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Biomedical subjects

G Gangeri

Publications and source records attributed to G Gangeri.

3 recordsLinked to original sources

PC-based differential model fitting as a support for clinical research.

A PC-based minimisation software written in C-language is described, which solves numerically both simple non-linear regression problems and problems expressed as systems of (unsolved) initial-value ordinary or partial differential equations. The software uses second-order iterated Runge-Kutta algorithm to approximate numerically the solution curves. It uses a quasi-Newton algorithm to minimize either sums of squares (weighted or unweighted) or NONMEM loss functions. Inverse Hessian approximation to the parameter dispersion and Monte Carlo generation of artificial samples are offered to test the robustness of the parameter values obtained. A real test problem is described, involving the hydrolysation of plasma Medium Chain Triglycerides to Free Fatty Acids and the uptake of these from plasma. Two competing models were evaluated, one involving linear terms for each transfer and one involving carrier-mediated, rate-limited hydrolysis and tissue absorption steps. The simpler linear model was found to be more robust and eventually used to describe the experimental data.

Algorithms↗

[Primary carcinoid of the umbilicus. Description of the 1st case].

A 78-year old male came to our observation presenting and enlargement of bilateral inguinal lymph nodes and a tumor of the mesogastric abdominal wall. Three years before the patient had been operated on for a primary tumor of the umbilicus with concomitant longstanding diarrhea. No histological examination was performed at that time. We performed a lymph node biopsy which demonstrated carcinoid metastasis. We went on to perform radical resection of the abdominal wall, regional lymphadenectomy and right hemicolectomy for malignant villous adenoma of the right colon. The abdominal defect was repaired by using Goretex mesh. Cyclic adjuvant alpha-interferon therapy was continued for more than 1 year, followed by long term therapy with longastatin. Twenty months after the operation the patient is in good clinical conditions and disease-free. On the basis of literature review our case appears to be the first primary carcinoid of the umbilicus.

Abdominal Muscles↗

Kinetics of medium-chain triglycerides and free fatty acids in healthy volunteers and surgically stressed patients.

To determine the hydrolysis rate of medium-chain triglycerides (MCTs) to medium-chain free fatty acids (MCFAs) and the disposition rate of MCFAs, five healthy volunteers (H) and eight surgically stressed patients (S) received 0.5 mL of Lipofundin 20% per kilogram body weight as an intravenous bolus. Serum MCTs (C8 and C10) and MCFAs were measured by high-performance liquid chromatography during the 120 minutes postinjection. A linear two-compartment model was found to be descriptive and robust: the apparent volumes of distribution were found to be similar in healthy and surgical subjects for both MCTs and MCFAs. The first-order transformation rate constant (hydrolysis) from MCTs to MCFAs was not significantly different between the H and S groups (overall 0.112 +/- 0.022/min, C8; 0.078 +/- 0.020/min, C10). The rate constant for tissue MCFA uptake from plasma was significantly different between S and H subjects both for C10 alone (H: 0.0337 +/- 0.0078; S: 0.1194 +/- 0.0240; p = .020) and for C8 and C10 together (H: 0.0382 +/- 0.0054; S: 0.1012 +/- 0.0168; p = .008), whereas it failed to attain significance when C8 alone was considered (H: 0.047 +/- 0.0077; S: 0.0829 +/- 0.0230; p = .210). These results show that use of MCTs is increased in surgical patients because of enhanced tissue uptake of the corresponding free fatty acids, whereas there does not seem to be an increase of MCT hydrolysis in response to acute disease. This would indicate that the stressed patient is in fact able to effectively use this alternative lipid substrate in the face of increased metabolic demand.

Adult↗