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Biomedical subjects

C Andreoni

Publications and source records attributed to C Andreoni.

At least 19 recordsLinked to original sources

Opinions and self-reported health status of Italians seeking homeopathic treatment.

The use of homeopathy is increasing worldwide. This multi-centre cross-sectional study aims to describe the opinions and self-reported health status of a sample of Italian people seeking homeopathic care. A self-administered questionnaire including socio-demographic characteristics, knowledge and opinions about homeopathy, personal experience with homeopathy, and, self-reported health status (SF-12), was administered to a sample of people who had sought homeopathy. Of a possible 1229 individuals invited to participate, 1223 did so. The majority of the participants were female, young (mean age 42 years), well educated (mean 13 years of education). The reason for seeking care was for either physical or emotional conditions. Most participants had fair to good knowledge of homeopathy, and the self-experienced effect (subjective judgment on efficacy) was good regardless of the type of health condition reported. The Physical Component Summary (PCS-12) scores were similar to the general Italian population, but the Mental Component Summary (MCS-12) scores were lower in all relevant strata examined. This study provides information on the characteristics of people seeking homeopathic care, in particular the results of the SF-12 self-reported health status evaluation.

Adult↗

Toward a detailed characterization of feline immunodeficiency virus-specific T cell immune responses and mediated immune disorders.

Infection of domestic cats with feline immunodeficiency virus (FIV) is associated with the development of an acquired immunodeficiency syndrome (AIDS). The pathogenesis of FIV is not fully understood but it has been reported that the immune system is progressively impaired during disease progression. As a result, anti-FIV specific immune response will usually not clear the virus and the acute stage is followed by a chronic asymptomatic phase. The overall objective of this study was to characterized FIV-induced immune cellular responses and -mediated immune disorder following the first weeks post-infection. Using both cytokine ELISpot and intracellular staining assays, FIV-specific T cells were monitored at 6, 9 and 12 weeks post-infection. We demonstrated that both IFNgamma(+) and, CD4 and CD8 TNFalpha(+) T cells specifically respond to FIV antigens. These responses were found to reach a peak at 9 weeks post-infection. It was further shown that the TNFalpha(+)CD8(+) responding T cells were contained within a CD8beta(low)CD62L(-) T cell subpopulation, expanded in FIV-infected cats. This T cell subpopulation which present features of activated CD8 T cells was further shown to be susceptible to spontaneous apoptosis following a short-term in vitro culture. Moreover, it was observed that cell death by apoptosis of this T cell subset was increased following FIV antigen-recognition. Therefore, FIV might alter immune homeostasis in inducing chronic activation of TNFalpha(+)CD8(+) T cells which eventually will die following antigen contact while deleting CD4(+) T cells. Interestingly, this study confirmed the strong similarity between FIV and HIV pathogenesis.

Animals↗

Porcine reproductive and respiratory syndrome (PRRS) virus-specific interferon-gamma(+) T-cell responses after PRRS virus infection or vaccination with an inactivated PRRS vaccine.

Although field studies have found porcine reproductive and respiratory syndrome (PRRSV) inactivated vaccines to be beneficial in reducing losses linked to PRRSV infection, immune mechanisms induced by these vaccines need better understanding. In the study reported here, we examined the interferon-gamma(+) (IFNgamma(+)) PRRS-specific T cell responses induced after infection and vaccination with an inactivated PRRS vaccine. Autologous monocyte-derived dendritic cells loaded with the PRRSV P120 strain were used to re-stimulate ex vivo T cells that had been primed in vivo by either the virus or the vaccine, or both. Virus-specific IFNgamma(+) T cells were quantified by using a porcine IFNgamma- ELISpot assay. A specific but low live virus-induced response was observed between days 35 and 70 for most of the pigs tested, while a significant inactivated vaccine-induced PRRSV-specific IFNgamma(+) T-cell response was measured soon after vaccination. Moreover, we observed that vaccination of pre-challenged pigs clearly favoured the PRRSV-specific cell-mediated immunity primed by the live virus. To characterize further the nature of the PRRSV-specific T cells, the different T-cell subsets involved in PRRSV immunity were analyzed by flow cytometry. We showed that the inactivated vaccine was able to prime both CD4(+)CD8(int+) and CD8(high) virus-specific T cells and that CD4(+)CD8(int+) were preferentially recalled by the live virus.

