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Biomedical subjects

M Marano

Publications and source records attributed to M Marano.

At least 19 recordsLinked to original sources

Low dose remifentanyl infusion for analgesia and sedation in ventilated newborns.

AIM: The aim of this study was to evaluate the analgesic effects of remifentanyl on mechanically ventilated newborns. METHODS: Eighteen newborns, mechanically ventilated, were submitted to continuous infusion of R. A pain scale was used to evaluate comfort during mechanical ventilation. Data were collected at T0, T1, Tn, T ext, T post-ext; statistical analysis was performed by Student's t test and Pearson coefficient. RESULTS: Mean R infusion time was 66.94+/-22.24 h, with mean dose of R 0.146+/-0.038 gamma/kg/min. Mean time to reach comfort was 20+/-13.11 h with a mean infusion of R equal to 0.173+/-0.146 gamma/kg/min; R was 0.18+/-0.039 gamma/kg/min on pressure controlled ventilation and R was 0.09+/- 0.045 gamma/kg/min on assisted ventilation. Statistically significant was considered the decrease in HR as well as the increase of SpO2 at T0 vs 30 min after infusion. CONCLUSION: No adverse effects were observed during and after infusion.

Analgesia↗

Sub-100-ps amplitude-modulation mode-locked Tm-Ho:BaY2F8 laser at 2.06 microm.

We report the generation of sub-100-ps pulse trains near the 2.06-microm wavelength in an actively mode-locked diode-pumped Tm-Ho:BaYF laser operating at room temperature. Transform-limited, 97-ps Gaussian pulses at a 100-MHz repetition rate with an average power in excess of 20 mW and with a carrier wavelength tunable by approximately 50 nm near 2.066 microm are demonstrated.

Journal Article↗

Quantum-mechanical analogy of beam propagation in waveguides with a bent axis: dynamic-mode stabilization and radiation-loss suppression.

Wave propagation in an optical waveguide with a bent axis is studied under the scalar and paraxial wave approximations, and the quantum mechanical analogy with the electron dynamics in an atomic potential interacting with an intense electromagnetic field is highlighted. In particular we show that for a truncated parabolic waveguide with a periodically curved axis, a dynamic mode splitting with reduced radiation losses can be observed, which is fully analogous to the phenomenon of wave packet dichotomy and ionization quenching found in strong-field atomic physics.

Journal Article↗

Monitoring of intrathoracic volemia and cardiac output in critically ill children.

AIM: Hemodynamic monitoring is an important step in the management of critically ill children despite the difficulty in measuring preload indices continuously. The aim of the study was to analyze cardiac output parameters and preload indices after acute changes in mean airway pressure and volemia. METHODS: Twenty-three children treated at our unit were enrolled in a prospective non randomized cohort study. Respiration was supported by controlled mechanical ventilation with positive expiratory-end pressure (PEEP), peak inspiratory pressure <20 cm H(2)O and mean airway pressure <10 cm H(2)O, and hemodynamic monitoring using the PiCCO system. Hemodynamic parameters were measured at T0 (base line), T(1) (after an increase in PEEP of 5 cm H(2)O for 10 min), and T(2) (after fluid challenge). The statistical analysis (BMPD New System software package) comprised comparison of changes at T(0) vs T(1), T(1) vs T(2) and T(0) vs T(2), construction of 3 correlation matrices and multiple linear regression analysis. RESULTS: Sixty-nine hemodynamic parameters were measured in the 23 patients. A comparison between T(0) and T(1) showed no significant changes; differences between T(0) and T(2) were found for cardiac index (CI), (p=0.003); between T(0) and T(2) significant differences were found for CI (p=0.0015), intrathoracic blood volume index (ITBVI) (p=0.04) and stroke volume index (SVI) (p=0.06). The analysis of the correlation matrices yielded ITBVI with CI (p=0.0006), ITBVI with SVI (p=1 x 10(-5)), CI with SVI (p=0.002); a significant correlation between CI and extravascular lung water index (EVLWI) was found only at T(1). Multiple linear regression analysis showed that ITBVI and SVI were predictive for variance of CI at each time point. CONCLUSION: ITBVI measured by a volumetric monitoring system such as the PiCCO may be considered a sensitive preload indicator also in critically ill children.

