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Biomedical subjects

G Gargiulo

Publications and source records attributed to G Gargiulo.

108 records · Page 6Linked to original sources
PubMedDate not supplied

Recovery kinetics of oxygen uptake is abnormally prolonged in patients with Mustard/Senning repair for transposition of the great arteries.

The aim of this study was to evaluate the ability to recover from exercise in patients with a Mustard/Senning (M/S) repair for transposition of the great arteries and to identify the major determinants. A total of 40 consecutive patients with a M/S repair at a mean age of 10.0 +/- 9.8 months underwent maximal cardiopulmonary exercise testing at 19.5 +/- 11.3 years of age. Results were compared to those of a cohort of 153 healthy individuals. Decay of oxygen uptake (VO2), CO2 (VCO2), minute ventilation (VE), heart rate (HR) was calculated for the first minute of recovery. M/S patients had reduced peak VO2(22.9 +/- 7.2 vs 34.2 +/- 9.5 ml O2/kg/min, p < 0.0001) and VO2 slope (0.27 +/- 0.10 vs 0.47 +/- 0.2 L O2/min, p < 0.0001), Peak O2 pulse (p < 0.0001) and peak HR (p = 0.001) were reduced. VCO2 and VE slopes were reduced (p < 0.0001 for both), whereas HR slope was similar (p = 0.38). In M/S patients, the only independent determinants of VO2 slope during recovery were pulse O2 slope (p < 0.0001) and VCO2 slope (p < 0.0001). In M/S patients, a limited cardiopulmonary reserve affects not only maximal exercise responses but also the recovery phase. A prolonged recovery of O2 pulse and a prolonged CO2 retention with subsequent prolonged hyperpnea are the main determinants of the delayed recovery.

Adolescent↗
PubMedDate not supplied

Tandem action of exercise training and food restriction completely preserves ischemic preconditioning in the aging heart.

Ischemic preconditioning (IP) has been proposed as an endogenous form of protection against ischemia reperfusion injury. IP, however, does not prevent post-ischemic dysfunction in the aging heart but may be partially corrected by exercise training and food restriction. We investigated the role of exercise training combined with food restriction on restoring IP in the aging heart. Effects of IP against ischemia-reperfusion injury in isolated hearts from adult (A, 6 months old), sedentary 'ad libitum' fed (SL), trained ad libitum fed (TL), sedentary food-restricted (SR), trained- and food-restricted senescent rats (TR) (24 months old) were investigated. Norepinephrine release in coronary effluent was determined by high performance liquid cromatography. IP significantly improved final recovery of percent developed pressure in hearts from A (p<0.01) but not in those from SL (p=NS) vs unconditioned controls. Developed pressure recovery was partial in hearts from TL and SR (64.3 and 67.3%, respectively; p<0.05 vs controls) but it was total in those from TR (82.3%, p=NS vs A; p<0.05 vs hearts from TL and SR). Similarly, IP determined a similar increase of norepinephrine release in A (p<0.001) and in TR (p<0.001, p=NS vs adult). IP was abolished by depletion of myocardial norepinephrine stores by reserpine in all groups. Thus, IP reduces post-ischemic dysfunction in A but not in SL. Moreover, IP was preserved partially in TR and SR and totally in TR. Complete IP maybe due to full restoration of norepinephrine release in response to IP stimulus.

Aging↗
PubMedDate not supplied

The surgical treatment of thoracic and lumbar fractures by posterior approach.

A review of large case series, biomechanical studies and the development of surgical approaches and various types of instrumentation have led to different orientations in the surgical treatment of vertebral fractures. The authors present their experience in 67 cases treated by posterior approach using segmental fixation for the instability of the lesion and the possible association of neurologic deficit (Magerl A in 35 cases, B in 25, C in 7; Frankel A in 21 cases, B in 15, C in 9, D in 6). At a mean follow-up of 3 years, treatment by posterior approach allowed us to suitably treat most of the vertebral fractures observed with clinically satisfactory results, but without observing a definite correlation between neurologic recovery and quality of the reduction. The overall realignment of the spine with extension synthesis and adequate geometry and the development of good bone callus allowed us to obtained a stable spine, protecting consolidation of the fractured metamere.

Adolescent↗
PubMedDate not supplied

Successful surgical repair of an aortico-left ventricular tunnel in a two day old child.

Repair of an aortico-left ventricular tunnel was successfully accomplished on the second day of life in a neonate with severe cardiac failure. During pregnancy an echocardiographic diagnosis of aortic insufficiency (AI) was made and the type of the malformation was completely clarified after birth. Repair was accomplished using an open patch aortoplasty technique as suggested by Bjork.

Aorta↗
PubMedDate not supplied

Powdered alumina implants in the experimental animal: a histological study conducted in the rat.

The authors present a histological study conducted in the rat after powdered alumina implantation in the subcutis, the muscle and the peritoneum. After two weeks the same intense acute inflammatory reaction was observed in all of the implantation sites. After eight weeks the inflammatory reaction had regressed: there was a thin layer of connective tissue around the implant, completely isolating it from the surrounding tissues.

Aluminum Oxide↗
PubMedDate not supplied

Os odontoideum.

