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Biomedical subjects

A Poletti

Publications and source records attributed to A Poletti.

At least 91 records · Page 5Linked to original sources

Reed-Sternberg cells and their cell microenvironment in Hodgkin's disease with reference to macrophage-histiocytes and interdigitating reticulum cells.

Fifty-eight paraffin-embedded lymph node biopsies from patients with Hodgkin's disease (36 nodular sclerosis, 14 mixed cellularity, five lymphocyte depletion, and three lymphocyte predominance) were immunostained with a panel of monoclonal (anti-Leu-M1, antileukocyte common antigen) and polyclonal (to lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin, and S-100 protein) antibodies by using the avidin-biotin immunoperoxidase technique. Both the immunostaining features of the Reed-Sternberg (R-S) cells and their variants, and the numbers of immunostained accompanying cells morphologically corresponding to macrophage-histiocytes (M-H) and to interdigitating reticulum cells (IRC) were analyzed. Variable numbers of R-S cells and their variants were positive for Leu-M1 in 83% of the cases, for alpha 1-antitrypsin in 40%, for alpha 1-antichymotrypsin in 30%, and for leukocyte common antigen in 3.4%; they were constantly negative for lysozyme and S-100 protein. Whereas the average numbers of accompanying cells immunostained for Leu-M1 were very low, the numbers of S-100-positive IRC were relatively high in all the Hodgkin's subtypes. The average numbers of M-H were lower (P less than 0.1 for lysozyme; P less than 0.001 for alpha 1-antichymotrypsin) in the nodular sclerosis than in the other pooled subtypes. In the nodular sclerosis subtype, however, R-S cells and their variants that stained positive for Leu-M1 appeared to express more frequently the lineage markers of M-H (alpha 1-antitrypsin and/or alpha 1-antichymotrypsin). These data appear to suggest that there is not an apparent qualitative correspondence between the immunostaining features of the cellular microenvironment composed of M-H and IRC and the features of the R-S cells.

Antigens, Differentiation, T-Lymphocyte

Practical importance of routine paraffin-embedded bone marrow biopsy in multiple myeloma.

Paraffin-embedded bone marrow biopsy specimens obtained prior to (37) or after (25) therapy from 62 patients with multiple myeloma (MM) were analyzed with particular reference to infiltration pattern, extent of infiltration, and myeloid to myeloma tissue percentage ratio (MMR) to verify their mutual relationships and clinicopathologic relevance. Fifty-nine biopsies were evaluable for infiltration pattern (diffuse in 27, interstitial in 25, and nodular in 7). Diffuse and interstitial patterns were more common (P less than 0.025) in stage III and stage I patients, respectively. A higher (P less than 0.001) mean serum paraprotein level was found in patients with the diffuse pattern than in those with the interstitial pattern. The average extent of infiltration by myeloma cells in the residual myeloid tissue was higher (P less than 0.001) and a high extent (75% or more) was more frequently (P less than 0.005) seen in diffuse than in interstitial pattern cases. The average MMR value was lower (P less than 0.001) and a MMR value less than 1 was more frequently (P less than 0.005) seen in the diffuse pattern group than in the interstitial pattern group. All these differences were present also when a separate analysis was performed for treated and untreated patients. It seems that a diffuse histologic pattern, as opposed to interstitial, would significantly predict a bone marrow extent of infiltration of 75% or more, a MMR lower than 1, a higher serum paraprotein level, and a clinical stage III. Bone marrow biopsy appears thus to play a role in providing parameters of prognostic relevance in MM also in the course of the disease. Prospective studies are needed to establish whether histologic pattern has an independent prognostic value.

Biopsy

Involuntary grasping and groping responses to space-related visual stimuli.

Involuntary groping-grasping responses to visual stimuli were studied in relation to the location of the stimuli in the space surrounding the patient. The following space-related patterns of stimulus-response were observed in four patients: (a) responses were evoked only by visual stimuli in the hemispace ipsilateral to the arm involved; (b) responses were evoked only by visual stimuli within the reach of maximal arm extension; (c) responses were evoked only by visual stimuli in the space around the hand; (d) all such patterns were variously combined. These findings are discussed in relation to the general problem of specific correlations between sensorimotor subsystems and peripersonal behavioral space.

Adult

Widespread codistribution of glycoprotein gp 115 and elastin in chick eye and other tissues.

