Biomedical subjects
Publications and source records attributed to G Ferrari.
Data pertaining to 193 patients with renal cancer, evaluated and treated in our department from 1966 to 1982, were subsequently examined and studied with regard to survival in relation to the pathological stage. In our experience the transluminal propagation of a tumor thrombus within the renal vein or the inferior vena cava, as an isolated condition, does not appear to worsen the prognosis as does the lymph node involvement.
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We have previously demonstrated that a brief contact of native whole blood with ADP, promotes a dose dependent release of the contents of platelet alpha granules. In the present study we have shown that in our system there is not a parallel release of the contents of platelet dense bodies as measured by the release of serotonin (5 HT). This early and partial platelet activation determines an increase in platelet retention in glass bead columns. After exactly 15 seconds of activation of native whole blood from 6 healthy volunteers with ADP, in fact, there was a significant fall in the platelet count following the flow of native whole blood across glass beads. A significant decrease (from x = 182,000 +/- 13,700 to x = 120,000 +/- 8,00/microliters p less than 0.001) was present when the blood was stimulated with 0.4 microM ADP final concentration. These results suggest that early, partial platelet activation by ADP could facilitate their possible adhesion to a suitable surface exposed along the vascular tree.
Retrospective study on 23 GBP in-patients was undertaken in an attempt to evaluate the effectiveness of plasmapheresis used in 8 cases: all patients were treated with corticoids. Evaluation methods and criteria for the choice of patients are discussed. Plasmapheresis appeared no better than other therapeutic methods currently in use, including support methods.
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Plasma diamine oxidase (DAO) values are enhanced by intravenous injection of heparin which releases the enzyme, synthesized in small bowel enterocytes, from binding sites located on endothelial cells of the intestinal microvasculature. Intestinal DAO, in analogy with lipoprotein lipase (another heparin-released enzyme), is believed to be electrostatically linked to endothelial binding sites composed of a glycosaminoglycan (GAG) which is presumably heparan sulphate, but the complete mechanism of enzyme release is not known. In this study we assayed in rats the DAO-releasing capability of heparan sulphate, dermatan sulphate, chondroitin sulphate A and hyaluronic acid, all heparin related compounds. Heparan sulphate, a compound with the same hexosamine as heparin but with a lower concentration of sulphated iduronic acid, induced a very high release of DAO (3-fold less than heparin), while the other tested GAGs, composed of higher proportions of non sulphated uronic acid and with galactosamine instead of glucosamine, induced a significantly lower release. In rats treated with 60 mg heparan sulphate the significant decrease in ileal mucosal DAO activity indicates that, in analogy with heparin, the high plasma enzymatic activity induced is of enterocytic origin. It is suggested that the high charge density of the compounds tested, due to the degree of sulphatation, is the decisive factor in promoting the release of intestinal DAO.
In spite of the widespread use of antibiotics wound infection are still a common complication of elective colon and rectal surgery. Oral administration of poorly absorbed antibiotics was for a long time a common practice in preparing patients for elective clo-rectal operations. Systemic antibiotic prophylaxis allowed a significant improvement of septic complication rate. As the clinical effectiveness of the combined antibiotic regimen is still not completely demonstrated, we carried out a study on 165 patients who underwent colo-rectal surgery. A group of 63 patients submitted to short term prophylaxis with Clindamycin and Gentamycin was compared with a 102 patients group who received preoperative topic antibiotics (Neomycin and Metronidazole) plus short term prophylaxis. The two groups did not show a statistically significative incidence of wound infections (6.3% vs 3.9%; p greater than 0.05).
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Neuronotrophic effects of basic fibroblast growth factor (bFGF) have been reported for some central nervous system neurons. Here we report that also rat mesencephalic neurons are responsive to bFGF. bFGF produces a significant increase in the number of neurite-bearing cells, as well as in the degree of their fiber network. The present findings also provide the first evidence that bFGF can affect, in a concentration-dependent manner, at least two defined CNS neuronal populations, i.e., dopaminergic and gabaergic neurons. This effect was quantified by assessing the specific [3H]dopamine and [gamma-14C]aminobutyric acid uptakes with time in culture. Stimulation of uptake was more pronounced for dopaminergic neurons, suggesting a relative specificity in the actions of bFGF. These effects of bFGF were completely blocked by affinity-purified polyclonal antibodies. The possibility that bFGF plays a key role in normal nervous system development or function is discussed.
