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Biomedical subjects

A Carbone

Publications and source records attributed to A Carbone.

At least 325 records · Page 18Linked to original sources
PubMed1993

Evaluation of vesico-urethral and sweating function in disorders presenting with parkinsonism.

Investigation of vesico-urethral and sweating function was performed in twelve patients with classical idiopathic Parkinson's disease and ten patients with parkinsonism associated with features suggestive of more extensive involvement of the nervous system, as in the Shy-Drager syndrome. The urodynamic studies revealed detrusor hyperreflexia with reduction of maximal cystometric capacity in only one patient with Parkinson's disease (8%), but in nine patients with parkinsonism associated with other features (90%). Urethral sphincter electromyography did not indicate denervation in any patient of either group. Delayed or incomplete relaxation of the urethral sphincter during micturition was observed in seven patients with Parkinson's disease (58%) and in two patients of the other group (20%). Decreased sweating responses were found in both groups of patients when compared with control subjects. Hypohidrosis was more pronounced in parkinsonism associated with other features than in Parkinson's disease. Differences in sweating between the two sides of the body were observed in both groups of patients. Although there are differences in vesico-urethral and sweating function, they do not precisely differentiate between patients with classical Parkinson's disease and those with parkinsonism associated with features suggestive of more extensive involvement of the nervous system.

Aged↗
PubMed1993

The nonlymphoid microenvironment of reactive follicles and lymphomas of follicular origin as defined by immunohistology on paraffin-embedded tissues.

Twenty-five reactive lymph nodes, 10 palatine tonsils, and 72 B-cell non-Hodgkin's lymphomas (NHLs) of supposed follicular origin were investigated in an immunohistologic study of fixed, paraffin-embedded tissues using a panel of monoclonal antibodies reactive with antigens resistant against fixation and paraffin-embedding techniques together with polyclonal antibodies. The results concerning the microenvironmental organization of reactive lymphoid follicles confirmed that the distribution of CD21+ and CD23+ dendritic reticulum cells, vimentin+ fibroblastic reticulum cells, and CD68+ tingible-body macrophages is heterogeneous with reference to their immunostaining patterns and topographic localization within the germinal center and mantle zone. Moreover, a close microenvironmental similarity between the follicular lymphomas of supposed germinal center or mantle zone origin and their normal counterparts was noted. The study of the microenvironment of the B-zone small lymphocytic lymphoma cases, showing the same distribution patterns for the nonlymphoid cells as seen in mantle zone lymphomas, corroborated the supposed follicular origin of this unusual variant of small lymphocytic lymphoma. In conclusion, this study shows that monoclonal antibodies recognizing CD21, CD23, and CD68 antigens may be valuable additions to vimentin, S-100 protein, laminin, and type IV collagen antibodies for investigating the microenvironmental organization of lymphoid tissues in both normal and neoplastic conditions.

Biomarkers↗
PubMed1993

KP1 (CD68)-positive large cell lymphomas: a histopathologic and immunophenotypic characterization of 12 cases.

CD68/KP1 antigen expression in a series of 298 non-Hodgkin's lymphoma (NHL) cases, including 41 cases of CD30/Ki-1-positive anaplastic large cell (Ki-1+ ALC) lymphomas, was examined. Among the cases in this series, 12 large cell NHLs, including five centroblastic (G group according to the Working Formulation) NHLs, three immunoblastic (H group) NHLs, and four Ki-1+ ALC lymphomas, were found to express KP1. By extensive immunophenotypic analysis and in situ hybridization, KP1-positive large cell lymphomas of the G and H groups were assigned a B-cell phenotype. The pattern of KP1 staining usually consisted of localized small to medium-sized cytoplasmic dots; only two cases showed diffuse fine granular reactivity. In two of the four Ki-1+ ALC lymphomas tumor cells failed to express a B- or T-cell phenotype and stained positively for lysozyme, whereas in the other two cases they showed a hybrid T/histiocytic, phenotypic profile. KP1 staining of Ki-1+ ALC lymphoma cells was usually intense and showed a diffuse granular cytoplasmic pattern; tumor cells also expressed the CD13 antigen and showed strong reactivity with the anti-CD68 EBM11 antibody. Our results suggest that certain subsets of large "blastic" B-cell lymphomas may simultaneously express the CD68/KP1 histiocyte-specific marker and other myeloid-associated antigens, indicating the necessity of using a multiparameter approach in the determination of cell lineage. Moreover, this study, which demonstrates that the expression of CD68/KP1 and CD30 antigens is not mutually exclusive, supports the view that a fraction of cases diagnosed as Ki-1+ ALC lymphomas (at least those with KP1 expression along with the lack of B- or T-antigen expression) represent true histiocytic lymphomas despite the Ki-1+ phenotype.

