1
|
Rota S, Marchesi D, Farina C, De Bièvre C. Trichoderma Pseudokoningii Peritonitis in Automated Peritoneal Dialysis Patient Successfully Treated by Early Catheter Removal. Perit Dial Int 2020. [DOI: 10.1177/089686080002000119] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- S. Rota
- Division of Nephrology and Dialysis, Ospedali Riuniti di Bergamo Bergamo, Italy
| | - D. Marchesi
- Division of Nephrology and Dialysis, Ospedali Riuniti di Bergamo Bergamo, Italy
| | - C. Farina
- Microbiology Institute, Ospedali Riuniti di Bergamo Bergamo, Italy
| | | |
Collapse
|
2
|
Mingardi G, Mingardi G, Marchesi D, Perticucci E, Rota S, Tiraboschi G, Cornalba L, Brunzieri C, Foroni I, Lupi G, Cortinovis E, Ondei P, Alongi G, Lorenz M, Apolone G, Mosconi P, Ruggiata R. Quality of Life and End Stage Renal Disease Therapeutic Programs. Int J Artif Organs 2018. [DOI: 10.1177/039139889802101110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- G. Mingardi
- Nephrology and Dialysis Division, Ospedali Riuniti di Bergamo, Bergamo - Italy
| | | | | | | | - S. Rota
- Ospedali Riuniti di Bergamo, Bergamo
| | | | | | | | - I. Foroni
- Ospedale Predabissi di Melegnano, Milano
| | - G. Lupi
- Ospedale Predabissi di Melegnano, Milano
| | | | - P. Ondei
- Policlinico San Pietro di Ponte San Pietro, Bergamo
| | - G. Alongi
- Policlinico San Marco di Zingonia, Bergamo
| | - M. Lorenz
- Policlinico San Marco di Zingonia, Bergamo
| | - G. Apolone
- Istituto di Ricerche Farmacologiche Mario Negri, Milano
| | - P. Mosconi
- Istituto di Ricerche Farmacologiche Mario Negri, Milano
| | - R. Ruggiata
- Istituto di Ricerche Farmacologiche Mario Negri, Milano
| | | |
Collapse
|
3
|
Feng H, Hu W, Marchesi D, Qiao J, Hershlag A. The effect of slow-freeze versus vitrification on the oocyte: an animal model. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
4
|
Indrieri M, Podestà A, Bongiorno G, Marchesi D, Milani P. Adhesive-free colloidal probes for nanoscale force measurements: production and characterization. Rev Sci Instrum 2011; 82:023708. [PMID: 21361602 DOI: 10.1063/1.3553499] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We describe novel approaches for the production and characterization of epoxy- and adhesive-free colloidal probes for atomic force microscopy (AFM). Borosilicate glass microspheres are strongly attached to commercial AFM cantilevers exploiting the capillary adhesion force due to the formation of a water meniscus, and then a thermal annealing of the sphere-cantilever system at a temperature slightly below the softening point of borosilicate glass. Controlling the wettability of the surfaces involved turned out to be a crucial element for the control of surface adhesion and for the implementation of a completely adhesive-free production method of colloidal probes. Moreover, we present a statistical characterization protocol of the probe dimensions and roughness based on the AFM inverse imaging of colloidal probes on spiked gratings. We have assessed the influence of defects of the grating on the characterization of the probe, and discussed the accuracy of our characterization technique in comparison to the methods based on scanning electron or optical microscopy, or on the manual analysis of AFM inverse images.
Collapse
Affiliation(s)
- M Indrieri
- CIMaINa and Dipartimento di Fisica, Università degli Studi di Milano, Milano, Italy
| | | | | | | | | |
Collapse
|
5
|
Abstract
STUDY DESIGN An animal study was performed to evaluate lumbar spinal fusion radiologically and mechanically. OBJECTIVES To assess the efficacy of interconnected porous hydroxyapatite in achieving posterolateral lumbar arthrodesis in sheep. SUMMARY OF BACKGROUND DATA Posterolateral spinal arthrodesis with autologous bone graft is the gold standard procedure for lumbar fusion. The procedure for harvesting bone from the iliac crest increases morbidity. Interconnected porous hydroxyapatite has been used effectively as an alternative to cancellous bone graft material in metaphyseal bone defects. Little is known about the efficacy of interconnected porous hydroxyapatite in achieving lumbar spinal fusion. METHODS Four groups of seven sheep underwent bisegmental posterolateral lumbar fusion with instrumentation using different intertransverse graft material. In group 1, no graft material was used. In group 2, autologous bone was used. Group 3 had interconnected porous hydroxyapatite. Group 4 had an equip of interconnected porous hydroxyapatite and autologous bone. The animals were killed at 20 weeks after surgery. Radiographs and computed tomography images were obtained. The fusion masses were graded for bone resorption and trabecular connectivity on the computed tomography images. Mechanical testing of the specimens was performed, and the three-dimensional segmental motion was measured in flexion/extension, axial rotation, and lateral bending. RESULTS The radiographic images were difficult to interpret because of the radiodense interconnected porous hydroxyapatite granules. According to mechanical stability criteria, the fusion rate for the different groups was as follows: 100% (14/14) for the autologous bone group, 72% (10/14) for the bone/interconnected porous hydroxyapatite group, 50% (7/14) for the pure interconnected porous hydroxyapatite group, and 15% (2/14) for the sham group. CONCLUSIONS Spinal arthrodesis using interconnected porous hydroxyapatite alone or mixed with bone as graft material reduced segmental motion. It was not, however, as effective as autologous bone graft material in achieving spinal arthrodesis. The sheep model using autologous bone achieved a 100% fusion rate. Because the nonunion rate for a single level in humans may be as high as 40%, the fusion rate with bone/interconnected porous hydroxyapatite in humans may be lower than the 72% found in the sheep model. The little resorption of the radiodense interconnected porous hydroxyapatite granules made the radiologic evaluation of the fusion masses difficult.
