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1.
Am J Physiol Endocrinol Metab ; 303(9): E1142-50, 2012 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-22932783

RESUMEN

The hormone relaxin exerts a variety of functions on the smooth muscle of reproductive and nonreproductive organs, most of which occur through a nitric oxide (NO)-mediated mechanism. In the stomach and ileum, relaxin causes muscle relaxation by modulating the activity and expression of different nitric oxide synthase (NOS) isoforms region-dependently. Nothing is known on the effects of relaxin in the colon, the gut region expressing the highest number of neuronal (n) NOSß-immunoreactive neurons and mainly involved in motor symptoms of pregnancy and menstrual cycle. Therefore, we studied the effects of relaxin exposure in the mouse proximal colon in vitro evaluating muscle mechanical activity and NOS isoform expression. The functional experiments showed that relaxin decreases muscle tone and increases amplitude of spontaneous contractions; the immunohistochemical results showed that relaxin increases nNOSß and endothelial (e) NOS expression in the neurons and decreases nNOSα and eNOS expression in the smooth muscle cells (SMC). We hypothesized that, in the colon, relaxin primarily increases the activity and expression of nNOSß and eNOS in the neurons, causing a reduction of the muscle tone. The downregulation of nNOSα and eNOS expression in the SMC associated with increased muscle contractility could be the consequence of continuous exposue of these cells to the NO of neuronal origin. These findings may help to better understand the physiology of NO in the gastrointestinal tract and the role that the "relaxin-NO" system plays in motor disorders such as functional bowel disease.


Asunto(s)
Colon/metabolismo , Contracción Muscular , Músculo Liso/metabolismo , Neuronas/metabolismo , Óxido Nítrico Sintasa de Tipo III/metabolismo , Óxido Nítrico Sintasa de Tipo I/metabolismo , Relaxina/metabolismo , Anestésicos Locales/farmacología , Animales , Colon/irrigación sanguínea , Colon/citología , Colon/inervación , Colon Ascendente/citología , Colon Ascendente/efectos de los fármacos , Colon Ascendente/inervación , Colon Ascendente/metabolismo , Colon Transverso/citología , Colon Transverso/efectos de los fármacos , Colon Transverso/inervación , Colon Transverso/metabolismo , Inhibidores Enzimáticos/farmacología , Femenino , Guanilato Ciclasa/antagonistas & inhibidores , Técnicas In Vitro , Células Intersticiales de Cajal/citología , Células Intersticiales de Cajal/efectos de los fármacos , Células Intersticiales de Cajal/metabolismo , Fenómenos Mecánicos , Ratones , Ratones Endogámicos , Contracción Muscular/efectos de los fármacos , Músculo Liso/irrigación sanguínea , Músculo Liso/citología , Músculo Liso/inervación , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Proteínas del Tejido Nervioso/metabolismo , Neuronas/citología , Neuronas/efectos de los fármacos , Donantes de Óxido Nítrico/farmacología , Óxido Nítrico Sintasa de Tipo I/antagonistas & inhibidores , Óxido Nítrico Sintasa de Tipo III/antagonistas & inhibidores , Concentración Osmolar , Plexo Submucoso/citología , Plexo Submucoso/efectos de los fármacos , Plexo Submucoso/metabolismo
2.
J Cell Mol Med ; 15(11): 2411-20, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21535398

RESUMEN

Caveolin (Cav)-1 is an integral membrane protein of caveolae playing a crucial role in various signal transduction pathways. Caveolae represent the sites for calcium entry and storage especially in smooth muscle cells (SMC) and interstitial cells of Cajal (ICC). Cav-1(-/-) mice lack caveolae and show abnormalities in pacing and contractile activity of the small intestine. Presently, we investigated, by transmission electron microscopy (TEM) and immunohistochemistry, whether the absence of Cav-1 in Cav-1(-/-) mouse small intestine affects ICC, SMC and neuronal morphology, the expression of NK1 and NK2 receptors, and of Ano1 (also called Dog1 or TMEM16A), an essential molecule for slow wave activity in gastrointestinal muscles. ICC were also labelled with c-Kit and tachykinergic neurons with Substance P (SP). In Cav-1(-/-) mice: (i) ICC were Ano1-negative but maintained c-Kit expression, (ii) NK1 and NK2 receptor immunoreactivity was more intense and, in the SMC, mainly intracytoplasmatic, (iii) SP-immunoreactivity was significantly reduced. Under TEM: (i) ICC, SMC and telocytes lacked typical caveolae but had few and large flask-shaped vesicles we called large-sized caveolae; (ii) SMC and ICC contained an extraordinary high number of mitochondria, (iii) neurons were unchanged. To maintain intestinal motility, loss of caveolae and reduced calcium availability in Cav-1-knockout mice seem to be balanced by a highly increased number of mitochondria in ICC and SMC. Loss of Ano-1 expression, decrease of SP content and consequently overexpression of NK receptors suggest that all these molecules are Cav-1-associated proteins.


