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Biomedical subjects

M Sessa

Publications and source records attributed to M Sessa.

At least 19 recordsLinked to original sources
PubMed2006

[Haemocoagulative modifications correlated with pregnancy].

AIM: The aim of this paper was to establish the physiologic changes in the coagulation and fibrinolytic systems during normal pregnancy. METHODS: One-hundred and twenty normal pregnant women were investigated in a longitudinal study involving 3 measurements: blood samples were collected at 12, 24 and 36 weeks of gestation and were assayed for prothrombin time, antithrombin III (ATIII) activity, protein C activity, protein S (PS) activity, prothrombin fragments 1+2, type 1 plasminogen activator inhibitor activity, tissue plasminogen activator antigen, plasminogen, activated protein C resistance, factors VII and VIII levels and D dimer. Student t-test, one way analysis of variance (ANOVA) and Fisher test were used for statistical analysis. RESULTS: Factor VII and factor VIII were always increased with respect to controls. Variance analysis showed a statistically significant reduction for anticoagulants (PS) and a rise for F1+2 and D dimer. With regard to fibrinolysis, there was an increase both for t-PA and PA1-1 during pregnancy. Moreover, the increased activity of factors of haemostasis was accompanied by an increase of activity and concentration of ATIII and acquired activated protein C resistance. CONCLUSIONS: These findings suggest that normal pregnancy is associated with an hypercoagulable state, resulting into a moderate risk for thrombosis during the different trimesters of pregnancy. Also broad spectrum assays which measure a range of trombin/fibrin formation in serum have become an established mean to identify activation of blood coagulation and/or fibrinolysis. There is a considerable interest in the application of these assays to the diagnosis of other acquired hypercoagulable states; such as thrombophilia during pregnancy. From the viewpoint of coagulation/fibrinolysis changes, the follow-up of thrombophilia markers could be recommended when levels of coagulation parameters exceed the normal values during pregnancy.

Adult↗
PubMed2006

[Hypercoagulability during pregnancy: evidences for a thrombophilic state].

AIM: The development of thrombotic disorders is a major threat for young women during pregnancy. It is one of the main causes of pregnancy-related disorders, which may also result in harm for the conceptus. Successful pregnancies require an even balance of coagulation and fibrinolysis, in order to secure stabilization of the basal plate as well as adequate placental perfusion. Broad spectrum assays which measure a range of thrombin/fibrin formation in serum have become an established means of identifying activation of blood coagulation and/or fibrinolysis. There is considerable interest in the application of these assays to the diagnosis of other hypercoagulable states, such as thrombophilia during pregnancy. We investigated coagulation/fibrinolysis parameters for significant differences between pregnant women during their gestation (first, second and third trimester) with or without pregnancy loss and healthy nonpregnant women. METHODS: Thirty-nine pregnant women, aged 24-39 years, were studied. They were subdivided according to pregnancy trimester: 15 patients in the first trimester; 13 in the second and 11 in the third. The selection of patients was carried out in cooperation with the Transfusion Center of the Second University of Naples in order to obtain a homogeneous sample group. The control group included 400 healthy patients. Biochemical and blood coagulation tests were performed for each patient and the results obtained were compared with the control group. RESULTS: A decrease in free protein S (PS) and fibrinolysis (t-PA/PAI-1) activities and an increase in Factor VII, Factor VIII, prothrombin fragment 1+2 (F1+2), D-dimer (D-dimer) were observed in pregnant women during the follow-up of gestation. However, there were statistical differences between the groups of women with one or more pregnancy loss where it was found the lowest values in t-PA and PAI and the highest values in FVII and F1+2. Among subjects with more than one abortion, coagulation/fibrinolysis derangements before the partum were more prominent. A significant association exists between consecutive recurrent abortions and pregnancy complications such as placental abruption, hypertensive disorders and CS. This association persists after controlling for variables considered to coexist with recurrent abortions. CONCLUSIONS: These findings suggest that an excessive hypercoagulable state is associated with the termination of pregnancy resulting into a moderate risk for thrombosis during the different trimesters of pregnancy. The follow-up of fibrinolytic markers could represent a useful diagnostic tool for termination of pregnancy.

Blood Coagulation↗
PubMed2004

[Thrombophilic syndrome associated to phenotypic resistance to activated protein C in postmenopausal women].