Collapse
Affiliation(s)
- H G Baramki
- Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, McGill University, Montreal, Canada
| | | | | | | | | |
Collapse
|
6
|
Arlet V, Marchesi D, Papin P, Aebi M. Decompensation following scoliosis surgery: treatment by decreasing the correction of the main thoracic curve or "letting the spine go". Eur Spine J 2000; 9:156-60. [PMID: 10823433 PMCID: PMC3611363 DOI: 10.1007/s005860050227] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Coronal decompensation following correction of adolescent idiopathic scoliosis (AIS) has been reported to be due to the Cotrel-Dubousset rod derotation maneuver, or to a hypercorrection of the main thoracic curve. The treatment of such decompensation consists classically in observation, bracing, or extension of the instrumentation in the lumbar spine for a King 2 curve, or in the upper thoracic spine for a King 5 curve. As the postoperative decompensation is related to a hypercorrection of the main thoracic curve (relative to the compensatory curve), we hypothesized that if we were to "let the spine go" to some of its initial deformity, the balance of the patient would be improved. The purpose of the study was therefore to report on two cases where a postoperative imbalance following scoliosis surgery was successfully treated by decreasing the correction of the main thoracic curve. Two patients with AIS were found to have significant imbalance after scoliosis surgery. Both patients had been treated for a right thoracic curve (82 degrees and 85 degrees respectively) with an anterior release and posterior instrumentation. The revision surgery consisted for both patients in removing all the hooks between the end vertebrae of the main thoracic curve. This was done before the 3rd postoperative month for both patients. After revision surgery, the balance of both patients improved dramatically within a few weeks. The shoulders became almost level, and the trunk shift improved concomitantly. The Cobb angle increased by 8 degrees and 10 degrees, and the apical vertebra shifted to the right by 15 and 10 mm for the respective patients. These results were stable at 1-year follow-up. In the event of a persisting imbalance, we recommend, in selected cases, letting the spine go by removing all the implants located between the end vertebrae of the main thoracic curve. This adjustment or fine-tuning of the instrumentation should be done before the fusion takes place, and is best achieved with an instrumentation in which the hooks can be easily removed from the rod.
Collapse
Affiliation(s)
- V Arlet
- Montreal Children's Hospital, Division of Orthopedics, Quebec, Canada.
| | | | | | | |
Collapse
|
7
|
Abstract
Posterolateral and anterior interbody spinal arthrodesis is a frequent procedure, but high nonunion rates are reported and harvesting autologous bone graft from the iliac crest significantly increases morbidity. Bone graft substitutes are an alternative, but to date clinical results are not conclusive. Bone substitutes can be organic or inorganic, biologic or synthetic. They can have osteoconductive properties, inductive properties or both. Animal experiments are essential to investigating bone substitutes using biomechanical and histologic methods not available in clinical studies. Few authors reported on instrumented anterior fusion models, but none used the sheep model. In the current study posterolateral and anterior interbody fusion models in sheep are described. Both models used instrumented fusions, applying porous mineral scaffolds, alone or mixed with bone. The surgical techniques are described step-by-step and potential difficulties are highlighted. Preliminary results are reported for the posterolateral fusion model using coralline graft substitutes. The coral granules mixed with locally harvested bone had fusion outcomes similar to pure autologous bone. The graft substitute showed marked resorption between 12 and 20 weeks. All fusions had bone cortex and good trabecular connectivity. Histologic evaluation suggests after 20 weeks nearly the entire surface of the substitute is covered with new bone. Porous mineral bone substitutes mixed with locally harvested autologous bone are thought to be a valid alternative for posterolateral fusions.
Collapse
Affiliation(s)
- T Steffen
- Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
| | | | | |
Collapse
|
8
|
Rota S, Marchesi D, Farina C, de Bièvre C. Trichoderma pseudokoningii peritonitis in automated peritoneal dialysis patient successfully treated by early catheter removal. Perit Dial Int 2000; 20:91-3. [PMID: 10716593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
|
9
|
|
10
|
Abstract
Forty-one patients with thoracic adolescent idiopathic scoliosis (AIS) treated with only a posterior spine fusion using specialized pedicle hooks (SPH) (hooks augmented with 3.2-mm screws) at the apex of the curve were reviewed in order to assess the effectiveness of this correction method. Inclusion in the study group required a minimum of 2 years' follow-up and the same strategy of correction where the apical vertebrae (3 or 4 vertebrae on the concave side) were instrumented with SPH. The mean preoperative Cobb angle was corrected from 55 degrees (42 degrees -80 degrees) to 18 degrees (67%) postoperatively and to 23 degrees (58%) at the last follow-up (28-50 months) for a flexibility index of 46%. Apical vertebral translation was corrected to 70% at the last follow-up. Thoracic kyphosis remained unchanged, from 23 degrees to 26 degrees, and the lumbar lordosis went from -53 degrees to -59 degrees. The lumbar curve was corrected from 38 degrees to 18 degrees. Coronal balance improved from 10 to 1 mm; shoulder balance was improved from 15 to 5 mm. The rib hump was improved from an average of 30 mm preoperatively to 15 mm postoperatively, but only to 25 mm at the last follow-up (17% of correction). One case of a spastic bladder was observed postoperatively, which resolved completely after 8 months. Three patients had to have their instrumentation removed because of pain. There was no complication related to the use of the SPH. The authors conclude that apical correction with SPH allows effective scoliosis correction without spinal distraction and does not require supra- or infralaminar hook in the spinal canal.
