Biomedical subjects

G Galli

Publications and source records attributed to G Galli.

At least 19 recordsLinked to original sources

PubMed1999

[Contralateral transinguinal laparoscopy in unilateral inguinal hernia].

BACKGROUND: Indication for surgical exploration of the contralateral groin during unilateral herniorraphy in children is the subject of a worldwide debate. Routine exploration based on the likelihood of a patent processus vaginalis (PV) according to age, gender or side to some extent leads to unnecessary procedures, while routine abstention may leave a peritoneal sac, likely to later induce a symptomatic hernia in about 10% of cases. METHODS AND PATIENTS: One hundred and twenty-five children aged from 1 month to 15 years underwent transinguinal laparoscopic assessment of the contralateral groin, using a 3 mm trocar and a 70 degrees telescope gently introduced through the exposed PV. Surgical exploration was performed only in those patients who exhibited a patent PV, and in patients where the groin was poorly visualized due to technical problems. RESULTS: Regardless of age, contralateral surgery was not considered in 88 (70%) of the 125 children. Among the 37 patients that were operated upon, eight had a negative exploration due to an erroneous endoscopic evaluation. Surgery was avoided in 35 (56%) of the 62 infants aged less than 2 years, including nine of the 13 prematures who were previously routinely operated upon. Conversely, in the 63 older patients who were readily spared from surgical exploration, the videoscopic evaluation allowed appropriate selection for contralateral surgery in six. CONCLUSION: A routine policy, either of surgery or observation, is no longer indicated as a quick, safe and cost-effective method is available to detect a patent PV. The transinguinal laparoscopy is safe and could be easily performed by surgeons already skilled in pediatric herniorraphy. Therefore, the videoscopic transinguinal contralateral evaluation is worth being promoted to ensure an appropriate surgery tailored to the anatomical features.

Adolescent↗

PubMed1998

Characterization of the syringomycin synthetase gene cluster. A link between prokaryotic and eukaryotic peptide synthetases.

With this work we have completed the characterization of the syringomycin synthetase gene cluster. In particular, by sequencing additional 28.5 kilobase pairs we show that the nine modules involved in the binding of the nine amino acids of syringomycin are localized on SyrB and SyrE, with SyrE carrying eight modules. The recombinant SyrB and the first and second modules of SyrE (SyrE1 and SyrE2) have been expressed in Escherichia coli and purified. The biochemical data indicate that SyrB binds threonine, the putative precursor of the last amino acid of syringomycin, whereas SyrE1 and SyrE2 bind serine, the first and the second amino acids of syringomycin, respectively. On the basis of the sequence analysis and the biochemical data presented here, it appears that syringomycin synthetase is unique among peptide synthetases in that its genetic organization does not respect the "colinearity rule" according to which the order of the amino acid binding modules along the chromosome parallels the order of the amino acids on the peptide. This feature, together with the absence of a single transcription unit and the absence of epimerase-like domains make syringomycin synthetase more related to the eukaryotic peptide synthetases than to the bacterial counterparts.

Amino Acid Sequence↗

PubMed1998

Binding of hepatitis C virus to CD81.

Chronic hepatitis C virus (HCV) infection occurs in about 3 percent of the world's population and is a major cause of liver disease. HCV infection is also associated with cryoglobulinemia, a B lymphocyte proliferative disorder. Virus tropism is controversial, and the mechanisms of cell entry remain unknown. The HCV envelope protein E2 binds human CD81, a tetraspanin expressed on various cell types including hepatocytes and B lymphocytes. Binding of E2 was mapped to the major extracellular loop of CD81. Recombinant molecules containing this loop bound HCV and antibodies that neutralize HCV infection in vivo inhibited virus binding to CD81 in vitro.

Amino Acid Sequence↗

PubMed1998

Mycobacterial Cpn10 promotes recognition of the mammalian homologue by a mycobacterium-specific antiserum.