AIM: Hormone replacement therapy (HRT) may reduce the risk of cardiovascular events in healthy postmenopausal women. However recent studies suggest a 2-4 fold increased risk of idiopathic venous thromboembolism (VTE) among users of HRT. Our aim was to evaluate the overall effect of HRT on hemostatic variables probably related to increased VTE risk reported in epidemiological studies. METHODS: Therefore, 100 healthy postmenopausal women aged 45-60 years divided into 50 HRT non-users and 50 HRT users were examined. The authors assayed on the automated coagulometer ACL7000 (Instrumentation Laboratory, Milan) the procoagulant proteins: factor VIII (VIII:C) and factor VII (VII:C); the natural anticoagulant proteins: antithrombin (ATIII), protein C (PC), protein S (PS) and the resistance to anticoagulant action of activated protein C (APC-Resistance). The free tissue factor pathway inhibitor (TFPI) was measured with an ELISA method (Diagnostica Stagò; France, Roche). The in vivo coagulation and fibrinolysis activation was evaluated by the assays of prothrombin fragment 1+2 (F1+2) and plasmin- antiplasmin complexes (PAP) using ELISA techniques. RESULTS: Increased levels of FVIII:C and FVII:C were observed in HRT users and HRT non-users women compared to controls (FVIII:C= 126+/-58%, 120+/-59% vs 85+/-15% p=0.0001; FVII: C 113+/-23%, 103+/-19% vs 90+/-16% p=0.0001). The activation peptides were significantly different compared to those found in control subjects; higher values were observed in HRT users compared to HRT non-users (F1+2=1.11+/-0.44 nM, 077+/-0.31 nM vs 0.45+/-0.35 p=0.00001; P-AP= 606+/-406 ng/ml, 514+/-205 ng/ml vs 235+/-59 p=0.0001). The ATIII and the PC were similar among the 3 different groups of subjects, but reduced levels of PS were observed in HRT users (PS 93+/-23%, 105+/-22% vs 109+/-12 p=0.0001). The mean normalized APC sensitivity ratio (APC-SR) was lower in the two populations of women as compared with that of controls (nAPC-SR 1.02+/-0.7, 1.02+/-0.8 vs 1.1+/-25 p=0.02). The values of free TFPI were reduced in HRT users compared to HRT non-users (9.1+/-1.9 ng/ml, 10.1+/-2.3 ng/ml vs 4.6+/-1.5 ng/ml p<0.0001). CONCLUSION: HRT appears to be associated to a shift in the procoagulant-anticoagulant balance towards a procoagulant state. The changes in hemostatic system could explain the increased risk of VTE in healthy postmenopausal women during HRT, nevertheless this risk could be higher in women known to have a congenital or acquired thrombophilic state.

Activated Protein C Resistance↗
PubMed2003

Role of the dopamine D5 receptor (DRD5) as a susceptibility gene for cervical dystonia.

Cervical dystonia (CD) is one of the most common forms of primary dystonia. The pathogenesis of the disease is still unknown, although evidence suggests a role for genetic factors. Recently, a polymorphism in the dopamine D5 receptor (DRD5) gene has been associated with the disease in a British population, suggesting that DRD5 is a susceptibility gene for CD. To confirm these data, we performed a case-control study of the microsatellite (CT/GT/GA)(n) at the DRD5 locus in 104 Italian CD patients and 104 healthy controls. The frequency of allele 4 was higher in the CD patients compared to the controls. This resulted in a twofold increased risk of developing the disease. These results provide further evidence of an association between DRD5 and cervical dystonia, supporting the involvement of the dopamine pathway in the pathogenesis of CD.

Adult↗
PubMed1997

Atypical hereditary neuropathy with liability to pressure palsies (HNPP): the value of direct DNA diagnosis.

We report two patients with suspected hereditary liability to pressure palsies. Neurophysiological studies showed a mixed axonal-demyelinating sensory-motor polyneuropathy with focal slowing of conduction velocities at the common sites of entrapment. Morphological studies on sural nerve biopsy from the proband showed active axonal regeneration without typical tomacula. Molecular analysis confirmed the presence of a deletion of chromosome 17p11.2 in both patients. Our observation confirms the heterogeneity of hereditary liability to pressure palsies and the relevance of DNA testing for the diagnosis of this hereditary neuropathy.

