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Biomedical subjects

F Cossu

Publications and source records attributed to F Cossu.

At least 19 recordsLinked to original sources

[Non-recurrent inferior laryngeal nerve: anatomy, frequency and surgical considerations].

AIM: Systematic exposure and isolation of the inferior laryngeal nerve in thyroid surgery is a secure method to prevent complications. The knowledge of the nerve anatomy and its anomalies is essential to reduce laryngeal nerve injuries. By a re-examination of literature we underline the importance and some particular anatomical aspects of the anomalies which, even if rare, present an incidence of about 1%. METHODS: From January 1995 to December 2002 in our hospital we performed 299 interventions for thyroid diseases: total thyroidectomy (254 cases), partial thyroidectomy (45 cases). In 2 cases we observed a high variant (type I) of non recurrent laryngeal nerve. RESULTS: The global incidence of non recurrent laryngeal nerve was 0.66% (2/299 operations) and 0.72% if we consider the explorations of the cervical right side (2/274) where this anomaly is more frequent. The incidence of nerve injuries was 2/299 (0,66%); we had no complications in the 2 cases of non recurrent nerve observed. CONCLUSIONS: Our experience in thyroid surgery confirms the common opinion that only the knowledge of the laryngeal nerve anatomy and the awareness of its anomalies, associated to the systematic exposure of the nerve during surgery can prevent surgical injuries.

Humans↗

Autosomal recessive hypercholesterolemia caused by mutations in a putative LDL receptor adaptor protein.

Atherogenic low density lipoproteins are cleared from the circulation by hepatic low density lipoprotein receptors (LDLR). Two inherited forms of hypercholesterolemia result from loss of LDLR activity: autosomal dominant familial hypercholesterolemia (FH), caused by mutations in the LDLR gene, and autosomal recessive hypercholesterolemia (ARH), of unknown etiology. Here we map the ARH locus to an approximately 1-centimorgan interval on chromosome 1p35 and identify six mutations in a gene encoding a putative adaptor protein (ARH). ARH contains a phosphotyrosine binding (PTB) domain, which in other proteins binds NPXY motifs in the cytoplasmic tails of cell-surface receptors, including the LDLR. ARH appears to have a tissue-specific role in LDLR function, as it is required in liver but not in fibroblasts.

Adolescent↗

Anatomical and descriptive study of the radial extensor muscle (M. extensor carpi radialis).

The M. extensores carpi radiales have been studied in detail in humans. The aim of this study was to carry out a comparative anatomical study of these muscles using four species--rabbit, cat, dog and sheep--and to propose a 'systematization' in a few standard models according to the morphological variations seen. In these species, there is marked morphological evolution, with two muscles in humans, one in sheep and a more or less distinct division of the muscle in the rabbit, cat and dog. Examination of the vascularization and nerve supply enables us to determine degrees of division in species with similar muscle morphology. Thus we were able to distinguish three morphological types which allow us to infer the morphological evolution of the M. extensores carpi radiales and to estimate the point at which one muscle became two. However, there is a strong chance that some process of convergence may have occurred, and in pentadactyl species many elements represent the plesiomorphis and are therefore of little use in constructing a classification on the basis of evolution.

Animals↗

Bowel obstruction after biliopancreatic diversion: a deceptive complication.

BACKGROUND: Although obesity surgery is now practiced in most of the world, many general surgeons, faced with an emergency, are not experienced in the diagnostic problems associated with these techniques, or about the most suitable treatment to resolve the acute pathology while preserving the weight loss. The biliopancreatic diversion (BPD), because of its complexity, could cause a delay in the diagnosis and therapy, with possible catastrophic consequences for the patient. METHODS: We report 3 patients with bowel obstruction after BPD. In the first patient intestinal occlusion was due to an adhesion obstructing the alimentary tract; in the other two patients the occlusion was localized to the biliopancreatic tract, due to a serrate stenosis of the entero-entero anastomosis in one patient and due to volvulus of the biliopancreatic loop in the other patient. RESULTS: Signs and symptoms were different according to whether the obstruction was in the alimentary tract or the biliopancreatic tract. In all cases a prompt gastrointestinal x-ray with barium and ultrasound scan and/or CT scan induced us to a mandatory laparotomy with resolution of the obstruction. CONCLUSIONS: After BPD, diagnosis of an intestinal obstruction must be made promptly. Even colleagues who express doubts must be persuaded to perform immediately an upper gastrointestinal tract x-ray and an U/S or CT scan. In this way, it may be possible to avoid intestinal resection and catastrophic complications.

Adult↗

Genetic linkage of hyper-IgE syndrome to chromosome 4.

