The genesis of the Armanni-Ebstein lesion in diabetic nephropathy.
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Diabetic Nephropathies↗
Biomedical subjects
C Giordano
Publications and source records attributed to C Giordano.
Immunohistochemical identification of Encephalitozoon cuniculi in phacoclastic uveitis in four rabbits.
PURPOSE: Encephalitozoon cuniculi is a microsporidium with a wide range of mammalian hosts. In rabbits it can be responsible for cataract and lens-induced uveitis (LIU). The aim of this study was to provide specific immunohistochemical demonstration and localization of E. cuniculi within the eye, in rabbits with LIU. MATERIAL AND METHODS: Four rabbits were presented with a white mass in the eye and iris discoloration. Complete ophthalmic examinations were performed and a presumptive diagnosis of LIU was made in all cases. Initial therapy with a topical steroid, atropine and systemic enrofloxacin was instituted while serologic (IFA or ICA tests) and cytologic lab results were pending. The final outcome in all cases was enucleation. Routine histology and immunohistochemistry (ABC method) with an antiserum anti-Encephalitozoon cuniculi were performed. RESULTS: Indirect immunofluorescence performed on one rabbit serum expressed a titer of 1 : 32; carbon immunoassay on the serum of the other three rabbits expressed a titer of 1 : 5120 in one, and a titer of 1 : 2560 in the other two cases. Histologically, an intraocular, locally extensive pyogranulomatous infiltration that partially filled the posterior chamber, encasing a wide anterior lens capsule break, was detected in all cases. Immunohistochemically, spores reacting with anti-Encephalitozoon cuniculi antiserum were present in all specimens, occasionally within macrophages and lens epithelial cells. CONCLUSION: Detection of E. cuniculi in rabbits with phacoclastic uveitis has been investigated in the past with different methods. Based on our results, we suggest that immunohistochemistry should be regarded as a useful tool both for specific demonstration of E. cuniculi and for its localization within tissues.
Animals↗
Chemotherapy for recurrent salivary gland malignancies: experience of the ENT Department of Turin University.
Twenty-seven patients (17 males, 10 females; median age 59 years) with recurrent high-grade malignancies of major (22 cases) and minor (5 cases) salivary gland origin (10 adenoid cystic carcinomas, 9 adenocarcinomas, 4 poorly differentiated carcinomas, 1 mixed malignant tumor, 3 mucoepidermoid carcinomas) were treated by monochemotherapy--cisplatin (CDDP) in 8 cases, or adriamycin in 5 cases--or polychemotherapy--CDDP + epirubicin + 5-fluorouracil/cyclophosphamide in 9 cases or CDDP + 5-fluorouracil in 3 cases with mucoepidermoid carcinomas. In adenocarcinoma-like tumors, patients treated by polychemotherapy showed a better response (9.1% CR, 36.3% PR) than patients treated with monochemotherapy (no CR, 23% PR). Patients with local recurrence and adenocarcinoma exhibited a better response. Median response duration: 7.5 months after poly- and 4 after monochemotherapy. Median overall survival time was 8+ months (responders: 14+) in the polychemotherapy group and 5.5 (responders: 8) in the monochemotherapy group. In the 3 cases with mucoepidermoid carcinoma 1 patient achieved a PR (33.3%) and in 2 there was no change.
Adult↗
Glycemic response to pasta: effect of surface area, degree of cooking, and protein enrichment.
To see whether food form, the degree of cooking, or protein enrichment affected the glycemic response to pasta, we gave test-meal breakfasts to 13 diabetic patients. Macaroni had a significantly greater glycemic index (GI) (68 +/- 8) than spaghetti (45 +/- 6, P less than .01); the GI of star pastina was intermediate (54 +/- 6). The GI of spaghetti was not significantly affected by cooking for 5 or 15 min (45 +/- 6 and 46 +/- 5, respectively), or by protein enrichment (38 +/- 4). The GI of spaghetti was similar in 11 non-insulin-dependent and 6 insulin-dependent diabetic patients (49 +/- 7 compared with 57 +/- 8). We conclude that different types of pasta may produce different glycemic responses but that these are not necessarily related to differences in cooking or surface area.
