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Biomedical subjects

C Servadio

Publications and source records attributed to C Servadio.

At least 127 records · Page 7Linked to original sources

The mechanism of human NK cell-mediated cytotoxicity. Mode of action of surface-associated proteases in the early stages of the lytic reaction.

The possible involvement of cell surface-associated proteolytic enzymes in human NK cell-mediated cytotoxicity and the mechanism by which such enzymes exert their activity have been studied. The treatment of intact cells with 3H-DFP under restricted conditions that predominantly bind surface-associated enzymes resulted in the labeling of five to six enzyme bands. Among these were a 35,000-dalton enzyme, which may be a previously identified trypsin-like proteinase engaged in cytotoxicity, and a 58,000-dalton elastase. The latter seems not to be involved in the reaction, as potent inhibitors of this enzyme have negligible effect on cytotoxicity. Of the membrane-associated enzymes, those engaged in cytotoxicity seem to be concealed from the external environment, as pretreatment of the effector cells with protease inhibitors such as trasylol and PMSF have no effect on the reaction. Immediately upon addition of the target cells and the initiation of cytotoxicity, the reaction becomes highly sensitive to inhibitors for a limited time interval of 2 to 5 min when trasylol is employed and 5 to 10 min when TPCK is the inhibitor, suggesting that target cell binding triggers the exposure of the enzymes to the external environment, rendering them accessible to the inhibitors. This short sensitivity period parallels the interval in which the reaction is sensitive to the microfilament inhibitor cytochalasin B. As the reaction proceeds, it becomes increasingly resistant to inhibitors of both proteolysis and cytoskeleton, at the same time suggesting that microfilament action and the unraveling of proteases may be processes that bear a close linkage with one another. The surface-associated elastase on the other hand maintains a constitutive mode of activity distinctive and unrelated to that of enzymes engaged in cytotoxicity. These findings suggest the existence on the surface of the NK lymphocyte of a mechanism that associates the receptor for target cells with an array of enclaved proteolytic enzymes via microfilaments. The resting cytotoxic structures become activated as the receptor attaches to the target cell, triggers the exposure of the proteolytic moiety, and initiates the lytic phase of the reaction.

Aprotinin↗

T cell subsets in renal transplanted patients defined by theophylline sensitivity and monoclonal antibodies.

Peripheral T cell subsets were determined in 26 patients after renal transplantation. Thirteen patients were undergoing acute rejection episodes at the time of blood sampling. Two methods were used for the determinations: the theophylline sensitivity test (THST) and the monoclonal antibodies method OKT8 and OKT4. In both rejecting and non-rejecting groups, the percentages of T suppressor lymphocytes (TS) was found to be higher by the OKT8 method than by the THST. Furthermore, no significant difference in TS percentages could be revealed by the OKT8 method between the two groups. However, with the THST the differences were significant with a mean value of 13.5 +/- 7.9 per cent in the rejecting group and 21 +/- 5.9 per cent in the non-rejecting group (p less than 0.01). The different results between the two methods could be attributed to the fact that by THST only TS cells are defined while the OKT8 conjugates also with cytotoxic T lymphocytes. The measuring of T helper cells (TH) revealed much higher percentages of TH in the rejecting group than in the non-rejecting group, 51 +/- 9.5 per cent mean value and 29 +/- 13 per cent mean value, respectively (p less than 0.05). The ratio OKT4+/OKT8+ was below one in the non-rejecting group and above 1.5 in the rejecting group. We concluded that the THST as well as OKT4+/OKT8+ ratio may be a helpful laboratory test to confirm a clinically suspected acute rejection episode.

Antibodies, Monoclonal↗

Kidney transplantation in patients on continuous ambulatory peritoneal dialysis.

In the 45 months from April 1980 to December 1983, 137 patients received first cadaver kidney grafts. Thirty-two of the patients were on continuous ambulatory peritoneal dialysis (CAPD group) and 105 were on haemodialysis (HD group). The two groups of patients were similar in respect to pre-transplant blood transfusions, mean age, HLA-A, B, DR matching and immunosuppressive therapy. In 14 CAPD patients at least one episode of peritonitis was documented before transplantation. The actuarial graft and patient survival was 57 per cent and 84.4 per cent, respectively for the CAPD group and 55.8 per cent and 85.3 per cent in the HD group. No patient in either group had evidence of peritonitis after the transplantation. These similar results indicate that kidney transplantation in CAPD patients carries no greater risk than in patients on haemodialysis.

Adolescent↗

Hyperthermia in the treatment of prostate cancer.

