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Biomedical subjects

M Bartolo

Publications and source records attributed to M Bartolo.

At least 19 recordsLinked to original sources

Venous wall ultrastructure in generalized venomegaly.

The ultrastructure of the v. colica sinistra in a case of generalized vasomegaly in man was examined. Elastic material was found in three forms: as a lightly osmiophil amorphous material bordering on myocytes, as a highly osmiophil elastic membrane, and as highly osmiophil slim elastic fibres of different orientation in the tunica media and adventitia. The slightly osmiophil elastic material is assumed to be newly formed by pinocytotic activity of the myocytes. The highly osmiophil elastic material indicates its impairment. No typical atherosclerotic changes were found in the examined vein. Based on a comparison with previous findings in the case of vasomegaly of the a. mesenterica inferior, the authors conclude that the venomegaly phenomenon is connected with degenerative changes in the elastic material of the vessel wall.

Aged

A contribution to the morphology of tortuosity of arteries, aneurysms and arteriomegaly.

Using the electron microscope, the authors examined the structure of the wall in a case of arteriomegaly of the inferior mesenteric artery in man. Structural changes concerned the elastic material showing signs of degeneration. Based on a comparison with literary findings, the authors conclude that tortuosity of the arteries, aneurysms and arteriomegaly are caused by congenital, age-dependent and pathological changes in the elastic material in the vessel wall. There exist basic structural differences in the arterial wall in arteriomegaly and in atherosclerosis.

Aged

Light reflection rheography and thoracic outlet syndrome.

The authors have studied with a light reflection rheograph (LRR) 112 cases: 54 patients with suspected "thoracic outlet syndrome" (TOS) in the functional phase, 28 patients with phlebothrombosis localized in upper limbs, and a control group of 30 healthy subjects to evaluate the upper limbs' venous outlet. They recorded a good correlation among results obtained with LRR, clinical examination, Doppler, and phlebographic examination. The data obtained lead them to propose this methodology as an important examination in the evaluation of upper thoracic pathology.

Adult

[Hemorheologic changes in patients with obliterative arteriopathy of the leg before and after muscle exercise tests].

Blood and plasma viscosity, erythrocyte filtrability and blood gas analysis were determined in 25 subjects with arteriosclerosis obliterans of the lower limbs before and after a muscle exercise test. Thirty-six shear rates between 0 and 230 s1 were studied to obtain viscosity curves, and regression analysis was performed for each curve. Mean viscosity curves for pathologic and control populations were plotted. The purpose of the study was to determine whether viscosity curves for blood and plasma before and after exercise, based on a high number of measurements, can provide information on rheological changes during intermittent claudication. Practically all viscosity curves in pathologic and control subjects could be described using a hyperbolic equation. Plasma as well as blood viscosity increased in pathologic subjects after exercise. However, erythrocyte filtrability and blood gas analysis in pathologic and control subjects, and blood and plasma viscosity in control subjects, showed no statistically significant changes after exercise. It is suggested that muscle exercise in reduced blood flow conditions can alter the aggregation of macromolecular complexes of plasma proteins, which could have an influence on cell components by modifying blood rheological behavior during claudication.

Arteriosclerosis

[Arteriectasis: a forgotten chapter].

In 1942, Leriche described the first "dolichomégaartères" (or "arteriomegaly" according to the definition subsequently proposed by Anglo-Saxon researchers). We detected 199 cases of arteriomegaly (16.29% of cases examined) during a review of 1,221 translumbar arteriographies of the lower limbs performed from 1980 to 1985 in the vascular radiology department of our hospital. The percentage of associated aneurysms was 33.16%. The possible dysplastic pathogenesis of the affection and the differential diagnosis with atherosclerosis and other vascular affections found in connective tissue diseases is noted. Histopathology showed dystrophic lesions of the media and especially of the elastic fibers as well as occasional associated venous lesions and a familial basis. The peripheral symptomatology was acute, pseudoembolic and severe as revealed by ischemia and cyanosis. There was no collateral circulation. Medical treatment consisted especially in anti-coagulant and hypervolemic hemorrheologic therapy during ischemia. Ultrasonography enabled us to monitor the regular, systematic course of arteriomegaly, to make the diagnosis initially, to measure the exact size of the arteries, to observe the morphology of the wall and, moreover, to determine the presence or not of megaveins capable of reinforcing the dysplastic genesis of arteriomegaly.

Dilatation, Pathologic

[Buerger's disease: etiologic role of the rickettsiae?].

Specific seroagglutination tests were performed in 70 patients with Buerger's disease to detect possible antibodies to rickettsia, the test being repeated in 8 cases after activation by doxycycline administration over 10 days. In 21 patients a Weil-Felix test was also carried out. Tests were assessed as positive in 44 cases (62.8%): 18 times for Rickettsia Q. 18, 14 times for Rickettsia Mooseri, 13 times for Rickettsia Burnetii, 5 times for Rickettsia Conorii and 3 times for Rickettsia Prowazekii. After activation by doxycycline the antibody titre was increased 5 times, unchanged 3 times and reduced once. The Weil-Felix gave positive results in 3 of the 21 cases (14.28%), the reaction being positive to Rickettsia Prowazekii. These findings provide supplementary arguments for a possible pathogenic role of rickettsial infection in Buerger's disease.

Adult

Results of clinical, laboratory and haemorheological investigations of the use of pentoxifylline in high doses.

