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Biomedical subjects

M Gentile

Publications and source records attributed to M Gentile.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

[Hemorrhoidectomy with stapler vs. traditional hemorrhoidectomy: comparative outcome of 2 groups of patients].

Authors compare the results of two groups of patients, with III and IV degree haemorrhoids. The first group (48 patients) were treated with traditional surgery, open or closed. The second group (42 patients) treated with stapling haemorrhoidectomy. The groups were compared in order to determine if a true advantage exists regarding post-operative pain and functional recovery. Authors conclude that stapler haemorrhoidectomy, is somehow better in reducing the pain and offers a quick functional recovery. But the technique must be adopted in selected patients with mucosal prolapse, when the haemorrhoidal plexus is below the dentate line. In those cases, with inveterate mucosal prolapse, and thickened external fibrous tissue, or an irreducible prolapse of the external haemorrhoidal plexus, the choice must be carefully evaluated.

Adult↗
PubMedDate not supplied

[Role of crural inguinal lymphadenectomy and dynamic sentinel lymph node biopsy in lymph node staging in squamous-cell carcinoma of the penis. Our experience].

PURPOSE: We determine the value of dynamic sentinel node biopsy for staging squamous cell carcinoma of the penis. MATERIALS AND METHODS: During a period of 2 years 17 patients with penile cancer was performed after lymphoscintigraphy pre and intraoperatively with gamma ray detection probe at biopsy of the sentinel node with the aid of perilesional administered patent blue dye. After 20 days regional lymph node dissection was performed in all patients. RESULTS: Sentinel node metastasis was found in 5 patients; in one case lymphoscintigraphy not visualized sentinel node. All negative node biopsy was confirmed with the regional lymph node dissection. No major complication did occur after sentinel node biopsy. CONCLUSIONS: Occult lymph node metastases can be detected by dynamic sentinel node biopsy including preoperative lymphoscintigraphy, vital dye and gamma ray detection probe with a sensitivity of 78%, predictive negative value of 100% and with low morbidity.

Aged↗
PubMedDate not supplied

A macrophage derived blastogenic factor -MBF- induces cytokines and cytotoxic effectors in human peripheral blood mononuclear cells.

A soluble macrophage-derived blastogenic factor, previously reported as MBF, is secreted from macrophages activated with galactose oxidase. It was previously shown that MBF is able to induce IFN-gamma production and proliferation of T lymphocytes. In this study we found that MBF is able to induce in human peripheral blood mononuclear cells (PBMC) production of interleukin 1 (IL-1) beta, interleukin 2 (IL-2) and tumor necrosis factor (TNF) alpha and generation of MHC-unrestricted cytotoxic activity. The induction of killer cells is likely to rely on IFN-gamma production in that in PBMC treated with a monoclonal antibody (Mab) against IFN-gamma, the MBF induced cytotoxic activity was drastically reduced. A comparison of MBF induced cytotoxic effectors with those induced by IL-2 showed that both cytotoxic effectors pertain to NK lineage, in that they were CD3- and CD16+. On the contrary, the precursors of MBF and IL-2 induced killer cells were different; MBF cytotoxic precursor cells were highly sensitive to L-Leucine methyl ester (Leu-OME), a drug able to eliminate monocytes and NK cells, whereas IL-2 cytotoxic precursors were unaffected by this drug.

Cell Division↗
PubMedDate not supplied

Evaluation of DOWNSTAGING as leading concept in sphincter-saving surgery for rectal cancer after preoperative radio-chemotherapy (Preop RCT).