Asunto(s)
Caveolina 1/deficiencia , Canales de Cloruro/metabolismo , Íleon/metabolismo , Íleon/ultraestructura , Miocitos del Músculo Liso/metabolismo , Miocitos del Músculo Liso/ultraestructura , Receptores de Neuroquinina-1/biosíntesis , Receptores de Neuroquinina-2/biosíntesis , Sustancia P/metabolismo , Animales , Anoctamina-1 , Caveolas/metabolismo , Caveolas/ultraestructura , Caveolina 1/genética , Caveolina 1/metabolismo , Motilidad Gastrointestinal , Íleon/citología , Íleon/inmunología , Inmunohistoquímica , Células Intersticiales de Cajal/metabolismo , Ratones , Ratones Noqueados , Microscopía Electrónica de Transmisión , Mitocondrias Musculares/ultraestructura , Contracción Muscular , Neuronas/citología , Neuronas/metabolismo , Neuronas/ultraestructura , Proteínas Proto-Oncogénicas c-kit/biosíntesis , Proteínas Proto-Oncogénicas c-kit/metabolismo , Receptores de Neuroquinina-1/inmunología , Receptores de Neuroquinina-2/inmunología , Transducción de Señal , Sustancia P/inmunología
3.
Am J Physiol Endocrinol Metab ; 300(2): E380-91, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21081707

RESUMEN

Impaired gastric motility ascribable to a defective nitric oxide (NO) production has been reported in dystrophic (mdx) mice. Since relaxin upregulates NO biosynthesis, its effects on the motor responses and NO synthase (NOS) expression in the gastric fundus of mdx mice were investigated. Mechanical responses of gastric strips were recorded via force displacement transducers. Evaluation of the three NOS isoforms was performed by immunohistochemistry and Western blot. Wild-type (WT) and mdx mice were distributed into three groups: untreated, relaxin pretreated, and vehicle pretreated. In strips from both untreated and vehicle-pretreated animals, electrical field stimulation (EFS) elicited contractile responses that were greater in mdx than in WT mice. In carbachol-precontracted strips, EFS induced fast relaxant responses that had a lower amplitude in mdx than in WT mice. Only in the mdx mice did relaxin depress the amplitude of the neurally induced excitatory responses and increase that of the inhibitory ones. In the presence of L-NNA, relaxin was ineffective. In relaxin-pretreated mdx mice, the amplitude of the EFS-induced contractile responses was decreased and that of the fast relaxant ones was increased compared with untreated mdx animals. Responses to methacholine or papaverine did not differ among preparations and were not influenced by relaxin. Immunohistochemistry and Western blotting showed a significant decrease in neuronal NOS expression and content in mdx compared with WT mice, which was recovered in the relaxin-pretreated mdx mice. The results suggest that relaxin is able to counteract the altered contractile and relaxant responses in the gastric fundus of mdx mice by upregulating nNOS expression.


Asunto(s)
Motilidad Gastrointestinal/efectos de los fármacos , Motilidad Gastrointestinal/genética , Óxido Nítrico/fisiología , Relaxina/farmacología , Estómago/efectos de los fármacos , Actinas/metabolismo , Animales , Western Blotting , Estimulación Eléctrica , Fundus Gástrico , Inmunohistoquímica , Técnicas In Vitro , Isoenzimas/biosíntesis , Isoenzimas/genética , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos mdx , Contracción Muscular/fisiología , Relajación Muscular/efectos de los fármacos , Óxido Nítrico/metabolismo , Óxido Nítrico Sintasa/biosíntesis , Óxido Nítrico Sintasa/genética , Estómago/enzimología
4.
Oncol Res ; 17(11-12): 559-64, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19806786

