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Biomedical subjects

G Cozzi

Publications and source records attributed to G Cozzi.

At least 37 records · Page 2Linked to original sources
PubMed2000

Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis.

Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula was cured in 1 week. In 36 cases of cicatricial stenosis, 17 at the coloanal anastomosis and 19 at the pouch, radiological examination always detected the lesion, correctly defining its anatomical characterisitics, nature and extension. Of the 19 cases of stenosis treated radiologically, 15 recovered an adequate intestinal calibre for tients operated on, 21 cases of reccurrence were detected. Radiological examination was requested as the first investigation in only one of these cases, for a patient with subocclusion. Radiological investigations in patients who have undergone colonanal anastomosis are of read diagnostic value in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients.

Anal Canal↗
PubMed2000

TP53 mutations and mdm2 protein overexpression in cholangiocarcinomas.

Tumor suppressor protein p53 is a positive regulator of MDM2 gene expression and the mdm2 protein can bind to p53, preventing the transactivation of p53 responsive genes, thus mimicking TP53 mutation. The authors looked for alterations that could affect, directly and indirectly, p53 function in 13 patients with extrahepatic cholangiocarcinoma. Molecular analysis by single strand conformation polymorphism and DNA sequencing revealed that TP53 gene mutations occurred in only 2 of 13 cholangiocarcinomas. High levels of mdm2 protein were found, by immunohistochemical staining, in 61% of the cholangiocarcinomas and in almost all specimens (70%) displaying stabilized p53 protein in the absence and in the presence of TP53 mutations. The finding of co-overexpressed mdm2 and p53 proteins in cholangiocarcinomas indicates that they can upregulate the expression of mdm2 protein to a level sufficient for binding and accumulating p53 in a presumably inactive complexed form. The presence of TP53 mutations or upregulation of MDM2 gene expression in 9 of the 13 cholangiocarcinomas strongly supports that the impairment of the p53 pathway is an important and specific step in cholangiocarcinoma pathogenesis. At variance with other authors, no alteration of p16ink4/CDKN2 gene was observed in all 13 cholangiocarcinomas.

Aged↗
PubMed2000

Molecular characterization of a multiethnic group of 21 patients with type 3 von Willebrand disease.

Type 3 von Willebrand disease is a rare autosomal disorder characterized by unmeasurable levels of von Willebrand factor and severe hemorrhagic symptoms. We studied a multiethnic group of 37 patients, from Italy (n = 14), Iran (n = 10) and India(n = 13) to identify the molecular defects and to evaluate genetic heterogeneity among these populations. Twenty-one patients (6 Italians, 9 Iranians and 6 Indians) were fully characterized at the molecular level. Twenty-four different gene alterations were identified, 20 of which have not been described previously. The majority of the mutations caused null alleles, 11 being nonsense mutations (Q218*, W222*, R365*, R373*, E644*, Q706*, S1338*, Q1346*, Y1542*, R1659*, E2129*), 4 small deletions (437delG, 2680delC, 6431delT, del 8491-8499), 3 possible splice site mutations [IVS9(-1)g-->a, IVS29(+10)c-->t, IVS40(-1)g-->c], 3 candidate missense mutations (C275S, C2174G, C2804Y), 2 small insertions (7375insC, 7921insC) and 1 large gene deletion. The latter mutation was associated with the development of alloantibodies to VWF, but this complication was also found in a patient homozygous for a nonsense mutation (Q1346*). Due to the ethnic origin of the patients most of them were the offspring of consanguineous marriages and so were homozygous for the mutations found (18/21). Our results indicate that molecular defects responsible for type 3 VWD are scattered throughout the entire VWF gene (from exon 3 to 52), and that there is no prevalent and common gene defect in the three populations studied by us.

Adolescent↗
PubMed1997

A blend of animal and cereal protein or fish meal as partial replacement for soybean meal in the diets of lactating Holstein cows.

