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Biomedical subjects

P Barsotti

Publications and source records attributed to P Barsotti.

At least 37 records · Page 2Linked to original sources

Long-term thromboxane-synthase inhibition prolongs survival in murine lupus nephritis.

Systemic lupus erythematosus (SLE) is an autoimmune disease, characterized by nephritis, in which mortality is largely influenced by the severity of renal involvement. As there are evidences that thromboxane (TX)A2 plays an important role in the pathogenesis of lupus nephritis, we decided to assess the effects of long-term suppression of TXA2 synthesis on the progression of the disease, by designing a study of TXA2-synthase inhibition having adequate size to detect an effect on mortality as the primary end-point. Thus, we randomized 362 NZBxNZW mice (11-week-old at entry) to one of the following treatments: a TXA2 synthase inhibitor, FCE 22178 (300 mg/kg daily), saline or cyclophosphamide (5 mg/mouse weekly x 4 weeks) used as reference treatment. The TXA2 synthase inhibitor suppressed TXA2 biosynthesis, as reflected by urinary TXB2 and 2,3-dinor-TXB2 excretion (by 78% and 90%, respectively) and significantly reduced mortality (death rate: 34% vs. 61% in controls, at 37 weeks, P < 0.01). A significant reduction in proteinuria (9 +/- 1.6 vs. 17.3 +/- 2.4 mg/24 hr in FCE 22178 vs. saline, P < 0.01) and glomerular lesions was observed up to 30 weeks but not at 37 weeks. In contrast, cyclophosphamide prevented the development of proteinuria and histologic lesions, and reduced mortality to 8% at 37 weeks. Renal plasma flow and glomerular filtration rate were lower (by 29% and 52%, respectively) in 37-week-old as compared to young NZBxNZW mice. These parameters were further depressed by cyclophosphamide (by 48% and 45% vs. age-matched controls, respectively, P < 0.01) but were not altered significantly by FCE 22178.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Acute myeloid leukemias M2 potentially misdiagnosed as M3 variant French-American-Britain (FAB) subtype: a transitional form?

From 1990 to 1994, 3 patients with de novo acute myeloid leukemia (AML) in whom light microscopy and cytochemistry suggested a FAB subtype M3 variant were observed at our Institute. Immunophenotype showed HLA-DR-, CD13+, CD33+, CD2+, CD9+; promyelocytic features were also detected by electron microscopy. However, leukemic cells lacked both translocation t(15;17) and RAR alpha/PML genes rearrangement. These cases were considered to be 'M2 atypical' subtypes and they contribute to point out how cytogenetics and molecular biology are mandatory for a correct diagnosis of acute promyelocytic leukemia (APL) particularly because therapy with all trans retinoic acid (ATRA) is now the best treatment for APL. Nevertheless these 3 cases indicate that the atypical M2 subtype may be confused with the M3v if only cytochemistry, immunophenotype and electron microscopy are used in the defining the FAB subtypes.

Adult↗

[Cystic dystrophy on an aberrant duodenal pancreas. Apropos of a case].

Cystic dystrophy of the aberrant pancreas is a rare poorly understood condition which is difficult to diagnose and treat. The primary clinical signs are epigastralgia associated with poor general health and complications due to stenosis of the duodenum. Endoscopy gives the most information on tissue lesions and cystic formations in the duodenal mucosa. Although the condition is benign, and due to the lack of sufficient history in endoscopically treated cases, cystic dystrophy of the aberrant duodenal pancreas appears to require duodenopancreatectomy.

Adult↗

De-novo COL4A5 gene mutations in Alport's syndrome.

Before the advent of direct molecular gene analysis the diagnosis of Alport syndrome was operationally based on three of the four classical clinical criteria. Recently, mutations have been identified in the COL4A5 gene, which is involved in X-linked Alport syndrome. Here we describe two de-novo mutations in two unrelated children, a male and a female, both with early onset of the nephropathy, but with only one of the diagnostic criteria, i.e. electron-microscopy alterations. Because of the significant estimated proportion of de-novo mutations this diagnosis should be considered in children with early signs of nephropathy, even without a suggestive family history or clinical picture (ocular or audiologic abnormalities). In the future the diagnosis of Alport syndrome will probably be made on the basis of both clinical findings and molecular analysis. Now Alport syndrome is clearly underdiagnosed.

Adolescent↗

[Predictive factors of recurrence in surgically treated rectal villous tumors. Therapeutic approach based on 184 cases].

The aim of this retrospective study on 184 operated cases was to propose a therapeutic management scheme for villous tumours of the rectum. Among the 184 operated patients, 167 (90,7%), mean age 65 years, were seen after a follow-up of 2 to 20 years. The tumour was most often localized in the rectal ampoula (141 cases) and was benign in 65 p. 100. Endoanal surgery was performed in 76 patients among whom recurrence was observed in 29.7%. Posterior exeresis (Kraske method) was performed in 52 cases with a recurrence rate of 31.9%). Finally, abdominoperineal amputation was performed 20 times, essentially for advanced stage tumours. Based on the statistical analysis of the recurrence factors for these different techniques, we have concluded that endoanal surgery predominates for benign tumours smaller than 5 cm situated at least 8 cm from the anus. Above the size of 5 cm, due to the major risk of tumourectomy, we believe rectal exeresis is the most rational treatment.

