Biomedical subjects

K Cesarini

Publications and source records attributed to K Cesarini.

7 recordsLinked to original sources

PubMed1996

Neurochemical monitoring using intracerebral microdialysis in patients with subarachnoid hemorrhage.

The authors have developed a method for routine monitoring of disturbances in brain energy metabolism and extracellular levels of excitatory amino acids using intracerebral microdialysis in 10 patients with subarachnoid hemorrhage. Microdialysis was conducted for periods ranging from 6 to 11 days after ictus. Altogether, 16,054 chemical analyses from 1647 dialysate samples were performed. Concentrations of the energy-related substances lactate, pyruvate, glucose, and hypoxanthine were measured, and the lactate/pyruvate ratio was calculated. The excitatory amino acids glutamate and aspartate were measured. The microdialysis data were matched with computerized tomography findings, clinical course, and outcome. The results support the concepts that microdialysis is a promising tool for chemical monitoring of the human brain and that extracellular fluid levels of lactate, lactate/pyruvate ratio, glucose, hypoxanthine, and glutamate are useful markers of disturbances in brain energy metabolism in neurointensive care patients. These results have generated a working hypothesis that the pattern of these extracellular markers may help differentiate between various causes of energy perturbations, such as hypoxia and different degrees of ischemia. The correlation between the dialysate levels of excitatory amino acids and outcome supports the concept of glutamate receptor overactivation in acute human brain injury.

Aged↗

PubMed1994

Findings and outcome in whiplash-type neck distortions.

STUDY DESIGN: The authors assessed the clinical and imaging findings and late outcome in 50 patients with whiplash-type neck distortions (17 men, 33 women, mean age 33 years). SUMMARY OF BACKGROUND DATA: Early symptoms are neck pain, stiffness, and sometimes radiating pain; later bizarre symptomatology poses intricate clinical and medicolegal problems. Pathoanatomic studies indicate that soft tissue injuries may be overlooked. METHODS: Repeated clinical and radiographic examinations (plain and flexion-extension radiograms and contrast magnetic resonance imaging evaluated with a new grading system); surgical findings; follow-up were performed after 1 and 5 years by an independent observer neurologist. RESULTS: Neck pain persisted in 24 patients; radiating pain developed within 6 weeks in 19 patients. Two patients with segmental instability had posterior fusions and complete pain relief. Eight patients with severe radiating pain and large disc protrusions on magnetic resonance had nine surgically confirmed fresh disc herniations. Discectomy and fusion alleviated pain in these patients, whereas symptoms largely persisted in the conservatively treated patients. CONCLUSIONS: A high incidence of discoligamentous injuries was found in whiplash-type distortions. Most patients with severe persisting radiating pain had large disc protrusions on MRI that were confirmed as herniations at surgery. Neck and radiating pain were alleviated by early disc excision and fusion.

Adolescent↗

PubMed1991

Locking screw-plate fixation of cervical spine fractures with and without ancillary posterior plating.

Forty consecutive patients with 19 fractures and 21 fracture-dislocations in the lower cervical spine were treated prospectively with open reduction and interbody fusion, using the AO titanium locking screw-plate system. There were 30 men and 10 women with a mean age of 36 years (range 16-90 years). Eight were admitted tetraplegic, 12 tetraparetic, and 6 had nerve root injuries. Eleven of the fractures and 18 of the fracture-dislocations were also plated posteriorly. Complications included two cardiac arrests, two transient neurological impairments, two severe gastrointestinal bleedings, and one esophageal fistula. At 2-year follow-up, three patients had died and one had emigrated. Three out of ten patients who had complete motor loss initially had regained useful muscle function, while incomplete motor loss usually returned to normal. All fusions had healed in a good or acceptable position. Twenty-four of the 60 posterior plates impinged on facet joints and five were loose. Six screws transgressed facet joints below the fusion. Ten posterior fusions extended to adjacent mobile segments by exuberant bony overgrowth. Ancillary posterior plating significantly reduced the range of neck mobility and also caused significantly more pain than anterior plate fixation alone.

Adolescent↗

PubMed1986

Experimental endovascular reinforcement.

