[An unusual case of abdominal myoclonus of uncertain clinical classification].
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Biomedical subjects
Publications and source records attributed to F Simone.
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In vitro antitumor effects of LAK cells and alpha-2b-Interferon (IFN) either alone or in combination were evaluated on NK resistant (K562) and NK sensitive (Namalwa, Raji) cell lines. Tumor cells were incubated with LAK cells for 4, 8 and 24 hours at a LAK: tumor cell ratio of 1:1, 10:1, 100:1, or with IFN for 48 and 96 h at the concentrations of 100, 1000, 10,000, 100,000 IU/ml. A clonogenic assay was utilised to enumerate residual cells after in vitro treatment. A positive correlation was found between tumor cell killing and effector: target ratio, IFN of 100:1 incubated for 4 h, and 100 IU/ml of IFN incubated for 48 h were further chosen. A synergistic effect was found when IFN was incubated before LAK cells or contemporarily, but not when IFN was incubated after LAK cells. These findings demonstrate that an additive or a synergistic effect in vitro can be obtained by adding the two agents in different sequences and suggest that a potential utility of LAK cells and IFN in vivo should be tested in clinical trials.
The neuroleptic malignant syndrome (NMS) is a very rare but life-threatening complication of neuroleptic treatment. The mortality of NMS has been estimated at 8-30% and the most common cause of death is respiratory failure. Signs and symptoms of NMS are attributed to impairment of dopaminergic neurotransmission in the central nervous system. We describe two cases of NMS successfully treated with intravenous lisuride in combination with oral L-Dopa.
Micturition syncope accounts for 8.39% of the total number of syncopes and is prevalent among men in the 50 and 60 year age groups. The cardiovascular vegetative nervous system is unaffected in patients with micturition syncope. Sixty-one percent of patients with micturition syncope also exhibit other kinds of syncope. These patients experience vasovagal reaction during the vegetative activation tests more often than patients exclusively with micturition syncope.
The vegetative nervous system (VNS) plays a prominent role in many syncopes according to either organic or (days)functional pathogenetic mechanism. Vasovagal syncopes are typically (dys)functional and related to both vasodepression and cardioinhibition, whereas syncopes due to autonomic failure (AF) show a clearly organic pathogenesis and are related to the impairment of baroceptor control on arterial blood pressure. The differences between (dys)functional and organic vegetative syncopes are discussed. AF is a model for studying the effects of chronic vegetative insufficiency in man and makes it possible to speculate on the functional role of the VNS. Vasovagal syncopes seem to be inhibitory integrated vegetative-somatic behaviours, with a protective and adaptive functional role.
The incidence of different types of syncopes and their relationship to sex and age were studied. In agreement with previous findings in the literature, a cause of syncopes in a large proportion of patients could not be determined. Vasovagal syncopes clearly prevailed among diagnosed syncopes with a female prevalence. Other syncopes (due to orthostatic hypotension, carotid-sinus syndrome etc.) had a male preponderance. Syncopes with poor prognosis prevailed in elderly patients.
Two hundred and seventy-nine consecutive patients referred for transient loss of consciousness, compatible with syncope, underwent head-up tilt to 70 degrees during polygraphic (EEG, ECG, pneumographic) and blood pressure monitorings. Vasovagal syncopes occurred in 28 patients with the following EEG changes: progressive slowing until the appearance of middle or high amplitude delta waves generalized and synchronous in 9 patients; delta waves suddenly followed by transient flattening of EEG activity in 16 patients. In 2 patients EEG could not be interpreted because of muscle and/or movement artifacts. Fifteen out of 28 patients exhibited a marked cardioinhibition, expressed by long-lasting cardiac pauses; a relationship between duration of EEG flat and duration of asystole was not found.
Thirty-one patients affected by advanced ALL entered this study. Twenty (1 in I CR, 9 in II CR, 6 in III CR and 4 extramedullary relapses) were treated with the BMVC conditioning regimen. Eleven (9 in II CR, 2 in III CR) received the Busulfan plus Cytoxan conditioning regimen. Asta-Z 7654-purged marrow was reinfused at day 0. Both protocols were well tolerated. Two patients treated with the BMVC regimen died in aplasia from sepsis; 1 patient died in CR 5 months after transplantation, 13 relapsed after a median time of 4 months (range 1-31). Four patients are in CCR with a median follow-up of 16 months (range 11-24). In the BU + CY treated group no toxic deaths were observed. Four patients relapsed after a median of 3 months (range 2-7) and 7 are in CCR with a median follow-up of 5 months (range 2-28).
In this study in vitro results obtained with hu rec IFN-alpha 2b on Ph1+ stem cells from patients with chronic myelogenous leukemia in chronic phase (CML in CP) will be discussed: cells were incubated with different IFN concentrations (100, 1000, 10000 IU/ml) for different times (24, 96 hrs, 8, 15, days) and maintained in long term marrow cultures (LTMC); CFU-GM assay, cytochemistry and cytogenetic analyses were performed weekly. A high sensitivity of CML cells to the in vitro treatment with IFN was observed. Cell count in LTMC showed a progressive reduction inversely proportional to time of incubation and concentration of IFN; a marked decrease in colony growth was observed at the end of incubations and during the course of LTMC. Low concentrations of IFN permitted a morphological maturation and the expression of alkaline phosphatase. Cytogenetic analyses showed a marked reduction of mytoses in cultures treated with high concentrations of IFN as result of a combined cytostatic and cytolitic effect; the persistance of 100% Ph1+ cells in LTMC and in CFU-GM colonies might be related, as opposed to in vivo results, to different IFN exposure conditions or might be influenced by other factors.
An adrenergic central control on fusimotor activity has been demonstrated since 1954. At peripheral level, a muscle spindle autonomic innervation is not clearly demonstrated in man, but several data seem to suggest a direct autonomic innervation of muscle spindle in cats and rabbits. Data obtained in patients with peripheral adrenergic denervation (Idiopathic Orthostatic Hypotension) suggest a prevalent control of central adrenergic pathways on muscle spindle sensitivity.
Head-up tilt to 70 degrees lasting for 30 min is a further useful test for studying syncope. In 26.69% of 109 consecutive out-patients referred for loss of consciousness, it induced vasodepressor and/or cardioinhibitory reactions. All symptomatic patients had similar EEG changes and blood pressure fall during symptoms: by contrast, ECG features, due to vagal activation, were different. The pathogenetic mechanism of vasovagal or vasodepressor syncope is an abrupt sympathetic cardiovascular inhibition with more or less marked vagal cardiac activation. This cardiovascular pattern is due to a cardiac reflex in orthostatic syncope or, probably, to a central activation in emotional fainting.
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