Biomedical subjects
Publications and source records attributed to S Manzoni.
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834 consecutive patients (630 female), aged between 26 and 46 years, who were suspected of having allergic contact dermatitis were patch tested with the GIRDCA standard series during 1989-1990. The most frequent sensitizers observed included nickel sulphate, cobalt, Kathon CG, perfumes, potassium dichromate and balsam of Peru. We have evaluated the influence of individual factors such as sex, age and occupation on the patch test results, and the coexistence of 2 or more unrelated but statistically significant sensitivities.
In decerebrate cats with the cerebellum intact we recorded the activity of lateral vestibulospinal neurons projecting to lumbosacral segments of the spinal cord (IVS neurons) and related the resting discharge, as well as the response characteristics of these neurons to roll tilt of the animal and neck rotation, with the cell size inferred from the conduction velocity of the corresponding axons. A slight negative correlation was found between resting discharge rate and conduction velocity of the whole population of IVS neurons responsive and unresponsive to animal tilt and neck rotation, so that the faster the conduction velocity, the lower was the unit discharge at rest. This correlation, however, was found only for the dorsocaudal LVN neurons, which contributed to the majority of IVS units, but not for the rostroventral LVN neurons. Moreover, it affected the units unresponsive but not those responsive to vestibular stimulation; the opposite, however, occurred for the units tested to neck stimulation. These findings indicate that the static properties of the IVS neurons can only in part be related to cell size. If we consider the IVS neurons responsive to roll tilt of the animal (76 neurons) and neck rotation (75 neurons) at the standard parameters of 0.026 Hz, +/- 10 degrees, no significant correlation was found between gain (impulses X s-1 X deg-1) of the labyrinth or neck responses and conduction velocity of the axons. Thus, due to the presence of slight negative relation between resting discharge and conduction velocity of the axons, larger neurons exhibited a greater percentage modulation (sensitivity) to the labyrinth and neck inputs than smaller neurons; this correlation involved particularly the dcLVN neurons. These findings suggest that the afferent pathways driven during dynamic stimulation of labyrinth and neck receptors produce an higher number or density of synaptic contacts on IVS neurons of increasing size. No significant differences in the means of resting discharge, conduction velocity, gain and sensitivity were found between all the IVS units responding to labyrinth and neck inputs. These findings indicate that the effectiveness of the two inputs was almost comparable and did not vary in different units as a function of cell size. The IVS neurons were mainly excited during side-down animal tilt and side-up neck rotation. Although these neurons showed the same spectrum of conduction velocity as those displaying the opposite response patterns, the response gains of the predominant populations of units were on the average higher than those obtained from the remaining populations of units.(ABSTRACT TRUNCATED AT 400 WORDS)
A short neuropsychological test battery designed to measure language, memory and visuospatial abilities was administered to 217 patients with reversible ischemic attacks. Patients were tested twice: the first time more than one month, but less than one year, from the last ischemic episode, and the second time three years later. A comparison between the first and the second testing session did not disclose any significant worsening. The degree of atherosclerosis and the occurrence of further ischemic episodes during the follow-up period were found to be unrelated to change in performance at the test battery. These results seems to challenge the hypothesis that multi-infarct dementia may follow apparently reversible, or even clinically silent, ischemic episodes.
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The effects of lead on porphyrin metabolism and peripheral nervous system were studied in a group of 38 subjects who had not been exposed for a period of time, ranging from 3 to 27 years. The mean values for blood lead (PbB), chelated lead(PbUEDTA), and free erythrocyte protoporphyrin (FEP) were found to be significantly higher in the subjects with past lead exposure than in controls. In all cases the neurological examination was negative. The mean values for maximum motor conduction velocity (MMCV) and conduction velocity of the slower fibers (CVSF) of the ulnar and peroneal nerves were found to be significantly lower in the subjects with past lead exposure than in the control group of 23 subjects standardized for age. Signs of partial denervation were present in four cases, with two presenting a decrease of the motor conduction velocity (MCV) as well. No correlation was found between electrophysiological findings and biochemical indicators of dose and effect. The length of exposure showed a significant negative correlation only with the MMCV of the ulnar nerve. A significant difference from controls standardized for age was observed only in subjects with exposure of more than 6 months for all the electromyographic (EMG) parameters. It does not appear that the EMG findings could depend upon modest lead deposits still present in the organism; they should rather give evidence to the permanent effect of alterations that occurred during the prolonged exposure to lead.
Continuous-wave Doppler sonography is a reliable technique for the diagnosis of subclavian steal. This tool also allows us to identify incipient steals, characterized by either alternating flow or systolic flow deceleration in the vertebral artery, which might escape detection by conventional angiography. Diagnostic criteria are reported and results of a 48-patient study are compared with angiographic data. The different patterns of vertebral flow depend on the degree of proximal subclavian or innominate artery functional stenosis. The Doppler examination is a useful method because it is non invasive, harmless to the patient and allows for the evaluation of associated lesions in other extracranial vessels. It is of particular interest for the diagnosis when the clinical picture is still apparently normal and in the absence of both neurological findings and asymmetrical blood pressure in the arms.
