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Biomedical subjects

A Ferrari

Publications and source records attributed to A Ferrari.

At least 181 records · Page 10Linked to original sources
PubMed1995

Portal hypertension: review of data and influence on management.

It is evident that endoscopic ultrasonography could have a great clinical role in the selection of the best treatment for the individual patient because it allows the simultaneous visualization of a large part of the portal venous system and its collaterals. It has not been shown that the same kind of treatment is suitable for every patient with portal hypertension, and failure of a particular treatment may be attributable to an incorrect selection of patients. Further perspective studies with EUS in patients with portal hypertension are thus necessary in order to clearly state the cost-benefit of this technique in the management of these subjects.

Endoscopy, Digestive System↗
PubMed1994

Regulation of phosphoprotein p18 in leukemic cells. Cell cycle regulated phosphorylation by p34cdc2 kinase.

p18 is a phosphoprotein that is expressed at very high levels in leukemic cells, at moderately high levels in proliferating normal lymphocytes, and at low levels in quiescent lymphocytes. Induction of terminal differentiation of leukemic cells in culture results in a decrease in cellular proliferation. These phenotypic changes are associated with rapid phosphorylation of p18, followed by a more gradual decrease in the level of its mRNA expression. More than 12 different phosphorylation products of p18 have been identified in different cells by high resolution two-dimensional polyacrylamide gel electrophoresis. Previous studies have suggested that p18 may be a substrate for protein kinase C in some cellular processes and protein kinase A in others. In this report, we show that the phosphorylation of p18 increases as cells progress toward the G2-M phases of the cell cycle in proliferating leukemic cells. We have examined the hypothesis that the putative role of p18 in cellular proliferation may be mediated by its involvement in the p34cdc2 kinase signal transduction pathway. We have produced recombinant p18 in bacterial cells and shown that it can be phosphorylated in vitro by purified p34cdc2 kinase with a stoichiometry of 0.86 mol of PO4/mol of substrate. We have used site-directed mutagenesis to demonstrate that the site of p34cdc2 phosphorylation is the serine at position 38. This same site has previously been shown to be phosphorylated in vivo in bovine brain along with another serine at position 25. The observation that p18 gets phosphorylated in the G2-M phases of the cell cycle and the demonstration that p18 is phosphorylated efficiently by p34cdc2 kinase in vitro at a residue that is also phosphorylated in vivo support the hypothesis that p18 may be a physiologic substrate for p34cdc2 kinase in vivo. We have also examined the effect of inhibiting the expression of p18 on cell cycle progression. These experiments demonstrated that antisense inhibition of the expression of p18 in K562 erythroleukemia cells is associated with a decrease in cellular proliferation and accumulation of cells in the G2-M phases of the cycle. The implications of these findings to the proposed role of p18 in the regulation of cellular proliferation are discussed.

Base Sequence↗
PubMed1994

Topical testosterone in the treatment of vulvar lichen sclerosus.

OBJECTIVES: Comparison between 2% testosterone propionate and petrolatum ointment in the treatment of vulvar lichen sclerosus in a randomized, double-blind, controlled clinical study. METHODS: Fifty-eight consecutive patients with histologically confirmed vulvar lichen sclerosus were enrolled. They underwent a 1-year period of topical treatment with either medication, with clinical evaluations of symptoms and gross appearance at 2-month intervals, followed by histological evaluation at the end of the treatment period. Statistical analysis was performed according to the chi-squared test and the Student-Newman-Keuls test. RESULTS: A substantial improvement in symptoms was achieved in 20 (66.6%) patients in the testosterone group and in 21 (75%) patients in the placebo group. No statistical differences were observed between the two groups. Gross changes were observed in a few cases and no case demonstrated histologic modifications. CONCLUSIONS: Petrolatum ointment is as effective as 2% testosterone in the treatment of vulvar lichen sclerosus.

Administration, Cutaneous↗
PubMed1994

Risk factors for placenta praevia.