Six replications in Experiment 1 and four replications in Experiment 2 of a 3 x 3 Latin square arrangement of treatments were used to compare soybean meal or soybean meal partially replaced with fish meal or a protein blend for response in intake, milk yield and composition, ruminal NH3 N, blood urea, and ruminal fermentation in lactating Holstein cows. The blend contained 30% corn gluten meal, 30% poultry by-products, 30% blood meal, and 10% feather meal. Periods were 28 d, and the first 7 d were used for adjustment. In addition to these protein sources, diets contained corn silage, alfalfa haylage, dried cracked corn, ground barley plus added fat, and a mineral and vitamin mixture. In Experiment 1, mean DMI was 24.4 kg, mean milk yield was 36.7 kg, mean fat percentage was 3.48%, and mean milk protein percentage was 3.06%; there were no significant differences. In Experiment 2, DMI was different for soybeans (22.6 kg) versus other sources (21.4 kg), but milk yield (32.1 kg) and fat (3.39%) and protein (2.87%) percentages did not differ among diets. In Experiment 1, ruminal NH3 N was greatest for cows consuming soybean diets (11.0 mg/dl) and lowest for cows consuming diets containing the protein blend (8.7 mg/dl). No differences in VFA were found. The lack of response to RUP can be explained by a rather high intake of a fermentable diet, which supplied sufficient absorbable AA according to the Cornell AA model.

Animal Feed↗
PubMed1997

The use of near infrared analysis for in situ studies.

This study evaluated the use of near infrared reflectance spectroscopy to estimate the chemical composition of feed residues after in situ ruminal incubation. Residues of three alfalfa hays (n = 93) and three alfalfa pellets (n = 93) obtained after ruminal exposure were analyzed for dry matter, crude protein, neutral detergent fiber, acid detergent fiber, and acid detergent lignin by wet chemistry and were also scanned with a near infrared monochromator instrument. A calibration was calculated that combined hay and pellet samples (n = 60). Validation tests were performed using the remaining feed residues. The coefficients of determination and standard errors (percentage of dry matter) of the validation tests for crude protein, neutral detergent fiber, acid detergent fiber, and lignin were of 0.95 and 0.92, 0.96 and 1.68, 0.95 and 1.56, and 0.99 and 0.48, respectively. Similar statistics were obtained using the SELECT algorithm of sample selection; a further 30% reduction was observed in the number of samples that were used for calibration. Kinetics of ruminal degradation and effective degradabilities that were calculated based on chemical composition of the residues as determined by wet chemistry or estimated by near infrared reflectance spectroscopy were not significantly different for 68 out of 71 means. Differences in ruminal kinetics caused by the different forages were also unaffected by method of residue analyses. Near infrared reflectance spectroscopy allowed a reduction in the number of necessary laboratory analyses of feed residues without affecting the results of in situ studies.

Animal Feed↗
PubMed1997

[The absorbed dose to the gonads in adult patients undergoing defecographic study by digital or traditional radiographic imaging].

INTRODUCTION: Doses to the gonads and skin of adult people were evaluated during the study of functional anorectal disorders with defecography. MATERIALS AND METHODS: The radiologic procedure relies heavily on fluoroscopy with lateral and anteroposterior projections for a mean time of 2.4 minutes; the stages of interest are recorded on a mean of 6 films. Absorbed doses to the gonads and to the skin were measured with LiF thermoluminescence dosimeters placed inside and outside the anthropomorphic "Rando" phantom. The administered doses during the different examination phases (anteroposterior and lateral fluoroscopy and radiography) were measured. Digital and conventional radiography were compared. RESULTS: Gonadal absorbed doses in a standard DSI examination were: 5.0 +/- .1 mGy to the right ovary, 25.2 +/- .7 mGy to the left ovary and 2.7 +/- .1 mGy to testes when at the margin of the irradiation field. Doses to gonads and skin are about 15% higher when the examination is performed with conventional radiography. DISCUSSION: The considerable radiation dose to ovaries shows that defecography can cause radiation-induced genetic effects in women younger than 40 years with a probability of the order of one thousandth of the natural incidence genetic defects. CONCLUSIONS: Defecography must be correctly indicated in fertile women, because of the relatively high absorbed dose to ovaries. In fact, the ovaries absorb about twice as many radiations during defecography than radiologic examinations of the lower gastrointestinal tract.

