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Biomedical subjects

M M Anceschi

Publications and source records attributed to M M Anceschi.

At least 37 records · Page 2Linked to original sources

Differences in erythrocyte membrane cholesterol to phospholipids ratio in postmenopausal women with and without hormone replacement.

OBJECTIVES: To investigate the changes in the cholesterol:phospholipids (C/PL) ratio of erythrocyte membrane in post-menopausal women with and without hormone replacement therapy (HRT). STUDY DESIGN: A cross-sectional study including 83 patients divided into three groups according to HRT (group 1, no HRT (n = 52); group 2, combined HRT (n = 16); and group 3, estrogen-only therapy (n = 15)). RESULTS: The C/PL ratio was lower in group 2 with respect to group 1 and group 3 (P = 0.03). No difference was found in erythrocyte membrane cholesterol between the three groups; however, the phospholipid concentration was higher in group 2 with respect to the other groups (P < 0.05). In the control group, C/PL values correlated positively with plasma LDL levels (P < 0.005) and negatively with HDL levels (P < 0.005). CONCLUSIONS: From our data the addition of progestogens in HRT appears to decrease the C/PL of the erythrocyte membrane possibly resulting in a beneficial effect on rheological properties of erythrocyte membrane. The results of our study thus suggest additional benefits from supplementation of progestogens in HRT, in addition to prevention of estrogen dependent endometrial hyperplasia and adenocarcinoma.

Aged↗

Amniotic fluid endothelin-1 levels are increased in pregnancy-induced hypertension and intrauterine growth retardation.

Endothelin-1 (ET-1) is a potent vasoconstrictor released by vascular endothelium. Because endothelial cell damage is considered determinant in the pathophysiology of pregnancy-induced hypertension (PIH), this study was conducted to evaluate the role of ET-1 produced by feto-placental tissues in PIH. Amniotic fluid samples obtained by amniocentesis from patients with PIH (N = 33), intrauterine growth retardation (IUGR) (N = 16), and PIH associated with IUGR (N = 12) were evaluated for ET-1 and compared to 42 normotensive pregnancies using a specific radioimmunoassay. ET-1 levels were significantly increased in PIH (35.6 +/- 1.9 pg/ml) and IUGR groups (33.8 +/- 4.6 pg/ml) compared to controls (20.8 +/- 1.4 pg/ml) (P < 0.01). In patients with PIH associated with IUGR, ET-1 concentrations were higher (P < 0.05) with no correlation with the severity of IUGR. Our data indicate that in PIH and IUGR ET-1 production and/or secretion is enhanced in the amniotic compartment, suggesting that the peptide may contribute to the pathophysiologic modification observed in these conditions.

Adult↗

Surfactant administration to the human fetus in utero: a new approach to prevention of neonatal respiratory distress syndrome (RDS).

Supplementary surfactant (80 mg in 1 ml) was administered intra-amniotically in proximity of the fetal mouth to 4 preterm fetuses (28 to 32 wks) with immature amniotic fluid indexes and whose delivery was imminent. Administration was preceded by a aminophylline infusion (loading dose of 240 mg and maintenance of 0.8 mg/kg/min) to the mother in order to elicit sustained fetal breathing movements. Following delivery by cesarean section, the absence of signs of respiratory distress in the infants along with a completely uneventful clinical course suggests that the present therapeutic approach has great potential for becoming a reliable option for the antenatal prevention of RDS.

Adult↗

A comparison of the shake test, optical density, L/S ratio (planimetric and stechiometric) and PG for the assessment of fetal lung maturity.

Our aim was to determine the diagnostic accuracy and reliability of four tests for the assessment of fetal lung maturity (FLM): shake test, optical density at 650 nm (OD650), lecithin to sphingomyelin ratio (L/S) by planimetry and stechiometry, and presence of phosphatydylglycerol. Amniotic fluid was obtained from 74 patients at various gestational ages. The shake test and the OD650 were performed according to published methods L/S was determined by TLC (thin-layer chromatography) and the ratio assessed by planimetry and stechiometrically by measurement of organic phosphorus from the chromatographic spots. PG was assessed similarly by TLC. When correlated with gestational age at amniocentesis, all tests correlated positively: shake test (r = 0.46, p < 0.005); OD650 (r = 0.31, p < 0.005); planimetric L/S (r = 0.77, p < 0.005); stechiometric L/S (r = 0.52, p < 0.005) and PG (r = 0.54, p < 0.005). The diagnostic accuracy of each test was as follows: the shake test and the OD650 had a sensitivity of 50%, while the steciometric L/S had a sensitivity of 75%, the planimetric L/S and the presence of PG were 100%. All four tests demonstrated a specificity greater than 64%, the highest for the PG presence being (83%) and the shake test (86%). Predictive negative values for lung maturity were > 93% for all tests, with the highest for the planimetric L/S and presence of PG being (100%). The study confirms that the determination of L/S ratio is still superior to other tests in terms of overall diagnostic accuracy. In addition, it was found that presence of PG was highly associated with the absence of respiratory complications in the newborn.

