Hepatitis C virus and mixed cryoglobulinaemias.
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Biomedical subjects
Publications and source records attributed to G Monti.
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A new case of IgE myeloma is described. A 77-year-old woman presented with bone pain and fatigue. Serum protein analysis revealed a paraprotein of the IgE kappa type; bone marrow aspirate and immunofluorescence confirmed the diagnosis; ultrastructural examination showed immature plasma cells. Treatment with prednisone, melphalan, cyclophosphamide and interferon alfa did not produce any improvement and the patient died 5 months after diagnosis. The patient's clinical and laboratory data are compared with those of IgE myeloma cases reported in the literature.
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In recent there has been increasing interest in the definition of hormone influence on the immune system. Physical stress provides a suitable model for studying the interactions between the immune system and the neuroendocrine factors which have been shown to modulate the lymphoid cellular compartment. Our approach has been devoted to defining the stable modifications induced in the immune system in athletes during agonistic training. The results show that the circulating compartment of the immune system tends to modulate its different subsets under the continuous influence of stress hormones, together with a specific functional impairment of the helper subset in the proliferative response after stimulation with PHA, and particularly with PWM.
The clinical and epidemiological data of 170 patients aged between 8 months and 13 yrs 9 months hospitalised for Schönlein-Henoch syndrome in the period 1976-87 have been analysed. There were more females than males (78/92); a triggering event, usually inflammation of the first airways, was identified in 58% of patients. In 60% of cases onset was autumn-winter. Extrarenal symptoms infrequently take on a certain degree of clinical gravity. Nephropathy is observed, at onset (30%) or some time later from one month to 3 years and 3 months (7.6%), is seen in 37.6% of patients. In all, 7/64 (11%) of patients were at stage D of nephropathy at the end of follow-up. 2 of these began with IRA, 2 with nephritic syndrome, 2 with hypertension and one with monosymptomatic microhaematuria. The latter figure suggests that this symptom should not be underestimated at onset and its course should be followed closely. The mesangium was the primary localisation in the 6 patients biopsied. Finally, there do not appear to be any substantial differences between patients treated and those not treated with corticosteroids and/or anti-platelet aggregators, in agreement with what most authors state.
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A 54 year old patient suffering from mycosis fungoides developed an immune complex disease with mixed cryoglobulinemia (type III) and pulmonary vasculitis, an association so far unreported. We believe that the pathogenesis could be ascribed to a T-cell imbalance (increase in OKT4+ cells with inversion of the OKT4/OKT8 ratio) and to a functional T-cell defect, as suggested by the reduced mitogenic responses to PHA and ConA we observed.
Sixteen patients with cirrhosis of the liver and a history of haemorrhaging oesophageal varices all given Warren-type splenorenal bypasses were subjected to intraoperative measurement of portal flow and pressure after the administration of Somatostatin and Glypressin. Glypressin was distinctly more effective in producing a significant and long term reduction in portal flow and pressure. Somatostatin made no significant difference to these parameters.
We examined and evaluated the immunologic status of 15 patients suffering from neoplastic, not ematologic, diseases, who underwent external beam radiation therapy. We determined the total lymphocyte count, the percentage of E and EAC rosettes, surface membrane immunoglobulins, the lymphocyte reactivity to PWM and PHA, and T-lymphocyte subpopulations by means of monoclonal antibodies (OKT3-OKT4-OKT8). Besides we evaluated the percentage of LEU7 and OKM1 cells and lymphocytes response to MLR. Blastogenesis tests (PHA and MLR), after 18 months, were performed with and without monocytes. We found out that the amount of T and B lymphocyte subpopulations, which was extremely variable during and after radiotherapy, gradually returned to initial value. After 30 months, the functional impairment seems to be almost completely recovered. At 18 months from the beginning of radiation treatment, the mixed lymphocyte reaction was normal. The presence of monocytes doesn't change either MLR or PHA responses. LEU7+ cells are normal, while OKM1+ cells increased.
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The following trials were carried out to evaluate the antispasmodic effect of sintropium bromide in a group of 30 patients. The antispasmodic effect on the gastroduodenal system was observed endoscopically. The results were compared by means of double blind tests carried out using placebo and rociverine. The effect in a group of 10 patients was examined by X-ray of the digestive tract. The effect on another group of 20 patients suffering from abdominal colic was clinically evaluated. Sintropium bromide has a prompt anticholinergic action and for this reason may be used in the treatment of painful conditions of the bile, gastro-enteric and renal tracts, and also during the course of endoscopic examinations.
The effects of radiotherapy on subset lymphocyte populations of 15 neoplastic patients were studied. The initial impairment of lymphocyte functions, was restored after eighteen months to 78% of initial values. The numerical equilibrium of T and B subpopulations was completely reinstated.
The mid-term effects of radiotherapy on T and B peripheral lymphocytes of 15 patients treated for various malignancies were evaluated. All patients had a significant impairment of lymphocyte functions, as measured by blastogenesis after stimulation with phytohemagglutinin and pokeweed mitogen. Such impairment lasted for 1 year after the completion of radiotherapy, when numerical variability of T and B subpopulations, observed during and after radiation treatment, was restored to initial values.
The distribution of T-lymphocyte subsets was assessed using monoclonal antibodies in 20 symptom-free patients with haemophilia. In 15 patients, the T-cell subsets appear substantially balanced with only a moderate reduction in the proportion and absolute number of OKT4 positive cells. In the remaining 5, all with a reversed OKT4/OKT8 ratio, the proportion and absolute number of OKT4 positive cells was significantly reduced (p less than 0.0002) while the absolute number of OKT8 positive cells was normal or reduced although the proportion of these cells appeared increased. Functional studies, testing the proliferative response to PHA and PWM, were normal in all cases including those with immunological abnormalities. These results suggest that a proportion of patients with classic haemophilia show some immunological abnormalities similar to those observed in patients with acquired immunodeficiency syndrome and that regular evaluation of several immunological parameters is warranted in these patients.