Risk factors for placenta praevia have been analysed in a case control study conducted in Milan, Italy. A total of 140 cases of placenta praevia and the two women who delivered healthy babies consecutively after each index case (280 controls) were identified reviewing clinical records of 49,765 registered deliveries at the Clinica Mangiagalli in Milan from 1979 to 1991. An increased relative risk (RR) of per cent confidence interval, CI, 2.3-6.7) and among those with previous abortions (RR = 1.8, 95 per cent CI, 1.2-2.8) or with more than one previous pregnancy (RR = 1.9, 95 per cent CI, 1.1-3.3). A non-significant trend in risk was observed with parity (RR = 1.2 for one and 1.5 for two previous deliveries versus nulliparas) and for caesarean section (RR = 1.2 for one and 2.1 for two previous caesarean deliveries versus no previous caesarean section). No relation emerged with sex of the newborn and multiple pregnancy and risk of placenta praevia. Our study shows that older age and previous abortions are associated with an increased frequency of placenta praevia.

Adult↗
PubMed1994

Insulin-like growth factor-II stimulates human granulosa-luteal cell proliferation in vitro.

OBJECTIVE: To determine the effect of insulin-like growth factor-II (IGF-II) on human granulosa cell proliferation in vitro. DESIGN: Thymidine incorporation and cell count were determined to assess human granulosa cell proliferation. SETTING: The study was performed in an academic research environment. PATIENTS: Granulosa cells were obtained from women undergoing IVF procedures. INTERVENTIONS: Granulosa cells were dispersed enzymatically and cultured in both serum-containing and serum-free medium. MAIN OUTCOME MEASURE: Granulosa cell proliferation in basal conditions and after stimulation with IGF-II given alone or in combination with basic fibroblast growth factor (basic FGF). RESULTS: Treatment of human granulosa cells with IGF-II for 24 hours significantly increased thymidine incorporation. Furthermore, this mitogenic effect was confirmed when granulosa cells were cultured in presence of IGF-II for 7 to 10 days and their proliferation was evaluated by cell counting. The association of IGF-II and basic FGF did not result in a synergistic or additive effect. CONCLUSION: As already demonstrated in other species, IGF-II also is able to stimulate human granulosa cell proliferation in vitro. Thus, it might be considered among the intraovarian modulators of granulosa cell physiology.

Cell Count↗
PubMed1994

The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis.

To evaluate the diagnostic accuracy of fine-needle aspiration, fine-needle biopsy and extranodular fine needle biopsy in identifying focal lesions in cirrhosis, 100 consecutive ultrasound detected nodules were studied. Seventy-three were hepatocellular carcinomas (31 were well-differentiated hepatocellular carcinomas), 23 were benign lesions (one angioma and 22 large regenerative nodules) and two were metastases. The lesions were divided according to maximum diameter as follows: < 20 mm in 36, > 20 < 30 mm in 27, and > 30 mm in 33. In four cases there were multiple nodules of different sizes. Fine needle aspiration, intranodular fine needle biopsy and extranodular fine needle biopsy were obtained in each lesion. The sensitivity, specificity and diagnostic accuracy of each procedure were evaluated separately by three independent pathologists. Seven fine needle aspirations and three intranodular fine needle biopsies were considered inadequate. The highest diagnostic accuracy (96%) was obtained by the combined analysis of fine needle aspiration plus intranodular and extranodular fine needle biopsy, and this superiority was confirmed in each group of lesions. Fine needle aspiration showed a lower accuracy (48%) than intranodular fine needle biopsy (67%). When fine needle aspiration and intranodular fine needle biopsy were evaluated together, an accuracy of 91% was found. Intralesional fine needle biopsy plus extranodular fine needle biopsy analysis gave an accuracy of 78% and, particularly relevant, a specificity of 95%. These results indicate that, in patients with cirrhosis with nodular lesions < 30 mm, fine needle biopsy is superior to fine needle aspiration and that the combined evaluation of fine needle aspiration plus intranodular and extranodular fine needle biopsy is the most accurate approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy, Needle↗
PubMed1994

Endoscopy versus endoscopic ultrasonography in staging reflux esophagitis.

