Biomedical subjects
Publications and source records attributed to E Mantovani.
A case is reported of an asymptomatic unilateral jet-black mass lesion of the optic nervehead with contiguous iuxtapapillary choroidal pigmentation; unilateral ocular hypertension was present in the affected eye. Diagnosis of melanocytoma with contiguous choroidal nevus was made and an 18 month follow-up was performed. The diagnostic work-up and the importance of follow-up of melanocytoma-affected patients are stressed.
Primary or secondary impairment of blood supply to the optic nerve results in a spectrum of ischemic optic neuropathies with multiple etiopathogenesis. Among these the clinical features of traumatic and radiation optic neuropathy are outlined. Diagnostic criteria, associated conditions, risk factors and functional prognosis of anterior ischemic optic neuropathy are reviewed and discussed in the light of the contribution of recent literature.
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A case of juvenile sudden death, occurring during athletic activity and due to obstructive atherosclerosis of coronary arteries, is reported. Repeated maximal exercise stress tests, Holter monitoring (24 hours) and echocardiograms, performed because of recurrent episodes of palpitation during effort, gave negative results. Uncertainties regarding the diagnostic sensitivity of the protocols for competitive sport fitness in revealing latent myocardial ischemia are stressed.
The records of 293 patients admitted to Padua University Eye Clinic with diagnosis of optic neuropathy were reviewed. Age and sex distribution of different types of optic neuropathies were analyzed. 84 patients (28.7%) with a mean age of 61.9 years had anterior ischemic optic neuropathy (AION). The mean follow up of these patients was 3 years. In less than 30% of patients stabilized visual acuity of the first affected eye was better than 20/200; however, patients younger than 65 showed a significantly (p less than 0.01) better visual acuity than patients older than 64. Involvement of the second eye was found in 26 patients with AION (30.9%), of whom only five were considered idiopathic. The latency before controlateral eye involvement was significantly (p less than 0.05) shorter in patients over 64 years of age than in the younger group. Commonly known associated conditions such as giant cell arteritis (3.6%), arterial hypertension (34.5%), diabetes mellitus (10.7%), both arterial hypertension and diabetes (8.3%), migraine (7.2%) or intracapsular cataract extraction (1.2%) were considered. The frequency of a number of risk factors was found out in patients with arterial hypertension and/or diabetes and in patients with idiopathic AION. Symptoms or signs of ischemic cardiopathy and/or peripheral nonarteritic vascular disease, TIAs prior to AION onset, elevated plasma cholesterol or triglyceride levels, excessive smoking were considered. These risk factors were not found in 11.1% of diabetic patients with AION, in 37.9% of hypertensives, in 14.2% of both diabetic and hypertensive patients and in 31% of patients with idiopathic AION. Our data seem to indicate that the onset of AION may be influenced more strongly from these risk factors than aging.
Electroretinograms (ERG), oscillatory potentials (OP) and pattern reversal visual evoked potentials (VEP) were performed in nine patients (mean age 66 years) with unilateral long-standing anterior ischemic optic neuropathy (AION) and in an age matched control group. Normal ERGs but bilateral impaired OPs were observed in virtually all AION affected patients. Regardless of visual acuity, VEP amplitude reduction was found in all eyes with AION and in controlateral eyes of patients with associated systemic conditions such as diabetes mellitus, arterial hypertension and atherosclerosis. A normal latency of VEP was found bilaterally in AION affected patients; however no correlation between VEP latency and visual acuity or fields could be established. Our results seem to indicate moderate ischemic damage to the retina and to the axons of the optic pathways in patients with AION.
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A second case of sudden death during athletic activity, due to anomalous origin of the right coronary artery from the left anterior sinus of Valsalva, is presented. Post-mortem examination disclosed widespread myocardiosclerosis involving the subepicardial layers of the posterior wall of the left ventricle. Submaximal exercise testing had been performed to evaluate the presence of a ventricular extrasystole on a basal ECG, but no significant ischemic alterations of the ST tract had been detected. This case proposes once again the uncertainties regarding the diagnostic sensitivity of the protocols for competitive sport fitness in revealing latent chronic ischemia.
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The method developed to evaluate the hemocompatibility of artificial materials involves the determination of thromboxane production during the clotting of rabbit blood, in test tubes of different materials. The concentration of serum TXB2 obtained after incubation of whole blood in glass test tubes, for 40 min at 37 degrees C, averaged 416.8 +/- 23.3 ng/ml (mean +/- SE). Polymethylpentene, recognised as having a relatively poor blood compatibility, elicited 309.5 +/- 17.2 ng/ml of serum TXB2, while silicone and Avcothane, considered of better hemocompatibility, showed thromboxane levels of 276.2 +/- 28.2 and 222.9 +/- 31.5 ng/ml, respectively. These values validate the usefulness of the proposed method as a preliminary in vitro screening test of artificial materials intended for biomedical application.
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Our aim was to check the possibility of modifying the cardio-toxicity of Daunomycin and Adriamycin on guinea pig atria in vitro, through a reduction of calcium concentration in the medium. In a first series of tests, left and right atria still beating were put in a bath containing Tyrode solution. In order to test the influence of hypocalcic conditions on the negative inotropic effects of the two drugs. Tyrode solution contained either the usual amount of calcium or only 50% of it. In a second series of experiments isolated tissues were electrically stimulated in Krebs-bicarbonate solution. In order to avoid the spontaneous activity of the preparations, only isolated left atria were used. Again the medium contained either the normal quantity of calcium or only 50%. The reduction of calcium concentration in the medium results in a statistically significant potentiation of the negative inotropic activity of the two drugs.
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