Blood Glucose↗
Cold carbon apparatus for hemodialysis.
A prototype of artificial kidney with regeneration of the dialysis fluid in active carbon at low temperature is presented. The data obtained through a series of simulated dialysis show that carbon adsorbs, besides creatinine and other compounds, urea in satisfactory quantities. Furthermore, the possibility of completely regenerating carbon with tap water washing makes the routine use of an artificial kidney based on a cold operating carbon depurator extremely practical.
Adsorption↗
The use of micropuncture, isolated tubule, and vesicle technique in the study of the action of thyroid hormones on the proximal tubule function.
In hypothyroid rats (TX), the isotonic fluid reabsorption (Jv), that is closely linked to the transepithelial sodium transport (JNa), is impaired. The administration of physiological doses (10 micrograms/kg body weight per day) of tri-iodothyronine (T3) doubles Jv in three days (TX+T3). This phenomenon could be explained by several mechanisms: a direct stimulation of Na-K-ATPase, an increase in the Na+ entry step, changes in the permeability properties of the luminal and/or basal lateral membranes. Using a kinetic microassay, Na-K-ATPase activity was measured in early (S1) and late (S2) proximal tubules segments isolated from control, TX, and TX+3T3 animals. In TX rats the enzyme activity was lower (70%) in both segments versus control rats, it remained unchanged after 3 days, and it increased after 7 days of T3 substitution. The Na+ permeability of brush border membrane (BBM) vesicles isolated from TX and TX+T3 rats was identical. However the valuation of the K+ membrane permeability by in vivo perfusion of the lumen and peritubular space of proximal tubules of TX rats, with perfusate containing the K+ ionophore valinomycin (1 microgram/ml), induced a significant increase in Jv that accounted for 40% of that elicited by T3. Taken together, the in vivo and in vitro experiments suggest that the early effect on Jv of physiological doses of T3 cannot be explained by a direct action of T3 either on the Na+ entry step across the BBM or on the Na+ exit step (i.e., the Na-K-ATPase), but rather by an increase in K+ permeability of proximal tubular cell membranes.(ABSTRACT TRUNCATED AT 250 WORDS)
Absorption↗
[Clinical significance of serum complement in chronic liver diseases and in acute hepatic insufficiency].
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Acute Disease↗
[The diagnosis and treatment of dysphagia].
The structures in the head and neck are important in respiration, deglutition and communication. The post surgical head and neck cancer patient will probably exhibit a variety of disorders in both speech and swallowing. This study examined swallowing problems in three groups of patients following ablative surgery for pharyngolaryngeal carcinoma: supraglottic laryngectomies, hemilaryngectomies and subtotal laryngectomies. A total of 28 patients were studied. Videofluoroscopic studies with liquid and thick paste were completed one week post initiation of oral feeding following surgery and during the rehabilitation treatment.
Deglutition↗
[Wallenberg's syndrome: an assessment of the dysphagic and postural symptomatology].
Dysphagia and postural disorders are the most important symptoms of the Wallenberg [correction of Wallemberg] syndrome, which takes in a considerable number of neurological symptoms including an alternate sensitive syndrome, the Claude Bernard Horner syndrome, paralysis of the half palate, of the half pharynx and of the vocal fold on the side of the injury, a vestibular syndrome and, finally, a cerebellar hemisyndrome. In the course of this study, four patients with the Wallenberg [correction of Wallemberg] syndrome were examined and underwent further periodical checks after injury. All the patients were fed employing a naso-gastric tube and in one case an emergency tracheostomy was performed because acute dyspnea. The diagnostic protocol following included the collection of a series of anamnestic data, an objective study of U.A.D.T. with fiberoptic endoscopy, swallowing simulation, dynamic radiologic examination (videofluoroscopy) and computerized static posturography. This routine was repeated upon every successive check. During the first observation a substantial uniformity of physiopathological characteristics was found in all the patients. Following logopedic and rehabilitation treatment, a high degree of diversity in the results obtained was observed in three patients (one of the patients was absent from successive checks). The most interesting phenomenon was the difference in time necessary to rehabilitate the swallowing reflex only after which it was possible to reassume oral alimentation. After two months of physiokinesitherapy, computerized static posturography, which initially revealed a sharp increase in the number of oscillations, showed a partial improvement of the postural disease with a reduction in oscillation amplitude. Even though the number of case followed was limited, our experience encourages us to underline importance of immediate rehabilitation therapy and of the collaboration of patients and their family members.