Precise staging of reflux esophagitis is very important for therapeutic decisions; in fact, chronic gastroesophageal reflux may cause transmural inflammation that leads to fibrosis with loss of esophageal wall compliance. In reflux esophagitis, endoscopic stating is limited to mucosal injury, while endoscopic ultrasonography (EUS) is able to visualize changes in the layer structure and localized or diffuse thickenings of the esophageal wall. In order to evaluate the usefulness of EUS in reflux esophagitis, a prospective study of 31 patients and ten normal subjects was performed. Endoscopic reflux esophagitis was staged as: E1 (erythema, n = 7), E2 (erosions, n = 13), E3 (ulcers, n = 11). EUS findings were recorded and evaluated at five different levels, starting from the gastroesophageal junction, using a quantitative method, the center line method. With this method, the sectorial and mean thickness, and area were calculated for each level. There was a significant difference between patients with reflux esophagitis and normal subjects in our study. E3 patients showed a significant upward involvement of the wall far from the visible lesions. Mild esophagitis may also cause esophageal wall thickening, involving even the entire wall. There was no correlation between the onset time of symptoms and the degree of thickening. In conclusion, EUS seems to be an important supplement to endoscopy in staging reflux esophagitis, as the progression of the inflammation is not related to the endoscopic findings.

Adult↗
PubMed1994

Uncommon clinical presentation of a lymphocytic lymphoma of intermediate differentiation in a patient with systemic sclerosis.

The association of systemic sclerosis (SSc) and non-Hodgkin lymphoma is a rare event and its pathogenetic mechanism remains to be clarified. We describe a previously unreported association of SSc with a lymphocytic lymphoma of intermediate differentiation (IDL), involving the gastrointestinal tract, gallbladder and one salivary gland. Whereas the morphological, immunological and cytogenetic features were typical of IDL, the extensive extranodal involvement and the association with an autoimmune disorder were suggestive of two other lymphomas of mantle lineage: mucosa-associated lymphoid tissue (MALT) lymphoma and monocytoid B-cell lymphoma (MBCL).

Female↗
PubMed1994

Alpha 1-adrenergic blockade and sudden cardiac death.

INTRODUCTION: The primary goal of the present study was to test whether selective pharmacologic blockade of alpha 1 receptors, and specifically of the subtype alpha 1a, could prevent ventricular fibrillation (VF) during acute myocardial ischemia. BACKGROUND: The development of new autonomic interventions is of clinical interest in view of the failure of traditional antiarrhythmic drugs to prevent sudden death. Experimental evidence indicates that alpha 1 receptors, and in particular the subtype alpha 1a, may be involved in the genesis of malignant arrhythmias during acute myocardial ischemia and reperfusion. Despite this evidence, questions have been raised about the actual antifibrillatory efficacy of alpha-adrenergic blockade in the acutely ischemic myocardium. The effects of prazosin and of abanoquil (UK 52,046), a highly selective alpha 1a receptor blocker, were tested and compared with propranolol in a conscious animal preparation for sudden death. METHODS AND RESULTS: Ten dogs with a 1-month-old anterior wall myocardial infarction were studied. These dogs had all developed, in control conditions, VF during a 2-minute occlusion of the circumflex coronary artery while exercising (n = 9) or lying on the table (n = 1). Afterwards, the dogs underwent additional tests with the following intravenously administered drugs: abanoquil (n = 10; 1 micrograms/kg), prazosin (n = 9; 0.1 mg/kg), and propranolol (n = 10; 1 mg/kg). Internal control analysis was used. All dogs tested had recurrence of VF with both alpha-adrenergic blockers. Propranolol significantly reduced heart rate during ischemia and prevented VF in 5 of 10 dogs tested (P < 0.05). When heart rate was kept constant by atrial pacing (n = 3), 2 of the 3 animals remained protected by propranolol. Just prior to onset of VF, heart rate was not significantly different in the control and in the abanoquil tests (237 +/- 45 and 253 +/- 34 beats/min, respectively), whereas it was higher (P < 0.05) with prazosin (288 +/- 40 beats/min). CONCLUSIONS: Alpha 1 and alpha 1a receptor blockers do not prevent VF secondary to acute myocardial ischemia in the presence of elevated sympathetic activity and heart rate. In the same setting, beta-adrenergic blockade prevents the reflex heart rate increase due to ischemia and provides a significant protection.

