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Biomedical subjects

F Vacca

Publications and source records attributed to F Vacca.

17 recordsLinked to original sources

Is laparoscopic bladder diverticulectomy after transurethral resection of the prostate safe and effective? Comparison with open surgery.

PURPOSE: In a retrospective nonrandomized study, we compared our experience with transurethral resection of the prostate (TURP) plus sequential laparoscopic bladder diverticulectomy with a series of combined open bladder diverticulectomies with transvesical prostatectomy. PATIENTS AND METHODS: We considered 12 consecutive patients (group A) having 16 diverticula who underwent sequential TURP and transperitoneal laparoscopic bladder diverticulectomy and 13 consecutive patients (group B) having 13 diverticula who underwent open bladder diverticulectomy and transvesical prostatectomy. We evaluated the size and position of the diverticulum, adenoma volume, operative time, postoperative hemoglobin variations, analgesia requirement, complications, postoperative hospital stay, and uroflowmetry results. RESULTS: No statistically significant differences existed between the groups in adenoma volume or diverticulum size or position. However, a significantly longer operative time was recorded in group A. The endolaparoscopic approach proved to be statistically superior to open surgery regarding blood loss, postoperative analgesia requirement, and hospital stay. No intraoperative complications were recorded. In addition, no statistically significant difference was found in uroflowmetry results. CONCLUSIONS: In our experience, the endolaparoscopic approach has proved to be safe, effective, and minimally invasive and therefore superior to transvesical prostatectomy and open bladder diverticulectomy. Its only disadvantage is the longer operative time.

Diverticulum↗

Postmenopausal osteoporosis and hormone replacement therapy.

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Postmenopausal osteoporosis is a major public health problem. Estrogen deficiency is a key factor in the pathogenesis of postmenopausal osteoporosis. Among the several types therapeutic intervention in osteoporosis, hormone replacement therapy (HRT) has traditionally been seen as the gold standard method of preventing osteoporotic fractures among postmenopausal women.The estrogenic effect on bone is dose-dependent. For oral therapy, studies have demonstrated that doses of 0.625 mg of conjugated equine estrogen and 2 mg of micronized estradiol prevent postmenopausal bone loss. Percutaneous 17 beta-estradiol prevents skeletal bone loss as effectively as oral HRT. Although the greatest benefits from HRT in terms of bone sparing effects can be obtained shortly after the menopause, the literature contains clear evidence that HRT prevents bone loss in all stages of postmenopausal life. However, estrogen therapy must be long-term, possibly lifelong, to have any lasting impact on bone health. One strategy to improve long term continuation of HRT is to reduce the dosage of estrogen and the consequent side-effects of the higher dose HRT. Various studies have assessed the efficacy of low-dose HRT (LD-HRT) as well as the standard dose HRT in the prevention of osteoporosis in postmenopausal women. LD-HRT may enhance patient acceptability and continuation, ensuring adequate bone protection and menopausal symptoms control, and given physicians the possibility to personalize the doses on the basis of each individual patient's needs.

Estrogen Replacement Therapy↗

Dropout rates with olanzapine or risperidone: a multi-centre observational study.

OBJECTIVE: In patients with schizophrenia, risperidone and olanzapine are the two most commonly used atypical anti-psychotics. A recent meta-analysis based on randomized trials suggests that, in the long term, olanzapine can have a lower frequency of treatment discontinuation (or dropout) in comparison with risperidone. To better test this hypothesis, our observational study was aimed at assessing whether or not this advantage of olanzapine versus risperidone could be confirmed in a patient series examined in an observational setting. METHODS: Our study was based on a retrospective multi-centre observational design. We collected the following information from each patient: demographic characteristics; current anti-psychotic treatment (olanzapine or risperidone, under the condition of a stable therapy over months -1 to -4); cumulative dose of the drug; previous anti-psychotic treatment (during months -5, -6, -7 and/or, when available, also before month -7); daily dose and treatment duration. Our primary analysis traced back the patient's history from the date of enrollment retrospectively up to month -7. The secondary analysis followed-up the patient's history prior to month -7, thus extending this retrospective recording as long as possible (depending on what information was actually available for individual patients). RESULTS: The patients were enrolled from 31 institutions. In our primary analysis (months -1 to -7), a total of 144 patients were included; in this subgroup treated with olanzapine or risperidone as initial drug ( n=94), we observed 4 of 54 switches from olanzapine to risperidone and 11 of 40 switches from risperidone to olanzapine ( P=0.01). A total of 454 patients were enrolled in our secondary analysis (from month -1 up to month -73); the same comparison showed 9 of 236 switches from olanzapine to risperidone and 17 of 150 switches from risperidone to olanzapine ( P=0.004). CONCLUSION: Our analysis confirms the results of a recent meta-analysis and shows that olanzapine might imply a lower risk of dropout than risperidone.