Self-tolerance, a key feature of the immune system, is still a matter of intense debate. We give here evidence for a peculiar behavior of an antiserum against Mycobacterium tuberculosis chaperonin 10 (m-Cpn10), which could have implications for the mechanism of self-recognition by antibodies against non-self. We show that this antiserum can interact in terms of both inhibition of biological activity and physical association (immunoprecipitation), with the mammalian homologue of m-Cpn10, but only if the bacterial protein is present. Several lines of evidence led us to exclude that the two proteins physically associate to form heterocomplexes: (1) the behavior of the antiserum was not shared by a monoclonal antibody against m-Cpn10; (2) a matrix selective for human Cpn10 (h-Cpn10) did not co-purify m-Cpn10; (3) the distribution pattern in non-denaturing isoelectric focusing of labeled m-Cpn10 was not altered by the presence of the unlabeled h-Cpn10. We conclude therefore that the antiserum against M. tuberculosis Cpn10 also recognizes mammalian Cpn10, with an affinity/avidity regulated by the mycobacterial protein, or by the promotion of hetero-oligomerization. This emergence of self-recognition in the presence of M. tuberculosis Cpn10 could imply a breaking of self-tolerance in situations of infection or vaccination.

Animals↗

PubMed1998

Coordinate transcription and physical linkage of domains in surfactin synthetase are not essential for proper assembly and activity of the multienzyme complex.

Bacterial peptide synthetases have two common features that appear to be strictly conserved. 1) The enzyme subunits are co-regulated at both transcriptional and translational level. 2) The organization of the different enzymatic domains constituting the enzyme fulfills the "colinearity rule" according to which the order of the domains along the chromosome parallels their functional hierarchy. Considering the high degree of conservation of these features, one would expect that mutations such as transcription uncoupling and domain dissociations, deletions, duplications, and reshuffling would result in profound effects on the quality and quantity of synthesized peptides. To start testing this hypothesis, we designed two mutants. In one mutant, the operon structure of surfactin synthetase was destroyed, thus altering the concerted expression of the enzyme subunits. In the other mutant, the thioesterase domain naturally fused to the last amino acid binding domain of surfactin was physically dissociated and independently expressed. When the lipopeptides secreted by the mutant Bacillus subtilis strains were purified and characterized, they appeared to be expressed approximately at the same level of the wild type surfactin and to be identical to it, indicating that specific domain-domain interactions rather than coordinated transcription and translation play the major role in determining the correct assembly and activity of peptide synthetases.

Bacillus subtilis↗

PubMed1998

Enhanced HIV expression during Th2-oriented responses explained by the opposite regulatory effect of IL-4 and IFN-gamma of fusin/CXCR4.

The human alpha-chemokine receptor fusin/CXCR4 is an important cofactor for entry of T lymphocyte-tropic HIV-1 strains. We investigated the possible regulatory role of T cell cytokine patterns on CXCR4 as well as HIV expression by using in vitro models of both secondary and primary immune responses. Antigen-specific memory CD4+ T cells infected with a T-tropic HIV-1 strain showed significantly higher CXCR4 and HIV-1 expression in Th0/2-oriented responses in comparison with Th1-oriented responses. Similarly, in naive CD4+ T cells activated in the presence of IL-4 or IL-12 and infected with the same T-tropic strain, IL-4 up-regulated whereas IL-12 down-regulated both CXCR4 and HIV-1 expression. The down-regulatory effect of IL-12 on CXCR4 expression was found to be dependent on its capacity to induce IFN-gamma production. These observations can account for the higher risk of progression in HIV-1-infected individuals undergoing Th0/2-oriented immune responses.

Cells, Cultured↗

PubMed1998

Antenatal rupture of a diverticular rectal duplication with neonatal perineal fistulization.

A cystic pelvic malformation was found in a fetus on antenatal sonography (US) at 26 weeks of gestational age that was no longer present 3 weeks later on control US. The male child presented at birth with a right-sided perineal mass that fistulized with meconial drainage. A radiopaque enema showed a low posterior rectal fistula filling a poorly delineated pouch. Surgery performed through a posterior sagittal approach allowed identification and closure of the fistula and pouch drainage. The diagnosis of a diverticular rectal duplication was considered, although no intestinal lining was observed macroscopically or histologically. The child's anorectal function was normal after a 20-month follow-up. Labeling of the malformation and embryological hypotheses are discussed since the case does not fulfill all the criteria of an intestinal duplication. Surgical techniques are discussed, with an emphasis on the sagittal posterior approach.