The effect of long-term ethanol administration on the membrane mechanism of thiamine entry in rat enterocytes was investigated by using microvillous vesicles of small intestine. Experiments were carried out in three groups of Wistar albino rats of both sexes (290-400 g of initial body wt). Group I did not receive any treatment, group II received 4.7 g of ethanol/kg body wt (as a 50% hydroalcoholic solution) daily by gastric gavage for 35 days and group III (pair-fed controls) received a daily solution of saccharose (isoenergetic with the dose of ethanol administered to group II) by gastric gavage for 35 days. Ethanol or saccharose were administered in the morning and a standard diet was given throughout the treatment period. All animals were killed by decapitation 24 hr after the last administration, when the blood level of ethanol was virtually zero. Microvillous small intestinal vesicles were incubated with 3H-thiamine (3H-T) at 25 degrees C and the amount of 3H-T taken up was measured by a rapid filtration method. Compared with data obtained in groups I and III, chronic ethanol administration was found to induce a statistically significant decrease in 3H-T vesicular uptake at 4 sec (determined at 3H-T concentrations ranging from 0.12 to 7.5 microM) and a decrease in the apparent Jmax (maximal transport rate) value of the saturable component, without affecting the apparent Km (half-saturation concentration) value. These results indicate that in rats chronic ethanol administration may impair the intestinal absorption of thiamine by reducing thiamine entry into the enterocyte.
Eight patients were studied during four sessions of acetate-free biofiltration (AFBF). AFBF is a new dialysis technique with no base replacement agents in the dialysate and with the addition in postdilution mode of bicarbonate (HCO3) solution directly into the extracorporeal blood circuit. In this study the effects on acid-base balance of different infusions of sodium bicarbonate (NaHCO3) ranging from 751 to 1,002 mEq per session was evaluated. There were significant positive correlations between the HCO3 infused and net HCO3 gained (r = 0.776, p less than 0.0001) and between HCO3 infused and plasma intratreatment HCO3 changes (n = 0.562, p less than 0.001). Stepwise multiple linear regression analysis demonstrated that HCO3 infused and plasma predialysis HCO3 values played the major role in HCO3 balance in AFBF. The best correction of metabolic acidosis was obtained with the infusion of 900-1,000 mEq of HCO3. The use of substitution fluid with 145 mEq/L of Na concentration avoids the risk of a positive intratreatment Na balance.
Human deep posterior lingual glands (von Ebner's glands) are located beneath the circumvallate papillae. They are formed by tubuloalveolar adenomeres, intercalated ducts and excretory ducts coming together in the main excretory duct. The tubuloalveolar cells, pyramid-shaped, show large and dense secretory granules (clear cored) throughout the cytoplasm, rare basal folds and packed cisternae of rough endoplasmic reticulum (RER) at the basal pole. The columnar cells of the intercalated ducts are arranged in a monolayer. They are characterized by dense, clear-core secretory granules (mostly in the apical cytoplasm), a basal nucleus, well-developed RER and Golgi apparatus, and thin filaments distributed in supra- and perinuclear cytoplasm. Striated ducts are absent. Excretory ducts, coming together in the main duct, are lined by a bistratified epithelium. The inner layer consists of columnar cells showing bundles of tonofilaments with scarce secretory activity. The outer layer is composed of basal cells lying on the basal lamina. The main excretory duct, which opens at the bottom of the vallum, shows a stratified epithelium. The outer side is composed of 2-3 layers of malpighian cells lying on the basal lamina. The inner side consists of a single layer of cuboidal-columnar cells with dense apical granules and well-developed organelles synthesizing and condensing secretions. These cells interpolate with goblet cells, rare mitochondria-rich cells, ciliated cells and numerous small globous cells showing a clear matrix and lacking secretory granules. The cilia show a 9 + 2 microtubular structure with basal bodies provided with striated rootlets. Myoepithelial cells surround with their processes the basal portions of the secretory cells and the intercalated ducts. The conclusions concern some comparative aspects and some hypothesis on the functional role of goblet cells, ciliated cells and epithelial cells lining the different ducts, also in relation to the final secretory product.
