Biomedical subjects
Publications and source records attributed to M Marino.
One case of Chronic Granulocytic Leukemia is reported, in which the patient showed, during a blastic crisis, an aneupolid cariotype 45, XX, t (9; 22) (q34; q11), -16. This paper emphasizes the rare involvement of the chromosome 16 in Leukemias, and stresses the high frequency of the alterations of the chromosome group E in the course of blastic crisis.
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Sputum specimens taken at random from 420 of 2,500 sweepers of Naples (369 male smokers, at least ten filter cigarettes daily for a minimum of ten years, and 51 male controls, nonsmokers) have been investigated. In the smokers group, 220 cases (59.6%) with nonspecific chronic inflammatory disease, 54 cases (14.6%) with regular squamous metaplasia, 13 (3.5%) with atypical squamous metaplasia, and one case (0.3%) of presumed carcinoma in situ have been identified. In the control group, 17 cases (35.3%) of nonspecific chronic inflammatory processes with occasional regular squamous metaplasia were the only found pathology. Based upon their results, the authors have been unable to demonstrate that air pollution may enhance the smoking effect on the respiratory tract.
Following a short review of the viruses underlying viral hepatitis and those which, as a secondary factory in the clinical picture, may cause fleeting liver damge, the subdivision of chronic hepatitis conditions on histopathological bases is described. Particular attention is paid to pathogenesis, with a study of the elimination of B virus, correlated to particular histopathological types. A series of 27 PCH and 49 ACH cases is reported. Of special significance was the observation of 14 ACH out of 17 biopsied drug addicts. The therapeutic problem of chronic hepatitis is then tackled.
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Here is presented a practical method for predicting creatinine clearance for pediatric patients from serum creatinine concentration and patients age without collection 24 h urine. Creatinine excretion rate (ER) can be predicted from the patients age, in years, by the formula: ER = (0.0463 x age) + 0.4049. Creatinine clearance can be predicted using the predicted excretion rate and serum creatinine concentration. There was a correlation (r = 0.66) between predicted and observed creatinine clearance in 101 subjects. This method allows renal function to be rapidly estimated.
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Liver histobiopsy was carried out in 21 patients with burns of from 25 to 75 percent, between the 2nd and 125th day following trauma. The most frequent type of lesion encountered was albuminoid degeneration and hydropic ballooning of the cytoplasm to the point that the parenchyma assumed a "vegetable" appearance. No steatosis intervenes until the 6th-8th day after the burn and where it was not present previously, is a sign that the patient's condition is worsening. Total, or nearly total, disappearance of glycogen from the sections is an indication that the patient is worsening; in effect in patients who died, biopsy carried out shortly beforehand revealed the extreme paucity of PAS-positive material in the hepatocytes.
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The apparent low adverse effect profile of the new drug zafirlukast has made it an attractive choice in the treatment of asthma. We present the first case (to our knowledge) of a potentially serious drug-drug interaction between zafirlukast and theophylline. A 15-year-old white girl with asthma had been taking theophylline (Slo-bid, Rhone-Poulenc Rorer Pharmaceuticals Inc, Collegeville, Pa) (300 mg twice daily), with drug levels of approximately 61 micromol/L (11.0 microg/mL) for several years. Recently, her serum theophylline levels had increased to the toxic range (133.2 micromol/L [24 microg/mL]) shortly after the addition of zafirlukast (Accolate, Zeneca Pharmaceuticals, Wilmington, Del) to her regimen. Attempts were made to stop and then restart the theophylline therapy at progressively lower doses; however, with each attempt, the patient's reaction to the drug became more toxic, with serum theophylline levels ranging between 99.9 and 149.9 micromol/L (18 and 27 microg/mL). So this potential drug-drug interaction could be investigated, the patient stopped taking both drugs for 1 week. Then, she again started taking theophylline (75 mg twice daily), and over 2 days reached a steady state serum theophylline level of 12.8 to 14.4 micromol/L (2.3-2.6 microg/mL). On the third day, zafirlukast (20 mg twice daily) was reintroduced to the regimen, and the theophylline therapy was continued. By the fifth day, a dramatic 7-fold increase was seen in the serum theophylline level (101.6 micromol/L [18.3 microg/mL]). The areas under the curve for theophylline alone and theophylline with zafirlukast were 29.3 and 197 (mg x h)/L, respectively. One explanation for the noted increase in the theophylline level is that metabolism occurs mainly by cytochrome P450 (CYP 1A2), an enzyme that is known to be inhibited with high concentrations of zafirlukast. Although the current metabolism of the 2 drugs in combination is poorly understood, the potential for serious interactions seems to exist in the rapidly growing population of persons with asthma, for whom they may be prescribed. The noted increase in the theophylline level after zafirlukast administration is in contrast to the original reports by the manufacturer. Therefore, we recommend that physicians evaluate serum theophylline levels closely when prescribing the 2 drugs in combination.