Adolescent↗
PubMed1993

Increased frequency of lymphocyte depletion and mixed cellularity subtypes of Hodgkin's disease in HIV-infected patients. Italian Cooperative Group on AIDS and Tumours.

To assess whether the histological pattern of Hodgkin's disease (HD) in human immunodeficiency virus (HIV)-infected patients differs from that among HD patients without HIV infection, the observed (O) number of HD cases according to histological subtype [i.e. lymphocyte predominance (LP), nodular sclerosis (NS), mixed cellularity (MC) and lymphocyte depletion (LD)] among 92 Italian HIV-infected patients was compared with the expected (E) number derived from two case series of HD from Europe and the U.S.A. (14,315 cases of HD) and Italy (125 cases). After age standardisation, the O/E ratio was computed, along with its 95% confidence interval (CI). In comparison with 125 Italian HD patients not infected with HIV, a 4-fold higher frequency of the MC histological subtype (95% CI: 2.9-5.1) and an approximately 12-fold higher frequency of the LD subtype (95% CI: 7.0-18.0) emerged among HIV-infected patients. These results were substantially confirmed when the comparison was made with the case series from Europe and the U.S.A. These data show different histological patterns of HD between a group of HIV-infected patients and HD patients from the general population. Although caution is needed in their interpretation, the study results seem to indicate that HD of the MC or LD subtypes may be considered an AIDS-related malignancy.

Adult↗
PubMed1993

Mixed renal tumor with carcinomatous and fibroleiomyomatous components, associated with angiomyolipoma in the same kidney.

A 54-year-old woman, without the stigmas of tuberous sclerosis, underwent radical nephrectomy for simultaneous occurrence of an Angiomyolipoma (AML) and a carcinomatous and fibroleiomyomatous mixed tumor in the same kidney, diagnosed by computerized tomography, selective renal arteriography and anatomopathological examination. The peculiar findings of the mixed neoplasia, characterized by a mixture of carcinomatous and fibroleiomuscular components are stressed. The latter component is considered to be a proliferative element interacting with the carcinomatous one. After review of the pertinent literature, this is the first example of an association of AML and renal cell carcinoma (RCC) in which the RCC is constituted by a mixture of carcinomatous and fibroleiomyomatous cells.

Adenocarcinoma, Clear Cell↗
PubMed1993

Type 2 Epstein-Barr virus genome and latent membrane protein-1 expression in a T-cell-rich lymphoma of probable B-cell lineage.

In a 79-year-old white woman, a lymphoproliferative disorder that was associated with type 2 Epstein-Barr virus (EBV) infection or reactivation, documented by three subsequent lymph node biopsies, was studied. After an initial phase with features of reactive lymphadenopathy with exhaustion of the follicular germinal centers and depletion of the B-cell lymphoid population, the disease evolved to a T-cell-rich lymphoma in which a clonal cell population of probable B-cell origin was identified. Such clonal cell population harbored the viral genome and expressed EBV latent membrane protein-1 but not EBV nuclear antigen-2. The implications of immunologic interactions between the clonal EBV-infected cells and the reactive T-cell component in the pathogenetic process are discussed.