AIM: To evaluate the downstaging of rectal cancer after preop R +/- CT. METHODS: 392 patients (pts) with rectal cancer were observed. Only 172 pts (58%) with II and III stage cancer of middle and lower third were examined. Enrol-led pts were 168: 52 of them received preop R +/- CT (32 RT, 20 R + CT). Preop R +/- CT group included 14 middle third cancers (73%), 38 lower third (17%). In this group, tumor stage was as follows: 44 T3 stage tumors (86.4%), 8 (15.4%) T4. Mean age of this group was 57 years (range 42-67). Patients received 45 Gy for 5 weeks in 25 fractions and continuous administration of 5-FU (300-500 mg/m2/die). Surgery was performed 6 weeks +/- 7 days after the therapy. RESULTS: Downstaging, at least of 1 T-stage level, was detected in 45 patients (86%) (8 middle third; 32 lower third), in 5 (9.6%) (4 middle third, 1 lower third), tumor decreased to pT0N0, while in 7 (13.5%) (2 middle third, 5 lower third), there was no response. An Anterior Resection (AR) was performed in 40 patients (77%) [4 Downstaged to pT0N0 middle third cancers; 36 downstaged but with residual disease (8 middle third, 28 lower third)]; APR was performed in 12 (23%) (7 No responders patients, 1 Downstaged to pT0N0 lower third cancer, 4 downstaged but with residual disease of lower third). CONCLUSIONS: Preop R +/- CT is effective in obtaining a significative downstaging to allow sphincter saving surgery, without compromising oncological results.

Adult↗
PubMedDate not supplied

[Streptococcus agalactiae in pregnant women. Prevalence at the Posadas Hospital].

Streptococcus agalactiae (Lancefield group B Streptococcus), is the most frequent microorganism involved in neonatal infections through the mother-fetus vertical transmission. It is also responsible for infections in pregnant women, and adults with underlying diseases. The objective of this work was to know the S. agalactiae carrier prevalence in pregnant women who attended to Posadas Hospital, and to study the susceptibility pattern of the isolates to penicillin, erythromycin and clindamycin. From 1203 pregnant women studied, S. agalactiae was recovered in 113, which means a prevalence of 9.39%. Antimicrobial susceptibility was tested to 87 isolates. All of them were susceptible to penicillin, and only 2 isolates were resistant to erythromycin and clindamycin (constitutive MLS mechanism). We emphasize the importance of knowing these last resistance, in the case of beta-lactam antibiotics allergic women.

Adolescent↗
PubMedDate not supplied

Role of glycosilation in the susceptibility of "acid labile" interferon alpha to acid treatment.

Mononuclear cells from blood of healthy donors produce acid-labile interferon (IFN) alpha when stimulated with HIV-infected cells. A large proportion of this IFN appears to be glycosilated, as treatment with neuraminidase causes a shift of the isoelectric point (IP) from pH = 5.2-5.4 to pH = 5.8-6.2. To assess the role of glycosilation in determining the instability of antiviral activity after exposure to acid (pH lower than 4) peripheral blood mononuclear cells (PBMC) were induced to produce IFN with HIV-infected cells in the presence of tunicamycin, an inhibitor of glycosilation. The IFN produced under such experimental conditions (tu-IFN) was acid-stable. Tu-IFN was compared to a standard acid-labile IFN by affinity chromatography on Con A-sepharose. The elution pattern showed that tu-IFN does not bind to the gel, whereas the acid-labile IFN is eluted in two fractions, one unbound, which is stable at pH2, and one bound, which retains the initial acid-lability. These results suggest that acid-labile IFN alpha is largely glycosilated, and that the presence of glycosilated molecules contribute to render the IFN molecule unstable at acidic pH. It is to be determined whether some glycosilated molecule present in the IFN preparation, or glycosilation of the IFN molecule per se, is responsible for acid-lability of the antiviral activity.

Chromatography, Affinity↗
PubMedDate not supplied

[Acid-labile alpha interferon produced by peripheral blood mononuclear cells stimulated by cells infected by HIV].