RESUMEN

Single-agent gemcitabine has been established as standard treatment for advanced pancreatic cancer since clinical studies have shown an improvement in overall survival and significant clinical benefit when compared to the best supportive care despite low overall objective response. Several phase II studies have tested other single agents and different gemcitabine-based regimens in pancreatic cancer, but both response and survival rates have remained low. Irinotecan, a topoisomerase I inhibitor currently approved for the treatment of metastatic colon cancer, has also demonstrated improved response rate in patients with pancreatic cancer. Our purpose was to determine the activity and toxicity of this regimen in patients with unresectable or metastatic pancreatic cancer. Patients with histologically confirmed pancreatic adenocarcinoma received gemcitabine 1000 mg/m2 plus irinotecan 100 mg/m2 IV on days 1, 8, and 15 of a 28-day cycle for 6-8 months. From February 2004 to April 2006, 33 patients were entered into this study, 32 of whom were evaluable for treatment response, toxicity, median time to progression, and median survival. Characteristics included a median age of 63 years (range 41-79), 21 males (64%), and 12 females (36%). One patient discontinued treatment due to adverse effects. The total number of cycles administered was 188 and the median number of cycles for patients was 5.6 (range 2-7). Thirty-two patients were assessable for toxicity and response. Grade 3 hematological toxicity occurred in 9% of patients and was primarily neutropenia. No grade >2 gastrointestinal toxicities or death due to treatment were observed. The most frequent nonhematological adverse event was fatigue. Ten patients responded to treatment with two complete responses (6.3%) and eight partial responses (25.0%), for an overall response rate of 31.3%; 11 patients achieved stable disease (34.3%). The median time to tumor progression and the median survival were 9.2 (95% CI: 6.0-12.4) and 11.8 (95% CI: 7.7-15.9) months, respectively, with a 2-year survival of 22%. On the basis of this trial, the combination of gemcitabine plus irinotecan, administered in a weekly schedule and at this dose, is well tolerated and offers encouraging activity in the treatment of advanced and/or metastatic pancreatic cancer.


Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Pancreáticas/tratamiento farmacológico , Adenocarcinoma/mortalidad , Adulto , Anciano , Camptotecina/administración & dosificación , Camptotecina/efectos adversos , Camptotecina/análogos & derivados , Desoxicitidina/administración & dosificación , Desoxicitidina/efectos adversos , Desoxicitidina/análogos & derivados , Femenino , Humanos , Irinotecán , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/mortalidad , Gemcitabina
5.
Cephalalgia ; 28(3): 300-1, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18254899

RESUMEN

Hemicrania continua (HC) is an indomethacin-responsive headache characterized by a chronic, strictly unilateral, side-locked without side-shifting, persistent headache. We report three cases of HC with atypical features in which an acute administration of indomethacin 50 mg IM (INDOTEST) was performed. In all three cases INDOTEST predicted chronic responsiveness to indomethacin. Thus, in cases of HC with atypical features, INDOTEST could help for a correct diagnosis and therapy.


Asunto(s)
Cefalea/diagnóstico , Cefalea/tratamiento farmacológico , Indometacina/administración & dosificación , Adulto , Anciano , Enfermedad Crónica , Método Doble Ciego , Femenino , Humanos , Valor Predictivo de las Pruebas
6.
Neurogastroenterol Motil ; : e13333, 2018 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-29575442

RESUMEN

BACKGROUND: Gastric emptying is a complex physiological process regulating the division of a meal into smaller partitions for the small intestine. Disrupted gastric emptying contributes to digestive disease, yet current measures may not reflect different mechanisms by which the process can be altered. METHODS: We have developed high temporal resolution solid and liquid gastric emptying breath tests in mice using [13 C]-octanoic acid and off axis- integrated cavity output spectroscopy (OA-ICOS). Stretched gamma variate and 2-component stretched gamma variate models fit measured breath excretion data. KEY RESULTS: These assays detect acceleration and delay using pharmacological (7.5 mg/kg atropine) or physiological (nutrients, cold exposure stress, diabetes) manipulations and remain stable over time. High temporal resolution resolved complex excretion curves with 2 components, which was more prevalent in mice with delayed gastric emptying following streptozotocin-induced diabetes. There were differences in the gastric emptying of Balb/c vs C57Bl6 mice, with slower gastric emptying and a greater occurrence of two-phase gastric emptying curves in the latter strain. Gastric emptying of C57Bl6 could be accelerated by halving the meal size, but with no effect on the occurrence of two-phase gastric emptying curves. A greater proportion of two-phase gastric emptying was induced in Balb/c mice with the administration of PYY (8-80 nmol) 60 min following meal ingestion. CONCLUSIONS AND INFERENCES: Collectively, these results demonstrate the utility of high temporal resolution gastric emptying assays. Two-phase gastric emptying is more prevalent than previously reported, likely involves intestinal feedback, but contributes little to the overall rate of gastric emptying.