Adult↗

An obstetric and neonatal study on unplanned deliveries before arrival at hospital.

OBJECTIVE: To establish the prevalence of unplanned deliveries before arrival at a big metropolitan hospital and to determine the demographic characteristics of the group of women at risk of delivering before arrival. DESIGN: A random case control study. Each baby born before arrival and its mother were compared to the next baby born in the same Department. SUBJECTS: All babies born before arrival at the Department of Obstetrics and Gynecology, University "La Sapienza" in a 10 yr. period (Jan 1983-Dec 1993). RESULTS: Of 27,274 consecutive deliveries in the study period, 22 (0.8%) babies were born before arrival at hospital. Of the 22 women who delivered before arrival, 16 were Italian, 5 were considered nomad (no fixed address) and one was a Polish tourist. No statistical difference was found between groups regarding maternal age, parity, gestational age, birth weight and immediate delivery complications. No mortality cases were observed in the study or control group. Neonatal stay in the neonatal ward was longer in the study group (6.5 vs 3.5 days, P < 0.001). Hypothermia was the highest morbidity (P < 0.001) and neonatal complications were more prevalent in babies delivered before arrival than in-born babies (P < 0.001). CONCLUSIONS: Delivery before arrival to hospital does not seem to carry a higher neonatal mortality risk. However, the prevalence of complications was higher in such babies, with hypothermia being the highest morbidity.

Academic Medical Centers↗

Pregnancy in adolescents. A case-control study.

OBJECTIVE: to investigate pregnancy outcome and incidence of pregnancy-related disorders in the adolescent. DESIGN: a matched control retrospective study. SUBJECTS: pregnant adolescents aged 14 to 19 years admitted to the Departments of Obstetrics and Gynecology--Policlinico Umberto I, between the years 1984 and 1993; a comparable number of pregnancies aged 20 to 24 years was considered as a control group. RESULTS: In the 10 yrs. period a total of 304 pregnancies in adolescents were considered. Preterm deliveries were 9.5% in the adolescent group vs 5.9% in control (P > 0.05). A higher incidence was found in number of cesarean section (P < 0.001), spontaneous abortion (P = 0.003), intrauterine growth retardation (P = 0.04) and fetal distress (P = 0.04) in the adolescent group vs matched controls. Also mean birth weight was significantly lower in the adolescent group when compared with normal group (P < 0.001). CONCLUSION: we found a higher incidence of obstetric complications, such as IUGR, acute fetal distress in labor and lower birth weight, in the adolescent group, resulting in a higher number of cesarean sections. We hypothesise that the relative state of "hypoarterialisation" characteristic of the adolescent uterus may be involved in the afore-mentioned complications.

Adolescent↗

Clinical and ultrasonographic implications of uterine leiomyomatosis in pregnancy.

OBJECTIVE: To study the complications related to leiomyomatosis in pregnancy by clinical and ultrasonographic assessment. DESIGN: A retrospective study. SUBJECTS: All pregnancies admitted to the 2nd Institute of Gynecology and Obstetrics, Policlinico Umberto I, in the period between January 1992 to December 1993 were surveyed. RESULTS: Gestational age at the time of ultrasonographic neoplasm diagnosis was 25.1 +/- 13.4 weeks, 'we found no correlation between maternal age or parity affecting pregnancy outcome, Leiomyomatosis complicated pregnancy rate was 1.68%. Myomatosis was diagnosed clinically in 25 of 67 cases (37.3%). Regarding the location of the neoplasm, 59% was located in the corpus-uteri, 21% was considered a diffuse neoplasm and the 14% was located in the fundus. Threatened abortion was the most frequent complication (20%), abortion was the second (16.4%). We observed an increased abortion threat rate (p < 0.001) in those cases where the leiomyoma was in relation with the placenta. We had a surgery rate of 76% in pregnancies complicated by myomatosis, and the indication for surgery was given either primarily or exclusively by the presence of myomatous formation in 19 cases (50%). CONCLUSIONS: Our study suggests that location of the leiomyoma in relation to the placenta is a higher risk factor than its size, and that there is a higher risk for threats of abortion and abortion rates in pregnancies complicated by leiomyomatosis. We recommend that every pregnant woman with a suspected myoma should be ultrasonographically scanned.