Frozen sections of chick tissues were exposed to affinity-purified monoclonal antibodies raised against chick gp 115 and to affinity-purified antibodies raised against chick tropoelastin to study the distribution pattern of the corresponding antigens by the avidin-biotin immunoperoxidase technique. Laminin and fibronectin antibodies were used for comparison. Gp 115 and tropoelastin antibodies localized to the same structure in several of the tissues examined. The endothelial membrane of the cornea and Bruch's membrane in the choroid were positive, while the corneal epithelial membrane was negative. Both antibodies displayed a peculiar punctate reactivity in the corneal stroma and a very fine fibrillar pattern in the conjunctiva and at the corneal-scleral junction. Liver, heart and large vessels, striated muscle and skin showed a similar pattern both for tropoelastin and gp 115 antibodies. Few differences were seen in the distribution of the reactivity: the pericellular matrix of intestinal smooth muscle cells was stained by gp 115 but not by tropoelastin antibodies. However, the reactivity of gp 115 and tropoelastin antibodies was similarly distributed in the lung smooth muscle cell clusters. The peritubular matrix in the kidney did also not react with tropoelastin antibodies as did the brain intraparenchymal vessels; whereas gp 115 antibody reactivity was present in both sites. We interpret these lack of apparent codistribution in some tissues as a variation in the relative availability of the target antigen for the reaction with the antibody and not as a consequence of a qualitative difference in the distribution of gp 115 and tropoelastin. By the use of anti gp 115 monoclonal antibodies that do not cross-react, and presumably recognize different epitopes, it was shown that some but not all antibodies, react with brain intraparenchymal blood vessels; whereas the pattern of distribution in other tissues was the same. This suggests that in vessels with an undetectable level of elastin, certain epitopes of gp 115 molecule might not be recognized as a result of being masked by other components or by a different conformation of the molecule.

Animals

S-100 protein immunostaining in teratomatous well-differentiated tissues.

The presence and distribution of S-100 protein were studied in a case of ovarian teratoma using avidin-biotin complex immunoperoxidase method. S-100 immunoreactivity within the well-differentiated teratomatous tissues appeared to mirror that of their normally developed human counterparts, although we could unexpectedly detect S-100 immunoreactivity in bone osteoblasts and osteocytes, and in tooth germ odontoblasts. Choroid plexus-like formations present in the teratoma were also positive. Our results suggest that the presence of S-100 protein might be associated with a basic cell function regardless of the presence of a physiologically end-developed human organism.

Female

S-100 protein, fibronectin, and laminin immunostaining in lymphomas of follicular center cell origin.

Forty-nine paraffin-embedded biopsy specimens of involved nodal and extranodal tissue (bone marrow, spleen, and liver) from 13 patients with follicular center cell lymphomas (FCCL) and 14 with small lymphocytic lymphomas (SLL), including 11 cases with chronic lymphocytic leukemia, were tested for S-100 protein immunoreactivity. Analysis for fibronectin and laminin immunoreactivities was limited to the lymph node biopsy specimens. In FCCL, S-100-positive dendritic reticulum cells (DRCs) were found in 23 of the 26 tissue specimens examined, regardless of the involved sites and the growth pattern. Cases with completely or predominantly follicular pattern were usually associated with a spherical meshwork pattern of S-100-positive DRCs; in the FCCL specimens with a diffuse pattern (lymph nodes and bone marrow) as well as in the specimen areas with a minimally follicular tumor pattern, S-100-positive DRCs were consistently fewer in number and composed loosely aggregated nests. No S-100-positive DRCs were found in all the biopsy specimens in SLL. Concerning fibronectin and laminin immunostainings, results showed that no differences were present between areas of follicular and diffuse neoplastic growth and that the neoplastic growth of FCCL maintained for each antiserum the same distribution pattern as that seen in normal follicles. Analysis of the microenvironmental components as revealed with antisera used in the current study--particularly with anti-S-100 protein antiserum--appears to be a useful adjunct for the identification of FCCL in paraffin-embedded biopsy specimens, especially in extranodal sites.

Dendritic Cells

Immunohistochemical, enzyme histochemical, and immunologic features of giant lymph node hyperplasia of the hyaline-vascular type.

A combined histologic, immunohistologic, enzyme histochemical, and immunologic study has been carried out in a 7-year-old girl with recurring extramediastinal monocentric giant lymph node hyperplasia of hyaline-vascular type. A large panel of monoclonal and polyclonal antibodies to lymphoid and nonlymphoid cell markers were tested on frozen and paraffin-embedded lymph node tissue as well as on cell suspension and peripheral blood. Tissue enzyme histochemical study, including a conventional hematologic panel, was performed on frozen and plastic-embedded sections. The pattern was dominated by nodular aggregates of round BA-1+ Leu-14+ HLA-DR+ ATPase+ lymphocytes with polyclonal sIgD and sIgM positivity and lacking cIg and BA-2 staining. Leu-1+/Leu-4+, OKT6+, OKT10+, Leu-7+, and CALLA+ cells were few or absent in the nodules, whereas DRC-1+ BA-2+ HLA-DR+ 5'-Nuc+ cells formed a dendritic network in the outer portion of the nodules. No immunoreactivity for lymphoid and nonlymphoid cell markers, including cytokeratin and keratin, was detected in centrinodular histiocytic-like cells. Particularly, the Hassall's-like structures contained a target-like positivity for laminin, and consisted of flattened acid phosphatase (AP), alpha-naphthyl acetate esterase (ANAE), 5'-nucleotidase (5'-Nuc), and adenosine triphosphatase (ATPase) positive cells, whose enzyme profile overlapped with that of the histiocytic-like cells. The extranodular areas were mainly composed of Leu-1+/Leu-4+ lymphocytes with Leu-3a+/OKT4+ phenotype and, to a lesser extent, of OKT6+ OKT10+ lymphoid cells and scattered cells with markers of histiocytic lineage. The abundant vascular component was generally identified by laminin positivity and, in smaller proportion, it was positive for Factor VIII-related antigen. Most of the medium-sized vessels with high endothelium had marked AP, ANAE, and ATPase activities. The process observed resulted from vascularized nodular aggregates of nontransformed B-cells with the phenotype of primary follicle lymphocytes, associated to centrinodular histiocytic-like cells with a distinct enzyme profile.

