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Biomedical subjects

G Giannone

Publications and source records attributed to G Giannone.

At least 19 recordsLinked to original sources
PubMed2006

Aggressive fibromatosis of the neck initiated after thyroidectomy.

We describe the case of a 44-yr-old woman, who 2 yr after thyroidectomy for a multinodular goiter with a follicular adenoma showed a rapidly growing mass of the neck causing dysphagia and moderate pain. Fine needle aspiration biopsy revealed the presence of fibroblast-like cells, partially with atypical features and no colloid: the cytological diagnosis was suspicious for an indeterminate (mesenchymal) neoplasm. Histological diagnosis, after extensive surgery, indicated aggressive fibromatosis. Immunohistochemistry was positive for vimentin and negative for thyroglobulin. After surgery, nuclear magnetic resonance showed a persistent mass of approximately 2 cm; dysphagia and pain persisted. Therefore, the patient received external radiation therapy (total dose 60 Gy) with clinical benefit. The patient is without symptoms 1 yr after surgery.

Adenoma↗
PubMed2004

Maintenance of a normal meal-induced decrease in plasma ghrelin levels in children with Prader-Willi syndrome.

Ghrelin is a 28-amino acid peptide recently identified in the stomach as the endogenous ligand for the growth hormone secretagogue receptor (GHS-R1a). Ghrelin is a potent stimulator of GH secretion. It was recently shown that circulating ghrelin levels in humans rise shortly before and fall shortly after every meal, and that ghrelin administration increases voluntary food intake. The hypothesis that ghrelin hypersecretion might contribute to genetic obesity has never been investigated. In this context, Prader-Willi syndrome is the most common form of human syndromic obesity. As ghrelin affects appetite as well as GH secretion and both are abnormal in PWS, it has been surmised that these alterations might be due to ghrelin dysregulation. The aim of the study was to investigate whether ghrelin is suppressed by the meals differently in PWS children than in PWS adults. Overnight circulating fasting ghrelin levels and ghrelin levels 120 min after breakfast were assayed in 7 PWS children (10.2 +/- 1.7 yr), 7 subjects with morbid obesity (10.3 +/- 1.3 yr), and 5 normal controls (8.4 +/- 1.4 yr). Because of the data spread, no statistical difference was observed in fasting ghrelin levels between PWS and control children (p = NS); anyway, fasting ghrelin levels were significantly lower in obese children than in the other groups (p < 0.05 vs. control and PWS children). Ghrelin levels were slightly suppressed by the meal in control subjects (mean fasting ghrelin: 160.2 +/- 82 pg/ml; after the meal, 141.2 +/- 57 pg/ml, p = NS); the meal failed to suppress ghrelin levels in obese children (mean fasting ghrelin: 126.4 +/- 8.5 pg/ml; after the meal, 119.1 +/- 8.3 pg/ml, p = NS). Interestingly, the meal markedly suppressed ghrelin levels in PWS children (mean fasting ghrelin: 229.5 +/- 70.4 pg/ml; after the meal, 155.8 +/- 34.2 pg/ml, p < 0.01). In conclusion, since a lack of decrease in circulating ghrelin induced by the meal was previously reported in PWS adults, the finding of a meal-induced decrease in ghrelin levels in our population of young PWS would imply that the regulation of the ghrelin system involved in the orexigenic effects of the peptide is operative during childhood, although it progressively deteriorates and is absent in adulthood when hyperphagia and obesity progressively worsen.

Adipose Tissue↗
PubMed2004

[Functional outcomes and quality of life in patients with anterior resection for rectal cancer. Does preoperative manometry predict the feasibility of a J-pouch?].

INTRODUCTION: The goal in the treatment of rectal cancer is the recovery of the disease with the best fecal continence and quality of life. The Authors compared quality of life and manometric results in patients treated with neo-adjuvant chemotherapy and rectal low anterior resection (LRA). METHODS: From January 1998 to March 2002 50 patients with advanced (T3-T4) rectal cancer underwent neo-adjuvant chemotherapy. Subsequently 41 of them underwent LRA with colon pouch (19) or without the pouch (22). After few months the quality of life was evaluated through a questionnaire. Later they underwent manometric evaluation measuring resting, squeeze and rectal compliance. RESULTS: The manometric results and the questionnaire scores agreed in 75% of patients. In detail, patients with hypotonic sphincter had a better (one could say good) quality of life if a LAR with pouch had been performed respect to the patients without pouch. CONCLUSION: Performing LAR with colon pouch after neoadjuvant chemotherapy in patients with hypotonic sphincter improves quality of life. Preoperative anorectal manometry could select patient who would benefit from pouch construction.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Mechanism of calcium oscillations in migrating human astrocytoma cells.

