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Biomedical subjects

C Pozzi

Publications and source records attributed to C Pozzi.

At least 55 records · Page 3Linked to original sources
PubMed1993

Methylprednisolone normalizes superoxide anion production by polymorphs from patients with ANCA-positive vasculitides.

It has been convincingly documented that reactive oxygen species released from activated neutrophils mediate glomerular damage in experimental glomerulonephritis. Recent findings that antineutrophil cytoplasmic autoantibodies (ANCA) induce neutrophils to degranulate and produce oxygen radicals in vitro led us to explore whether neutrophils from patients with ANCA-positive vasculitides and necrotizing glomerulonephritis generated an increased amount of superoxide anion (O2-). Since glucocorticoids inhibit oxygen radicals generation in vitro we also evaluated the effect of intravenous pulses of methylprednisolone. Polymorphs were isolated from peripheral blood collected before (basal), 6 and 24 hours after the first infusion of methylprednisolone and 24 hours after the third one. O2- release by cells was assessed after 30 minute incubation without specific stimuli. Basal O2- release was significantly higher in patients than in controls (P < 0.01). Intravenous infusion of high doses of methylprednisolone markedly reduced O2- production with respect to the basal value, and the difference was statistically significant at various time interval considered after the steroid infusion. Besides reducing the excessive O2- formation, methylprednisolone induced an increase in polymorph expression of the gene encoding for manganese superoxide dismutase (Mn-SOD) enzyme. We conclude that polymorphs taken from patients with ANCA-positive vasculitides and necrotizing glomerulonephritis generate higher amounts of O2- than those from normal subjects. Methylprednisolone normalizes the abnormal generation of O2-, likely through its ability to up-regulate the gene for Mn-SOD, a potent antioxidant enzyme.

Adult↗
PubMed1993

Quantitative expression of HLA class I molecules in acute non-lymphoblastic leukaemia cells.

The present study concerns a panel of 33 acute non lymphoblastic leukaemia (ANLL) patients, previously typed for HLA-A,B serological specificities and including samples with a normal HLA-A,B phenotype (3,4 detected specificities) as well as samples with missing and extra specificities. Samples were analysed at the protein and/or RNA level in order to verify whether the observed typing anomalies were due to a modified quantitative expression of class I molecules. The number of HLA-A,B assigned specificities correlated significantly with the cell surface class I expression detected by indirect immunofluorescence using the monomorphic anti-class I MoAb W6/32 (Spearman rank correlation test, P < 0.01) and with the amount of class I Heavy Chain (HC, P < 0.05) and beta-2-microglobulin (beta 2m, P < 0.05) evaluated by Western blot in whole cell extracts. The RNA analysis suggested a HC-beta 2m coordinated down regulation at the mRNA level in a patient with no assigned HLA-A,B specificities. Another patient with no detectable HLA-A,B specificities showed a low expression selectively of the beta 2m protein. The results reported here demonstrate a heterogenous quantitative HLA class I expression in ANLL blasts, analogous to results reported for solid tumours.

Antigens, Neoplasm↗
PubMed1993

IgA nephropathy: remission during pregnancy and relapse in the puerperium.

A 39-year-old woman, with proteinuria and microhematuria, at about the 8th week of pregnancy showed a reduction in proteinuria. After the 16th week, proteinuria disappeared. In the 40th week, the patient spontaneously delivered a 1.990-kg still-born female. Six days later, blood pressure increased (to 150/100 mm Hg), and laboratory examinations showed that proteinuria was 2.7 g/24 h. Given that urinalysis confirmed the presence of proteinuria, 6 weeks later, a renal biopsy was performed. The final diagnosis was IgA nephropathy. It is possible that the presence of the fetus may have led to changes in the maternal immunological system which may have attenuated the immunopathogenic mechanisms responsible for IgA nephropathy.

Adult↗
PubMed1993

Idiopathic membranous nephropathy in the elderly.

