Search PubMed⌕ Search

Biomedical subjects

M Piattelli

Publications and source records attributed to M Piattelli.

At least 19 recordsLinked to original sources

CD10 expression in stromal cells of oral cavity squamous cell carcinoma: a clinic and pathologic correlation.

OBJECTIVE: CD10 is expressed on the majority of follicle-center lymphomas and Burkitt lymphomas. CD10 has also been shown to be present in a variety of other neoplasms. DESIGN: The aim of this study was a correlation of CD10 and several parameters: age, tumor size, presence of lymph node metastases, clinic stage, histologic grading, presence of local recurrences. MATERIALS AND METHODS: The tissues of 77 consecutive patients with oral cavity squamous cell carcinoma were evaluated using immunostaining with monoclonal antibody for CD10. MAIN OUTCOME MEASURES: Highly significant correlations were found with the lymph node status, the presence of local recurrences and the histologic grading. The presence of CD10-positive cells was not correlated with the age of patients, tumor size and clinic stage. RESULTS: The results of the present study show that in oral squamous cell carcinoma CD10 positivity is an indicator of worse prognosis. Another strong correlation was found with the presence of local recurrences. Also the histologic grade was significantly correlated with the CD10 positivity. CONCLUSION: Our results point to the fact that CD10 expression can, perhaps, have an important role in tumor invasion, probably facilitating the occurrence of metastases.

Adult↗

A randomized controlled trial of pegylated interferon alpha-2a (40 KD) or interferon alpha-2a plus ribavirin and amantadine vs interferon alpha-2a and ribavirin in treatment-naïve patients with chronic hepatitis C.

We determined whether triple therapy comprising amantadine (AMA), ribavirin (RBV) and either peginterferon (PEG-IFN) alpha-2a or conventional IFN alpha-2a would improve sustained virological response (SVR) rates over dual therapy with IFN alpha-2a and RBV in patients with chronic HCV infection. A total of 362 treatment-naïve patients were randomized to 48 weeks of treatment with: PEG-IFN alpha-2a 180 microg/week (group A) or IFN alpha-2a 3 MU tiw (groups B and C). All patients received RBV 1000 or 1200 mg/day and those in groups A and B received AMA 200 mg/day. SVR was defined as an undetectable HCV RNA after 24 weeks of untreated follow-up. At the end of therapy, 74.4% (95% CI 0.66-0.82) of patients in group A were HCV RNA-negative compared with 42.5% (95% CI 0.33-0.50) of those in group B (P = 0.0001) and 48.8% (95% CI 0.40-0.56) of those in group C. SVR was achieved in a significantly greater proportion of patients in group A compared with groups B and C: 65.3% (95% CI 0.53-0.56), 33.3% (95% CI 0.25-0.41) and 44.6% (95% CI 0.36-0.53; P = 0.0001) respectively. In patients with genotype 1, SVR rates were 55.2, 22.8 and 28.8% with the three regimens respectively. Factors independently associated with SVR were HCV genotype 2 or 3, therapy with PEG-IFN, female gender and age. In treatment-naive patients with chronic hepatitis C, triple therapy with PEG-IFN alpha-2a, RBV and AMA produces higher SVR than dual or triple therapy with conventional IFN alpha-2a.

Adolescent↗

IL-10 haplotypes as possible predictors of spontaneous clearance of HCV infection.