Adenoma, Villous↗

Renal involvement in feline immunodeficiency virus infection: a clinicopathological study.

Renal tissues from 15 cats naturally infected with feline immunodeficiency virus (FIV) were examined histologically, immunohistochemically and ultrastructurally. Renal function and urinary proteins were also studied. Kidney abnormalities were found in 12 cats and were characterized by mesangial widening with segmental to diffuse glomerulosclerosis and presence of IgM and C3, and scanty IgG deposits in the mesangium. Tubulointerstitial lesions were also present. In 6 cats the lesions were severe enough to cause marked increase in blood urea nitrogen and creatinine, and heavy glomerular nonselective proteinuria. These findings suggest that a renal involvement is a frequent occurrence in FIV-infected cats. As the histopathological features observed were similar to those described in HIV-infected patients, FIV-infected cats may represent a valuable model for a better understanding of HIV-associated nephropathy in humans.

AIDS-Associated Nephropathy↗

Neuroendocrine epithelial cells of the main pancreatic ducts and ampulla.

In this study we investigated by immunocytochemistry (peroxidase-conjugated extravidin-biotin system) the existence of neuroendocrine cells in the main ducts draining the exocrine pancreas and in the ampulla of Vater of six human specimens obtained at surgery (duodenocephalopancreasectomy). Using a panel of primary antibodies for Chromogranin A, gastrin, CCK, somatostatin and serotonin (5HT), we visualized scattered neuroendocrine cells in the epithelium of Wirsung duct and in the ampulla. All were positive for Chromogranin A and the majority were also positive for serotonin (5HT), while gastrin cells were seldom observed. Interestingly, their number was far lower than in the adjacent duodenal mucosa. We believe that these neuroendocrine epithelial cells may have specific physiological roles such as epithelial trophism and differentiation.

Aged↗

Tricuspid valve vegetation in a child with periarteritis nodosa.

We report a case of a child who was first seen for acute renal failure and periarteritis nodosa. Angiography findings confirmed this diagnosis. Ultrasound scan revealed large tricuspid valve vegetation, as well as minute vegetation on the right ventricular wall. All vegetation disappeared after 12 months of immunosuppressive therapy. Serology findings for lupus were negative. All clinical and laboratory findings strongly support the hypothesis that this previously undescribed heart involvement is caused by PAN.

Acute Kidney Injury↗

Mucin-producing cells and endocrine cells of gallbladder epithelium in patients with uncomplicated cholelithiasis.

In this study we have investigated various morphofunctional features of gallbladder mucosa in patients with uncomplicated cholelithiasis. The histological changes, endocrine cell types and their distribution, and mucin-producing cells were characterized by immunocytochemistry and mucin histochemistry; moreover, we attempted to correlate these findings to the number and size of gallbladder stones and the type of bacteria present in the bile. Our results indicate that, despite similar clinical parameters, a wide range of histological changes can occur in the gallbladder mucosa of these patients. Moreover, the presence of certain endocrine and mucin-producing cell types in so-called "pyloric metaplasia" led us to hypothesize that this finding may be a trivial event in the gallbladder epithelium.

Cholelithiasis↗

[A retrospective study of 54 children hospitalized in the Department of Pediatric Surgery for suspicion of child abuse].

Forty-five children admitted to the department of pediatric surgery at Strasbourg (France) from 1980 through 1989 were reported as being possible victims of abuse. The conditions of the hospital admission and nature of the injuries found are analyzed. On the basis of the data in the reports established by social workers and judicial authorities and in psychiatric expert evaluations, the social and familial characteristics of child abuse are defined. Although based on the demonstration of many elements pointing in the same direction, the diagnosis of child abuse remains fraught with difficulty.

Age Factors↗

Silver staining of interphase nucleolar organizer regions in cytologic smears previously stained by the Papanicolaou and May-Grünwald-Giemsa techniques.

