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Biomedical subjects

F Ceccarelli

Publications and source records attributed to F Ceccarelli.

At least 19 recordsLinked to original sources
PubMed2005

Nailfold capillaroscopy changes in systemic lupus erythematosus: correlations with disease activity and autoantibody profile.

In systemic lupus erythematosus (SLE) nailfold capillaroscopy (NC) studies have described many different nonspecific patterns. We decided to evaluate NC changes in 44 SLE patients, comparing them with the main clinical, demographic and laboratory parameters, thus to define the real role for NC and its abnormalities in the management of this disease. Fifteen patients (34%) complained of Raynaud's phenomenon; nine of them (20%) showed relevant capillaroscopic changes (capillaroscopic score >1). In details: three patients (6.8%) had loss of capillaries, while 18 (41%) had a capillary length variability, 16 (36.5%) showing shorter and two (4.5%) longer capillaries; tortuous, meandering, bizarre, ramified and/or bushy capillaries were found in 26 (59%), seven (16%), two (4.5%), three (7%) cases, respectively. An irregular distribution of the capillary array was present in six cases (14%) while microhaemorrhages were found in four cases (9%). 4 patients (9%) showed enlarged capillaries and changes of blood flow. A capillaroscopic score >1 was more frequently associated with higher ECLAM (P < 0.005) and SLEDAI (P < 0.01) activity scores, with the presence of anti-cardiolipin (P < 0.04) and anti-Sm (P < 0.04) antibodies, and also with the presence (P < 0.04) and higher titer (P < 0.001) of anti-dsDNA antibodies. No statistically significant correlation was found among the different capillaroscopy findings, age, disease duration, or treatment, nor with any clinical manifestation of the disease, such as cutaneous, renal or neurological. Our findings confirm the importance of the microvascular involvement in SLE. The NC abnormalities seem to be related to the disease activity and to the presence of many different antibodies, highly involved in the expression of SLE. NC proved to be an easy-to-perform noninvasive technique, able to achieve useful data to better evaluate such a pleomorphic disease as SLE.

Adolescent↗
PubMed2003

Interleukin-13 in systemic sclerosis: relationship to nailfold capillaroscopy abnormalities.

The aim of this study was to investigate whether interleukin-13 (IL-13) serum levels correlate to different nailfold capillaroscopy (NC) findings in patients with systemic sclerosis (SSc). IL-13 serum levels were measured using an ELISA method. The following NC abnormalities were considered: the presence of giant loops, haemorrhages, loss of capillaries, disorganisation of the vascular array, ramified/bushy capillaries and sludging of blood. A semiquantitative rating scale was adopted to score these changes, as well as a rating system for avascular areas and three morphological NC patterns ('early', 'active' and 'late'). Mean capillary density was determined by counting the total number of capillaries in a 1 mm length, and the arterial and venous diameters of the capillary as well as the total loop diameter were measured. In SSc patients IL-13 serum levels were significantly higher than in controls ( P < 00.1), whereas in patients with ( n=8) and without ( n=24) abnormal IL-13 serum levels (>17 pg/ml) the comparison of the NC features showed significantly relevant differences concerning a more frequent 'active' NC pattern ( P < 0.02), the presence of haemorrhages ( P < 0.0037) and sludging of blood ( P < 0.038), as well as larger total loop ( P < 0.036) and arterial ( P < 0.03) diameters, in those patients with elevated IL-13 serum levels. The study confirmed that IL-13 serum levels are higher in the sera of patients with SSc, and shows for the first time the significant correlations between this serological finding and some of the main relevant SSc capillaroscopic features, leading us to believe that this cytokine not only seems to sustain the immunological and fibrotic process of SSc, but might have a role in determining the more severe microvascular lesions in this disease.

Adult↗
PubMed2001

Regulation of agonist binding to rat ET(B) receptors by cations and GTPgammaS.