7.
Eur J Neurol ; 14(3): 346-9, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17355560

RESUMEN

Neurosarcoidosis occurs in 5-15% of sarcoidosis cases. Approximately 50% of patients with neurosarcoidosis present with a neurological disease at the time sarcoidosis is first diagnosed. Spinal sarcoidosis is rare. We report the case of a 61-year-old man with a highly aspecific intramedullary lesion as the first manifestation of sarcoidosis. One year after the onset of neurological symptoms, the high levels of angiotensin-converting enzyme and the results of a total body gallium scan and bronchoalveolar lavage supported the diagnosis of sarcoidosis. Isolated single reports indicate that spinal neurosarcoidosis may be the initial manifestation of sarcoidosis. In our case, magnetic resonance imaging of the dorsal spine showed a largely aspecific lesion. Neurosarcoidosis should be considered in the differential diagnosis of intramedullary cord lesion with leptomeningeal enhancement; a systematic search for evidence of sarcoidosis should be mandatory in all cases for a correct diagnosis and early treatment.


Asunto(s)
Sarcoidosis/complicaciones , Sarcoidosis/patología , Enfermedades de la Médula Espinal/etiología , Enfermedades de la Médula Espinal/patología , Médula Espinal/patología , Biomarcadores/sangre , Lavado Broncoalveolar , Diagnóstico Diferencial , Progresión de la Enfermedad , Galio , Humanos , Pulmón/patología , Pulmón/fisiopatología , Imagen por Resonancia Magnética , Masculino , Meninges/patología , Meninges/fisiopatología , Persona de Mediana Edad , Peptidil-Dipeptidasa A/sangre , Valor Predictivo de las Pruebas , Sarcoidosis/fisiopatología , Selenio , Médula Espinal/fisiopatología , Enfermedades de la Médula Espinal/fisiopatología
8.
Artículo en Inglés | MEDLINE | ID: mdl-27781339

RESUMEN

BACKGROUND: Delayed gastric emptying in diabetic mice and humans is associated with changes in macrophage phenotype and loss of interstitial cells of Cajal (ICC) in the gastric muscle layers. In diabetic mice, classically activated M1 macrophages are associated with delayed gastric emptying, whereas alternatively activated M2 macrophages are associated with normal gastric emptying. This study aimed to determine if secreted factors from M1 macrophages could injure mouse ICC in primary culture. METHODS: Cultures of gastric ICC were treated with conditioned medium (CM) from activated bone marrow-derived macrophages (BMDMs) and the effect of CM was quantified by counting ICC per high-powered field. KEY RESULTS: Bone marrow-derived macrophages were activated to a M1 or M2 phenotype confirmed by qRT-PCR. Conditioned medium from M1 macrophages reduced ICC numbers by 41.1%, whereas M2-CM had no effect as compared to unconditioned, control media. Immunoblot analysis of 40 chemokines/cytokines found 12 that were significantly increased in M1-CM, including tumor necrosis factor alpha (TNF-α). ELISA detected 0.697±0.03 ng mL-1 TNF-α in M1-CM. Recombinant mouse TNF-α reduced Kit expression and ICC numbers in a concentration-dependent manner (EC50 = 0.817 ng mL-1 ). Blocking M1-CM TNF-α with a neutralizing antibody preserved ICC numbers. The caspase inhibitor Z-VAD.fmk partly preserved ICC numbers (cells/field; 6.63±1.04, 9.82±1.80 w/Z-VAD.fmk, n=6, P<.05). CONCLUSIONS & INFERENCES: This work demonstrates that TNF-α secreted from M1 macrophages can result in Kit loss and directly injure ICC in vitro partly through caspase-dependent apoptosis and may play an important role in ICC depletion in diabetic gastroparesis.


Asunto(s)
Células Intersticiales de Cajal/metabolismo , Macrófagos/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Animales , Recuento de Células/métodos , Células Cultivadas , Relación Dosis-Respuesta a Droga , Técnicas de Sustitución del Gen , Células Intersticiales de Cajal/efectos de los fármacos , Ratones , Ratones Endogámicos BALB C , Factor de Necrosis Tumoral alfa/farmacología
9.
Neuropharmacology ; 48(6): 788-95, 2005 May.
Artículo en Inglés | MEDLINE | ID: mdl-15829251