Adult↗

The cholesterol to phospholipids ratio (C/PL) of the erythrocyte membrane in normotensive, hypertensive pregnant and in cord blood as assessed by a simple enzymatic method.

The study described was conducted to evaluate a simple enzymatic method for the study of the cholesterol/phospholipids ratio in erythrocyte membrane (C/PL) in a group of normal pregnant, of hypertensive pregnant, in non-pregnant controls and in cord blood. Subjects consisted of 28 normotensive pregnant women (NT), 14 women with pregnancy induced hypertension (PIH), 10 non-pregnant normotensive women (Non-Preg) and 14 samples obtained from umbilical cord (C) at delivery from normotensive pregnant. Red blood cells were isolated from heparinated blood samples. Lipids were extracted from erythrocytes by isopropanol/chloroform, without preparation of cell ghosts. Cholesterol content was evaluated by cholesterol oxidase and phospholipids were estimated as organic phosphorus in the total lipid extract. We found a significant difference of C/PL between the PIH group and the NT group (1.01, SD 0.11 vs. 0.76, SD 0.10, 95% CI 0.74-0.78; p < 0.001) and the Non-Preg group (0.83, SD 0.11, 95% CI 0.80-0.86; p < 0.001). Cord blood C/PL was significantly elevated with respect to NT (1.25, SD 0.13 vs. 0.76, SD 0.10; p < 0.001). The method was proven to be fast, reliable and of value for the study of the pathophysiology of the alteration of the lipid composition, i.e., the increased cholesterol content, of the red cell membrane found in hypertensive pregnant patients.

Adult↗

Human papilloma virus infection and Ki-ras oncogene in paraffin-embedded squamous carcinomas of the cervix.

42 paraffin-embedded squamous cervical carcinomas were screened for the presence of human papilloma virus (HPV; 6b, 11, 16, 18) and for activation of the Ki-ras oncogene family by polymerase chain reaction. In 72% of cases we found one or more HPV types, but no mutations of the Ki-ras gene (codon 12-1 and 61-1, 61-2 and 61-3) were found. We conclude that mutations of the Ki-ras oncogene, at the positions analyzed, are not likely to be involved in the events leading to cervical carcinogenesis.

Carcinoma, Squamous Cell↗

Inhibin and activin in human fetal membranes: evidence for a local effect on prostaglandin release.

Trophoblast and fetal membranes (amnion and chorion) are the tissues forming the anatomical/functional interface between the mother and the fetus. The aim of the present study was to evaluate the presence and a possible effect of inhibin and activin in human amnion and chorion. The expression of inhibin/activin alpha, beta A, and beta B subunit messenger RNA (mRNA) and the localization of immunoreactive material were evaluated in amnion and chorion collected at term pregnancy by a Northern blot analysis and by immunohistochemistry. Amnion cells expressed the mRNA of the three inhibin/activin subunits, with the beta B message the most abundantly expressed. The epithelial layer of the amnion showed an intense fluorescent staining of beta B inhibin/activin subunit, and positive signals were also observed for the alpha and beta A subunits. Inhibin/activin alpha and beta A subunit mRNAs were found highly expressed in chorion. The cytotrophoblast of the chorion showed a positive staining for the three inhibin/activin subunit antisera. The addition of activin A increased the release of prostaglandin E2 from human amnion-derived cultured cells. The effect was dose and time dependent. Inhibin A did not induce significant changes of prostaglandin E2 release from amnion cells. The present results show that amnion and chorion produce inhibin and activin subunits and that activin stimulates the release of prostaglandin E2 from cultured amnion cells, suggesting a possible role of inhibin and activin in fetal membranes.

Activins↗

Perinatal AIDS.

AIDS is the major public health concern today. The short-term history of the disease adds considerable emphasis to the problem in that it has literally exploded in a few years. The pathophysiology and natural history and, what is most important, the treatment, remain enigmatic. Management of women at risk of HIV infection is colored by the nature of the illness, the subgroups of the people first infected, the mode of transmission, and the implication of vertical transmission.

Acquired Immunodeficiency Syndrome↗

Erythrocyte membrane composition in pregnancy-induced hypertension: evidence for an altered lipid profile.

