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Biomedical subjects

R Bartoli

Publications and source records attributed to R Bartoli.

14 recordsLinked to original sources

Impaired splenic function and tuftsin deficiency in patients with intestinal failure on long term intravenous nutrition.

BACKGROUND: Reticuloendothelial system function is impaired in humans receiving lipid regimens. AIMS: To evaluate the effects of long term administration of long chain triglyceride emulsions on reticuloendothelial system function. METHODS: Splenic function and tuftsin activity were measured in 20 patients on intravenous nutrition for intestinal failure, 20 patients with Crohn's disease who were not receiving intravenous nutrition, and 50 healthy controls. RESULTS: Pitted red cells counts in patients on intravenous nutrition (8.0%) were significantly higher (p<0.001) than in healthy controls (0.6%) and in patients with Crohn's disease (0.9%). No difference was found between healthy controls and patients with Crohn's disease. There was a correlation (r=0.50; p<0.03) between percentage of pitted red cells and duration of intravenous nutrition. Tuftsin activity was significantly reduced in the intravenous nutrition patient group (6%) compared with both disease controls (16.5%, p<0.01) and healthy volunteers (17.8%, p<0.001). An inverse correlation between tuftsin activity and pitted red cell percentage was found in the patients on intravenous nutrition (r(s) =-0.44, p<0.05). No relation was found in the patients on intravenous nutrition between pitted red cell percentage or tuftsin activity and type of disease, percentage of ideal body weight, residual length of small intestine, or administration (quantity and frequency) of lipid emulsion. Eight patients on intravenous nutrition had serious infections within the previous 12 months. CONCLUSIONS: Patients with a short bowel treated with long term intravenous nutrition have impaired splenic function, reduced tuftsin activity, and an increased risk of infection.

Adult↗

Splenic autotransplantation after splenectomy: tuftsin activity correlates with residual splenic function.

This study set out to determine the relationship between splenic function (as assessed by the percentage of pitted red cells) and tuftsin activity, and to confirm the return of effective splenic function after splenectomy for trauma. Twenty-three patients (13 men) took part. Ten of mean age 48.5 (range 30-74) years had had the spleen removed for traumatic rupture and 13 of mean age 49.7 (range 23-66) years had undergone elective splenectomy. At the time of the study all patients had had the spleen removed a minimum of 1 year previously (mean 6.1 (range 1-15) years). Fifty healthy volunteers matched for sex and age were also studied. In each subject, residual splenic function was evaluated by counting the percentage of pitted red cells. Tuftsin activity was also determined. A highly significant negative correlation was found between pitted red cell percentage and tuftsin activity (rs = -0.80, P < 0.001). Compared with healthy controls (mean 21.6 (range 13-37) per cent), tuftsin activity was significantly reduced both in patients who had undergone splenectomy for trauma (mean 4.4 (range 0-9) per cent; P < 0.0001) and in those who had had elective splenectomy (mean 0; P < 0.0001). Tuftsin activity was significantly (P < 0.001) more depressed after elective than traumatic splenectomy. These data confirm a decrease in tuftsin activity following splenectomy and show that this deficit is significantly greater after elective than emergency removal. These observations confirm that residual splenic function is often present after traumatic splenectomy.

Adult↗

[Ligation of the hilar arteries in hemorrhages due to traumatic rupture of the liver].

The paper reports two cases of severe hematoperitoneum due to the traumatic rupture, or so-called explosion, of the liver. During surgery one of these cases underwent ligature of the right and left hepatic arteries, while the other only underwent right hepatic arterial ligature. Selective arteriography at varying intervals after surgery showed that vascular occlusion had taken place together with the creation of an adequate compensation circle. Both patients now lead absolutely normal lives, respectively five and two years after surgery. This technique of hemostasis, which is reserved for use in cases of otherwise unresolvable hepatic hemorrhage, although still rarely used, should form part of every surgeon's general training since it might prove unexpectedly essential.

Adolescent↗

Candida and stapedial otosclerosis: histopathological findings.

The stapes of 6 patients with stapedial otosclerosis was found to contain fungus hyphae (Candida) in the sectioned specimens. The footplate of all cases and the head of the stapes in 2 of the cases revealed single or multiple erosion cavities containing numerous thin branching PAS-positive fungus hyphae with swollen terminal endings and scanty blastospores. Osteoclasts were not observed; occasional osteoblasts, blue mantles and otosclerotic foci were seen. Four patients had been treated for several years with antibiotics and corticosteroids for recurrent serous otitis media and 1 patient had had frequent catheterization of the eustachian tube. It may be suggested that the Candida infection was a secondary event induced by a general and/or local immunodepressed condition.

