Biomedical subjects

F Arena

Publications and source records attributed to F Arena.

At least 37 records · Page 2Linked to original sources

PubMed1997

Segmental up-regulation of transforming growth factor-beta in the pathogenesis of primary megaureter. An immunocytochemical study.

OBJECTIVE: To examine the maturational-delay hypothesis of primary megaureter (PM), i.e. that the condition arises by a segmental maturational delay of the ureteric wall that can resolve spontaneously within the first year of life, using comparative immunocytochemistry of ureters resected from infants and from homologous pre-natal ureters. MATERIALS AND METHODS: Seventeen distal urinary tracts were obtained from children with PM who were referred for surgery (aged 6 months to 8 years, mean 2.1 years). These were compared with ureteric buds obtained from 11-week-old human and 11- to 38-week-old calf fetuses. The samples were immunostained using a monoclonal antibody specific for transforming growth factor beta (TGF-beta). RESULTS: The histological appearances of the narrowed ureteric segments from patients under 18 months old were like the fetal ureteric buds at 26-38 weeks of gestation. Positive TGF-beta immunoreactions were detected in the longitudinal muscle layer in the ureter from patients 6-12 months old. Such reactions weakened progressively in those patients older than 1 year, becoming negative in all children older than 3 years. The TGF-beta immunolabelling in resected ureters was closely similar to that in fetal ureters from 20 to 26-week old calves. CONCLUSIONS: From these results, PM should be ascribed to a segmental developmental delay of the terminal ureter arising at about 20 weeks of gestation, with a possible pathogenetic involvement of autocrine TGF-beta overexpression.

Animals↗

PubMed1997

Nocturnal enuresis and daytime wetting: a multicentric trial with oxybutynin and desmopressin.

OBJECTIVE: Different etiopathological mechanisms of enuresis are today under study, and different therapies and drugs have been proposed. The Italian Multicentric Trial was undertaken in twelve pediatric and urological centers in order to assess the efficacy of two of the most popular drugs, desmopressin (DDAVP) and oxybutynin. METHODS: 114 enuretic patients were enrolled in the study. After a 2-week observation period, 66 patients with primary monosymptomatic enuresis were treated with DDAVP, 30 micrograms/day intranasally, for 6 weeks, 48 patients with enuresis and voiding dysfunction were randomly assigned to a protocol with oxybutynin alone or oxybutynin plus DDAVP. The efficacy of the two drugs was measured in terms of reduction of wet nights per week during the 6-week treatment period and a 2-week follow-up period. Children with 0-3 dry nights/week were considered as nonresponders. RESULTS: Patients with monosymptomatic enuresis treated with DDAVP reported a significantly lower number of wet night during treatment than during the baseline period, with 79% showing a 'good' (6-7 dry nights/week) or 'intermediate' response (4-5 dry nights/week). Of the patients with diurnal voiding disturbances and enuresis, those treated with oxybutynin alone had a 54% success rate. The patients treated with both oxybutynin and DDAVP showed a better response, with a 71% rate of success. CONCLUSIONS: The efficacy of the two drugs is confirmed in patients carefully selected on the clinical basis of voiding disturbances. In patients with enuresis and voiding dysfunction, the reduced urinary output and the lower bladder filling rate due to DDAVP can reduce uninhibited bladder contractions, thus enhancing the oxybutynin action.

Administration, Intranasal↗

PubMed1997

[The role of echotomography in minor renal traumatology].

We examined retrospectively the records of 108 patients with blunt renal trauma to determine the importance of echography as radiological investigations in minor renal trauma. Of patients 62 (66.6%) had a minor renal injuries, 21 (22.5%) had a moderate injuries and 10 (10.7%) had a major renal renal injuries. All patients who had microscopic hematuria without shock or other associated injuries had minor injuries. Echography and excretory urogram (IVP) confirmed the injuries except in 5 cases who presenting with only gross hematuria and the IVP don't confirmed the presence of a subcapsular hematoma identified by echography. Echography was more sensitive and specific than an IVP in minor renal trauma. Radiological investigations are not needed in those with microscopic hematuria and no shock or associated injuries, however we prefer performing ever an echography for medical and legal risk because a microscopic hematuria may include a neoplasm or other lesions.