Endothelins exert their physiological effects through interaction with cell surface receptors that are members of the G-protein-coupled receptor family. The endothelin receptor subtype B (ET(B) receptor) is abundantly expressed in rat cerebellum. Since agonist binding to G-protein-coupled receptors may be modulated by cations and guanine nucleotides, we investigated the effects of cations and guanosine 5'-O-(2-thiotriphosphate) (GTPgammaS) on 125I-endothelin-1 (125I-ET-1) binding to rat cerebellar membranes. Both Na+ and Mg2+-stimulated 125I-ET-1 binding causing an increase in receptor affinity for the agonist. While the effect of the divalent cation was evident at relatively low concentrations (5-10 mM), the stimulatory activity of the monovalent cation appeared at relatively high concentrations (50 mM). Additive activities of 25-50 mM NaCl and 1 mM MgCl2 suggested that monovalent and divalent cations increased receptor affinity for ET-1 by different mechanisms. In the presence of 5 mM MgCl2, 50 mM NaCl caused an additional modest reduction of the Kd value. Whereas 5 mM MgCl2 affected the displacement curves of both ET-3 and suc-[Glu9, Ala11,15]-endothelin-1 (8-21) (IRL 1620), the influence of 50 mM NaCl on these curves was less substantial. All together, these results suggest that modulation of receptor affinity by NaCl depends on the nature of the displacing agonist. In the presence of 5 mM MgCl2 or 50 mM NaCl, a partial regulation of 125I-ET-1 binding by GTPgammaS was detectable, while in the absence of cations no GTPgammaS-dependent inhibition was evident.

Animals↗
PubMed2001

Probing the shape of a hydrophobic pocket in the active site of delta-opioid antagonists.

The change of selectivity and the induction of antagonism by the insertion of 1,2,3,4-tetrahydroisoquinoline-3-carboxylic acid (Tic) in the second position of several opioid peptides have led to the interpretation of Tyr-Tic as a specific message domain for delta-opioid antagonists and to the discovery of dipeptides with substantial opioid activity. Selectivity and activity increase enormously when Tyr is substituted by 2',6'-dimethyl tyrosine (Dmt), hinting that the side chain of Dmt fits a hydrophobic cavity of the receptor very tightly and precisely. We have investigated the specificity of this fit by systematic changes of the substituents on the aromatic ring of ryr. Mono- and disubstitutions different from 2',6'- invariably lead to catastrophic decreases of activity. The only substitution compatible with retention of substantial antagonism is 2-methyl. An analysis of the conformational properties of all analogues reveals that substitutions do not affect the global shape of the molecule significantly. Accordingly, it is possible to use the shape of the different side chains to map the hydrophobic cavity of the receptor. The resulting complementary image is funnel shaped.

Amino Acid Substitution↗
PubMed2001

Binding characteristics of ET receptors in retinal pericytes and effects of high glucose incubation.

PURPOSE: Autoregulation and control of blood flow within the retina is dependent on vascular endothelial release of vasoconstrictors and dilators. The effector cells are the pericytes and vascular smooth muscle cells of the retinal microvascular bed. Many studies show that the responses of these effector cells are affected by diabetes or artificially elevated glucose. In particular, the contractile response of pericytes to endothelin-1 (ET-1) is markedly reduced. ET-1 and related isopeptides exert their effects by binding and activating specific cell surface receptors (ETRs). Pericytes express two subtypes of ETRs, ET(A) and ET(B). The purpose of this study was to assess the dynamics of [(125)I]ET-1 binding to ET(A) and ET(B) receptors when cultured in normal and high glucose concentrations. METHODS: Bovine retinal pericytes (BRP) were exposed to normal (5 mM) or high glucose (25 mM) concentrations for up to 14 days. Displacement of binding and competitive inhibition of binding was carried out in perictye membranes. mRNA expression for ETR subtypes was examined using northern blotting. The expression of G protein alpha subunits (Galpha(s) and Galpha( q)) was detected by western blotting. RESULTS: Highly specific binding of [125I]ET-1 was seen with BRP membranes. In competition assays, ET-3 was found to displace [125I]ET-1 binding to BRP membranes in a biphasic manner, indicating the presence of two classes of binding sites. The presence of both ETR subtypes was supported by competition experiments with selective ligands. The expression of Galpha(s) and Galpha(q) subunits decreased in pericytes incubated with 25 mM glucose. Conclusions. No significant differences in binding parameters were evident after culture in high glucose concentrations. However northern blot analysis which confirmed the presence of ET(B) receptor mRNA did identify an increase in the expression of this receptor.