Collapse
Affiliation(s)
- V Arlet
- Division of Orthopedic Surgery, McGill University, Montreal, Quebec, Canada
| | | | | | | |
Collapse
|
11
|
Arlet V, Papin P, Marchesi D. Halo femoral traction and sliding rods in the treatment of a neurologically compromised congenital scoliosis: technique. Eur Spine J 1999; 8:329-31. [PMID: 10483837 PMCID: PMC3611187 DOI: 10.1007/s005860050182] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In severe congenital scoliosis, traction (whether with a halo or instrumental) is known to expose patients to neurologic complications. However, patients with restrictive lung disease may benefit from halo traction during the course of the surgical treatment. The goal of treatment of such deformities is, therefore, twofold: improvement of the respiratory function and avoidance of any neurologic complications. We report our technique to treat a 17-year-old girl with a multi-operated congenital scoliosis of 145 degrees and cor pulmonale. Pre-operative halo gravity traction improved her vital capacity from 560 c.c. to 700 c.c., but led to mild neurologic symptoms (clonus in the legs). To avoid further neurologic compromise, her first surgery consisted of posterior osteotomies and the implantation of two sliding rods connected to loose dominoes without any attempt at correction. Correction was then achieved over a 3-week period with a halofemoral traction. This allowed the two rods to slide while the neurologic status of the patient was monitored. Her definitive surgery consisted of locking the dominoes and the application of a contralateral rod. Satisfactory outcome was achieved for both correction of the deformity (without neurologic sequels) and improvement of her pulmonary function (1200 c.c. at 2 years). This technique using sliding rods in combination with halofemoral traction can be useful in high-risk, very severe congenital scoliosis.
Collapse
Affiliation(s)
- V Arlet
- Division of Orthopedic Surgery, McGill University, Montreal, Quebec, Canada
| | | | | |
Collapse
|
12
|
Arlet V, Marchesi D, Papin P, Aebi M. The 'MW' sacropelvic construct: an enhanced fixation of the lumbosacral junction in neuromuscular pelvic obliquity. Eur Spine J 1999; 8:229-31. [PMID: 10413350 PMCID: PMC3611157 DOI: 10.1007/s005860050163] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Fixation to the lumbosacral spine to correct pelvic obliquity in neuromuscular scoliosis has always remained a surgical challenge. The strongest fixation of the lumbosacral junction has been achieved with either a Galveston technique with rods or screws or with iliosacral screws. We have devised a new fixation system, in which iliosacral screws are combined with iliac screws. This is made possible by using the AO Universal Spine System with side opening hooks above and below the iliosacral screws and iliac screws below it. The whole sacropelvis is thus encompassed by a maximum width (MW) fixation, which gives an 'M' appearance on the pelvic radiographs and a 'W' appearance in the axial plane. We report on our surgical technique and the early results where such a technique was used. We feel that this new means of fixation (by combining the strongest fixation systems) is extremely solid and should be included in the wide armamentarium of sacropelvic fixation.
Collapse
Affiliation(s)
- V Arlet
- Division of Orthopedic Surgery, McGill University, Montreal, Quebec, Canada
| | | | | | | |
Collapse
|
13
|
Papin P, Arlet V, Marchesi D, Rosenblatt B, Aebi M. Unusual presentation of spinal cord compression related to misplaced pedicle screws in thoracic scoliosis. Eur Spine J 1999; 8:156-9. [PMID: 10333156 PMCID: PMC3611145 DOI: 10.1007/s005860050147] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Utilization of thoracic pedicle screws is controversial, especially in the treatment of scoliosis. We present a case of a 15-year-old girl seen 6 months after her initial surgery for scoliosis done elsewhere. She complained of persistent epigastric pain, tremor of the right foot at rest, and abnormal feelings in her legs. Clinical examination revealed mild weakness in the right lower extremity, a loss of thermoalgic discrimination, and a forward imbalance. A CT scan revealed at T8 and T10 that the right pedicle screws were misplaced by 4 mm in the spinal canal. At the time of the revision surgery the somatosensory evoked potentials (SSEP) returned to normal after screw removal. The clinical symptoms resolved 1 month after the revision. The authors conclude that after pedicle instrumentation at the thoracic level a spinal cord compression should be looked for in case of subtle neurologic findings such as persistent abdominal pain, mild lower extremity weakness, tremor at rest, thermoalgic discrimination loss, or unexplained imbalance.
Collapse
Affiliation(s)
- P Papin
- Division of Orthopedic Surgery, McGill University, Montreal, Quebec, Canada
| | | | | | | | | |
Collapse
|
14
|
Arlet V, Marchesi D, Aebi M. Correction of adolescent idiopathic thoracic scoliosis with a new type of offset apical instrumentation: preliminary results. J Spinal Disord 1998; 11:404-9. [PMID: 9811101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Twenty patients were operated on with the same method using the AO Universal Spine System. The entire apex of the curvature was instrumented on the concave side with a newly designed pedicle hook augmented by 3.2-mm endplate screw. An offset configuration of apical and end vertebrae implants was done to maximize translation. The concave rod was derotated to 120 degrees without any distraction. The convex side was instrumented in the usual fashion. Prospective analysis showed a mean Cobb angle correction of 63% for a mean preoperative angle of 54 degrees. The apical vertebral translation was corrected to 72%. There was no major complication at the last follow-up (18-30 months). This technique compares favorably with the ones using CD principles, but needs no distraction and no instrumentation in the canal (supra or infralaminar hook).
Collapse
Affiliation(s)
- V Arlet
- Division of Orthopedic Surgery, McGill University, Montreal, Quebec, Canada
| | | | | |
Collapse
|
15
|
Papin P, Arlet V, Marchesi D, Laberge JM, Aebi M. [Treatment of scoliosis in the adolescent by anterior release and vertebral arthrodesis under thoracoscopy. Preliminary results]. Rev Chir Orthop Reparatrice Appar Mot 1998; 84:231-8. [PMID: 9775045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
PURPOSE OF THIS STUDY The purpose was to evaluate short term results of thoracoscopic anterior release and fusion in adolescent scoliosis. MATERIAL AND METHODS An independent observer reviewed retrospectively hospital files and X-rays of 8 consecutive patients. The average follow-up was 14 months. The mean age at the time of surgery was 12 years old, all patients were skeletally immature. The surgical technique consisted in a thoracoscopic release and fusion of the discs space followed in the same time by a posterior instrumentation and fusion. Six cases were done in the prone position, two in the lateral decubitus. RESULTS The release could be done in 7 cases. In one case a severe bronchospasm prevented from doing discectomy. Four levels in average could be released and fused. The thoracoscopic time was 240 mn in average and the total surgical time 430 mn. The bleeding of the thoracoscopic procedure was minimal (less than 200 cc) in all but one case (2000 cc). The duration of the chest tube was 4.4 days. At last follow up the cosmetic advantage was obvious. The angular correction of the Cobb angle was 63 per cent (similar to our isolated posterior instrumentation). The radiologic aspect of the anterior fusion seemed to be less satisfactory than the ones of classic thoracotomies (although we did not observe any non union). DISCUSSION Our experience and these results moderate the initial enthusiasm of these new techniques reported in literature. Our current indications are therefore patients at risk of crankshaft, and complementary anterior fusion of dysplasic spines. As to the major curves we still recommend the anterior release through a formal thoracotomy which allows a more complete disc excision on more levels and a more abundant graft, with a shorter surgical time, with an associated morbidity which does not seem superior.
