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Biomedical subjects

M La Cava

Publications and source records attributed to M La Cava.

11 recordsLinked to original sources
PubMed2002

ICP and CBF regulation: effect of the decompressive craniectomy.

The view of the intracranial system as a rigid and closed box has been criticised by many authors who take into account the possibility of a certain degree of elastic bulk accommodation, mainly in the spinal sac. In nine patients, who underwent decompressive craniectomy for treatment of life-threatening intracranial hypertension, when the clinical conditions improved, just before cranioplasty, the blood flow velocities at middle cerebral artery (MCA) and at superior sagittal sinus (SSS) level were simultaneously recorded. The measurements were repeated after cranioplasty. The blood flow velocity recorded from SSS in craniectomized patients appeared flat, without evident pulsation; after cranioplasty a clear-cut pulsatile wave became again evident. The disappearance of a pulsatile shape in the blood flow velocity recorded from the SSS when the intracranial system was "open" and the reappearance of a pulsatile blood flow waveform after the "closure" of the skull confirm that the venous bed acts as a bulk compensatory system in order to maintain the intracranial volume absolutely constant.

Blood Flow Velocity↗
PubMed2002

ICP and CBF regulation: a new hypothesis to explain the "windkessel" phenomenon.

The brain tamponade represents the final condition of a progressive intracranial pressure (ICP) increase up to values close to arterial blood pressure (BP) producing a reverberating flow pattern in the cerebral arteries with no net flow. This finding implies intracranial volume changes, therefore a full application of the Monro-Kellie doctrine is impossible. To resolve this contradiction, in eight pigs a reversible condition of brain tamponade was produced by infusing saline into a cerebral ventricle. The following parameters were measured: BP in the common carotid artery, ICP by the same needle utilised for the infusion, arterial and venous blood flow velocity (BFV) at, respectively, internal carotid artery (ICA) and sagittal sinus (SS) site by ultrasound technique. When ICP approached carotid BP values, reverberating BFV waves both at ICA and SS site were simultaneously observed. The arterial and venous reverberating waves appeared to be almost exactly superimposable, with a delay of about 40 msec. This synchronism between the pulsatile arterial and venous BFV indicates that the residual pulsation, still occurring at the arterial proximal level, is compensated by a passive compression-distension of the SS with no blood volume (that is net flow) crossing the intracranial vasculature.

Animals↗
PubMed1999

Long-term follow-up of anterior uveitis after cataract extraction and intraocular lens implantation.

PURPOSE: To assess whether cataract surgery and intraocular lens (IOL) implantation in patients with anterior uveitis interfere with the natural course of the ocular disease. SETTING: Tertiary care center at the University of Rome "La Sapienza", Rome, Italy. METHODS: Cataract extraction and IOL implantation were performed in 24 patients with uveitis-related cataract: 12 with Fuchs' heterochromic iridocyclitis (Group 1) and 12 with other types of anterior uveitis (Group 2). The mean follow-up in the 2 groups was 33.6 months and 24.8 months, respectively. The number and severity (inflammatory score) of uveitis relapses in all patients over the same period were recorded. RESULTS: After surgery, the mean number and severity of uveitis relapses decreased: Group 1, from 1.83 +/- 1.90 (SD) to 1.00 +/- 1.21 and from 1.08 +/- 0.90 to 0.92 +/- 0.67, respectively; Group 2, from 2.74 +/- 3.44 to 1.25 +/- 1.71 and from 1.83 +/- 1.10 to 1.25 +/- 0.75, respectively (P = .046). There were no statistically significant between-group differences. In Group 2, a trend toward worse visual rehabilitation was seen; this was significantly different from the result in Group 1 (P = .018) because of preoperative optic nerve damage, macula disease, or both. CONCLUSION: Cataract surgery and IOL implantation did not negatively influence the natural course of uveitis in patients with Fuchs' heterochromic iridocyclitis. Correct surgical timing, selection of cases, and adequate anti-inflammatory therapy may promote similar results in patients with other types of anterior uveitis.

Adolescent↗
PubMed1996

Endogenous uveitis: an analysis of 1,417 cases.

A retrospective study on 1,417 uveitic patients referred to the Ocular Immunovirology Service of the University of Rome 'La Sapienza' was carried out to determine the occurrence of the various forms of uveitis. To detect also the possible changing patterns of uveitis during the last 25 years the obtained data were compared with those reported in two previous studies performed by the same author, at the same institution in 1978 and 1985. Anterior uveitis was the most frequent anatomical type of intraocular inflammation (49.12%); intermediate uveitis was diagnosed in 12.42% of all the cases and showed an increased incidence over the years (p < 0.0001). Posterior and diffuse uveitis accounted for 22.1 and 16.37% of the cases. An improvement in diagnostic definition has been confirmed by the significant decrease in the percentage of 'idiopathic uveitis' from 56.8 to 38.1% (p < 0.0001). Associated infectious conditions were detected in 17.43% of the cases. Toxoplasma gondii was the most common etiologic agent of uveitis (6.63%). An associated systemic disease was diagnosed in 15.03% of uveitic patients, and 6% of them were affected with Behçet's disease. Specific ocular diseases and clinical entities increased from 7.8 and 14.68% to 29.42% in the last 25 years (p < 0.0001), the most frequent being pars planitis (11.99%) and Fuchs' heterochromic iridocyclitis (8.32%).