RESUMEN

Kynurenine 3-mono-oxygenase (KMO, kynurenine hydroxylase) inhibitors increase brain kynurenic acid (KYNA) synthesis and cause pharmacological actions possibly mediated by a reduced activity of excitatory synapses. We used in vivo microdialysis and passive avoidance to study the effects of local KYNA or systemic KMO inhibitor administration on glutamate (GLU) neurotransmission. Local application of KYNA (30-100 nM) through reverse microdialysis reduced GLU content in caudate and cortical dialysates by 75 and 55%, respectively. No changes were found in the hippocampus. Systemic administration of Ro 61-8048 (4-40 mg/kg) increased KYNA levels in dialysates obtained from the cortex (from 10.3 +/- 1.9 to 45.5 +/- 15 nM), caudate (from 2.4 +/- 0.8 to 9.5 +/- 0.9 nM) and hippocampus (from 7.7 +/- 1.7 to 19.2 +/- 3.5 nM). It also caused a parallel robust decrease in GLU levels in the dialysates collected from the caudate (from 2.2 +/- 0.5 to 0.63 +/- 0.05 microM) but not in those collected from the parietal cortex or the hippocampus. In a passive avoidance paradigm, the administration of the NMDA receptor antagonist MK-801 (0.1 mg/kg) reduced, while Ro 61-8048 (4-80 mg/kg) did not change the latency time of entering into the dark compartment on the recall trial. Our data show that KMO inhibitors increase brain KYNA synthesis and selectively reduce GLU extracellular concentration in the basal ganglia.


Asunto(s)
Ganglios Basales/efectos de los fármacos , Química Encefálica/efectos de los fármacos , Espacio Extracelular/efectos de los fármacos , Ácido Glutámico/metabolismo , Oxigenasas de Función Mixta/antagonistas & inhibidores , Sulfonamidas/farmacología , Tiazoles/farmacología , Animales , Reacción de Prevención/efectos de los fármacos , Ganglios Basales/metabolismo , Conducta Animal/efectos de los fármacos , Bloqueadores de los Canales de Calcio/farmacología , Cromatografía Líquida de Alta Presión/métodos , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas , Espacio Extracelular/metabolismo , Ácido Quinurénico/metabolismo , Ácido Quinurénico/farmacología , Quinurenina 3-Monooxigenasa , Masculino , Microdiálisis/métodos , Cloruro de Potasio/farmacología , Ratas , Ratas Wistar , Estadísticas no Paramétricas , Factores de Tiempo , omega-Conotoxina GVIA/farmacología
11.
Neurogastroenterol Motil ; 27(7): 997-1009, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25930994

RESUMEN

BACKGROUND: Otilonium bromide (OB) is used as a spasmolytic drug in the treatment of the functional bowel disorder irritable bowel syndrome. Although its acute effects on colonic relaxation are well-characterized, little is known about the effects of chronic administration of OB on enteric neurons, neuromuscular transmission, and interstitial cells of Cajal (ICC), key regulators of the gut function. METHODS: Adult Sprague-Dawley rats were treated with OB in drinking water at a dose of 2 mg/kg for 30 days. The colons of OB-treated and age-matched control rats were studied by confocal immunohistochemistry to detect immunoreactivity (IR) in myenteric plexus neurons for nitrergic and tachykininergic markers, and also by microelectrode electrophysiology. KEY RESULTS: Using immunohistochemistry, chronic OB administration did not change total neuron number, assessed by anti-Hu IR, but resulted in a significant increase in NK1 receptor positive neurons, a decrease in neuronal nitric oxide synthase expressing neurons, and a reduction in volume of substance P in nerve fibers in the myenteric plexus. Chronic OB administration potentiated inhibitory and excitatory junction potentials evoked by repetitive electrical field stimulation. The various types of colonic ICC, detected by Kit IR, were not altered nor were slow waves or smooth muscle membrane potential. CONCLUSIONS & INFERENCES: Chronic treatment with OB caused significant changes in the nitrergic and tachykinergic components of the myenteric plexus and in both inhibitory and excitatory neurotransmission in the rat colon.


Asunto(s)
Colon/metabolismo , Óxido Nítrico/metabolismo , Compuestos de Amonio Cuaternario/administración & dosificación , Transducción de Señal/efectos de los fármacos , Taquicininas/metabolismo , Animales , Colon/efectos de los fármacos , Masculino , Plexo Mientérico/efectos de los fármacos , Plexo Mientérico/metabolismo , Óxido Nítrico Sintasa de Tipo I/metabolismo , Ratas , Ratas Sprague-Dawley , Receptores de Neuroquinina-1/metabolismo
12.
Theor Appl Genet ; 104(2-3): 223-228, 2002 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12582690

