Biomedical subjects

F Isgro

Publications and source records attributed to F Isgro.

22 records · Page 2Linked to original sources

PubMed1997

A predictive parameter in patients with brain related complications after cardiac surgery?

OBJECTIVE: The prognostic estimation of cerebral complications after cardiac surgery is a major problem in the early postoperative period. Neuron specific enolase (NSE) is an enzyme involved in glycolysis, which is localized in neurons and axonal processes. It escapes into the blood and cerebrospinal fluid at the time of neural injury. Therefore we focused the study on the question of how far serum levels of neuron specific enolase can predict the neurological and neuropsychological outcome after cardiac surgery. METHODS: We determined, with a prospective study design of NSE serum levels in 200 patients undergoing cardiac surgery preoperatively, right after the operation and 48 h later. The NSE was measured with a solid phase enzyme immuno assay which utilized a highly specific monoclonal antibody to NSE. We evaluated the neurological and neuropsychological status before and 72 h after surgical intervention. As a control group we recruited 50 patients undergoing general surgical treatment. RESULTS: The preoperative serum levels of NSE are constantly low in all patients with a mean value of 11.1 ng/ml (8.3-13.6) and a mean +/- S.D. of 3.12 in the main group and a mean value of 9.6 ng/ml (7.8-10.3) and a mean +/- S.D. of 1.84 in the control group. The early postoperative measurements indicated a significant increase to a mean value of 19.7 ng/ml (8.7-70.9) with a mean +/- S.D. of 2.89 in the main group. In contrast there is no increase of NSE serum levels after general surgery. The 48 h postoperative mean levels declined to 14.2 ng/ml (9.9-26.2), S.D. of 3.23. In 17 out of the 200 patients a neurological complication occurred. Elevated NSE levels were found in 16 of these 17 patients. The highest concentrations of NSE were measured in 7 patients with the most severe neurological complications being transient ischemic attack and stroke. CONCLUSIONS: The early serum levels of NSE after cardiopulmonary bypass, in those patients with severe neurological deficits, indicate that NSE is a suitable marker for the detection and quantification of cerebral injury after open heart surgery. Therefore, in addition NSE seems to be of predictive value for the clinical outcome and gives implications for the treatment and prognosis of patients with brain related complications in cardiac surgery.

Adult↗

PubMed1997

Myxoma complex associated with transient hyperthyroidism: are diseases of the thyroid part of the complex?

The myxoma complex is a very rare disease. We report on a 31-year-old woman who suffered a hyperthyreosis, which resolved spontaneously. A few months later she developed a Cushing's syndrome, caused by a primary adrenocortical nodular dysplasia. A bilateral adrenalectomy had to be performed. 15 months after this operation she developed a cerebral infarction caused by an embolus from a left atrial myxoma. Our patient is a further case of Carney's syndrome. The aspect of the hyperthyreosis is interesting: Perhaps disease of the thyroid represents a new element of Carney's syndrome.

Adult↗

PubMed1989

Influence of peripheral arterial occlusive disease on muscular metabolism. Part 2: Changes in pyruvate, alanine, and urea concentration in femoral blood.

The metabolites pyruvate, alanine and urea were determined under resting conditions in blood from the femoral artery, femoral vein and cubital vein of 23 patients with stage II, 10 patients and 20 diabetics with stage IV PAOD as well as 19 healthy volunteers. Measurements were also carried out immediately and 20 min after ergometric calf exercise in the patients with stage II PAOD and the controls. In both patient groups with stage IV PAOD, there were lower arterial and venous alanine levels and higher urea concentrations at rest than in patients with adequate resting circulation, which is evidence for increased hepatic alanine extraction. After exercise, a significantly higher increase in the arteriovenous difference of pyruvate concentration was to be found in the patient group with stage II PAOD than in the control group. Moreover, there was a significant increase in femoral venous concentration and a rise in the arteriovenous difference of alanine, indicating muscular release, only in the PAOD patients and not in the volunteers in spite of a three times higher exercise load. The exercise-induced rise in femoral venous alanine correlated closely with those of pyruvate and ammonia. Alanine formation fulfills the function of a non-toxic carrier of muscularly produced amino groups and represents in PAOD a compensating mechanism that delays the limitation of muscular contractility. Alanine determination, especially in association with an exercise test, appears to be suitable for assessing the extent of anaerobic energy production in muscles of limbs affected by PAOD.

Alanine↗

PubMed1989

Influence of peripheral arterial occlusive disease on muscular metabolism. Part 1: Changes in lactate, ammonia, and hypoxanthine concentration in femoral blood.

The concentrations of lactate, ammonia and hypoxanthine were determined in blood from the femoral artery, femoral vein and cubital vein under resting conditions in 23 patients with stage II, 10 patients and 20 diabetics with stage IV peripheral arterial occlusive disease (PAOD) and in 19 healthy subjects. The metabolite concentrations were also measured immediately and 20 min after calf exercise in the patients with stage II PAOD and in the controls. At rest, there was a negative arteriovenous difference in femoral lactate level and a positive arteriovenous difference in the ammonia level in all groups. After exercise to the claudication limit, the femoral venous concentration and arteriovenous difference for lactate increased in the patient group significantly higher than in the controls, who were exercised three times as heavily. Furthermore, there was a significant rise in femoral venous ammonia concentration with inversion of the arteriovenous difference into the negative range and an increase in femoral venous hypoxanthine concentration only in the patients with PAOD and not in the controls. A significant correlation was found between the exercise-induced increases in lactate and ammonia. The results indicate activation of the purine nucleotide cycle in the muscles of limbs with impaired circulation, even for a short duration of load. This can be explained by activation of the AMP-deaminase in type I and type IIa muscle fibres by anoxaemia. The purine nucleotide cycle has an emergency metabolic function in ischaemia to maintain muscle contractility. Ammonia determination in femoral blood permits, in association with lactate and hypoxanthine determination, a precise quantitative assessment of the metabolic effects of PAOD.(ABSTRACT TRUNCATED AT 250 WORDS)

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