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A Ferrante

Publications and source records attributed to A Ferrante.

287 records · Page 16Linked to original sources
PubMedDate not supplied

Cytotoxic molecule mRNA expression in chronically rejected human kidney allografts.

The pathogenesis of immunological and nonimmunological components that cause chronic kidney allograft nephropathy (CAN), is not yet completely understood. To explore the possible contribution of alloreactive cytotoxic T cells, we analyzed the transcription of cytotoxic molecules such as granzyme B and perforin using semiquantitative RT-PCR on surgically removed grafts obtained from two groups: group 1 (n = 10) were cases of CAN; group 2 (n = 3) had no CAN. Among group 1 kidneys, granzyme-B was expressed in 7 of 10, whereas perforin was detectable in 9 of 10 cases; their detection was not related to the presence of superimposed signs of acute graft lesions. Cytotoxic molecules were never found in group 2 kidneys. These results show that explanted chronically rejected grafts display cytotoxic molecule transcripts in addition to Th2 type cytokines, such as IL-10, IL-3, and IL-6, suggesting that both cellular and humoral alloreactive mechanisms may play important roles in CAN pathogenesis.

Antigens, CD↗
PubMedDate not supplied

Immunity to Acanthamoeba.

Human serum contains antibodies, mainly of the IgM and IgG isotypes, to pathogenic species of Acanthamoeba. This, as well as the capacity of these amebas to activate complement via the alternative pathway, may be a first-line defense against acanthamoeba infections in humans. Both antibody and complement appear to be important in promoting recognition of these amebas by phagocytic cells such as neutrophils. However, killing of amebas by neutrophils is dependent on lymphokine/monokine priming of the neutrophil. This priming augments the respiratory-burst activity and release of lysosomal enzymes of neutrophils in their response to the ameba. The products of the oxygen-dependent respiratory burst appear to be of prime importance in the killing of this free-living ameba. Antibodies also may prevent tissue invasion by Acanthamoeba by inhibiting its adherence, phagocytic activity, and migration and by neutralizing cytopathogenic amebic agents. Studies on experimental Acanthamoeba infections in mice showed marked species and strain specificity with regard to induction of protection with amebic antigens. Immune compromise or, alternatively, invasion at unique body sites in healthy individuals may form the basis for human infection with Acanthamoeba.

Acanthamoeba↗
PubMedDate not supplied

Immunoglobulin G subclasses and lymphocyte subpopulations and function in osteomyelitis and septic arthritis.

We investigated serum IgA, IgG, IgM and IgG subclass concentrations, complement activity, lymphocyte subpopulations, lymphocyte responses to mitogens and natural killer cell cytotoxicity in 15 children who had had osteomyelitis and septic arthritis and in a group of control subjects. IgG subclass concentrations below the fifth percentile for age occurred in 4 patients. We found isolated deficiencies of IgG1 and IgG3 and combined deficiencies of IgG2/IgG3/IgG4 and IgG2/IgG4. Concentrations of IgA and of IgG tended to be below the mean for age. The percentage of Leu-11+ cells was reduced in patients. Other immunological parameters studied were normal. These findings suggest that although most patients who have had osteomyelitis and septic arthritis do not have low immunoglobulin concentrations, impaired antibody production may be a predisposing factor in at least a few such children.

Adolescent↗
PubMedDate not supplied

Evaluation of prognostic factors in patients with acute pancreatitis.