Collapse
Affiliation(s)
- P Papin
- Division de Chirurgie Orthopédique, Université McGill Montreal Children's Hospital, Québec, Canada
| | | | | | | | | |
Collapse
|
16
|
Abstract
BACKGROUND Hepatitis C virus (HCV) infection is present in most but not all patients with type II mixed cryoglobulinemia. OBJECTIVE To investigate the role of GB virus C (GBV-C) in type II mixed cryoglobulinemia. DESIGN Retrospective study of serum and cryoprecipitate samples. SETTING Tertiary care hospital in Bergamo, Italy. PATIENTS 58 cryoglobulinemic patients, 35 of whom were treated with interferon-alpha. MEASUREMENTS GB virus C RNA was determined by a reverse-transcription polymerase chain reaction assay done by using primers derived from the conserved GBV-C helicase region. RESULTS GB virus C RNA was detected in serum specimens from 23 of 58 cryoglobulinemic patients (40% [95% CI, 27% to 53%]) and 1 of 145 healthy blood donors (0.7%) (P < 0.001). Twenty of the 23 patients with GBV-C RNA were simultaneously infected with HCV. Unlike antibodies to HCV and HCV RNA, GBV-C RNA did not concentrate in cryoprecipitate in patients co-infected with GBV-C and HCV. Furthermore, the therapeutic effectiveness of interferon-alpha in patients with coinfection was related to the disappearance of HCV RNA but not GBV-C RNA from serum. None of 3 patients with GBV-C infection alone had detectable GBV-C RNA in cryoprecipitate. CONCLUSIONS Infection with GBV-C, usually associated with HCV, is common in patients with type II mixed cryoglobulinemia but is unlikely to have a primary role in this disease.
Collapse
|
17
|
Marchesi D, Arlet V, Stricker U, Aebi M. Modification of the original Luque technique in the treatment of Duchenne's neuromuscular scoliosis. J Pediatr Orthop 1997; 17:743-9. [PMID: 9591975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Luque segmental instrumentation with Galveston technique for pelvic fixation is generally used in the correction of Duchenne's neuromuscular spinal deformities with pelvic obliquity. Particularly difficult is the control of the lumbopelvic junction. Instrumentation failures and only mediocre correction of pelvic obliquity are reported. To obtain better sacropelvic anchorage and to improve pelvic correction, this technique was modified with the introduction of sacral screws in each S-1 pedicle and a device for transverse traction between the caudal right-angle bends of the L-rods. From 1988 and 1993, 25 consecutive patients (mean age, 14 years) were operated on using this technique. Before surgery, mean spinal deformity measured 68 degrees (range, 46-90 degrees), and pelvic obliquity, 21 degrees (range, 7-45 degrees). At the last examination (mean follow-up, 36 months), mean spinal curvature was 18 degrees (range, 3-37 degrees), and pelvic obliquity was always <15 degrees (range, 0-15 degrees) with mean correction of 75%. No instrumentation failure or loss of correction >3 degrees could be observed in the entire series. In every patient, a good sitting balance could be restored after surgery.
Collapse
Affiliation(s)
- D Marchesi
- McGill University, Montreal, Quebec, Canada
| | | | | | | |
Collapse
|
18
|
Steffen T, Rubin RK, Baramki HG, Antoniou J, Marchesi D, Aebi M. A new technique for measuring lumbar segmental motion in vivo. Method, accuracy, and preliminary results. Spine (Phila Pa 1976) 1997; 22:156-66. [PMID: 9122795 DOI: 10.1097/00007632-199701150-00006] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN A direct method for three-dimensional in vivo spine kinematic studies was developed and used to measure segmental motion patterns in healthy subjects. OBJECTIVES To validate the new method, and to study the L3-L4 segmental motion patterns for complex dynamic movements. SUMMARY OF BACKGROUND DATA Conventional two-dimensional and three-dimensional radiographic methods have been used in the past to study spine kinematics. Few studies provided a direct approach to study segmental kinematics. No dynamic recordings of three-dimensional segmental motion patterns have been reported previously. METHODS In 16 healthy men, Kirschner wires were inserted in the spinous processes of L3 and L4. Electromagnetic tracking sensors were attached to the pins. Motion data recorded during ranging exercises were used with biplanar radiographs to calculate L3-L4 segmental motion patterns. Errors resulting from pin deformation and the dynamic accuracy of the tracking system were investigated thoroughly. RESULTS The average range of motion for flexion-extension was 16.9 degrees, for one side lateral bending 6.3 degrees and for one side axial rotation 1.1 degrees. Large intersubject variation was found in flexion-extension with values ranging from 7.1 to 29.9 degrees. Coupled motion patterns were found to be consistent among subjects in active lateral bending and inconsistent for active axial rotation. CONCLUSIONS This new method offers dynamic recording capabilities and a measurement error comparable with stereo radiographic methods. Repetitive ranging experiments are highly reproducible. The range of motion for axial rotation seems overestimated in previous cadaveric studies. Coupling patterns show large variations between individuals.