RESUMEN

We have isolated and sequenced 52 microsatellites or simple sequence repeats (SSRs) from nearly 60 positive clones obtained from two 'Frantoio' olive genomic libraries enriched in (AC/GT) and (AG/CT) repeats, respectively. The repeat-containing fragments obtained from genomic DNA restricted with Tsp509I were separated using a biotinylated probe bound to streptavidin-coated paramagnetic beads. Fragments were then cloned into lambda ZAPII vector and sequenced. Thirty of the 36 primer pairs which gave correct re-amplification in the source genome were used to assay the polymorphism of 12 olive cultivars, namely four well-known cultivars ('Coratina', 'Frantoio', 'Leccino', 'Pendolino') and eight ancient cultivars grown locally near Lake Garda ('Casaliva', 'Favarol', 'Fort', 'Grignan', 'Less', 'Raza', 'Rossanel', 'Trep'). The local cultivars were each re- presented by two to four long-lived individuals. The analysis was carried out using (33)P-labelled primers and 6% polyacrylamide sequencing gels. All except two microsatellites showed polymorphism, the number of alleles varying from 1 to 5. The average genetic diversity ( H) was 0.55. The power of discrimination ( PD) was 0.60. All cultivars, including the local ones, were easily separated from each other. Variations in the SSR pattern were observed among individual plants of the same cultivar in four out of the eight local cultivars analysed. Several primer pairs (17%) amplified more than one locus.

13.
Minerva Med ; 78(22): 1687-705, 1987 Nov 30.
Artículo en Italiano | MEDLINE | ID: mdl-3320814

RESUMEN

A report is presented on 58 patients (46 males, 12 females) all suffering from post-traumatic epilepsy (PTE) and followed up for a minimum of 1 year to maximum of 23 years after the injury (mean 6.3 years). The type and site of the head injury, the nature of the brain lesions, the time elapsing before the first critical manifestation, the clinical character of the epileptic attacks, EEG, cerebral CAT and RMN data were performed are given for all patients. The therapeutic and prophylactic strategies adopted are then described in detail with particular emphasis on the use of diphenylhydantoin (DPH) and barbexaclone. The latter drug, used for the last 3 years was found to be particularly useful in the treatment of patients suffering from a post-traumatic psycho-organic syndrome in addition to the PTE.


Asunto(s)
Anticonvulsivantes/uso terapéutico , Lesiones Encefálicas/complicaciones , Carbamazepina/uso terapéutico , Epilepsia/prevención & control , Fenobarbital/análogos & derivados , Fenobarbital/uso terapéutico , Fenitoína/uso terapéutico , Primidona/uso terapéutico , Adolescente , Adulto , Niño , Preescolar , Quimioterapia Combinada , Epilepsia/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad
14.
Int J Obstet Anesth ; 1(1): 19-23, 1991 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15636791

RESUMEN

In 56 women undergoing elective caesarean section, general anaesthesia was induced with either propofol 1% or thiopentone 2.5% followed by 50% nitrous oxide in oxygen and isoflurane 0.75% until delivery. In the thiopentone group the arterial pressure rose following tracheal intubation and skin incision, while in the propofol group there was a significant tendency to hypotension immediately following induction of anaesthesia. There were differences in electroencephalogram (EEG) between the groups, while laryngoscopy, intubation and surgical stimulation had no effect on EEG pattern. Recovery after anaesthesia did not differ between groups. None of the patients had recall of the intraoperative period, but 53% of patients induced with propofol showed signs of light anaesthesia between induction and delivery. Neonates in the propofol group had lower Apgar scores 1 min after birth than those in the thiopentone group, but these differences were no longer significant at 5 min. No differences were noted in neurobehavioural status at 1, 4 and 24 h.

15.
J Clin Anesth ; 3(3): 211-4; discussion 214-5, 1991.
Artículo en Inglés | MEDLINE | ID: mdl-1652265

RESUMEN

STUDY OBJECTIVE: To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section. DESIGN: Randomized, double-blind, placebo-controlled (standard commercial preparation of 2% mepivacaine with epinephrine) study. SETTING: Inpatient obstetric department at a general hospital. PATIENTS: Seventy patients scheduled for elective cesarean section under epidural anesthesia. INTERVENTIONS: Two groups of 35 patients each receiving either the standard commercial preparation of mepivacaine or the pH-adjusted solution (prepared with the addition of 0.1 meq/ml of sodium bicarbonate to the standard commercial solution). MEASUREMENTS AND MAIN RESULTS: Measurements of sensory (pinprick) and motor (Bromage's criteria) block were taken at 1- to 2-minute intervals beginning after the completion of the epidural injection. Increasing the pH of the mepivacaine resulted in a significant shortening of the time of analgesia onset (9.3 minutes compared with 16.01 minutes, p less than 0.01) and of peak effect (11.1 minutes compared with 21.2 minutes, p less than 0.01). The alkalinization did not affect duration of the block, intensity of motor block, or mean dose of local anesthetic used. CONCLUSION: The alkalinization allowed the surgery to proceed more rapidly, significantly decreasing the time interval between epidural block and delivery of the infant.


