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Biomedical subjects

M Ferrari

Publications and source records attributed to M Ferrari.

At least 181 records · Page 10Linked to original sources
PubMed1997

Evaluation of an active coronary perfusion balloon device using Doppler flow wire during PTCA.

The aim of this study was to assess whether active coronary perfusion catheters (APC) can provide a sufficient coronary flow in large caliber vessels during balloon inflation. To prevent myocardial ischemia during PTCA, these APC may be employed. However, it is as yet unknown whether the active flow rate of these devices approaches the flow rate prior to PTCA during balloon inflation. Therefore, we measured the efficacy of the APC during balloon inflation in vessels supplying a large amount of myocardium. In 12 patients (1 female, 11 males, 53 +/- 12.6 yr) with stenosed vessels (average diameter 3.4 +/- 0.26 mm), the coronary flow velocity was measured using a 0.014" Doppler guidewire, which was placed distally bypassing the balloon of the APC. The active perfusion balloon catheter was advanced through a 7F guiding catheter along a 0.014" guidewire. After removal of the guidewire, arterial blood being withdrawn from the side port of the femoral angioplasty sheath was pumped through the catheter to the distal coronary vessel. The perfusion volumes of the pump were set to different levels between 30 to 60 ml/min. Intracoronary flow rate was calculated by the angiographically assessed vessel luminal area [symbol: see text] average peak velocity [symbol: see text] 0.5. The mean coronary flow rate prior to PTCA was 43 +/- 17.7 ml/min. Maximum flow during PTCA was 55 +/- 19.6 ml/min. We found a good correlation between the preset external pump rate and the coronary flow in situ (r = 0.92). Pre-PTCA flow rates were achieved in 11 of 12 patients (92%) during balloon inflation. No relevant decrease in the arterial pressure occurred during dilation times of 4.6 +/- 1.63 min. Only two patients showed significant ECG changes during these balloon inflations. After an average follow-up period of 13 +/- 6.3 mo, only one patient (8%) had a significant re-stenosis requiring the implantation of a stent. The combination of intravascular Doppler velocity measurements with quantitative coronary angiography offers the opportunity of exact online flow registration during angioplasty. Using APC, It is possible to maintain a sufficient coronary flow in the distal vessel during balloon inflation even in large vessels. Therefore, as compared with mechanical circulatory assist devices, coronary assist by APC is a little invasive, but according to our measurements it might be a sufficient tool for performing PTCA also in high-risk patients.

Adult↗
PubMed1997

Lack of association of DMB polymorphism with insulin-dependent diabetes.

Considerable evidence exists that the genes coding for the HLA class II DQ molecules in the MHC region are major contributors to genetic susceptibility in insulin-dependent diabetes. Located centromeric to the DQ loci are the genes encoding DMA and DMB, two class II-like molecules which play an essential role in the pathway leading to antigen presentation by HLA class II. In this study we have examined the distribution of the DMB allele and studied HLA DQA1-DQB1-TAP2-DMB haplotypes in 52 IDDM families and 65 un-related controls. DMB allele frequencies in IDDM and control subjects were not significantly different. DMB*0101 was present in 85% of patients vs. 76% of controls, DMB*0102 in 12 vs. 17%, DMB*0103 in 3 vs. 5%, DMB*0104 in 0 vs. 2%. The IDDM-susceptible MHC DQA1-DQB1 haplotypes found by analysis of IDDM families were not associated with specific DMB alleles. We conclude that the described DMB polymorphisms are not associated with IDDM susceptibility and DMB genotyping is unlikely to improve the assessment of genetic risk for IDDM.

Alleles↗
PubMed1997

Adaptation of the QT interval to heart rate changes in isolated perfused guinea pig heart: influence of amiodarone and D-sotalol.