Numerous studies show that intracellular calcium controls the migration rate of different mobile cell types. We studied migrating astrocytoma cells from two human cell lines, U-87MG and A172, in order to clarify the mechanisms by which calcium potentially influences cell migration. Using the wound-healing model to assay migration, we showed that four distinct components of migration could be distinguished: (i) a Ca(2+)/serum-dependent process; (ii) a Ca(2+)-dependent/serum-independent process; (iii) a Ca(2+)/serum-independent process; (iv) a Ca(2+)-independent/serum-dependent process. In U-87MG cells which lack a Ca(2+)-dependent/serum-independent component, we found that intracellular Ca(2+) oscillations are involved in Ca(2+)-dependent migration. Removing extracellular Ca(2+) greatly decreased the frequency of migration-associated Ca(2+) oscillations. Furthermore, non-selective inhibition of Ca(2+) channels by heavy metals such as Cd(2+) or La(3+) almost completely abolished changes in intracellular Ca(2+) observed during migration, indicating an essential role for Ca(2+) channels in the generation of these Ca(2+) oscillations. However, specific blockers of voltage-gated Ca(2+) channels, including nitrendipine, omega-conotoxin GVIA, omega-conotoxin MVIIC or low concentrations of Ni(2+) were without effect on Ca(2+) oscillations. We examined the role of internal Ca(2+) stores, showing that thapsigargin-sensitive Ca(2+) stores and InsP(3) receptors are involved in Ca(2+) oscillations, unlike ryanodine-sensitive Ca(2+) stores. Detailed analysis of the spatio-temporal aspect of the Ca(2+) oscillations revealed the existence of Ca(2+) waves initiated at the leading cell edge which propagate throughout the cell. Previously, we have shown that the frequency of Ca(2+) oscillations was reduced in the presence of inhibitory antibodies directed against beta3 integrin subunits. A simple model of a Ca(2+) oscillator is proposed, which may explain how the generation of Ca(2+) oscillations is linked to cell migration.

Astrocytoma↗
PubMed2000

Novel activation of non-selective cationic channels by dinitrosyl iron-thiosulfate in PC12 cells.

Low molecular mass dinitrosyl iron complexes (DNICs) are nitrosating agents and it is known that the dinitrosyl iron moiety can be transferred to proteins. The aim of the present study was to determine if the formation of protein-bound dinitrosyl iron can modulate ionic channel activity. In PC12 cells, dinitrosyl iron-thiosulfate (50 microM) caused irreversible activation of a depolarizing inward current (IDNIC). IDNIC was partially inhibited by the metal chelator diethyldithiocarbamate (DETC, 1 mM), but not by the reducing/denitrosylating agent dithiothreitol (DTT, 5 mM). The activation of IDNIC was not reproduced by application of nitric oxide (NO., 100 microM), S-nitrocysteine (200 microM) or ferrous iron-thiosulfate (50 microM), and was not prevented by the irreversible guanylyl cyclase inhibitor 1H-[1,2,4]oxadiazolo-[4, 3-a]quinoxalin-1-one (ODQ, 1 microM). Similarly, intracellular perfusion of dinitrosyl iron-thiosulfate (100 microM) did not result in activation of IDNIC. Ion replacement experiments show that the DETC-sensitive component of IDNIC is a non-selective cationic current. In accordance, IDNIC was blocked by antagonists of receptor-operated calcium entry, gadolinium (25 microM) and SK&F 96365 (25 microM). Single-channel measurements from outside-out patches reveal that the DETC-sensitive component of IDNIC is an inward current carried by a cationic channel having a conductance of 50 pS. The present observations suggest that the formation of ion channel-bound dinitrosyl iron represents another mechanism of regulation of ion channel activity by NO.-related species, which may be particularly important in pathophysiological processes where NO. is overproduced.

Animals↗
PubMed2000

Neuroregulation of growth hormone during exercise in children.