Diverticulum↗

PubMed1998

LC-UV-electrospray-MS-MS mass spectrometry analysis of plant constituents inhibiting xanthine oxidase.

PURPOSE: A previous screening showed that Amyema scandensi [corrected] Danser (Loranthaceae) efficiently inhibited XOD. The aim of this study was to identify the compounds with anti-XOD properties. For this purpose, Electrospray Tandem Mass Spectrometry (ESI-MS-MS) coupled with UV and Diode Array LC techniques were employed. METHODS: Leaves were delipidized with petroleum ether and extracted with acetone:water 70:30, v:v. The extract was fractionated into the ethyl acetate and water soluble phases. Chemical investigation was performed following the bioactivity guided fractionation. Two fractions with anti-XOD activity were isolated by silica gel column chromatography of the ethyl acetate phase and analyzed by LC-UV-ESI-MS-MS. RESULTS: The compounds identified with authentic standards were: catechin, epicatechin, epicatechin-3-gallate, quercetin-3-O-glucoside, quercetin-3-O-rhamnoside, and isorhamnetin-3-O-glucoside. Other constituents, only partially characterized, were a procyanidin dimer, a procyanidin trimer, three dimers epi/catechine-epi/catechine gallate and isorhamnetin-O-deoxyhexose. The anti-XOD activity was mainly due to galloyl-containing oligomeric proanthocyanidins. CONCLUSIONS: The coupling of UV Diode Array-HPLC with ESI-MS-MS represents a versatile tool for the rapid characterization of compounds in complex mixtures, avoiding time-consuming previous isolation.

Chromatography, High Pressure Liquid↗

PubMed1998

Acetate-free biofiltration versus bicarbonate haemodialysis in the treatment of patients with diabetic nephropathy: a cross-over multicentric study.

BACKGROUND: Morbidity and mortality rates in diabetic patients on regular dialysis treatment (RDT) are higher than in non-diabetic-subjects on RDT. Moreover, diabetic patients experience an intradialitic morbidity unacceptably higher than in patients with other causes of terminal renal failure. The aim of the present investigation was to compare standard bicarbonate haemodialysis (BHD) with acetate-free biofiltration (AFB) in a group of 41 diabetic patients stable on dialysis treatment for 25 +/- 22 months. METHODS: Twenty-four type II and 17 type I diabetic patients, all requiring insulin therapy, were included and were followed for 1 year in a 6-month cross-over randomized study for both methods. The analysis was carried out on dialysis symptoms, interdialysis symptoms, and nutritional status, and the multivariate analysis of variance for repeated measures on the same subjects in the two techniques was used. RESULTS: AFB significantly reduced dialytic and extradialytic symptoms (P=0.003 and 0.001 respectively). Cardiovascular collapses decreased by 43%, and other dialysis symptoms showed a similar trend (-35%). The interdialysis symptoms decreased by 28% and were accompanied by an increase in subjective wellbeing (39%) when patients were switched from traditional haemodialysis to AFB. Acid base control was better with AFB (P=0.01), both at the beginning and during the session. Slightly significant differences were also obtained for Kt/V (AFB 1.48 +/- 0.29 vs BHD 1.38 +/- 0.30), while no significant difference was noted with respect to sodium mass balance, nutritional status, calorie-protein intake, nPCR, blood glucose profile, and insulin requirements. The number of hospital admissions and the mortality rate, which were much lower during the AFB than the BHD period, were not analysed statistically. CONCLUSIONS: AFB allows better control of some metabolic aspects, reduces intra- and extradialysis symptoms, and improves patient quality of life. Whether the long-term prognosis can be improved by AFB remains to be established with further studies.

Acetates↗

PubMed1998

Acetate free biofiltration (AFB): from theory to clinical results.