Aged↗
PubMed1993

Demonstration of Epstein-Barr viral genomes by in situ hybridization in acquired immune deficiency syndrome-related high grade and anaplastic large cell CD30+ lymphomas.

From September 1984 through December 1991, of those with human immunodeficiency virus infection seen at the acquired immune deficiency syndrome unit of the Centro di Riferimento Oncologico, Aviano, Italy, 71 patients had systemic non-Hodgkin's lymphomas. The most frequent histotypes were small noncleaved cell, anaplastic large cell (ALC) CD30/BerH2+, and large cell immunoblastic. In 22 representative cases of these histotypes, including 9 of small noncleaved cell, 9 of ALC CD30/BerH2+, and 4 of immunoblastic non-Hodgkin's lymphomas, Epstein-Barr virus genetic information was assessed by in situ hybridization and correlated with histologic and immunophenotypic findings. Expression of B-cell associated markers, usually including CD19, CD20, CD22, CDw75, and CD74, was found in 17 of the 22 evaluated cases. All small noncleaved cell and immunoblastic cases and four cases of ALC lymphomas expressed B-cell immunophenotypes, whereas the remaining ALC cases were immunologically undetermined. In situ hybridization detected Epstein-Barr virus in 12 of 22 cases (54.5%). Seven of nine ALC lymphomas were positive, as were three of five small noncleaved cell type (Burkitt's lymphoma), one of four small noncleaved cell type (non-Burkitt's variant), and one of four large cell immunoblastic type. The results of this study indicate that Epstein-Barr virus genomes might be identified in more than 50% of the evaluated high grade non-Hodgkin's lymphomas; this association occurred significantly more often in the small noncleaved cell lymphomas resembling endemic Burkitt's lymphoma (60%) and with ALC CD30/BerH2+ lymphomas (77.8%). These findings support the notion that Epstein-Barr virus may play a role in the development of non-Hodgkin's lymphomas in a proportion of human immunodeficiency virus-infected patients.

Antigens, CD↗
PubMed1993

Epirubicin and ifosfamide in advanced soft tissue sarcomas.

BACKGROUND: To evaluate the feasibility, toxicity and efficacy of the combination of (IFO) ifosfamide and epirubicin (EPI) given at conventional doses for monochemotherapy, we started a phase II study in advanced/metastatic soft tissue sarcoma patients. PATIENTS AND METHODS: Treatment consisted of: epirubicin 75 mg/m2 i.v. day 1; IFO 1.8 g/m2 days 1 to 5; MESNA 20% of the IFO dose at 4-hour intervals three times a day during IFO administration. Cycles were given every 3-4 weeks for at least three cycles. RESULTS: The overall response rate for non-visceral sarcomas (51 pts) was 31% (95% confidence limits +/- 13%). Among the 13 visceral sarcomas no response was seen for the leiomyosarcomas of the gastrointestinal tract, whereas one complete and one partial remission were observed for the uterine sarcomas. The duration of response was 10 months (range 5-34+) for complete responses and 9 (range 4-42+) for partial responses. The median survival for responders is 18 months (range 2-60+) and for non-responders 10 months (range 1-33) (p < 0.004). CONCLUSIONS: This combination proved to be feasible and tolerable. The overall response rate does not appear to be superior to those with other standard treatments, but it should be pointed out that our patient population was totally unselected.

Adolescent↗
PubMed1993

Human immunodeficiency virus-associated systemic lymphomas may be subdivided into two main groups according to Epstein-Barr viral latent gene expression.