Animals↗

Quantitative analysis of the antigen-specific IFNgamma+ T cell-mediated immune response in conventional outbred pigs: kinetics and duration of the DNA-induced IFNgamma+ CD8+ T cell response.

It is now well established that antigen-specific CD8(+) T cells play a major role in vaccine-induced immunity against intracellular pathogens and tumor cells. The detection of these immune cells in outbred animals has been hampered mainly by the need to generate individual autologous antigen-presenting cells (APCs) due to the high degree of polymorphism of the major histocompatibility complex (MHC) Class I loci. We used individually derived immature porcine dendritic cells infected with a pox-based recombinant viral vector to ex vivo stimulate PBMCs from vaccinated conventional pigs. The frequencies of antigen-specific T cells was determined by the number of IFNgamma-secreting cells in a quantitative enzyme-linked immune spot (ELISPOT) assay. Using this approach we were able to rank different pseudorabies virus (PRV) vaccines strategies for their ability to prime viral-specific IFNgamma(+) T cells. Plasmid DNA has recently emerged as a promising tool with multiple applications in the field of infectious diseases, allergy and cancer. We showed for the first time in this study that DNA immunization induced a long-lived antigen-specific IFNgamma(+) T cells response in conventional pigs. Additional studies allowed us to show that these virus-specific IFNgamma(+) responding cells detected in this ELISPOT assay were MHC-restricted and comprised in the CD8alpha(bright) pig T cell subset. These new data confirm the usefulness of DNA vaccines to control diseases requiring cellular immunity in pigs.

Animals↗

Comparison of renal ablation with cryotherapy, dry radiofrequency, and saline augmented radiofrequency in a porcine model.

BACKGROUND: Needle ablative therapy has recently generated a lot of interest in the urologic community. We compare renal lesions produced in a porcine model using three forms of needle ablative energy: cryoablation (CR), dry radiofrequency (RF), and saline augmented radiofrequency (SARF). STUDY DESIGN: In 10 farm pigs, under ultrasonographic guidance, 40 laparoscopic renal lesions were produced: 825-mm CR lesions were produced with 2.4-mm cryoprobes (Endocare Inc, Irvine, CA), after 1-mL preinfusions of 14.6% saline, 12 SARF lesions were created with 22-gauge needles (2 mL/minute 14.6% saline, 50 W 510 kHz RF for 60 seconds), 12 RF lesions were created with a 2-cm array LeVeen electrode and an RF2000 generator using impedance limited 30 to 60 W double activations (Radiotherapeutics Corp, Mountain View, CA), and 8 RF lesions were produced using 22-gauge needles and double 10 W activations with the RF2000 generator. Eight animals were sacrificed after 1 week for acute pathology. An additional two animals were sacrificed at 8 weeks to provide chronic pathology results for the LeVeen dry RF and SARF modalities. RESULTS: CR produced a regular 18- to 22-mm zone of complete necrosis bordered by a 1.5- to 2.5-mm zone of partial necrosis. Acutely, LeVeen RF and single-needle RF produced lesions 25 to 45 mm and 6 to 10 mm wide, respectively. Acutely, SARF produced irregular cone-shaped lesions 15 to 31 mm wide. Only one of eight acute LeVeen RF lesions showed complete necrosis; none of the four 8-week LeVeen RF lesions displayed complete necrosis. Two of the four 8-week SARF lesions displayed complete necrosis. The remainder of the LeVeen RF, single-needle RF, and SARF lesions showed early, indeterminate tubular damage with relative glomerular sparing and bands of complete necrosis (0.5 to 1.5 mm) and inflammation (0.5 to 2 mm) at the periphery. Only CR could be consistently monitored with laparoscopic ultrasonography. CONCLUSIONS: Renal cryoablation produces well-defined, completely necrotic lesions that can be monitored reliably with ultrasonography. Longer followup may be required to characterize the full extent of renal necrosis produced by RF, but in the short run, none of the RF modalities reliably produced 100% necrosis in all cases.