The hyper-IgE syndrome (HIES) is a rare primary immunodeficiency characterized by recurrent skin abscesses, pneumonia, and highly elevated levels of serum IgE. HIES is now recognized as a multisystem disorder, with nonimmunologic abnormalities of the dentition, bones, and connective tissue. HIES can be transmitted as an autosomal dominant trait with variable expressivity. Nineteen kindreds with multiple cases of HIES were scored for clinical and laboratory findings and were genotyped with polymorphic markers in a candidate region on human chromosome 4. Linkage analysis showed a maximum two-point LOD score of 3.61 at recombination fraction of 0 with marker D4S428. Multipoint analysis and simulation testing confirmed that the proximal 4q region contains a disease locus for HIES.

Chromosome Deletion↗

Evaluation of IgA deficiency in Sardinians indicates a susceptibility gene is encoded within the HLA class III region.

IgA deficiency (IgA-D) has been associated with the HLA region, in particular with the North European haplotype HLA-A1, -B8, -DR3, but the exact location of the susceptibility gene(s) is unknown. Some reports suggest that a susceptibility gene is encoded in the class II region, while others implicate the class III region. We exploited differences between the common Sardinian and North European HLA-DR3 haplotypes to help localize the IgA-D susceptibility gene(s). With the knowledge that approximately 13% of HLA-DR3 homozygous individuals of North European origin are IgA-D, we examined 43 HLA-DR3 homozygous Sardinians to find that all had normal serum IgA, IgG and IgM levels. A detailed analysis of their MHC haplotypes indicated a common Sardinian HLA-DR3 haplotype TAP1A, TAP2A, HLA-DQB1*0201, -DQA1*0501, -DRB1*0301, LH1-(Z + 2), D3A-(Z + 2), C4B-0, C4A-L, G11-15, Bf-0-4, C2-a, HSP70-7.5, 9N3-(Z + 10), 82I-(Z - 2), TNFalpha-9, 62-(Z - 20), HLA-B18, -Cw5, -A30 which diverges from the common North European HLA-DR3 haplotype telomeric to the HLA-DR region. In parallel studies of five Sardinians with IgA-D, two of the 10 HLA haplotypes (20%) contained HLA-DR3, a frequency similar to that observed in the background population. One of these was the HLA-DR3- B8 North European haplotype, which occurs rarely in Sardinia. Our data favour the hypothesis that a class III region allele, present on the common North European but not on the Sardinian HLA-DR3 haplotype, confers susceptibility to IgA-D.

Disease Susceptibility↗

[Precision of drug dilution techniques].

OBJECT: Evaluation of accuracy of three common dilution methods for drugs. EXPERIMENTAL PLAN: Perspective double blind investigation from March to June 1995. PLACE: Anaesthesia and Resuscitation Service of Children's Hospital of Iglesias (CA). METHODS: Forty dopamine at 2/1000 samples, obtained by dilution of dopamine at 40/1000 on sale with three different methods by five different operators, were analysed with a chromatography system in liquid phase at high pressure. RESULTS: Mean concentration with difference not exceeding 5% from the goal, are considered acceptable. Only one group of samples was found to be into these limits, but it was also the most dangerous for the high percentage of great mistakes in dilution. Although there are significant differences in the accuracy and safety of the three dilution methods, the highest and lowest final concentrations obtained differ very much from those estimated. CONCLUSIONS: It is suggested that drugs confections with proper dilution for different clinical uses might be on sale.

Indicator Dilution Techniques↗

[The immunological assessment of a combined therapeutic approach (chemo- + radiotherapy +/- surgery) including immunotherapy in neoplasms of the head and neck area at an advanced stage].

Fourty-eight patients entered the study, 37 of whom were evaluable, who underwent a nonrandomized combined modality approach plus a randomized immunotherapy treatment assigning the patients to one of the three arms: 1) thymostimulin, 2) beta IFN, 3) thymostimulin + beta IFN. The patients enrollment started in May 1991 and was closed in February 1993: the final evaluation was in February 1994. An immunological evaluation was made for all patients enrolled. The immunological assessment confirms some previous reports, such as the defective proliferative response of PBMC, the high serum level and the low production in culture of soluble IL 2 receptor (s IL 2 R), the low serum level and the low production of IL 2, and moreover shows new data. It is noteworthy that the significant increases--especially for cytokines and s IL 2 R, except for IL 1 alpha which has decreased, both for serum levels and for culture production--are induced by treatment with beta IFN (or with thymostimulin + beta IFN), suggesting that beta IFn is the immunologically effective moiety.

Adult↗

Cytotoxic activity of some gold(III) complexes.

The [Au(N-MeIm)Cl3], [Au(2-MeBO)Cl3] and [Au(2,5-diMeBO)Cl3] complexes (where N-MeIm = N-methylimidazole, 2-MeBO = 2-methylbenzoxazole and 2,5-diMeBO = 2,5-dimethylbenzoxazole), had been previously prepared and characterized by the Author. These compounds, when tested in vitro against murine leukemia cell lines L1210, human ovarian carcinoma A2780 and their sublines L1210/CDDP and A2780/CDDP resistant to cisplatin, in comparison with cisplatin and carboplatin, showed an interesting cytotoxicity, extended to resistant sublines.