Adolescent↗
PubMed1995

Behçets disease in children.

Ophthalmic and clinical analysis were carried out on 16 children and 122 adult patients affected by Behçet's disease (BD) to delineate the clinical features of BD in childhood and to investigate the differences between the expression of the disease in children and adults. The mean follow-up period was 7.8 and 7 years, respectively. Pediatric onset of BD was found in 7.6% of all the cases with a male:female ratio of 1.29:1. The complete type of the disease was observed in 50% of the children. No statistical significant differences were noted between children and adults in the incidence of oral aphthae, genital ulcers, skin lesions, arthritis, gastrointestinal involvement, neuropsychiatric symptoms and the presence of HLA-B51. Thrombophlebitis was associated with the onset of the disease in adult age (P=0.022). Uveitis alone or in combination with other major symptoms was the presenting sign in a higher percentage of children (P=0.077), As in adults, in children diffuse uveitis was the most common type of ocular inflammation, while ocular complications have been found mainly in children (P=0.021), who more frequently developed cataract, maculopathy and retinal detachment (P=0.024). Both adult and young male patients have shown a lower age at onset and higher rate of optic atrophy than females. In conclusion, no significant differences have been found between children and adults in the expression of the major and most of the minor symptoms of BD. Ocular involvement in childhood may be very severe, as was confirmed by the high frequency of diffuse uveitis and ocular complications. Young males, as adult males, showed an earlier onset of the disease and a worse ocular prognosis.

Adolescent↗
PubMed1994

Structural alterations in the carboxyl-terminal domain of the BCRABL gene product activate its fibroblastic transforming potential.

Activation of the c-abl protooncogene occurs in Abelson murine leukemia virus, Hardy-Zuckerman-2 feline sarcoma virus, and during the chromosomal translocation that generates the BCRABL fusion gene. The three genes exhibit varying degrees of transforming activity; the two viral genes transform NIH-3T3 cells in vitro, whereas the BCRABL gene is incapable of transforming these cells. To determine whether genetic alterations can enhance the transforming potential of the BCRABL gene, we employed genetic selection techniques which led to the isolation of a mutant form of the BCRABL gene with high levels of fibroblastic transforming activity. Molecular analysis of this clone shows that it suffered a deletion of 3' ABL sequences and their replacement with a cellular sequence of unknown origin, termed X. This tripartite gene is capable of inducing 35 foci/10 ng of DNA. Deletion of 3' ABL sequences analogous to that seen in the activated BCRABL protein without the addition of X yields 5 foci/100 ng of DNA. These results suggest that carboxyl-terminal truncations unmask the fibroblastic transforming activity of the BCRABL gene product and the addition of X sequences dramatically enhances this transforming potential, indicating a dominant contribution by the X reading frame.

3T3 Cells↗
PubMed1986

[Duodenal diverticula].

After an examination of the anatomopathological and clinical features of duodenal diverticula, the various ancillary pathologies are analysed as are the complications linked to the diverticulum itself. A meticulous review of the literature and several personal surgical cases confirms the view that only those diverticula causing evident symptoms or complications should be treated. The various surgical techniques selected as appropriate for the different cases are also described.

Adult↗
PubMedDate not supplied

Ibopamine treatment in chronic hypotony secondary to long-lasting uveitis. A case report.

PURPOSE: To assess the clinical efficacy of ibopamine eye drops in severe hypotony secondary to chronic progressive uveitis. METHODS: Case report. A 47-year-old man with a 37-year history of diffuse uveitis and severe refractory hypotony was treated with topical 2% ibopamine (Trazyl) six times a day. Intraocular pressure, visual acuity, visual field and side effects were recorded during 15 months of follow-up. RESULTS: IOP, visual acuity and visual field increased after four days of therapy and lasted for two months when the drug was suspended because of the onset of filamentous keratopathy. A new course of treatment with 2% ibopamine eye drops in a different solvent (BSS) resulted in a stable increase in IOP, VA and visual field, with no side effects in a follow-up of 13 months. CONCLUSIONS: Ibopamine 2% eye drops in BSS solvent seem effective in the treatment of uveitis-related hypotony.

Chronic Disease↗