BACKGROUND/AIMS: The severity of acute pancreatitis is variable and does not always correlate with structural and functional changes in the pancreas. More precise predictors of severity are necessary to enable intensive therapy to be targeted at patients with severe attacks, and to judge efficacy of treatment, to help in the early detection of complications, and to facilitate comparison of patients from different centers. METHODOLOGY: On admission, clinical criteria, biochemical and hematological parameters and multiple prognostic scores (Ranson, Imrie and APACHE-II scores) were collected from patients with acute pancreatitis. RESULTS: Two hundred and twenty-seven patients were seen during the study period. The overall mortality rate was 11.4%. A significantly higher mortality was found in patients with severe pancreatitis (25.8%) than in those with mild disease (1.5%, p=0.00001). Mortality was related to the presence of fever at admission (16.5% vs. 5.0%, p=0.006), and not to age, sex, etiological associations, or concomitant medical or surgical diseases. Of the biochemical and hematological parameters tested, ten factors (plasma glucose, BUN, serum creatinine, serum calcium, serum lactate dehydrogenase, serum albumin, red cell count, white cell count, hematocrit, and lymphocytes count) were found to be statistically significant, and four factors (serum potassium, alkaline phosphatase, total bilirubin, and hemoglobin) were marginally significant. In high-risk patients (Ranson and Imrie scores > or = 3, APACHE-II score > or = 10) mortality rates were higher (22.5%, 23.0%, and 22.5%, respectively) than in low-risk patients (2.4%, 2.3%, and 0.8%, respectively, p=0.00001). APACHE-II scores may be especially useful for monitoring the progress of patients with pancreatic necrosis and secondary pancreatic necrosis. CONCLUSIONS: Acute pancreatitis still represents a condition of variable severity. The adoption of multiparametric criteria proposed together with morphological evaluation consents the formulation of a discreetly reliable prognosis on the evolution of the disease a few days from onset, even though this still appears insufficient to plan a varied and timely therapeutic program.

APACHE↗
PubMedDate not supplied

Hemorrhagic adrenal cyst: an unusual reason of acute hypovolemia.

Adrenal cysts are often asymptomatic and included in the larger "incidentaloma" group. They may reach significant size without onset of compressive symptoms and are often left undiagnosed until an ultrasound or CT scan are performed for a vague lumbar or flank discomfort. Intracystic hemorrhage is a rare but life-threatening complication since a sudden and significant blood loss may occur without any evident clinical source, hypovolemic shock resulting as the first symptom. The authors report their personal experience in two patients along with a review of the literature on this insidious emergency, its diagnosis and therapeutic approach.

Acute Disease↗
PubMedDate not supplied

Polymorphonuclear leukocyte myeloperoxidase levels in patients with Behçet's disease.

Myeloperoxidase was measured in the plasma and in the supernatants of polymorphonuclear granulocyte cultures from patients with Behçet's disease. High levels were found in both plasma and supernatants from patients with active disease. The addition of pentoxifylline to granulocyte cultures determined a significant decrease of myeloperoxidase levels in active patients only. Hyperactive neutrophils are present during the course of Behçet's disease and may be considered of importance in the pathogenesis of the vascular lesions.

Adolescent↗
PubMedDate not supplied

Impaired expression of erythrocyte glycosyl-phosphatidylinositol-anchored membrane CD59 in patients with psoriatic arthritis. Relation to terminal complement pathway activation.

OBJECTIVE: Complement-mediated injury is regulated by many factors; among these CD59 has been identified as a widely distributed glycoprotein that inhibits membrane C5b-9 (terminal complement component) formation. The aim of the study was to assess erythrocyte CD59 expression in patients with psoriatic arthritis in order to understand the role of CD59 in the pathogenesis. METHODS: Washed erythrocytes from 50 patients with psoriatic arthritis, 8 with cutaneous psoriasis and 24 healthy subjects were incubated with monoclonal anti-CD59 antibody followed by a second FITC conjugated antibody and fluorescence intensity analysed by FAC-Scan flow cytometer to assess their CD59 membrane expression. SC5b-9 levels were measured in the plasma by ELISA and results compared with CD59 values. Immune complexes, complement C3 and C4 and rheumatoid factor were also determined. RESULTS: Impaired expression of erythrocyte membrane-anchored CD59 was found in patients with psoriatic arthritis; the lowest levels were seen in active patients (p < 0.01). Increased SC5b-9 was seen in the plasma of patients with active disease. An inverse correlation was also found between plasma C5b-9 and the CD59 expression levels (r = -0.81, p < 0.001). CONCLUSION: The low CD59 expression on erythrocytes from patients with psoriatic arthritis may be an index of a low tissue CD59 expression. This impairment could facilitate the activation of complement pathway and increase the risk for arthritis. Membrane attack complex formation in deficient membrane bound CD59 may also exacerbate synovial cell injury and inflammation.