PURPOSE: We report a pathologic characterization of human immunodeficiency virus (HIV)-associated systemic lymphomas, including the association of Epstein-Barr virus (EBV) in different categories. PATIENTS AND METHODS: Eighty-seven HIV-associated non-Hodgkin's lymphoma (NHL) were classified according to classic NHL classification and a recent description of morphologic variants of high-grade B-cell NHL. Seventy-one cases were immunophenotypically-genotypically characterized, whereas, in 49 representative cases, the association of EBV was assessed by nonisotopic in situ hybridization (ISH) and the immunohistochemical demonstration of latent membrane protein-1 (LMP-1). In addition, 14 Hodgkin's disease (HD) cases, occurring in patients with HIV infection, were investigated for the frequency of LMP-1 expression. RESULTS: Most lymphomas were of B-cell derivation and showed a blastic cell morphology, with (1) small noncleaved cells (SNCCs; 36 cases), (2) large noncleaved cells (10 cases), and (3) immunoblasts, usually polymorphic (12 cases). Moreover, 12 cases were classified as anaplastic large-cell (ALC) Ki-1-positive (Ki-1+) lymphoma. Combined ISH studies (for viral DNA and EBV RNA [EBER]) and immunohistologic demonstration of LMP-1 suggested that there were differences in viral latent gene expression between ALC Ki-1+ or immunoblastic lymphomas (usually EBV+, LMP-1+), and EBV-infected cells of SNCC lymphomas, which did not show LMP-1 expression. A high proportion (10 of 14) of LMP-1+ HD cases was found. CONCLUSION: Differences in EBV association and LMP-1 expression were found between a major group of HIV-associated systemic NHL with blastic cell morphology, including SNCC lymphoma and its variants, and anaplastic cell lymphomas. A proportion of immunoblastic (polymorphic) lymphomas was different in viral latent gene expression from other blastic cell systemic lymphomas. It is concluded that only a group of these lymphomas (most ALC Ki-1+ and HD cases, along with a nonnegligible fraction of immunoblastic lymphomas) seems to be linked etiopathologically to EBV.

Gene Expression Regulation, Viral↗
PubMed1993

Cytogenetic rearrangement of C-MYC oncogene occurs prior to infection with Epstein-Barr virus in the monoclonal malignant B cells from an AIDS patient.

Two cell lines were originated from the peripheral blood (PB-LAM) and bone-marrow (BM-LAM) of a patient with Burkitt-type acute lymphoblastic leukemia and AIDS. 26 and 7 clones were isolated from PB-LAM and BM-LAM respectively by limiting dilution. All of these had surface IgM lambda and the CD10 marker with low to absent CD23, CD30, CD39 and surface adhesion molecules. Furthermore, they shared the same chromosomal abnormalities (trisomy 7 and t(8;14) translocation) and the same rearrangements of immunoglobulin L and H chain and of c-myc gene loci. These features are those most frequently found in Burkitt's lymphoma (BL) cells and were different from those of the parental cell lines, which, besides cells identical to those of the malignant clones, also contained normal lymphoblastoid cells. Therefore, the cloning procedure used selected for the growth of cells with malignant features. EBV latent antigens were detected in all clones by Western blotting and their pattern of expression resembled that usually observed in BL cells. All the clones were positive for the EBV genome by Southern blotting and had monomorphic EBV-fused termini as determined by using cDNA probes specific for sequences at either end of the viral genome. However, the clones derived from PB-LAM had EBV fused termini of a different size from that of the clones derived from BM-LAM. The presence of different EBV-fused termini in otherwise monoclonal malignant cells indicate that EBV infection was possibly a late event in lymphomagenesis following rearrangement of the c-myc and the Ig gene loci.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Ultrasonographic and urodynamic evaluation in stress incontinence].

