Hereditary progressive nephropathy with sensorineural deafness. Report on four kindreds.
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Biomedical subjects
Publications and source records attributed to P Brambilla.
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Our study was performed in 1986-'87 and 1987-'88 school years on 12.354 three to eighteen years old students (the whole scholastic population of zone 20 of Milan) in order to apply dietary education on obese subjects. Mean prevalence of obesity was 13.4% with elevated percentages in 11 to 13 years old students (17.9%), with respect to primary (14.1%), high school (12.4%) and nursery school (4.7%). The 36% of obese subjects (more than 50% of adolescents) had already tempted to reduce body weight. Intervention reduced % weight excess (from 33.6 +/- 0.5% to, 28.8 +/- 0.5% after 12 months, p less than 0.001); 67% of obese subjects lost weight and body weight returned within normal limits in 31% of subjects. An educational dietetic strategy may be successful in childhood obesity.
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Urinary excretion of D-glucaric acid (uGA) is an index of type II hepatic microsomal enzyme induction, indirectly revealing possible organic effects of some drugs and environmental pollutants. However, its determination is often cumbersome. We suggest a new, fast microanalytical method for uGA determination in which beta-glucuronidase (BG; EC 3.2.1.31) activity inhibition produced by uGA-derived 1,4-D-glucarolactone is measured. With use of purified BG, the method is suitable for centrifugal analyzers, allowing assay of greater than 100 samples per day. Moreover, the method measures uGA more accurately than other enzymatic methods based on BG inhibition. The within-day CV ranges from 7.9% to 4.6% (uGA 31.55-121.31 mumol/L); the between-day CV ranges from 11.5% to 5.0% (uGA 26.09-124.10 mumol/L). The detection limit is 6.0 mumol/L. The standard curve is linear from 10 to 200 mumol/L. Mean analytical recovery is 100%. Comparison with the method of Simmons et al. (Clin Chim Acta 1974;51:47-51) gave a correlation of r = 0.978, y = 1.40x-2.81. Reference intervals were established in a healthy population sample of 369 people (165 under 14 y), and uGA, expressed in micromoles per gram of creatinine, was higher in women than in girls or in males.
We present the clinical and neuroradiological features of tethered cord syndrome in a young woman and discuss the diagnostic role of CT scanning, performed before and after myelography.
To determine whether immature or defective glucose counterregulation was responsible for the severe recurrent hypoglycemic episodes (3.6 per patient per year) observed during conventional therapy (CT) in six pre-school-age diabetic children, we investigated their metabolic and hormonal responses to insulin infusion (40 mU/kg i.v. for 60 min). Counterregulation was considered adequate because no patient experienced symptoms requiring discontinuation of the test, and blood glucose (BG) nadirs averaged 42 +/- 5 mg/dl. Glucose production rate decreased from 4.2 +/- 0.2 to 2.6 +/- 0.6 mg X kg-1 X min-1. Blood 3-hydroxybutyrate levels were elevated (approximately 3 mM) and did not change during insulin infusion. The responses of epinephrine (from 137 +/- 37 to 393 +/- 143 pg/ml), norepinephrine (from 145 +/- 33 to 347 +/- 152 pg/ml), and growth hormone (from 6.0 +/- 1.5 to 20.3 +/- 5.1 ng/ml) were normal for this age group. As previously observed in diabetic adults, glucagon response was deficient (from 117 +/- 30 to 114 +/- 18 pg/ml). The six children were subsequently treated with continuous subcutaneous insulin infusion (CSII), which resulted in a 20-fold decrease in the number of severe hypoglycemic reactions. Predisposition to severe hypoglycemia in this subset of diabetic children, which remains a refractory problem even after considerable efforts have been made to decrease them, may thus be sharply decreased with CSII therapy. During this therapy, a significant inverse correlation appeared between the individual frequency of BG values less than 40 mg/dl and BG nadir during the insulin infusion test (r = .94, P less than .001).
Following a major environmental accident near Seveso, Italy, on July 10, 1976, we attempted to determine if the 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) released into the atmosphere had any effect on the liver function and lipid metabolism of exposed children. From July 1976 to June 1982, we analyzed the results of more than 4500 laboratory tests (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, cholesterol, and triglycerides in plasma and delta-aminolevulinic acid in urine) in a population of about 1500 children aged 6 to 10 years at the moment of the accident. The children exposed to the highest concentration of TCDD showed alterations in serum gamma-glutamyltransferase and alanine aminotransferase activity compared with the control group. These differences were restricted to values inside limits set from the lower end of the normal range to slightly above it. The observed abnormalities were slight and disappeared with time.