Physical exercise is an important physiological stimulus to growth hormone (GH) release in man. Many neurotransmitters are involved in GH regulation. We studied the effect of the cholinergic pathway on GH secretion induced by physical exercise. Particularly, we studied the effect of a cholinergic muscarinic agonist on GH-induced physical exercise, both in children and adults. Moreover, we investigated the refractoriness of GH secretion after a second physical exercise stimulus. Three different protocols were performed: 1) GH response to physical exercise in children and adults; 2) effect of pyridostigmine on exercise-induced GH secretion in children and adults; 3) GH response to two consecutive exercises in children and adults. Our data show that in children GH peak after physical exercise is higher than in adults. Pyridostigmine enhances GH release in children and in adults. Exercise stimulus was able to release GH in the second test only in children, while the refractory phase did not permit a new GH release in adults. The shift to a modality of neural control of GH secretion peculiar of adults is likely due to neuroregulatory mechanisms which may be partly dependent on long-term variation in hormonal milieu.

Adolescent↗
PubMed1998

Benign fibromatous tumor (fibroma) of the kidney: a case report.

Benign fibromatous tumor (fibroma) of the urogenital tract is a distinctive pathologic entity occurring in the testis, paratesticular structures and renal peripelvis. We report a well-circumscribed tumor replacing the cortex and the medulla of more than half of the upper kidney, radiographically thought to be renal cell carcinoma. Histologically, the tumor was characterized by a variable cellularity and was composed of bland spindle-shaped cells loosely dispersed in a fibromyxoid to densely fibrous stroma in which calcifications and chronic inflammation were not observed. Immunocytochemistry showed that cells were positive for vimentin and, only focally, stained positive for desmin and alpha-smooth muscle actin. Differential diagnosis included a wide spectrum of benign and malignant spindle cell tumors. The clinicopathologic features were consistent with benign fibromatous tumor (fibroma) of the kidney. To our knowledge, this is the first case of benign fibromatous tumor (fibroma) of the kidney reported in the English literature.

Aged↗
PubMed1997

[The clinico-instrumental assessment of the vascular status of the uremic patient for the making of a vascular access for hemodialysis].

For almost twenty years the Institute of General Surgery and Organ Transplant at Palermo Polyclinic has dealt with vascular problems arising during the preparation, monitoring and search for vascular access in uremic patients. For a number of years advantage has been taken of the vascular status in uremic patients; in fact, the possibility of creating a long-lasting and efficient vascular access also depends on the optimal use of the patient's vascular resources. The authors briefly describe the clinical and instrumental diagnostic strategy for the approach to a vascular access in uremic patients which must be correct and must respect the vascular resources of a "chronic" patient by definition, for whom hemodialysis is often the only prospect of therapy.

Adult↗
PubMed1997

[1st case of extra-gastrointestinal anisakiasis in a human diagnosed in Italy].

A case of extra-gastrointestinal infection by Anisakis in a woman living in Catania (Sicily, Southern Italy) is described. The patient complained of severe pain in the ileocecal region, and a diagnosis of acute appendicitis led to an appendectomy. During the intervention, a laparoscopic exploration showed a nodule on the large omentum that was surgically removed. Parasitological diagnosis was achieved on the basis of morphological observations carried out on the histological sections of the nodule.

Abdominal Pain↗
PubMed1995

S-100 protein expression in a case of elastofibroma dorsi.

Elastofibroma is a rare tumorlike process that manifests as slowly growing, solid mass in the subscapular region of elderly persons. Histologically, it is characterized by the presence of fibrous connective tissue in which eosinophilic fibers and globular masses, stained by the elastic tissue stains, are interspersed. We report the immunohistochemical study of the cellular component in a case of subscapular elastofibroma in a 41-year-old man. An unexpected immunoreactivity for S-100 protein was detected in most fibroblast-like cells. S-100 protein expression may be related to a chondroid metaplasia of fibroblast-like cells in response to the continuous traumatic process occuring during the friction between the scapula and the underlying chest wall.

Adult↗
PubMed1989

[Changes in the lymphocyte subpopulations in a patient with orthotopic transplant of the liver].

