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Biomedical subjects

F Ricci

Publications and source records attributed to F Ricci.

At least 55 records · Page 3Linked to original sources

[The role of surgery in the treatment of small cell lung cancer].

Small cell lung cancer (SCLC) is a biologically aggressive tumor with a low long-term survival rate. SCLC is highly responsive to chemotherapy and surgery has a very limited role in its treatment because the disease is usually widely disseminated at the diagnosis. Good results from surgery have been reported in the small subgroup of T1-2 N0 M0 patients. In N1 peripheral SCLC, surgery in combination with other treatments, can obtain fair results. Surgical treatment does not influence the prognosis in SCLC as stage III and IV.

Aged↗

Effect of native and oxidized low-density lipoprotein on endothelial nitric oxide and superoxide production : key role of L-arginine availability.

BACKGROUND: Native and oxidized LDLs (n-LDL and ox-LDL) are involved in the atherogenic process and affect endothelium-dependent vascular tone through their interaction with nitric oxide (NO). METHODS AND RESULTS: In this study we evaluated directly, by using a porphyrinic microsensor, the effect of increasing lipoprotein concentrations on endothelial NO and superoxide (O(2)(-)) production. We investigated where lipoproteins may affect the L-arginine-NO pathway by pretreating cells with L-arginine, L-N-arginine methyl ester (L-NAME), and superoxide dismutase. Bovine aortic endothelial cells were exposed for 1 hour to increasing concentrations of n-LDL (from 0 to 240 mg cholesterol/dL) and ox-LDL (from 0 to 140 mg cholesterol/dL). A stimulated (calcium ionophore) NO concentration decreased to 29% of the control at n-LDL concentration of 80 mg cholesterol/dL and to 15% of the control at 20 mg cholesterol/dL of ox-LDL. L-Arginine partially neutralized the inhibitory effect of n-LDL and ox-LDL on the NO generation. Superoxide dismutase pretreatment did not modify NO production, whereas L-NAME blunted NO generation at all LDL concentrations. O(2)(-) production was increased at low n-LDL and very low ox-LDL concentrations; this was reversed by L-arginine. CONCLUSIONS: These findings confirm the inhibitory role of n-LDL and ox-LDL on NO generation and suggest that lipoproteins may induce a decreased uptake of L-arginine. The local depletion of the L-arginine substrate may derange the NO synthase, leading to overproduction of O(2)(-) from oxygen, the other substrate of NO synthase.

Animals↗

Octyl 2-cyanoacrylate in sutureless surgery of extraocular muscles: an experimental study in the rabbit model.

BACKGROUND: Sutureless surgery for strabismus eliminates the risk of perforating the ocular bulb in patients with extremely thin sclerae. Thus far, however, the results obtained with tissue adhesives such as the cyanoacrylates instead of sutures have been less than satisfactory. METHODS: A new adhesive, octyl 2-cyanoacrylate, was tested in 36 rabbit eyes in which the superior rectus was recessed 5 mm. In 36 other eyes the same operation was performed using 5/0 Vicryl sutures. Animals were killed 1, 3, 5, 15, 30 and 45 days after surgery. One eye from each animal was used for histopathological examination of the reinserted muscle and sclera, while the other was used in a tensiometric test to measure how many grams of weight were needed to detach the muscle from its new insertion site. RESULTS: The tensile strength of the bond achieved with the cyanoacrylate adhesive was 94+/-12 g 1 day after surgery (vs 238+/-19 g in the suture group) and 520+/-24 g after 45 days (vs 576+/-27 g with sutures). No cases of slippage, muscle detachment, or local tissue reactions were observed in either group. There were no differences in histological findings between the eyes of the two groups. CONCLUSIONS: Although further study will be necessary before this technique can be used in humans, our findings indicate that octyl 2-cyanoacrylate is superior to the cyanoacrylate adhesives used in the past in terms of adhesion and holding power; given its favorable toxicity profile, this product may offer interesting applications in the future.

Animals↗

Oxygen-induced retinopathy in the newborn rat: morphological and immunohistological findings in animals treated with topical timolol maleate.