Animals↗
PubMed2001

Mortality from cardiovascular diseases and exposure to inorganic mercury.

OBJECTIVE: To study the mortality from cardiovascular and other chronic non-neoplastic diseases after long term exposure to inorganic mercury. Limited information is available on the effect of chronic exposure to mercury on the cardiovascular system. METHODS: The mortality was studied among 6784 male and 265 female workers from four mercury mines and mills in Spain, Slovenia, Italy, and the Ukraine. Workers were employed between 1900 and 1990; the follow up period lasted from the 1950s to the 1990s. The mortality of the workers was compared with national reference rates. RESULTS: Among men, there was a slight increase in overall mortality (standardised mortality ratio (SMR) 1.08, 95% confidence interval (95% CI) 1.04 to 1.12). An increased mortality was found from hypertension (SMR 1.46, 95% CI 1.08 to 1.93), heart diseases other than ischaemic (SMR 1.36, 95% CI 1.20 to 1.53), pneumoconiosis (SMR 27.1, 95% CI 23.1 to 31.6), and nephritis and nephrosis (SMR 1.55, 95% CI 1.13 to 2.06). The increase in mortality from cardiovascular diseases was not consistent among countries. Mortality from hypertension and other heart diseases increased with estimated cumulative exposure to mercury; mortality from ischaemic heart disease and cerebrovascular diseases increased with duration of employment, but not with estimated exposure to mercury. Results among women were hampered by few deaths. CONCLUSION: Despite limited quantitative data on exposure, possible confounding, and likely misclassification of disease, the study suggests a possible association between employment in mercury mining and refining and risk in some groups of cardiovascular diseases.

Cardiovascular Diseases↗
PubMed2000

Double-blind manometric assessment of two topical glyceryl trinitrate formulations in patients with chronic anal fissures.

BACKGROUND: Chronic anal fissure is a frequent and troubling condition, that may need surgical sphincterotomy for relief of symptoms. However, this approach may yield minor incontinence in up to 30% of cases. Interest has, therefore, recently increased in "chemical sphincterotomy" by using topical glyceryl trinitrate ointment. Unfortunately, there is, to date, no specific pharmaceutical preparation of such compound. AIMS: To compare, according to a randomized double-blind crossover study, the effects of a pharmaceutical preparation of a specific 0.2% glyceryl trinitrate ointment (PMF 303) and of the common preparation reported in the literature on the anal resting pressure in patients with anal fissure. PATIENTS AND METHODS: Twelve patients with chronic anal fissure (6 males and 6 females, age range 23-60 years] were recruited for the study. Two paired manometric studies were carried out at one-week intervals. After the basal anal pressure had been assessed, the patients were randomized to receive either one of the two preparations, and manometric measurements were repeated at 20, 40 and 60 minutes. RESULTS: No differences were found between anal resting pressure in the basal study. Both preparations were able to significantly decrease (p=0.001) anal pressure throughout the study period. No significant differences were found between the two preparations. CONCLUSIONS: PMF 303 is able to decrease anal pressure in patients with anal fissure, to a similar extent to the widely tested (galenic) literature preparation. Availability of a specific formulation for the treatment of this condition may be clinically useful.

Administration, Topical↗
PubMed2000

Surgical versus non-surgical treatment of calcaneal fractures in children: a long-term results comparative study.

This study compared surgical and non-surgical treatment of 46 calcaneal fractures in children aged 3-17 years. Patients were divided into: Group A ranging 3-14 years and Group B 15-17 years, and classified according to surgical or non-surgical treatment. Mean follow-up was 22.8 years. Extra-articular fractures were treated non-surgically and all results were satisfactory. Results of articular fractures in Group A were satisfactory regardless of the type of treatment. Articular fractures surgically treated in group B were satisfactory, and those non-surgically treated were mainly poor. Extra-articular fractures can be treated non-surgically. Articular fractures in skeletally immature children can be treated non-surgically; conversely, those in children with skeletal maturity must be treated surgically.

