Biomedical subjects
Publications and source records attributed to F Salsano.
Post-hysterectomy fallopian tube prolapse is a rare complication with only 80 cases described since 1902. Symptoms are non-specific and often of delayed onset. Final diagnosis is confirmed by vaginal biopsy with salpingectomy being the treatment of choice, preferably performed laparoscopically. Following surgery, complete symptom resolution is usually observed and no recurrence has been reported.
OBJECTIVE: To assess the efficacy and tolerability of N-acetylcysteine (NAC) in patients with Raynaud's phenomenon (RP) secondary to systemic sclerosis (scleroderma; SSc). METHODS: Twenty-two patients with RP secondary to SSc were enrolled in a multicenter, open clinical trial lasting 11 weeks and conducted in winter. Primary outcome measures were frequency and severity of RP attacks, and number of digital ulcers. Secondary outcome measure was improvement in digital cold challenge test assessed by photoelectric plethysmography. Patients received a continuous 5 day intravenous infusion of NAC starting with a 2 h loading dose of 150 mg/kg subsequently adjusted to 15 mg/kg/h. RESULTS: All 22 patients completed the 5 day infusion and 20 of them the posttreatment followup. Both frequency and severity of RP attacks decreased significantly compared to pretreatment values. Active ulcers were significantly less numerous at all followup visits (25.18% of baseline count on Day 33 from the beginning of infusion). In the cold challenge test mean recovery time fell by 69.56%, 67.70%, 71.42%, and 71.05% on Days 12, 19. 33, and 61 from the beginning of treatment. Side effects were minor, easily controlled, and reversible. CONCLUSION: N-acetylcysteine appears to be safe for the treatment of RP secondary to SSc. These preliminary data warrant further controlled studies.
AIM: To determine whether inducible nitric oxide synthase (iNOS) stimulation of human atrial fragments can be diminished by the naturally occurring signal molecules, such as morphine, anandamide, and estrogen. The use of iNOS as an indicator is justified since it has been associated with initiation of various types of cellular damage either directly or indirectly. METHODS: Western blots were performed on control and drug-exposed atrial tissue before and after lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma) exposure. RESULTS: Preincubation of the tissue with morphine, anandamide or estrogen prior to, but not after, the addition of LPS + IFN-gamma, blocked iNOS expression. The nitric oxide donor SNAP also blocked iNOS induction while preincubation of atrial fragments with an inhibitor of NOS, L-NAME, prior to morphine or anandamide exposure, restored LPS + IFN-gamma induction of iNOS. CONCLUSION: These data suggest a direct regulatory link at the transcriptional level between constitutive (c) NOS and iNOS in human atrial tissue.
UNLABELLED: This study was performed to evaluate the clinical usefulness of nuclear matrix protein 22 (NMP22) as urinary marker for bladder cancer and to define its role in comparison with urinary cytology in diagnostic management of patients with hematuria. MATERIALS AND METHODS: NMP22 values in voided urines were determined on 90 patients (81 males, 14 females) with macro or microscopical hematuria, using the NMP22 test-kit (Matritech) based on an enzyme-linked immuno-sorbant assay. The cut-off value for positive samples was 10U/ml. In all cases urinary cytology was performed on the same sample. Patients suspected for the presence of a transitional cell carcinoma (TCC) underwent cytoscopic control. Statistical signification of the medians difference was analyzed using both medians variance analysis and Student's test. The increasing in diagnostic predictivity was analyzed elaborating contingency tables and performing consequently chi 2 test. RESULTS: 32 cases of TCC were endoscopically detected: sensitivity of cytopathology was 75.8%, specificity was 62.5%. The positive predictive value of the cytology was 22% and negative predictive value was 49%. The results concerning NMP22 dosage are: sensitivity 84%, specificity 62%. Positive predictive value of NMP22 test was 30% and predictive negative value was 40%. No significant differences between cytopathology and NMP22 dosage were founded (p > 0.995). Considering both cytopathology and NMP22 dosage, sensitivity was 82.7% and specificity raises up to 90.6% with statistical signification (P < 0.001). The median NMP22 value in patients affected by TCC endoscopically confirmed (group A) was 55.2 U/ml, in subjects with no evidence of malignancy (group B) it was 19.1 U/ml. The difference shows statistical signification (p < 0.001). In 20 cases with TCC, hystological grading were available and were investigated in relationship with NMP22 title in U/ml, median NMP22 value for each grade was: CIS = 102 U/ml, G0 = 35 U/ml, G1 = 30 U/ml, G2 = 66 U/ml, G3 = 54 U/ml. It can be assessed that NMP22 test is useful in differentiating subjects affected by TCC from subjects with no evidence of malignancy and may help in early diagnosis of TCC and in predicting recurrent even if low grade tumors especially if used in association with cytology and endoscopy.