Oxygen-induced retinopathy (OIR) similar to that seen in premature infants can be produced in newborn rats by exposure to 80% oxygen for the first 5 days of life, with subsequent recovery for 7 days in a room air environment. Previous studies have shown that the latter phase is associated with degeneration of retinal astrocytes. In the absence of astrocytes, the vascular endothelial growth factor (VEGF) is produced by the neurons of the inner retina. In this study, immunohistochemical methods were used to assess retinal expression of VEGF protein in ratlings exposed to the above protocol, with and without simultaneous treatment with topical timolol maleate. Intraocular pressure (IOP) and arterial pressure were measured. The severity of OIR was also evaluated in retinal flat mounts after India ink perfusion. The mean IOP was 8.25 +/- 0.32 mm Hg in untreated ratlings and 5.15 +/- 0.24 mm Hg in timolol-treated animals. OIR in retinas from the timolol group was less severe than that seen in untreated ratlings. VEGF protein expression was almost completely absent in the latter group. Retinas from timolol-treated animals expressed VEGF protein, though the level was inferior to that found in controls raised under room air conditions. In conclusion, these data seem to indicate that experimental OIR can be attenuated by a reduction of the IOP during and after oxygen supplementation. It is possible that these effects are due to improved ocular perfusion pressure, which would mitigate the hypoxic insult to the retina during the room air recovery period.

Administration, Topical↗

Detection of nitric oxide release induced by bradykinin in guinea pig trachea and main bronchi using a porphyrinic microsensor.

Indirect evidence using nitric oxide (NO) synthase (NOS) inhibitors suggests that in guinea-pig airways bradykinin releases bronchoprotective NO. In this study, using a recently developed electrochemical method of NO measurement based on a porphyrinic microsensor, we investigated whether bradykinin releases NO from guinea-pig airways and whether the epithelium is the main source of NO. Further, the Ca(2+)-dependence of bradykinin-induced NO release was assessed stimulating airway preparations with bradykinin in Ca(2+)-free conditions. We also studied the immunohistochemical distribution of the Ca(2+)- dependent constitutive isoforms of NOS (constitutive NOS [cNOS]: neuronal and endothelial [ecNOS]) in our preparations. The porphyrinic microsensor was placed in the bathing fluid onto the mucosal surface of tracheal or main bronchial segments. Addition of bradykinin vehicle (0.9% saline) did not cause any detectable change of the baseline signal. Addition of bradykinin caused an upward shift of the baseline that reached a maximum within 1 to 2 s. The amplitude of the response to bradykinin was concentration-dependent between the range 1 nM to 10 microM, with a maximum effect at 10 microM. Bradykinin-induced NO release was higher in tracheal than in main bronchial segments. The selective bradykinin B(2) receptor antagonist D-Arg(0)-[Hyp(3), Thi(5), D-Tic(7), Oic(8)]bradykinin (1 microM) inhibited NO release induced by a submaximum concentration of bradykinin (1 microM). The ability of bradykinin to release NO was markedly reduced in epithelium-denuded segments, and abolished in Ca(2+)-free conditions and after pretreatment with N(G)-monomethyl-L-arginine (100 microM), but not with N(G)-monomethyl-D-arginine. Both cNOS isoforms were present in trachea and main bronchi, ecNOS being the predominant isoform in the epithelium. The study shows that bradykinin via B(2) receptor activation caused a rapid and Ca(2+)-dependent release of NO, mainly, but not exclusively, derived from the epithelium. It also shows that both cNOS isoforms may be involved in bradykinin-evoked NO release.

Animals↗

Effects of low day 3 luteinizing hormone levels on in vitro fertilization treatment outcome.