Collapse
Affiliation(s)
- T Steffen
- Orthopaedic Research Laboratory, McGill University, Montreal, Canada
| | | | | | | | | | | |
Collapse
|
19
|
Misiani R, Bellavita P, Fenili D, Vicari O, Marchesi D, Sironi PL, Zilio P, Vernocchi A, Massazza M, Vendramin G. Interferon alfa-2a therapy in cryoglobulinemia associated with hepatitis C virus. N Engl J Med 1994; 330:751-6. [PMID: 8107741 DOI: 10.1056/nejm199403173301104] [Citation(s) in RCA: 462] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Essential mixed cryoglobulinemia is frequently associated with hepatitis C virus (HCV) infection. A beneficial effect of interferon alfa therapy has been reported, but we do not know whether the antiviral activity of the drug affects the clinical and biochemical manifestations of disease. METHODS In a prospective randomized, controlled trial, we studied 53 patients with HCV-associated type II cryoglobulinemia. A group of 27 patients received recombinant interferon alfa-2a thrice weekly at a dose of 1.5 million units for a week and then 3 million units thrice weekly for the following 23 weeks. The 26 control patients did not receive anything apart from previously prescribed treatments. All patients were then followed for an additional 24 to 48 weeks. RESULTS Interferon was usually well tolerated, but it was permanently discontinued in two patients because of atrial fibrillation and depression. Two of the 26 patients in the control group were lost to follow-up. After the treatment period, serum HCV RNA was undetectable in 15 of the remaining 25 patients who received interferon alfa-2a, but in none of the controls. In comparison with the control group, the 15 patients with undetectable levels of HCV RNA in serum had significant improvement in cutaneous vasculitis (P = 0.04) and significant decreases in serum levels of anti-HCV-antibody activity (P = 0.007), cryoglobulins (P = 0.002), IgM (P = 0.002), rheumatoid factor (P = 0.001), and creatinine (P = 0.006). After treatment with interferon alfa-2a was discontinued, viremia and cryoglobulinemia recurred in all 15 HCV RNA-negative patients. On resumption of treatment, three of four patients had a virologic, clinical, and biochemical response. CONCLUSIONS The therapeutic efficacy of interferon alfa-2a in HCV-associated cryoglobulinemia is closely related to its antiviral activity, thus supporting the idea that HCV infection may be a cause of this disease.
Collapse
Affiliation(s)
- R Misiani
- Division of Nephrology and Dialysis, Ospedali Riuniti di Bergamo, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Abstract
Ten consecutive patients with severe spondylolisthesis were treated with reduction and pedicular fixation (four Internal Fixator instrumentations, six Cotrel-Dubousset instrumentations). There were six Grade III spondylolisthesis and four spondyloptoses at the L5/S1 level. All patients had complete clinical and radiographic evaluation with an average follow-up of 56 months (range, 43-75 months). The percentage of slippage averaged 78.5% preoperatively and 39.6% postoperatively. The slip angle averaged 43 degrees preoperatively and 17 degrees postoperatively. Four patients with spondyloptosis were treated with combined posterolateral and interbody fusion and had solid fusion without loss of reduction. Five of six patients in whom reduction and stabilization was performed by a single posterolateral fusion demonstrated loss of reduction, nonunion, and implant failure. Four of these patients were reoperated. Ultimately all patients had resolution of pain, solid fusion, and no further slip progression. Reduction, pedicular fixation, and combined posterolateral and interbody fusion is a technically demanding procedure, which should be reserved for selected patients. Pedicular fixation systems may only allow permanent reduction and stabilization of high-grade spondylolisthesis in conjunction with a combined interbody and posterolateral fusion.
Collapse
Affiliation(s)
- N Boos
- Department of Orthopaedic Surgery, Inselspital University of Berne, Switzerland
| | | | | | | |
Collapse
|
21
|
Boos N, Marchesi D, Aebi M. Survivorship analysis of pedicular fixation systems in the treatment of degenerative disorders of the lumbar spine: a comparison of Cotrel-Dubousset instrumentation and the AO internal fixator. J Spinal Disord 1992; 5:403-9. [PMID: 1490037 DOI: 10.1097/00002517-199212000-00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We retrospectively analyzed the frequency and clinical consequences of pedicular fixation system failure in 50 patients who underwent Cotrel-Dubousset transpedicular instrumentation (CDI), and 46 patients who underwent AO internal fixator (IF) instrumentation for similar indications. After 2 years, 14 implants in the CDI group and 13 in the IF group had failed. The overall probability of implant survival was similar in both groups (CDI, 71.9% versus IF, 71.7%). However, more implant failures were associated with nonunion, loss of reduction, and nerve-root compromise in the IF group (four versus none) than in the CDI group. Implant failure usually occurred after solid fusion, and did not significantly affect the short-term clinical results. Therefore, implant failure does not a priori indicate failure of the operation.
