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Biomedical subjects

E Greco

Publications and source records attributed to E Greco.

At least 73 records · Page 4Linked to original sources
PubMed1995

Nitric oxide release during hypothermic versus normothermic cardiopulmonary bypass.

Cardiopulmonary bypass (CPB) produces hemodynamic and inflammatory disorders involving changes in vascular permeability and regional blood flow and alterations of coagulation and complement systems. It has been reported that an abnormal release of vasoactive substances during CPB, like bradykinin or nitric oxide, could play a role. The aim of this study was to investigate the changes in nitric oxide (NO) release occurring in patients undergoing CPB, under both hypothermic and normothermic conditions. Forty patients (mean age 61.4 +/- 8.4 years) undergoing coronary bypass surgery were studied. In 20 patients (group A) systemic hypothermic CPB and antegrade cold intermittent crystalloid cardioplegia were used. The remaining 20 cases (group B) underwent surgery under systemic normothermic CPB and with antegrade warm blood intermittent cardioplegia. Nitric oxide was measured as the nitrite plasma level (NPL) by the Gries reaction. The time course of changes in NPL were obtained by collecting five whole blood samples: before CPB, 10 and 30 min after the start of CPB, and 10 and 60 min after the end of CPB. Although there were no significant variations of NPL shortly after the start of CPB (10 min after), values measured 30 min after CPB commencement and 10 min after the end of CPB showed a significant increase (P < 0.0001) in both groups. Considering the two groups separately, NPL changes seemed to be similar, so independent of temperature; however, in group B higher values of NPL were measured during (30 min) and after (60 min) CPB (P < 0.0001). In conclusion, during CPB there is a progressive increase, independent of temperature in NO release.

Blood Pressure↗
PubMed1995

Combined coronary bypass grafting and mitral valve surgery: Early and late results.

It is reported that the mortality rate for combined coronary bypass grafting and mitral valve replacement is greater than for either isolated operation. To evaluate the effects of various predicting factors we analyzed the results of 67 consecutive patients undergoing combined mvr and CABG. The mean age was 61.3 +/- 7 years. There were 55 males and 12 females and the mean follow-up was 59.4 +/- 7 months. The hospital mortality rate was 13.4% (9/67). Preoperative NYHA functional class (p<0.05), left-ventricular motion score (increased scores indicating impaired function, (p<0.05), and aortic cross-clamp time (p<0.05) were associated with hospital mortality. There was no significant relationship of age (>60), cause of mitral valve disease, severity of mitral regurgitation, number of grafts, or previous myocardial infarction with hospital mortality. There were 7 late deaths, and survival at five years was 76.1%. Although there was a trend for preoperative NYHA class and aortic cross-clamp time to be associated with late survival, the only factor significantly related to late survival was global wall-motion score (p<0.05). Severity of mitral regurgitation and cause of mitral valve disease have been reported as being related to late survival, but we have found no such relationship. Our results indicate that both hospital and late mortality are strongly correlated with preoperative left ventricular function.

Adult↗
PubMed1995

Styles of regulation in the bipolar spectrum.

Styles of regulation were assessed with the Serial Color-Word Test in a group of 35 compensated DSM-III--R bipolar patients (Bipolar) and in 3 control groups: Major Depression (n = 35), Schizophrenia (n = 50), and self-rated Personality Disorder (n = 40). On several measures of nonlinear change (V), patients in the Bipolar group had mean scores between those of the Personality Disorder and the Schizophrenic groups, and overlapped with those of the Major Depression group. Patients in the Bipolar group with clearcut temperaments (hyperthymic or depressive) were significantly more dissociative and less stabilized than other patients in the same group. A further group of nonclinical subjects with hyperthymic temperament (n = 20) was significantly more dissociative than the Personality Disorder group.

Adolescent↗
PubMed1995

Left thoracotomy for coronary revascularization after esophagoplasty with substernal colon interposition.

A 66-year-old man was referred to our institution with recurrent angina pectoris caused by 95% stenosis of the left anterior descending coronary artery. Twelve years earlier, he had undergone esophagoplasty with substernal colon interposition for an esophageal burn caused by a caustic substance. A left thoracotomy approach and femoro-femoral bypass were used safely for coronary artery revascularization.