Absorption↗
PubMed1995

Polyurethane-coated, self-expandable biliary stent: an experimental study.

RATIONALE AND OBJECTIVES: We describe a self-expanding metallic biliary Gianturco-Rösch stent coated with polymeric material. The coating was designed to prevent the growth of neoplastic and reactive tissue within the biliary ducts. METHODS: The stents were coated with a solvent-casting technique, which consists of dissolving polyurethane (polyether urethane or polycarbonate urethane) pellets in a solvent (dimethylacetamide), dipping the stent in the solution, and completely evaporating the solvent. In vitro mechanical characterization of the stent was performed to determine the adhesion of the coating to the metallic cage, the best introducer caliber for implantation of the device, and the relationship between the stent's diameter and radial stress. RESULTS: Reports in the literature on the biostability of polycarbonate urethane compared with polyether urethane prompted us to use the former material to coat the stents. The solvent technique gives a smooth internal surface of the stent wall, leaving in relief the coated structure of the stent on the external surface. The functional tests demonstrated that the coating did not compromise the original characteristics of the stent in terms of self-expandability, axial flexibility, and increased radial rigidity of the device. CONCLUSION: Functional tests verified coating stability and device handling, which are the first steps toward in vivo experimentation.

Bile Ducts↗
PubMed1995

In situ ruminal disappearance of essential amino acids in protein feedstuffs.

Four protein sources were incubated in situ to estimate AA disappearance. Bags containing either soybean meal, corn gluten meal, herring meal, or meat meal were washed in water or suspended in the rumen of two Holstein cows for 8, 12, 16, 24, 48, 72, and 120 h. Cytosine, a bacterial marker for microbial contamination, was used to correct the essential AA profile for microbial contribution to determine the residual essential AA composition of the protein sources after incubation. Ruminal disappearance of individual essential AA was different among feedstuffs. Relative to original feed protein, soybean meal and corn gluten meal decreased the concentration of specific essential AA in the RUP. Concentration of all essential AA, except Arg and His, increased in undegraded meat meal protein. The difference between original and residual AA concentrations in herring meal approached statistical significance. Use of the original AA profile of the feed protein to predict essential AA available for absorption is not accurate because accuracy differs with sources.

Amino Acids, Essential↗
PubMed1994

Corn gluten meal or dried brewers grains as partial replacement for soybean meal in the diet of Holstein cows.

Holstein cows (n = 24, 9 primiparous) were assigned equally to diets based on corn silage and high moisture corn supplemented with soybean meal alone or with either corn gluten meal or dried brewers grains. In diets with two protein sources, the protein quantity from each source was similar. Dietary CP and ADF averaged 16.3 and 18.8%, and undegraded protein as a percentage of CP was 33.6, 41.1, and 41.8% for the respective diets. After parturition, cows were fed the soybean meal diet for a 3-wk covariant period, an experimental diet for 10 wk, the soybean meal diet for 3 wk, and the experimental diet for another 10 wk. Milk production by cows fed those diets averaged 30.9, 31.7, and 34.9 kg/d; protein averaged .90, .94, and 1.02 kg/d; and DMI averaged 16.8, 18.8, and 18.2 kg/d, respectively, for the two 10-wk periods. No dietary differences occurred for 3.5% FCM, estimated DM digestibility, BW, BW gain, or percentages of milk fat, protein, or SNF. Ruminal isobutyrate and isovalerate differed by diet; isovalerate was highest in the diet containing soybean meal plus corn gluten meal, probably because of the high Leu content of corn gluten meal. Ruminal NH3 N did not differ. The favorable production response by cows fed dried brewers grains can be explained by a more favorably balanced AA profile in the ruminally undegraded protein than in other diets.