Adolescent↗

PubMed1997

Research on heterocyclic compounds. XXXVIII. Synthesis and pharmacological activity of imidazo[1,2-b]pyridazine-2-carboxylic derivatives.

A series of imidazo[1,2-b]pyridazine-2-carboxylic acids, esters and amides was synthesized and tested for antiinflammatory, analgesic and ulcerogenic activities. The ethyl esters were prepared by cyclocondensation of some 3-aminopyridazines with ethyl bromopyruvate, followed by hydrolysis or ammonolysis in order to obtain the corresponding acids and amides. The inhibitory activity on the carrageenan-induced edema in the rat paw and on writhes induced by acetic acid in mice was evaluated, as well as the ulcerogenic action on the rat gastric mucosa. The pharmacological activity was discussed in terms of structure-activity relationships. In particular, the analgestic activity shown by these carboxylic derivatives was compared with that found in other series of imidazo[1,2-b]pyridazine analogues previously examined.

Amides↗

PubMed1996

A novel X-linked gene, DDP, shows mutations in families with deafness (DFN-1), dystonia, mental deficiency and blindness.

In 1960, progressive sensorineural deafness (McKusick 304,700, DFN-1) was shown to be X-linked based on a description of a large Norwegian pedigree. More recently, it was shown that this original DFN-1 family represented a new type of recessive neurodegenerative syndrome characterized by postlingual progressive sensorineural deafness as the first presenting symptom in early childhood, followed by progressive dystonia, spasticity, dysphagia, mental deterioration, paranoia and cortical blindness. This new disorder, termed Mohr-Tranebjaerg syndrome (referred to here as DFN-1/MTS) was mapped to the Xq21.3-Xq22 region2. Using positional information from a patient with a 21-kb deletion in chromosome Xq22 and sensorineural deafness along with dystonia, we characterized a novel transcript lying within the deletion as a candidate for this complex syndrome. We now report small deletions in this candidate gene in the original DFN-1/MTS family, and in a family with deafness, dystonia and mental deficiency but not blindness. This gene, named DDP (deafness/ dystonia peptide), shows high levels of expression in fetal and adult brain. The DDP protein demonstrates striking similarity to a predicted Schizosaccharomyces pombe protein of no known function. Thus, is it likely that the DDP gene encodes an evolutionarily conserved novel polypeptide necessary for normal human neurological development.

Abnormalities, Multiple↗

PubMed1996

Traumatic injury of the penis: surgical management.

Three cases of penile injury secondary to mishap during sexual intercourse are described. The injury involved unilateral corpus cavernosum associated with urethral rupture in one case, penile fracture in the second patient and isolated urethral fracture in the third. Diagnosis and treatment of these uncommon lesions are discussed.

Adult↗

PubMed1996

[Gittes' pubovaginal suspension in the treatment of stress urinary incontinence (SUI)].

Since the 1993, a series of 22 women with stress urinary incontinence underwent bladder neck suspension, according to Gittes (pubovaginal suspension). No patients had preoperative detrusor instability or intrinsic sphincter dysfunction; 14 pts had a significant cystocele (II-III degree). We followed up 20 pts at 6 months: 9 pts (45%) were cured, 3 were significantly improved and 8 were not improved. Disappearance or marked improvement of moderate or severe cystocele wasn't confirmed in all pts. No serious complications were recognized. We believe that this procedure is quick and easy to perform with low morbidity and is useful where the indication is correct: patients with stress incontinence without significant anterior vaginal wall prolapse.

Aged↗

PubMed1996

[The use of PGE1 in the treatment of erectile deficiency].