Adult↗

Up-regulation of P2X2, P2X4 receptor and ischemic cell death: prevention by P2 antagonists.

In the present work we examined the involvement of selected P2X receptors for extracellular ATP in the onset of neuronal cell death caused by glucose/oxygen deprivation. The in vitro studies of organotypic cultures from hippocampus evidenced that P2X2 and P2X4 were up-regulated by glucose/oxygen deprivation. Moreover, we showed that ischemic conditions induced specific neuronal loss not only in hippocampal, but also in cortical and striatal organotypic cultures and the P2 receptor antagonists basilen blue and suramin prevented these detrimental effects. In the in vivo experiments we confirmed the induction of P2X receptors in the hippocampus of gerbils subjected to bilateral common carotid occlusion. In particular, P2X2 and P2X4 proteins became significantly up-regulated, although to different extent and in different cellular phenotypes. The induction was confined to the pyramidal cell layer of the CA1 subfield and to the transition zone of the CA2 subfield and it was coincident with the area of neuronal damage. P2X2 was expressed in neuronal cell bodies and fibers in the CA1 pyramidal cell layer and in the strata oriens and radiatum. Intense P2X4 immunofluorescence was localized to microglia cells. Our results indicate a direct involvement of P2X receptors in the mechanisms sustaining cell death evoked by metabolism impairment and suggest the use of selected P2 antagonists as effective neuroprotecting agents.

Animals↗

Sequential transurethral resection of the prostate and laparoscopic bladder diverticulectomy: comparison with open surgery.

OBJECTIVES: To compare our experience with transurethral resection of the prostate and sequential laparoscopic bladder diverticulectomy with a previous series of combined open bladder diverticulectomy and transvesical prostatectomy. METHODS: We compared the data of 10 consecutive patients (group 1) who underwent sequential transurethral resection of the prostate and transperitoneal laparoscopic bladder diverticulectomy and 13 consecutive patients (group 2) who underwent traditional combined open bladder diverticulectomy and transvesical prostatectomy. The following parameters were considered: size and position of the diverticulum, transrectal ultrasound adenoma volume, operative time, postoperative hemoglobin variations, analgesic requirement, complications, postoperative hospital stay, and urinary flowmetry. RESULTS: No statistically significant differences existed between the two groups either for diverticulum size (6.8 versus 7.2 cm) or diverticula position. A significant difference was observed in the operative time (247 minutes for group 1 versus 136 minutes for group 2, P <0.0001), mean postoperative hemoglobin decrease (2.6 g/dL for group 1 and 3.9 g/dL for group 2, P = 0.001), analgesic requirement (1.3 ampoules of buprenorphine cloritrate for group 1 versus 1.8 ampoules for group 2, P = 0.45), and postoperative hospital stay (3 days for group 1 versus 9.6 days for group 2, P <0.0001). No statistically significant difference was recorded for control flowmetry. No intraoperative complications were recorded for the two groups. CONCLUSIONS: In our series, sequential transurethral resection of the prostate and transperitoneal laparoscopic diverticulectomy for large diverticula proved to be a safe, effective, and minimally invasive procedure, despite the longer operative times compared with transvesical prostatectomy and open bladder diverticulectomy.

Combined Modality Therapy↗

Transactivation of the epidermal growth factor receptor in endothelin-1-induced mitogenic signaling in human ovarian carcinoma cells.

