[Treatment of chronic cardiac decompensation in patients 70 years of age and older].
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Biomedical subjects
Publications and source records attributed to F D'Amore.
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Haematologic effects of delayed 16 h administration of leucovorin (LV) following high-dose methotrexate (HDMTX) were analyzed in C57Bl X C3H F1 mice. Results show that 16 h administration of LV significantly reduces the toxic effects of HDMTX on hemopoietic progenitors and bone marrow cells. At 12 days after HDMTX administration, the bone marrow level of CFUs was significantly higher in HDMTX-LV treated mice than in HDMTX treated animals. In comparison with previous data obtained when LV was injected 2 h after HDMTX, the delay in administration of LV does not appear to reduce the protective effect of the vitamin.
The phenotypic characteristics of a cloned giant cell line, SU/RH-HD-1, established from the spleen of a patient with Hodgkin's disease were studied. The cells grew slowly, adhered to the culture vessel surface, and had an elongated, irregular shape. After trypsinization, they became spherical and measured 30-100 micron in diameter. Although most cells were mononuclear, binucleated and multinucleated cells could be identified in expanded cultures. The cells phagocytized latex and ink particles and were nonspecific esterase-positive, but they did not secrete lysozyme. They were Epstein-Barr nuclear antigen-negative, and their culture fluid supernatants were devoid of reverse transcriptase activity. Electron microscopy revealed cells with a pronounced smooth endoplasmic reticulum, free ribosomes, some filaments, and mitochondria. Many 0.5- to 1.0-micron invaginations (pits) were seen along the cell membrane. Nucleoli were enlarged and prominent in the very heterochromatic nuclei. The SU/RH-HD-1 cells had 10- to 100-micron-long pseudopodia that were sometimes forked or branching, as well as multiple stress fibers. Electron microscopic appearance was suggestive of that of macrophages. This interpretation of the results was substantiated by monoclonal antibody studies, which revealed that the cells express antigenic determinants distinctive for cells of the monocyte-macrophage lineage and by functional studies demonstrating that the cells are capable of specific antigen presentation to immune T-cells. The SU/RH-HD-1 cells were aneuploid and could be cloned, first in liquid culture by limiting dilution and later in semisolid medium. It was likely that the SU/RH-HD-1 cells were derived from the neoplastic giant cell population in Hodgkin's disease and that they originated from cells of the mononuclear phagocyte-reticulum cell lineage.
The hematologic toxicity of 4-demethoxydaunorubicin (4-dmDNR), a new anthracycline more potent and less cardiotoxic than doxorubicin (Dx), was studied. Dose-survival curves of bone marrow hematopoietic precursor cells (HPC) in situ were determined with the use of (C57BL X C3H)F1 mice and with assays of colony-forming units--spleen, culture, and erythroid--by in vivo and in vitro methods. Time response of HPC was followed in mice treated at days 0, 2, and 5 with 0.75 mg 4-dmDNR/kg of 4.5 mg Dx/kg and in mice receiving 2.23 mg 4-dmDNR/kg or 3.96 mg Dx/kg twice a week for 4 weeks. The dose-survival curves of HPC for 4-dmDNR were exponential. Slight differences in sensitivity among assayed populations were seen. Although the doses of 4-dmDNR required to reduce the survival of HPC to 37% were similar or lower than those of Dx, following intermittent treatment with doses of 4-dmDNR with the same optimal antitumor activity as with Dx, 4-dmDNR seemed to have a lesser effect on hematopoietic progenitors and a greater effect on peripheral blood cells than did Dx. However, during prolonged administration 4-dmDNR appeared to be toxic at every hematopoietic level.
The effects of 4'epi-doxorubicin (4'-epi-DX) on survival of in situ murine bone marrow hematopoietic precursor cells (HPC) were studied. The drug was given to (C57BL X C3H)F1 mice in increasing single doses, in repeated administration (three time in 5 days), or for a long period (twice a week for 10 weeks). Survival of colony-forming units (CFUs, spleen; CFUc, culture; and CFUe, erythroid) was assayed by in vivo and in vitro methods; dose survival curves were exponential. It appears that single doses of 4'epi-DX have a greater impact on murine HPC than single doses of the parent compound. Following repeated administrations, pluripotential stem cells recover better after the derivative than after its parent drug. During prolonged treatment, the bone marrow content of committed progenitors is depleted to a lesser extent in the animals treated with 4;-epi-DX than in those receiving DX. It is, however, possible that, following the same prolonged treatment, this difference is minimal. The conclusion, these experimental data seem to indicate that 4'-epi-DX has lower toxicity in murine HPC than DX and that this is evident mainly after repeated administrations for a short period of time.