Hyperthermia-the sustained heating of tissues to temperatures of 42 degrees C to 43.5 degrees C--increasingly is being studied by scientists as a new tool to destroy cancer cells, either alone or in conjunction with other well established forms of treatment, such as radiotherapy and chemotherapy. Many studies on tissue cultures, on animals and also on humans, have established the fact that this new nonconventional adjuvant form of treatment is actually effective. Progress is being made in the development of the necessary technology for delivering the desired and controlled form of heat to the diseased site, while protecting the surrounding healthy tissues from irreversible damage. Initial clinical trials in this direction are very promising and seem to offer new avenues in the methods of treatment for cancer of the prostate.

Aged↗

Carcinoma of the prostate in Israel: some epidemiological and therapeutic considerations.

Analysis of the different rate of prostatic cancer in Israel among Jews from various countries of origin reveals some very interesting and marked varieties in incidence, which are studied more closely now. Aggressive, combined treatment for the invasive cases of prostatic cancer has been used since 1975. This was based on orchiectomy, DES, and chemotherapy for the stage D2 disease, and on radiotherapy and hormonal therapy for the stage C, and possibly also the stage D1 disease. Results so far have been very encouraging indeed, and with considerably better results than obtained with the individual, more conventional forms of therapy. Five-year survival in the stage D2 disease has been 63.5%, and 87.6% in the stage C (+D1?) disease. It appears that this approach is more justified, certainly in the advanced stages of this disease.

Aged↗

Familial occurrence of undescended testes.

We had the opportunity of treating a family with 6 siblings, 2 of them twins, all sons of the same father and mother, 5 of whom had undescended testes. We hereby report on this rare occurrence of familial undescended testes. Only 1 similar case was previously reported in the English literature. The literature is reviewed, and possible etiologic factors are mentioned.

Adolescent↗

Steroid receptors in renal cell carcinoma: relevance to hormonal therapy.

The relevance of the presence of steroid receptors in the response to hormonal therapy was examined in 19 patients with renal cell carcinoma who were treated by surgery and progestins. Estrogen and progesterone receptors were determined in tissue samples obtained from the tumors, and normal (autologous) and control kidneys. The tumoral tissues had the lowest content of estrogen and progesterone receptors, and the lowest percentage of samples positive for receptor. Autologous kidneys had a higher percentage of positive estrogen and progesterone receptors compared to tumoral tissues, and a lower estrogen receptor content compared to control kidneys. The 18-month survival rate under progesterone therapy for 9 patients with stages I and II tumor was 86 per cent and for 10 with stage IV tumor it was 8 per cent. The low content of progesterone and estrogen receptors in patients with renal cell carcinoma may explain the poor response rate of these patients to hormonal therapy.

Adenocarcinoma↗

T-cell subsets in a cyclosporin-A treated recipient of cadaveric kidney allograft as defined by theophylline sensitivity and monoclonal antibodies.

Three different methods (theophylline sensitivity, monoclonal antibodies and a local xenogeneic graft-versus-host reaction) were used to study the T-cell subsets in two renal allograft recipients, one who was treated with cyclosporin-A + prednisone after having received preoperative gradual lymphoid irradiation and one who was treated by conventional methods following transplantation. In the patient treated with cyclosporin-A, who experienced no clinical rejection and has been in good condition during four months of follow-up, the percentage of theophylline-sensitive TS cells rose from 3% following irradiation to 38% one week after transplantation and treatment; T suppressor cells tested by OKT8 antibodies ranged from 60% to 100% whereas the helper cells tested by OKT4 ranged from 10% to 40%, with a ratio of OKT4/OKT8 below 0.6. In the patient receiving conventional treatment, who underwent unresponsive acute renal rejection 21 days after transplantation, the level of suppressor cells was much lower, ranging from 12% to 42%, with the OKT4/OKT8 ratio ranging from 1.47 to 2.5.

Adult↗

Unusual clinical presentation of metastatic prostatic carcinoma in elderly patients.

Three elderly patients with unusual symptoms of metastatic prostatic carcinoma are presented. The first patient suffered from recurrent acute renal failure, the second presented with induration of penis, and in the third patient an acute onset of paraparesis was the presenting symptom of prostatic cancer. The incidence of such symptoms is reviewed and the importance of early diagnosis and therapy is discussed.

Acute Kidney Injury↗

Combined external radiotherapy and hormonal therapy for localized carcinoma of the prostate.

Forty-nine patients with localized carcinoma of the prostate were treated by external radiotherapy together with hormonal manipulation and were followed up to six years. Hormonal manipulation included bilateral orchiectomy and diethylstilbestrol, 3 mg/day. The cumulative five-year survival for the 49 patients was 87.6%, with 11% progression rate to stage D during that period. In 40 patients (81.6%), a decrease in the size of the prostate was noted. In none of the patients was there local recurrence of the tumor during the period of follow-up. Transient gastrointestinal and/or urinary symptoms occurred following radiotherapy in 11 patients (22.4%), and in four patients severe cystitis or proctitis appeared. Complications related to hormonal therapy occurred in 11 patients (22.4%). The high survival rates reported herein, together with the low progression rate to stage D during six years of follow-up, may justify the early institution of radiotherapy in combination with hormonal manipulation for patients with localized carcinoma of the prostate. A randomized study with an extended number of patients is underway to further evaluate this mode of therapy.