Adrenergic alpha-Antagonists↗
PubMed1994

Complete testicular feminization with normal gonadotropin and high androgen secretion: a case report.

A patient with a complete form of testicular feminization with normal gonadotropin and high testosterone levels is described here. These findings are in contrast to previous reports that have shown high circulating luteinizing hormone (LH) levels in adults affected by this syndrome. Testicular histology revealed tubular atrophy and hyperplastic Leydig cells which are in accordance with the high testosterone levels and the difficulty in visualization of the testes. Because of the increased risk of gonadal malignancy, a laparoscopic gonadectomy was performed.

Adult↗
PubMed1994

Deoxycoformycin induces long-lasting remissions in hairy cell leukemia: clinical and biological results of two different regimens.

The use of alpha interferon (alpha IFN) and, more recently, of the purine analogues deoxycoformycin (dCF) and 2-chlorodeoxyadenosine (2-CdA) has dramatically improved the prognosis of patients affected by hairy cell leukemia (HCL). DCF has been shown to induce an higher and more durable response rate than IFN, with only moderate myelosuppression and relatively few side effects. In this paper, we report our experience with dCF in a series of 38 HCL patients who had progression of their disease after IFN therapy. Serum interleukin-1 beta (IL-1 beta), soluble interleukin-2 receptors (sIl-2R) and Tumor Necrosis Factor alpha (TNF alpha) levels were also evaluated before, both during and after treatment in order to monitor clinical response. Two schedules of treatment were employed: 23 patients were treated with the EORTC protocol and the following 15 with the NCI regimen. The overall response rate was 94.7%; no significant differences in response rates were observed between the two schedules. In respect to toxicity, we recorded nausea and in two cases a cutaneous rash. Four patients experienced localized herpes zoster and one had a fungal pneumonia. Median overall survival after therapy is 38.5 months, 55 percent of patients enrolled in the EORTC schedule and 77% of those who received the NCI program are currently in CCR at 3 years. Serum IL-1 beta and sIL-2R levels significantly decreased after treatment, while no significant changes in serum TNF alpha levels were observed. In our study, dCF was confirmed as an effective agent in HCL, inducing an high response rate with only moderate side effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

HLA typing in hairy cell leukemia.

In HCL patients some cases of familial occurrence of the disease were reported, without an association with a specific haplotype or HLA antigen. In a series of a non familial HCL patients an increase in DR11 frequency was reported. We performed HLA class I and class II antigens in a series of 38 consecutive HCL patients. An increased frequency of B17 (10/38-27%) and DR11 (22/38-57%) antigens compared with the normal Caucasian population was recorded. As clinical characteristics, no significant differences were recognized between DR11 positive and DR11 negative patients. In response to IFN treatment, a complete response (CR) was achieved in 20% of DR11 patients and in 46% of DR11 negative patients. In this study an increase frequency of B17 and DR11 antigens was found; furthermore DR11 positive patients seem to be less responsive to IFN treatment but a larger series of patients will have to be studied in the future in order to establish this observation with more certainty.

Adult↗
PubMed1994

Adult Philadelphia-chromosome-positive acute lymphoblastic leukemia: experience of treatments during a ten-year period.

Adult Philadelphia-chromosome-positive acute lymphoblastic leukemia (Ph1-positive ALL) represents about 30% of all adult ALL, and is considered a poor prognosis disease, since complete remission (CR), which can be achieved in 50-70% of cases, is usually short in patients treated with conventional chemotherapy. Presently bone marrow transplantation, performed early in first CR is becoming the treatment of choice, as it has shown to be able to cure some cases. In a ten-year period, at our department, among 108 adult ALL patients, in which cytogenetics was successfully carried out at diagnosis, 24 (22%) resulted Ph1-positive. Molecular biology was performed in 13 out of these 24 patients: 10 patients showed a p210 rearrangement and three p190. All patients have been treated at induction with conventional drugs, with a CR rate of 96%. As post-remission therapy, the first 17 cases (group 1) followed a chemotherapeutic program, like the other adult ALL; while the remaining six patients (group 2) have been enrolled in a pilot study including early BM transplantation. In group 1, the median overall duration of first CR is 7 months; 50% of relapses were recorded within the first 6 months, although in this group five patients exhibited a first CR prolonged more than 30 months. In group 2, among the six patients, three were submitted to allogeneic bone marrow transplantation (BMT), and three to autologous bone marrow transplantation (ABMT). Overall median duration of first CR is 13 months. Three patients relapsed, three are in continuous CR for 11, 31 and 32 months.