Techniques to reinforce a vessel wall without occluding its lumen are being studied. In pilot experiments the intimal surface along a short segment of vein was coated with plastic by injecting liquid silicone rubber into a vessel, spreading the material along the vessel with a balloon catheter, allowing polymerization and then removing the catheter. In 17 experiments in the iliac vein of rabbits, successful coating was obtained in 5. If perfected, these techniques might be applicable to treating some aneurysms or arteriosclerotic plaques.

Angioplasty, Balloon↗

PubMed1985

Cytofluorescence localization of ethidium bromide in the nervous system of the mouse. I. Ethidium bromide: its distribution in regions within and without the blood-brain barrier after intravenous injection.

A direct fluorescence-microscopic technique was effected to determine in the central nervous system (CNS) of the mouse the distribution of ethidium bromide after intravenous (i.v.) injection. The compound was visualized in thin cryostat sections of the brain fixed by vascular perfusion through the heart with a 10% buffered formalin solution. Ethidium bromide emitted a bright red fluorescent light in model experiments. The compound could not be detected in the vessel walls or brain parenchyma of the cerebral gray and white matters after i.v. injection indicating the presence of a blood-brain barrier (BBB) phenomenon to this compound. Signs of extravasation of ethidium bromide were present in the choroid plexus, the postremal area, the Gasserian ganglion, and in the circumventricular organs of the brain (neurohypophysis, organum vasculosum lamina terminalis, and median eminence) 3 min after the i.v. injection. Intense fluorescence was present in the nucleus and the cytoplasm of the cells in these areas, located outside of the BBB. Fluorescence had disappeared 24 h after the injection. Unexpectedly, red fluorescent material was seen in the parenchyma of the olfactory lobes of some animals, indicating, possibly, the presence of ethidium bromide. Ethidium bromide is known to suppress RNA, DNA, and protein synthesis in mammalian cells and has been used previously in neuropathology for studies on myelin lesions after injury to oligodendroglial cells. It can now, by a simple fluorescence-microscopic method, be traced directly in fixed tissue. Correlations can therefore be made between localization of the compound and its cytotoxic effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1985

Cytofluorescence localization of propidium iodide injected intravenously into the nervous system of the mouse.

Propidium iodide, like its analogue ethidium bromide, is a compound which can be used as a marker of nucleic acids. This substance emits a red fluorescent light after exposure to UV light and has therefore been used previously as a nuclear stain in immunofluorescence studies and in flow cytometry. The present experiments were carried out to find out if propidium iodide could be traced in sections of the nervous system after i.v. injections. Due to the general toxicity of the compound detectable amounts of propidium iodide could not be obtained by a single i.v. injection. However, multiple injections of small amounts (0.1 mg) over a period from 15 min to 8 h (total dose 0.7-1.0 mg) were tolerated without any signs of adverse effects. In such experiments propidium iodide did not extravasate into the cerebral gray or white matter, i.e., areas of the brain located within the blood-brain barrier (BBB). On the other hand, the compound spread into the choroid plexus, the circumventricular organs, the Gasserian ganglion, and sciatic nerve, i.e., regions located outside the BBB. It had a strong tendency to label the nucleus and the perikaryon of the cells in each of these territories. Perifascicular injection of propidium iodide around the sciatic nerve was followed by a marked cellular uptake not only in the epineurium but also in the endoneurium. The shape and position of the labeled nuclei strongly indicated that they were the nuclei of Schwann cells. Previous studies have shown that propidium iodide can be used as a retrograde tracer in neuroanatomic research.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1984

Fluorescence-microscopic localization of in vivo injected ethidium bromide in the nervous system of the mouse.

Ethidium bromide is a compound which can suppress DNA, RNA, and protein synthesis in mammalian cells. It is a very useful tool in experimental neuropathology for studies on myelin lesions taking place in the spinal cord after injury to oligodendroglial cells following intracisternal or intraspinal administration. By using a technique described in this short original communication we can now directly trace the distribution of the compound in various cells of the central and the peripheral nervous systems after its administration to a living experimental animal. Therefore, in the future direct correlations can be made between the cellular distribution of the compound and its cytotoxic effects.

Animals↗