Earlier experimental studies have shown that the cyclosporin immunosuppressive effect (CsA) can be modulated by drug timing as well as dose. More specifically treatment during the night was constantly associated with a statistically significant improvement in the prevention or delay of allograft rejection. The present study reports on the circadian variations in T-lymphocyte subpopulations in the peripheral blood of a patient given an orthotopic liver allograft and treated with CsA and steroids. In particular, a statistically significant circadian rhythm (p = 0.012) was observed for the T-helper (OKT4) subset with a peak time (acrophase) occurring during the night at 4:27 A.M. In this patient, CsA treatment was, therefore, adapted to the T-helper cycle with the aim of marching CsA blood level variations to that curve. The results suggest that CsA timing can provide a tool for daily dose reduction and then improve the success rate of drug treatment.

Antigens, Surface↗
PubMed1989

Peak flow records in asthma: evaluation of an algorithm for interpretation of patterns.

The clinical value of serial measurements of peak expiratory flow (PEF) in asthma is well established, but the analysis of the PEF records is not standardized. We developed an algorithm for interpretation of PEF, based upon the characteristic features of chronic airflow limitation, and retrospectively analysed the PEF of fifty outpatients affected by non-seasonal asthma. For each patient we correlated the developed indices of evolution of PEF with, respectively, the severity of asthma (evaluated in terms of consumption of drugs), forced expiratory volume in one second and with the trend of the indices over several months. The developed indices were well correlated with the severity score and to a lesser extent to other investigated parameters. These results seem to provide a useful approach to a computerized evaluation of the results of PEF monitoring.

Adolescent↗
PubMed1987

Continuous positive airway pressure improves the quality of sleep and oxygenation in obstructive sleep apnea syndrome.

We tested the effects of continuous positive airway pressure (CPAP) in 8 patients with obstructive sleep apnea syndrome (OSAS). The comparison of a nocturnal polygraphic study performed during spontaneous breathing with a study during CPAP administration performed the following night showed a significant reduction in stage 1 and increase in REM, the abolition of obstructive apneas and a significant increase in mean oxyhemoglobin saturation. Most patients reported marked relief of symptoms after the first night of treatment. However 3 patients, though confirming the improvement refused further CPAP. We conclude that CPAP is an effective measure for prevention of apneas in OSAS and that in compliant patients it may be regarded as a short-term measure when a permanent correction of the causes is planned, or as a long-term treatment when the latter is not feasible.

Aged↗
PubMed1986

Effects of almitrine bismesylate on nocturnal hypoxemia in patients with chronic bronchitis and obesity.

In a double-blind placebo controlled randomised study, the effects of almitrine bismesylate on the sleep induced Hb desaturations, associated or not with disorders of breathing, were tested. Patients (37-75 yrs, 8M and 2F) were affected by chronic bronchitis (out of any exacerbation) and obesity (weight excess at least 20%). They were known to have at least one nocturnal episode of hypoxemia (SaO2 fall higher or equal to 10%) with respect to the wakefulness level. Patients received either placebo or almitrine (1.5 mg/Kg/day) for 18 days and nocturnal polysomnography was performed both before and the last day of treatment. Almitrine induced an increase in PaO2 during wakefulness (p less than .05), an increase in mean SaO2 during sleep (p less than .01) and a decrease in the quantity of desaturation (Qd) during sleep, defined as the product of the mean desaturation by the duration of the episodes of desaturation (p less than .025). No clear effect could be observed either on the mean duration of the sleep disordered breathing (SDB) events or on their frequency whereas the desaturations due to them had a decrease.

Adult↗
PubMed1986

Long term results of high selective vagotomy: a 12-year experience.

The long term results (6 to 12 years) of high selective vagotomy are reported. The study includes 470 patients operated electively for uncomplicated duodenal ulcer. The indications for surgery were: persistence of ulcer after medical treatment; recurrent ulcer after repeated treatments with antacids and/or H2 blockers; noncompliance of the patients with the medical treatment for various reasons. The procedure was performed following the technique described by Goligher with minor modifications. Subsequently, a personal technique of intraoperative transesophageal gastric pHmetry was applied for the control of the completeness of vagotomy. The clinical results were classified according to Visick grading. It is concluded that the absence of mortality, the negligible postoperative morbidity, the clinical and functional results make high selective vagotomy the best treatment for uncomplicated duodenal ulcer.

Duodenal Ulcer↗