Animals↗

[Fentanyl prevents the pain at the site of propofol injection].

The effect of fentanyl, administered immediately before propofol, when pain is experienced at the site of propofol injection was studied in 28 children undergoing elective surgery. The intravenous administration of fentanyl (2 micrograms/kg) significantly reduced such pain compared with a control group receiving saline. The results suggest that the administration of fentanyl may be a valid procedure in relieving pain on injection of propofol.

Child↗

[Radiosensitivity of lymphocyte subpopulations in subjects with systemic lupus erythematosus. An in vitro preliminary study].

The Authors have studied the radiosensitivity of lymphocyte cultures of patients affected by systemic lupus erythematosus in the active phase, and in the remissive phase after treatment with cyclosporine and fluocortolone, compared to a group of normal subjects. Total lymphocyte cultures and cultures of T, B, NK lymphocytes, T helper/inducer and T suppressor cytotoxic obtained with specific monoclonal antibodies were used and then irradiated with Co-60 gamma photons at scale doses between 0 and 10 Gy. Damage due to irradiation was evaluated using 3H-TdR. Patients in the clinically active phase of the disease showed an increased lymphocytic sensibility of the total lymphocytic population as well as of the various populations and T subpopulations studied. Radiosensitivity tended to become normal in patients in the remissive phase of the disease. The Authors conclude that a preliminary study of the lymphocytic sensitivity should be carried out in all patients treated with radiotherapy with autoimmune pathologies in order to avoid damages due to irradiation. Moreover, the Authors retain that a test for lymphocytic sensitivity to radiation could apply with regard to the evaluation of the clinical remissive conditions of patients affected by systemic lupus erithematosus.

Adult↗

Peripheral blood lymphocyte response to exogenous interleukin 2 by PHA-prestimulated and non-PHA-prestimulated cells in patients with cancer.

The study aims were to assess the response of peripheral blood lymphocytes (PBL) of cancer patients to exogenous Interleukin 2 (IL 2) either by PHA-prestimulated or non PHA-prestimulated PBL, and to carry out preliminary experiments for a direct quantitative evaluation of endogenous IL 2 production by PBL cultures of cancer patients in order to define the actual role of IL 2 in the disease. Analysis of PBL subsets was also carried out with monoclonal antibodies in a selected group of patients. A total of 134 patients entered the study. Cancer sites were: larynx 32, breast 36, lung (NSC) 24, colorectal 17 and gynecologic 25. In the former 3 cancer sites staging showed localized or only locally advanced disease, and in the last 2 sites disseminated disease. Our results provided evidence that cancer patients exhibit a T-cell functional immunodepression, which progresses during tumor growth, so that the localized disease shows a low-grade defect, and advanced disease a high-grade defect. Our data also clearly suggested that the factor involved with a primary role in this functional immune impairment is the IL 2 deficiency. A perspective may be drawn on the therapeutic administration in vivo of IL 2 and IL 2-activated lymphokine-activated killer cells in controlled clinical trials of selected groups of cancer patients.

Cells, Cultured↗

Radiosensitization by tinidazole: pharmacokinetic study.

In previous study on cell-cultures, the authors have proved that tinidazole had radiosensitizing properties on hypoxic cells similar to those of metronidazole. The radiosensitizing activity of tinidazole becomes useful in vitro using a concentration of 1 millimol. The purpose of this study was to determine the dose of tinidazole necessary to produce a useful radiosensitizing effect in patients cured by radiotherapy. The pharmacokinetic properties of tinidazole were studied by treating patients with 1.5-3-4.5 g of the drug per day, using single doses for two consecutive days. The plasma concentration was determined by 15 series samples during a period of 48 h. Moreover endotumoural concentrations of tinidazole were studied in a group of patients using high pressure liquid chromatography techniques. The results showed that a dose of 4.5 g of tinidazole was sufficient to reach plasmatic and endotumoural concentrations similar to those which provide a radiosensitizing effect in vitro with an enhancement factor ratio of approximately 1.5. The initial dose and the accumulation factor were also determined in order to maintain the above-mentioned concentrations for a time sufficient to be able to apply multiple daily fractions of radiotherapy. The tolerance of the drug throughout the study was excellent.

Drug Administration Schedule↗

[Prognostic value of CEA in postoperative monitoring of colorectal cancers].

The prognostic value of CEA for the purposes of postoperative monitoring assessed in 45 patients with cancer of the colon and rectum. Values were obtained 1-36 months after surgery in all operable cases. Means were also evaluated statistically at various follow-up times. In patients who relapsed, values stayed significantly higher for up to 6 months after surgery than in those who did not. Cockran's method showed that the prognostic significance of this difference 6 months after surgery was p less than 0.05.

Carcinoembryonic Antigen↗