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Biomedical subjects

L Pagano

Publications and source records attributed to L Pagano.

At least 109 records · Page 6Linked to original sources

[The blood coagulation system in progressive systemic scleroderma].

Twenty-five scleroderma patients have been studied to evaluate blood coagulative and fibrinolytic parameters. An increase in FVIII related activities and a reduction in fibrinolytic activity was observed. These changes may be related to the endothelial damage present scleroderma patients I the consequent "in loco" activation of blood coagulation may cause the microthrombosis that is very often observed in the earliest phases of the disease.

Adult↗

Antithrombin III in full-term and pre-term newborn infants: three cases of neonatal diagnosis of AT III congenital defect.

Antithrombin III (AT III) plasma levels were investigated in 18 full term neonates and 14 healthy preterm neonates. A control group of 20 healthy adults was also studied. AT III was measured as antigen concentration (Ag) and antithrombin or anti-factor Xa heparin cofactor (H.C.) activities. Crossed immunoelectrophoresis on heparin-agarose (H-CIE) was carried out on plasma samples; moreover the distribution of isoantithrombins was investigated on whole plasma by a technique of crossed immunoelectrofocusing (CIEF). AT III plasma levels in full term infants were significantly lower as compared to the adult values. The preterm newborns group showed a further significant decrease in AT III levels as compared to the full term neonates. In all infants AT III H-CIE runs displayed a single fast moving anodal peak, so that a normal binding to heparin was demonstrated. The CIEF AT III plasma pattern of the adults as well as of all neonates displayed three major peaks at pH range 5.2-4.9, a small amount of AT III at pH 4.9-4.8 and a minor peak at pH 4.8-4.6, so that it was concluded that the isoantithrombins plasma distribution in neonatal age is identical to that of the adult subjects. Four neonates whose mothers were affected by AT III congenital defect were also investigated: diagnosis of congenital deficiency was established in three cases.

Adult↗

Beta-thalassaemia in Campania: DNA polymorphism analysis in beta A and beta thal chromosomes and its usefulness in prenatal diagnosis.

In order to evaluate the feasibility of first trimester prenatal diagnosis of beta-thalassaemia by restriction fragment length polymorphism (RFLP) in Campania, one of the most affected regions in Southern Italy, DNA polymorphism analysis was performed on 40 unrelated patients, affected with homozygous beta-thalassaemia, and on their parents. Frequency of the presence of the Hinc II epsilon, Hind III G gamma and A gamma, Hinc II psi beta and 3' psi beta, Ava II psi beta, Ava II beta and Bam HI 3' beta sites have been determined in the beta A and beta thal chromosome samples. In 31 families (over 75%), RFLPs enabled tracing the beta-thalassaemia mutations in both father and mother (100% diagnosis). In the remaining nine families, RFLPs enabled tracing only one of the two mutations (50% diagnosis) because the other parent was found to be homozygous in all the analysed polymorphic sites. Restriction haplotypes, assembled on the basis of linkage analysis, were most heterogeneous, hence a wide heterogeneity of mutations is expected.

Adolescent↗

Spinal fluid procoagulant activity in leukaemic patients treated with intrathecal methotrexate.

A procoagulant activity was found in cerebrospinal fluid (CSF) of patients with myelo- or lymphoproliferative diseases on intrathecal therapy with methotrexate, independently of leukaemic CNS involvement. This activity did not correlate with the cell count in CSF and disappeared on storage at -40 degrees C or after filtration with 0.22 nm filters. Dosage of coagulation factors revealed a strong increase in Factor V activity (F. V:C), an increase in Factor VIII procoagulant activity (F. VIII:C) without a correspondent increase in Factor VIII related antigen (F. VIII R:Ag), and an inconstant increase in Factor IX activity (F. IX:C). These activities all disappeared after filtration with 0.22 micron filters but not with 1.2 micron filters. It is concluded that complexes formed by membrane phospholipids and Factor V were responsible for the procoagulant activity lost after storage. The F. VIII and F. IX.-like procoagulant activity was not lost after storage; it was considered unspecific and attributed to thromboplastin-like substances.

Adult↗

Cerebrospinal fluid protein findings during prophylaxis and treatment of neuromeningosis in leukaemic patients.

Methotrexate and Aracytin commonly employed in prophylaxis and treatment of leukaemic neuromeningosis, can induce neuromeningeal injury. Cerebrospinal fluid (CSF) protein disturbance may reflect the damage. In this study we have examined 141 CSF samples collected by lumbar puncture from 51 subjects: 15 normal controls and 36 leukaemic patients during the prophylaxis or the Central Nervous System (CNS) involvement treatment. In all the CSF samples, total proteins, IgG and IgA were examined. CSF total protein and albumin levels increased in the presence of leukaemic neuromeningosis and also after a prolonged CNS prophylaxis or therapy. The same behaviour was found in IgG levels. The IgA levels did not show any modification. We conclude that these parameters are not reliable indices of leukaemic CNS involvement.