Collapse
Affiliation(s)
- N Boos
- Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland
| | | | | |
Collapse
|
22
|
Misiani R, Bellavita P, Fenili D, Borelli G, Marchesi D, Massazza M, Vendramin G, Comotti B, Tanzi E, Scudeller G. Hepatitis C virus infection in patients with essential mixed cryoglobulinemia. Ann Intern Med 1992; 117:573-7. [PMID: 1326246 DOI: 10.7326/0003-4819-117-7-573] [Citation(s) in RCA: 374] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To study the association between hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia. SETTING Wards and clinics of the Ospedali Riuniti di Bergamo and Ospedale di Treviglio e Caravaggio, Italy. PATIENTS Fifty-one patients with essential mixed cryoglobulinemia associated with glomerulonephritis and 45 controls with noncryoglobulinemic glomerulopathies. MEASUREMENTS Antibodies to hepatitis C virus (anti-HCV) in sera from patients with essential mixed cryoglobulinemia and from controls, using two enzyme-linked immunosorbent assays (c100 ELISA and c22/c200 ELISA) and a recombinant immunoblot assay (4-RIBA); cryoprecipitate anti-HCV before and after use of dithiothreitol, a substance able to destroy IgM antibodies with rheumatoid factor activity, in patients with essential mixed cryoglobulinemia; serum HCV RNA by polymerase chain reaction in patients with essential mixed cryoglobulinemia. RESULTS In patients with essential mixed cryoglobulinemia, the c22/c200 ELISA detected anti-HCV in 98% of serum samples (95% CI, 90% to 100%), whereas the rate of reactivity remained at 2% (CI, 0% to 12%) in the control group (P less than 0.0001). These results were confirmed by the 4-RIBA in 66% of patients with essential mixed cryoglobulinemia. The study of cryoprecipitate by c100 ELISA showed anti-HCV in 41% (Cl, 28% to 56%) of patients. After dithiothreitol, the rate of reactivity increased to 94% (CI, 84% to 99%; P less than 0.0001 by the McNemar paired chi-square test), suggesting that the elimination of rheumatoid factor leads to unmasking of anti-HCV in cryoprecipitate. Polymerase chain reaction detected HCV RNA in 13 of 16 sera from patients with essential mixed cryoglobulinemia. CONCLUSIONS The extremely high prevalence of anti-HCV in serum and cryoprecipitate along with the frequently associated serum HCV RNA suggests a close relation between essential mixed cryoglobulinemia and chronic HCV infection.
Collapse
|
23
|
Abstract
We treated 50 consecutive patients with Cotrel-Dubousset instrumentation (CDI) for symptomatic spondylolisthesis. Average follow-up was 25 months. Fusion in situ was performed in 32 of 44 patients with mild spondylolisthesis, while 12 patients had reduction in conjunction with neural decompression. Two of six patients with severe spondylolisthesis who were treated via a single posterior approach had loss of reduction and nonunion. In another patient a Grade III spondylolisthesis could not be reduced via a posterior approach. Seventy-six percent of the patients had a good clinical result. The rate of solid fusion was 96%. One nerve root compromise recovered completely. One superficial wound infection healed uneventfully. This study suggests that combined anterior and posterior fusion is required for permanent and sufficient correction of severe spondylolisthesis even with CDI. Low-grade spondylolisthesis should be reduced only in conjunction with neural decompression.
Collapse
Affiliation(s)
- N Boos
- Department of Orthopaedic Surgery, University of Bern, Inselspital, Switzerland
| | | | | |
Collapse
|
24
|
Abstract
This study analyzed 86 patients who sustained a cervical spine injury and who had 93 anterior surgical interventions of the cervical spine. The average age of the patients was 39 years, the mean follow-up 40 months. Twenty-two patients had predominantly vertebral body fractures (burst or tear-drop fractures) and were treated by bisegmental anterior bone grafting and plating. Sixty-four patients had predominantly posterior lesions, either discoligamentous or osteoligamentous, and were treated by unisegmental bone grafting and plating. Forty-three patients were neurologically intact. There were no relevant complications except in one patient, who needed reoperation because of a secondary redislocation due to a technically insufficient osteosynthesis. The technique of anterior bone grafting and plating is shown to be straight-forward, atraumatic, and reliable for predominantly anterior lesions as well as for posterior injuries when performed properly. This clinical experiences does not support experimental data and earlier clinical work, which advocate posterior surgery over anterior surgery and assert that anterior surgery should not be done in predominantly posterior lesions.
Collapse
Affiliation(s)
- M Aebi
- Department of Orthopedic Surgery, University of Bern, Inselspital, Switzerland
| | | | | |
Collapse
|
25
|
Misiani R, Marchesi D, Tiraboschi G, Gualandris L, Pagni R, Goglio A, Amuso G, Muratore D, Bertuletti P, Massazza M. Urinary albumin excretion in normal pregnancy and pregnancy-induced hypertension. Nephron Clin Pract 1991; 59:416-22. [PMID: 1758531 DOI: 10.1159/000186601] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We measured the urinary excretion of albumin in 67 healthy primigravidae, at monthly intervals, from 16 to 36 weeks of gestation and 12 weeks postpartum. Of the 67 primigravidae, 55 completed a normal pregnancy and 12 developed pregnancy-induced hypertension. In the latter group, an additional measurement of urinary albumin excretion was performed at 24 weeks postpartum. The aims of the study were: to look for changes of urinary albumin excretion during the progression of normal pregnancy; to assess if microalbuminuria could be an early feature of pregnancy-induced hypertension; to evaluate the effects of physical activity on the excretion of albumin in normal pregnancy and pregnancy-induced hypertension. In contrast with glomerular hyperfiltration and increased urinary total protein, two recognized characteristics of the pregnant state, we found that normal primigravidae, during the day, excrete significantly less albumin (p between less than 0.01 and less than 0.001) in comparison with the postpartum period and nonpregnant women. Normal primigravidae, as a group, showed parallel changes of urinary albumin excretion and diastolic blood pressure throughout pregnancy and postpartum, suggesting an important physiologic role of hemodynamic factors in regulating glomerular permeability to albumin. The daytime urinary albumin excretion in patients developing pregnancy-induced hypertension was significantly higher (p between less than 0.005 and less than 0.001) than in normal pregnancy from the 28th gestational week onwards. The increased urinary albumin excretion preceded the onset of hypertension and tended to persist long after blood pressure had returned to normal levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- R Misiani
- Divisione di Nefrologia e Dialisi, Ospedali Riuniti di Bergamo, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Arici C, Gregis GP, Marchesi D, Mingardi G, Mecca G, Bellavita P. Effectiveness of a preventive programme for non-A, non-B hepatitis in a large dialysis unit. Nephrol Dial Transplant 1990; 5:902-3. [PMID: 1965018 DOI: 10.1093/ndt/5.10.902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
|
27
|
Marchesi D, Schneider E, Glauser P, Aebi M. Analyse morphométrique des pédicules thoraco-lombaires et lombaires, étude anatomo-radiologique. Surg Radiol Anat 1988. [DOI: 10.1007/bf02116454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
28
|
Abstract
The geometric properties of 380 vertebral pedicles, ranging from T6 to L5, were analysed. Measurement were made directly from the specimens as well as from roentgenograms. The parameters considered were the horizontal and vertical pedicle diameters, pedicle angles in the transverse and sagittal planes, and the transverse and anteroposterior widths of the spinal canal and vertebral body. In addition, the length of the pedicle and the length of the pedicle including the vertebral body to the anterior cortex were measured along the pedicle axis and in a line parallel to the midline of the vertebral body. The smallest horizontal and vertical pedicle diameters were found at vertebral levels from T6 to T10. The correlation between pedicle widths and screw dimensions is obvious. In the transverse plane, the pedicle angle diverged from the vertebral body at all levels, except at T12. In the sagittal plane, the pedicles were angled cephalad from T6 to L3 and slightly caudally at L5. Knowledge of the length of the pedicle to the anterior vertebral body cortex is very important for safe screw purchase. At all levels, with the exception of T12, this length was found to be significantly greater along the pedicle axis than along a line parallel to the midline of the vertebral body.