Adolescent↗

Experimental observation of superluminal pulse reflection in a double-Lorentzian photonic band gap.

We report on the experimental observation of superluminal reflection of picosecond optical pulses at 1.5 microm using a specially designed 30-cm-long fiber Bragg grating (FBG) that realizes a spectral reflectivity profile given by the superposition of two closely spaced Lorentzian lines. Probing pulses of 380 ps duration tuned midway between the two Lorentzian lines are reflected without appreciable distortion with a measured peak pulse advancement of approximately 60 ps. The achievement of the negative group delay is due to the interference of the two resonance modes of the FBG structure and has a close connection to the phenomenon of negative group velocity for pulse propagation in an inverted medium possessing a doublet line.

Journal Article↗

Superluminal optical pulse propagation at 1.5 microm in periodic fiber Bragg gratings.

We report on the experimental observation of superluminal tunneling of picosecond optical pulses in a periodic fiber Bragg grating. Optical pulses of 380-ps duration, generated by an externally-modulated single-frequency erbium-ytterbium laser operating near 1.5-microm wavelength, were propagated at a group velocity greater than approximately 1.97 times the speed of light in vacuum across a 2-cm long fiber grating. Owing to the very large ratio between the thickness of the barrier (2 cm) and the wavelength of probing optical pulses ( approximately 1.5 microm), our experiment allows for the observation of superluminal tunneling in the optical region by direct optoelectronic time-domain measurements.

Journal Article↗

Analysis of gene expression in human bullous keratopathy corneas containing limiting amounts of RNA.

PURPOSE: To validate the use of polymerase chain reaction (PCR)-amplified full-length cDNA as a substitute for mRNA in nucleic acid array and gene expression analysis. METHODS: Total RNA was isolated from age-matched normal autopsy corneas and pseudophakic bullous keratopathy (PBK) corneas. Full-length cDNA was generated and PCR amplified using the Smart cDNA synthesis technology. Southern blot analysis of this cDNA was compared with Northern blot analysis of the RNA. Amplified cDNA was used to probe a commercial gene array. By immunohistochemistry, the expression pattern of several adhesion molecules represented on the array was assessed. RESULTS: The cDNA produced by the Smart cDNA system gave results very similar to those of northern blot analysis when examined for beta2-microglobulin, Rab geranylgeranyl transferase, and tenascin-C. This cDNA obtained from normal or PBK corneas was labeled and used to probe a 588 gene array (Clontech). Among other differences, beta6 integrin was detected only with the PBK probe, beta-catenin was markedly elevated in PBK, and beta4 integrin appeared to be reduced in PBK. Immunohistochemical patterns of these proteins were consistent with the hybridization signals on the gene array. CONCLUSIONS: Smart cDNA synthesis and nucleic acid arrays were combined and validated for the first time to identify differential gene expression in normal and diseased corneas. These techniques require very little RNA such as that equivalent to a half of a single cornea, which is useful when the amount of tissue is limiting. Altered expression of adhesive proteins beta6 integrin and beta-catenin may be related to the formation of epithelial bullae and microcystic changes in PBK patients.

Antigens, CD↗

Quality control study of H2 breath testing for the diagnosis of carbohydrate malabsorption in Italy. The "Tenue Club" Group.

