Biomedical subjects
Publications and source records attributed to V Caputo.
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Penicillium purpurogenum produces several enzymes active in xylan hydrolysis, of there, the acetyl xylan esterase (AXE) activity secreted by the fungus has now been studied. The amount of activity obtained in the culture is related to the degree of acetylation of the carbon source used, the best being chemically acetylated xylan. AXE was concentrated from culture supernatants by ultrafiltration and (NH4)2SO4 precipitation and fractionated by gel filtration in Bio-Gel P-300. Two peaks of activity (AXE I and AXE II) were obtained. These two enzymes were further purified separately to homogeneity by chromatography in CM-Sephadex C-50 and chromatofocusing. AXE I (M(r) 48,000) has a pl of 7.5, while AXE II (M(r) 23,000) has a pl of 7.8. Optimal enzyme activity was at pH 5.3 and 50 degrees C for AXE I and pH 6.0 and 60 degrees C for AXE II. Both enzymes are active towards several acetylated substrates. Antisera against the two enzymes do not cross-react, and the N-terminal sequences of AXE I and II do not show similarities. These results suggest that AXE I and AXE II are the products of different genes.
To ensure the effectiveness of radiation-therapy treatments, both in-phantom and in-patient reliable dose measurements are required. Thermoluminescence dosimeters are used commonly for both applications. Among the various available materials, the relatively new LiF:Mg,Cu,P phosphor is a suitable candidate for quality control of in vivo dosimetry in electron-beam therapy. The response behaviour of LiF:Mg,Cu,P chips to 6-21 MeV electron beams used in radiotherapy was studied. Batch homogeneity, dose linearity, sensitivity change after use, dose and dose-rate response, energy dependence and fading characteristics were investigated. The contribution from each factor to the overall uncertainty in dose measurement was evaluated. The results of this work show that the LiF:Mg,Cu,P chips are comparable to the commonly used LiF:Mg,Ti ones, and support their use for in vivo electron-beam dosimetry to an accuracy within +/- 10%.
We investigated a case of anastomotic disjunction of the termino-lateral insertion of a bifurcate aortic graft in the right external iliac artery. The graft in woven Dacron R n. 19, was implanted in 1977 and the left femoral insertion became infected shortly after surgery. The infection was treated according to standard procedures with removal of the infected branch, reconstruction with the transobturatory by-pass and antibiotics. For antibiotic treatment of local and general sepsis the approach was completely new as regards dose regimen and duration. In 1993 a pseudoaneurysm developed through weakening of the right iliac anastomosis. In view of the anamnesis we were surprised to find that the origin was of a mechanical nature.
This study follows the recently published paper on the in vivo behaviour of patent Dacron vascular prostheses and focuses in particular on anastomotic disjunction. The question of the evolution of anastomoses was tackled by examining its three basic components: prosthetic tissue, suture thread and arterial wall. The authors' observations were based on material taken from reoperations performed between 7 and 18 years after the first graft. These data enable the authors to affirm that the prosthesis undergoes a general physical and chemical deterioration which varies in intensity according to the type of weaving. On the contrary, in the anastomotic zone this phenomenon is not intense enough to jeopardize the anchorage of the suture thread since the original weft does not show any loss of compactness. In spite of surface morphological deterioration of various intensity, the suture threads maintain satisfactory mechanical properties and structural integrity. The artery wall in the anastomotic zone shows a massive degeneration in terms of its true anatomic structure responsible for the rupture of the suture rima. On the basis of these results the authors conclude that this phenomenon represents the "Achilles' heel" of anastomotic junction.
The paper deals with study of long-term stability as far as concerns Dacron vascular prostheses in woven and knitted double velour. Among our vascular prostheses case-reports, we evaluated three of them explanted after 11, 12, 20 years; all of the prostheses were patent. Chemical-physical, histopathological and ultrastructural analysis have been carried on in order to evaluate in vivo ageing of the examined prostheses. The results all indicate strong alterations of the original properties related to double velour of knitted prostheses and weak alterations of woven one.
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To evaluate the effects of uncomplicated revascularization surgery on resting global and regional left ventricular function we studied 34 patients, enrolled consecutively, by radionuclide angiocardiography. After surgery, we found no significant change in global left ventricular ejection fraction; this was true even in the subgroup of 14 patients who developed paradoxical septal motion. This finding indicates that the development of paradoxical septal motion after uncomplicated cardiac surgery does not compromise global left ventricular function. Both in the subgroup of patients with paradoxical septal motion and in the subgroup without paradoxical septal motion regional ejection fraction calculations showed the same postoperative pattern consisting of increase of the proximal and distal posterolateral regional ejection fraction, increase in the inferoapical regional ejection fraction and unchanged proximal and distal septal regional ejection fraction. In our patients paradoxical septal motion is not due to pericardial effusion, conduction disturbance, septal ischemia or infarction. Our data suggest that the anteromedial translation of the entire heart during systole, due to surgical removal of constraints, may account for both the false improvement of posterolateral and inferoapical regional wall motion and the development of paradoxical septal motion.