BACKGROUND: In hepatitis C virus infection an inappropriate ratio of pro-inflammatory and anti-inflammatory cytokines may either determine different outcomes of the infection or affect the benefit of antiviral treatment. Given that polymorphisms in regulatory regions of cytokine genes influence cytokine production, we determined frequency of polymorphisms of IL-10, IFNgamma, and TNFalpha genes in HCV-infected patients and healthy controls, and investigated their association with either ongoing or cleared HCV infection, or with response to treatment. METHODS: Genomic DNA from 270 patients and 145 controls sharing the same ethnic background was studied by polymerase chain reaction, restriction enzyme digestion, direct sequencing, and microsatellite analysis. RESULTS: The IL-10 ATA haplotype was more frequent in patients with spontaneous HCV RNA clearance (36.0%) than in patients with persistent infection (23%) (p=0.009, p corrected = 0.036). Neither TNF -308 and -238 polymorphisms nor IFNgamma alleles variability were associated with different HCV outcome. However, the combination of ATA homozygous state and IFNgamma 119 allele was more frequent in patients with spontaneous HCV clearance than in patients with ongoing disease (p=0.012; p corrected = 0.048). We could not confirm the reported effect of genetic influence on the response to treatment. CONCLUSIONS: Our findings indicate that heterogeneity in the promoter region of the IL-10 gene has a role in determining a spontaneous favourable outcome of HCV infection.

Adult↗

Viral clearance in HCV viraemic patients with normal alanine aminotransferase after combination therapy: a controlled, open-labelled study.

BACKGROUND: In patients with chronic hepatitis C virus infection and persistently normal alanine aminotransferase levels, liver fibrosis has been reported in 0-22% of cases and advanced liver disease in 5-10% of cases. AIM: To determine whether patients with persistently normal alanine aminotransferase levels clear infection after anti-viral therapy at equal or different rates from infected patients with raised alanine aminotransferase levels. METHODS: Thirty-five hepatitis C virus RNA-positive patients with fibrosis at liver histology (Group 1) were matched for genotype, sex, age and histology with patients with raised alanine aminotransferase levels (Group 2). Both groups were treated with 3 MU interferon-alpha2b plus ribavirin (1000-1200 mg) for 12 months. RESULTS: End-of-therapy response was achieved in 71.4%[95% confidence interval (CI), 56.4-86.3] of patients in Group 1 and in 52.3% (95% CI, 42.8-61.9) of those in Group 2 (P = 0.04). At week 72, 22 patients (62.8%; 95% CI, 46.8-78.1) in Group 1 and 50 patients (47.5%; 95% CI, 38.0-57.1) in Group 2 showed a sustained virological response (P = 0.11). Non-1 genotype was the only independent predictor of sustained response (P = 0.002), with an odds ratio of 3.45 (95% CI, 1.58-7.50). At month 3 of therapy, the positive predictive values for non-response were 100% and 96% in Groups 1 and 2, respectively. CONCLUSIONS: Interferon and ribavirin induce comparable sustained virological response in patients with persistently normal or raised alanine aminotransferase levels. Stage 1 fibrosis, rather than alanine aminotransferase levels, may be the criterion on which to decide whether or not to treat patients with persistently normal alanine aminotransferase levels.

Adult↗

The stiff-person syndrome. Case report.

The stiff-person syndrome is a rare and disabling disorder, characterized by muscle rigidity with superimposed painful spasms involving axial and limb musculature. The clinical symptoms are continuous contraction of agonist and antagonist muscles caused by involuntary motor-unit firing at rest and the spasms that are precipitated by tactile stimuli, passive strach, volitional movement of affected or unaffected muscles, startling noises and emotional stimuli. Both the rigidity and the spasms are relieved by sleep, general anaesthesia, myoneural blockade and peripheral nerve blockade. The cause of the stiff-person syndrome is unknown but an autoimmune pathogenesis is suspected because 1) the presence in the cerebrospinal fluid (CSF) of antibodies against glutamic acid decarboxylase (GAD), the rate-limiting enzyme for the synthesis of the inhibitory neurotrasmitter gamma-aminobutyric acid (GABA), 2) the association of the disease with other autoimmune disorders, 3) the presence of various autoantibodies and 4) a strong immunogenetic association. The stiff-person syndrome is clinically elusive but potentially treatable and should be considered in patients with unexplained stiffness and spasms. Drugs that enhance GABA neurotransmission, such as diazepam, vigabatrin and baclofen, provide modest relief of clinical symptoms. Immunomodulatory agents such as steroids, plasmapheresis and intravenous immunoglobulin, seem to offer substantial improvement.

Aged↗

Localized ridge augmentation using titanium micromesh.