BACKGROUND AND AIMS: H2 breath testing is increasingly used in Italy. The aim of this multicenter study was to assess the accuracy of this technique in the diagnosis of carbohydrate malabsorption. METHODS: An anonymous questionnaire was used to collect information about H2 breath testing methods and to design the quality control study. Fifteen out of 23 laboratories responded to the questionnaire and 12/23 completed the entire study. RESULTS: The survey revealed that a large variety of H2 testing methods are employed in Italy, but none have been previously tested for accuracy. This prospective study showed that these tests fail to identify > 20% of patients with malabsorption. In contrast, a new method based on single H2 breath measurement at 6 hours after lactulose ingestion and a cutoff value of greater than 5 ppm, had a sensitivity of 92% +/- 4% and a specificity of 94% +/- 0.5%. Increasing the cut-off to 10 ppm resulted in a sensitivity of 88% +/- 9% and a specificity of 100%. This improved accuracy was obtained with a much simpler testing procedure in which only one breath sample is analyzed, in contrast to the baseline and multiple subsequent samples that are analyzed using the currently employed techniques. CONCLUSIONS: A great improvement in the accuracy of the H2 breath test, as well as a considerable saving in terms of time and costs, may be possible through the use of a new, simplified H2 breath test followed by careful H2 analysis.

Breath Tests↗

Tumour location influences local cytokine production and host metabolism.

To determine whether the location of tumour growth influences host cytokine and metabolic responses, experimental subcutaneous (SQ) and liver (LIV) tumours were compared in Buffalo rats. An LIV tumour that was only 1 +/- 1% (P < 0.05 versus SQ) of body weight produced similar anorexia, weight loss, acute phase response, and systemic cytokine responses as are SQ tumour that was 10 +/- 2% of body weight. Neither tumour-bearing group had abnormal liver function tests or evidence of obstructive biliary pathology. Tumour necrosis factor (TNF) was detected by western analysis in both tumour as well as histologically normal liver remote from the tumour in the LIV group but not in livers of animals in freely fed and SQ groups. The proximity of the tumour to competent tissue macrophage populations, such as hepatic Kupffer cells, may be sufficient to induce cachexia. Hence, tumour location may be as important as tumour burden in determining the host's response to cancer.

Animals↗

Recombinant human growth hormone enhances the metabolic efficacy of parenteral nutrition: a double-blind, randomized controlled study.

This multicenter, randomized, double-blind study was performed to investigate whether recombinant GH improves the efficacy of total parenteral nutrition (TPN). Fifteen stable patients requiring parenteral feeding due to gastrointestinal/pancreatic disease were studied. Constant maintenance TPN providing approximately 30 kcal/kg day and approximately 1.6 g protein/kg.day was administered during an initial 7-day baseline period. After randomization, daily sc injections of saline (control, n = 9) or GH (10 mg/day, n = 6) were administered a 14-day treatment period as nutrient intake remained constant. Elemental balances for nitrogen (N), potassium (K), phosphorus (P), and sodium (Na) were determined daily and serial blood indices, vital signs, and other clinical parameters were monitored. Nutrient balances approached equilibrium during the baseline week in both groups. With GH administration, a significant increase in N, K, and P balance occurred; in contrast, nutrient balances did not change significantly from baseline values in control patients. The cumulative change (delta) in nutrient balances from the baseline week was also significantly greater in the GH-treated patients (delta N: control+2 +/- 7 g vs. GH+36 +/- 6. g, P less than 0.005; delta K:+57 +/- 45 mmol vs.+199 +/- 19 mmol, P less than 0.03; delta P: -27 +/- 30 mmol vs. +91 +/- 69 mmol, P less than 0.02). Plasma insulin-like growth factor-I concentrations rose 5-fold and serum cholesterol rose slightly with GH; no other significant change in group mean blood values occurred. One patient receiving GH and chronic prednisone therapy developed moderate hyperglycemia and mild peripheral edema; no other deleterious effects attributable to GH were observed. GH was well tolerated and significantly enhanced nutrient retention compared to standard parenteral feeding alone. GH improves the efficacy of parenteral nutrient utilization in patients requiring TPN.

Adolescent↗

[Role of neurolysis of the posterior tibial nerve in plantar perforating diseases of diabetic origin].

Perforating ulcers of the foot in diabetics constitute a difficult therapeutic problem. In a series of 17 cases, the authors stress the value of tibial nerve neurolysis associated with periarterial sympathectomy which results in cure of the 15 patients treated within 30 days. Although no electromyographic improvement was observed, perfusion studies and oxymetry demonstrated an improved local vascular situation which promoted healing.