Animals↗

Functional and phenotypic characterization of distinct porcine dendritic cells derived from peripheral blood monocytes.

Dendritic cells (DCs) are bone marrow-derived antigen-presenting cells that have an exquisite capacity to interact with T cells and modulate their responses. Little is known about porcine DCs despite the fact that they represent an important target in strategies that are aimed at modulating resistance to infection in pigs and may be of major importance in transplantation biology. We generated immature monocyte-derived porcine dendritic cells (MoDCs) directly from adherent peripheral blood cells treated with porcine granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4). The cells were observed via electron microscopy and their phenotype was characterized using monoclonal antibodies. The functionality of the porcine MoDCs was demonstrated showing that the cells were capable of different specialized functions relevant to antigen capture and were potent stimulators in a primary allo-mixed leucocyte reaction. Treatment of the MoDCs with porcine cell line-derived necrotic factors resulted in the phenotypic and functional maturation of MoDCs. We confirmed also that monocyte-derived DCs were differentially regulated by cytokines, showing that transforming growth factor-beta1 (TGF-beta1) is able to redirect monocytic precursors into the differentiation pathway of Langerhans' cells presenting typical Birbeck granules. Interestingly, and in contrast to the human and murine model, we showed that the monocyte-derived porcine Langerhans'-type cells (MoLCs) were much more potent activators of allogeneic T cells than MoDCs obtained without TGF-beta1.

Animals↗

Flexible ureteroscopic lithotripsy: first-line therapy for proximal ureteral and renal calculi in the morbidly obese and superobese patient.

BACKGROUND AND PURPOSE: The surgical treatment of kidney and proximal ureteral stones in morbidly obese patients (>14 kg/m2) remains difficult because shockwave lithotripsy is precluded by weight limitations and percutaneous nephrolithotomy is associated with difficult access and a high (9%) rate of transfusion. We review our experience with retrograde ureteroscopic lithotripsy in morbidly obese patients with renal and proximal ureteral stones. PATIENTS AND METHODS: Between December 1992 and April 2000, five women and three men with a mean age of 46.5 years (range 33-68 years) and a mean body mass index of 54 (range 45-65.2) underwent 10 independent ureteroscopic procedures for urolithiasis. The average stone size was 11.1 mm (range 5-25 mm). Lithotripsy was performed with the holmium laser in eight patients (60%) the electrohydraulic lithotripter in four (30%), and the tunable-dye laser in the remaining patient. Stone-free status was defined as no stones visible on a plain film with nephrotomograms or CT scan at 3 months. RESULTS: The mean operation time was 101 minutes (range 45-160 minutes), and 60% of the procedures were done on an outpatient basis. After the initial procedure, the stone-free rate was 70%. Two patients had fragments <4 mm, and no further therapy was undertaken. There was one complication: transient renal insufficiency (serum creatinine concentration 3.7 mg/dL) secondary to aminoglycoside toxicity. No transfusions were needed. CONCLUSION: In the morbidly obese patient with symptomatic stones <1.5 cm, ureteroscopic lithotripsy is safe, successful, and efficient.

Adult↗

Assessment of optimal balloon size for rupture of the ureteropelvic junction and mid-ureter in a porcine model.