Guided bone regeneration (GBR) has been used recently for the regeneration of bone in conjunction with the placement of dental implants, for augmentation of resorbed alveolar crests, and to treat localized ridge deformities. Twenty-two patients with alveolar crest defects or peri-implant dehiscences participated in this study. Titanium implants were inserted, and the defects were covered with a titanium micromesh, above which was positioned an e-PTFE membrane. After healing, the 2 membranes were removed and a small specimen of the underlying tissues was retrieved with a small trephine. The postoperative healing was mostly uneventful, and only a few dehiscences with membrane exposure were observed. The space under the membranes was, in all patients, filled by a tissue with the macroscopic features of newly formed bone. No residual bone defects were observed and an increase of the alveolar width or height was observed. No untoward effects on bone regeneration were observed in the cases with membrane exposure. Histology showed that the underlying regenerated tissues were composed, in all cases, by newly formed bone. In conclusion, our results show that very satisfactory results concerning GBR techniques can be obtained even without the use of grafts under barrier membranes.

Adult↗

Singly bridged calix

Crowned calix[8]arenes are obtained by direct alkylation of p-tert-butylcalix[8]arene (1) with poly(ethylene glycol) ditosylates in the presence of various bases. K2CO3 promotes the preferential formation of 1,3-calix[8]crowns. Cs2CO3 mainly gives the 1,5-isomers, which are selectively obtained in high yields when shorter chains are used (1,5-crown-2, 88%; 1,5-crown-3, 78%). NaH affords the 1,4-isomers in yields up to 46%, often as the sole crown derivative, besides unreacted 1. 1,2-Calix[8]crowns are also obtained in appreciable amount in some instances. The observed regioselectivity is rationalized in terms of preferential formation of specific anions in dependence of the base strength. Dynamic NMR and modeling studies prove that the polyether chain, depending on its bridging mode, may significantly reduce the available space for the through the annulus passages leading to derivatives conformationally blocked (on the NMR time scale).

Journal Article↗

Bone regeneration using Bioglass: an experimental study in rabbit tibia.

Bioglass (BG) has been shown recently to be osteoconductive and osteopromotive in different experimental and clinical conditions. The aim of the present study was to evaluate BG particles in bone defects in rabbit tibia. In control sites, bone was observed only in the peripheral areas of the defects, while in test sites, newly formed bone was found around all BG particles, even those located in the central portion of the defect. Osteoblasts were actively secreting osteoid matrix directly on the granules' surface. BG seems to be a highly osteoconductive material.

Animals↗

A microscopical evaluation of 24 retrieved failed hollow implants.

Twenty-four hollow ITI implants (four screws, and 20 cylinders) were retrieved because of failure, and evaluated in our laboratory, in a eight-year period (1989-1996), to see if a common cause could be observed in this implant design. No selection of these implants was carried out, and they represented the total number of implants of this type received in the above-mentioned time frame. The implants had been inserted by several different clinicians and were received from four universities and a private practice. The implants had been removed for mobility, pain, and presence of a vertical bone loss. About two-thirds of the implants were unstable in the jaw at the time of retrieval. Twenty implants had been used as single implants restoration and four in bridge reconstructions. Most of our specimens showed that the inflammatory process had reached the hollow portion of the implants. The following microscopical features were present in almost all our specimens: calculus and plaque on the coronal portion of the implant surface, presence of proliferating epithelium and of bone sequestra, and presence of bone apically to the inflammatory process. Perhaps, when the inflammatory process reaches the implant hollow portion, the infection runs a more rapid course due to the scarce vascularity of the bone inside this part.

Dental Implants↗

Benign cementoblastoma associated with an unerupted third molar.

Benign cementoblastoma is a rare lesion representing less than 1% of all odontogenic tumours. It usually affects young people and is located in the posterior jaw. In almost all cases the tumour tends to be associated with an erupted permanent tooth, most often the first molar: only rarely has an association with an impacted or deciduous tooth been reported. The authors present a case of a cementoblastoma involving an impacted third molar.