Two groups of viscose rayon production workers were examined 10 years after discontinuation of exposure to CS2. Group A comprised 20 subjects exposed to high CS2 concentrations and group B 13 subjects with lower exposure. Clinical findings and the measurements of nerve conduction velocity of the slow fibres in the peripheral nerves were evaluated. Twelve subjects had both clinical and electromyographic evidence of neuropathy and 10 showed a diminution in motor conduction velocity. A relationship between the degrees of exposure to CS2 and prevalence of polyneuropathy was found. On re-examining 12 subjects with neuropathy who had been examined four years before no significant electromyographic improvement was observed. These findings are consistent with a permanent axonal neuropathy caused by carbon disulphide.
The Doppler ultrasound technique is a useful tool for the screening and follow-up of patients with extracranial atheromatous lesions of the carotid tree. Doppler examination was performed on 654 patients and compared with angiographic visualization of a total of 261 carotid arteries in 171 patients. The Doppler diagnostic criteria and their reliability are reported and discussed. This technique is not alternative but complementary to angiography.
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Levels of beta-thromboglobulin and platelet factor 4 in 46 patients with transient ischemic attacks and the influence of treatment with dipyridamole or aspirin plus dipyridamole were evaluated. Patients not receiving therapy showed levels of beta-thromboglobulin significantly higher than controls. However, patients taking only dipyridamole showed values of beta-thromboglobulin significantly lower than untreated patients or those taking aspirin plus dipyridamole. No significant difference was observed with regard to platelet factor 4 between the patients.
A phase II trial aiming to verify the effectiveness of a regimen including carboplatin and vindesine was performed. From November 1989 to September 1990, nineteen patients with advanced small cell lung cancer entered this study. Polychemotherapy treatment included: carboplatin 400 mg/sm, on day 1 and vindesine 3 mg/sm, on days 1 and 15, repeated every 4 weeks, as an outpatient regimen. Observed toxicity was mild; myelodepression, and nausea and vomiting were the main adverse events. No objective response was obtained; 14 no changes in the disease and 4 progressions were detected. The low objective response rate observed in this study is strongly influenced by a set of unfavourable prognostic factors. The median overall survival time [32 weeks] is comparable with the results of other studies.
BACKGROUND: A promising regimen including 5-Fluorouracil, methotrexate and oxaliplatin is reported. PATIENTS AND METHODS: Patients with untreated measurable metastatic disease received bolus 5-Fluorouracil (600 mg/m2) on days 2 and 16, modulated by methotrexate (200 mg/m2) 24 h earlier, alternated with 4 weeks of continuous infusion of 5-Fluorouracil (200 mg/m2/daily) plus oxaliplatin (130 mg/m2) on days 29 and 56, followed by 2 weeks of rest. Serum vascular endothelial growth factor (VEGF) was analyzed at baseline and before every cycle. RESULTS: Fifty-eight patients were enrolled. Objective remissions were reported in 45.6% (95% CI=34.3%, 57.3%). The median progression-free survival was 7.8 months and the median overall survival was 19.4 months. No grade 4 toxicity was reported, except for one case of diarrhea. The serum VEGF evaluated in 23 patients showed a decreasing trend during therapy. CONCLUSION: The regimen was active, well tolerated and may be a possible option in patients not suitable for radical surgery.
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60 patients under 65 years of age with one or more episodes of reversible ischemic attacks lasting less or more than 24 hours (T.I.A. or R.I.N.D.) were studied. Each patient had a complete clinical assessment and an EEG, followed by an arteriogram. 35 patients had an EEG activation with digital carotid compression. EEG abnormalities were present in 26 cases while 34 patients had normal records. No correlation was found between EEG abnormalities and arteriographic alterations. EEG activation by digital carotid compression is a valuable hemodynamic test but cannot necessarily indicate a controlateral carotid artery occlusion.
The authors examine the diagnostic accuracy of ophthalmodynamometry in detecting extracranial internal carotid artery stenosis. 58 patients with T.I.A.s or R.I.N.D.s are studied. The test, compared with angiography, is positive only in 50% of patients presenting unilateral internal carotid artery occlusion.
Regional cerebral blood flow determination, following post-angiographic intracarotid injection of 133Xenon, was performed in 11 patients with transient (T.I.A. - R.I.N.D.) or established (Stroke) cerebrovascular disorders. The regional cerebral perfusion rate of the grey matter was compared with angiographic data. There was a good correlation between angiographic abnormalities and regional cerebral perfusion rate disturbances. The Authors emphasize the presence of regional cerebral perfusion rate disturbances (not shown by angiography) even some time after transient ischemic episodes.
Palmar-Plantar Erythrodysestasia Syndrome (PPES) or Hand-Foot Syndrome (H&F S) is an underestimated adverse reaction to chemotherapeutic agents, mainly related to 5-Fluorouracil. From March 1991 to February 1992, at the San Giovanni Oncologic Hospital of Torino, we observed 12 out of 163 patients (7.3%) displaying PPES while being treated with 5-FU containing regimens. No correlation with type of neoplastic disease, sex, age and total dose of administered 5FU was observed. Dose reductions or drug suspension achieved PPES reversal. The etiopathogenesis remains unclear. Both an idiosyncratic pattern and cutaneous drug accumulation are suggested.