PURPOSE: Balloon dilation potentially represents a safer and simpler technique for the treatment of ureteropelvic junction (UPJ) obstruction and ureteral strictures. Using a porcine model, we sought to establish the optimal balloon size for endoballoon rupture of the UPJ and ureter. MATERIALS AND METHODS: The efficacy of endoballoon rupture of the proximal and middle ureter with 24F, 30F, and 36F balloon catheters was compared in 19 female minipigs. At the proximal ureter, the effect of the rate of dilation also was evaluated for each balloon size. Extravasation of methylene blue-stained contrast material was assessed with retrograde pyelograms and direct laparoscopic vision. After acute sacrifice, the dilated segments were evaluated histologically with hematoxylin and eosin and Masson's trichrome staining. RESULTS: At the proximal ureter, free extravasation of contrast was observed in 61% of the rapid inflation and 72% of the slow inflation trials; contained extravasation was noted in 28% of the rapid inflation and 17% of the slow inflation trials. Except for two of the 24F slow inflation trials, all of the proximal ureteral trials produced at least one full-thickness tear into the periureteral fat. Grossly, the tears appeared linear with various lengths and no consistent orientation. Rapid inflation and increasing balloon size tended to produce a ureterotomy with less damage to the ureter surrounding the tear. At the mid-ureter, none of the balloon sizes consistently produced a transmural tear. CONCLUSIONS: Rapid dilation and use of a 36F balloon capable of maintaining a low profile after inflation may result in a cleaner proximal ureterotomy with less distortion of the untorn neighboring proximal ureter. Both 36F and 30F balloons consistently produced a full-thickness proximal ureterotomy in normal porcine tissue. For mid-ureteral strictures, balloon dilation to even 36F may fail to create a suitable ureterotomy. However, it must be noted that dysplastic or scarred tissue may respond differently to dilation than the more elastic normal porcine tissues used in this study.

Animals↗

Laparoscopic bilateral hand assisted nephrectomy for autosomal dominant polycystic kidney disease: initial experience.

PURPOSE: The laparoscopic technique for bilateral nephrectomy in patients with autosomal dominant polycystic kidney disease is technically difficult. The procedure may be more acceptable if alterations to the technique made it safer and easier to perform. We describe our initial experience with, and the feasibility and potential benefits of hand assisted laparoscopic nephrectomy for approaching these large kidneys in patients with autosomal dominant polycystic kidney disease. MATERIALS AND METHODS: This approach was successfully applied in 3 patients with end stage renal disease due to autosomal dominant polycystic kidney disease. After obtaining transumbilical pneumoperitoneum ports were placed in the umbilicus (12 mm.), sub-xiphoid in the midline (12 mm.) and subcostal in the midclavicular line on each side (12 mm.). The table was tilted 40 degrees away from the planned side of initial nephrectomy with the patient in the half lateral position. A 7 cm. midline incision was made that incorporated the umbilical port and a commercially available hand assistance device was positioned. One surgeon hand was inserted into the abdomen to serve as a retractor/blunt dissector, while the other operated the electrosurgical instruments. The right hand was inserted for left nephrectomy and the left hand was inserted for right nephrectomy. The laparoscope was passed via the sub-xiphoid port and the instruments were placed through the ipsilateral subcostal laparoscopic port. Nephrectomy was completed and the specimen was removed through the hand port incision by draining the cysts as they were exposed to view via the midline incision. When dissection was difficult, an additional port was placed in the anterior axillary line at the umbilical level. Some cysts were ruptured or aspirated to decrease overall kidney size and make extraction possible via the 6 to 7 cm. midline incision. RESULTS: All procedures were successfully completed. Mean operative time for bilateral hand assisted laparoscopic nephrectomy was 5.5 hours (range 4.5 to 6.6). Estimated blood loss was 200 cc or less. Patients resumed oral intake on postoperative day 1. The mean amount of parenteral analgesics required postoperatively was decreased. Mean hospital stay was 4.3 days but it was 3 days when considering nephrectomy only. Patients returned to normal activity after an average of 2 weeks. There was sustained resolution of preoperative discomfort based on pain analog scales. At 1 month or less all patients recorded absent pain. They uniformly noticed improved preoperative pulmonary and gastrointestinal symptoms CONCLUSIONS: Hand assisted laparoscopic nephrectomy in patients with autosomal dominant polycystic kidney disease makes bilateral nephrectomy a reasonable option. The bilateral procedure may be performed as rapidly as laparoscopic only, unilateral nephrectomy in these cases. The advantages of the hand assisted approach include using tactile sensation to facilitate dissection, rapid blunt finger dissection, hand retraction and the application of immediate tamponade when needed. This procedure provides the benefits of minimal intraoperative blood loss, minimal postoperative pain, brief hospital stay and rapid convalescence in this group of patients at high risk.