Adolescent↗
PubMed1999

Multiroute exposure assessment and excretion of urinary metabolites of fenitrothion during manual operations on treated ornamental plants in greenhouses.

The results of environmental and biological (five subjects) monitoring of exposure to fenitrothion during manual operations on treated ornamental plants in greenhouses are reported. Urinary excretion [GM (GSD)] of alkylphosphates [dimethylphosphate (DMP) + dimethylthiophosphate (DMTP)] (nmol/g creat) was 244.8 (1.8), 174.0 (2.0), and 354.4 (1.6) respectively, on the first (Monday), third (Wednesday), and fifth (Friday) days of work. These levels were not significantly higher than those recorded in a control group (21 subjects) in which urinary excretion [GM (GSD)] of DMP + DMTP was 102.8 (4.2) nmol/g creat. Air concentrations of fenitrothion (nmol/m3) ranged from 45.5 to 81.2 on Monday, 17.3 to 27.1 on Wednesday, and 9.7 to 19.1 on Friday. Dose estimates showed that the respiratory-absorbed doses of fenitrothion accounted, on the average (GM), for 94.7%, 93.1%, and 91.5% of the total absorbed dose on Monday, Wednesday, and Friday, respectively. Multiple regression analysis showed a significant correlation (r2 = 0.595) between urinary excretion of DMP + DMTP, respiratory-absorbed dose, and skin-absorbed dose, estimated on Monday and Wednesday. Total estimated absorbed doses did not exceed the acceptable daily intake for fenitrothion. Serum and erythrocyte cholinesterase activities were not significantly different before and after exposure.

Adult↗
PubMed1999

Suc-[Glu9,Ala11,15]-endothelin-1 (8-21), IRL 1620, identifies two populations of ET(B) receptors in guinea-pig bronchus.

The pharmacological properties of endothelin receptors (ETR) were investigated in guinea-pig bronchus by comparing binding and functional results. In binding assays, both the ET(B) agonists, endothelin-3 (ET-3) and N-suc-[Glu9,Ala11,15]ET-1(8-21) (IRL 1620), and the antagonist, N-cis-2,6-dimethylpiperidinocarbonyl-L-gamma-methylleucyl-D- 1-methoxycarbonyltryptophanyl-D-norleucine (BQ 788), showed biphasic inhibition curves of [125I]-endothelin-1 (ET-1) binding to bronchus membranes prepared from intact or epithelium-deprived tissue. IRL 1620 did not completely displace specifically [125I]-ET-1 bound to these tissue preparations. In the presence of the ET(A)-selective antagonist, cyclo(-D-Trp-D-Asp-L-Pro-D-Val-L-Leu) (BQ 123, 1 microM), IRL 1620 displacement curves were shallow but a complete inhibition was reached at a concentration of 1 microM. Both curves were better represented by two-site models. In addition, BQ 788 competition curves became monophasic when binding experiments were performed in the presence of 1 microM BQ 123. The non-selective agonist, ET-1, and BQ 123 inhibited [125I]-ET binding to bronchus membranes in dose-dependent fashions with monophasic curves. The contracting activity of IRL 1620 (0.55 nM- 1.6 microM) was tested on multiple-ring bronchial preparations pretreated with peptidase and cyclo-oxygenase inhibitors. BQ 788 shifted IRL1620 concentration-response curves to the right while BQ 123 did not influence bronchial responsiveness. In addition, a potentiation of the maximal response to the agonist was observed in BQ 788 treated bronchial rings. This effect was abolished by tissue pretreatment with Nomega-nitro-L-argininemethylester (L-NAME) or epithelium removal but not by pretreatment with atropine or iberiotoxin. Our results demonstrate that guinea-pig bronchus contains two populations of ET(B) receptors with different affinities for the ET(B)-selective agonist, IRL 1620. One ET(B) receptor population appears to activate bronchial muscle contraction while another on epithelial cells causes muscle relaxation through the release of nitric oxide (NO).