Experience with 54 patients affected by pulmonary carcinoma treated or not with surgery and undergoing thymostimulin administration during long-term follow-up (70 mg i.m. every other day for 3 months), is reported. Drug intolerance was observed in 5.5% of cases. In patients who were able to complete the therapeutic cycle (50 cases) objective improvement of Performance Status was obtained in 46% of cases and subjective improvement in nearly 90%. The course of neoplastic disease showed definite progression (presence of local recurrence or distant metastasis) in 20% of cases, remission in 6%. No case of onset of pulmonary or extrapulmonary infections was observed. After treatment, a significant increase (between 24% and 108%) in blood parameters (circulation lymphocytes, CD3, CD4, CD8, CD16, IgG, IgA, IgM) was observed in 28-56% of cases. As for CD4 increase, this was accompanied by concomitantly positive Merieaux test in 44.5% of cases. Quiescence or complete remission has appeared to occur together with high CD16 values, progression with high CD8 and low CD16 values.
Lymphoproliferative disease of granular lymphocytes (LDGL) is a recently recognized, relatively rare atypical lymphocytosis characterized by the presence of over 2000 lymphocytes with cytoplasmic azurophilic granules/mm3 in the peripheral blood. The clinical course is heterogeneous, varying from spontaneous regression to progressive, malignant disease. As a consequence, clinical intervention is not standardized. In a worldwide multicenter study, the authors observed 151 patients with LDGL for a mean follow-up time of 29 months. Forty-three patients were asymptomatic at the time of diagnosis. In the remaining cases, clinical symptoms included fever (41 cases), infections (58), neutropenia (47), anemia (17), and thrombocytopenia (12). In 69 cases, LDGL coexisted with an associated disease. Most patients had a nonprogressive clinical course despite the presence of severe symptoms. In 19 patients, death related to LDGL occurred within 48 months. The authors investigated which features at diagnosis were significantly associated with increased mortality. In the univariate analysis, lymph node and liver enlargement, fever at presentation, skin infiltration, a low (less than or equal to 5000/mm3) or high (greater than 20,000/mm3) peripheral leukocyte count, relatively low (less than or equal to 3000) or high (greater than 7000/mm3) absolute peripheral granular lymphocyte (GL) count, and a low (less than or equal to 15%) percentage of HNK-1-positive cells were found to be predictors of increased mortality. In the multivariate analysis, significant independent predictors were fever at diagnosis, a low (less than or equal to 15%) percentage of HNK-1-positive peripheral blood mononuclear cells (PBMC) and a relatively low (less than or equal to 3000) GL count. These results showed that about 25% of the patients with LDGL were diagnosed after a routine blood count and had no clinical symptoms. The remaining patients were symptomatic, with some experiencing a fatal clinical course. The author's analysis of the significant prognostic features of LDGL may help in understanding the heterogeneous nature of this syndrome.
Using microquantitative measurements of alcohol dehydrogenase activity in microdissected samples of liver tissue along the sinusoidal length, the intra-acinar distribution profiles were studied in seven groups of female rats at different times during 24 h with a light phase from 6:30 h to 18:30 h. The mean values of alcohol dehydrogenase activity showed a circadian rhythm with a minimum at 13.30 h and a maximum at 17.30 h (p less than 0.001). However, the intra-acinar gradients remained almost unchanged, indicating that increase and decrease in enzyme activity takes place simultaneously in all parts of the liver acinus. This observation, together with data from the literature, suggests that the circadian rhythm of alcohol dehydrogenase activity reflects variations in different liver cell constituents, rather than enzyme protein synthesis or proteolysis.
The in vitro inhibitory activity of Lonidamine on the aerobic glycolysis of normal as well as leukemic lymphocytes has been investigated. The extent of the impairment of lactate production induced by Lonidamine on normal thymus (T)- and bone marrow (B)-derived lymphocytes was found to be dependent on their source of origin, i.e. residing or circulating pool. Among leukemia tested 'null' and B cell leukemias appeared the most affected metabolically by the compound. Administration in vivo of the drug to the patient with B cell chronic leukemia resulted in a decrease of lactate production by leukemic cells comparable to that induced in vitro. These metabolic changes were paralleled in normal, as well as in leukemic cells by ultrastructural lesions, mainly confined to the mitochondrial compartment.
