HIV (human immunodeficiency virus) viraemia in serum or plasma of HIV-infected individuals was investigated by the polymerase chain reaction assay (PCR) in combination with reverse transcription to detect HIV-1 genomic RNA. Before PCR, plasma or serum was ultracentrifuged, precipitated virions were then treated with a RNase-free DNase, and a cDNA from the HIV-1 genomic RNA was synthesized. Thirty-three fresh plasma and seven sera from either HIV-1 antibody-positive individuals or patients treated with AZT were tested. Plasma from three patients were assayed 3 or 6 months apart. Twelve sera from HIV-1 antibody-negative individuals were used as negative control. PCR was performed with primers in LTR, gag and env regions: 11 of 40 samples were positive with three primer pairs, 16 with two primer pairs and 11 with only one primer pair. PCR on HIV-1 genomic cDNA was positive in 38 out of the 40 plasma or serum samples (95%), regardless of the clinical stage of the infection: HIV-1 was detected in 14 of the 15 untreated subjects and in 24 of the 25 AZT-treated patients. HIV p24 antigen was detected in the serum of 38% of subjects (15 of 40). The results suggest that this method is suitable for the detection of viral particles in plasma or serum from HIV-1-infected individuals irrespective of antiviral treatment.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

HIV2 chronic infection of promonocytic cells.

HIV1 infection of mononuclear phagocytes is now well established, whereas HIV2 infection of these cells is less well documented. In this work, we studied the replication of the HIV2ROD strain in the U-937 promonocytic cell line and compared it with that of the HIV1BRU strain. p24 antigen and RT (reverse transcriptase) activity were assessed at regular intervals in cell-free supernatants, as was the infectiousness of the produced virus. In the case of HIV2, after a phase of high cell mortality, a chronically infected cell population releasing infectious virions was obtained (the infection remained stable after 60 days of culture). By contrast, for a given multiplicity of infection (i.e. 10,000 cpm RT/10(6) cells), HIV1 replication in U-937 cells was only transient (i.e. 14 days), leading to the synthesis of slightly infectious and probably defective viral particles. Abortive infection was finally obtained, as confirmed by a polymerase chain reaction which failed to detect any proviral HIV1 DNA in the cell line. These results indicate a marked difference between HIV1 and HIV2 in their in vitro interaction with mononuclear phagocytes.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Lack of HIV tat-gene amplification in blood monocytes compared to T lymphocytes.

T-lymphocytes (T-Ly) and monocytes/macrophages are thought to be the main in vivo targets for HIV 1. We previously demonstrated, using the polymerase chain reaction (PCR), that HIV provirus could be detected in 20 out of 21 T-Ly samples and 13 out of 21 monocyte samples from HIV 1-seropositive individuals, with at least gag, env or LTR primers. In the present study, we wanted to find out whether the HIV 1 tat gene could be detected in 14 of these circulating monocyte and T-Ly samples. The tat primers were chosen in order to amplify the overall second exon of this regulatory gene. This new set of primers could not detect HIV provirus in monocytes but it did in T-Ly, among cells previously shown to be positive with one of the other 3 primer pairs. Further molecular studies should help characterize these probable monocytotropic variants and elucidate their contribution to HIV pathogenesis.

Base Sequence↗

PubMedDate not supplied

In vitro transmission and antigenicity of a retrovirus isolated from a multiple sclerosis patient.

We have recently isolated an apparently novel retrovirus (LM7) from a patient with multiple sclerosis (MS). We present here results showing that (1) LM7 retrovirus can be transmitted in vitro to a normal human leptomeningeal cell culture and that (2) specific antibody against this retroviral strain can be detected in MS cases. Our results suggest that, if this virus is an endogenous retrovirus, it is different from human endogenous elements already described.

Antibodies, Viral↗

PubMedDate not supplied

Risk of cancer onset in sub-Saharan Africans affected with chronic gastrointestinal parasitic diseases.