Adult↗
PubMed1993

Differences and variations in the patterns of early independent walking.

The early development of walking was investigated in 25 normal fullterm and in 25 low-risk preterm infants. All subjects were videorecorded within 3-4 weeks of the beginning of independent walking and again 4 months later. Analysis of the videos was carried out according to a predetermined list of items, with a semiquantitative score for each. The results indicate wide interindividual differences in normal infants in the form of independent walking. Several items seemed to be associated in different ways in different individuals. Age of onset, as long as the corrected age was considered, did not differ between preterm and fullterm infants, neither did their walking patterns. Gait asymmetries were often observed in both groups and they were related with asymmetries observable in prewalking locomotor behaviour. Toe-strike often occurred at the beginning of walking, but not after 4 months; in preterm infants the toe strike pattern correlated significantly with certain motor characteristics observed during the first weeks of life.

Aging↗
PubMed1993

Primary carcinoma of the fallopian tube.

BACKGROUND: Because of the rarity of fallopian tube cancer, clinical approaches have changed during the last 18 years. METHODS: Twenty-nine patients with fallopian tube cancer were treated at the Gynecologic Oncology Department of Milan University from 1970 to 1988. The mean patient age was 59 years. Parity, symptomatology and histology were considered. Distribution by stage was as follows: I, 11 (37%); II, 10 (34%); III, 8 (27%) according to the Dodson classification. Twenty patients (69%) underwent surgery followed by pelvic irradiation. Adjuvant chemotherapy was performed in the treatment of 5 women with stage I disease, 6 with stage II, and all 8 with stage III. RESULTS: Five-year overall survival was 41.38%: 47.6% at stages I and II, 25% at stage III. Radiotherapy has not been replaced by cisplatin-based multiagent chemotherapy. Optimal surgical debulking combined with accurate lymph node sampling are not followed by systematic use of repeat laparotomy. CONCLUSIONS: The procedures described in this work improve the clinical assessment and patient survival, and make different series comparable.

Adult↗
PubMed1993

Antioxidant vitamins or lactulose for the prevention of the recurrence of colorectal adenomas. Colorectal Cancer Study Group of the University of Modena and the Health Care District 16.

Colonic adenomas represent the natural precursor lesions of most colorectal cancers. The treatment of choice is endoscopic polypectomy. However, after endoscopic removal, polyps recur in a large fraction of cases. Thus, we evaluated the effect of antioxidant vitamins or lactulose on the recurrence rate of adenomatous polyps. After polypectomy, 255 individuals were randomized into three groups. Group 1 was given vitamin A (30,000 IU/day), vitamin C (1 g/day), and vitamin E (70 mg/day); Group 2 was given lactulose (20 g/day); Group 3 received no treatment. Forty-six subjects had to be excluded because the histologic diagnosis was not consistent with adenoma. The remaining 209 individuals were included in the analysis according to the "intention to treat" criterion, though 34 did not adhere to the scheduled treatment or were lost during the follow-up. Subjects were followed at regular intervals for an average of 18 months. Polyps recurring before one year from index colonoscopy were considered missed by the endoscopist. In the 209 evaluable subjects, the percentages of recurrence of adenomas were 5.7 percent, 14.7 percent, and 35.9 percent in the vitamins, lactulose, and untreated groups, respectively. The fraction of subjects remaining free of adenomas, estimated by Kaplan-Meier survival curves, was significantly different among the three groups (log-rank chi-squared = 17.138; P < 0.001). Using Cox's regression analysis, treatment was the only variable that significantly contributed to the model (regression coefficient = 0.905; P < 0.001). In conclusion, either antioxidant vitamins or, to a lesser extent, lactulose lower the recurrence rate of adenomas of the large bowel and can be proposed as chemopreventive agents, at least in high-risk individuals.

Adenoma↗