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Viable, intact gastric cells were obtained by pronase digestion of inverted rat stomach. The cell suspensions contained two main distinct cell population, i.e. 'large' cells (mean diameter 16 microns) and 'small' cells (mean diameter 8.5 microns). By indirect immunofluorescence on smears of dispersed rat gastric cells, the large cells were identified as parietal cells, since all the sera containing parietal cell antibodies (PCA) were seen to react with the cytoplasm of these cells, leaving the cytoplasm of the small cells completely unstained. Thirty-one PCA-positive sera and forty-one PCA-negative sera were tested for gastric cell surface-reactive antibodies by an indirect immunofluorescence technique on suspensions of viable gastric cells. All the PCA-containing sera yielded a membrane immunofluorescence confined to the large cells, while none of the PCA-negative sera induced this fluorescent pattern. The surface reaction persisted unmodified when F(ab')2 fragments processed from IgG PCA-positive sera and FITC-conjugated pepsin fragments of rabbit IgG directed against the F(ab')2 fragments of human IgG were employed for the membrane fluorescence studies. The absorption of PCA-positive sera with viable, intact gastric cells led to the disappearance of both the surface immunofluorescence of the viable large cells and the cytoplasmic fluorescence of the rat parietal cells. These results demonstrate that PCA invariably react with an antigen represented on the surface of parietal cells, and that this antigen is immunologically identical to the intracytoplasmic 'microsomal' antigen.
Morphological, cytochemical, immunological and ultrastructural studies were performed on peripheral blood mononuclear cells from a patient with hairy-cell leukemia. Immunofluorescence studies showed a very strong intensity of fluorescence and indicated that hairy cells had monoclonal surface-membrane immunoglobulins (SmIg) actively produced by the cells. An unusual spontaneous SmIg redistribution induced by antibodies was also noted. Immunoultrastructural studies demonstrated that antibody-induced redistribution of SmIg on hairy cells is in form of a singular polar cap and that the cell membrane is rapidly cleaned of the complexes by endocytosis. The behavior of hairy cells regarding several membrane markers, mitogen stimulation and antibody-induced cytotoxicity suggests that hairy projections could represent the expression of a functional stage common to different lymphocyte subpopulations, or alternatively, a marker of a peculiar subset of B lymphocytes.
A patient with an IgG(chi) monoclonal serum protein developed in the course of the disease a second monoclonal spike of the same light chain type and of the IgA class. The latter monoclonal protein progressively increased and eventually exceeded the first IgG(chi) protein. Antigenic analysis of the two myeloma proteins demonstrated that they shared idiotypic determinants. Immunofluorescence studies, carried out with anti gamma and anti alpha reagents tagged with different fluorochromes revealed that the two isotypes were produced by different plasma cells. The data are discussed in the prospect of a possible transitional mechanism from IgG to IgA synthesis within a single B cell clone.
In the present work the effect of drug treatment on different lymphocyte populations in chronic lymphocytic leukemia was studied. During therapy there was evidence of an increased number of cells unidentifiable by conventional surface markers, provisionally termed lymphocyte surface-marker-negative cells. In addition, evidence of increased numbers of T lymphocytes in untreated patients and further evidence of IgG chronic lymphocytic leukemia cells were obtained.
The ultrastructural appearances of the interaction between normal phytohaemagglutinin (PHA)-stimulated human lymphocytes and chicken red cells (ChRBC) were studied. Close contact between ChRBC and control non-stimulated lymphocytes was often observed indicating that this is a non-specific phenomenon. In mixtures of PHA-stimulated lymphocytes and ChRBC, time-dependent development of interdigitating pseudopods between the two cell types was observed which was not seen in controls. Their development followed the same time-course as release of 51Cr when the ChRBC were pre-labelled with this marker. The findings suggest a relationship between the morphorlogical changes observed and the destruction of the target cells (ChRBC).
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Lymphocytes with receptors for IgG and phagocytes were detected simultaneously by incubating Bøyum separated mononuclear cells with IgG coated latex particles. IgG-latex particles formed rosettes around lymphoid cells with receptors for IgG, whereas phagocytes ingested these particles. This test was performed on cells from normal subjects and from patients with various diseases involving lymphocyte or monocyte proliferations. The results show that most chronic lymphocytic leukemia cells formed IgG-latex rosettes. Hairy cells from the patients studied showed a similar behaviour but poor phagocytic properties. Acute monocytic leukemia cells, in contrast, were largely phagocytes. This test is easy to perform and does not require sophisticated reagents, thus providing a basis for reproducibility, a rare occurrence in cellular immunology studies.