Between January 1981 and December 1985 at the Rizzoli Orthopaedic Institute 8 patients affected with atlo-axial instability secondary to os odontoideum were submitted to surgery: all of the patients were characterized by persistent cervical pain and neurological deficit, which was still at an initial stage in 5 cases, and more severe in the remaining 3 (severe spastic tetraparesis). All of the patients were submitted to a similar treatment protocol in three stages: 1) preoperative reduction in halo-plaster, 2) surgical stabilization of C1-C2 by posterior vertebral fusion (limited to C1-C2 in 6 cases and extended as far as the occiput in the remaining 2), 3) postoperative immobilization in halo-plaster for an average of 12 weeks. At follow-up obtained after an average of 4 years and 2 months there was consolidation of the fusion in all of the cases treated: in 1 case, however, revision of the fusion was required 3 and 1/2 months after surgery, whereupon fusion was finally obtained. The total regression of pain was obtained in all 8 of the cases treated and there was evident neurological recovery in the 3 patients who had been characterized by severe spastic tetraparesis prior to surgery. The treatment protocol used in this series of patients proved to be a reliable one. Thus, it was possible to avoid the onset of chronic atlo-axial instability and its severe neurological sequelae in those cases where neurological deficit was still at an initial stage; furthermore, effective recovery was obtained in patients in whom neurological deficit was severe.

Adolescent↗
PubMedDate not supplied

Medullary compression secondary to acute post-traumatic cervical disc herniation: 5 cases.

Based on their observation of 5 cases of acute posttraumatic cervical disc herniation with medullary lesion, as well as on what is reported in the literature, the authors examine the clinical features of the disease, at the same time evaluating and comparing the major diagnostic studies. What emerges from the study is the importance of NMR and CAT in the diagnosis of the lesion. Finally, the authors emphasize the importance of early surgical treatment.

Adult↗
PubMedDate not supplied

Beta-endorphin concentrations both in plasma and in cerebrospinal fluid in response to acute painful stimuli.

The beta-endorphin-like-immunoreactivity (beta-ELI) has been evaluated both in plasma and in cerebrospinal fluid (CSF) in 30 patients during trans-sphenoidal surgery. Blood and liquoral samples were collected in five conditions: (1) "reference", (2) "pain", (3) "analgesia", (4) "end", and (5) "24th hour". A significant rise of both plasma and liquoral beta-ELI levels (p less than 0.00001 and p less than 0.08, respectively) when compared to basal ones occurred following the painful stimulation due to the divarication of the nasal mucosa by speculum. A significant decrease (p less than 0.01) was noticed for plasma concentrations at the third sample followed by a new significant increase at the end of the operation, (p less than 0.05 when compared to the third sample and p less than 0.01 when compared to the reference sample). In CSF, beta-ELI levels decreased at the third sample (p less than 0.01 when compared to the painful levels) and at the end of surgery (p less than 0.01, p less than 0.01 and p less than 0.05 vs first, second and third samples, respectively). Twenty-four hours after surgery either plasma and liquoral beta-ELI levels decreased (p less than 0.05). The modifications of the opiatergic system after acute painful stimuli should be, hence, characterized by an early rise followed by a progressive decrease of beta-ELI concentrations. The increase of plasma beta-ELI levels, at the end of surgery, could be due to pituitary manipulation with massive release in the peripheral blood.

Acute Disease↗
PubMedDate not supplied

The epidemiology of idiopathic scoliosis in the city of Bologna. A three-year review of positive cases.

The authors report the results obtained in a review of all of the young patients who have been found to be affected with vertebral deformity in an epidemiological study conducted during the academic years 1983-84 and 1984-85. There is predilection for the female sex, which is also more vulnerable to the risk of progression. Menarchal age constitutes the most important period for the progression of the deformity. The most frequent type of curve observed is the double primary one, in particular, right thoracic and left lumbar, which proved to be that most vulnerable to angular progression. The cases which in a previous screening had been defined risk cases were followed-up, and thanks to early diagnosis and suitable treatment surgery was not required in any of these.

Adolescent↗
PubMedDate not supplied

Experimental model of nervous anastomosis between intercostal and lumbar nerves in the rabbit.

The authors propose a new experimental model of nervous anastomosis between intercostal and lumbar nerves in rabbit with the purpose of providing a technique to by-pass a spinal lesion. Before carrying out the surgical experiments, an histological study has been performed on the donor and receiver nerves which demonstrated the great difference in number of nervous fiber between these two nerves. The purpose of the method is thus to reinnerve a lumbar nerve by means of two intercostal nerves. Histological controls are performed on the 120th day.

Animals↗
PubMedDate not supplied

Giant cell tumor of the spine. Surgical findings.

The authors report 5 cases of giant cell tumor surgically treated. After a mean follow-up of 7 years posterior stabilization alone in the latent form, and wide intralesional curettage in the four aggressive forms allowed for suitable treatment of the lesion, with remission of symptoms leaving stability of the spine intact. Radiation therapy was used successfully in only 1 case of local recurrence occurring 4 months after surgical treatment. Unlike localizations of giant cell tumor in other skeletal segments, whether or not margins are left intact does not seem to influence clinical results.

Adult↗
PubMedDate not supplied

The surgical treatment of cervical metastases.

Vertebral instability and the neuroaggressiveness produced by the occurrence of cervical metastasis in a neoplastic patient during remission or quiescence of the disease is rare, but it may negatively influence the prognosis of the patient and drastically reduce his or her life expectancy. The authors describe their experience with conservative or surgical treatment in 151 patients affected with cervical metastases.

Adult↗