To determine the independent effects of left bundle branch block (LBBB) on global and regional left ventricular (LV) function we performed equilibrium radionuclide angiocardiography at rest in 3 patients with chronic LBBB (group I, mean age 53.6 years and in 6 patients with intermittent LBBB (group II, mean age 41.5 years). All patients were judged to have an apparently normal heart. In 2 of 3 patients of group I a LV ejection fraction lower than 50% was observed, and in all 3 patients septal motion abnormalities were present. In all patients of group II the global LV ejection fraction was normal during normal conduction and decreased during LBBB; the inferoapical regional ejection fraction decreased in 5 of 6 cases and the posterolateral regional ejection fraction in 3 of 6 cases. Moreover, septal hypokinesis was observed both during normal and abnormal conduction in all group II patients. These findings seem to confirm that LBBB, chronic or intermittent, is able to deteriorate LV performance at rest, even in patients with an otherwise normal heart.
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We studied 19 consecutive subjects affected by effort angina using following tests: ecg stress test, stress 201-Tl scan, coronary arteriography; 201-Tl scan, coronary arteriography, hemodynamic, echo 2 D, ecgraphic monitoring during Dipyridamole test (D). Basing on coronary arteriography results we divided patients; in the group A (10 patients with significant stenoses greater than or equal to 50%) stress ecg and scintigraphy were positive in 9 patients; Dipyridamole test induced angor and ecgraphic changes in 5 patients and in 4 left ventricle wall motion disorders, 201-Tl scan was positive in all 9 patients tested. In the group B (9 subjects with no significant stenosis) ecgraphic changes were observed in 2 subjects and 201-Tl scan was positive in 6 subjects; D induced in 2 cases angor, in 1 case ecgraphic changes, in 1 case left ventricle wall motion disorders and the same 201-Tl defects in 6 previously individualized patients. In both groups we observed at coronary arteriography during D identical findings in comparison with the immediately before performed. In our experience D infusion is confirmed as provocative test of ischemia. The same ischemic pattern observed at stress and Dipyridamole scintigraphy in patients with no significant coronary stenosis suggests as pathogenetic mechanism the regional lack of dilatory reserve.
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A multicenter study was performed to analyze the efficacy of 99mTc- and 111In-labeled F(ab')2 fragments of monoclonal antibody (MoAb) 225.28S (reactive with a high molecular weight melanoma associated antigen) to radioimage malignant lesions in patients with melanoma. A total of 254 melanoma patients, carrying 412 documented melanoma lesions, were studied in 10 nuclear medicine departments. A total of 377 lesions were visualized in 206 patients; in particular (a) 250 of 412 known lesions were visualized in 159 of 191 patients known to carry melanoma lesions; (b) 95 occult lesions were visualized in 61 patients of the same group; and (c) 32 lesions were visualized in 15 of 63 patients without diagnosed lesions. The melanomic nature of 101 of 127 radioimaged occult lesions was confirmed by clinical criteria and/or by additional laboratory investigations. These results indicate that immunoscintigraphy with radiolabeled F(ab')2 fragments of MoAb 225.28S can provide clinically useful information. Analysis of the variables influencing the outcome of immunoscintigraphy with 99mTc- and 111In-labeled F(ab')2 fragments of MoAb 225.28S confirmed the role of size, anatomic site, and level of high molecular weight melanoma associated antigen in melanoma lesions. Such analysis also showed, for the first time, the influence (a) of the isotope used to radiolabel the antibody fragments and (b) of the clinical stage of the patients. The present study has shown good agreement in the results obtained by the 10 nuclear medicine departments, suggesting that immunoscintigraphy with radiolabeled F(ab')2 fragments of MoAb 225.28S is a reliable procedure.
Thrombosis in the right atrium or ventricle is a rare complication of permanent endocardial pacing in adults. To the best of our knowledge, this complication has not been previously reported at all in the pediatric age group. We report on a case of a 7-year-old boy who had large left ventricular thrombi that occurred during permanent endocardial electrical stimulation. Subsequent pulmonary emboli complicated congestive heart failure in this patient. As a diagnostic approach, echocardiography and pulmonary perfusion scintigraphy were used. We comment on possible causes of this serious complication and suggest hemorrheological and platelet activation studies in patients with permanent endocardial pacing.
Hepatic blood flow (HBF) has been reported to reflect liver cell mass. HBF was studied in 21 patients with chronic active hepatitis (CAH) and in 20 patients with liver cirrhosis (LC). It was correlated with such indices of liver protein synthesis as serum albumin, Normotest, plasma activity of antithrombin III, prekallikrein, alpha 2-antiplasmin and plasminogen. No correlation between HBF and the examined parameters was seen in CAH. HBF correlated with all the indices of liver protein synthesis in LC, thus suggesting that serum albumin, antithrombin III, Normotest, prekallikrein, plasminogen, and alpha 2-antiplasmin could reflect the residual liver cell mass in LC.
The authors describe a case of left ventricle myocardial infarction who showed right ventricular failure. The patient is been studied by mono and bidimensional echocardiography, myocardial scintigraphy, ecg, chest X ray and right catheterism. Myocardial scintigraphy localized "cold" areas in interventricular septum and in right inferior wall. Echocardiography showed dilatation of the right side but not on the left heart side. The not invasive examinations allowed to assess that right ventricular failure was primary and not secondary left ventricular failure. The authors discuss findings of echocardiographic examination and of other non invasive methods.
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