Carbohydrate additives to modern embryo culture media are based on three basic energy sources, glucose, pyruvate and lactate. Although the use of these substrates is almost universal, debate continues as to the roles of the individual components in the human. This is mainly due to the lack of human embryos for research and the reliance on animal model systems. In the present work, the human embryo was used to study the role of the above simple substrates in the maintenance of the mitochondrial membrane potential and cell division. The mitochondrial membrane potential was measured with fluorescence techniques. Cell division was scored as the number of blastomeres on day 3. Both the mitochondrial membrane potential and cell division were dramatically lost in the absence of energy sources. The mitochondrial membrane potential and cell division were normal in media containing all three energy sources, or in pyruvate-containing media. Both glucose and lactate individually proved poor energy sources for the maintenance of the mitochondrial membrane potential. However, cell division continued in the presence of glucose, suggesting that some energy production can continue. These data suggest that pyruvate is an absolute requirement for mitochondrial respiration and cell cleavage during human preimplantation development. The role of lactate is as yet unclear.
The purpose of this study was to compare the manual assessment of muscle strength with a small, handheld (by the examiner) force-measuring device developed by the Institute of Sports Medicine and Athletic Trauma (ISMAT). One hundred twenty-eight patients presented with a known lower extremity orthopaedic pathology. All patients were clinically evaluated for hip abductor and hip flexor weakness in standard positions using the "break test" technique. All 128 patients were then evaluated with the ISMAT Manual Muscle Tester, a small, hand-held device which recorded the peak force (kg) required to break a muscle contraction. Three bilateral measures of hip abduction and hip flexion were recorded, averaged, and compared to the subjective clinical evaluation using a chisquare analysis. Bilateral values which were within 5% of each other were not considered significant and therefore not included in the calculations. The average hip abduction and hip flexion scores measured by the ISMAT tester were consistent with the examiner's perception of muscle weakness (P less than 0.001). The results demonstrate consistent detection of muscle weakness by the ISMAT Manual Muscle tester over a broad range of testing conditions.
PURPOSE: To evaluate the clinical characteristics and the visual prognosis of uveitis in juvenile rheumatoid arthritis (JRA). METHODS: The authors examined 63 patients with uveitis and JRA observed from January 1985 to December 2000. The following characteristics of each patient were considered: age at first visit, age at onset of uveitis and arthritis, sex, laterality and localization of uveitis, ocular complications, antinuclear antibody (ANA) and human leukocyte antigen (HLA) DR11 positivity, and follow-up. A retrospective study on mid-time visual outcome and ocular complications was performed on 42 patients with more than 12 months of follow-up. RESULTS: A total of 76.2% of the patients were female, with a mean age of 8.1 years. Chronic anterior uveitis was bilateral in 77.8% of the cases and unilateral in 22.2%. Arthritis was oligoarticular at onset in 87.3% of cases, and polyarticular in 12.7%. Mean age at arthritis onset was 4.5 years and mean age at uveitis onset was 5.4 years. ANA were positive in 92% of cases and HLA DR11 was present in 36 of the 43 patients tested (83.7%). Among the 42 patients with more than 12 months of follow-up, ocular complications occurred in 90.5% of cases and the most frequent were cataract (64.4% of eyes) and band keratopathy (59.2% of eyes). Secondary glaucoma (25% of eyes) was associated with the worst visual prognosis. A total of 64.5% of eyes maintained a visual acuity between 20/33 and 20/20 at the end of the follow-up. CONCLUSIONS: Visual prognosis of uveitis associated with JRA is improving, owing to earlier diagnosis and intensive treatment. Ocular complications occurred frequently in patients with uveitis and JRA but they did not seem to seriously affect the final visual outcome. The authors did not observe any correlation between prognosis and sex, age at the onset of uveitis or arthritis, pattern of arthritis, or positivity for ANA or HLA DR11. In a percentage of cases, uveitis may develop before arthritis or years after the onset of arthritis; therefore, continuous ophthalmologic examinations are needed in young people with JRA.