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Biomedical subjects

G Lamberti

Publications and source records attributed to G Lamberti.

At least 19 recordsLinked to original sources

The heterozygous 20210 G/A genotype prevalence in patients affected by central and branch retinal vein occlusion: a pilot study.

BACKGROUND: Several inherited conditions have been associated with an increased or decreased incidence of retinal vein occlusion (RVO). The A allele in the 20210 G/A prothrombin gene has been found to be associated with systemic venous thrombosis. The aim of this study has been to verify the prevalence of this mutation in patients affected by central RVO (CRVO) or branch RVO (BRVO). METHODS: A retrospective study was carried out on 100 consecutive patients suffering from RVO, more than 50 years old, unaffected by systemic diseases known to be associated with markedly increased RVO occurrence. We determined the frequency of this mutation by performing mutagenised amplification of exon 14 followed by restriction analysis of the amplified DNA fragment. RESULTS: The overall frequency of prothrombin 20210A allele in RVO patients was 6.0%. All heterozygous patients had suffered from CRVO. In this study subgroup, the frequency of the 20210 G/A prothrombin heterozygosis was 12.0%. The difference in the frequency of this the genetic variant between the CRVO and BRVO groups was statistically significant. None of the conventional RVO risk factors were statistically related to the occurrence of the disease in either the CRVO or the BRVO subgroup. CONCLUSION: The prevalence of the prothrombin 20210A mutation observed in CRVO patients is significantly higher than in the normal Italian population. Moreover, the prevalence is significantly greater in CRVO than in BRVO patients. These results raise the possibility that the prothrombin 20210A variant may be considered as a risk factor for CRVO.

Aged↗

Effect of hinged lamellar keratotomy on postkeratoplasty eyes.

PURPOSE: To evaluate the effect of a hinged lamellar keratotomy on refraction, vision, and corneal topography of postkeratoplasty eyes with high-degree astigmatism. DESIGN: Noncomparative, interventional case series. PARTICIPANTS: A hinged lamellar keratotomy was performed on nine eyes of nine patients at least 9 months after penetrating keratoplasty and with high-degree astigmatism. All patients were spectacle and contact lens intolerant. INTERVENTION: A superiorly hinged lamellar keratotomy (corneal flap), 160 microm in thickness and 9 mm in diameter, was created on all eyes included in this study. Each patient was examined 1 day, 1 month, and 3 months after surgery. MAIN OUTCOME MEASURES: Uncorrected visual acuity, best spectacle-corrected visual acuity, refraction, computerized analysis of corneal topography. RESULTS: At each postoperative examination time, there was a significant reduction in both average spherical equivalent (P < 0.05) and average absolute value of astigmatism (P < 0.01) over mean preoperative values. The major changes were seen as early as 1 day after surgery, but both progression and regression of the effect were documented at later postoperative examinations. In all patients best spectacle-corrected acuity was maintained or improved after the procedure. Postoperatively, four patients could be successfully corrected either with spectacles (n = 2) or with gas-permeable contact lenses (n = 2). There were no surgical flap or corneal graft complications. CONCLUSIONS: Hinged lamellar keratotomy improves vision and refraction of postkeratoplasty eyes with high-degree astigmatism. In some cases it may be so effective as to make planned excimer laser treatment unnecessary.

Adult↗

Idiopathic central retinal vein occlusion in a thrombophilic patient with the heterozygous 20210 G/A prothrombin genotype.

PURPOSE: To report the occurrence of monolateral central retinal vein occlusion in a patient with heterozygous 20210 G/A prothrombin genotype, known to be associated with high thrombophilic risk. METHODS: A monolateral central retinal vein occlusion was diagnosed in a 71-year-old woman, who had suffered from a deep vein thrombosis in her left leg at the age of 36 years. Mutations of the genes involved in the coagulation process were investigated by DNA polymerase chain reaction. RESULT: DNA analysis showed the patient to be heterozygous for the prothrombin 20210 G/A genetic variation. CONCLUSION: The 20210 G/A prothrombin gene mutation may be associated with central retinal vein occlusion.