The effect of Adriamycin and 4-Eip-Adriamycin was studied on CFUs, CFUc, CFUe of murine bone marrow and spleen. Differences among the bone marrow stem cells and the spleen stem cells have been observed. It seems possible to explain some of these differences admitting a process of redistribution from the bone marrow to the spleen.
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At first the AA. present the recent progresses reached in the Endocrinology diagnostic with the aid of the radioisotopic techniques; successively they refer about the principles regulating the chemical reactions used in the dosage of the single hormones and about the use of index interesting the clinical practice. The AA. compare the methods of dosage used in the kits of various firms outlining the problems concerning the technological times, the operations number, the contamination risk. They performed several control tests on the T3 RIA, recently introduced into the clinical diagnostic, on the calibration curve, on the repeatibility of the results, on the recovery tests, on the sensitivity of the tarature curve, showing the normal and abnormal values obtained in their hospital. They refer moreover on the results obtained dosing together on the same samples T4, TBC, ETR, T3, RIA, TSH and on the clinical utility of the single tests. Several dosages of T3 and of T4 were effected on urine to have informations on the urinary excretion levels of the thyroid hormones in normal and abnormal subjects. At last they hypothesize the use of the hormonal urinary values and the plasmatic ones for calculating an ormonal thyroid clearance.
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We examined the effect of nutritional supplementation for 13 wk on anthropometric, pulmonary function, and immunological status in malnourished ambulant patients with pulmonary emphysema (EP). The study was placebo controlled, randomized and double blind. Twenty-eight patients were included. Thirteen patients in the fed group were provided with a nutritional formula providing 20% protein, 30% fat, and 50% carbohydrate, 1 Kcal/ml, 400 ml/day. The control group was provided with a reference product of the same consistency and taste containing 0.1 Kcal/ml, 400 ml/day for 13 wk. The fed group had a mean weight gain of 1.5 kg during the study period, the control group increased concomitantly 0.16 kg, the difference being significant (p less than 0.01). Sum of four skinfolds increased 2.7 mm in the fed group, and decreased 0.9 mm in the control group the difference being significant (p less than 0.01). No difference were observed regarding pulmonary function or immunological status. We also found a high habitual energy intake in our study group (204% Basal Energy Expenditure). We conclude that nutritional supplementation produce weight gain in malnourished patients with EP, but it does not change other indices of well-being.
The Authors describe a rare case of esophageal stenosis complicated by gastroesophageal reflux due to Trichosporon beigelii in the absence of a pathologic predisposition or immunodeficiency. The diagnosis was drawn by embedding membrane fragments obtained endoscopically in Sabouraud and blood-Agar cultures. The patient was treated with antimicotics, immunostimulants, inhibitors of the gastric protonic pump, prokinetics and later underwent endoscopic dilatation combined with Savary-Guillard and pneumatic dilatators of growing diameter, until complete "restitutio ad integrum" of the esophageal lumen.
Two cases of neuroleptic malignant syndrome are reported. Although affecting chiefly psychiatric patients, this rare, polymorphic disease should be well-known to internists, general practitioners, and emergency staff because of its high risk of fatality. Our patients, who presented without some of the main symptoms, fell in the category of incomplete variants of the syndrome, the most difficult to recognize. In both patients, computerized tomography carried out at the outset of symptoms, evidenced signs of cerebral edema, a datum never before reported. The symptomatic polymorphism, pathogenesis, differential diagnosis, and therapy of this disease are illustrated and discussed.
The Authors report a case of spontaneous large gastric phytobezoar in an unoperated stomach and describe this pathology especially with regards to pathogenesis, diagnosis and endoscopic treatment.