Conditioned medium obtained from the adrenocortical LAF1 mouse tumor (Y-1) cell cultures was able to stimulate the proliferation and the differentiation of granulocyte-macrophage precursors in the normal murine bone marrow. Colony-stimulating factor (CSF) was spontaneously produced by Y-1 cells also in serum-free cultures. By two cycles of gel chromatography on Sephadex G-150 of concentrated conditioned medium two peaks of colony-stimulating activity were isolated that corresponded to apparent molecular radii of 100,000 and 29,000, respectively. At this step of purification, the two factors gave a similar dose-response curve, showed a remarkable resistance to the heat treatment and pH changes, and were not extracted by ether. Because Y-1 cells resulted in infection by retrovirus, they provide a useful model to investigate the relations between viral coded information and CSF production.
Murine EL-4 lymphoma cells when stimulated with optimal doses of phytohemoagglutinin (PHA) release colony stimulating factor (CSF) in the conditioned medium. CSF production depends on PHA and stops when the lectin is withdrawn. The production is dependent on protein synthesis and is not related with DNA replication. The CSF produced by El-4 cells stimulates murine bone marrow cells to differentiate in vitro into mature granulocytes. Unstimulated EL-4 cells do not produce CSF while its conditioned medium is able to inhibit EL-4 proliferation in vitro. Gel filtration chromatography of conditioned medium from PHA-stimulated EL4 cells yields a peak of activity corresponding to an apparent molecular weight of 20,000-25,000 daltons.
We investigated the presence of colony-stimulating factor (CSF) in supernatants obtained from TS/A, a new metastatic murine cell line, and from its high-and low-metastatic clonal derivatives (E and F clones, respectively). TS/A cells produced a CSF in vitro that induced proliferation and differentiation of murine monocytic and granulocytic progenitors in agar cultures. In TS/A-bearing mice remarkable splenomegaly, blood granulocytosis and thymus depletion were observed along with a stimulatory activity in serum and a strong proliferative activity both in spleen and in bone marrow populations. Conditioned media from E clones showed an in vitro colony-stimulating activity greater than those of F clones. Mice injected subcutaneously with cells of all clones studied showed granulocytosis, splenomegaly and thymus depletion, although to varying degrees. However, no direct correlation between granulocytosis-splenomegaly and the number of spontaneous lung metastases was observed.
It is well known that macrophages play an important role in the control of tumor growth. This control may be the result of a direct action of macrophages or mediated by several biologically active products or factors elaborated by these and other cell populations. Our studies on the proliferation of a murine T-cell lymphoma (EL-4) showed that the treatment of the ascitic fluid (from the peritoneum of EL-4 bearing mice) with carbonyl iron resulted in a depletion of phagocytes concomitant with a significant increase of [3H] thymidine uptake by EL-4 cells. Further, the growth of EL-4 cells cultured in semisolid agar was significantly inhibited by an underlayer of large quantities of macrophages both from normal and EL-4 bearing mice as well as when cultured in the presence of PGE2. The underlayer of tumor macrophages P388 D1 resulted in an increase of the EL-4 cell growth. Also, conditioned media obtained from in vitro liquid cultures of EL-4 cells and L 1210 cells (B-lymphoma) produced a remarkable inhibition of the in vitro cloning capacity and [3H] thymidine uptake by EL-4 cells. These data support the hypothesis that different factors from normal and hemopoietic tumor cells may control the tumor growth and point out that self-produced factors may modulate the proliferation of tumor cells.
Extremely small doses of TCDD have been shown to induce hepatic microsomal enzymes in animals. Whether levels of environmental exposure to TCDD were sufficient to produce enzyme induction in man, has been investigated in Seveso, where in July 1976 explosion in a factory spread toxic substances, one of which was TCDD, to the surrounding area. The hepatic microsomal enzyme activity was assessed by estimating urinary d-glucaric acid (UGA) excretion in children 6-8 years old. In 31 children, urine samples were collected between August and December 1976; in 67 other children in February 1979. As a control group 60 children living in Busto Arsizio (a small industrial town near Milan) and 26 living Cannero (a non-industrialized village on Lake Maggiore) were chosen. In the first period of collection, children with chloracne (which is considered to be a characteristic manifestation of intoxication with chlorinated products), showed significantly increased levels of UGA compared with children without chloracne. In 1979, children living in the Seveso area showed a statistically significant enhancement of d-glucaric acid excretion compared to the control groups. In conclusion, this study demonstrates that many children living in the Seveso area have an increased activity of hepatic microsomal enzymes, since, although the urinary excretion of d-glucaric acid is only an indirect measure of enzyme activity, studies in man have indicated that it is both sensitive and quantitative. As far as the cause of this increase is concerned, since it is possible to exclude the influence of alcohol, contraceptives, phenobarbitone or other drugs, it is reasonable to conclude that TCDD, a potent inducer agent, could be responsible for this phenomenon.