The inadequacy of the QT interval to shorten following heart rate increase is a feature of the inherited long QT syndrome and may have a role in the genesis of the typical arrhythmias associated with this syndrome (torsade des pointes). The aim of our study was to evaluate whether drugs that prolong the QT interval, such as amiodarone and D-sotalol, may also impair the ability of the QT interval to adapt to sudden heart rate changes. Experiments were carried out on isolated perfused guinea pig hearts (Langendorff preparation). Driving frequency was changed, in steps, every two minutes (Hz: 2.5-3-2.5-3.75-2.5-5-2.5), while epicardial ECG was continuously recorded on magnetic tape. QT interval was automatically measured by means of a beat-by-beat analysis program. D-sotalol was added to the perfusion medium at a concentration of 4 micrograms ml-1, while amiodarone was administered, before in vitro evaluation, for seven days (50 mg kg-1 per day, intraperitoneally). In control experiments two phases of QT adaptation were identified: an abrupt QT shortening at the first beat after frequency change (QT1), followed by a gradual, exponential QT shortening that reached a new steady state in about 1 min (half life: 13 sec). The electrical restitution curve (the relation between QT1 and the corresponding diastolic interval) had a rate constant of 57 +/- 8 ms. Neither drug changed the slow component of QT adaptation. However, both drugs increased the ability of QT to shorten upon premature stimulation: D-sotalol by increasing the rate constant of the restitution curve and amiodarone by decreasing the y-intercept. Our results indicate that D-sotalol and amiodarone do not impair QT shortening during tachycardia but, on the contrary, they may favour QT adaptation, thus reducing the likelihood of the potentially lethal 'R on T phenomenon'. This may be an additional mechanism by which these drugs can exert their antifibrillatory action.

Adaptation, Physiological↗
PubMed1997

Short-term assessment of leakage of Class V composite restorations placed in vivo.

The purpose of this study was to investigate the effectiveness of two dentin bonding systems, one of which was also in combination with a self-curing resin, when applied in V-shaped circular cavities cut in anterior teeth crossing the cementum-enamel junction. Twenty-seven teeth scheduled for extraction for periodontal reasons were treated in vivo. The sample teeth were divided at random into three groups. Group 1 was treated with All Bond 2 (AB2) + Z-100 composite, group 2 with Scotchbond Multipurpose Plus (SMPP) + Z-100, and group 3 with AB2 in conjunction with Bisfil 2B as liner and Z-100. The in vivo restored teeth were extracted after 2-3 months of clinical service. They were then immersed in a dye solution for 24 h, sectioned, and scored for marginal leakage. Analysis of variance revealed no significant differences between the three groups both at cervical and incisal sites. The enamel sites were free from any leakage. Only two cervical sites of groups 1 and 2 and one of group 3 showed a score 1 for leakage. The results of the short-term clinical performance of the three systems were promising.

Analysis of Variance↗
PubMed1997

Influence of gestational age on fetal deoxyribonucleic acid retrieval in maternal peripheral blood.

OBJECTIVE: We wanted to verify whether gestational age influences the retrieval of fetal deoxyribonucleic acid in maternal blood to identify the best period for maternal blood sampling for a future noninvasive prenatal diagnoses. STUDY DESIGN: We amplified 81 deoxyribonucleic acid samples extracted from the peripheral blood of 27 pregnant women (18 bearing male fetuses and 9 bearing females) by nested polymerase chain reaction of the Y-specific sequence DYS14. We obtained three blood samples (one per gestational trimester) from each woman. Statistical evaluation was assessed by the McNemar test of symmetry. RESULTS: Polymerase chain reaction results in male-bearing pregnancies differed significantly between the first and second trimesters and between the second and third trimesters (p < 0.025) in parallel with a decrease in sensitivity in the second trimester (67%) compared with the first (94%) and third trimesters (100%). CONCLUSIONS: The drop in sensitivity from the first to the second trimester witnesses a variable concentration of fetal cells in maternal blood, with a negative balance in the second trimester. Therefore, to achieve an adequate polymerase chain reaction accuracy, the choice of gestational age is relevant and the first trimester seems to be more suitable than the second trimester.

DNA↗
PubMed1997

Sealing ability of several restorative materials used for repair of lateral root perforations.

Amalgam, IRM, Vitremer, Bisfil, and Ana Norm Liner were evaluated for repair of experimentally induced lateral perforations. Eighty-five sound, mandibular, and maxillary molars, extracted for periodontal reasons, were selected for this study. The sample teeth were randomly divided in five groups with 15 specimens each. Ten teeth were used as control groups. After the perforations were filled with the above-mentioned materials, the teeth were immersed in a 2% methylene blue solution for 48 h, sectioned, and dye penetration was measured. The results indicated that Bisfil 2 B provided a significantly better seal than the other materials.