Asunto(s)
Anestesia Epidural , Anestesia Obstétrica , Cesárea , Mepivacaína/administración & dosificación , Adulto , Bicarbonatos/administración & dosificación , Parto Obstétrico , Método Doble Ciego , Epinefrina/administración & dosificación , Femenino , Humanos , Concentración de Iones de Hidrógeno , Neuronas Motoras/efectos de los fármacos , Bloqueo Nervioso , Neuronas Aferentes/efectos de los fármacos , Embarazo , Sodio/administración & dosificación , Bicarbonato de Sodio , Factores de Tiempo
16.
Minerva Cardioangiol ; 41(4): 153-6, 1993 Apr.
Artículo en Italiano | MEDLINE | ID: mdl-8332272

RESUMEN

We describe two cases of corrected transposition of great vessel (L Transposition). The first case was diagnosed in a man of 70 years old and was not associated with other congenital defects. The second case regards a young man of 16 years old and congenital cardiopathy was associated with interventricular defect and left Ebstein disease. We discuss the different evolution of L Transposition according to the presence or not of other congenital defects and we analyse right ventricle behaviour when it is submitted systemic pressure. In the literature only 26 cases of L Transposition were described in patients over 40 years old. The first case represents a rarity and it shows how in the absence of associated congenital defects, the right ventricle is able to adapt to systemic pressure. Bidimensional echocardiography in the method of choice to diagnose and evaluate congenital cardiopathy in adult age.


Asunto(s)
Cardiopatías Congénitas/complicaciones , Transposición de los Grandes Vasos/complicaciones , Anomalías Múltiples/diagnóstico por imagen , Anomalías Múltiples/cirugía , Adolescente , Factores de Edad , Anciano , Anomalía de Ebstein/complicaciones , Anomalía de Ebstein/cirugía , Ecocardiografía , Cardiopatías Congénitas/diagnóstico por imagen , Cardiopatías Congénitas/cirugía , Humanos , Masculino , Transposición de los Grandes Vasos/diagnóstico por imagen , Transposición de los Grandes Vasos/cirugía
17.
Minerva Cardioangiol ; 41(12): 563-7, 1993 Dec.
Artículo en Italiano | MEDLINE | ID: mdl-8139775

RESUMEN

The study examined a group of 150 patients with acute myocardial infarction aged under 60 years old. The subjects examined were divided into smokers and non-smokers; smokers were further subdivided into three groups: those smoking less than 20, between 20 and 40 and more than 40 cigarettes a day. Furthermore, they were divided into two groups aged under or over 40. The following parameters were evaluated and compared: the method of onset of acute myocardial infarction, the site of infarction, the presence or absence of the Q wave on the ECG, the presence of angina before and after acute myocardial infarction, arrhythmia during the acute phase and during hospitalisation, mortality during the first 10 days of hospitalisation. The results showed that cigarette smoking is a major risk factor able to influence the age of onset of acute myocardial infarction, especially if over 20 cigarettes a day, whereas it has no influence on clinical history and early death.


Asunto(s)
Infarto del Miocardio/etiología , Fumar/efectos adversos , Adulto , Distribución de Chi-Cuadrado , Electrocardiografía , Humanos , Persona de Mediana Edad , Infarto del Miocardio/complicaciones , Infarto del Miocardio/epidemiología , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/epidemiología , Isquemia Miocárdica/etiología , Factores de Riesgo , Ciudad de Roma/epidemiología , Fumar/epidemiología , Población Urbana/estadística & datos numéricos
18.
Minerva Cardioangiol ; 45(5): 229-34, 1997 May.
Artículo en Italiano | MEDLINE | ID: mdl-9273474

RESUMEN

BACKGROUND: This work aims to correlate retina vessel alteration with the possible presence of coronary alteration in the same patient. METHODS: For this purpose 103 patients have been studied. Of these, 63 had symptoms of coronary heart disease while the remaining 40 were used as a control. 29 patients, out of the 63, were also afflicted with angine while 34 had previously had myocardial infarction. Eye fundus tests and coronarography have been carried out, and risk factors such as high cholesterol, high blood pressure, diabetes and smoking have been investigated. RESULTS AND CONCLUSIONS: This work shows that there is a close correlation between a positive eye fundus and coronarography alteration whereas a negative one is not incompatible with organic lesions. A positive eye fundus due to alteration of retina microcirculation can be indicative of atherosclerosis in symptomatic patients.