Endothelin (ET)-1 is produced in ovarian carcinoma cells and is known to act through ET(A) receptors as an autocrine growth factor in vitro and in vivo. In OVCA 433 human ovarian carcinoma cells, ET-1 caused phosphorylation of the epidermal growth factor receptor (EGF-R) that was accompanied by phosphorylation of Shc and its recruitment complexed with Grb2. These findings suggested that an EGF-R/ras-dependent pathway may contribute to the activation of mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (Erk) 2 and mitogenic signaling induced by ET-1 in these cells. Specific inhibition of EGF-R kinase activity by tyrphostin AG1478 prevented ET-1-induced transactivation of the EGF-R, as well as Shc phosphorylation and recruitment with Grb2. Furthermore, ET-1-induced activation of Erk 2 was partially inhibited by tyrphostin AG1478. In accord with this finding, the mitogenic action of ET-1 in OVCA 433 cells was also significantly reduced by a concentration of tyrphostin AG1478 that abolished the growth response of EGF-stimulated cells. Inhibition of protein kinase C activity, which contributes to the proliferative action of ET-1 in OVCA 433 cells, had no effect on the activation of Erk 2 by ET-1, which suggests that this effect of protein kinase C does not involve ras-independent activation of Erk 2. Inhibition by wortmannin of PI3-kinase activity, which has been implicated in ET-1 and other G protein-coupled receptor (GPCR)-mediated signaling pathways, reduced Erk 2 activation by ET-1 but had no effect on ET-1-induced EGF-R and Shc phosphorylation. These findings indicate that ET-1-induced stimulation of Erk 2 phosphorylation, and mitogenic responses in OVCA 433 ovarian cancer cells are mediated in part by signaling pathways that are initiated by transactivation of the EGF-R.

Adaptor Proteins, Signal Transducing↗

The chemokine growth-related gene product beta protects rat cerebellar granule cells from apoptotic cell death through alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate receptors.

Cultured cerebellar granule neurons are widely used as a cellular model to study mechanisms of neuronal cell death because they undergo programmed cell death when switched from a culture medium containing 25 mM to one containing 5 mM K(+). We have found that the growth-related gene product beta (GRObeta) partially prevents the K(+)-depletion-induced cell death, and that the neuroprotective action of GRObeta on granule cells is mediated through the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) type of ionotropic glutamate receptors. GRObeta-induced survival was suppressed by 6-cyano-7-nitroquinoxaline-2,3-dione, which is a specific antagonist of AMPA/kainate receptors; it was not affected by the inhibitor of N-methyl-D-aspartate receptors, 2-amino-5-phosphonopentanoic acid, and was comparable to the survival of granule cells induced by AMPA (10 microM) treatment. Moreover, GRObeta-induced neuroprotection was abolished when granule cells were treated with antisense oligonucleotides specific for the AMPA receptor subunits, which significantly reduced receptor expression, as verified by Western blot analysis with subunit-specific antibodies and by granule cell electrophysiological sensitivity to AMPA. Our data demonstrate that GRObeta is neurotrophic for cerebellar granule cells, and that this activity depends on AMPA receptors.

2-Amino-5-phosphonovalerate↗

SDF-1alpha-mediated modulation of synaptic transmission in rat cerebellum.

The functional expression of the seven-transmembrane domain G protein-coupled chemokine receptor CXCR-4/fusin in rat nerve cell was demonstrated by staining with a polyclonal anti-CXCR-4 Ab, and by evaluating the calcium responses to the physiological agonist stromal-derived cell factor-1alpha (SDF-1alpha) in both cerebellar granule cells in culture and Purkinje neurons (PNs) in cerebellar slices. Cerebellar glial, granule and Purkinje cells showed a pronounced staining for CXCR-4. Furthermore, cultured granule cells exhibited Ca2+ transients elicited by the application of SDF-1alpha, both in cell bodies and in neuronal processes. Whole-cell patch-clamped PNs in cerebellar slices responded to SDF-1alpha application by a slow inward current followed by an increase of both intracellular Ca2+ level and spontaneous synaptic activity. In particular, the SDF-1alpha-induced slow inward current was considerably reduced by ionotropic glutamate receptor blockers, but developed fully in a medium in which synaptic transmission was inhibited, indicating that this current might be, at least in part, mediated by extrasynaptic glutamate, possibly released from the surrounding glial and/or nerve cells. Taken together, these findings indicate a functional involvement of CXCR-4 in the modulation of synaptic transmission, adding another member to the repertoire of the chemokine receptors exerting a neuromodulatory role in the cerebellum.