Coloring Agents↗
PubMed1997

Resistance of cementum in Class II and V cavities to penetration by an adhesive system.

OBJECTIVES: As the cervical margin located in cementum-dentin is still the most unpredictable area of an adhesive resin restoration, the aim of this investigation was to evaluate the morphology of the cementum layer at the cervical margins of Class V and Class II cavities and the impregnability of this layer to resin bonding systems. METHODS: Three different types of in vitro investigations of the cervical margins were performed by scanning electron microscopy: 1) direct anatomical observation of conditioned cavities; 2) observation of resin replicas; and 3) observation of resin infiltration. During direct observation, the presence of opened tubules was evaluated; in the resin replicas, the presence of resin tags and their density were observed; in the observation of resin infiltration, the presence of an acid-resistant interdiffusion was investigated. RESULTS: From direct observation, cut tubules were seen 200 microns from the cervical margin. After treatment with a dentin bonding system, the outer layer was infiltrated by the resin. In the resin replica, the presence of resin tags was detectable 150-200 microns from the margin. In Class II samples, the presence of an outer layer at the cervical margin, which could not be identified as bulk dentin or cementum, was clearly detectable by both direct and indirect observation. In the Class V samples, the border between this layer and bulk dentin was less evident. SIGNIFICANCE: The presence of a cementum layer of approximately 150-200 microns at the cervical margins of cavities may pose a serious clinical problem for reliable bonding. Although in the present study the observation of a zone of resin-impregnated cementum may confirm the improvement obtained with the last generation of hybridizing dentin bonding systems, the effectiveness of the bond is still unclear.

Composite Resins↗
PubMed1997

A serological survey of bovine herpesvirus-1 infection in selected dairy herds in northern and central Italy.

Serum samples from a total of 6979 dairy cattle from 55 herds in northern Italy (51 herds) and central Italy (4 herds), were examined by the serum neutralization test for the presence of antibody to bovine herpesvirus-1 (BHV-1). It was found that 84.31% of the farms selected in northern Italy and all the farms from central Italy had seropositive animals at titers of 1:4 or higher. The prevalence of infection was essentially the same among the cattle populations of the two selected areas of the country, being of 34.99% in the north and of 38.65% in central regions. A comparison of the data from the present study with those obtained in a serological survey conducted in Italy in 1966, shows that the rate of seropositive cattle to BHV-1 has increased by about 5.0% in the last 30 years.

Animals↗
PubMed1997

Mapping of tubule and intertubule surface areas available for bonding in Class V and Class II preparations.

OBJECTIVES AND METHODS: The aim of this in vitro study was to evaluate the morphology of dentine in Class V and the Class II preparation walls in terms of tubule orientation, density and increase in surface area after conditioning. Six circular V-shaped preparations were cut at the cementum-enamel junction (CEJ) of anterior teeth and six Class II cavities with the cervical margin 1 mm below the CEJ were prepared in posterior teeth. The preparations were conditioned with 10% maleic acid. The samples were directly studied by SEM. The observations were organized according to location in the preparation, tubule density was counted and the increase in area available for bonding after acid etching was calculated. RESULTS: Dentine morphology of Class V and Class II preparation walls was mostly regular according to predictable patterns. Between the tubules, along the walls of the cavity, the etched dentine surface exhibited a porous network of collagen fibers. More than 50% of Class V and Class II cavity surface presented oblique or parallel tubule orientation with respect to the cut surface. Because of the presence of a structureless cementum layer. the morphology of the cervical area turned out to be less predictable. The tubule density varied considerably in different regions of the preparations. The intertubular dentine surface area increased after conditioning in Class V preparations from 20.9% to 50.3% on the walls where tubules were cut parallel to their long axis, and from 5.8% to 47.8% where tubules were cut perpendicularly. These same values for Class II preparations ranged from 0.6% to 46.4% on the walls where tubules were cut parallel to their long axis, and 29.8% of the tubules were cut perpendicularly. CONCLUSIONS: Based on this morphological investigation, the increase in intertubular dentine surface area might very well be responsible for the enhanced bond strength after acid etching of dentine, but not all areas exhibited equal responses to etching. In particular, the bonding substrate at the gingival margins may contribute little in terms of micromechanical retention.