Animals↗
PubMed1999

p53 overexpression in lymph node metastases predicts clinical outcome in ductal pancreatic cancer.

In this study, we evaluated the prognostic significance of both p53 overexpression and proliferating activity in 133 primary ductal pancreatic carcinomas and in their regional synchronous lymph node metastases by immunohistochemistry, by using DO7 and MIB1 monoclonal antibodies, respectively. Tumor samples and lymph nodes were obtained from formalin-fixed, paraffin-embedded archival material of patients operated on between 1976 and 1996. Patients had a well-documented clinical history and were given accurate follow-up. p53 accumulation was observed in 77 (54%) of 133 primary tumors and in 22 (44%) of 50 patients with nodal metastases. The p53 overexpression was directly related to proliferating activity (p = 0.01) in the primary tumors. A significant direct correlation was present between the p53 expression in the primary tumor and in nodal metastases (p = 0.01); the same occurred for proliferating activity by MIB1 (p = 0.002). The patients' overall survival was affected by the presence of nodal (p = 0.02) and distant (p = 0.0001) metastases. The p53 immunoreactivity in nodal metastases was associated with a statistically significant decrease in the postoperative survival period (p = 0.005). Multivariate analysis confirmed these results, and the only two parameters that maintained statistical significance were M1 status (p = 0.0006) and p53 overexpression in nodal metastases (p = 0.01).

Adenocarcinoma↗
PubMed1998

Historical exposure to inorganic mercury at the smelter works of Abbadia San Salvatore, Italy.

Metallic mercury production from cinnabar ore may result in high exposures to inorganic mercury, that are difficult to assess separately from the exposures originating from underground extraction, and previously have only been scantily described. We retrieved and analysed the air and biological mercury determinations on workers involved in the smelting process of the Abbadia San Salvatore mine (Monte Amiata, Italy). Native mercury was not present in the ore, and the exposure in the underground extraction was low. The smelter operated from 1897 to 1983. Blood and urine (24/h urine collections and concentration samples) had been sampled in 1968 to 1982, and analysed for mercury by atomic absorption spectrophotometry, and relate to all subjects. Exposure to mercury in air had been determined in a small set of personal samples in 1982. The data relate to all jobs in the smelter process, and all jobs entailed substantial exposure to mercury. The overall distribution of breathing zone air, blood and urinary levels is right-skewed and similar to the log-normal distribution (air, median 48 micrograms/m3, n = 49; blood, arithmetic mean AM 49 micrograms/L; geometric mean GM 26 micrograms/L, n = 192; urinary excretion, AM 140 micrograms/24 h, GM 78 micrograms/24 h, n = 839; and urinary concentration, AM 160 micrograms/L, GM 83 micrograms/L, n = 632). Air, blood and urinary values show a high ratio of the between- and within-job variance, indicating differences in exposure by job. Cinnabar pigment production, of which the exposure has not been characterised previously, was the job with the highest air (AM 160 micrograms/m3) and urinary levels (excretion AM 690 micrograms/24 h; concentration AM 1100 micrograms/L). Other jobs with high urinary levels were soot purification, laboratory work, and bottling. Cleaning of condensers showed the highest blood level (AM 280 micrograms/L). There is a downwards time trend in mercury concentration in blood and in urine. The corresponding trend is not seen for urinary excretion levels, the reason for this being unclear. Roasters, which is the most frequently monitored group, show however a decreasing trend in all sets of data (e.g. the mean of urinary excretion decreased from 300 micrograms/24 h in 1968/69 to 50 micrograms/24 h in 1980/81). The mercury exposure experienced by the smelters of Abbadia San Salvatore is in line with the few available data on workers from other mercury mines and smelters, and our data confirm the high exposure levels in this occupational group, in particular at cinnabar pigment production, soot purification, and condenser cleaning.

Aerosols↗
PubMed1998

Cancer occurrence among European mercury miners.