In this retrospective non-randomized study we reviewed the outcome for 41 patients with membranous nephropathy older than 65 years at onset and followed for at least 1 year. Twelve of the patients never received any specific treatment (group A), 15 were treated with a 6-month course of methylprednisolone alternated to chlorambucil every other month (group B), and 14 received corticosteroids alone for 3-12 months (group C). At the end of a mean follow-up of 92 +/- 61 months in group A, 53 +/- 35 in group B, and 38 +/- 25 in group C there were significantly more remissions of nephrotic syndrome in group B than in group A (P = 0.035) or in group C (P = 0.010). Moreover patients in group B spent a significantly longer period without nephrotic syndrome than patients in group A (P = 0.000) and C (P = 0.000). Three patients in group A and one in group B died. During the follow-up six patients of group A, two of group B, and five of group C developed renal function deterioration. In patients followed for at least 5 years the mean plasma creatinine increased from a basal of 112 +/- 29 to 239 +/- 287 mumol/l at the 5th year in group A and from 113 +/- 14 to 124 +/- 30 mumol/l in group B. The mean urine protein excretion remained unchanged in group A (basal 4.6 +/- 2.3 versus 4.8 +/- 5.7 g/day at 5 years) while it decreased in group B (from a basal of 6.8 +/- 3.5 to 1.1 +/- 0.4 g/day at 5 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Chronic dialysis in patients with systemic amyloidosis: the experience in northern Italy.

The clinical outcome of 61 patients with renal amyloidosis treated with chronic dialysis was reviewed. Eighteen patients, 4 with primary or AL amyloidosis and 14 with reactive or AA amyloidosis, died within one month from starting treatment. The other 43 patients were treated with dialysis for 3 to 199 months and are the object of this study. Sixteen patients had AL amyloidosis and 27 had AA amyloidosis. Thirty-five patients were treated with hemodialysis (HD) for a mean period of 40 +/- 47 months and 8 were treated with continuous ambulatory peritoneal dialysis (CAPD) for 20 +/- 15 months. Patient survival rate at 1 and 5 years was 68% and 30% respectively. There was no difference in survival rate between patients treated with HD and those treated with CAPD, while patients younger than 45 had a better 5-year survival rate. Twenty four (60%) patients achieved a satisfactory rehabilitation with dialysis. At the last follow-up, 15 patients (14 on HD, 1 on CAPD) were alive 61 +/- 58 months after starting dialysis. Twenty-eight patients died after 30 +/- 20 months. The main causes of death were: cardiovascular accident (11), stroke (3), sepsis (5) and cachexia (5). The most important extra-renal complications of amyloidosis were related to cardiovascular involvement (heart failures, arrhythmias, hypotension) and gastrointestinal involvement (malabsorption). Intra-dialytic hypotension in patients on HD and peritonitis in patients on CAPD were the main problems related to dialytic procedure. his study confirms that life expectancy and the quality of life of dialysis patients with systemic amyloidosis are poorer than those of general dialysis population.(ABSTRACT TRUNCATED AT 250 WORDS)

Amyloidosis↗
PubMed1991

[Treatment of residual and recurrent biliary calculi: the surgical option].

Retained and recurrent bile duct stones can be treated with a variety of non-surgical methods. The list includes endoscopic papillotomy, chemical dissolution, by T-tube extraction, percutaneous or extracorporeal lithotripsy. The various attempts at non-surgical therapy are described in two patients with retained bile duct stones before biliary clearance was achieved by re-operation. The failure of oral dissolution using biliary acids, endoscopic papillotomy and by T-tube extraction, led to a delay of 6 and 8 months respectively in the elimination of the retained stones in each patient. Surgical re-exploration proved relatively simple due to the long interval after the first operation, and the stones were removed without particular difficulties. The paper underlines the importance of the choice of treatment for use in cases of secondary common bile duct calculi, evaluated on the basis of a correct assessment of the cost/benefit, risk/benefit ratios.

Cholangiography↗
PubMed1991

Utility of immunofluorescence of urine sediment for identifying patients with renal disease due to monoclonal gammopathies.

Immunofluorescence (IF) of urine sediment with antisera to light-chain immunoglobulins (LC) was used for patients with renal disease due to various monoclonal gammopathies. Urinary casts and/or masses from 20 of 27 patients (74%) of this group stained predominantly for one or another of the two LC, but from none of the 25 controls, who all had renal diseases other than monoclonal gammopathies. In all but one patient with monoclonal gammopathy the more intensely staining LC in the urine sediment was the same as that found in the paraprotein. For 68.7% of patients, the prevailing LC in urinary casts was the same as that prevailing in the casts of the renal biopsies. The sensitivity of IF of urine sediment for identifying patients with plasma cell dyscrasias was 74%, the specificity 100%, and the accuracy 86.5%. The positive predictive value was 100% and the negative predictive value was 78%. Globally, urine sediment IF was more sensitive than serum or urine electrophoresis (74% v 63% and 66.6%), but less than serum or urine immunoelectrophoresis (74% v 85%). In light-chain deposition disease, a disorder in which there are often no definite symptoms, urine sediment IF was more sensitive than both traditional methods. We conclude that IF of urine sediment is a useful test to identify patients with renal disease associated with monoclonal gammopathies.