Acid Etching, Dental↗
PubMed1997

Additional luminal area gain by intravascular ultrasound guidance after coronary stent implantation with high inflation pressure.

AIMS: Studies by intravascular ultrasound demonstrated inadequate expansion in a large number of stents, which lead to the increase of inflation pressure for stenting. The present study examined whether routine use of high-pressure inflation would be sufficient for an optimum stent expansion without sonographic guidance. METHODS AND RESULTS: Two types of single coronary stents (Palmaz-Schatz in 54, and Wiktor in 25) were implanted with inflation pressures of 16-20 atm in 79 nonocclusive coronary lesions. IVUS before stenting was used in 78% to select the adequate stent size. Intravascular ultrasound after stenting was used to asses the minimum stent are and diameter, the reference areas, and the strut apposition to the vessel wall. The difference between the area of the expanding balloon and the stent area was calculated as the luminal deficit of the stent. Completeness of stent expansion required full strut apposition and lesion coverage, and a minimum stent area that was larger than the distal reference, and larger than 60% of the proximal reference. Intravascular ultrasound before stenting lead to an increase of the stent size in 47%. After high-pressure expansion, even with the optimized balloon size, 8% of stents had struts protruding into the lumen. The stent area (6.87 +/- 1.93 mm2) was significantly smaller than both the proximal (9.59 +/- 2.91 mm2; p < 0.001) and distal reference area (8.23 +/- 3.03 mm2; p < 0.001). The criteria for complete expansion were met in 48%. The expansion with a larger high-pressure balloon in 28 stents lead to an increase of the stent area by 19% (8.19 +/- 2.24; p < 0.001), and full stent apposition in all cases. The criteria of stent expansion were met in 82%. A wide range of the luminal deficit upto 48% was observed, which was not related to sonographic lesion characteristics, except in lesions with complete circumferential calcifications. The different stent designs were characterized by a slightly lower luminal deficit in slotted-tube stents (23 +/- 13% vs. 28 +/- 12%; p = 0.11) and a better index of stent symmetry as compared with the coil stent (0.87 +/- 0.08 vs. 0.82 +/- 0.09; p < 0.05). CONCLUSION: Routine use of high-pressure stent expansion did not lead to a sufficient stent expansion, even when the initial stent size had been guided by intravascular ultrasound. Further stent dilatation with larger balloons under ultrasound guidance would be required to optimize the luminal area gain.

Adult↗
PubMed1997

Cardiac effects of quinidine on guinea-pig isolated perfused hearts after in vivo quinidine pretreatment.

1 Experimental and clinical studies suggest that class I and class III antiarrhythmic drugs may be subject to pharmacological tolerance during long term treatment, leading to loss of therapeutic effectiveness. 2 The aim of this study was to ascertain whether prolonged in vivo treatment with the Class Ia agent quinidine can modify cardiac (electrical and mechanical) responses to the drug. 3 A group of guinea-pigs (n = 7) was treated intraperitoneally (q.d.) for 6 days with 75 mg kg-1 quinidine sulphate. Preliminary pharmacokinetic experiments indicated that this dose could attain Plasma concentrations similar to those that are therapeutic in man (2-5 mg l-1). A control group (n = 7) received a saline solution for the same period. 4 Twenty-four hours after the last administration hearts were removed and retrogradely perfused at constant flow (stimulation frequency: 2.5 Hz). The following parameters were measured: maximal derivative of intraventricular pressure (dP/dtmax); coronary perfusion pressure (Cp); PR, QRS and JT intervals, on surface ECG. The effects of quinidine on these parameters were measured at different concentrations (2, 4, 8, 12, 16, 20 microns) and compared in the two experimental groups. 5 In the group quinidine decreased in a dose-dependent manner dP/dt and increased PR and QRS intervals. JT interval was increased at the lowest concentrations and decreased at the highest (biphasic effect). Cp did not change significantly. 6 In the pretreated group quinidine qualitatively produced the same effects on dP/dt and ECG intervals as in control group. Also the magnitude of these effects was not significantly different between the two groups. In contrast with findings in control experiments. Cp was significantly decreased by increasing quinidine concentration. Mean baseline Cp was higher in pretreated than in the control group (though not significantly, P = 0.072) and quinidine addition abolished this difference. Thus, it is suggested that quinidine withdrawal induced a rebound increase in coronary tone, due to the unmasking of vasoconstrictor homeostatic mechanisms elicited by the in vivo vasodilating effect of the drug. 7 In conclusion, our data do not support the possibility that tolerance ensues during long term quinidine treatment, at least as far as electrophysiological and contractility effects are concerned. Further experimental work is needed to explain the appearance of a coronary vasodilating effect in pretreated hearts.