In a previous study we demonstrated that women with day 3 luteinizing hormone (LH) values < 3 IU/l subjected to controlled ovarian hyperstimulation without pituitary desensitization responded with a lower number of follicles > 15 mm compared to women with a higher basal LH level. The aim of this study was to determine whether in patients with day 3 LH levels < 3 IU/l a further reduction of serum LH concentration by gonadotropin-releasing hormone (GnRH) analog impairs follicular response to follicle stimulating hormone (FSH) and treatment outcome in in vitro fertilization (IVF) cycles. For this purpose we retrospectively studied 249 consecutive women subjected to standard IVF treatment employing pituitary desensitization with buserelin and follicular stimulation with urinary highly purified FSH. The patients were divided into two groups according to their day 3 LH value. The first group (group A) showed day 3 LH levels < 3 IU/l and the second (group B) had day 3 LH levels > 3 IU/l. Group A and B patients did not show statistically significant differences in the ovarian response to FSH, nor in IVF treatment outcome, showing that in FSH treated GnRH analog suppressed cycles, the ovarian responsiveness and IVF outcome do not differ according to basal LH values. However, the high dosage of FSH we employed in group A and B patients could account, at least in part, for this result. Indeed, comparative evaluations with unsuppressed cycles (our previous study) strongly suggest that a reduced ovarian responsiveness to gonadotropins in patients with day 3 LH values < 3 IU/l should be considered in clinical practice.

Adult↗

Emergency cholecystostomy and subsequent cholecystectomy for acute gallstone cholecystitis in the elderly.

BACKGROUND: The morbidity and mortality rates associated with acute cholecystitis are higher in the elderly. This study reports the results of treatment of acute cholecystitis in the elderly with emergency ultrasonographically guided percutaneous cholecystostomy followed by elective cholecystectomy after endoscopic treatment of any common bile duct stones diagnosed by percutaneous cholangiography. METHODS: From January 1989 to December 1998, 92 patients aged over 70 years were treated for acute gallstone cholecystitis. A group of 84 patients with ultrasonographic signs of severe cholecystitis or an American Society of Anesthesiologists score of II to IV were submitted to ultrasonographically guided percutaneous cholecystostomy. Transcatheter cholangiography was performed in all patients and endoscopic sphincterotomy was performed before operation in patients with common bile duct stones. After resolution of the acute phase and treatment of any associated diseases, patients were submitted to cholecystectomy. RESULTS: Cholecystostomy was performed successfully in 83 patients and permitted resolution of the acute attack in all after a mean period of 1.8 days. Cholangiography yielded a diagnosis of non-gallstone obstruction in one patient and common bile duct stones in 19 patients; preoperative endoscopic sphincterotomy and stone extraction was performed in 18 patients. Elective cholecystectomy was then performed in 70 patients with no deaths and a morbidity rate of 24 per cent. CONCLUSION: Combining emergency ultrasonographically guided percutaneous cholecystostomy, preoperative endoscopic treatment of common bile duct stones and subsequent elective cholecystectomy constitutes an optimal treatment regimen for acute gallstone cholecystitis in selected elderly patients with a mortality rate of zero in the authors' experience.

Acute Disease↗

Prevalence and incidence of age-related cataract in a population sample from Priverno, Italy.

PURPOSE: To study the prevalence and incidence of age-related cataract in a random population sample from the town of Priverno in the Lazio Region, Italy. METHODS: In 1987, 860 people between the ages of 45 and 69 years, already participating in a study on cardiovascular risk factors, underwent an ophthalmological examination. Patients with lens opacities, assessed by a clinical biomicroscopy and a best-corrected VA equal to or worse than 0.2 LogMar (20/30), were defined as age-related cataract cases. Of the 828 patients without age-related cataract at the baseline, 602 were re-examined in 1994. The 7-year Cumulative Incidence was calculated in three ways, as follows: - referring to the baseline sample without age-related cataract; - referring to the follow-up sample without age-related cataract at baseline; and - adjusted for non-response to the follow-up. RESULTS: In the baseline sample, the prevalence of age-related cataract was 3.7% (2.7%-5.2%, 95% C.I.). Cumulative Incidence referring to the baseline sample was 6.5% (4. 8%-8.2%, 95% C.I.); Cumulative Incidence referring to the follow-up sample was 9.0% (6.7%-11.3%, 95% C.I.). Adjusted Cumulative Incidence of age-related cataract was 7.6% (5.6%-9.5%, 95% C.I.). CONCLUSIONS: The study suggests that, in the Priverno sample, aging, but not gender, is a very important risk factor for cataract. The authors conclude that more information is needed on incidence of age-related cataract needing surgical rehabilitation and on risk factors causing both progression of lens opacities and visual loss.