OBJECTIVES: To study the carcinogenicity of inorganic mercury in humans. METHODS: We studied the mortality from cancer among 6784 male and 265 female workers of four mercury mines and mills in Spain, Slovenia, Italy and the Ukraine. Workers were employed between the beginning of the century and 1990; the follow-up period lasted from the 1950s to the 1990s. We compared the mortality of the workers with national reference rates. RESULTS: Among men, there was no overall excess cancer mortality; an increase was observed in mortality from lung cancer (standardized mortality ratio [SMR] 1.19, 95 percent confidence interval [CI] 1.03-1.38) and liver cancer (SMR 1.64, CI 1.18-2.22). The increase in lung cancer risk was restricted to workers from Slovenia and the Ukraine: no relationship was found with duration of employment or estimated mercu ry exposure. The increase in liver cancer risk was present both among miners and millers and was stronger in workers from Italy and Slovenia: there was a trend with estimated cumulative exposure but not with duration of employment, and the excess was not present in a parallel analysis of cancer incidence among workers from Slovenia. No increase was observed for other types of cancer, including brain and kidney tumours. Among female workers (Ukraine only), three deaths occurred from ovarian cancer, likely representing an excess. CONCLUSIONS: Exposure to inorganic mercury in mines and mills does not seem strongly associated with cancer risk, with the possible exception of liver cancer; the increase in lung cancer may be explained by co-exposure to crystalline silica and radon.

Carcinogens↗
PubMed1996

Exposure-response relationship for vibration-induced white finger among forestry workers.

The relation between the occurrence of white finger and vibration exposure was investigated in a group of 222 forestry workers using chain saws. The forestry workers and 195 controls never exposed to hand-transmitted vibration were interviewed by occupational health physicians. The diagnosis of vibration-induced white finger (VWF) was made on the basis of subjective symptoms of finger blanching and the results of a cold test with plethysmographic measurement of finger systolic blood pressure. Vibration was measured on a representative sample of AV and non-AV chain saws. Daily vibration exposure was assessed in terms of 8 h energy-equivalent frequency-weighted acceleration [A(8)]. A lifetime vibration dose was estimated for each of the forestry workers. The overall prevalence of VWF among the forestry workers was 23.4%. Raynaud's phenomenon was discovered in 2.6% of the controls. In the forestry workers, the risk of VWF showed positive increments with each increment of vibration dose, suggesting a monotonic dose-response relationship. The responsiveness to cold in the digital arteries of the forestry workers was also found to increase with increasing vibration dose. The estimated relation between VWF and vibration exposure showed that the expected occurrence of VWF increased in approximately linear proportion to either A(8) (with exposure duration unchanged) or the number of years of exposure (with equivalent acceleration unchanged). In this study of VWF among forestry workers the estimated exposure-response relation showed that if the magnitude of vibration acceleration is doubled, the total duration of exposure should be halved to produce an equivalent effect. On the basis of the assessment of vibration exposure, the estimated risk for VWF in the study population was found to be lower than that predicted by the International Standard ISO 5349. The results of this study tend to support the vibration exposure levels currently under discussion within the European Union.

Adult↗
PubMed1995

Dose-response relation for vascular disorders induced by vibration in the fingers of forestry workers.

OBJECTIVES: To study the relation between the prevalence of vascular disorders (white finger) and vibration exposure in a group of 222 forestry workers, of whom 164 (73.9%) had work experience limited to antivibration (AV) chain saws only and 58 (26.1%) had operated both non-AV and AV chain saws. METHODS: The chain saw operators and 195 control workers never exposed to hand transmitted vibration were interviewed with health and workplace assessment questionnaires. The diagnosis of vibration induced white finger (VWF) was made on the basis of subjective symptoms of finger blanching and the results of a cold test with plethysmographic measurement of systolic blood pressure of the finger. Vibration was measured on a representative sample of AV and non-AV chain saws. Daily vibration exposure was assessed as eight hour energy equivalent frequency weighted acceleration (A(8)). A lifetime vibration dose was estimated for each of the forestry workers. RESULTS: The overall prevalence of VWF among the forestry workers was 23.4%. The diagnosis of VWF was made in 13.4% of the forestry workers who handled only AV chain saws and in 51.7% of those who had also operated non-AV chain saws in the past. Raynaud's phenomenon was found in 2.6% of the controls. In the forestry workers, the risk for VWF showed positive increments with each increment of vibration dose, suggesting a monotonic dose-response relation. The responsiveness to cold in the digital arteries of the forestry workers was also found to increase with increasing vibration dose and severity of VWF. The estimated relation between VWF and vibration exposure showed that the expected prevalence of VWF increased almost linearly to either A(8) (with exposure duration unchanged) or the number of years of exposure (with equivalent acceleration unchanged). CONCLUSIONS: In this study of VWF among forestry workers, the estimated dose-response relation showed that if the magnitude of vibration acceleration is doubled, the total duration of exposure should be halved to produce an equivalent effect. On the basis of the assessment of vibration exposure, the estimated risk for VWF in the study population was found to be lower than that predicted by the international standard ISO 5349. These findings suggest a revision of the risk estimates for VWF currently provided by ISO 5349.