OBJECTIVE: To investigate whether the increased membrane fluidity postulated as a possible contributing factor to the hypertensive states of pregnancy is related to the lipid composition of the erythrocyte membrane. DESIGN: An observational case control study. SUBJECTS: 30 women with pregnancy induced hypertension, 26 normotensive pregnant women matched for gestational age, and 10 normotensive non pregnant nulliparous women. INTERVENTIONS: Erythrocyte membranes were prepared from venous blood samples obtained from all the women. MAIN OUTCOMES MEASURES: Lipid analysis, including cholesterol to phospholipids ratio, distribution of phospholipid classes and fatty acid composition of total phospholipids in erythrocyte ghosts. RESULTS: The cholesterol/phospholipid ratio was significantly higher in the women with pregnancy induced hypertension compared with the normotensive pregnant women (mean 1.24, SD 0.31, 95% CI 1.12 to 1.35 vs mean 0.90, SD 0.09, 95% CI 0.86 to 0.94; P less than 0.01). Normotensive non-pregnant erythrocyte membrane cholesterol/phospholipid ratio was 0.88 (SD 0.11, 95% CI 0.79 to 0.96). The percentage distribution of different phospholipid classes and fatty acid composition was similar in all the four groups. CONCLUSIONS: The increased cholesterol/phospholipid ratio of the erythrocyte membrane found in pregnancy-induced hypertension represents one factor involved in the pathophysiology of this condition and a possible biochemical marker of the disease.

Adult↗

Abnormal platelet lipid membrane composition in pregnancy induced hypertension.

The cholesterol:phospholipid ratio (C/PL) was measured in platelet plasma membrane in patients with pregnancy-induced hypertension [with proteinuria (PE), and without proteinuria (PIH)] and in matched normotensive gestational controls (NT). The C/PL was raised in the platelet membrane from PE (1.52 +/- 0.50, 95% CI 1.13 to 1.90) and PIH (1.38 +/- 0.34, 95% CI 1.08 to 1.67) compared with that from NT controls (0.88 +/- 0.13, 95% CI 0.80 to 0.95) (p less than 0.01, ANOVA test). No correlation was found when C/PL was regressed against total serum cholesterol levels. The abnormality of lipid composition of the platelet plasma membrane could account for some of the changes in platelet function that have been described in PIH.

Blood Platelets↗

Collagen and elastin in rabbit fetal lung: ontogeny and effects of steroids.

Ontogeny of lung collagen and elastin were studied in fetal rabbit from day 25 to term. Collagen (isolated by hot trichloroacetic acid treatment) and elastin (contained in the residue) were hydrolyzed and the hydroxyproline and desmosine quantitated by hplc. Hydroxyproline slightly increased from day 25 to day 30 (204 to 244 micrograms/100g dry weight). Over the same period desmosine increased from 2.2 to 5.1 micrograms/100 mg dry weight (P < 0.01). The effect of antenatal corticosteroids on the lung of prematurely-delivered fetuses was also evaluated. Betamethasone (B) was given to pregnant does at a dose of 0.2 mg/kg 24 and 48 h before delivery of the fetuses at 26, 27 and 28 days. In treated animals elastin concentration increased significantly by about 22% on day 26 (P = 0.05), by 29% on day (P < 0.02) and by 47% on day 28 (P < 0.02). Hydroxyproline was not affected by steroid treatment at any gestational age. This suggests that steroids affect fetal lung development also via changes in connective tissue.

Animals↗

CA 125 in peritoneal fluid: reliable values at high dilutions.

Forty-three samples of peritoneal fluid from women undergoing laparotomy or laparoscopy for various gynecologic diseases were examined to determine and characterize CA 125 antigen. The data were compared with the corresponding serum levels. CA 125 levels in undiluted peritoneal fluid ranged between 41-301 U/mL and were significantly higher than levels in serum, except in cases of ovarian carcinoma. However, when CA 125 of peritoneal fluid was measured at dilutions greater than 1:50, higher antigen levels were measured (1120-31,500 U/mL), with the highest CA 125 values in patients with ovarian carcinoma. Measurements at dilutions of less than 1:50 were also affected but did not show any decreased binding of the antigen. Immunoblotting analysis of serum and peritoneal fluid indicated the presence of two main bands in each. The monoclonal antibody OC 125 reacted strongly with peritoneal fluid CA 125, in agreement with the CA 125 values obtained by immunoradiometric assay using high dilutions. These data suggest that CA 125 measurements in peritoneal fluid are unreliable unless the samples are diluted 1:50 or more. Furthermore, the statistical difference found between patients with benign and malignant tumors and those with leiomyomata uteri and controls suggests that diluted peritoneal fluid could have a role in identifying abnormal antigen levels.

Antigens, Tumor-Associated, Carbohydrate↗