Transvaginal sonography can show partial urinary penetration in the urethra in patients with no clinical incontinence. The Fluid Bridge Test-Pressure urodynamically demonstrates the same phenomenon. We compared these two technics in women with stress urinary incontinence (SUI). 49 patients underwent urodynamic testing and transvaginal sonography; 18 had SUI, 20 were asymptomatic postoperatively (Burch procedure) and 11 were normal controls. Urodynamics consisted of filling cystometry with saline (infusion speed: ml 70/min) using transurethral Foley catheter (n degree 14 Fr), and a profilometric-pressure Bard catheter (10 Fr); micturitional cystometry; uroflowmetry; clino- and orthostatic urethral pressure profile (UPP) (extraction speed: cm 0.5-1/sec; infusion speed: cm 1.2/min); sphincteric electromyography (EMG); FBT-P with the Bard catheter only. During extraction patients were requested to cough (stress condition). If the urethra is incompetent pressure is transmitted to the water column connected to the pressure transducer, and a "spike" is observed. A competent urethra shows little pressure variation. Ultrasound (US) equipment consisted in a General Electric (RT 3600) sonograph with an electronic transvaginal probe (7.5 MHz) inserted in a gel-lubricated condom. The probe was positioned in the vaginal vestibule in direct proximity to the urethra. Axial and coronal scannings were performed. Echo-imagings were submitted to "post-processing" on US recording equipment. Fluid penetration in the urethra was evident if iperchogenic "turbulence" was observed on playback of the dynamic sonogram on a videocassette recorder (VCR) connected to the sonograph. The SUI group shows leakage of water under stress without detrusorial activity and dynamic UPP with reduced transmission of abdominal pressure on the urethra.(ABSTRACT TRUNCATED AT 250 WORDS)

Electromyography↗
PubMed1993

Mixed acute leukemia with genotypic lineage switch: a case report.

Morphologically well classifiable leukemias can reveal a mixed phenotype. A case of acute myeloid leukemia (CD13, CD33, CD14, CD11b) which at presentation showed a co-expression of B-lymphoid markers (CD19, CD10, CD20), at the time of the first relapse revealed a morphologic, phenotypic and genotypic switch of the blasts to a purely lymphoid form. Analysis of the immunoglobulin (Ig) H chain locus and of the T-cell receptor (TCR) genes showed at diagnosis a germline configuration of the IgH, TCR beta and tau genes, and a deletion of the TCR delta gene at the second chromosome. At relapse, monoclonal rearrangements of the IgH, TCR tau, and TCR delta were detected. At a subsequent relapse, the blasts re-expressed myeloid morphologic features and myeloid-associated antigens, while they retained the same rearranged configuration of the IgH and TCR beta and delta genes. The TCR delta gene configuration, which links each phase of the disease, may represent an early pathogenetic event and makes the emergence of a second malignancy unlikely. Each phenotypic change occurred after anti-myeloid and anti-lymphoid oriented chemotherapy. The close correlation between the progressive acquisition of different phenotypes and the switch at the genomic level represent the peculiar features of this unusual case.

Adult↗
PubMed1993

[Comparison of methods for the diagnosis of urinary obstruction in women].

The International Continence Society does not offer secure guidelines for the diagnosis of micturitional obstruction. The problem has been extensively addressed in relation to male voiding difficulties. Little is known on the subject in female patients. Two criteria for the diagnosis of obstructed micturition are in clinical use. The Sussett formula divides the maximum micturitional pressure by the square of the corresponding maximum urinary flow rate. Two cutoffs, corresponding approximately to the 90th and 95th centiles can be used (0.15, and 0.5). A more complex graphic nomogram developed by Schafer plots maximum flow versus maximum detrusor pressure, identifying obstruction and detrusor dysfunction simultaneously according to the author. We feel that these methods, extensively tested on a male population, can both be used on a female population. We noticed that in some instances the results were different. 469 women referred for micturitional disturbances underwent pressure/flow studies. 62 (13.2%) were obstructed according to the Schafer nomogram, 103 (21.9%) and 31 (6.6%) respectively using the Sussett mathematical formula using two different cutoffs (0.15 and 0.5). The two methods identify the same patients only if micturitional pressures are normal (40 to 60 cmH2O) to high (over 60 cmH2O) and the Sussett formula is used with a higher (95th centile) cutoff. This means that both methods are clearly insufficient in the diagnosis of obstruction if detrusor function is impaired. This can happen in case of chronic retention due to detrusor failure after a long-standing obstruction or for primary failures due to central nervous system lesions. Extreme care should be exercised if pressure-flow studies indicate obstruction at low micturitional pressures.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1993

[Evaluation of the specific delayed cutaneous hypersensitivity response(DTCH) after specific active immunotherapy (SAI) using autologous tumor cells in patients operated upon for renal carcinoma].