Case-Control Studies↗
PubMed1995

[Assessment of sapheno-femoral junction continence in 42 patients with primary varicocele].

Varicose veins present a major health problem, causing chronic leg symptoms and disability to a large segment of population. The prevalence rate in adults shows great geographical variations and increases with age. Several authors reported that most cases of primary varicose veins are due to valvular incompetence of saphenofemoral junctions. On the base of close physiopathologic and hemodynamic relationships between primary varicose veins and primary varicocele we decided to evaluate the continence of saphenofemoral junctions in a selected group of young men affected by primary varicocele. MATERIALS AND METHODS. 42 patients were included in the study. The age ranged from 13 to 55 years; the mean age was 28 years. In all cases a clinical and instrumental (ultranosography. Doppler flowmetry) diagnosis of primary varicocele was performed. Bidirectional Doppler flowmetry was used to evaluate the continence of 84 saphenofemoral junctions. RESULTS. Among the group of studied 36 (85.7%) showed a monolateral or bilateral valvular incompetence of saphenofemoral junctions; in the remaining 6 patients (14.3%) there was no evidence of valvular insufficiency. In 84 saphenofemoral junctions studied 52 (61.9%) were found incompetent, 32 to the left side and 20 to the right side. Moreover 2 patients had clinically detectable varicose veins of the lower limbs and symptoms related to chronic venous insufficiency. DISCUSSION. Varicose veins are one of the most prevalent chronic conditions in industrialized countries and places a considerable demand on the health services. Since this pathology is potentially preventable it seems very important to select within populations asymptomatic groups in which there is an increasing risk of chronic venous insufficiency and to perform a clinical and instrumental assessment, based on non invasive techniques. In the past varicose veins were related to other diseases and among them some authors suggested primary varicocele, that is due to venous spermatic reflux and/or valvular incompetence; furthermore varicocele and varicose veins are often familiar. In our 42 patients affected by varicocele only 6 (14.3%) had no Doppler flowmetry evidence of incompetence of saphenofemoral junctions and more than half (61.9%) of the junctions were found incompetent. CONCLUSIONS. In our experience we found a considerable relationship between primary varicocele and venous incompetence of saphenofemoral junctions. Perhaps these patients must be considered a group with an increasing risk to develop primary varicose veins. So we suggest that clinical examination and instrumental assessment should be performed in young men affected by varicocele, in order to obtain a prevention of chronic venous insufficiency of the lower limbs. Nevertheless this retrospective study has to be further confirmed by longterm prospective studies.

Adolescent↗
PubMed1994

Surgical repair of achilles tendon ruptures using polypropylene braid augmentation.

Surgical repair in fresh rupture of the Achilles tendon should be considered in active patients and athletes to restore their preinjury level of activity. Fifteen cases of Achilles tendon rupture underwent surgical repair using interpositional augmentation. This technique provides an immediate mechanical strength of the repair, avoiding the need for a postoperative plaster cast and allowing immediate motion of the ankle. No wound infection, scar adherence of the skin to the tendon, or rerupture of the tendon is present in this series. All patients were subjectively satisfied with the results and returned to their preinjury level of activity. Objectively, isokinetic assessment revealed no significant difference, as per t-test evaluation (P < .05), between the operated leg and the controlateral one.

Achilles Tendon↗