Aged↗

ATP contents of human semen, seminal plasma and isolated sperm at time intervals after ejaculation.

1. ATP was estimated in 105 samples of human semen, seminal plasma and sperm of normozoospermic and oligozoospermic origins at time intervals after ejaculation. 2. In semen with sperm counts up to 40 millions per ml and in seminal plasma, ATP levels were lower than in specimens with higher sperm counts. 3. In isolated sperm, the ATP content decreased with the increase in sperm density. 4. The decrease in ATP after 24 hr was the highest in sperm, lower in semen and the lowest in seminal plasma, being maximal in specimens with high sperm counts.

Adenosine Triphosphate↗

Early combined hormonal and chemotherapy for metastatic prostatic carcinoma.

Twenty-four patients with confirmed Stage D carcinoma of the prostate were treated with a combination of bilateral orchiectomy, estrogens (diethylstilbestrol) and chemotherapy (5-fluorouracil), and cyclophosphamide soon after diagnosis was established. Patients were followed up between forty-two to seventy-two months. Seventy-five per cent of patients reported relief of bone pain after initiation of therapy, and 83.3 per cent reported relief of their urinary symptoms. The primary tumor shrank in all patients, and initial stabilization or partial disappearance of osteoblastic lesions on bone scans was noted in 79.1 per cent of patients. The cumulative survival rates at five and six years were 63.48 and 50.78 per cent, respectively. The combined therapy was well tolerated by the patients, and complications were not severe and of a transient nature.

Aged↗

Use of hydrogen gas clearance for measurement of renal circulation. An experimental study.

Inhalation of hydrogen gas and its immediate diffusion into the blood permits an accurate and reproducible determination of its clearance through a fine platinum electrode inserted in the renal cortex. The oxidation of molecular hydrogen at the surface of the electrode generates a current which is then easily recorded. Such recordings accurately reflect regional arterial circulation. Experiments have been done in rats to determine regional renal cortical arterial circulation in (1) normal conditions, (2) immediately following unilateral, complete ureteral obstruction, and (3) following a twenty-four-hour ureteral obstruction. Hundreds of simple and reproducible recordings were obtained. Although acute obstruction does not immediately affect cortical blood supply, a twenty-four-hour obstruction was accompanied by a 31.3 per cent reduction in circulation.

Animals↗

The influence of lower urinary tract infection on the recurrence rate of superficial transitional cell carcinoma of the bladder.

We studied retrospectively 78 patients with recurrent superficial bladder tumors in an effort to determine whether transitional tumor cells implant and grow preferentially in patients who have undergone endoscopic resection of stage T1 bladder tumors in the presence of an inflamed urothelium. Of the patients 32 (group 1) had an undetected lower urinary tract infection at the time transurethral resection was performed and 46 (group 2) were free of infection. All patients had intravesical chemotherapy by thiotepa (triethylenethiophosphoramide) and were treated with appropriate antibiotics as soon as the urinary tract infection was recognized from 24 to 48 hours postoperatively. Of the patients in group 1, 37.5 per cent had tumor recurrence in less than 6 months and 15.6 per cent in less than 3 months, compared to 30.4 and 6.5 per cent, respectively, in group 2. Although the tumor recurrence rates 3 and 6 months postoperatively were higher among the group 1 patients (with urinary tract infection) the difference between the 2 groups was not significant. Because the patients were treated by intravesical chemotherapy, and antibiotics in those with urinary tract infection, our study does not allow a definite conclusion regarding the contribution of urinary tract infection on the recurrence rate of superficial bladder tumors.

Aged↗

In vitro induction of T suppressor lymphocytes in recipients of renal allografts by THF, a thymic hormone.

Lymphocyte subpopulations were determined in 13 patients, recipients of kidney allografts, 7 of them during an acute rejection episode (ARE). Monitoring of the T lymphocyte suppressor or T helper cells was performed by aid of the theophylline sensitivity test and the local xenogeneic graft-versus-host reaction (GVHR). An absence or a striking decrease of theophylline-sensitive T suppressor cells was found in all patients during ARE. Incubation of the lymphocytes of these patients with a thymic hormone, THF, raised the number of TS lymphocytes from nil or from a very low level to normal or above. The therapeutic use of THF in selected renal allograft recipients is proposed.

Acute Disease↗