Age Distribution↗

Antibodies reactive with neutrophils following allogeneic haematopoietic stem cell transplantation.

Allogeneic haematopoietic stem cell transplants might induce immunological alterations leading to autoimmune-like syndromes. In particular neutrophil-associated antigens could represent the target for autoantibodies against neutrophils in patients receiving an allogeneic peripheral stem cell or bone marrow transplantation, giving rise to granulocytopenia. With this aim we studied prospectively 43 allotransplanted patients for the presence of antibodies reacting with neutrophils (ARN), looking for a correlation with a post-engraftment neutropenia. Our data showed that the direct test for ARN was positive in 30 patients. Interestingly, 7/7 patients who received a T-cell-depleted marrow transplant developed ARN. Antibodies with a specific neutrophil-antigen reactivity were detected in 4 patients, 1 with an anti-CD16/FcbetaRIIIb receptor reactivity and 3 with anti-NA 1 reacting patterns, respectively. From a clinical point of view, it was not possible to demonstrate a close and significant relationship between neutropenia and ARN, although patients showing ARN had slightly lower absolute levels of peripheral neutrophils until 6 months after BMT. In conclusion, ARN may be detected in the majority of patients following allogeneic stem cell transplantation; in addition, since ex vivo or in vivo T-cell-depletion leads to a higher percentage of patients positive for ARN, it could be hypothesized that "autoimmune-like" disorders in transplanted patients might be related to a T-cell derangement due to different numbers and subsets of T lymphocytes.

Adult↗

Characterization of the endothelin receptor subtype mediating epithelium-derived relaxant nitric oxide release from guinea-pig trachea.

1. The endothelin (ET) receptor subtype that mediates niric oxide (NO)-dependent airway relaxation in tracheal tube preparations precontracted with carbachol and pretreated with indomethacin was investigated. The release of NO induced by ET from guinea-pig trachea using a recently developed porphyrinic microsensor was also measured. 2. ET-1 (1 pM-100 nM) contracted tracheal tube preparations pretreated with the NO-synthase inhibitor, L-NMMA, and relaxed, in an epithelium-dependent manner, preparations pretreated with the inactive enantiomer D-NMMA. The effect of L-NMMA was reversed by L-Arg, but not by D-Arg. 3. The selective ET(B) receptor agonists, IRL 1620 or sarafotoxin S6c, both (1 pM-100 nM) contracted tracheal tube preparations in a similar manner either after treatment with D-NMMA or with L-NMMA. In the presence of the ET(A) receptor antagonist, FR139317 (10 microM), ET-1 administration resulted in a contraction that was similar after either L-NMMA or D-NMMA. In the presence of the ET(B) receptor antagonist, BQ788 (1 microM), ET-1 relaxed and contracted tracheas pretreated with D-NMMA and L-NMMA, respectively. 4. Exposure of tracheal segments to ET-1 (1-1000 nM) caused a concentration-dependent increase in NO release that was reduced by L-NMMA. IRL1620 (1 microM) did not cause any significant NO release. FR139317 (10 microM), but not, BQ788 (1 microM), inhibited the NO release induced by ET-1. 5. These results demonstrate that in the isolated guinea-pig trachea activation of ET(B) receptors results in a contractile response, whereas activation of ET(A) receptors cause both a contraction, and an epithelium-dependent relaxation that is mediated by NO release.

Animals↗

Endoscopic clipping of anastomotic leakages in esophagogastric surgery.