Aged↗
Acute renal failure with prolonged oliguria.
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Acute Kidney Injury↗
[Role of salvage surgery in the recurrence of mouth and oropharynx tumors].
Educational objectives at the conclusion of this presentation, the participant should be able to identify the different criteria that lead to the surgical approach rather than to the medical treatment (radiation therapy -RT--and/or chemotherapy--CT). Introduction. When we have to deal with medium or big recurrence of an oral or oropharingeal cancer is very difficult to make the right choice between the surgical or medical therapy: what we have to ask to ourselves is whether is legitimate to reoperate considering the sequences due to surgery and the results expected. Methods. From January 1997 to December 2002 we have treated by surgery 135 patients (mean age, 54) with oral and/or oropharingeal squamous cell carcinoma (SCC). The percentage of local recurrence was 30% (41/135 patients) and nodal recurrence was 6% (8/135 pt). Twenty-two/53 patients underwent to a salvage surgery; the others 31 patients to a RT and/or CT therapy. Conclusion. The overall survival was 29% in surgical patients after 3 years and 14% after 5; in the other patients the survival was 11% after 3 and 3% after 5 years. The comparison between the results in case of recurrent cancer of this distrect shows that the best approach is the surgery, where is possible; the choice is conditioned by the following parameters: the extension of the tumor, primary and recurrent; the presence of lymph node or distant metastases; time of recurrence; grading and histological characteristics of the tumor and performance status of patients.
Adult↗
[A case-control study of multiple occupational risk factors in relation to laryngeal cancer].
In this work the A.A. present the results of a case-control study on 2,997 subjects carried out to evaluate the role of professional factors in the development of laryngeal cancer. Our analysis included only cases of laryngeal neoplasia at first diagnosis in 1990. From a statistical point of view we calculated the Odds Ratio (OR) and confidence limits at 95% following Miettinen. The analysis was made on 113 cases and 754 controls, all males smokers or ex-smokers, aged between 35-80 years. The results show a statistically significant correlation between laryngeal cancer and jobs in agriculture (OR = 3.77), in iron-steel industries (OR = 3.25), in metal-mechanic industries (OR = 1.72). Precise knowledge of such data could be very useful in promoting primary and secondary prevention campaigns in the above-mentioned work places. The A.A. stress the need to make experimental cancerogenesis studies to evaluate the effects of the association of occupational risk factors, tobacco smoke and alcohol consumption on the natural history of laryngeal cancer.
Adult↗
[Chronic cholesteatomatous otitis media: the histopathological and clinical aspects].
In recent years the immunologic aspects of the normal and pathological ear have been studied by several authors, with particular attention given to the histopathologic aspects of the epidermis of the tympanic membranes of the outer ear canal and of the middle ear mucosa in normal physiologic as well as in inflammatory conditions. Such studies may help in giving a more precise definition to the pathogenesis and clinical behavior of middle ear cholesteatoma. In this paper we report the results of an immunohistopathologic study carried out using the immunohistochemical technique of monoclonal antibodies on cholesteatoma matrix samples taken during radical mastoidectomy or tympanoplasty. In particular, the presence of T-lymphocytes and Langerhans cells was evaluated using selective monoclonal antibodies and a relationship between the data collected and the clinical expression of the disease in each case was sought. In this study it was not possible to establish a close relationship between clinical behavior and immunohistopathological findings, which appeared rather similar in all the cases. The presence of Langerhans' cells may confirm the hypothesized role they play in phlogistic reactions and bone reabsorption due to the presence of the cholesteatoma in the middle ear. Yet, in order to evaluate their true role correctly, more detailed studies should be carried out on the spatial distribution of T-lymphocytes and Langerhans' cells in the cholesteatoma matrix as well as on their ultrastructural characteristics.