Adult↗

Ovarian granulocytic sarcoma with central nervous system involvement.

The authors describe 2 cases of acute myeloid leukemia (AML) with ovarian granulocytic sarcoma (GS) and central nervous system (CNS) involvement. The patients had an unfavorable clinical course in a short period of time. It has been reported that GS or CNS involvement does not have a bad prognostic significance. We suggest that the association of these two complications worsens the prognosis of AML.

Adult↗

[Neurological complications of acute myeloid leukemia in adults].

Neurological involvement in acute myeloid leukaemia has become more common in recent years. The increase seems to be related to the longer survival rates made possible by more intensive treatment protocols. The predictive elements appear to be the tumour mass, cytomorphological variety M5, splenomegaly and serum LDH. Prophylaxis with craniospinal radiotherapy or spinal chemotherapy does not modify the course of the leukaemia or diminish the frequency of neuromeningeal complications. Six cases of AML involving the central nervous system were examined, two at onset and 4 at first relapse. Neuromeningeal complications are to be feared since they are extremely difficult to eradicate completely and the prognosis is extremely unfavourable especially if a bone marrow relapse occurs simultaneously.

Adolescent↗

OKT4/OKT8 ratio and serum beta 2-microglobulin in mycosis fungoides and chronic benign dermatitis.

Pre-treatment Serum Beta 2-microglobulin (S B2-m) and OKT4/OKT8 Ratio (T4/T8 R) were studied in 15 patients with Mycosis Fungoides (MF) and in 10 subjects with Chronic Superficial Benign Dermatitis (CSBD) in order to verify whether these parameters may lend support to an earlier differential diagnosis. S B2-m levels and T4/T8 R showed no significant difference in CSBD as compared to normal controls. MF patients displayed elevated S B2-m and T4/T8 R values in comparison to healthy controls and subjects suffering from CSBD (P less than 0.001). After photochemotherapy (PUVA), markedly decreased S B2-m and T4/T8 R values were observed in all patients but two who proved to be unresponsive to PUVA treatment. On the basis of reported data, S B2-m and T4/T8 R can be regarded as an additional tool to discriminate CSBD and MF when clinical and histological features are not significantly diagnostic. Finally, these parameters seem to provide reliable information in monitoring response to treatment.

Adult↗

Cerebrospinal fluid beta-2-microglobulin: a reliable index of leukaemic infiltration of central nervous system.

Cerebrospinal fluid (CSF) beta-2-microglobulin (B2m) has been proposed as a marker of central nervous system (CNS) involvement in myelo-lymphoproliferative diseases. Recently its reliability has been put in question because of false positive and false negative results. In our study, B2m was measured in 574 CSF samples collected from 74 patients affected by ALL, ANLL or lymphomas; 20 of these patients had CNS-involvement while they were under observation. There was a significant difference in CSF B2m between the patients with and without CNS-involvement (p less than 0.001). No false positive or false negative results were obtained. In 4 cases the rising of CSF B2m was observed 8, 6, 4 and 4 wk before the clinical and laboratory diagnosis of CNS-involvement. In all patients the clinical and laboratory improvement of the neurological disease was associated with a progressive decrease of CSF B2m. Some hypotheses about the origin of CSF B2m are discussed. The authors conclude that CSF B2m is a useful and reliable marker of CNS-involvement in myelo-lymphoproliferative disease.

Acute Disease↗

Antithrombin III during high-dose cytosine arabinoside therapy with or without asparaginase.

Fourteen patients with hematologic neoplasia (11 acute myeloid leukemias, 2 non-Hodgkin's lymphomas and 1 blast crisis of chronic myeloid leukemia) who underwent high-dose cytosine arabinoside (HIDARAC) therapy with or without sequential asparaginase (ASNase) were investigated in order to evaluate liver toxicity and a possible decrease in antithrombin III (AT III) plasma level. AT III was found decreased only in patients who received ASNase, whereas HIDARAC alone did not influence AT III levels. It is pointed out that a single dose of ASNase seems to be sufficient to induce a decrease in AT III. A mild and transient liver toxicity due to HIDARAC therapy does not seem to be of any clinical relevance.

Adult↗

Cerebrospinal fluid beta-2-microglobulin level as marker of central nervous system involvement in lymphoma.

The cerebrospinal fluid (CSF) and serum beta-2-microglobulin (B-2-m) level was determined in 15 patients affected by lymphoma with and without central nervous system (CNS) involvement and in 15 normal controls. No statistical difference in CNS B-2-m was found between patients affected by lymphoma without CNS involvement and normal subjects. CSF B-2-m was significantly increased (p less than 0.001) in patients with CNS involvement as compared to normal subjects or patients without CNS involvement. These findings suggest that CSF B-2-m can be used as a useful marker of CNS involvement in patients affected by lymphoma.

Adult↗