Animal Feed↗
PubMed1994

[Self-expanding metal stents in the treatment of neoplastic esophageal stenosis. The technic and preliminary results].

Self-expanding metal stents have been recently used for the treatment of neoplastic esophageal stenoses. In our series, nitinol Strecker stents were implanted in ten patients with malignant esophageal intrinsic or extrinsic strictures, as a definitive palliation. Thirteen stents in all were used: two stents were positioned in three patients to recanalize the esophagus. The prostheses could always be inserted in the treated patients and in all of them swallowing was markedly improved. No major early complications were observed after stent insertion. All the stents but one were patent until the patient's death. Two patients are alive and bearing well-functioning stents. Self-expanding metal stents are to be preferred to plastic endoscopic tubes because their caliber is smaller at the time of insertion and they do not require general anesthesia, as endoscopic tubes sometimes require. Moreover, their complication rate is lower for both early and late complications. Tumor ingrowth through the stent mesh with stent occlusion is the major pitfall of these prostheses, together with the impossibility to use them when esophageal fistulas are present: these limitations will be soon overcome when silicone-coated expandable stents are on the market.

Aged↗
PubMed1994

[Digital fluorography in gastroenterological radiology].

The clinical value of two digital fluoroscopy systems not connected to a PACS was investigated and compared with that of conventional radiology. Some critical variables were considered: image intensifier diameter, image definition, examination time, acquisition speed, patient exposure and finally film consumption. The main problems in the use of the digital techniques consisted in the limited size of the examination fields, which was not big enough to demonstrate the whole colon during double contrast enema, and in the difficult representation of the actual size on the image printed on the laser films. Definition was considered as sufficient for GI examinations. The main advantages consisted in acquisition speed, allowing detailed examinations of cervical esophagus, cardias and fistulous tracts, reduced patient dose and finally the real time visualization of the acquired image on the TV monitor.

Digestive System↗
PubMed1993

The outcome of cholangitis after percutaneous biliary drainage in neoplastic jaundice.

The purpose of this paper is to evaluate factors affecting the outcome of cholangitis after PTBD in jaundiced cancer patients. Twenty nine patients with neoplastic jaundice (male/female ratio 13/16, median age 55 years) with full clinical data, were treated by PTBD and developed cholangitis at a median of 9 days later. Four patients (14%) died of biliary sepsis a median of one month after PTBD while the other 25 survived a median of 6 months, with one week median duration of cholangitis. The probability of the cholangitis resolving was analyzed by time to resolution and it was found that 50% and 100% of the recoveries occurred 5 and 9 months respectively from the onset of the complication. The series was analyzed to determine the role of several variables (disease/patient/treatment related) in the resolution of cholangitis. Only a low stricture site, a large initial drainage catheter (10F) and a temperature increase exceeding 39 degrees C were correlated with a positive outcome. We conclude that PTBD-related cholangitis has, in our experience, a good chance of cure, low mortality rate and satisfactory 6 months median survival.

Acute Disease↗
PubMed1993

Observations on in situ degradation of forage cell components in alfalfa and Italian ryegrass.

The rate and extent of degradation of forage feed fractions contained in alfalfa and Italian ryegrass hays were determined. Nylon bags filled with 4 g of each forage were suspended in the rumen of two cannulated cows immediately before feeding and incubated for 10 different times (0, 2, 4, 8, 12, 24, 48, 72, 120, and 168 h). The alfalfa hay, which had lower NDF, showed a lower extent, but a higher rate, of NDF degradation than the Italian ryegrass (41.1 vs. 59.8% and 4.64 vs. 2.91%/h, respectively). Alfalfa cell walls were degraded more rapidly than Italian ryegrass even though their lignin content was higher. The hemicellulose fermentation of alfalfa showed a longer lag time (13 h) and an undegradable fraction nearly twice that for Italian ryegrass (63.3 vs. 37.1%). Cellulose from alfalfa was degraded at a higher rate than NDF or ADF, indicating that cellulose may be the primary site of hydrolysis of the cell wall in the rumen. Calculations based on in situ degradability indicate that alfalfa can have a higher inclusion than Italian ryegrass in diets for dairy cows because of lower NDF and greater availability of cell contents.