Adult↗
PubMedDate not supplied

[Carcinoid neoplasms: report of 5 personal cases].

The authors report 5 cases of carcinoid tumor differently located. The typical carcinoid syndrome has been observed only in one case, presenting with high levels of urinary serotonin and 5-OH-HIAA. The remnant patients were completely asymptomatic and the correct diagnosis was obtained only by histologic examination of the surgical specimen. On the basis of their experience and of the literature, the authors evaluate the current diagnostic and therapeutic options for these neoplasms. The indication for surgical treatment, even in cases with local or distant metastases, is emphasized.

Aged↗
PubMedDate not supplied

[Conservative meso-pancreatectomy for cystic papillary tumor: apropos a case report].

A case of papillary-cystic neoplasm of the pancreas is reported in a 22-year-old woman. The only symptom was a palpable pulsating mass in her upper left abdomen. A conservative surgical treatment was adopted, consisting of pancreatic body resection (meso-pancreatectomy) and pancreaticojejunostomy to distal pancreatic stump. These neoplasms are quite uncommon, and can be difficult to differentiate from other cystic lesions of the pancreas. Surgical excision is curative in these tumors and is the treatment of choice due to its low morbidity and good long-term survival.

Adult↗
PubMedDate not supplied

Interferon-gamma increases human neutrophil-mediated cartilage proteoglycan degradation.

Interferon gamma (IFN-gamma) is known to activate neutrophils and is produced by the synoviocytes, macrophages, T cells and other inflammatory cells in rheumatoid arthritis. Neutrophils participate in articular cartilage destruction and predominate in the synovial fluid of inflamed joints during the early stages and acute exacerbations of the disease. In this study we investigated the effect of recombinant human IFN-gamma on human neutrophil damage to bovine articular cartilage explants which had been coated with heat-aggregated IgG (HAGG). Cartilage proteoglycan degradation by neutrophils was augmented by IFN-gamma at 10(2)-10(4) U/ml. IFN-gamma also increased neutrophil-mediated proteoglycan degradation when the cells were preincubated with IFN-gamma and washed before addition to cartilage. This activity of IFN-gamma was abolished by boiling and was unaffected by polymixin B, indicating that the effects of IFN-gamma were not due to endotoxin contamination. In the absence of neutrophils IFN-gamma had no effect on proteoglycan metabolism, and the ability of IFN-gamma to increase neutrophil-mediated proteoglycan degradation did not require living chondrocytes. Adherence of neutrophils to HAGG-coated and uncoated cartilage explants was enhanced by IFN-gamma. Opsonisation of the cartilage with HAGG also increased the adhesion of neutrophils. In contrast to the enhancement of neutrophil-mediated proteoglycan degradation, IFN-gamma had no effect on the inhibition of proteoglycan synthesis by neutrophils.

Animals↗
PubMedDate not supplied

The level of soluble Granzyme A is elevated in the plasma and in the Vgamma9/Vdelta2 T cell culture supernatants of patients with active Behçet's disease.

