida 10, para 0) referred to our center at 13 weeks' gestation for severe Rh alloimmunization. Pre-pregnancy indirect Coombs titers ranged from 1:1024-2048. All nine past pregnancies (conceived with three different partners) had ended in abortion, intrauterine death or neonatal death METHODS: The patient was treated with a single session of plasmapheresis (week 14) immediately followed by five days of immunoglobulin therapy and immunosuppressive therapy based on azathioprine and prednisone (weeks 15-22). Seven fetal transfusions (one intraperitoneal, six intravascular) were performed beginning at 16 weeks. RESULTS: The pregnancy, which was characterized by insulin-dependent gestational diabetes, spontaneously resolving polyhydramnios and peak indirect Coombs titers of 1:65,536, ended at 27 weeks with cesarean section delivery of a viable female weighing 1,000 g. In spite of numerous neonatal complications, the child is physically well at age 3, with normal intellectual and psychomotor development. CONCLUSION: In light of the negative outcomes of the patient's nine past pregnancies, our experience suggests that the early initiation of an integrated approach based on noninvasive and invasive techniques can play a potentially decisive role in the management of severe Rh-alloimmunization.

Adult↗

Ontogeny of the fetal immune system: study on pregnancies with Rh-isoimmunization and nonimmune fetal hydrops.

This study aims at observing and comparing the antigen expression of some fetal T- and B-lymphocyte subpopulations in Rh-isoimmunization, which determines anemic hypoxia in the fetus, and nonimmune fetal hydrops (NIFH) which, even if there are some etiological factors involved, causes hipoxic hypoxia in the fetus. Twelve fetuses were studied by way of 30 fetal blood samples obtained by ultrasound-guided cordocentesis between the 20th and 36th gestational week. Twenty-four blood samples in all where taken from the eight fetuses with Rh-isoimmunization. Six blood samples were obtained from the four fetuses with NIFH. The lymphocyte phenotypes studied by monoclonal antibodies and flow cytometry were the following: CD3, CD4, CD8, expression of T-lymphocyte subpopulations; BsIg, CD19, expression of B-lymphocyte subpopulations. We observed a near-normal maturation process in fetuses with Rh isoimmunization, whereas in fetuses with NIFH we observed inhibition and/or delayed expression of T-lymphocytes. An early and increased B-lymphocyte activation marked a cooperation between the two systems in the early gestational periods.

Anemia↗

Multimodal approach in invasive fetal therapy.

BACKGROUND: Integrated fetal therapy is a new approach to prenatal management consisting of a combination of invasive procedures which complement each other to provide as much information as possible on the fetal compartments. METHODS: We carried out a study on 50 fetuses of singleton pregnancies undergoing invasive procedures -- at least three per fetus -- for diagnostic and therapeutical purposes. A total of two hundred and fifty invasive procedures were adopted. The study population was divided into two groups, those studied between 1988 and 1992 and those studied between 1993 and 1995. RESULTS: The diagnostic and therapeutic utility of complementary invasive procedures in fetuses with nonimmune fetal hydrops and urinary tract malformations was assessed. In fetuses with nonimmune fetal hydrops integrated invasive procedures markedly affected the fetal-neonatal survival rate, whereas in those with urinary tract malformations scheduled for postnatal surgery these procedures made it possible to limit intrauterine renal damage. CONCLUSIONS: Complementary invasive procedures in NIFH fetuses particularly influence the fetal-neonatal survival rate. Since urinary tract malformations must be treated by postnatal surgery, complementary invasive procedures serve to limit intrauterine renal damage in the meantime and to reduce cesarean section rate.

Female↗

[The antioxidants (coenzyme Q10) in materno-fetal physiopathology].

