Impact of end user involvement in implementing guidelines on routine pre-operative tests.

Objectives: To assess the impact of health professionals' involvement in the implementation of practice guidelines aimed at reducing the use of pre-operative tests in patients at low anaesthetic risk undergoing elective surgery.

Intervention: A 6 month (September 1997 to February 1998) strategy based upon organization of local meetings involving health professionals from six hospitals of Canton Ticino (Switzerland).

Design: Observational study (pre/post) of pre-operative test utilization between March 1996 and December 1998.

[Evaluation of the impact of guidelines for rationalizing the prescription of preop tests for patients ASA 1 and 2 undergoing elective surgery].

Objectives: To evaluate the impact of implementation of guidelines aimed at reducing the use of laboratory and diagnostic preoperative tests in patients with low anesthesiologic risk, admitted to six public hospital of Ente Ospedaliero Cantonale in Cantone Ticino (Switzerland).

Design: Observational study.

Methods: Time series analysis of patterns of use of preoperative tests, on 14,585 patients admitted to public hospitals form March 1996 to June 1998.

Cerebrovascular carbon dioxide reactivity during exposure to equipotent isoflurane and isoflurane in nitrous oxide anaesthesia.

We have studied the effects of hypocapnia on cerebrovascular changes in two MAC-equivalent anaesthetic regimens, using the transcranial Doppler technique as an index of cerebral blood flow (CBF) in 24 healthy ASA I patients undergoing spinal surgery. Eight of the patients were subjected to carbon dioxide reactivity challenges in the awake state. Before surgery, the other 16 patients received, in random order, either 1.

Studies on co-localization of 7B2 and pancreatic hormones in normal and tumoural islet cells.

The distribution of protein 7B2, a protein with structural characteristics of GTP-binding proteins, has been studied in normal pancreatic islets and in a series of 70 pancreatic endocrine tumours with emphasis on the co-localization of 7B2 and the different pancreatic hormones. Although all cell types of normal islets were found to store 7B2, variations from intense expression to absence of reaction were seen within each cell type. In particular, B cells showed intense immunostaining for 7B2 in small compact islets and weak or no staining in larger islets with lobular arrangement.

Gastric carcinoids and their precursor lesions. A histologic and immunohistochemical study of 23 cases.

A histologic and immunohistochemical study was carried out in 23 unselected nonantral gastric carcinoids and their precursor lesions classified according to Solcia et al. None of the patients showed Zollinger-Ellison syndrome. Two variants of carcinoids showing distinctive pathologic and pathogenetic characteristics were identified on the basis of presence or absence of associated chronic atrophic gastritis type A (A-CAG).

Mandibular leiomyoma in an infant. Report of a case.

A case of mandibular leiomyoma in a 8-month-old baby is reported. This is the 5th case of intrabony leiomyoma of the jaws reported so far. The tumor presented as a symptomless swelling of the mandibular ramus and required a limited resection.

Quantitative ultrastructure of endocrine cells of oxyntic mucosa in Zollinger-Ellison syndrome. Correspondence with light microscopic findings.

The endocrine cells of the oxyntic mucosa of five patients with longstanding Zollinger-Ellison syndrome were quantitatively investigated with electron microscopy and two light microscopic methods (Grimelius and immunostaining for chromogranin A). Ultrastructurally, the volume density of endocrine cells was 3.2% +/- 1.

Glycoprotein hormone alpha subunit in endocrine cells of human oxyntic mucosa. Studies on its relation to neuroendocrine tumors.

Expression of the alpha-subunit of glycoprotein hormones is an acquired feature of the endocrine cells of the oxyntic mucosa in patients with sustained serum levels of gastrin, and may be related to the hyperplasia-carcinoid sequence occurring in these patients. In the present study we have investigated the intragastric cellular localization and the circulating levels of alpha-subunit in a patient with Zollinger-Ellison syndrome. In this patient we have found that: 1) Endocrine cells accounted for 2.

Composite carcinoid-adenocarcinoma of the stomach associated with multiple gastric carcinoids and nonantral gastric atrophy.

A case of multiple gastric carcinoids and nonantral atrophic gastritis in which the larger tumor was a composite carcinoid-adenocarcinoma is presented. The two components of the composite tumor immunohistochemically showed clear-cut diverging functional differentiations although the available evidence supported a common histogenesis from the metaplastic intestinal epithelium of the gastric mucosa. The carcinoid tissue of the composite tumor, which showed "atypical" features, also differed from the other, pure carcinoids, in which the histologic appearance was "typical.

Structure and function of endocrine cells in the oxyntic (acid-secreting) mucosa of human stomach.

The morphological and functional characteristics of the endocrine cells of the oxyntic (acid-secreting) mucosa of the human stomach, a target of the trophic effect of gastrin, are reviewed. In healthy subjects these cells account for 0.90 +/- 0.

Action of dopamine and serotonin on the membrane potential of cultured astrocytes.

The actions of dopamine, apomorphine and serotonin on the membrane potential of cultured astrocytes from rat spinal cord and striatum were examined. All three compounds caused a hyperpolarization of the majority of astrocytes tested. A small number of cells was depolarized and on a relatively large number of cells the amines had no effect.

[Post-heparin lipase activity in beta-thalassemia major: preliminary data].

We studied serum lipids and post-heparin triglyceride lipase activities in 8 patients with Beta-Thalassaemia Major, under high transfusion programme and regular chelation therapy and in 8 control subjects. Total cholesterol and HDL-cholesterol were significantly lower in patients with Cooley's anaemia, whereas triglyceride levels did not differ in the two groups. Post-heparin triglyceride lipase activities were determined according with the method of Krauss et A1.

[Changes in HDL subfractions in patients with type I diabetes mellitus before and after metabolic control].

In order to further investigate the behaviour of high density lipoproteins in diabetes mellitus, we studied HDL subclasses, HDL2 and HDL3, in 10 patients with newly detected, untreated insulin-deficient diabetes before starting insulin treatment and after getting a good metabolic control. We used the extractive method of Abell to determine HDL-cholesterol after LDL and VLDL precipitation with polyanions and HDL3-cholesterol after HDL2 precipitation with dextransulphate 15,000 m.w.