A total of 118 patients entered into a pharmacological erection program using prostaglandin E1 (PGE1) from September 1994 to November 1995. Of the men 20 (16.9%) used PGE1 on a regular basis, median duration of drug use was 4 months with a range of 2 to 14 months, while 66 (55.9%) failed to continue in the program after the dose titration period, (median duration of drug use 6 weeks), 32 (27.1%) failed to initiate PGE1 pharmacological erection program. There have been no instances of cavernous fibrosis, systemic reaction, penile pain after injection or priapism (erection present longer than 4 hours) in any patient; 24 (20.3%) men were unable to achieve an adequate erection with PGE1 intracavernous injections. PGE1 appears to have a lower risk of prolonged erections than other intracavernous agents and will continue to increase in popularity. However we report an interesting number of men who fail to continue (55.9%) or fail to initiate (16.9%) PGE1 therapy.

Alprostadil↗

PubMed1996

[Respiratory syncytial virus lower respiratory tract infection: our series].

The authors report 57 cases of Respiratory Syncytial Virus (RSV) lower respiratory tract infection. The diagnosis was performed by detection of specific serum antibodies of IgM class or by direct detection of RSV antigens in nasopharyngeal specimens. Most of the patients were younger than one year. No one had risk factors for severe RSV infection form. All patients recovered. The authors emphasize the difficulties to discriminate between bronchiolitis and interstitial pneumonitis on the basis of the clinical and radiological features.

English Abstract↗

PubMed1995

Tamponade in patients undergoing cardiac surgery: a clinical-echocardiographic diagnosis.

The purpose of this study was to evaluate the sensitivity of current echocardiographic criteria in detecting cardiac tamponade in the patient who has undergone cardiovascular surgery. Because the current echocardiographic criteria for tamponade were initially developed and studied predominantly in patients with medical problems, relatively less information is available in patients who have undergone cardiac surgery. Of 848 consecutive patients who underwent cardiovascular surgery, patients were selected for the study if they had clinical or hemodynamic deterioration and had undergone an echocardiogram just before a successful pericardiocentesis or a surgical evacuation of pericardial blood or clot. The echocardiograms were evaluated for evidence of chamber collapse, cardiac motion, Doppler flow variations, and the location and width of pericardial separation. Fourteen patients were identified who met the inclusion criteria (clinical or hemodynamic deterioration, recent echocardiogram, and successful intervention) for cardiac tamponade. The clinical and hemodynamic findings were hypotension (13 patients), low cardiac output (7), low urine output (3), cardiopulmonary arrest (1), elevated central venous pressure (1), and shortness of breath (1). In these patients current echocardiographic criteria were seen infrequently: chamber collapse in the right atrium (6 of 14 patients) and right ventricle (4 of 14); Doppler flow variation (2 of 5); and swinging heart (0 of 15), whereas increased pericardial separation (> or = 10 mm) was seen in all (14 of 14) the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

A new X linked recessive deafness syndrome with blindness, dystonia, fractures, and mental deficiency is linked to Xq22.

X linked recessive deafness accounts for only 1.7% of all childhood deafness. Only a few of the at least 28 different X linked syndromes associated with hearing impairment have been characterised at the molecular level. In 1960, a large Norwegian family was reported with early onset progressive sensorineural deafness, which was indexed in McKusick as DFN-1, McKusick 304700. No associated symptoms were described at that time. This family has been restudied clinically. Extensive neurological, neurophysiological, neuroradiological, and biochemical, as well as molecular techniques, have been applied to characterise the X linked recessive syndrome. The family history and extensive characterisation of 16 affected males in five generations confirmed the X linked recessive inheritance and the postlingual progressive nature of the sensorineural deafness. Some obligate carrier females showed signs of minor neuropathy and mild hearing impairment. Restudy of the original DFN-1 family showed that the deafness is part of a progressive X linked recessive syndrome, which includes visual disability leading to cortical blindness, dystonia, fractures, and mental deficiency. Linkage analysis indicated that the gene was linked to locus DXS101 in Xq22 with a lod score of 5.37 (zero recombination). Based on lod-1 support interval of the multipoint analysis, the gene is located in a region spanning from 5 cM proximal to 3 cM distal to this locus. As the proteolipid protein gene (PLP) is within this region and mutations have been shown to be associated with non-classical PMD (Pelizaeus-Merzbacher disease), such as complex X linked hereditary spastic paraplegia, PLP may represent a candidate gene for this disorder. This family represents a new syndrome (Mohr-Tranebjaerg syndrome, MTS) and provides significant new information about a new X linked recessive sydromic type of deafness which was previously thought to be isolated deafness.