Acquired immunodeficiency syndrome (AIDS) is caused by infection with T-cell tropic retrovirus HIV. The disease is characterized by a profound defect in cell-mediated immunity and a number of serologic abnormalities. Among the serologic abnormalities, the presence of an unusual acid-labile interferon (IFN) has been repeatedly found, and it is considered to be a marker of infection HIV evolving toward illness. Because little is known about the relationships existing between the etiologic agent of AIDS (i.e. HIV) and acid-labile IFN alpha, we approached this problem by testing whether acid-labile IFN alpha is induced in vitro by this virus. In this paper we compared the IFN-inducing activity of free, infectious HIV to that of HIV-infected cells. A number of other enveloped viruses and virus-infected cells were used as controls. Interferon inducing activity by virions as compared to virus-infected cells was determined by incubating human PBMC either with VSV, HSV, and HIV or with cells infected with the same viruses. In this case cells were fixed with glutaraldehyde to prevent virus shedding. While VSV and HSV induced production of acid-stable IFN both as free virions and as virus-infected cells, HIV induced acid-stable IFN when applied as a viral suspension, but it did produce acid-labile IFN when virus-infected cells were used as the inducer. In fact the IFN produced under these circumstances lost more than 80% of its activity when treated to pH2, no matter whether H9/HIV or HIV infected PBMC were used as the inducer. Because acid-lability is a peculiar property of IFN gamma, whereas both native and cloned IFN alpha are completely stable under acid conditions, we compared the IFNs induced by either HIV and HIV-infected cells to standard IFN alpha and gamma preparations with respect to (i) acid stability (ii) neutralization with specific antisera (iii) apparent molecular weight estimated by gel filtration. Results indicate that HIV-induced IFN behaves exactly as standard IFN alpha, as it was completely stable at pH2, totally inactivated by anti-IFN alpha and not by anti-IFN gamma serum, and had apparent molecular weight of 20,000; conversely IFN induced by HIV-infected cells, both H9/HIV and PBMC/HIV, although sharing with IFN alpha both molecular weight and antigenic properties, was inactivated by acid treatment by more than 80%.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Toxic megacolon: physiopathologic mechanism and surgical choices].

Toxic megacolon is the most dreadful complication arising in patients affected with inflammatory bowel diseases. Its incidence is rather rare, bur mortality rate is significantly high (about 40% of cases). Pathological modifications occurring in toxic megacolon deeply influence evolution and prognosis of this complication and, consequently, surgical choices. Starting from the pathophysiology of toxic megacolon, the Authors review their experience with acute colitis, emphasizing the need for a radical treatment, as only total colectomy can assure, versus Turnbull's operation or more decompression of the bowel. To save the colon means, in fact, to leave the source of sepsis "in situ". The authors experienced Turnbull's procedure only in one of the patients observed with "quoad vitam" poor results.

Colitis, Ulcerative↗
PubMedDate not supplied

[Clinical-therapeutic aspects and surgical treatment of aortic coarctation associated with hypoplasia of the aortic arch in less than 3-month-old patients].

The surgical treatment of the CoAo plus Hypoplastic Aortic Arch is debated. The point is whether to treat or not the associated tubular hypoplasia performing an extended Resection and "End to End" Anastomosis (ERETE) or a subclavian flap angioplasty (Waldhausen). According to some report in the literature we called an arch hypoplastic if its diameter in the first or second portion was less than the patient body weight plus 1. Between January 1988 and December 1992 in our Institution 38 patients less than 3 months underwent aortic coarctation repair. In 14 cases we were able to consider the aortic arch as hypoplastic. These patients were aged between 3 days and 45 days (median 15 days), the body weight was between 2.6 and 3.9 kgs (median 3.2 kgs). 6 patients had CoAo as isolated lesion, in 3 cases there was Ventricular Septal Defect (VSD) associated. In 5 patients major intracardiac anomalies were associated (1 DORV, 1 TGA, 2 SV, 1 SV+Arterio-Ventricular discordance). In 7 cases in order to treat the arch an ERETE was performed. The other 7 patients had a Waldhausen procedure. In 5 cases a Pulmonary Artery Banding (PAB) was associated, in 1 case a palliative arterial switch operation. The hospital death was 43% (3 patients) in the ERETE group, and 28% (2 patients) in the Waldhausen group. The echocardiography and or angiography performed during the follow-up period showed a nice growth of the arch in both groups. Although from our present data it's impossible to get definitive conclusions, the ERETE doesn't give better result in terms of hospital death and long term aortic arch growth.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