Antibodies, Monoclonal

Enzyme- and immunohistochemical study of a case of histiocytic necrotizing lymphadenitis.

A combined morphological, immunohistological, and enzyme histochemical analysis was performed on frozen and fixed lymph node tissue in a case of histiocytic necrotizing lymphadenitis (HNL) using conventional histology, a panel of monoclonal and polyclonal antibodies, and a series of common haematological enzyme reactions. Histology showed multiple paracortical necrotizing foci which, in a prominently necrobiotic background devoid of granulocytes, contained large numbers of foamy histiocytes and macrophages intermingled with cells resembling degenerating plasmacytoid T-cells. Most of the histiocytes were alpha1-antichymotrypsin positive and foamy cells were also distinctly Leu-M1 positive. Strong granular acid phosphatase (AP) positivity was present in the cytoplasm of the macrophages and histiocytes. The cells with plasmacytoid features showed weaker and homogeneously diffuse AP staining. Alpha-naphthyl acetate esterase (ANAE) activity was much less striking than AP in the necrotizing foci and most of the ANAE negative cells corresponded to those with plasmacytoid features. No cells with B-cell lineage markers were present within the necrotizing foci; most of the occasional T-cells (Leu-1+, Leu-4+) present in the foci were Leu-2a+ (OKT8+) whereas OKT10+ lymphoid cells were abundant and appeared to correspond with the cells with plasmacytoid features. Our combined data confirm that the special type of necrosis found in HNL develops within foci of plasmacytoid T-cells undergoing regressive changes and apparently exhibiting distinct immunohistological and enzyme histochemical features.

Adult

A histopathologic study of persistent generalized lymphadenopathy in intravenous drug abusers.

Persistent generalized lymphadenopathy (PGL) has been reported in groups at risk for the acquired immunodeficiency syndrome including intravenous (iv) drug abusers. We investigated the histology of the lymph node biopsies obtained from 18 iv heroin abusers. All the patients (13 males and 5 females; median age 23.5) had generalized lymphadenopathy. This was associated with one or more systemic symptoms in 72% of the cases. Immunologic abnormalities were present in most of the patients. The overall histological picture consisted of a fairly repetitive pattern dominated by an exuberant and diffuse hyperplasia of frequently misshapen and poorly outlined follicles, associated with a striking proliferation of capillary vessels and a very consistent amount of plasma cells both extending in the follicular and interfollicular areas. Multinucleated giant cells of the Warthin-Finkeldey type ("mulberry cells") were encountered in 22% of the cases. It would appear that in the follicular district the most indicative diagnostic clues of PGL can be obtained if one considers the abnormal morphology of the follicles associated with a consistent presence of plasma cells and a scattered fine network of proliferating capillary vessels.

Adult

Neuropsychological deficits in arterial hypertension.

Sixty subjects with uncomplicated essential hypertension and 60 matched normal subjects were submitted to neuropsychological tests in order to establish whether some impairment of cognitive functions can be evidenced even in those hypertensive subjects that are in this respect asymptomatic on standard examination and interview. The hypertensive subjects obtained significantly poorer results than normotensive subjects on memory, visuo-motor and performance tests. In the control group, the classic negative correlation pattern between age and scores was observed, while in the patient group this correlation could be confirmed only in a few tests. Subgrouping of patients according to hypertension duration and treatment showed that the impairment of cognitive functions manifested itself very early and did not tend to progress within 6-10 years of hypertension duration.

Adolescent

The Italian experience in mental health care.

Italy's Law 180, passed in 1978, abolished mental hospitals and replaced them with community services. The Italian literature suggests that the law has been far less successful in improving services for mental patients than reports by foreign visitors have indicated. The authors visited Italy on two occasions in 1984 and 1985 to assess for themselves the impact of the law. In many parts of the country hospitals were still open but badly understaffed and physically deteriorated; in Trieste, where the reform movement started, there was a good system of services, but a hospital whose closing had been publicly celebrated still housed several hundred patients. The authors describe the social and political climate in which Law 180 was passed, discuss the central role of Franco Basaglia and his Psichiatria Democratica movement, summarize the findings of their two visits, and attempt to explain why members of Psichiatria Democratica consider hospitals that remain open to be closed.

Aged

The 'Italian Experience' reconsidered.

Our analysis of the problems of the Italian psychiatric services has drawn a lively correspondence challenging our findings. In September 1985, we undertook a second study tour in Italy. This is now reported, with notes on specific criticisms of the earlier paper.

Community Mental Health Centers