BACKGROUND: Coenzyme Q10 (ubidecarenone) is a torpeniod molecule mainly located in bacterial and mitochondrial membranes. It is a part of a specific enzyme system and acts primarily on the transport of electrons in the mitochondrial respiratory chain. It performs an antioxidant action. We studied both fetal and maternal coenzyme Q10 plasma levels in physiological conditions and also in the presence of some pathologies. METHODS: As regards the maternal side, we selected 483 pregnancies, performing 615 blood samples, and divided them into four groups: A: physiological pregnancies; B: spontaneous abortions; C: threatened abortions; D: threatened late abortions and threatened pre-term deliveries. We then selected 61 pregnancies which differed from the previous ones and determined Q10 levels in fetal samples obtained by cordocentesis. We divided a control group from pathological groups: intra-uterine growth retardation (IUGR); Rh-isoimmunization (with intra-uterine transfusion), non immune fetal hydrops, fetal malformations. Coenzyme Q10 levels were determined in only one laboratory by high-performance liquid chromatography (HPLC). Coenzyme Q10 concentrations were expressed as mg/ml, the data as the mean + SD. Statistical analysis was performed employing a linear regression model and the student "t"-test. RESULTS: After working out a normality curve of CoQ10 levels in maternal blood, we noticed that the levels of Coenzyme Q10 were low in spontaneous abortions, in threatened late abortions and in threatened pre-term deliveries. We determined the value of 0.3 mg/ml as a cutoff to differentiate the fetal from the adult values. Moreover, CoQ10 values turned out to be increased only in fetuses affected by non-immune fetal hydrops. CONCLUSIONS: Accordingly, we can say that maternal CoQ10 plasma levels can be considered as a marker of pathological uterine contractile activity. There is a substantial increase in CoQ10 fetal plasma levels in fetuses affected by hypoxic hypoxia and also in those affected by non-immune fetal hydrops.

Abortion, Spontaneous↗

Laparoscopic surgery for abdominal aortic aneurysms. Technical elements of the procedure and a preliminary report of the first 22 patients.

BACKGROUND: Laparoscopic surgery for infrarenal aortic aneurysms is based on the principle of retropertoneal exclusion of the aneurysms sac with aortofemoral or aortoiliac bypass. METHODS: Of 22 patients who met the selection criteria, 20 successfully underwent laparoscopic aortic surgery at Morristown Memorial Hospital between February and October 1997. Technical elements and steps of this operation are described and illustrated. RESULTS: Within 30 days of surgery, 2 patients died and 9 had various major and minor perioperative complications. As a group, the laparoscopic patients had less postoperative pain, needed fewer hours of ventilator support, had shorter intensive care unit (ICU) and hospital lengths of stay, and resumed diet and normal activity earlier than the historical norms of patients undergoing transabdominal or retroperitoneal aortic resections at the same institution. CONCLUSIONS: These early observations suggest that the laparoscopic treatment of infrarenal abdominal aneurysms may have several significant potential benefits. Long-term results and randomized prospective studies with patients matched by risk stratification will be needed to confirm these impressions.

Aged↗

The use of nifedipine as first-line hypotensive therapy in gestational hypertension.

Nifedipine was administered to 49 pregnant women with gestational hypertension as first-line therapy, and were longitudinally studied as paired observations for 3 or 10 day intervals of treatment with nifedipine until delivery. All the patients assumed a slow release formulation of nifedipine at the dose of 40-80 mg/24 hr in 2-3 administrations. Blood pressure was taken at least 4 times a day. The patients were divided in two groups: 32 women with non proteinuric gestational hypertension (NPGH) and 17 women with proteinuric preeclampsia (PP). No statistically significant modification of blood pressure was observed in both groups under treatment. However, NPGH showed a trend to reducing, while PP demonstrated a tendency to worsening both systolic and diastolic blood pressures. After treatment with nifedipine the platelet count of both groups was found unchanged. No adverse fetal or newborn effects imputable to the drug were observed. The present study demonstrates that nifedipine alone, at the doses used, is not effective in reducing blood pressure in long-term treatment. However the treatment could concur to avoid sharp and dangerous increases of blood pressure.

Adult↗

[Chemo-antibiotic prophylaxis in general surgery. A study of 1722 cases].

Up until now the problem of surgical infections has been one of the most important which surgeons must confront daily. In 1989 our Institute began programs for control and surveillance of surgical infections; these include, among others, the use of chemo-antibiotic prophylaxis protocols applied to all of the patients hospitalized for surgery. The authors report two years application of three protocols of chemo-antibiotic prophylaxis related to 1722 patients, in which we pointed out the passage from 27.6% of infected cases in the control group to 10.2% infected cases in one of the groups subject to prophylaxis. In these cases the antibiotic prophylaxis also acted reducing in a spectacular manner the incidence of clinically not significant infections.