From Dec 1986 to Dec 1990, 113 consecutive patients radically resected for renal cell carcinoma, have been randomized after surgery to observation or to Active Specific Immunotherapy (A.S.I.). 43 patients stage I-II and 13 p. stage III, according to TNM entered the treatment arm consisting of 10 autologous irradiated tumor cells injected intradermally, either mixed with BCG 10(7) (on days 28th and 35th after surgery) or alone (on day 42th). At randomization and 1, 6 and 12 months after treatment, patients were evaluated for the development of a DTCH to autologous tumor and to autologous normal cells, obtained by mechanical and enzymatic dissociation of the surgical specimens. Baseline DTCH were negative in all patients. One month after completing A.S.I. 36 out of 50 evaluable patients displayed a significant DTCH response to autologous tumor, which remained positive in 23/40 patients at 6 months. Our data clearly indicate that Active Specific Immunotherapy with autologous tumor cells mixed with BCG can elicit a specific immune response to autochthonous tumor as measured by DTCH.

Adult↗
PubMed1993

[Acute urinary obstruction in pregnancy].

Five cases of acute urinary obstruction during pregnancy are presented. A complete urodynamic workup, including pressure-flow studies showed high micturitional pressures with little or no flow, with at least 60% residual urine. Filling cystometry, urethral profilometry (static and dynamic), pelvic electromyography were normal. Two cases were due to uterine pelvic incarceration. One of these cases happened very early during pregnancy, because of extensive fibroids. Any cause of abnormal uterine enlargement can lead to early obstruction. Three cases were associated with paraurethral abscess (skenitis in 2 cases, urethral diverticulum in 1). Manual reduction in case of pelvic incarceration or surgical draining and antibiotic therapy in case of abscess were effective in all cases. Immediate catheterization is possible and indicated as soon as urinary obstruction is diagnosed. This prevents neuromuscular dysfunction due to excessive bladder distention. The transurethral catheter might work as a stent, and periurethral surgical drainage is probably safer with a catheter in place. Suprapubic catheterization is probably less useful in this respect. An indwelling catheter removes any urgency in treatment. Voiding difficulties can persist for some days after surgical treatment. Urodynamic testing performed in all indicated acute micturitional obstruction. Anyway, it added little to the clinical understanding of the problem, which was obvious, and the Authors feel that extensive urodynamic testing should be limited to cases presenting with a complex preexisting dysfunction or performed after treatment if symptoms do not disappear completely. All clinically doubtful cases should likewise be investigated. If periurethral abscess or incarceration are evident, simple evaluation of residual urine percentage should be sufficient in establishing the diagnosis.

Acute Disease↗
PubMed1993

Demonstration of a unique Epstein-Barr virus-positive cellular clone in metachronous multiple localizations of Hodgkin's disease.

The recent detection of clonal episomes of Epstein-Barr virus (EBV) in a significant proportion of Hodgkin's disease (HD) cases has suggested a re-evaluation of the possible pathogenetic role of EBV in the development of the disease. Here we report that in two EBV-positive HD, arisen in human immunodeficiency virus-1-infected drug users, a unique episomal EBV genome was detected in multiple metachronous HD lesions of each patient. These findings demonstrated that the same EBV-positive cellular clone was present in multiple localizations of HD as well as in specimens taken at different times. Combined in situ hybridization and immunohistological analyses evidenced EBV genome and EBV-encoded latent membrane protein-1 on Reed-Sternberg cells. Therefore, the data strongly support the possibility of a causal role for EBV in the pathogenesis of HD.

Adult↗