Adult↗
[Recurrence after radiotherapy and/or surgery of carcinoma of the oropharynx and the pharynx. Possibilities of salvage surgery].
Forty-seven laryngeal and 21 oropharyngeal recurrences were treated with salvage surgery alone or combined with radiotherapy at the ENT Clinic and Radiotherapy Division of the University of Turin, Italy. Primary tumors had been treated with surgery alone in 10 cases (larynx) and in 21 cases (oropharynx), with combined surgery and radiotherapy in 2 and 8 patients, and with radiotherapy alone in 9 and 18 cases. We observed 26/47 (larynx) and 12/21 (oropharynx) recurrences at the site of primary tumor, 20/47 and 9/21 in loco-regional nodes, and 9/47 and 3/21 in locations adjacent to the primary tumor. Salvage treatment employed surgery alone in 12 (oropharynx) and 16 (larynx) cases; radiotherapy was combined in 9 and 31 cases. Five-year actuarial NED survival was 45.5% for laryngeal and 24% for oropharyngeal cancer patients. After salvage surgery, 50% of laryngeal lesions and only 25% of oropharyngeal recurrences were completely cured. In our series, in 2 cases only the complications caused the patient's death, while in the extant cases a prolonged postoperative hospitalization was necessary. Our study was aimed at investigating the curative potentials of secondary therapy for recurrent carcinomas. A review of the literature on the subject is reported. The small amount of published data prevents "universal" treatment protocol from being assessed. The authors suggest the opportunity of employing a multimodal treatment policy for recurrences of head and neck cancers.
Adult↗
[Prostaglandins, suppressive action cells and carcinoma of the larynx: preliminary data].
The purpose of the present work was to analyze the role of PgE2 and indomethacin in the regulation of immune response. 18 patients with laryngeal cancer were chosen for the study. Three cultures on peripheral venous blood were taken from each subject in order to evaluate the variation in the different lymphocyte groups after the addition of PgE2 and its inhibiting factor: indomethacin. In the cultures with PgE2, an increase in T suppressor lymphocytes was observed while the T helper group showed a significant reduction (cultures with indomethacin produced the opposite effect). This result bears witness to the inhibiting effect PgE2 has on the immune system in subjects with laryngeal cancer. On the basis of these results, while awaiting further data, it can be suggested that future therapy be based on the administration of indomethacin in patients suffering from this disease.
Aged↗
[Vincristine-bleomycin-methotrexate in the treatment of recurrence of ORL carcinoma].
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Adult↗
[Bacterial infections of the ear: case contribution on clinical and microbiological aspects].
Ciprofloxacin was given in oral doses of 250 mg. each 8 hours to 21 patients with otitis. The efficacy of treatment was assessed by clinical and bacteriological parameters. The 61.9% of isolated bacteria are opportunistic. A case of chronic otitis by Achromobacter xylosoxidans is described.
Bacterial Infections↗
[Significance of associated causes in the evaluation of post-traumatic vestibular damage].
Any evaluation of vestibular diseases following head and neck injuries must take into consideration the existence of other diseases which may act with the trauma causing lesions which might not have taken place otherwise or which would have had less import. In the present work the authors examine what medico-legal doctrine considers in regard to pre-existing, simultaneous and cropped up aggravations of lesions or of invalidity. Finally, an explanation is given of personal experience with 1500 patients with head and neck injury. It is pointed out how in 130 cases the presence of pathological conditions associated with the traumatic event was the cause of problems in evaluation of primary importance.
Accidents, Occupational↗