Anti-Bacterial Agents↗

A set of STS assays targeting the chromosome 22 physical framework markers.

The widespread use of the sequence-tagged site (STS) as a quick, efficient, and reproducible assay for comparing physical and genetic map information promises to facilitate greatly long-range goals of the mapping of the human genome. We have designed 21 STS assays for loci on human chromosome 22. These assays primarily tag the physical framework markers of the long arm of 22, but additional assays have been designed from known genes and loci in the neurofibromatosis 2 (NF2) region. The availability of these assays will make these loci available to the research community without physical transfer of materials and will serve as start points for further efforts to physically map chromosome 22 with yeast artificial chromosome clones.

Animals↗

Genetic heterogeneity of gene defects responsible for familial Alzheimer disease.

Inherited Alzheimer's disease is a genetically heterogeneous disorder that involves gene defects on at least five chromosomal loci. Three of these loci have been found by genetic linkage studies to reside on chromosomes 21, 19, and 14. On chromosomes 21, the gene encoding the precursor protein of Alzheimer-associated amyloid (APP) has been shown to contain several mutations in exons 16 and 17 which account for roughly 2-3% of familial Alzheimer's disease (FAD). The other loci include what appears to be a susceptibility gene on chromosome 19 associated with late-onset (> 65 years) FAD, and a major early-onset FAD gene defect on the long arm of chromosome 14. In other early- and late-onset FAD kindreds, the gene defects involved do not appear to be linked to any of these three loci, indicating the existence of additional and as of yet unlocalized FAD genes. This review provides a historical perspective of the search for FAD gene defects and summarizes the progress made in world-wide attempts to isolate and characterize the genes responsible for this disorder.

Alzheimer Disease↗

[Takayasu disease in the genesis of cerebrovascular insufficiency. Description and considerations of a clinical case].

The authors in explaining their limited clinical experience relative to one single case, describe the peculiarity of Takayasu's disease and its rare incidence in western populations. The case under observation because of its peculiar rarity had been underestimated and treated in a completely inappropriate manner. Important instrument in its diagnosis is the High Resolution echography which in determining the diagnosis favors and speeds up the diagnostic therapeutic iter.

Adult↗

Mapping of cosmid clones in Huntington's disease region of chromosome 4.

Huntington's disease (HD) is tightly linked to genetic markers in 4p16.3. We have used a regional somatic cell hybrid mapping panel to isolate and map 25 cosmids to the proximal portion of 4p16.3 and 17 cosmids to the distal portion. The latter were positioned by long-range restriction mapping relative to previously mapped markers. One cosmid, L6 (D4S166), spans the critical breakpoint in the mapping panel that distinguishes proximal and distal 4p16.3. Four of the cosmids mapped distal to D4S90, the previous terminal marker on 4p, and stretched to within 75 kb of the telomere. Several of the cosmids that mapped between L6 and D4S90 were clustered near a number of previously isolated clones in a region with many NotI sites. Cosmid E4 (D4S168) was localized immediately proximal to the one remaining gap in the long-range restriction map of distal 4p16.3. Although pulsed field gel mapping with E4 failed to link the two segments of the map, the intervening gap was excluded as a potential site for the HD gene by genetic analysis.

Chromosome Mapping↗

Increased recombination adjacent to the Huntington disease-linked D4S10 marker.

Huntington disease (HD) is caused by a genetic defect distal to the anonymous DNA marker D4S10 in the terminal cytogenetic subband of the short arm of chromosome 4 (4p16.3). The effort to identify new markers linked to HD has concentrated on the use of somatic cell hybrid panels that split 4p16.3 into proximal and distal portions. Here we report two new polymorphic markers in the proximal portion of 4p16.3, distal to D4S10. Both loci, D4S126 and D4S127, are defined by cosmids isolated from a library enriched for sequences in the 4pter-4p15.1 region. Physical mapping by pulsed-field gel electrophoresis places D4S126 200 kb telomeric to D4S10, while D4S127 is located near the more distal marker D4S95. Typing of a reference pedigree for D4S126 and D4S127 and for the recently described VNTR marker D4S125 has firmly placed these loci on the existing linkage map of 4p16.3. This genetic analysis has revealed that the region immediately distal to D4S10 shows a dramatically higher rate of recombination than would be expected based on its physical size. D4S10-D4S126-D4S125 span 3.5 cM, but only 300-400 kb of DNA. Consequently, this small region accounts for most of the reported genetic distance between D4S10 and HD. By contrast, it was not possible to connect D4S127 to D4S125 by physical mapping, although they are only 0.3 cM apart. A more detailed analysis of recombination sites within the immediate vicinity of D4S10 could potentially reveal the molecular basis for this phenomenon; however, it is clear that the rate of recombination is not continuously increased with progress toward the telomere of 4p.

