[Alcohol and biligenesis. Possible implications of ethanol in the etiopathogenesis of pigmented and mixed biliary calculosis].
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Biomedical subjects
M Pozzoli
Publications and source records attributed to M Pozzoli.
[Left-ventricular thrombosis in recent myocardial infarction. An echocardiographic study].
To evaluate the incidence of left-ventricular thrombosis (LVT) in recent myocardial infarction (MI), M-mode and two-dimensional echocardiography (2DE) were performed in 200 patients enrolled in a rehabilitation program, three to 12 weeks after the acute episode (average 6 weeks). LVT was detected in 36 of 125 patients with anterior MI and in 4 of 75 patients with inferior MI. The presence of LVT correlated well with the electrocardiographic extension of myocardial necrosis; 90% of LVT was detected in patients with extensive MI. The same behaviour seems to be found in MI without evidence of ECG Q waves: 3 of 8 patients with extensive non-transmural MI had LVT. All thrombi were located at the apex. For this reason the apical acoustic window is the most useful in diagnosing LVT. All patients with LVT showed severe apical wall-motion abnormalities (akinesis, dyskinesis, aneurysm); the motion of the lower-posterolateral, septal and anterolateral segments was also frequently abnormal. None of the 40 patients with LVT had clinical evidence of systemic embolization during the in-hospital period. M-mode recordings wer of no help. Left ventricular diastolic dimensions and fractional shortening could not identify subgroups of patients at risk for LVT. In conclusion, patients with a recent large MI and severe apical wall-motion abnormalities are at high risk for LVT; nevertheless, the risk of systemic embolization seems to be virtually absent. 2DE is a useful screening technique for detecting LV in patients with recent MI before cineventriculography and cardiac surgery.
Adult↗
beta-Like globin RNA sequences in hemoglobin Lepore disease.
A Southern Italian patient homozygous for hemoglobin Lepore disease synthesizes approximately 3% Lepore delta beta-globin chains (relative to alpha chains) in the reticulocytes. Measurement of beta-like RNA sequences by hybridization to complementary DNA specific for beta-globin demonstrates a low level (1--2% relative to alpha sequences) of these sequences in cytoplasmic RNA from reticulocytes or spleen cells, suggesting that the Lepore gene is expressed into mRNA at a lower extent than normal alpha or beta genes; the comparison with the level of beta-like sequences found in nuclear RNA (6--8%) further supports this conclusion and indicates, in addition, that Lepore RNA might be degraded at a faster rate than normal. 2--3% beta-like sequences are found in nuclear RNA in three cases of homozygous beta0-thalassemia, setting the highest possible estimate for the delta-RNA level; this figure suggests that the 'delta-promoter'-dependent Lepore delta beta gene is somehow more actively expressed than the delta gene.
Globins↗
Left atrial appendage dysfunction: a cause of thrombosis? Evidence by transesophageal echocardiography-Doppler studies.
The blood flow velocity patterns within the left atrial appendage were studied by transesophageal color flow imaging and pulsed Doppler in 84 patients. At the time of the study, 57 of the patients were in sinus rhythm, 25 were in atrial fibrillation, and two were in atrial flutter. The relationships between atrial rhythm, blood flow pattern and the presence/absence of spontaneous echocardiographic contrast or thrombus within the appendage were investigated. Transesophageal echocardiography allowed recording of blood flow velocities in 81 of the 84 patients studied. In 51 of the 55 patients in sinus rhythm the pulsed Doppler study showed a biphasic blood flow pattern, whereas a multiphasic pattern was found in the two patients with atrial flutter and in 14 patients with atrial fibrillation. In four patients with sinus rhythm and 10 patients with atrial fibrillation, no significant blood flow velocity could be detected. Thrombus or spontaneous echocardiographic contrast were found within the left atrial appendage in 20 patients, and in all these patients blood flow was either absent or significantly reduced. Our findings indicate that an absent or low blood flow velocity within the left atrial appendage represents a predisposing factor for thrombosis. Isolated left atrial appendage dysfunction has been documented in four patients during sinus rhythm, which may lead to thrombosis. This observation may offer an explanation for cardioembolic events that occur occasionally in patients without apparent heart disease and sinus rhythm.
Adult↗