6-Cyano-7-nitroquinoxaline-2,3-dione↗

The growth-related gene product beta induces sphingomyelin hydrolysis and activation of c-Jun N-terminal kinase in rat cerebellar granule neurones.

The growth-related gene product beta (GRObeta) is a small chemoattractant cytokine that belongs to the CXC chemokine family, and GRObeta receptors are expressed in the brain, including the cerebellum. We demonstrate that rat cerebellar granule neurones express the GRObeta receptor CXCR2. We also show that, in addition to the known stimulation of a phosphoinositide-specific phospholipase C, GRObeta activates both neutral (N-) and acidic (A-) sphingomyelinases (SMase) and the stress-activated c-Jun N-terminal kinase 1 (JNK1). Although both exogenous ceramide and bacterial SMase stimulate JNK1, GRObeta-induced JNK1 activation is an event probably independent of ceramide generated by A-SMase, since it is maintained in the presence of compounds that block A-SMase activity. This is the first report on the activation of the SMase pathway by chemokines.

Animals↗

Simultaneous influenza and pneumococcal vaccination in elderly individuals.

The study was performed to evaluate the effects of influenza and pneumococcal vaccines administered alone or in combination. 124 elderly subjects living in community were vaccinated either with influenza split vaccine or with pneumococcal 23-valent or with both vaccines at the same time in different sites. Sera were tested for hemoagglutination inhibiting antibodies for influenza and for antibodies against 23-valent vaccine for streptococcus pneumoniae. No side effects were observed in the vaccinated population. Serological results indicated that influenza vaccine increased significantly antibody levels. No difference was observed between the group which received influenza vaccine alone and that which received influenza and pneumococcal vaccines associated, considering either G.M.T or the percentages of protected individuals or the percentages of subjects who seroconverted. When pneumococcal vaccine was administered at the same time with influenza vaccine, there was a not statistically significant reduction in both mean antibody concentration and mean fold increase. It is concluded that the simultaneous administration of influenza and pneumococcal vaccines to elderly individuals, including subjects at risk, is safe, effective and economically advantageous.

Adult↗

Structural and antifungal properties of a pathogenesis-related protein from wheat kernel.

We have purified and characterized a protein from the water-soluble fraction of wheat kernel (Triticum aestivum cv. S. Pastore) consisting of a single polypeptide chain blocked at its N-terminus by a pyroglutamate residue; the complete amino acid sequence has been determined by automated sequence analysis performed on peptide fragments obtained by enzymatic hydrolyses of the protein. Homology studies have shown that this protein is very similar (97% sequence identity) to the previously characterized wheatwin1 as well as to other members of the pathogenesis-related (PR) proteins of class 4; in analogy with wheatwin1, we have termed this protein wheatwin2. Both wheatwin1 and wheatwin2 have specific antifugal activity toward the wide-host-range pathogen Botrytis cinerea and the wheat-specific pathogenic fungi of wheat Fusarium culmorum and Fusarium graminearum of groups 1 and 2. On the basis of their structural and functional properties, wheatwin1 and wheatwin2 can be classified as members of the PR4 protein family; this represents the first report concerning the presence of this kind of protein in wheat.

Amino Acid Sequence↗

Immune response to a booster dose of enhanced potency inactivated polio vaccine administered in association with HBV vaccine in adolescents.