Asunto(s)
Fondo de Ojo , Isquemia Miocárdica/patología , Vasos Retinianos/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico
19.
Neurogastroenterol Motil ; 25(11): e728-39, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23901937

RESUMEN

BACKGROUND: Otilonium bromide (OB) is a quaternary ammonium derivative used for the treatment of intestinal hypermotility and is endowed with neurokinin2 receptor (NK2r) antagonist and Ca²âº channel blocker properties. Therefore, the possibility that OB might play a role in the neurokinin receptor/Substance-P/nitric oxide (NKr/SP/NO) circuit was investigated after chronic exposition to the drug. METHODS: Rats were treated with OB 2-20 mg kg⁻¹ for 10 and 30 days. In the proximal colon, the expression and distribution of muscle NOsynthase 1 (NOS1), NK1r, NK2r, SP and Cav 1.2 subunit (for L-type Ca²âº channel) and the spontaneous activity and stimulated responses to NK1r and NK2r agonists were investigated. KEY RESULTS: Immunohistochemistry showed a redistribution of NK1r and L-type Ca²âº channel in muscle cells with no change of NK2r at 30 days, a significant increase in muscle NOS1 expression at 10 days and a significant decrease in the SP content early in the ganglia and later in the intramuscular nerve fibers. Functional studies showed no change in spontaneous activity but a significant increase in maximal contraction induced by NK1r agonist. CONCLUSIONS & INFERENCES: Chronic exposition to OB significantly affects the NKr/SP/NO circuit. The progressive decrease in SP-expression might be the consequence of the persistent presence of OB, the increase of NOS1 expression in muscle cells at 10 days in an attempt to guarantee an adequate NO production, and, at 30 days, the redistribution of the L-type Ca²âº channel and NK1r as a sign to compensate the drug channel block by re-cycling both of them. The physiological data suggest NK1r hypersensitivity.


Asunto(s)
Canales de Calcio Tipo L/metabolismo , Colon/metabolismo , Óxido Nítrico Sintasa/metabolismo , Compuestos de Amonio Cuaternario/farmacología , Receptores de Taquicininas/metabolismo , Animales , Bloqueadores de los Canales de Calcio/farmacología , Colon/efectos de los fármacos , Estimulación Eléctrica , Masculino , Músculo Liso/efectos de los fármacos , Músculo Liso/metabolismo , Ratas , Ratas Wistar , Receptores de Taquicininas/antagonistas & inhibidores , Sustancia P/metabolismo
20.
Neurogastroenterol Motil ; 23(1): 96-102, e10, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-20879991

RESUMEN

BACKGROUND: The present aim was to study the modulation of NK2 receptor internalization by two compounds, the spasmolytic otilonium bromide (OB) endowed with NK2 receptor antagonistic properties and the selective NK2 receptor antagonist ibodutant. METHODS: Full-thickness human colonic segments were incubated in the presence of OB (0.1-10 µmol L(-1)) or ibodutant (0.001-0.1 µmol L(-1)), with or without the NK2 receptor selective agonist [ßAla8]NKA(4-10) and then fixed in 4% paraformaldehyde. Cryosections were processed for NK2 receptor immunohistochemical revelation. Quantitative analysis evaluated the number of the smooth muscle cells that had internalized the NK2 receptor. KEY RESULTS: Immunohistochemistry revealed that in basal condition, the NK2 receptor was internalized in about 23% of total smooth muscle cells. The exposure to the selective NK2 receptor agonist induced internalization of the receptor in more than 77% of the cells. Previous exposure to both OB or ibodutant, either alone or in the presence of the agonist, concentration-dependently reduced the number of the cells with the internalized receptor. CONCLUSIONS & INFERENCES: Both OB and ibodutant antagonize the internalization of the NK2 receptor in the human colon. As NK2 receptors are the predominant receptor mediating spasmogenic activity of tachykinins on enteric smooth muscle, we hypothesize that the antagonistic activity found for both OB and ibodutant should play a specific therapeutic role in gut diseases characterized by hypermotility.


Asunto(s)
Colon/efectos de los fármacos , Colon/metabolismo , Dipéptidos/farmacología , Fármacos Gastrointestinales/farmacología , Compuestos de Amonio Cuaternario/farmacología , Receptores de Neuroquinina-2/metabolismo , Tiofenos/farmacología , Adulto , Anciano , Anciano de 80 o más Años , Animales , Colon/anatomía & histología , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Receptores de Neuroquinina-2/antagonistas & inhibidores
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