Adult↗

Laparoscopic renal ablation: an in vitro comparison of currently available electrical tissue morcellators.

OBJECTIVES: Morcellation with the Cook high-speed electrical laparoscopic (HSEL) morcellator in an impermeable nylon/plastic sack (LapSac) has remained unchanged since its inception nearly one decade ago. Sack deployment and specimen entrapment remain relatively difficult, and morcellation with this device is expensive and relatively slow. As such, in an effort to facilitate specimen entrapment and morcellation, we adapted two currently available electrical morcellators (the Steiner gynecologic morcellator and the electrical prostate morcellator [EPM]) for renal morcellation and compared them with the HSEL morcellator. METHODS: All morcellation was performed through a simulated abdominal wall under direct laparoscopic vision. Ten porcine kidneys were ablated with each of the following techniques: HSEL morcellation in a LapSac; HSEL morcellation in a fluid-filled LapSac; Steiner morcellation in an insufflated Endocatch sack; and EPM morcellation in a fluid-filled Endocatch sack. A modified laparoscopic trocar was constructed and used for the Steiner and EPM morcellation. The time to complete morcellation, morcellation product size, and entrapment sack integrity were evaluated for each technique. Cost data for each morcellator are also presented. RESULTS: The mean morcellation time for the Steiner, HSEL dry, HSEL wet, and EPM morcellation was 6.0, 15.9, 14.7, and 26.0 minutes, respectively. The mean fragment size for these morcellators was 2.97, 0.65, 0.62, and 0.013 g, respectively. A single entrapment sack perforation was documented in a LapSac during routine HSEL morcellation. CONCLUSIONS: Renal morcellation with all three morcellators is feasible. The Steiner morcellator combined with an Endocatch resulted in more rapid morcellation and larger morcellation products.

Animals↗

The serum albumin-binding region of streptococcal protein G (BB) potentiates the immunogenicity of the G130-230 RSV-A protein.

BBG2Na is a protein comprising residues 130-230 of the respiratory syncytial virus subgroup A (RSV-A) G protein (G2Na) fused to the albumin-binding domain of streptococcal G protein (BB). BBG2Na was cloned, expressed in Escherichia coli and renaturated. In rodent models, this subunit RSV vaccine adjuvanted in Alhydrogel induced specific antibodies and conferred protection to RSV infection. Comparison of the antibody production in a BALB/c mouse model revealed that BBG2Na induced a stronger and earlier G2Na antibody response than G2Na alone, without altering the IgG subclass distribution. To address the role of the BB part, we explored its carrier properties and showed that it is a Th dependent antigen, generating a more potent G2Na-specific B cell memory response and able to generate Th cells that provide help for G2Na antibody production.

Animals↗

Evaluating the clinical performance of the Osseotite implant: defining prosthetic predictability.