Acetate free biofiltration (AFB) is a hemodiafiltration technique based on a buffer-free dialysate and bicarbonate infusion in the postdilution mode. The performance of AFB requires a dialysis machine equipped with an automatic control system to balance the infusion rate to that of ultrafiltration. The filters employed are usually polyacrylonitrile hollow-fiber hemodialyzers. A 145 mEq/l sodium bicarbonate solution is generally used and the infusion rate is regulated at about 8-10 liters per session to ensure optimal convective removal of toxins as well as to compensate for the bicarbonate lost in the dialysate. During AFB bicarbonate transfer results from the balance between diffusive and convective bicarbonate losses in the dialyzer and the amount of bicarbonate infused in the venous return. Thus bicarbonate supply can increase along with the rise in plasma bicarbonate concentration until a steady state is reached when the rate of infused bicarbonate equals bicarbonate losses into the dialyzer. A mild alkalosis may sometimes occur which can be avoided by slightly reducing bicarbonate concentration and/or infusion rate during the session. In spite of the large amount of sodium infused and the unusual high chloride concentration in the dialysate, no difference in the postdialysis plasma sodium levels nor in chloremia has been observed between AFB and bicarbonate dialysis. This is essentially due to the very large removal of these anions by convection (chloride and sodium) and by diffusion (sodium) into the dialyzer. Similarly the significant convective losses of calcium suggest a high dialysate calcium concentration to avoid negative intradialytic calcium balance. Polyacrylonitrile membranes, regularly employed in AFB, allow the passage of endotoxin fragments to the blood circuit in a lesser extent than other membranes. Coupled with the fact that a buffer-free dialysate and a sterile bicarbonate infusion are used AFB can be considered a highly biocompatible dialysis technique. As compared to conventional dialysis AFB allows adequate removal of small molecules and better removal of larger molecules such as beta2-microglobulin. In the short run AFB is characterized by an increase in cardiovascular stability: it improves dialysis symptoms and the subjective well-being of patients. A better acid-base correction is regularly reported together with a rise in some nutritional indices like serum albumin levels. The reasons for these favorable results are not well defined yet. A number of multicenter studies on the effects of AFB have been published with quite similar results, but most of them are non-randomized, and use historical controls. Only one prospective, cross-over study comparing bicarbonate dialysis with AFB in diabetic dialysis patients is available. It concludes that in a six-month observation period with AFB it is possible to better control some metabolic aspects and to improve both treatment tolerance and patients' life quality. However, it is not known whether these positive effects may entail better long-term prognosis; moreover, comparisons between AFB and conventional dialysis were never designed to ascertain the role of the dialysis membrane from that of the other components of AFB on clinical results. Therefore, large prospective trials with long observation periods are necessary to clarify the mechanisms through which AFB might be superior to conventional dialysis as well as the impact of these techniques on long-term prognosis. In such studies other relevant factors such as rehabilitation and life quality of the patients, which have been generally neglected in previous surveys, must also be included to evaluate cost-effectiveness of this therapy.

Acidosis↗

PubMed1998

[Clinical anatomy of the human mental foramen].

BACKGROUND: The great diffusion of the surgical technics in oral implantology and the progress of the radiological imaging produces some interest for the clinical anatomy of the mental foramen (MF). The study, in addition to the measurements that define it, considers others anatomical features of practical utility and the variableness of them. METHODS: In the Anatomic Institute of the Bologna University, it has been made a morphometric revision of the MF on 100 dried mandibles of normal young adults (78 males, 32 females) random chosen with the complete integrity of the dental apparatus and of the mandibular bone criteria. The measurements have been made by anthropometric methods on the two sides of the same mandible (n = 200) and for everyone has been reported in the tables the medium, the maximum and the minimum values with their specific variation interval. The results are applicable to the common work conditions because they take in consideration among the specific characteristics of the MF in addition to the seat, the course of the mandibular canal, the thickness and the height of the mandibular bone. RESULTS: To the clinical and diagnostic imaging object the medium values of the anatomical measurements can be considered sufficent. To anthropometric, anesthesiologic and surgical aims it is also necessary the knowledge of the maximum and the minimum values and the variation interval. In the living man the anatomicomedical study of the MF is made by the diagnostic imaging, especially by computed tomography with specific algorithm, because it makes possible absolutely exact measurements. CONCLUSIONS: Finally, the specifications on the MF provided by the present study are important not only for an anatomical but also for a practical point of view because they are a datum point value in the patient clinical management.