OBJECTIVE: Gramzyme A (GrA) is a serine proteinase with trypsin-like activity that is released extracellularly during the degranulation of cytotoxic cells. Among the cytotoxic cells, gamma/delta T cells participate in the early phases of the immune response and are known to express perforin and granzymes constitutively in agreement with their cytolytic pontential. METHODS: GrA activity was detected using the synthetic substrate N-alpha-benzyloxycarbonyl-L-lysine thiobenzyl ester in the plasma and supernatants of peripheral blood mononuclear cell cultured in the presence of Dimethylallyl pyrophosphate to obtain Vgamma9/Vdelta2 T cell expansion. RESULTS: Significantly high levels of GrA were found in the serum and supernatants of lymphocytes from patients with active Behçet's disease cultured in the presence of DMAPP. Levels were found to be significantly lower after remission. A positive correlation was observed between GrA levels in the supernatants and the Vgamma9/Vdelta2 T cell expansion factor. CONCLUSION: These results strongly suggest that Vgamma9/Vdelta2 T cells are active participants in the pathogenesis of the disease through their degranulation and granzyme release.

Adolescent↗
PubMedDate not supplied

[Carcinoid neoplasms of Vater;'s ampulla. Apropos a case examined].

Carcinoid tumors of the ampulla are an uncommon finding. The authors report an asymptomatic case of ampullary carcinoid in which the diagnosis was obtained only with definitive histology after radical surgery. The differential diagnosis of these tumors is quite difficult, mostly because they are often asymptomatic. Surgery seems to be the only effective therapy of these lesions; a wide resection with regional lymphectomy should be performed in all cases. Although the prognosis of ampullary carcinoids looks better than for adenocarcinoma and it is related to the tumor size, the history in this case suggests a more extensive indication for radical surgery.

Ampulla of Vater↗
PubMedDate not supplied

The nursing shortage crisis in Québec's McGill University affiliated teaching hospitals: strategies that can work.

A frequently recurring theme expressed in both the professional health literature and other multimedia sources is the current nursing shortage crisis. This shortage is an ever present reality that is of serious concern and that will continue to escalate unless innovative and creative strategies are implemented. This article will specifically address one hospital's approach to the nursing shortage crisis in Québec's McGill University affiliated teaching hospitals. The pivotal issues of retention, recruitment and attraction of nursing as a profession are examined. Recommendations for dealing with these issues include: 1) restructuring nursing salaries, 2) redefining the types of nursing personnel resources, 3) flexibility in work schedule, 4) recognition, 5) providing an accurate public image of nursing, and 6) recruitment of males and mature persons. This article provides nursing administrators in the hospital, community, and educational settings with potential strategies that they can explore and apply in their own settings.

Female↗
PubMedDate not supplied

[Incidental discovery of adrenal neoplasms: our experience].

Incidental radiologic diagnosis of clinically silent adrenal masses is reported with increasing rates. Between 1981 and 1994 we observed 30 patients with "incidentaloma": for each of them a careful hormonal and instrumental evaluation was obtained. 24 patients were surgically treated. No significant biochemical alterations were observed; ETG, TC and RMN had a sensitivity of 86%, 93% and 83%, respectively. At seleno-cholesterol scintigraphy 5 incidentalomas (all adenomas) had a concordant pattern and 5 (none of these adenoma) had a discordant pattern. MIBG scintigraphy showed an uptaking ganglioneuroma. The observed histotypes were: 10 adenomas, 3 cysts, 1 hematoma, 1 myelolipoma, 1 angiomyolipoma, 1 ganglioneuroma, 1 ganglioneurofibroma, 1 paraganglioma, 1 aspecific granulomatous necrosis, 4 cortical carcinoma and 3 metastatic lesions. We did not observe any postoperative acute adrenal failure. The main problem raised by incidentalomas is to define their nature; hence the need of a careful hormonometabolic, morpho-functional and instrumental evaluation. The available diagnostic procedures, even when combined, cannot always define if an incidentaloma is a benign or a malignant lesion: in the current clinical practice, the size of the mass is still the most important criterion to define a therapeutic approach. Surgical excision is mandatory in presence of an hormonal production, even subclinic, and/or a large size of the mass (over 5 cm). If the tumor size is less than 5 cm, an aggressive strategy may be chosen in selected low-risk patients, because of the low morbidity of adrenalectomy. In our experience, the transperitoneal subcostal approach has been adopted routinely with good results.

Adenoma↗