Adolescent↗

[Psychoacoustic tests: effects of atropine].

The efferent pathways exert a control action on the function of the cochlear nucleus and hair cells. Acetylcholine is the neurotransmitter of the centrifugal system and its action can be blocked by atropine. In order to give a contribution to the knowledge of the function of the efferent bundle and of the cochlea efficiency we examined 10 young normal subjects before and after infusion of 1 mg of atropine i.v. a battery of three psychoacoustical tests (Remote Masking, Critical Ratio and Brief Tone Audiometry). After infusion of atropine we have shown an increase of 0.25 Hz hearing threshold, an increase of RC values and a decrease of RM values. It can be concluded that the pharmacological block of the olivo-cochlear bundle determines a stiffness of outer hair cells and basilar membrane; this finding means that the atropine can inhibit the facilitating activity of the efferent system on the cochlear performance.

Adolescent↗

[Critical ratio: effects of contralateral masking on normal and pathological ears].

In order to evaluate the central interferences on the auditory efficiency, the effect of contralateral masking noise on Critical Ratio (CR) has been studied in 14 normal ears (control group), in 12 ears with cochlear disorders and in 6 with retrocochlear lesion (acoustic neuromas); in all cases the impairment was unilateral, while the other ear was normal. CR values were calculated for 1 KHz pulsed tones (duration 500 ms, rise/fall 25 ms, duty cycle of 50%); the masking noise was a wide band (90-20,000 Hz) delivered at 40 dB SL. The results have demonstrated that in the presence of contralateral masking noise, CRs don't modify both in the normal ears and in those with retrocochlear disorder, whereas they increase, almost always, in ears with cochlear deafness. These results demonstrate that the involvement of central auditory pathways, because of contralateral noise, makes the auditory efficiency worse, only in ears with cochlear dysfunctions; this behaviour seems to confirm the peripheral origin of CR.

Adolescent↗

[Brain-stem auditory pathways: effects of atropine].

The efferent pathways exert a control action on the function of the cochlear nucleus and hair cells. Acetylcholine is the neurotransmitter of the centrifugal system and its action can be blocked by Atropine. In order to give a contribution to the knowledge of the function of the efferent bundle, Auditory Brainstem Responses (ABRs) and Acoustic Reflex Latencies (ARLs) have been examined in 10 young normal subjects there was also a decrease in latency greater than or equal to 100 microseconds by at least other two waves. The only statistically significant difference was relative to the latency mean value of the wave III recorded in contralateral derivation at 11 pps. The ARLs, after the infusion of atropine, showed a statistically significant increase in 7 of the 10 cases; no change was recorded in the AR amplitude. It can be concluded that the pharmacological block of the olivo-cochlear bundle determines a delay in the neural conduction of the acoustic impulses; this finding means that the atropine can inhibit the facilitating activity of the efferent system on the brainstem afferent pathways.

Acetylcholine↗

[Evoked acoustic oto-emissions in cochlear deafness].

In order to give a contribution to the genesis of the EOAEs, we have recorded echos in 24 subjects with unilateral sudden deafness (I. group); 20 ears with Menière disease (II. group); 22 ears with progressive sensorineural hearing loss (III. group) and 10 normally hearing young subjects as control group. The results have shown that the EOAEs were present in 100% (I. group), 84.6% (II. group) and 86.3% (III. group) in response to the tone-burst; while the echos were present only in the 57.1% (I. group), 38.4% (II. group) and 45.4% (III. group) in response to the click, although the audiometric threshold mean were greater than 45 dB HL for 2-4 KHz and 1 KHz in the three experimental groups except for 2-4 KHz in the subjects with Menière disease (37.5 dB HL). The properties of EOAEs (detection and saturation threshold, dynamic range and duration) depended on the degree of hearing loss. Our results seem to corroborate the hypothesis that EOAEs could be also produced by a passive intracochlear mechanism attributable to the travelling wave of the basilar membrane provoked by the perilymph. In the normal ear this passive mechanism could be superimposed by an active mechanism, linked to the contractile activity of the outer hair cells with a consequent increase in amplitude of the EOAEs for the same stimulus intensity.

Acoustic Stimulation↗

[Evoked oto-acoustic emissions in retrocochlear deafness].