Adult↗

Histologic observations on 230 retrieved dental implants: 8 years' experience (1989-1996).

The histologic examination of dental implants retrieved from humans is important to establish the causal determinants of implant failure, and to compare and validate the results obtained from animal studies. This study presents a retrospective review of the histologic features of 230 implants retrieved in an 8-year period (1989-1996). All the implants were treated to obtain thin (20 to 30 microm) ground sections. The majority of implants were retrieved because of mobility (n=56), peri-implantitis (n=54), or fractures (n=90). Peri-implantitis occurred more frequently before (n=44) than after (n=10) abutment connection. A dense fibrous connective tissue with no inflammatory cells was present at the interface in the implants retrieved for mobility; bone was found only in the most apical part. In many of these implants epithelial cells were present. The main histologic features of peri-implantitis consisted of the presence of a bone sequestrum near the implant, many bacteria present on the implant surface, and an inflammatory infiltrate (macrophages, lymphocytes, and plasma-cells) nearby. Histology showed that in the implants removed for fracture, there was a very high percentage (80 to 100%) of peri-implant bone.

Animals↗

Hollow implants retrieved for fracture: a light and scanning electron microscope analysis of 4 cases.

One of the possible complications of implant treatment is the occurrence of an implant fracture. Metal fatigue and biomechanical overload seem to be the most common causes of fractured implants. This study evaluated 4 implants (3 hollow cylinders and 1 hollow screw) which fractured after a mean loading period of 2.8 years. All implants had a 4 mm diameter and had been inserted in a posterior location. In 3 cases parafunctional habits were present. In all cases a vertical resorption of the peri-implant bone was present. The endosseous portion of the implant presented always a very high bone-implant contact percentage. Scanning electron microscopic examination showed that at least one of the implant holes was involved in the fracture line; no porosities or material defects were observed on the fractured surface of the implant. In hollow implants the holes could represent a site of less resistance.

Alveolar Bone Loss↗

Microscopic and histochemical evaluation of demineralized freeze-dried bone allograft in association with implant placement: a case report.

A case report is presented in which a titanium implant was placed into a defect resulting from the extraction of an impacted tooth; the defect was filled with demineralized freeze-dried bone allograft particles without a membrane barrier. After a 6-month healing period the bone defect had completely healed and the tissue present had macroscopic features similar to mature bone. Histologic examination of this tissue showed that, in all demineralized freeze-dried bone allograft particles, mineralization nodules were scattered inside the demineralized bone; in the areas where the mineralization nodules were present, osteocyte lacunae could be observed. In the case presented, significant new vital bone formation was observed 6 months after placement of a demineralized freeze-dried bone allograft.

Acid Phosphatase↗

Implant periapical lesions: clinical, histologic, and histochemical aspects. A case report.

A new entity, the "implant periapical lesion," has recently been described. The etiology of this condition could be attributed to overheating of the bone, overloading of the implant, presence of a pre-existing infection or of residual root particles and foreign bodies in the bone, implant contamination during production or during insertion, or placement of the implant in an infected maxillary sinus. In this report, a titanium plasma-sprayed implant had been inserted into the mandible of a 53-year-old patient; after 5 months a fistula developed and periapical radiography showed a large radiolucent image around the apical portion of the implant. The implant was removed, and histologic examination showed necrotic bone and an inflammatory infiltrate inside the hollow portion of the implant. The etiology of the implant failure in this instance could be related to a fracture and vascular impairment of the bone inside the implant during insertion, to external contamination of the implant, or to the poor bone quality of the implant site.

Alveolar Process↗

Simultaneous demonstration of alkaline and acid phosphatase activity in bone, at bone-implant interfaces and at the epiphyseal growth plate in plastic-embedded undemineralized tissues.

The aim of the present study was to determine if it was possible to detect in bone, at the epiphyseal growth plate and at the bone-implant interface, the presence of alkaline and acid phosphatases using Technovit 7200 VLC resin. In the plastic-embedded specimens it was possible to observe the simultaneous presence of acid and alkaline phosphatases at the epiphyseal growth plate in the presence of intra-articular implants. The morphology of the cells positive for the phosphatases was very clear, with no apparent diffusion of the reaction product and no sputter ground staining.