Gastrointestinal Schistosomiasis and Amebiasis are uncommon in the western world, while such infections are frequent in the African community. In addition to the problems associated with the clinical symptoms of these parasitic infections, it is important to stress the increase in cancer of the Gastro-Intestinal (GI) tract. In this study we evaluate the prevalence of cancer in patients affected by chronic inflammatory diseases caused by the above named parasites. In three years, from January 2000 to December 2003, we observed a total of 1199 subject. Of these, 950 presented with complaints of diarrhoea, vomiting, abdominal pain, melena, hematemesis, rectal discharges and alteration of bowel habits. A total of 818 patients were evaluated in Uganda (Mulago and Arua hospitals) and 381 at Luisa Guidotti Hospital in Zimbabwe. An exhaustive clinical history was collected for each patient and then physical and laboratory examinations were performed. The clinical files of all patients previously admitted to the respective hospitals were obtained and the information taken from these files was then integrated with our clinical findings. Subjects who were found free of gastro-intestinal disease after examinations and did not have a clinical history of infective GI disease but presented with other pathologies, were regarded as control group. The control group was composed of 249 subjects. The subjects who were positive on examination underwent further investigations. The number of patients affected by schistosomiasis and amebiasis were 221 and 224 respectively. The number of patients who suffered from aspecific enterocolitis was 454, intestinal tuberculosis was present in 21 patients and we found 30 patients with esophageal candidiasis. Patients who had the above mentioned GI diseases were then divided into 3 groups. First group was composed of patients who had a clinical history of infective GI diseases and were re-admitted for similar symptoms, and on examination were positive for the presence of the same infective GI diseases. Such patients were placed in the Chronic group. The second group was formed of patients who had previously undergone treatment for infective GI diseases but on readmission were found free of infective GI disease, and this group was described as the Cured group. They had symptoms associated with other pathologies. A third group, which we described as the Acute group was composed of patients who did not have any previous case of GI infection and were admitted for the first time. Such patients were found positive on examination for infective GI diseases. In the 950 patients, we found a total of 45 tumors. The tumors were prevalent (42 tumors) in the chronic group. In 34 patients the tumor was in the colo-rectal region, in 3 patients in the stomach, in 4 patients in the esophagus and 1 patient had cancer in the small bowel. Our results show a strong association between the chronic infection of the GI tract and the likelihood to develop tumors. However, it is not clear which biological mechanisms are implicated in such transformations. They may depend on the chronic inflammation of the GI mucous which permits the entrance of carcinogenic materials or on the effects of mutagenic products produced by the parasites or both.

Africa South of the Sahara↗

PubMedDate not supplied

[The laparoscopic surgical therapy of gastroesophageal reflux disease].

Between January 1995 and February 1997 we performed 30 laparoscopic Nissen-Rossetti fundoplications and 3 laparotomic Nissen fundoplications. All patients were suffering from gastro-esophageal reflux disease (GERD) resistant to medical therapy, 19 patients were suffering also from hiatal hernia and 2 pz. were suffering from a para esophageal hernia. 1 patient had been previously treated with laparotomic Nissen fundoplication for GERD and hiatal hernia. Preoperative assessment included: oesophagogastroduodenoscopy (EGDS) with biopsies: 24-h pH-monitoring; 24-h manometry; barium swallow and DeMeester symptoms scoring. Mean operation time was 110 min. 1 pz. required conversion to laparotomy. 35% of pz. experienced mild grade dysphagia that resolved spontaneously in 4-8 weeks. Postoperative evaluation was performed in all patients 6 months after surgery. Overall results were characterised by a significant reduction of the symptoms score: mean score was reduced from 5.6/9 to 0/9. No signs of oesophagitis were seen at control EGDS. 24-h pH monitoring demonstrated a significant reduction of the total time at ph < 4 from a mean value of 28.2% preoperatively to 1.9% postoperatively. 24 h oesophageal manometry revealed a rise in lower oesophageal sphincter pressure from a mean of 11 mmHg preoperatively to a mean of 27 mmHg postoperatively. Our preliminary results demonstrate that laparoscopic Nissen-Rossetti fundoplication is a safe and effective procedure for gastro-oesophageal reflux disease but, sometimes, laparotomic technique can be considered in selected cases.