Adult↗
PubMed1991

Selective and early increase of IL-1 inhibitors, IL-6 and cortisol after elective surgery.

After trauma, inflammatory, immunological and hormonal changes are well documented. Surgical intervention is a form of programmed trauma. Through the study of surgical patients, changes in early endogenous mediators of inflammation, immune response and tissue repair can be investigated. Here we analysed changes in serum levels of IL-1 inhibitors, IL-1 beta, IL-6, tumour necrosis factor-alpha (TNF-alpha) and cortisol in patients undergoing elective surgery. C-reactive protein (CRP) was measured as a marker of the acute-phase response. Rises in serum levels of IL-1 inhibitors, IL-6 and cortisol were detected as early as 1 h after the intervention. Peak levels were reached between 2 and 5 h. Serum levels of IL-6 and cortisol remained elevated for several days implying a persistent production. Serum levels of IL-1 and TNF did not change after the intervention. CRP levels peaked on day 2. The communication system sustained by endogenous mediators is activated after surgery as shown by selective changes in IL-1 inhibitors, IL-6 and cortisol. These mediators have different kinetics in serum and IL-6 is not the only early mediator detected. Some IL-1 inhibitors might be involved in the immunological depression observed after major surgery, in the regulation of the inflammatory response or in tissue repair. IL-6 and cortisol seem to act synergistically to activate the acute-phase response. A systemic role for IL-1 and TNF is not evident, even if the possibility that these lymphokines may act locally is not ruled out.

Adult↗
PubMed1991

[Cytogenetic studies in renal carcinoma].

We have analyzed from cytogenetic point of view 24 cases of sporadic renal carcinoma. Clonal chromosome changes were found in 15 of 24 cases (62.5%) (-Y, +7, +10, del (3) (p21----pter), der (1). For what in concerning correlations between Karyotype and anatomo-pathological and clinical aspects we can observe that: 1) Cases with normal Karyotype showed low grade of anaplasia and stage I 2) No correlation exists between karyotype and diameter of the neoplasia. In 8 cases cytogenetic analysis was performed in normal renal tissue; five case showed the same clonal abnormality present in the correspondent neoplasia (-Y, +18, +10); one case showed trisomy 7. The result are discussed in respect to the previous literature and to the clinical significance.

Carcinoma, Renal Cell↗
PubMed1990

Altered expression of HLA-A,B specificities on acute lymphoid and myeloid leukaemia blasts.

HLA-A,B specificities were analysed on the neoplastic blasts of a panel of 69 lymphoblastic (ALL) and 50 non lymphoblastic (ANLL) acute leukaemias at onset using the standard lymphocytotoxicity technique. Analysis of the number of detected specificities per locus and, when possible, comparison of the results with those obtained on lymphocytes of the same patients during remission revealed many alterations in the expression of A,B specificities including extra specificities both at the HLA-A and -B loci mainly on lymphoblasts and missed specificities mainly at the HLA-B locus on myeloblasts. Lack of A,B antigens was complete in 6.2% of all tested samples (9% of ANLL) and selective for all the products of one locus in 16.8% of all tested samples (27.7% of ANLL). A decrease of class I molecules on the cell surface was evidenced with MoAb W6/32 on blasts missing detectable serological specificities.

HLA-A Antigens↗
PubMed1989

[Primary therapy after radical removal of sinus pilonidal].

The successful closure of the operative wound after removal of the Sinus pilonidalis, is linked, in our opinion, to the application of certain measures that should be taken during surgery. Specifically: 1) careful haemostasis, 2) correct positioning of effective deep drainage with exit into the left gluteal region, 3) diligent suture of the deep layers, 4) correction of tension at operative wound level. Two-year follow-up of 29 of 32 operated patients did not reveal relapses.

Adolescent↗