A new type of amyloidosis due to beta 2-microglobulin depositions has been recently described in long-term hemodialysis patients. This systemic complication mainly affects the osteoarticular system, with diffuse articular symptoms; among them carpal tunnel syndrome is the most frequent. The syndrome etiopathology is unknown, even though many causal factors have been identified, among which the repeated use of non-biocompatible dialytic membranes. The authors conducted a retrospective study of 138 hemodialysis patients, with mean dialytic age of 79.3 months, to evaluate both incidence and evolution of bone cysts involving the carpal bones. Bone cysts were detected in the hands of 18.8% of the patients at the beginning of dialytic treatment; their incidence was over 50% after 10 years of treatment. Their size and number showed a rapid progression after the 6th year of hemodialysis, and their features were not related to osteodystrophic bone lesions. The carpal tunnel syndrome appeared after several years and its incidence was 7.9%; a direct correlation was demonstrated with the size of carpal bone cysts. The influence of hemodialysis membrane type on the occurrence of hemodialysis-related amyloidosis was strong, but not exclusive.
In 113 children with atopic dermatitis RAST results for 9 food mixtures were analyzed. Sixty-eight children (60%) were RAST positive (greater than or equal to ++) for one or more mixture and 87% of those RAST positive had specific IgE for egg and/or cereals and/or legumes. Sensitization to egg, cow milk and meat was more frequent in the first years of life. RAST for the mixture of cereals and each single cereal, performed in 37 children, gave concordant results in 76%; agreement for the positive results was 88%, but only 54% for the negative ones. Breast versus cow milk feeding in the first months of life was not found to affect intensity of the skin manifestations or frequency of RAST positivity for the food mixtures or the respiratory symptoms.
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We studied 29 patients affected by acute renal failure due to multiple myeloma with Bence-Jones proteinuria greater than 1 g/day to evaluate the effectiveness of plasma exchange in the treatment of severe myeloma nephropathy. Renal failure was severe enough to require dialysis in 24 cases, while the remaining 5 patients showed serum creatinine levels greater than 5 mg/dl. The patients were randomly allocated to Group I (15 patients undergoing plasma exchange together with corticosteroids, cytotoxic drug, hemodialysis only when needed) or to Group II (14 patients undergoing peritoneal dialysis together with corticosteroids and cytotoxic drug). In Group I Bence-Jones proteinuria decreased dramatically (P less than 0.01) with a significant increase in urine output (P less than 0.001), while Group II presented a slight reduction in Bence-Jones proteinuria without a significant increase in daily diuresis. Thirteen out the 15 Group I patients recovered renal function reaching serum creatinine levels less than or equal to 2.5 mg/dl in most cases. Only two patients in Group II improved renal failure well enough to stop dialysis. The one-year survival rate was significantly higher in Group I (66%) than in Group II (28%, P less than 0.01). We conclude that plasma exchange associated to chemotherapy rapidly removes large amounts of light chains, improves both renal function and long-term survival expectancies.
If ABO antigens/antibodies play any role in the pathogenesis of acute graft-versus-host disease (GVHD), one would expect the highest incidence of GVHD in recipients of minor ABO-mismatched grafts, followed by ABO-matched grafts, and the lowest incidence in major ABO-mismatched transplants. To test this hypothesis 174 patients receiving an HLA-identical allogeneic bone marrow transplant (BMT) for aplastic anemia (n = 32) or leukemia (n = 142) were analyzed for factors associated with acute GVHD. Variables analyzed included diagnosis, sex, age, blood group of donor and recipient, ABO compatibility, Rhesus compatibility, sex compatibility, number of bone marrow cells given at BMT, year of transplant, day of engraftment, and GVHD prophylaxis. We first carried out an exploratory contingency table analysis: minor ABO incompatibility was associated with a significantly higher risk of severe acute GVHD when compared with ABO-matched and major-ABO mismatched pairs (P = 0.003): 14/9, 57/67, and 5/22 patients developed, respectively, 0-I/II-IV acute GVHD in ABO major-mismatched, matched, and minor-mismatched pairs. Donors of group 0, (P = 0.06), older recipient's age (P = 0.08), fast engraftment (P = 0.03), and older donor's age (0.08) were also associated with a higher risk of GVHD. Recipient's ABO group, diagnosis, year of transplant, Rhesus group of donor or recipient, Rhesus compatibility, sex of donor or recipient, sex compatibility, and type of GVHD prophylaxis were not predictive of GVHD. A Cox multifactorial proportional hazards analysis confirmed that ABO matching was the single most significant factor associated with GVHD (P = 0.006). The cumulative incidence of GVHD grade II+ was 39%, 54%, and 82% for ABO major-mismatched, matched, and minor-mismatched pairs (P = 0.01). This study suggests that ABO antigens may play a role in the development of acute GVHD.