Animals↗
PubMed1997

Tolerance to the repolarization effects of rac-sotalol during long-term treatment.

AIMS: To establish whether tolerance to the QT effect could ensue during maintenance treatment with rac-sotalol. METHODS: The effect of rac-sotalol on QT interval duration was studied in 10 patients after single oral administration (160 mg) and after 6-day multiple oral dosing (80 mg two or three times daily). In order to separate the pure Class III effect from the bradycardia-related QT prolongation, heart rate/QT relationship was preliminarly assessed in each patient after the administration of a pure beta-adrenoceptor blocker (propranolol, 80 mg orally). Repolarization changes were quantified as percent difference between the measured QT and the expected QT on the basis of the individual heart rate/QT relationship. RESULTS: In all patients QT interval prolongation was linearly correlated with rac-sotalol log plasma concentration. The maximal QT prolongation and peak plasma concentration were not significantly different following acute and chronic administrations (QT effect: +18.1+/-6.3% vs +14.2+/-3.3%; peak concentration: 1.64+/-0.49 mg l(-1) vs 1.83+/-0.66 mg l(-1)). Line slopes were also unchanged following chronic treatment (21.8+/-8.9 vs 21.1+/-9.2). In four cases a significant rightward shift of the line occurred during repeated administrations, consistent with the appearance of pharmacodynamic tolerance. The inconstancy of this change in responsiveness may either be ascribed to a genetically determined individual susceptibility or to a variable interplay between Class III effect, gradual QT prolongation due to long-term beta-adrenoceptor blockade and tolerance development. CONCLUSIONS: During maintenance treatment with rac-solatol, partial loss of repolarization effects occurred in some patients suggesting pharmacological tolerance.

Action Potentials↗
PubMed1997

Muscarinic modulation of endogenous noradrenaline release from adrenergic terminals in the guinea-pig colon.

1 The present study examined the role of muscarinic receptors in the modulation of noradrenaline (NA) release in the guinea-pig isolated distal colon. The spontaneous endogenous NA overflow assayed by HPLC-ED was taken as an index of NA release from enteric noradrenergic nerve terminals. 2 Physostigmine (10 microM) significantly enhanced spontaneous endogenous NA overflow. Hyoscine (muscarinic antagonist), (R)-(-)-trihexyphenidyl and telenzepine (M1-selective antagonists), and 11[[2-[(diethylamino)methyl]-1-piperydil]acetyl]-5,11 -dihydro-6H-pyrido[2,3-b][1,4]benzodiazepine-6-one (AF-DX 116, M2-selective antagonist) inhibited NA overflow in a concentration dependent manner, with the following EC50 values: 131.74 (18.19-953.96), 101.62 (58.83-175.60), 150 (60-330), 30 (5-170) nM, respectively. 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP, M1- and M3-selective antagonist) had no significant effect up to 100 microM. 3 The muscarinic agonist oxotremorine inhibited NA overflow in a concentration dependent manner, with an EC50 value of 0.67 (0.30-1.51) microM. The response to oxotremorine was inhibited by muscarinic antagonists with the following order of potency: hyoscine = (R)-(-)-trihexyphenidyl = telenzepine > 4-DAMP >> AF-DX 116. 4 In the presence of 3 microM tetrodotoxin (TTX), the effect of oxotremorine and 4-DAMP was unchanged, while hyoscine, (R)-(-)-trihexyphenidyl, telenzepine and AF-DX 116, instead of inhibiting, significantly enhanced NA overflow. 5 The present results indicate that, in the guinea-pig colon, endogenous acetylcholine sustains spontaneous NA release by activating muscarinic receptors possibly located on interneurones. In addition, inhibitory muscarinic receptors may exist on adrenergic terminals.

Acetylcholine↗