Adolescent↗
PubMed1995

Connective tissue proliferation and growth factors in animal models of Duchenne muscular dystrophy.

The difference in the lifespan of dy and mdx mice could be due to different muscle regeneration capabilities. In mdx an involvement of bFGF in stimulating regeneration has been postulated. The aim of our work was to detect the presence, and to study the distribution, of muscular and connective tissue growth factors in mdx and dy mice at different stages of muscle pathology. From 7 to 10 weeks of age the difference between the two dystrophic mice becomes evident. At 13 weeks the dy mouse presents a predominance of fibrosis and degenerative muscular phenomena while the main pathological feature in mdx mouse is the muscle regeneration. In both animal models fibrosis proliferation is correlated to the presence of EGF and its receptor and TGF beta 1. bFGF was localized to regenerating and degenerating fibers in both dy and mdx mice. The bFGF presented a normal pattern in mdx mice at 20 weeks when regenerative and degenerative phenomena were no longer present. Our data suggest that growth factors could influence the outcome of muscular regenerative and degenerative processes.

Animals↗
PubMed1995

[Transient osteoporosis of the hip in magnetic resonance imaging].

This study was aimed at assessing the MR patterns of transient osteoporosis of the hip and, consequently, the role of MRI in the diagnosis and follow-up of this condition. Even though this condition was originally observed in pregnant women, young or middle-aged men are most frequently affected. There is a spontaneous onset of pain, usually progressing over several weeks. The patients have no risk factors for osteonecrosis; they may have a history of minor trauma and there is a possible relationship to the third trimester of pregnancy. Laboratory values are negative. Pain may be severe enough to cause the patient to limp and to impair joint function. The possible causes of transient osteoporosis have been debated by many authors and include trauma, synovitis, neurovascular dysfunction and transient or reversible ischemia. Transient osteoporosis is a self-limiting disease which does not require surgical treatment. The differential diagnosis of transient osteoporosis of the hip is very important because this condition may simulate cancer, septic arthritis, osteomyelitis or avascular necrosis. We report the initial and follow-up features of transient osteoporosis of the hip on the MR images of 6 patients (M/F = 5/1; age: 37-49 years, mean: 41.8 years). The right side was involved in 3 patients, the left side in 2 patients. The patient with bilateral transient osteoporosis was a woman in the 3rd trimester of pregnancy. In all patients, MRI was performed with an 0.5 T MR unit. The MR changes in our 6 patients were rather uniform and included heterogeneous decrease in the signal intensity of the affected bone marrow on T1-weighted images and increased signal intensity on T2-weighted and STIR images, with no evidence of focal lesions. This pattern is known as the "bone marrow edema" (BME) pattern. All the patients received conservative treatment. The clinical symptoms and the MR abnormalities regressed completely within 6-10 months, with no late sequelae. To conclude, this follow-up MR study demonstrates the transient, reversible character of transient osteoporosis of the hip. Until the natural history of the BME pattern is better understood, we suggest a conservative management of this condition, especially in the patients with no risk factors for osteonecrosis. Radiographic and MR follow-up is recommended.

Adult↗
PubMed1995

[Immunohistochemical study of reserve cells: hypotheses on their origin].

The location of reserve cells make it possible the understanding of cervicovaginal repair by metaplasia process better, really some have studied the potentiality of such cells. Now we believe that totipotent stromal cell, which can evolve towards the epithelial cells, give origin to reserve cells. Immunohistochemistry methods point out stain positively for cytokeratin (DW 45-56,5 KD) present in reserve cells, confirmed the stromal origin of them.

Adult↗
PubMed1994

Developmental expression of P0 mRNA and P0 protein in the sciatic nerve and the spinal nerve roots of the rat.

Expression of myelin P0 protein by myelinating Schwann cells in vivo is dependent on axonal influences. This report describes P0 gene expression during development of rat sciatic nerve and spinal nerve roots using Northern blotting, in situ hybridization and immunohistochemistry. We demonstrate that: (1) the appearance of P0 mRNA and P0 protein in Schwann cells during nerve development in the rat begins prenatally, at day 18 post-fertilization (E18); (2) P0 mRNA and P0 protein have essentially identical developmental profiles, and are expressed in Schwann cells that are many days prior to myelin formation; (3) initial P0 gene expression is greatest in Schwann cells at the periphery of nerve bundles and in Schwann cells in contact with motor axons; (4) the decline in P0 expression with nerve maturation is accompanied by a sharp decline in P0 message levels in most Schwann cells, but a small subpopulation of these cells continue to synthesize very high levels of P0 mRNA. This study provides data on myelin P0 protein gene expression and distribution during PNS development and adds further insights into the axonal influences controlling Schwann cell behaviour during myelination of the rat PNS.