Aged↗

Intraoperative cauterization of the cornea can reduce postkeratoplasty refractive error in patients with keratoconus.

OBJECTIVE: This study aimed to evaluate the effect of intraoperative corneal cauterization on the postkeratoplasty refraction of patients with keratoconus. DESIGN: A randomized clinical trial. PARTICIPANTS: Thirty eyes of 29 patients with keratoconus undergoing standard penetrating keratoplasty by the same surgeon were evaluated (MB). INTERVENTION: Standard penetrating keratoplasty included the use of an 8.0-mm donor button sutured into a 7.5-mm recipient bed by means of two running 10-0 nylon sutures with 16 bites each. Before trephination of the recipient bed, superficial cauterization causing tissue shrinkage was applied to a 6-mm central area of the cornea of only 15 eyes (group A). The remaining 15 eyes (group B) did not undergo intraoperative cauterization. Before surgery, 6 months, and 13 months after surgery, a complete ophthalmologic examination was performed on each patient, including uncorrected and best-corrected visual acuity, refraction, keratometry, computerized corneal topography, as well as A-scan contact ultrasonography. MAIN OUTCOME MEASURES: Postkeratoplasty refractive error was measured. RESULTS: Both 6 months (sutures still in place) and 13 months (suture removal performed in all patients) after surgery, the average spherical equivalent was significantly less myopic in the patients undergoing cauterization. At 6 months, it was +1.72 diopters (D) +/- 1.13 D in group A and -3.16 D +/- 2.84 D in group B; at 13 months, it was +0.09 D 1.52 D in group A and -3.89 D +/- 3.01 D in group B. The average keratometric astigmatism also was significantly lower in group A than in group B both at 6 (2.5 D +/- 1.6 D vs. 4.1 D +/- 2.3 D) and 13 months (2.7 D +/- 1.5 D vs. 4.4 D +/- 2.4 D) after surgery. CONCLUSION: Cauterization of the central cornea improves the postkeratoplasty refractive results of patients with keratoconus.

Adolescent↗

[The Brodsky & Brodsky risk factor model of schizophrenia--an empirical contribution].

In the year 1981 the Canadian psychologists Patricia & Marvin Brodsky published an article about a model integrating risk variables involved in the development of Schizophrenia which is very important but not very well known in the German speaking countries. This model which describes essentially the interaction of four risk variables, such as mental health of the mother, neonatal status, temperament and mothering style, shall be published for the interested reader on the one hand. On the other hand the consequences of the risk variable "mothering style" should be empirically examined in a retrospective study. With a standardized interview containing all essential variables of Brodsky's risk model 73 patients suffering in schizophrenia and being inpatient in the Rheinische Landesklinik Bonn were examined and the interview data were evaluated with regard to the contents in contrast to a control group of 26 healthy persons. With regard to the "schizophrenia spectrum" the portion of so called "superphrenics" (defined as "artistically and muscially gifted offspring with a schziophrenic mother" was not significantly increased in the schizophrenic sample (17.8% vs 7.7%) but the comparison of mothering style (empathic contingent vs. non-empathic and non-contingent) revealed a statistically significant difference between the groups. Finally the data of the risk variable "mothering style" are discussed in the light of the Brodsky-model and it is pointed at the special problems in reliable and valid opertionalisation and assessment of the risk variables.

Adult↗

Changes in S-phase fraction and micronucleus frequency as prognostic factors in radiotherapy of cervical carcinoma.