A study was carried out in 127 patients (94 males and 33 females) presenting with arteriosclerosis (88 patients) or diabetic vasculopathy (39 patients) in different stages of severity (Fontaine) to assess the effectiveness and tolerance of treatment with high doses of pentoxifylline. Patients received a daily dosage of 2200 mg, given as 800 mg orally and 300 mg by intravenous infusion in saline twice daily, for a mean period of 15.8 days. Relevant clinical parameters were assessed and measurements made of biological and laboratory indices before and after treatment. The results showed that intermittent claudication was improved in 52.4% of the arteriosclerotic and 50% of the diabetic patients Stage II disease, pain at rest disappeared in 64% and 78% of patients in Stage III, respectively, and trophic lesions in Stage IV patients were reduced or became less clearly marked in 47% and 44%, respectively. Arterial blood pressure, recorded on the tibial arteries using Doppler ultrasound, showed a mean increase of 18%, but no significant changes in blood flow were evident from rheographic examination. Whole blood erythrocyte filtration time was reduced by a mean of 8%. The main changes in the biological indices after treatment were decreases in haematocrit, mean corpuscular volume and blood fibrinogen values, but these were not statistically significant. The other variables showed little if any change. Side-effects initially reported by the patients consisted of headache, nausea, sweating, pruritus and general malaise, and were mainly associated with the infusion time and regressed in most cases when this was extended.

Aged

[Epidemiology of vascular diseases in Italy].

The mortality rate from cardiovascular diseases was analysed for Italy as a whole and for individual regions in a sample year (1975). A distinction was made between cardiac and vascular diseases in order to assess the real incidence of the latter. The absolute number of deaths, the percentage mortality and the specific mortality quotient were studied. Deaths were also divided into age groups. Cardiovascular diseases were found to be the primary cause of death, circulatory disease the second. Among the latter, diseases of the encephalic circulation took first place. The same parameters were applied to the 1965-1983 period. Mortality due to cardiovascular disease remained constant over the period since the decrease in deaths from cardiac conditions was offset by an increase in those due to vascular disease in the strict sense. Finally the specific standardised mortality quotients per age and sex were considered in the 1970-1979 period. Mortality trends in Italy and in the individual regions were identical to those described using non-standardised indices.

Age Factors

Clinical-instrumental relationships in post-phlebitic syndrome.

981 lower limbs belonging to 829 subjects, 67.6% of which were females, have been examined. The average venous pressure at the tibial posterior vein was 101 +/- 12 mmHg and 102 +/- 13 mmHg on the internal saphenous vein. In 311 lower limbs with femoro-iliac thrombosis, venous pressures are slightly higher than in 670 lower limbs with calf veins occlusion. In the 44.4% of cases the phlebothrombosis was clearly dependent on traumas, deliveries, surgical operations or other conditions. The relationships between the supposed aetiopathogenesis of the affection and the pressure values have been examined. The 6.7% refers to phlebitis, which caused pulmonary embolism during their acute phase. The different objective and subjective symptoms have, furthermore, been taken into consideration. It has been noticed by the analysis of the diagrams of the pressure values in the time that the same values which are considerably high at the initial phase of the iliac postphlebitic syndrome, are always high in the following years. On the other hand, in postphlebitic syndrome of the leg those pressures whose value are not remarkably high in the initial phase, increase from the second to the fourth year after the arising of phlebitis and, finally become stable at fairly high values, but still lower than those of iliac syndrome. The venous orthostatic pressure of internal saphenous vein in the iliac postphlebitic syndrome was also found to exceed the deep pressures, likely because of the altered saphenous discharge at the cross level.

Adult

Instrumental evaluation of the venous circulation in the arteriopathic subjects.

In peripheric arteriopathies, alterations occur to the venous system with a particular swelling of the veins of the foot-top, in the subjects (sclerotic or diabetic) at the 2nd and 3rd Fontaine stage, which gradually decreases until the collapse in the most advanced levels of the arterious affection (4th stage). In order to verify all that, we examined 40 artheriopathic subjects at the different Fontaine stages through a c.w. doppler apparatus and an impedence plethysmograph. Together with the modification of the arterious doppler velocitogram and the reduction of the Winsor index, we noticed that the velocity of the venous flow increases together with a venous hypertension that reaching the highest values at the 3rd stage, while at the 4th stage they are reduced because of the progress of the sclerosis. The impedence plethysmogram shows a reduction of the systodiastolic sphygmic excursion with a variation of the basic line, depending on the respiration, proportional at the clinic stage. In diabetic subjects the progress of the disease is more precocious because of the quicker implication of the microcirculation.

Aged

[Hemodilution, defibrinogenation and plasmapheresis in hemorheology].

Blood and plasma viscosity can be influenced by various therapeutic procedures: among these, that of hemodilution stands out. This can be hypovolemic, normovolemic or hypervolemic; it is hypovolemic if blood subtraction is not followed by a liquid reintroduction, it is normovolemic or hypervolemic if there is a liquid reintroduction of the same or higher quantity than the subtracted blood mass. This method has been considered very favorably by surgery in order to save blood for transfusions. Hypervolemic hemodilution can also be carried out without blood subtraction; a report on this method shows good clinical results and positive hematochemical and hemodynamic effects obtained on 93 peripheral vasculopathic patients at stages III and IV of the Fontaine classification. Plasmapheresis, which would be best called plasma-exchange, consists in the removal of that part of the patient's plasma containing abnormal proteins, immune complexes or toxins, and in its substitution by other colloids or crystalloids. Defibrinogenation is not much employed in Italy, as the most effective drugs, such as ancrod and batroxobin are not available in this country. The good results reported were transitory, due to the rapid appearance of antibodies which can inhibit the effects of these drugs. Nevertheless, there also exist minor fibrinogenolytic drugs.

Ancrod