Acid Phosphatase↗

Histological and histochemical analyses of acid and alkaline phosphatases around hydroxyapatite-coated implants: a time course study in rabbit.

One of the concerns pertaining to hydroxyapatite (HA)-coated dental implants is their possible dissolution over time, with ultimate loss of the implant. HA-coated dental implants were inserted medially into rabbit femoral articular knee joints. The implants were retrieved after 1 week, 1 month, 3 months and 6 months. At 1 week, many alkaline phosphatase (ALP)-positive osteoblasts were observed near the implant surface. No signs of degradation of the coating were present. At 1 month, only few ALP-positive osteoblasts were present in the marrow spaces at the interface with the coating. Many acid phosphatase (ACP)-positive cells were observed near the coating. In many marrow spaces the HA coating was reduced in thickness. At 3 months, a further reduction of the thickness of the coating, in the areas in contact with marrow spaces, was seen. Many ACP-positive cells were present in tight contact with the coating. Few ALP-positive osteoblasts were present. At 6 months, in many areas in contact with marrow spaces, the HA coating was completely resorbed. The histological and histochemical results seem to point to the existence of two types of ACP-positive cells: multinuclear, often in the process of phagocytosing HA particles, and mononuclear, with a morphology similar to osteoclasts.

Acid Phosphatase↗

Histologic aspects of the bone and soft tissues surrounding three titanium non-submerged plasma-sprayed implants retrieved at autopsy: a case report.

The authors report the histological features found around three non-submerged titanium plasma-sprayed implants retrieved, after a 10-month loading period, from an autopsy case. At the time of implant insertion, the clinician had noted a wide vestibular dehiscence of the central implant, and it was decided to use a bioabsorbable membrane for guided bone regeneration in this area. After specimen processing, it was possible at low magnification to observe that in the most vestibular slides, the central implant was almost completely surrounded by connective tissue, while in the most lingual slides, the quantity of bone around the implant tended to increase. The other two implants had a bone-implant contact percentage of about 60%. Only in a few areas was mineralized bone in direct contact with the metal surface, while around the major portion of the implant perimeter a layer of unmineralized, red-stained, osteoid material was present. No inflammatory infiltrate was present in the epithelium and in the supracrestal connective tissues. The fibers of this tissue had a different orientation: in the most coronal portion of the implants (smooth surface), they tended to run parallel implant's surface, while in the most apical region (plasma-sprayed surface), they tended to be arranged in a perpendicular fashion. These results, in man, were strikingly similar to those previously reported in dogs and monkeys.

Absorption↗

Presence of multinucleated giant cells around machined, sandblasted and plasma-sprayed titanium implants: a histological and histochemical time-course study in rabbit.

A histological and histochemical evaluation was conducted in rabbit to study the presence of multinucleated giant cells (MGCs) at the interface with machined, sandblasted and plasma-sprayed titanium implants. No MGCs were observed, at any of the experimental times, around machined and sandblasted titanium surfaces. MGCs were, on the contrary, present at the interface with titanium plasma-sprayed implants at two weeks and at two months. At two weeks these cells were numerous, and in some areas, particularly around the spires, tended to line almost all the implant perimeter surface. MGCs were present in large numbers where bone was present at the interface, while, on the contrary, where there was no newly formed bone, they tended to be fewer in number and smaller in diameter. At four and eight weeks these cells tended to decrease in number. The histochemical staining for acid phosphatase (ACP) and alkaline phosphatase (ALP) showed that MGCs were negative to ACP, while many ALP-positive osteoblasts, actively secreting osteoid matrix, were in close and tight contact with the MGCs. In no case was an inflammatory infiltrate present in connection with the MGCs. The precise nature of MGCs is still not clear, but our histological and histochemical results could point to a priming effect on the activity of the osteoblasts in a similar way to the supposed role of the osteoclasts.

Animals↗