Follow-Up Studies↗

PubMedDate not supplied

[Ultrasonography of pancreatic neoplasms].

Pancreatic tumors are the fourth cause of death in Occident: the 5-year-survival rate is less than 5% because of diagnostic difficulties, low clinical expression at early stage, and complexity of the surgical treatment. The role of ultrasound (US) is in early diagnosis, because also in early cancer there could be lymphatic spread or peritoneal involvement. There are multiple modalities to study the pancreas with US: abdominal US, "contact" US (endosonography and intra-operative or laparoscopic US). The first is not invasive, cheap but limited by extrinsic and intrinsic factors, the latter are respectively characterized by high cost, and need of endoscopic specialists for endosonography, the complementarity to laparoscopy or surgery for the laparoscopic/intraoperative US. Abdominal US is the first diagnostic step for the pancreas, but it is not affordable in 15-25% of patients, because of meteorism. In all the other cases, it represents the pancreas with a good contrast between the normal parenchyma and tumoral tissues. Abdominal US, together with biopsy, can define the resectability. Ecoendoscopy is actually dedicated to small tumors staging, but recent studies demonstrate the same results achieved by spiral TC. Laparoscopic US is a second step imaging in patients already selected for surgery. The first finality in US evaluation of tumor masses is early diagnosis of pancreatic cancer; it can give to some of these patients the opportunity of undergoing to surgical treatment. This could be achieved by a proper use of the moititude of ultrasonic abdominal explorations that are requested in daily practice. US, together with CT and MR, can define the resectability of the tumor, with further supplementar evaluation by mean of laparoscopic US. Intraoperative US is now indicated for planning and guiding the surgeon in resection of the pancreatic cancer.

Humans↗

PubMedDate not supplied

Paraganglioma of the bladder: report of a case.

Paragangliomas are uncommon tumours that comprise less than 0.1% of all primary bladder neoplasms. Approximately half of the patients present the clinical triad of hypertension, haematuria and attacks associated with micturition. About 10% of vesical paragangliomas behave malignantly. This may be manifested as local invasion or metastatic spread, particularly to lymph nodes and lung. The best therapy remains total excision and partial cystectomy is considered adequate treatment for most cases. We report a case of paraganglioma of the bladder with extramural appearance in a 39-year-old man. Clinical symptoms were hypertension, dysuria and a well-defined hypogastric mass. One year after complete removal of the tumour, the patient is asymptomatic and normotensive, with normal catecholamine and vanillylmandelic acid (VMA) levels.

Adult↗

PubMedDate not supplied

Mechanisms of pain in chronic pancreatitis.

Pain is a leading symptom in chronic pancreatitis (CP) and often its management necessitates surgical intervention. Nevertheless the presence of different hypotheses, the pathophysiology of pain is not understood, thus the indications for therapy remain controversial. Increased pressure within the ductal system and/or the parenchyma has been suggested to be one of the causes of pain. This controversial theory has been substantiated by the demonstration of a relationship between intrapancreatic pressure and intensity of pain. On the other hand, recent studies have shown the inflammatory involvement of intrapancreatic nerve fibres in a so called "neuroimmune interaction". In fact, infiltration of inflammatory cells around the nerves together with an increase in the number of nerve fibres in the fibrotic pancreatic tissue have been proposed as a possible cause of pain in chronic pancreatitis. Moreover, immunohistological studies have shown that the amount of neurotransmitters, such as substance P and calcitonin gene related peptide, is increased in afferent pancreatic nerves and a close interrelationship between pain and immune cell infiltration of the nerves has been reported in CP. In addition to these hypothesis, extrapancreatic causes such as common bile duct obstruction and duodenal stenosis are discussed. This article review points to the different pathogenic mechanisms of pancreatic pain in CP.

Chronic Disease↗