Adult↗

PubMed1998

Transcriptional activation of the cholesterol 7alpha-hydroxylase gene (CYP7A) by nuclear hormone receptors.

The gene encoding cholesterol 7alpha-hydroxylase (CYP7A), the rate-limiting enzyme in bile acid synthesis, is transcriptionally regulated by bile acids and hormones. Previously, we have identified two bile acid response elements (BARE) in the promoter of the CYP7A gene. The BARE II is located in nt -149/-118 region and contains three hormone response element (HRE)-like sequences that form two overlapping nuclear receptor binding sites. One is a direct repeat separated by one nucleotide DR1 (-146- TGGACTtAGTTCA-134) and the other is a direct repeat separated by five nucleotides DR5 (-139-AGTTCAaggccGGG TAA-123). Mutagenesis of these HRE sequences resulted in lower transcriptional activity of the CYP7A promoter/reporter genes in transient transfection assay in HepG2 cells. The orphan nuclear receptor, hepatocyte nuclear factor 4 (HNF-4)1, binds to the DR1 sequence as assessed by electrophoretic mobility shift assay, and activates the CYP7A promoter/reporter activity by about 9-fold. Cotransfection of HNF-4 plasmid with another orphan nuclear receptor, chicken ovalbumin upstream promoter-transcription factor II (COUP-TFII), synergistically activated the CYP7A transcription by 80-fold. The DR5 binds the RXR/RAR heterodimer. A hepatocyte nuclear factor-3 (HNF-3) binding site (-175-TGTTTGTTCT-166) was identified. HNF-3 was required for both basal transcriptional activity and stimulation of the rat CYP7A promoter activity by retinoic acid. Combinatorial interactions and binding of these transcription factors to BAREs may modulate the promoter activity and also mediate bile acid repression of CYP7A gene transcription.

Animals↗

PubMed1998

Molecules associated with human Th1 or Th2 cells.

In the last few years, some surface molecules which preferentially associate with human Th1 or Th2 cells have been described. Th1-related molecules include CD26, membrane IFN-gamma, LAG-3, CCR5 and CXCR3, whereas CD62L, CD30, CCR3, CCR4, CCR8, and in a certain way even CXCR4, preferentially associate with human Th2 cells during certain phases of their differentiation/activation process. Although none of these molecules can be considered as a truly selective marker of human Th1 or Th2 cells, their combined detection may help to characterize the pathway of the specific immune response both in vitro and in vivo. Moreover, the understanding of mechanisms responsible for these associations may provide new insights into the functional programs of the specific effector cells, as well as on their regulation.

Animals↗

PubMed1997

Functional characterization and modulation of cytokine production by CD8+ T cells from human immunodeficiency virus-infected individuals.

CD8+ T-cell clones were generated from peripheral blood mononuclear cells (PBMC) of three human immunodeficiency virus (HIV)-seronegative individuals and six HIV-seropositive individuals and assessed for their cytokine secretion profile, cytolytic potential, and chemokine production. While the great majority of CD8+ T-cell clones generated from HIV-seronegative individuals produced interferon (IFN)-gamma, but not interleukin-4 (IL-4), that is a type 1 cytotoxic (Tc1) profile, high numbers of CD8+ T-cell clones generated from HIV-seropositive individuals produced IL-4 in addition to IFN-gamma or IL-4 alone, thus showing a type 0 cytotoxic (Tc0)- or a type 2 cytotoxic (Tc2) profile, respectively. Tc0/Tc2 cells displayed lower cytolytic activity than Tc1 cells, including a reduced ability to lyse autologous targets pulsed with HIV or HIV peptides. By contrast, the production of chemokines RANTES and macrophage inflammatory protein-1alpha was comparable in Tc1, Tc0, and Tc2 clones irrespective of whether they were derived from HIV-seronegative or HIV-seropositive individuals. When CD8+ T-cell clones were generated from PBMC cultures of HIV-seronegative individuals conditioned with IL-4 plus an anti-IL-12 antibody (Ab), a shift towards the Tc0/Tc2-like profile was observed. Conversely, the addition to PBMC cultures of IL-12 plus an anti-IL-4 Ab shifted the differentiation of CD8+ T cells from HIV-infected individuals towards the Tc1-like profile, whereas IL-12 or anti-IL-4 Ab alone had a lower Tc1-promoting effect. Irradiated PBMC from HIV-infected individuals, used as feeder cells, shifted the differentiation of CD8+ T cells from a healthy HIV-seronegative individual towards the Tc0/Tc2-like profile. On the other hand, a shift towards the Tcl-like profile was noted in CD8+ T-cell clones generated from the skin specimens of two HIV-seropositive patients with Kaposi's sarcoma, successfully treated with IFN-alpha, in comparison to CD8+ clones generated from the same skin areas before treatment. The IFN-alpha-induced Tc1 shift could be prevented by the incubation of skin-infiltrating CD8+ T cells with IL-4 before cloning. Taken together, these data indicate that both defective production of IL-12 and abnormal IL-4 production in bulk PBMC populations of HIV-infected individuals may contribute to the development of high numbers of CD8+ T-cell clones showing a Tc0/Tc2-like phenotype and reduced cytolytic potential against HIV itself. They also suggest that the cytokine profile of CD8+ T-cell clones can be modulated by cytokines (or anticytokine Ab) both in vitro and in vivo.