Adult↗

Endotoxemia elicits increased circulating beta 2-IFN/IL-6 in man.

beta 2-IFN/hepatocyte stimulating factor/IL-6 is a cytokine secreted by monocytes, fibroblasts, and endothelial cells in cell culture that possesses diverse biologic activity including the stimulation of acute phase plasma protein synthesis and immunomodulation. The circulating levels of this cytokine in man in response to bacterial LPS (endotoxin) were studied. A single i.v. bolus of endotoxin (20 U/kg) produced a monophasic rise in circulating immunoreactive IFN-beta 2/IL-6 and IFN-beta 2/IL-6 bioactivity (hepatocyte stimulation and B cell differentiation assays) peaking 2 to 4 h after the endotoxin challenge. Peak IFN-beta 2/IL-6 levels ranged from 4.1 to 27.5 ng/ml. Associated with this was a rise in circulating C-reactive protein levels detected 20 h after the endotoxin bolus. Thus, IFN-beta 2/IL-6 is likely one of the endogenous mediators which is triggered in man during bacterial infection and likely participates in the metabolic and immune responses of the infected host.

Adult↗

Anticachectin/tumor necrosis factor-alpha antibodies attenuate development of cachexia in tumor models.

C57BL/6 mice bearing either a transplantable methylcholanthrene-induced sarcoma or Lewis lung adenocarcinoma were passively immunized every other day with a rabbit immunoglobulin fraction raised against murine cachectin/tumor necrosis factor-alpha. Mice bearing methylcholanthrene-induced sarcoma developed tumor-associated hypophagia that was attenuated by anticachectin immunoglobulin treatment. In the same tumor-bearing animals, anticachectin treatment also significantly reduced the extent of carcass protein and fat loss, and reduced tumor weight. Mice bearing Lewis lung adenocarcinoma did not develop significant anorexia or carcass lean tissue depletion as tumor growth progressed, but they lost carcass lipid. Treatment of Lewis lung adenocarcinoma bearing mice with anticachectin antibodies diminished the degree of carcass lipid depletion and prevented plasma hypertriglyceridemia. However, in both tumor models, anticachectin treatment did not affect either the development of anemia, hypoalbuminemia or the increase in serum amyloid P concentrations seen with increasing tumor burden. We conclude that an endogenous cachectin response, inhibitable by exogenously administered antibody, contributes to anorexia and to changes in body fat and protein metabolism in these tumor-bearing animals. Neutralizing endogenous cachectin production with antibodies offers the potential to reduce tissue wasting that is frequently associated with neoplastic disease, but it does not appear to affect all of the hematologic and acute phase responses in these murine tumor models.

Adenocarcinoma↗

Cachectin/TNF or IL-1 alpha induces cachexia with redistribution of body proteins.

Macrophage secretory products are suspected to participate in the severe lean tissue wasting related to chronic illness. The protein metabolic effects of chronic, 7-day cachectin/tumor necrosis factor (cachectin) or interleukin 1 alpha (IL-1 alpha) administration in vivo were studied in male Wistar rats that were 1) freely fed, 2) pair fed, 3) total protein and calorie starved, 4) twice daily lipopolysaccharide (LPS) administered, 5) twice daily cachectin administered, and 6) twice daily IL-1 alpha administered. LPS, cachectin, or IL-1 alpha administration produced anorexia; weight loss in these groups was comparable to respective pair-fed animals. However, LPS, cachectin, or IL-1 alpha accelerated peripheral protein wasting while preserving liver protein content, unlike the pattern in the pair-fed or starved animals in which loss of liver proteins and relative preservation of skeletal muscle protein were observed. The decrease in skeletal muscle protein content in LPS- or cytokine-treated animals was associated with coordinate decreases in muscle mRNA levels for the myofibrillar proteins myosin heavy chain, myosin light chain, actin, and in the 18S and 28S subunits of ribosomal RNA. We conclude that chronic exposure to the cytokines, IL-1 alpha or cachectin, can simulate those body and muscle protein changes seen in experimental LPS administration or chronic disease and markedly differ from the pattern of protein redistribution due to caloric restriction.

Animals↗