Aged↗
PubMed1994

"Mold-like" calcification of the left atrium and of the pulmonary veins. Total endoatriectomy in a patient undergoing mitral valve replacement.

Mold-like left atrial calcification is a rare aspect of rheumatic mitral valvular disease. Its interest lies in the difficulty of surgical technique during interventions for valvular substitution. This is a case report in which the total excision of the calcified mold by a wide endoatriectomy was necessary in order to substitute the stenotic mitral valve.

Calcinosis↗
PubMed1994

Visceral pain threshold is deeply lowered far from the head in migraine.

A short-lasting over-distension of the hand-forearm veins, obtained through a non-invasive original maneuver (Hand Arm Vein Distension test) induces local pain when applied to migraine sufferers in inter-critical period. Conversely, subjects with an absolutely negative personal and family history for any type of idiopathic headache do not report any pain or only an uncertain, slight one. The injection of 1 mL of 2% to 8% (i.e. 0.34 mol/L to 1.36 mol/L) hypertonic saline into the antecubital vein during an extemporary short (1 minute) circulatory blockage (ischemia induced to guarantee a strictly local action of the chemical stimulus) provokes moderate, strong or unbearable local (arm vein) pain in migraine sufferers but not in subjects with a personal and family history absolutely free from any type of headache. These results show for the first time that migraineurs show a proneness to visceral pain in viscera (veins) distant from the head (arm-hand). Such a finding is consistent with the theory that migraine pain is due to a central derangement of the viscerosensory system.

Adult↗
PubMed1994

In vitro production of plasminogen activator by human granulosa cells.

Plasminogen activator (PA) production by granulosa cells has been demonstrated in several species. In the human ovary, tissue-type PA and urokinase-type PA antigens have been found in the follicular fluids, but neither PA activity nor mRNA for both enzymes was found in granulosa cells of preovulatory follicles. All of these studies were performed on granulosa cells collected from follicles immediately before ovulation, when the cells were already in the luteal phase. In the attempt to better characterize the PA/plasminogen system in the human ovary, we examined PA and PA inhibitor (PAI) production in cultures of granulosa cells obtained from normally cycling untreated women at different stages of the cycle. In addition, we analyzed granulosa-luteal cells obtained from hormonally stimulated women undergoing gamete intrafallopian tube transfer, as a model of late phase follicular development. Zymographic analysis as well as immunoprecipitation with specific antisera revealed that granulosa cells from follicles at early phases of antral stages secreted high levels of PA of the urokinase type in the medium. No free tissue-type PA activity was found in any of the examined samples. On the contrary, free PAI was undetectable in medium obtained from granulosa cell cultures, and it was abundant in granulosa-luteal cell cultures, where it was found in two forms. These data show that in the human ovary as in that of the rat, PAs and PAIs are tightly time regulated. The timing of PA production in human granulosa cells suggests a role for PA activity at early stages of follicular maturation.

Adult↗
PubMed1994

Microgenetic styles in histrionic and obsessive-compulsive personality disorders.

Microgenetic styles of regulation of subjects with (n = 46) and without (n = 44) psychometric evidence of personality disorders were assessed by means of the Serial Color-Word Test. The disordered group were characterized by the primary Dissociative pattern and by very low values of the initial strategy called ITa. Subjects with psychometric evidence of Histrionic (n = 21) and Obsessive-Compulsive (n = 21) Personality Disorders were then compared. Histrionic personality corresponded most often to a primary Stabilized style, with a progressive slight increase of dissociation over time (Cv type). The compulsive trait was instead associated with high primary cumulation (and moderately elevated dissociation), concomitantly with secondary dissociative patterns (CDr and Dv/CDv). These results seem to encourage further clinical research with the Serial Color-Word Test.

Adaptation, Psychological↗
PubMed1994

[The effect on left ventricular mass of treatment with amlodipine and diet therapy in obese patients with arterial hypertension].