Antibodies, Monoclonal↗

PubMed1997

Opposite role for interleukin-4 and interferon-gamma on CD30 and lymphocyte activation gene-3 (LAG-3) expression by activated naive T cells.

Polarized human type 1 and type 2 T helper cells not only produce different sets of cytokines, but they also preferentially express certain activation markers, such as lymphocyte activation gene-3 (LAG-3) and CD30, respectively. In this study we have examined the LAG-3 and CD30 expression in relation to the lineage commitment of human naive CD4+ T cells, as assessed at the single-cell level of committed T cells. Purified CD45RA+ umbilical cord blood T lymphocytes were activated with phytohemagglutinin and interleukin (IL)-2 in the absence or presence of interleukin IL-4 or IL-12 and assessed for CD30 and LAG-3 expression, as well as for intracellular cytokine synthesis. Significant numbers of CD30+ cells were only found in CD4+ and CD8+ T lymphocytes of cultures primed with IL-4, which developed into cells able to produce IL-4 and IL-13 in addition to interferon (IFN)-gamma. By contrast, LAG-3 expression was strongly up-regulated in CD4+ and CD8+ T cells from cultures primed with IL-12, which developed into high numbers of IFN-gamma producers. The addition of a neutralizing anti-IFN-gamma antibody to IL-12-primed CD4+ T cell cultures virtually abolished the development of LAG-3-expressing CD4+ T cells. Taken together, these data suggest that CD30 expression is dependent on the presence of IL-4, whereas LAG-3 expression is dependent on the production of IFN-gamma during the lineage commitment of human naive T cells.

Antigens, CD↗

PubMed1997

Quantitative cerebral blood flow and metabolism determination in the first 48 hours after severe head injury with a new dynamic SPECT device.

OBJECTIVE: To determine cerebral blood flow (CBF) and metabolism in the acute phase after severe head injury by a new dynamic SPECT device using 133Xenon and to evaluate a possible role of CBF and metabolism in the determination of prognosis. DESIGN: Prospective study. SETTING: General intensive care unit in a universitary teaching hospital. SUBJECTS: 23 severely head injured patients having CT scan and CBF determination, intracranial pressure (ICP) and jugular bulb oxygen saturation monitoring in the first 48 hours. MEASUREMENTS AND MAIN RESULTS: CBF varied from 18.0 to 60.0 ml/100 g/min. No correlation was found between early CBF and severity of trauma evaluated with the Glasgow Coma Score (GCS) (F = 2.151, p = 0.142) and between CBF and prognosis at 6 months evaluated with Glasgow outcome score (GOS) (F = 0.491, p = 0.622: rs = 0.251, p = 0.246). CMRO2 was depressed in relation to the severity of injury, specifically ranging from 0.9 +/- 0.5 ml/100 g/min in patients with GCS 3 to 1.7 +/- 0.8 ml/100 g/min in patients with GCS 6-7. In no patient with CMRO2 less than 0.8 ml/100 g/min was a good outcome observed. A significant correlation was found between GCS and GOS (rs = 0.699, p = 0.0002), between CMRO2 and GOS (F = 4.303, p = 0.031; rs = 0.525, p = 0.013) and between AJDO2 and GOS (F = 3.602, p = 0.046; rs = 0.491, p = 0.017). Fronto-occipital ratio (F/O) of CBF distribution was significantly lower than normal values (chi 2 = 18.658, p = 0.001) but did not correlate either with prognosis (chi 2 = 1.626, p = 0.443) or with severity (chi 2 = 1.913, p = 0.384). CONCLUSIONS: CBF in the first 48 hours after trauma varies within a large range of values and is not correlated with severity and prognosis. Clinical evaluation with GCS and CMRO2 are much more reliable indicators of severity of head trauma and have a significant role in the determination of prognosis. F/O ration is significantly altered from normal values confirming "post-traumatic hypofrontalism" but does not correlate with severity and prognosis.