Twenty-five patients with cervical carcinoma were treated with combined external beam and high dose rate afterloading radiotherapy. Biopsies obtained at different time points in the course of therapy were analysed with respect to cell proliferation and cytogenetic damage. The fraction of cells with an S-phase DNA-content as well as the frequency of micronuclei were determined. These two parameters were then related to treatment outcome, in particular patient survival. Neither S-phase fraction nor the micronucleus frequency before radiotherapy were predictive of treatment outcome in this small group of patients. However, when changes in response to therapy were considered, patients whose S-phase fraction decreased and patients whose micronucleus frequency increased tended to have a better prognosis. Although statistical significance was not achieved with either criterion alone, when applied together the combination predicted patient survival quite reliably; the 5-year survival rate of those patients who showed a decrease in S-phase fraction as well as an increase in micronucleus frequency was about 90% in contrast to less than 30% for the non-responders (p < 0.03).

Aged↗

[Neuropsychological analysis of schizophrenia-induced attention deficits--attempt at an overview].

In this review schizophrenic attention disorders are described from a neuropsychological perspective. After a historical excursion to Wundt, James and Kraepelin, the experimental psychology attention research of the last decades is presented, with special regard to Joseph Zubin's model of attention. After describing the symptomatology and course of schizophrenic psychosis, the concept of positive and negative symptoms according to Crow and Andreasen is set out as well. In describing the cognitive disorders it is on the one hand tried to elucidate the concept of "Basisstörung", and, on the other, to deal with attention disorders as potential vulnerability markers. After setting out various models re. the origin of attention disorders in both acute and chronic psychoses, implications for diagnosis and treatment are offered for the clinical psychologist in conclusion.

Attention↗

[Psychoses and driving fitness--development of criteria for clinical assessment].

The legal foundations for driver fitness evaluation in psychiatric conditions are enumerated in the 1985 "Illness and road traffic" expert opinion of the advisory medical council with the Federal Ministry of Transport. In case of the endogenous psychoses, in-patient episodes will invariably give rise to a call for expert psychiatric appraisement, notwithstanding the fact that reliable and valid criteria, with the exception of a standardized driving sample, continue to be almost non-existent. Carried out between 1989 and 1991 with support from the Federal Employment Institute in the framework of an employment creation project as well as from Bundesanstalt für Strassenwesen, the present study hence had been aimed at correlation-statistical identification of as valid driving ability predictors as possible in post-acute patients with a diagnosis of schizophrenic psychosis (ICD 295.3). The patients' pre-discharge fitness for driving, for one, was assessed using a number of psychological procedures and, for the other, was examined during a 60 minute practical driving sample, involving both city and autobahn driving. Driving behaviour during the practical trial was taken down according to pertinent categories, with subsequent judgment of overall driving performance both by self-ratings and by driving instructor ratings by means of a school grades scale of 1 to 6. With reference to pertinent studies elsewhere, our test battery had consisted of procedures for testing visual perception, reaction, selective and split attention, personality structure, anxiety, and risk-taking.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[The computer as an aid in attention training--a clinico-experimental study].

Reported is the evaluation of a computer-directed training programme for visual attention, that is based on the results of experimental studies by Zubin (1975) and Shakow (1979). With reference to Zubin's model, this training programme addresses active maintenance of selective visual attention (in terms of "sustained attention"), applying Shakow's diagnostic research paradigm (with a preparatory stimulus, an RT stimulus, and a variable preparatory interval) in a behavioural setting (learning of strategies for attention) for clinical purposes. In a pre-post-study carried out for a three-week programme, the results of single case experiments showed a significant decrease of reaction time variability, which partly persisted in follow-up studies. It was found that attentional performance increased in both psychotic patients and patients with cerebral dysfunction. In the second phase of statistical validation on patients with psychotic attention deviations, both attention performance and transfer effects were verified. The behavioural training methods, which were implemented to foster attention, proved helpful in the majority of cases. For greater practicability, a programme version for use on the home computer has been developed. The study on the whole illustrates the growing utilization of computer technology in neuropsychological rehabilitation.

Adult↗

Methods of prenatal determination of fetal maturity based on differentiation of the fetal skin during the last weeks of pregnancy.