Collapse
Affiliation(s)
- D Marchesi
- Department of Orthopedic Surgery, University of Bern, Switzerland
| | | | | | | |
Collapse
|
29
|
Belotti L, Cassina G, Mosconi G, Seghizzi P, Marchesi D, Mecca G. [Acute hepatonephritis in a subject occupationally exposed to chloroform]. G Ital Med Lav 1988; 10:73-5. [PMID: 3256518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We describe a case of acute hepatonephritis in a worker of a pharmaceutical factory, due to sporadic and short exposures to chloroform at levels even 70 times higher than its TLV.
Collapse
Affiliation(s)
- L Belotti
- Istituto di Medicina del Lavoro, Ospedali Riuniti di Bergamo
| | | | | | | | | | | |
Collapse
|
30
|
Preitner J, Gertsch P, Marchesi D, Mosimann R. [Tumors of the biliary tract]. Helv Chir Acta 1985; 51:683-7. [PMID: 3972618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
31
|
Frampton G, Parbtani A, Marchesi D, Duffus P, Livio M, Remuzzi G, Cameron JS. In vivo platelet activation with in vitro hyperaggregability to arachidonic acid in renal allograft recipients. Kidney Int 1983; 23:506-13. [PMID: 6405075 DOI: 10.1038/ki.1983.48] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Renal allograft recipients were investigated to determine the extent and possible nature of in vivo platelet activation. In 92 allografted patients stable for more than 4 months' duration, intraplatelet serotonin in circulating platelets was depleted significantly. In a further 16 patients studied serially for 12 to 16 weeks following transplantation, intraplatelet serotonin fell abruptly within 4 days from transplantation to very low levels, and remained thus for 10 weeks, rising toward normal at about 12 weeks. Although some patients showed abrupt falls in intraplatelet serotonin coincident with acute rejection episodes, there was no difference in intraplatelet serotonin in seven patients whose grafts functioned well immediately and remained stable, and seven in whom repeated rejection led to graft loss within 3 months. Thus, these tests of platelet function do not permit diagnosis of rejection or prediction of graft outcome. Plasma platelet factor 4 (PF4) concentrations, in contrast, were normal in most patients during the first 6 weeks after grafting, then rose and remained abnormal up to 13 years following the allograft in the long-term stable graft recipients. This discrepancy suggests a different mode of platelet activation in the first few weeks after grafting from subsequent months. Despite universal depletion of intraplatelet amines and alpha-granule contents only four out of 14 early allograft recipients had an abnormal bleeding time, and platelet aggregation thresholds with adenosine-5'-diphosphate and collagen were not different from controls. However, thresholds for platelet aggregation with arachidonic acid were reduced significantly (P less than 0.01) and thromboxane B2 generation was increased in vitro. There was no correlation between depletion of intraplatelet serotonin and circulating platelet-agglutinating material, but nine of 17 biopsy specimens from rejecting allografts taken during the first 3 months showed extensive glomerular localization of platelet membrane antigens and PF4.
Collapse
|
32
|
|
33
|
|
34
|
Remuzzi G, Zoja C, Marchesi D, Schieppati A, Mecca G, Misiani R, Donati MB, de Gaetano G. Plasmatic regulation of vascular prostacyclin in pregnancy. Br Med J (Clin Res Ed) 1981; 282:512-4. [PMID: 6780103 PMCID: PMC1504327 DOI: 10.1136/bmj.282.6263.512] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Activity of prostacyclin-stimulating factor was measured in six normal, non-pregnant women, six women in early normal pregnancy, six in late normal pregnancy, and six in late pregnancy complicated by severe pre-eclampsia. The activity was lower in the women in late pregnancy than in those in early pregnancy and the controls but was about normal in those with severe pre-eclampsia. These results may be relevant to the physiology of pregnancy and the pathogenesis of pre-eclampsia.
Collapse
|
35
|
|
36
|
Remuzzi G, Marchesi D, Zoja C, Muratore D, Mecca G, Misiani R, Rossi E, Barbato M, Capetta P, Donati MB, de Gaetano G. Reduced umbilical and placental vascular prostacyclin in severe pre-eclampsia. Prostaglandins 1980; 20:105-10. [PMID: 6996034 DOI: 10.1016/0090-6980(80)90010-6] [Citation(s) in RCA: 188] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Prostacyclin production was significantly depressed in foetal and placental vascular tissues from five patients with severe pre-eclampsia in comparison to vascular tissues from women with uncomplicated pregnancy. Such an abnormality may be responsible for a reduced blood flow and defective fetal nutrition thus playing a major role in the pathogenesis of this syndrome.