Adolescent↗

PubMed1995

[Extracorporeal shockwave lithotripsy (ESWL). Our experience].

The authors report their experience with a third generation lithotripter Storz-Modulith SL 20 with fluoroscopic and echography stone localization. A total of 284 patients, between september '92 and august '94, with 149 renal and 135 ureteral stones, underwent 483 treatments. The mean treatment rate was 1,7 and the over-all stone free rate was 93%. Auxiliary procedures before ESWL were performed in 5.1% of the sessions (stenting, nephrostomy tube) and in 1% post-ESWL manipulations for lithiasic steinstrasse. Complications as: renal damage, steinstrasse etc. occurred in 2.5% of the session; in 20 patients ESWL procedure failed.

Adult↗

PubMed1995

Research on heterocyclic compounds. XXXIII--Synthesis and analgesic activity of imidazo[1,2-b]pyridazine-2-acetic acid derivatives.

A series of imidazo[1,2-b]pyridazine-2-acetic esters, acids and amides was synthesized and tested for antiinflammatory, analgesic and ulcerogenic activities. The ethyl esters were prepared by cyclocondensation of some 3-aminopyridazines with ethyl 4-chloroacetoacetate, followed by hydrolysis or ammonolysis in order to obtain the corresponding acids and amides. The capacity of inhibiting the carrageenan-induced edema in the rat paw and the writhes induced by acetic acid in mice were evaluated, as well as the ulcerogenic action in rats. The acidic derivatives showed significant analgesic activity which is comparable to that found in other series of imidazo[1,2-b]pyridazine analogs previously examined.

Analgesics↗

PubMed1995

[Venous leakage impotence: anatomical and physiological considerations upon gravity cavernosometry and radio-fluorographic cavernosography].

We performed gravity cavernosometry and radio-fluoro-graphic cavernosography with pharmacological intracavernous injection in 15 patients with erectile dysfunction. On the basis of cavernosographyc findings, in the 15 patients leak sites visualized included deep dorsal vein in all 15 patients leak sites visualized included deep dorsal vein in all 15 patients (100%), cavernous veins in 7 (46,6%), glans in 4 (26,6%) and corpus spongiosum in 3 (20%). Aberrant veins documented in 4 patients (26,6%): communicating with the saphenous vein in 2 (13,3%), with scrotal veins and femoral vein in 1 (6,6%). Deep dorsal vein leakage as the only venous site was find in 2 patients (13.3%), 9 (60%) had leakage through 2 venous sites, 3 (20%) had leakage through 3 venous sites and 1 (6,6%) had leakage through 4 venous sites. Correlations among hemodynamic and radiographic observations allowed the identification of 2 types of cavernosometric findings. While type I developed an high intracavernous pressure during gravity infusion, an high intracavernous pressure was not observed in type 2. The FCG by the digital radio-fluoro-graphic digital system permit the possibility of sottraction and rielaboration of images and reduces examination and radiation time. The gravity FCM is simple, not expensive and respect the physiological intracavernous pressure.

Adult↗

PubMed1995

Orthotopic ileal neobladder: our experience.