Malignant cells are known to display a distinctive argyrophilic nucleolar organizer region (Ag-NOR) protein distribution compared with distribution in their benign counterparts. In this study, Ag-NOR staining was applied to smears from reactive and malignant serous effusions. The smears were either unstained or had been previously stained with the Papanicolaou or May-Grünwald-Giemsa (MGG) technique. The purpose of this study was to assess the feasibility and usefulness of Ag-NOR staining in diagnostic cytopathology and to set up a procedure that could be used on prestained smears in retrospective studies. The one-step silver staining method was applied to prestained smears after a weak destaining step in trichloracetic acid and to unstained smears after a postfixation step in Carnoy's fluid. Positive results were observed on both destained and unstained preparations, MGG-stained smears showing a better visualization of the silver deposits than Papanicolaou-stained smears. Major differences in size, shape, and distribution patterns of the Ag-NOR-positive granules were observed between neoplastic and reactive cells. Furthermore, the mean number of silver-stained dots per cell was significantly higher in malignant cells (33.32 +/- 2.23) than in reactive mesothelial cells (9.71 +/- 0.66). These data indicate that this Ag-NOR technique can be profitably applied to prestained cytologic smears to assist in the diagnosis of malignancy and that the technique has the advantage that cellular morphology and silver staining can be evaluated on the same slide.

Ascitic Fluid↗

Nucleolar organizer regions in the fine needle aspirates of lung tumours.

Nucleolar organizer region associated proteins (AgNOR proteins) have been identified by means of an argyrophil technique in smears of 60 consecutive fine needle aspirates from lung tumours. AgNOR proteins were visualized as silver-positive granules distributed in loose, intranuclear aggregates. Variations in the number as well as differences in the distribution pattern of AgNOR granules were found among different types of tumours. Except for small cell lung carcinoma, the count of AgNOR granules increased when the differentiation of tumours decreased. In particular well differentiated tumours had relatively few AgNOR granules, distributed in cohesive aggregates. Poorly differentiated tumours had many AgNOR granules organized in loose clusters and small cell lung carcinoma had relatively few granules dispersed throughout the nucleoplasm, showing characteristics unique among all lung neoplasms. The application of the AgNOR technique in cyto-preparations is useful in discriminating between small cell and non-small cell lung carcinomas. Moreover, the pattern of distribution of AgNOR proteins may be of diagnostic value in the assessment of tumours displaying overlap in AgNOR counts.

Adenocarcinoma↗

Membranous nephropathy associated with giant lymph node hyperplasia. A case report with histological and ultrastructural studies.

A young woman presented with nephrotic syndrome due to membranous nephropathy and a localized form of giant lymph node hyperplasia (Castleman's disease) occurring as a large intra-abdominal mass. Five months after surgical removal of the mass, only mild proteinuria persisted. Twenty months later a second kidney biopsy showed a near-normal morphology. Six years later the patient was free of symptoms and had normal urinalysis. Reviewing the pertinent literature, it seems to be the first case of a biopsy-proven cure of membranous nephropathy in a patient with membranous nephropathy and Castleman's disease.

Adolescent↗

Ultrastructural histochemistry of mesotheliomas and adenocarcinomas in malignant effusions.

The results of electron microscopic examination of cytologic specimens from six cases of mesothelioma and 10 cases of metastatic carcinoma of different origins are presented. The formation of cell clusters in malignant effusions from the two neoplasms has been thoroughly investigated: in mesotheliomas, cells had longer, more slender microvilli than in carcinomas and more abundant bundles of intermediate filaments; the central cavity often seen in the clusters frequently contained collagen and showed basement membrane production. The application of periodic acid-silver methenamine (PASM) and phosphotungstic acid (PTA) demonstrated a peculiar ultrastructural difference in cell coat staining in the two tumor types: in mesotheliomas, PTA and PASM were consistently negative along the outer surface of the cell aggregates, while carcinomas displayed a positive reaction either on the outer surface or on both inner and outer surfaces of the clusters. The diagnostic significance of the above-mentioned difference between the two neoplasms will require further investigation in a larger number of cases.

Adenocarcinoma↗

Heterotopic gastric mucosa of the rectum--characterization of endocrine and mucin-producing cells by immunocytochemistry and lectin histochemistry. Report of a case.

Heterotopic gastric mucosa in the rectum is particularly uncommon; only 23 cases have been reported to date. Moreover, no studies have been done on the neuroendocrine apparatus and glycoprotein production of the heterotopic mucosa. This study reports on a 13-year-old boy, admitted with rectal bleeding and persistent tenesmus. An ulcerative lesion was found on colonoscopy; biopsies revealed a fundic-type gastric tissue. Medical therapy (H2-blockers) promptly healed the rectal ulcer; surgical excision of the heterotopia was performed with complete and permanent relief of symptoms (3-year follow-up). Immunocytochemistry (PAP) revealed 5-Ht and somatostatin cells in the gastric-type mucosa, as in the normal human stomach. These cells also were present in the surrounding rectal epithelium where PYY-enteroglucagon cells were detected, which were absent in the heterotopic tissue. Mucin histochemistry showed PAS-positive cells also strongly stained by LA lectin in the heterotopic tissue, differentiating the rectal epithelium that remained unstained. Therefore, the morphofunctional status (endocrine cells and mucins) of the gastric heterotopia was almost identical to its orthotopic counterpart, confirming the hypothesis that endocrine cells and mucin-producing cells differentiate their metabolic products according to the anatomic and functional activity of the epithelium where they grow.

Adolescent↗