BACKGROUND AND STUDY AIMS: Anastomotic leakage is a severe complication in gastric surgery and it is associated with a high rate of mortality. Conservative treatment sometimes is not sufficient to stem the leakages and, even when it is sufficient, it takes a long time. The present study describes the first experience in the treatment of anastomotic leakages with endoscopic clipping. PATIENTS AND METHODS: From May 1995 to December 1996, seven patients with postoperative anastomotic leakages after gastric surgery were prospectively treated in our Endoscopy Service. Metallic endoclips (MD 850, Olympus Corp., Tokyo, Japan) with prongs 12 mm long and 6 mm wide were applied, controlling the closure of the leakage by endoscopy, using radiographs to confirm the closure 24 hours later. RESULTS: Complete closure of the leakage was obtained in all seven cases. A single session of endoscopic clipping was needed for five patients while two other required, respectively, two and three sessions. The median time of leakage closure after endoscopic clipping was 2.3 days (range 1-5 days). The clips spontaneously dislodged within 1 month in five patients and within the second month in the other two patients. CONCLUSION: Endoscopic treatment of anastomotic leakages by metallic clips represents a safe and easily repeated method and, compared to conservative treatment, it seems to offer several time and cost advantages. Further studies involving a larger number of patients are needed to verify this finding.

Adenocarcinoma↗

Standardized measurement of visual acuity.

The authors reviewed the main aspects of visual acuity evaluation such as the characteristics of the test devices, the notation employed in recording the visual acuity level and the procedures for V.A. assessment, in both distance and near tests. In addition, new ten-letter charts, that tend to follow strictly the standardization guideline suggested by NAS-NRC, are described.

Contrast Sensitivity↗

Fibrinolytic and coagulation factors in very old subjects: association with lipoprotein profile and anthropometric variables.

BACKGROUND: We evaluated plasminogen activator inhibitor-1 (PAI-1), factor VII activity (FVII), and fibrinogen in a sample of octo-nonagenarians. Furthermore, we investigated the relationship of these fibrinolytic and coagulation parameters with lipoprotein profile and anthropometric variables in the absence or presence of disability. METHODS: We enrolled a population of 162 octo-nonagenarians, divided in two groups on the basis of presence or absence of disability in the activity of daily living (ADL). All the anthropometric determinations were carried out according to standardized methods. Blood samples for hemostatic and lipid determinations were collected after overnight fasting and resting. RESULTS: PAI-1 activity and fibrinogen levels were significantly higher in disabled (DIS) compared to free-living (FL) adults, whereas FVII did not show differences in the two groups. PAI-1 activity and FVII positively correlated to anthropometric parameters (body mass index, subscapular and tricipital skinfold thickness) in both DIS and FL. No correlations were found between fibrinogen and other variables in FL, whereas a negative relation with high density lipoprotein-cholesterol levels emerged in DIS. FVII was positively related with total cholesterol low density lipoprotein-cholesterol, and apolipoprotein B in both FL and DIS. CONCLUSIONS: In a sample of octo-nonagenarians, PAI-1 activity and FVII show a significant correlation with several anthropometric and lipoprotein parameters, suggesting that these variables are strongly associated with body composition and lipid metabolism independent from age and disability. DIS presented higher PAI-1 and fibrinogen levels; this observation may take in account the high prevalence of vascular diseases and also occult inflammation, which are known to affect these parameters.

Activities of Daily Living↗

Low day 3 luteinizing hormone values are predictive of reduced response to ovarian stimulation.

The aim of the present work was to evaluate whether low day 3 luteinizing hormone (LH) values in the presence of normal follicle stimulating hormone (FSH) are predictive of poor response to ovarian stimulation. Two groups of women undergoing ovarian stimulation and differing only in the day 3 LH concentration (<3 mIU/ml, study group, n=30; >3 mIU/ml, control group, n=45) were retrospectively analysed. Study group patients developed a lower oestradiol peak (703+/-388 versus 955+/-400 ng/ml; P = 0.005) and a lower number of follicles >15 mm diameter at the time of human chorionic gonadotrophin (HCG) administration (2.6+/-1.3 versus 3.6+/-1.8; P=0.004) than the control group. Conversely, a similar ratio of oestradiol: follicles >15 mm diameter was observed (256+/-118 versus 269+/-93; P=0.563). The number of follicles >10 mm at the time of HCG administration appeared to be lower in the study group, but this difference was not statistically significant (6+/-3.9 versus 7.8+/-4.3). Our data indicate that day 3 LH values <3 mIU/ml are predictive of poor response to ovarian stimulation.

Chorionic Gonadotropin↗