Aging↗
PubMed1993

[Secondary hepatic hemochromatosis: diagnosis and quantification with 0.5 T magnetic resonance. Value and limitations].

Iron overload is a major cause of morbidity and mortality in thalassemia major patients. All chronic liver diseases may be associated with such endocrine symptoms as diabetes mellitus, testicular failure or hypothyroidism. We studied 15 thalassemic patients (12 men and 3 women; age range: 10-50 years, mean: 22.5 years). All patients received blood transfusions, but only some were treated with iron chelation. Seven patients were splenectomized. MRI was performed with an 0.5 T superconducting magnet, using SE T1- and T2-weighted and IR sequences. We used these data with Bloch's equation to calculate T1 and T2 values. Quantitative analysis was made by calculating signal intensity and relaxation times in 8 hepatic regions of interest: marked reduction in hepatic signal intensity and a negative relationship between T1 and serum ferritin (r = 0.646, p < 0.01) and between T2 and serum ferritin (r = 0.688, p < 0.01) were observed. Moreover, a negative relationship was found between hepatic signal intensity and aspartic aminotransferase (r = 0.524, p < 0.05). Our results confirm the value of MRI in the diagnosis and evaluation of hepatic iron overload but an accurate quantitative analysis can be made only when hepatic iron levels are between 1 and 2 mg/g of liver. Even though it is below statistical significance, the negative relationship between signal intensity and aspartic aminotransferase suggests that hepatic hemochromatosis can influence pituitary-thyroid axis and interfere with peripheral hormone metabolism.

Adolescent↗
PubMed1993

[Functional magnetic resonance of Peyronie's disease in the chronic stable phase].

La Peyronie's disease (induratio penis plastica) is a degenerative process involving the penis, whose cause is still not fully explained. Adequate treatment requires the correct staging of La Peyronie's disease. Diagnostic imaging plays a major role after case history and clinics. Several imaging methods are used, including self-photography, plain radiography, CT, pharmaco-cavernosography, plain and duplex Doppler US. Enhanced MRI can be useful to correctly localize the plaques and to detect early changes in La Peyronie's disease, since the fibrous plaques with persistent inflammatory infiltration can be distinguished from the plaques in which inflammation has ceased. The diagnostic approach to La Peyronie's disease has been substantially modified by adding an examination during the erection induced by the intracavernosal injection of papaverine to the examination in the flaccid state. The authors report on the capabilities of unenhanced MRI after the intracavernosal injection of papaverine in steady chronic La Peyronie's disease. MRI was performed with an 0.5 T superconductive unit. Six patients (age range: 46-60 years, mean 52 years) who had been ill for about five years were studied. SE T1-weighted images and FS T2-weighted images were performed in both the flaccid and the erect states. Our results prove MR capabilities in both states in steady chronic La Peyronie's disease, which suggests MRI as the technique of choice for planning surgical treatment.

Chronic Disease↗
PubMed1992

Effect of chronic treatment with recombinant interleukin-2 on the central nervous system of adult and old mice.

We have studied the effects of chronic treatment with recombinant interleukin-2 on the central nervous system of adult and old mice. Treatment with high doses of recombinant interleukin-2, on a schedule similar to that used in humans, was started at the age of 4 and 17 months, respectively, and ended 3 months later. At that time, all the mice were tested for acquisition of a passive-avoidance task and then sacrificed for histological examination. Three of the four groups (treated and control adults and control old mice) did not differ from one another in task performance or neuron density in frontal cortex, cerebellum, dentate gyrus or CA1-2, CA3, CA4 hippocampal areas. The old treated mice were unique in showing impairment of the mnesic functions and marked neuronal cell loss and degenerative changes limited to the hippocampal regions. Immunohistochemical studies did not show any significant amount of immunoglobulins in affected areas. Our results suggest that in old mice the impairment of the mnesic functions after recombinant interleukin-2 administration is due to hippocampal neuronal damage.

Aging↗