Animals↗

[Vascular microsutures with resorbable and nonresorbable sutures. A comparative study].

Modern technology has recently provided us with new resorbable suture material for use also in vascular surgery. Clinical use of these sutures has been impeded however by not little mistrust and by old dogmas without a rational experimental basis. We have therefore begun studies of two slowly resorbable materials, polyglactin 910 and polyglycolic acid, in comparison with two classic nonreabsorbable materials, nylon and polypropylene, used in experimental model of end-to-end anastomosis rats'infrarenal aorta, following up the healing process and its evolution after an interval. The results are discussed in relation to data collected from current literature.

Absorption↗

[Aneurysm of the abdominal aorta and stenosis caused by compression of the celiac tripod in a young woman with tuberous sclerosis and previous mesoblastic nephroma].

Tuberous sclerosis, first described by Bourneville in 1880, is a syndrome characterized essentially by mental deterioration, seizures and cutaneous sebaceous adenoma; an association with malformative lesions of the kidney and cardiovascular apparatus has been documented. Recently a case of a young woman with tuberous sclerosis has come to our observation; she was also affected by abdominal aortal aneurysm and stenosis due to compression of the truncus coeliacus; previously she operative elsewhere for right nephrectomy for breakage of nephric right arterial aneurysm: the histological examination of the removed kidney manifested the presence of a mesoblastic nephroma and afterward tuberous sclerosis was diagnosed. The angiomyolipomatosis evidence confirmed the suspicion of a notable inclination to polydistrict malformations in tuberous sclerosis.

Adult↗

A yeast artificial chromosome telomere clone spanning a possible location of the Huntington disease gene.

The Huntington disease (HD) gene has been mapped to the most distal subband of chromosome 4p. Analysis of recombination events has not provided an unequivocal location of the HD gene, but it indicates a position very close to the telomere as one possibility. We have constructed a yeast artificial chromosome (YAC) vector (containing a rare-cutter polylinker) for the cloning of mammalian telomeres, used it to prepare a BssHII-telomere library with DNA from an individual homozygous for HD, and have identified a 115-kb clone containing the telomere of 4p. One probable recombinant would confine the telomeric candidate location for the gene to the region covered by the YAC, which makes it possible that the clone described here contains the HD locus in its mutant form.

Chromosomes, Fungal↗

Mapping of D4S98/S114/S113 confines the Huntington's defect to a reduced physical region at the telomere of chromosome 4.

The dominant gene defect in Huntington's disease (HD) is linked to the DNA marker D4S10, near the telomere of the chromosome 4 short arm. Two other markers, D4S43 and D4S95, are closer, but still proximal to the HD gene in 4p16.3. We have characterized a new locus, D4S114, identified by cloning the end of a NotI fragment resolved by pulsed-field gel electrophoresis. D4S114 was localized distal to D4S43 and D4S95 by both physical and genetic mapping techniques. The "end"-clone overlaps a previously isolated NotI "linking" clone, and is within 150 kb of a second "linking" clone defining D4S113. Restriction fragment length polymorphisms for D4S113 and D4S114, one of which is identical to a SacI polymorphism detected by the anonymous probe pBS731B-C (D4S98), were typed for key crossovers in HD and reference pedigrees. The data support the locus order D4S10-(D4S43, D4S95)-D4S98/S114/S113-HD-telomere. The D4S98/S114/S113 cluster therefore represents the nearest cloned sequences to HD, and provides a valuable new point for launching directional cloning strategies to isolate and characterize this disease gene.

Animals↗