We report our experience with orthotopic ileal neobladder, after radical prostatocistectomy for local advanced cancer. We performed 2 reservoirs using Camey's I-II procedure, 4 Studer, 3 Hautmann, 4 VIP and 17 performed using staplers, according to Rouxel-Coadou's technique (we underline the simplicity and speed of automatic stapling devices, very important elements for surgical staff performance in this kind of surgery). Clinical and urodynamic evaluations were performed at 3,6,12,18 months and after every year (mean follow-up 18 months). All patients referred day-time continence already 3 months and 7/10 pts (70%) night-time continence too, after 24 months; the others referred moderate incontinence (1 pad for night). The urethral sphincter was well preserved in all patients (MUCP 72,4 cm H2O). At 18 months, post-void residual volume was absent, basal cystometric pressure was 10-15 cm H2O and mean neobladder capacity was 475 ml. We report 2 cases of reservoir calculosis, 2 stenosis of neobladder-urethral anastomosis and 2 pts with I-II grade hydronephrosis (in first case it's monolateral, the second is a bilateral case) owing to a stenosis of ureteral-ileal anastomosis. In short, the use of debutularizated and bended ileum allows to achieve a low pressure with an adequate capacity and continent orthotopic reservoir.

Follow-Up Studies↗

PubMed1995

[Clinical effects of verapamil in the treatment of Peyronie's disease].

Calcium antagonist increase extracellular matrix collagenase activity as well as decrease collagen, fibronectin synthesis and secretion, altering fibroblastic metabolism. Preliminary findings reports that Verapamil improves would healing; Levine (1994) suggest that intralesional calcium antagonist (Verapamil) therapy offers an economical and sensible non operative approach for the treatment of Peyronie's disease. We studied and verified the effect of Verapamil in Peyronie's plaque on 39 men. They received injections of Verapamil bi-weekly in to the plaques for 6 months. Subjectively, improvement in rigidity was observed in 23,1% and a plaque softening observed in 48,7%. Rapid resolution of pain was verified in 90,9%. Objectively, curvature improved in 50% of those in which the diagnosis of Peyronie's disease was less than one year old, but in only 10.2% when disease lasted more than one year. A decreased plaque volume was not observed. There was no toxicity related to Verapamil effect. In this nonrandomized study we retained that Verapamil appears to result in an improvement in patients with symptoms lasting less than one year. For patients without pain with symptoms related to more than one year, Verapamil had no important effect.

Calcium Channel Blockers↗

PubMed1993

[The role of LH-RH analogue in benign prostatic hyperplasia].

In our study 7 patients considered high risk for any surgical and anesthetic intervention, with benign prostatic hyperplasia, whose 2 with permanent catheter, were treated for 6 months with luteinizing hormone-releasing hormone analogue. The treatment resulted in an average decrease in prostatic volume of 21.7%; reduced the serum PSA/PAP values of 52% and 43%, respectively; 4 pz improved their symptom score (1 pz removed the permanent catheter), 2pz kept stationary and 1 pz made worse. No particular side effects were presented and all patients finished the therapy. We conclude that LH-RH analogue therapy should be restricted to selected patients and then it will have to be continued for a long period of time.

Aged↗

PubMed1992

Research on heterocyclic compounds. XXX. Synthesis and pharmacological activity of 2-methylimidazo[1,2-b]pyridazine-3-carboxylic acids.

A group of ethyl 2-methylimidazo[1,2-b]pyridazine-3-carboxylates were prepared by reaction in anhydrous ethanol of some substituted 3-amino-pyridazines with ethyl 2-chloroacetoacetate. The corresponding carboxylic acids were obtained via alkaline or acid hydrolysis and then tested both in vivo to evaluate their antiinflammatory, analgesic and ulcerogenic actions and in vitro for their ability to inhibit the prostaglandin biosynthesis. The pharmacological results are discussed in terms of both structure-activity relationships and mechanism of action.

Animals↗