In order to give a contribution to the genesis of the EOAEs, we have recorded the echoes in 6 subjects affected with unilateral acoustic neuroma, surgically proven (I. group); 11 subjects with sensorineural hearing loss with electrophysiological or balance signs of retrocochlear impairment (II. group) and 10 normally hearing young subjects as control group. In this study EOAEs have been recorded in response respectively to 3 ms 1000 Hz tone-burst and to 200-5000 filtered click, both sending with 2048 stimuli, at a repetition rate of 21 pps and different stimulus intensities ranging from 40 db SPL to saturation threshold in 10 db steps. The results have shown that the EOAEs were present in half of the tested patients in response to the clicks in both I. and II. group and in all the ears to the tone-burst although the 1.0 KHz audiometric threshold mean were > 65 db HL in I. group and in a third of the subjects in the II. group. The properties of EOAEs (detection and saturation threshold, dynamic range and duration) depended on the degree of hearing loss. These results suggest that acoustic tumor could determine a wallerian degeneration of the external fibers of the VIII nerve and consequently a dysfunction of the correspondent external hair cells of the cochlea, while in the II. group a contemporary or secondary involvement of the cochlear structures is possible.

Adult↗

[Stapedo-ovalar ankylosis: histomorphologic patterns].

This study reports the results of the histo-pathological investigation on the stapes (fragments or complets) of 46 patients (34 females and 12 males) with clinical diagnosis of stapedial otosclerosis and submitted to stapedectomy. Otospongiotic and otosclerotic areas have been found only in some cases; more frequently, erosion cavities filled with fibrous tissue and round-cells infiltration with lymphocytes and/or macrophages have been seen. Osteoclasts were observed only in few cases. Blue mantles have been observed in about half of the cases. Our findings show that non specific chronic inflammation should be more frequent than otospongiosis or otosclerotic foci, and indicate that a phlogosis could be the pathogenetic agent of this disease. This conclusion is in agreement with our previous research, and has been recently confirmed by the observations in stapes of otosclerotic patients of viral antigens and antibodies.

Ankylosis↗

[Evoked acoustic oto-emissions: effects of atropine].

The Evoked Otoacoustic Emissions (EOE) are a sinusoidal wave complex coming from the contractile properties of the cochlea and particularly of the outer hair cells. This activity is influenced by the centrifugal pathways whose transmitter is acetylcholine. In order to study the effects of the functional block of the cochlea, ten young normal subjects were examined recording the EOE before and ten mins after the i.v. infusion of 1 mg of atropine. The statistical analysis of the results has shown a significant decrease only in EOE appearance threshold in absence of modifications of the saturation level. These data have led us to believe that atropine blocking of the centrifugal pathways causes a disfunction of the outer hair cells that accept less energy to be transduced into a neural stimulus and on the other hand more energy as EOEs.

Adolescent↗

[Effects of body posture on cochlear performance].

Experimental research has demonstrated that changes in body position influence auditory function and, specifically, supine position produces a sensorineural hearing loss at low frequencies. The hypotheses to interpret these phenomena are principally referred to an increase of hydrostatic pressure of labyrinthine fluids. In order to evaluate the effects of head position on the cochlear performance a modern test battery has been performed to study cochlear function in 11 normal subjects ranged in age from 22 to 34 years. The tests (Remote Masking:RM; Brief Tone Audiometry:BTA; Critical Ratio:RC) have been evaluated in two positions: sitting upright and supine with the head at a 20 backward angle. The results of our research have shown that in all the cases, the supine position produces a significant shift of the auditory threshold at 250 and 500 Hz, and a decrease of RM values in about all of the cases. We have estimated non statistically significant differences for the RC and BTA values, in more than half of the ears tested. On the basis of the significance given to RM, BTA, RC: we can deduce that the modifications of the auditory performance related to an increase in perilymphatic hydrostatic pressure, induced by the head position are produced by an increase in rigidity of the mechanical vibratory structures of the cochlea rather than the expression of sensorineural damage.

Adult↗

Cholesteatoma in children: histopathologic findings in middle ear ossicles.

Middle ear ossicles removed during ear surgery in 40 patients were examined in order to compare the histopathologic changes in children with those observed in adults. Bone resorption, mainly localized at the level of the periosteum and haversian canals in adults, was much more extensive in children. Replacement of bone by fibrous granulation tissue was observed in 60% of children's ossicles and in 27% of those belonging to adults. In children, extensive active resorptive osteitis of the ossicles was frequently associated with intensive round cell infiltration, which seems to play an important role in bone absorption and in the aggressiveness of cholesteatoma.

Adolescent↗