Adolescent↗

PubMed1997

Estimation of glomerular filtration rate with 99Tc(m)-DTPA: a comparative assessment of simplified methods.

In 40 adult patients undergoing gamma camera renography, glomerular filtration rate (GFR) was measured using simplified 99Tc(m)-DTPA methods (i.e. a personal modification of the 'slope' method which does not require dose calibration, Gates' method and Carlsen's method) and compared to reference results (obtained using Sapirstein's formula and Russell's two-sample method with 51Cr-EDTA). Estimation of GFR from plasma creatinine (the Cockroft-Gault formula) was also carried out. Bias and imprecision of the simplified estimates were determined by the Bland-Altman method. The GFR values of the 'slope' method correlated best with the reference values (R2 = 0.88, S.E.E. = 11.3 ml min[-1]). Correlation of the two methods based on external determination with the gamma camera was no better at estimating GFR than that from plasma creatinine. Moreover, Gates' method underestimated GFR at all levels between 25 and 150 ml min(-1), while Carlsen's method overestimated at low levels and underestimated at high levels. The bias was as follows (ml): Cockroft-Gault 2.4; 'slope' -4.1; Carlsen 7.5; Gates 16.7. The imprecision was as follows (ml): 'slope' 11.8; Cockroft-Gault 16.4; Carlsen 20.5; Gates 22.8. We conclude that our modification of the slope method correlated best with the reference results, and would appear suitable for routine practice because of the small error involved. When performing sequential renal scintigraphy, it can also be used for a quick check of dubious data based on gamma camera methods.

Adult↗

PubMed1997

Do sputum eosinophils and ECP relate to the severity of asthma?

There is much evidence that eosinophils play an important role in bronchial epithelial damage in asthma by releasing cationic proteins. However, the extent to which eosinophil inflammation relates to indices of asthma severity in chronic stable asthma is still a matter of debate. We studied 46 clinically stable patients with mild to severe chronic asthma (forced expiratory volume in one second (FEV1) 50-126% of predicted value). The clinical severity of asthma was graded from 1 to 4 according to the Aas scoring system. Twelve normal subjects were also studied as controls. Induction of sputum was performed by hypertonic saline to determine differential cell count, and eosinophil cationic protein (ECP) by the so-called "plug technique". The concentration of ECP was measured by a fluoroimmunoassay. Bronchial hyperresponsiveness was recorded by inhaling progressive concentrations of histamine, and the concentration that caused a 20% decrease in FEV1 (PC20) was calculated. Sputum eosinophils (range 0-61%), sputum ECP (range 24-10,800 microg x L[-1]) and serum ECP (range 4-61 microg x L[-1]) were significantly greater in asthmatics than in normal subjects, and distinguished the most severe group with the highest Aas score from the others. Sputum eosinophils and sputum ECP were strongly related to each other. The relationships between sputum or serum ECP and PC20 (range 0.016-7.5 mg x mL[-1]), and between sputum ECP and FEV1 were found to be weak. In conclusion, sputum outcomes of eosinophil activation and serum eosinophilic cationic protein appear to be useful indicators of disease. They do not accurately reflect current clinical or functional indices of asthma severity in chronic stable patients, and might therefore provide complementary data disease monitoring.

Adolescent↗