A 5-year prospective, multicenter study is in progress at four private dental practices to determine the cumulative implant survival rate and prosthetic outcome when using the Osseotite dental implant in posterior maxillary and mandibular areas. An interim evaluation after 34.4 months of study progress is presented. A total of 219 Osseotite implants were placed in 74 patients (34 women and 40 men with a mean age of 57.8 +/- 15.2 years) using a conventional two-stage surgical protocol and 3- to 6-month healing time. Subsequently, patients were restored with fixed or removable restorations. Nineteen of the 74 patients reported smoking an average of 13.2 cigarettes per day. Restorative treatments included 40 single-unit restorations; 53 splinted 2-, 3-, 4-, and 5-unit implant-supported maxillary and mandibular prostheses; 4 full-arch fixed maxillary prostheses; 1 mandibular fixed/detachable hybrid prosthesis; and 1 mandibular overdenture. The mean time from implant placement to second stage surgery was 6.2 +/- 2.0 months; from restoration and implant loading to the most recent follow-up evaluation was 20.9 +/- 6.8 months. Of the 219 implants placed, three posterior maxillary implants developed infections and were removed prior to second stage surgery. No implant failures occurred at second stage surgery or after implant loading. Using the Kaplan-Meier method, the cumulative implant survival rate was 100% for anterior implants and 98.4% for posterior implants at 28.5 +/- 5.7 months. The cumulative postloading implant survival rate was 100% for both anterior and posterior implants. The results of this study indicate that the Osseotite dental implant achieved a high rate of integration that remained stable during nearly 2 years of implant function. In addition, because no postloading implant failures have occurred, the Osseotite implant has provided a high level of prosthetic predictability.

Dental Implantation, Endosseous↗

The recombinant Klebsiella pneumoniae outer membrane protein OmpA has carrier properties for conjugated antigenic peptides.

Klebsiella pneumoniae OmpA, the 40-kDa major protein of the outer membrane, was cloned and expressed in Escherichia coli. The recombinant protein was produced intracellularly in E. coli as inclusion bodies. Fusion of a short peptide to the N-terminus of native P40 facilitated high-level expression of the recombinant protein. Purified recombinant P40 was analyzed to verify purity and structural integrity. The molecular mass of purified recombinant P40 determined by electrospray mass spectrometry was 37,061 Da, in agreement with the theoretical mass deduced from the DNA sequence. Specific proliferation of recombinant-P40-primed murine lymph node cells in response to recombinant P40 stimulation in vitro indicated the presence of a T-cell epitope on recombinant P40. The induction of high serum antibody titers to a synthetic peptide derived from the attachment protein G of the respiratory syncytial virus when chemically coupled to recombinant P40 indicated that the protein had potent carrier properties.

Amino Acid Sequence↗

Avidin-binding to peripheral blood B lymphocytes and monocytes.

Avidin-coated magnetic beads bind peripheral blood B lymphocytes and monocytes. This unwanted reactivity is not due to the membrane expression of avidin target molecules since beads coated with a biotin-binding analogue are non-reactive and binding occurs even when cellular carbohydrate-binding sites are not active, in the absence of Mg2+ and Ca2+ cations, or when they are blocked by a alpha-D-glucose or alpha-D-mannose in presence of Ca2+ and Mg2+. The non-polar residues of avidin appear not to be engaged in a hydrophobic bond with the membrane molecule since suroptimal quantities of serum albumin do not prevent the avidin binding. It is suggested that ionic interactions explain the binding of avidin-coated beads to B lymphocytes and monocytes and that these can be inhibited with high molecular weight serum molecules or with 0.4 M NaCl.

Avidin↗

Modification of human long-term bone marrow cultures: establishment of a functional stromal microenvironment devoid of myeloid progenitors.

Differences in the plastic adhesive properties of bone marrow (BM) cells were used to initiate modified stromal layers (MSL) from long-term cultures by removing non-adherent cells shortly (4 to 18 hours) after initial seeding. Following this early modification, adherent cells generated a confluent layer after 21 days of culture. Cellular characteristics of volume and spontaneous fluorescence determined by flow cytometry showed that the MSL included 82% fibroblastic stromal cells, 8% macrophages and 10% myelomonocytic cells. Furthermore, clonogenic assays revealed that the MSL were devoid of hematopoietic progenitor cells. MSL were found to sustain long-term myelopoiesis for at least 7 weeks from exogenously added hematopoietic progenitors isolated from bone marrow (CD34+ cells), thereby demonstrating their functionality. The present experimental model appears of interest for the study of interactions between defined populations of hematopoietic cells and cells of the adherent layer. Of importance, our present modifications of human long-term bone marrow culture are technically simple and do not involve manipulation of the stromal cells.

Antigens, CD↗