Animal Feed↗
PubMed1992

Immunization and vaccination protocol in hemodialysis patients with naturally acquired hepatitis B antibody.

Long-term behavior of naturally acquired anti-HBs antibody was tested every 6 months for 3 years in 22 dialysis patients. Fifteen of them maintained protective levels throughout follow-up (102 and 85.5 mUI/ml at the beginning and the end, respectively). Seven of them became anti-HBs and were submitted to a 40-micrograms booster injection of hepatitis B vaccine. Seroconversion was observed in 6 of 7 patients (85.7%) with a mean anti-HBs titer of 90.4 and 47.3 mUI/ml after 3 and 6 months, respectively. Protective anti-HBs level may be maintained longer in patients with natural immunity than in HBsAg-negative vaccinated subjects. Effectiveness of a reduced vaccination protocol in patients who have lost their natural immunization should be confirmed with further studies.

Adult↗
PubMed1992

[Echocardiographic changes in patients with polycystic nephropathy].

We have studied with the echocardiography M-Mode, 2-D, Doppler three groups of 15 subjects for testing the presence of cardiac abnormalities probably related to primary collagen defect in patients with autosomal dominant polycystic kidney disease (ADPKD) The first group was made up of patients with ADPKD and normal renal function, the second of patients with ADPKD in hemodialysis (HD), the last one of patients in HD for other renal disease. In the first group we found no cardiovascular abnormalities while we found an increased incidence of valvular disease (p = 0.016) in patients with ADPKD in HD and an increased incidence in valvular disease (p = 0.016) and left atrial dilatation (p = 0.006) in patients in HD for different renal disease. When we estimated the cases on the ground of dialytic age uncorrelated with the initial renal disease, only the incidence of valvular calcifications was increased in patients on HD more than 3 years (p = 0.034). In our group of patients the echocardiographic abnormalities seem to be related more to uremic cardiomyopathy even if we cannot deny the existence of primary cardiac disease in patients with ADPKD.

Adult↗
PubMed1992

[High-resolution electrocardiography evaluation of late potentials. A comparison between Frank XYZ orthogonal leads and standard precordial electrocardiographic leads].

High-resolution electrocardiography has been used as a non-invasive method for the study of delayed potentials in order to evaluate the risk of the onset of ventricular arrhythmia first in ischaemic cardiopathy and then in various cardiopathies, generally using XYZ orthogonal derivations. The aim of this study was to compare the results obtained with those using standard precordial leads, in particular V4 and V6 leads. A group of 28 patients, males and females, aged between 15 and 55 years of age, was examined. All patients were suffering from different cardiopathies. Subjects with delayed right and left ventricular activation on the surface ECG tracing were excluded from the study. A 60-200 Hertz bandpass filter and time averaging of 300 consecutive complexes were used to analyse tracings. Dual recordings were performed for each patient. The following parameters were examined: total duration of filtered QRS complex and root-mean-square voltage of potentials in the last 40 msec of filtered QRS (RMS). In particular, the comparison between RMS using Frank's method and those obtained using V4 and V6 precordial leads provided a coefficient of correlation of r = 0.91 with p < 0.001 and r = 0.92 with p < 0.001 respectively, and the comparison between QRS obtained using the same method and that obtained using V4-V6 precordial leads gave a coefficient of correlation of R = 0.80, p < 0.001 and r = 0.77 and p < 0.001 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