During the process of 'maturation' of the fetal skin, detachment of the layer of vernix caseosa takes place from the fetal epidermis into the amniotic fluid, in the course of the last weeks of pregnancy. This results in: (a) a change of the cytological image of the amniotic fluid followed by a considerable increase in the proportion of the keratinized epidermic cells, (b) a simultaneous increase in the turbidity of the amniotic fluid and (c) a parallel increase in the quantity of sediment which remains after centrifugation of the amniotic fluid. The data presented in this paper, measured in 87 samples of amniotic fluid from normal, eutrophic, uncomplicated pregnancies, indicate the difference between the values of the various parameters before and after the main detachment of the vernix caseosa. Since the fetal skin is the organ reflecting most accurately the general status of the fetal maturity at the end of pregnancy, we consider that an overall examination of findings from the amniotic fluid indicating the condition of the fetal skin supplies us with reliable results for making a prenatal prediction of the maturity status of the fetus.

Amniotic Fluid↗

[Relation of steroid hormone receptors to axillary lymph node metastasis in breast carcinoma].

In 337 patients with primary cancer of the breast, the oestrogen and progesterone receptor concentration was correlated to the metastasis of axillary lymph nodes taking into account the age of the patients and the size of the primary tumour. The frequency of axillary lymph node involvement increases significantly with size, although not quite steadily but rather stepwise within the T classification. Whereas the tumour diameter influences the receptor status only slightly, the age of the patients plays a major rôle in the oestrogen receptor concentration. In the age group up to 50 years the oestrogen receptor concentration is significantly lower than in the age group over 50 years. There is no comparable influence of age on progesterone receptor concentration. With all 337 breast cancers, no difference in axillary lymph node metastasis is found either between oestrogen receptor positive and oestrogen receptor negative cancers, or between progesterone receptor positive and progesterone receptor negative cancers. In the age group up to 50 years, if looked upon separately, the oestrogen receptor positive cancers do show significantly more often an axillary lymph node involvement, than do oestrogen receptor negative cancers. As this difference exists in the age group up to 50 years only, it is assumed that endogenous oestradiol favours the axillary spread in oestrogen receptor positive cancers. With oestrogen receptor negative cancers the axillary lymph node involvement increases from the younger to the older age group, explaining why in unselected series the oestrogen receptor negative cancers show a more unfavourable course.

Adult↗

[Birth readiness of the uterine cervix. II. Cervix readiness score and its problems because of the variability of individual criteria].

Cervical ripeness was scored in nulliparous and parous women not in labor at term according to Bishop's pelvic score. The frequency distributions of the scores for the single criteria as well as of the total score reveal the problems of all those scoring systems caused by the grouping process as sequelae of the choice of width of the classes as well as of their limits. E.g. for cervical dilatation in none case 2 or 3 points had been reached and similar findings had to be stated concerning station of the presenting part. An other point of discussion erases from the results of the analysis for linear correlation of the single criteria between each other and between the single criteria and the total score. The total score is mostly influenced by the consistency (r = 0,81 in nulliparous and parous women) and the effacement (r = 0,80 and r = 0,81) of the cervix, whereas for dilatation and station lower correlation coefficients were found. In contrast, when labor had started spontaneously, even if the status of cervix was not advanced, a significant change in the correlative influence of the total score by the single criteria could be stated with high correlation coefficients for dilatation and station and lower one's for consistency and effacement.

Cervix Uteri↗

[Ultrastructural aspects of amniotic-fluid cells B. "vital cells" (author's transl)].

It has been shown, that apart from the mass of non-vital squamous epithelial cells, there also exist vital cells in the amniotic fluid. In this study, two types of amniotic fluid cells, which upon examination based on morphological characteristics gave rise to conclusions concerning their vitality, are presented, described and correlated with morphologically similar cells with known origin. Probably one type of these amniotic fluid cells are macrophages or Hofbauer-cells and the other types could be amnion-cells.

Amniotic Fluid↗