The immunogenicity and reactogenicity of a booster dose of enhanced potency inactivated polio vaccine (EIPV) were evaluated in 492 healthy 12 year old adolescents. The booster was administered at the same time as the HBV vaccine compulsory in Italy at this age. Blood samples and questionnaires on reactogenicity were collected over 9 months. Analysis of pre-vaccination immunity showed that 97.4% of the subjects were protected against all polio types, 1.9% were negative for two polio types and 0.6% for one. After vaccination 98.4% of the vaccinees showed a significant increase ( > or = 4 times) of antibody titre; the geometric mean titres (GMT) were markedly higher than before vaccination, particularly for poliovirus type 3. The polio booster dose did not affect HBV vaccination. An anti-HBs response > 10 mIU ml-1. (GMT = 2951 mIU ml-1) was observed in 781 (98.6%) of 792 vaccinees (492 given EIPV+HBV and 300 given only HBV) 9 months later. Only mild local and rare general reactions were noted for both the vaccines studied. These data confirm the suitability and efficacy of an EIPV booster dose and HBV vaccination in adolescents.

Antibodies, Viral↗

The amino acid sequence and reactive site of a single-headed trypsin inhibitor from wheat endosperm.

The sequence of a trypsin inhibitor, isolated from wheat endosperm, is reported. The primary structure was obtained by automatic sequence analysis of the S-alkylated protein and of purified peptides derived from chemical cleavage by cyanogen bromide and digestion with Staphylococcus aureus V8 protease. This protein, named wheat trypsin inhibitor (WTI), which is comprised of a total of 71 amino acid residues, has 12 cysteines, all involved in disulfide bridges. The primary site of interaction (reactive site) with bovine trypsin has been identified as the dipeptide arginyl-methionyl at positions 19 and 20. WTI has a high degree of sequence identity with a number of serine proteinase inhibitors isolated from both cereal and leguminous plants. On the basis of the findings presented, this protein has been classified as a single-headed trypsin inhibitor of Bowman-Birk type.

Amino Acid Sequence↗

[Total intravenous anesthesia with propofol vs. propofol/N2O anesthesia].

The authors have compared two groups of 31 patients each, undergone an anaesthesia with propofol-O2/N2O (group I) and propofol-O2/air (group II). The average anaesthetic dosage and the neuromuscular recovery time have been valued, keeping constant the dose of analgesic. The average consumption of propofol (except the inductive dose of 2 mg/kg) was 7.41 +/- 1.71 mg/kg/h in group I, and 7.47 +/- 1.76 in group II (p = 0.88; not significant) and the neuromuscular recovery time 56.12 +/- 34.55 m' and 49.48 +/- 40.50 m' respectively (p = 0.53; not significant). The cardiocirculatory parameters have been compared at the time of induction, surgical incision and for all the operation time, reporting every undesired effect. The awakening has been monitored until 15 m' from the interruption of propofol infusion. The data obtained don't permit to observe significant differences with regard to analgesia, neuromuscular block and awakening time. Therefore the authors put the question of the real necessity to use nitrous oxide, when it has utilized an efficient intravenous anaesthetic as the propofol has proved to be.

Adult↗

[Transmission of measles during four outbreaks in a partially vaccinated population].

All measles cases occurred between 1989 and 1991 in the territory of the Local Health Unit 10--Marche Region--Italy, were studied in order to evaluate the characteristics of the disease and the transmission mechanisms. A total of 4 outbreaks were evidenced: 2 occurred in a 40,000 population municipality (with 46 and 87 cases, respectively), 1 in a 10,000 population municipality (with 35 cases) and 1 in two closely-related municipalities of 4,600 population (with 67 cases). The immune status of children between 1 and 10 years of age was evaluated adding the number of vaccinated children to the number of those who resulted having had the disease. Immune children were between 52.3% and 89.1%. During the outbreaks, the percentage of cases occurred in subjects over 10 years of age was, in total, 65.5. No cases needed hospitalization and only one case occurred in a vaccinated boy. In 189 cases the subject who presumably transmitted the disease was identified. Transmission occurred: within the school in 51.8% of the cases; within the family in 30.7%; during social activity in 10.0%; from inhabitants of the same house in 7.4%. The epidemiology of measles, in the area of this study, seems different from that described in the United States.

Child↗