Increased parietal stress, in hypertensive obese patients, produces a left ventricular hypertrophy. In this study we demonstrated that the association of amlodipine with hypocaloric diet can decrease the parietal stress. MATERIALS AND METHODS. From February to July 1993 32 hypertensive obese patients (17 males, 15 females) were treated with amlodipine 10 mg/day for six months. Sixteen patients were treated with amlodipine 10 mg/day (Group A) and 16 patients were treated with amlodipine 10 mg/day and hypocaloric diet (Group B). All patients included had a Body Mass Index > 30 and diastolic blood pressure > 100 mmHg. The patients were studied with 2D guided M-mode echocardiogram before treatment and after 6 months. RESULTS. In Group A the septal thickness, the posterior wall thickness and the left ventricular mass decreased significatively (p < 0.05). In the Group B also the left ventricular diastolic diameter and the left atrial diameter decreased. CONCLUSION. The association of a hypocaloric diet with amlodipine therapy, in hypertensive obese patients, improves the effect of the drug on ventricular hypertrophy.

Amlodipine↗
PubMed1993

Dynamic echography of the penis in the follow-up of impotent patients treated with intracavernous injections.

Dynamic echography of the penis (DEP) after pharmacological stimulation of erection has been designed to evaluate the albugineal wall thickness (AWT), the cavernosal appearance in the normal penis and corporeal changes in patients treated with intracavernous injections presenting with haematomata, hyperechoic images, prolonged erection and Peyronie's disease. DEP was performed in 973 patients who had had an average number of 89 (+/- 16) intracavernous injections for 16.7 +/- 11.7 months. A total of 1424 DEP examinations were performed. Transducer positioning, erectile condition, clinical recording and computer retrieval methods were adapted to gather ultrasonography data. The standard average AWTs recorded in patients free from Peyronie's disease and who were untreated were 0.11 cm at the septum, 0.17 and 0.15 cm at the dorsal root and the tip of the albuginea respectively, 0.14 cm ventrally and the diameter of the corpus cavernosum averaged 1.61 cm. Intracavernous therapy brought an increase in AWT of 15.38% to the septum, 11.76% and 10.53% to the dorsal tip and root respectively and 12.5% ventrally. Frequent haematomata induced greater increase, while prolonged erections did not. Patients with untreated Peyronie's disease were found to have greater AWT which decreased after treatment with intracavernosal injections. Before treatment abnormal penile hyperechoic images were found in 3.18% (intracavernous images) and 3.31% (albugineal nodules) of DEP, and in 7.09% and 7.54% respectively post-treatment.

Erectile Dysfunction↗
PubMed1993

Aortic intussusception: a rare presentation of type A aortic dissection evidenced by transesophageal echocardiography.

Thoracic aorta dissection involving the ascending tract (type A) is an affection which can often become lethal. The possibility of reaching immediate diagnosis and setting up surgical treatment are fundamental for the patient prognosis. In the case report, trans-esophageal echocardiography (TEE) made it possible to reach an immediate diagnosis of an unusual presentation of the dissection of type A, the intussusception of the aorta, not diagnosed by other non invasive methodologies, thus permitting timely surgical treatment.

Aortic Dissection↗
PubMed1991

Intracavernous self-injection of vasoactive drugs in the treatment of impotence: 8-year experience with 615 cases.

Of 615 patients with impotence of varying etiologies who were followed from 12 to 96 months after the institution of intracavernous self-injection therapy with vasoactive drugs (papaverine alone, papaverine and alpha-blockers, and Ceritine, a new multilevel acting drug) 87% (533 patients) returned for followup visits or were regularly contacted. Of these patients sexual activity was restored in 91%. The dropout rate was 11.25%. The 114 episodes of prolonged erections among 51 patients (4.57%) represented less than 3 per 1,000 of the 34,875 recorded injections. All patients were treated without complications. The percentage of patients suffering from nodules or permanent deformations was 2.8%. There were no cases of intracavernous fibrosis. The percentage of satisfied patients (satisfaction index 7 or greater) was 84.8%. Improvement in spontaneous erections during sexual intercourse was obtained in 65% of the cases: 15% no longer needed self-injections and 50% only used them occasionally while 35% remained entirely dependent.

Adrenergic alpha-Antagonists↗