Some tumors are known to produce colony-stimulating factors (CSF). In mice bearing s.c. Ehrlich tumor (ET) we observed that tumor growth is responsible for hemopoietic perturbations in which the increase of granulocytic-macrophagic precursors (CFU-C) in bone marrow and in the spleen represents a remarkable aspect. CFU-C in bone marrow from ET-bearing mice are more sensitive than CFU-C from normal mice to CSF from L-cells (LC-CM), mouse embryo fibroblasts (MEF-CM) and from the same tumor (ET-CM). Macrophages from normal and from ET-bearing mice exert the same effect on the proliferation of normal bone marrow CFU-C. Bone marrow CFU-C from ET-bearing mice show an increased sensitivity to the inhibitory factors produced by macrophages from ET-bearing mice.
The possible role of some soluble factor produced by tumor cells or by tumor-host interaction on homeostatic mechanism of normal bone marrow was investigated. Our data show that the in vitro pretreatment of normal bone marrow cells with Ehrlich acellular ascitic fluid (EAF) produces a severe reduction of the number of colonies either in CFU-s (colony-forming unit-spleen assay for pluripotent stem cell compartment) or in CFU-c (colony-forming unit-culture test for granulocytic committed compartment). The differentiation of CFU-s and CFU-c was also affected in respect to the controls. In fact, when normal bone marrow cells were pretreated with EAF the proportion of erythroid colonies deriving from CFU-s changed in favor of the undifferentiated one, while the proportion of pure granulocytic colonies was increased in the CFU-c assay.
In 1976, an explosion at the Industrie Chimiche-Meda-Società Azionaria (ICMESA) plant in Meda, near the Italian town of Seveso, released a cloud of aerosol containing 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), which contaminated the surrounding area. Clean-up of the highly polluted area of Seveso started on May 1980: in order to avoid exposure to significant levels of TCDD, safety measures are being used, but a potential exposure cannot be ruled out. A prospective study was set up at the beginning of the clean-up procedures, and laboratory tests are being used to evaluate trends among the decontamination workers. A reference group who met eligibility criteria at the preemployment examination was selected from employees of the same firm employing the decontamination was selected from employees of the same firm employing the decontamination workers. Medical examinations and laboratory tests have been performed on both the exposed and nonexposed groups at the same facilities. Analysis of the first follow-up period did not show any remarkable changes in a battery of laboratory tests of the exposed and nonexposed groups.
3 cases of acute subdural hematoma associated with bleeding from cortical arteries are described. There was no history of trauma. Referred cases in the literature and the possible mechanisms are discussed.
The effect of normal mouse marrow preincubation with Ehrlich tumor fluid (EAF) and Ehrlich tumor cell-conditioned medium (ET-CM) was investigated both on the in vivo assay for pluripotential stem cells (CFU-S) and on the in vitro assay for granulocytic-macrophagic progenitors (CFU-C). A significant reduction of the number of CFU-S was found when bone marrow cells were incubated with EAF. The morphological analysis showed a relative increase in the granulocytic type colonies besides an absolute increase in undifferentiated ones and an absolute decrease in erythroid colonies. The in vitro data show a decrease in CFU-C production, by stimulation with standard Colony Stimulating Factor (CSF), when the marrow cells are preincubated with EAF and ET-CM. When standard CAF (obtained from L-cells) is used at the higher concentrations, the CFU-C in the ET-CM treated marrow increases to the control values. EAF and ET-CM incubation also affects the CFU-C differentiation by increasing the number of pure granulocytic clones. The experimental data were discussed in order to explain an hypothesis about the activity of tumor-related factors.
Treatment of Ehrlich ascites carcinoma (EAC) cells with carbonyl iron (20 mg/ml) produces a significant decrease in growth rate of tumor inoculum both in Swiss and in C57BL/6 mice. Possible interaction of the carbonyl iron or Fe+++ions with cell surface is suggested.