Collapse
|
37
|
Remuzzi G, Marchesi D, Schieppati A, Poletti E, Mecca G, Donati MB, de Gaetano G, Rossi EC. Aspirin and thrombosis in patients undergoing hemodialysis. N Engl J Med 1980; 302:1420-1. [PMID: 7374702 DOI: 10.1056/nejm198006193022515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
38
|
|
39
|
Remuzzi G, Misiani R, Marchesi D, Livio M, Mecca G, de Gaetano G, Donati MD. Treatment of the hemolytic uremic syndrome with plasma. Clin Nephrol 1979; 12:279-84. [PMID: 393447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Two patients with the hemolytic uremic syndrome were treated with plasma exchange an infusion: in both cases, the reduced platelet count reverted to normal values and the microangiopathic anemia ceased within a few days. Systemic blood pressure and requirement for antihypertensive drug therapy were also markedly reduced following treatment with plasma. Venousprostacyclin (antiplatelet aggregating) activity was undetectable in both patients before but was restored after treatment with plasma. The plasma samples collected before, but not those collected at various intervals after replacement therapy, had decreased capacity to stimulate prostacyclin activity in rat aortic rings. It is suggested that in patients with the hemolytic uremic syndrome or with other clinical conditions which can be included under this rubric (such as thrombotic thrombocytopenic purpura) a plasma factor is lacking which stimulates prostacyclin activity. Plasma would supply such a missing factor, thus representing a rational treatment for some of the life-threatening manifestations (thrombocytopenia, hemolytic anemia, hypertension) of this severe syndrome.
Collapse
|
40
|
Remuzzi G, Misiani R, Muratore D, Marchesi D, Livio M, Schieppati A, Mecca G, de Gaetano G, Donati MB. Prostacyclin and human foetal circulation. Prostaglandins 1979; 18:341-8. [PMID: 394195 DOI: 10.1016/s0090-6980(79)80052-0] [Citation(s) in RCA: 86] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Tissues from human umbilical cord arteries and placental veins generated much greater prostacyclin activity than vessels from normal adults. High prostacyclin generation could contribute to maintaining the low peripheral vascular resistance typical of foetal circulation in which blood pressure is low despite very high cardiac output.
Collapse
|
41
|
Remuzzi G, Marchesi D, Cavenaghi AE, Livio M, Donati MB, de Gaetano G, Mecca G. Bleeding in renal failure: a possible role of vascular prostacyclin (PGI2). Clin Nephrol 1979; 12:127-31. [PMID: 389502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Specimens of venous tissues from a group of 25 patients with chronic uremia and 7 patients with acute renal failure generated significantly higher PGI2-like (platelet aggregation inhibiting) activity than venous tissues from 30 normal subjects. After repeated washings, when this activity could barely be detected in the controls, pronounced inhibitory activity was still evident in samples containing venous tissues from uremic patients. Both prolonged bleeding times and increased PGI2-like activity returned to normal in 4 acute uremic patients on restoration of their renal function. These findings may be relevant to the pathogenesis of bleeding in renal failure.
Collapse
|
42
|
Remuzzi G, Marchesi D, Misiani R, Mecca G, de Gaetano G, Donati M. Familial Deficiency of a Plasma Factor Stimulating Vascular Prostacyclin (PGI2) Activity. Thromb Haemost 1979. [DOI: 10.1055/s-0039-1687212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We previously reported successful treatment with plasma in patients with thrombotic micro angiopathy and defective vascular PGI2 activity and suggested that a defect in a plasma factor stimulating PGI2 synthesis might be implicated in the pathogenesis. We report here that in one of these patients the plasma defect was still detectable 1 year after clinical remission (without recurrencies). Two of this patient’s 4 children had a simile,though less severe, plasma defect. The proposita is a 54-year-old woman admitted with a clinical and laboratory picture of haemolytic uraemic syndrome. Unlike normal plasma, the patient’s plasma had a low capacity to stimulate PGI2 production by rat aortic rings (previously washed until their endogenous PGI2 activity was exhausted). After plasma treatment the patient’s plasma behaved normally in this respect, but again appeared deficient at outpatient follow-up. PGI2 stimulating activity was normal in 2 daughters but consistently low (20-60% of control) in both patient’s sons. None of them had any history or clinical signs of microangiopathic disorders. Detection of this plasma defect in apparently healthy subjects and in patients who have recovered from thrombotic microangiopathic episodes could have clinical implications. Our observations support previous suggestions that some people have a congenital (or hereditary) predisposition to thrombotic microangiopathy.(Supported by Ass. Berg. Mal. Ren. and Italian CNR, Rare disease Project).
Collapse
|
43
|
Remuzzi G, Marchesi D, Misiani R, Mecca G, de Gaetano G, Donati MB. Familial deficiency of a plasma factor stimulating vascular prostacyclin activity. Thromb Res 1979; 16:517-25. [PMID: 390760 DOI: 10.1016/0049-3848(79)90098-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
44
|
|
45
|
Remuzzi G, Marchesi D, Livio M, Cavenaghi AE, Mecca G, Donati MB, de Gaetano G. Altered platelet and vascular prostaglandin-generation in patients with renal failure and prolonged bleeding times. Thromb Res 1978; 13:1007-15. [PMID: 373157 DOI: 10.1016/0049-3848(78)90229-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
46
|
Remuzzi G, Misiani R, Marchesi D, Livio M, Mecca G, de Gaetano G, Donati MB. Haemolytic-uraemic syndrome: deficiency of plasma factor(s) regulating prostacyclin activity? Lancet 1978; 2:871-2. [PMID: 81415 DOI: 10.1016/s0140-6736(78)91573-8] [Citation(s) in RCA: 240] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
It is suggested that patients with the haemolytic-uraemic syndrome and related disorders (such as thrombotic thrombocytopenic purpura) lack a plasma factor which stimulates prostacyclin (P.G.I2) activity. Normal plasma would supply the missing factor and is a rational treatment for some life-threatening symptoms (thrombocytopenia, haemolytic anaemia, hypertension) of this syndrome.
Collapse
|
47
|
Remuzzi G, Livio M, Cavenaghi AE, Marchesi D, Mecca G, Donati MB, de Gaetano G. Unbalanced prostaglandin synthesis and plasma factors in uraemic bleeding. A hypothesis. Thromb Res 1978; 13:531-6. [PMID: 369029 DOI: 10.1016/0049-3848(78)90138-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|