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Biomedical subjects

C Liguori

Publications and source records attributed to C Liguori.

At least 19 recordsLinked to original sources

[CK20 expression in the gastrointestinal tract of the embryo and fetus].

A novel type of cytokeratin, cytokeratin 20 (CK20), was added in 1990 to the classic catalog of human cytokeratins, a heterogeneous group of proteins present in almost all epithelia. In man, the expression of CK20 is almost entirely confined to the gastro-intestinal epithelium, to the urothelium and to Merkel cells. Since only few data are available regarding the expression of CK20 in the developing human intestinal mucosa, we studied CK20 immunoreactivity in fetal and neonatal human gut. Immunoreactivity for CK20 was tested in fetuses and newborns, from the twelfth up to the fortieth week of gestation. In each subject, a specimen from the oesophagus, stomach, small intestine, colon, appendix was studied. Tissue samples were routinely processed and paraffin sections were stained with the CK20-specific antibody IT-Ks 20.8. CK20 immunoreactivity was absent in the oesophageal epithelium and it was unevenly distributed in the gastrointestinal mucosa. Three main patterns of immunoreactivity were observed during normal development: the first, found in the stomach and in the small bowel, is characterized by a progressive increase in CK20 expression during gestation; the second pattern, found in the duodenum, shows a progressive decrease in CK20 expression during gestation; in colon and appendix (third pattern), we did not find significant changes in the degree of immunoreactivity for CK20 during gestation. CK20 is unevenly expressed in developing human intestinal mucosa. The degree of positivity for CK20 appears to be related to the epithelial maturation stage only in gastric and small bowel mucosa. Further studies are needed to verify if the uneven CK20 immunoreactivity in the gastrointestinal tract persists even in adulthood.

Biomarkers↗

Spontaneous resolution of pulmonary venous thrombosis after lung transplantation.

Thrombus formation at the pulmonary venous anastomotic site after lung transplantation may have catastrophic consequences, including allograft failure and stroke. However, treatment with systemic anticoagulation may facilitate bleeding in the early postoperative period. In the present report, we describe the clinical and transesophageal echocardiographic findings of pulmonary venous thrombosis in two patients in the immediate postoperative period after lung transplantation. Treatment with systemic anticoagulation was not feasible because of extensive postoperative thoracic bleeding in each instance. A conservative approach was taken on the basis of the small size of each thrombus and lack of accelerated flow velocity at the site of the thrombus. Each thrombus resolved spontaneously without clinical sequelae. These two cases suggest that thrombus size and flow velocity at the anastomotic site may be used to guide the clinical management of pulmonary venous thrombosis after lung transplantation.

Adult↗

Alpha-1-antichymotrypsin immunoreactivity in papillary carcinoma of the thyroid gland.

AIM: Papillary thyroid carcinoma (PTC) is the most common malignant tumour of the thyroid gland. The immunohistochemical profile of PTC is characterized by immunoreactivity of tumour cells for cytokeratins, thyroglobulin, vimentin, EMA and S100 protein. Recently, the presence of a serum protease inhibitor, alpha-1-antitrypsin (A1AT), has been demonstrated in tumour cells of PTC. The aim of our study was to test immunoreactivity of PTC for another inhibitor of proteases, alpha-1-antichymotrypsin (A1ACT). METHODS AND RESULTS: Serial paraffin sections of nine consecutive cases of PTC were tested with anti-A1AT and anti-A1ACT antibodies. No immunoreactivity for A1AT and A1ACT was found in the normal thyroid tissue surrounding each tumour. In seven out of nine cases, tumour cells of PTC showed cytoplasmic immunoreactivity for A1ACT. In two cases, A1ACT was detected even in the nuclei. Immunoreactivity for A1AT was found only in three cases. Two cases of PTC showed no staining for both A1ACT and A1AT. No significant correlation of A1ACT staining was found with various prognostic indices (age of patients, histological pattern, tumour size, presence of regional lymph node metastases). The two cases showing a lack of staining for both A1ACT and A1AT showed a more aggressive clinical behaviour. CONCLUSIONS: Our preliminary study shows that A1ACT is expressed by tumour cells in a large proportion of papillary carcinomas of the thyroid gland. Its significance remains, to the best of our knowledge, still unknown. The observation of a more aggressive behaviour in the two cases characterized by the absence of immunoreactivity for both A1ACT and A1AT suggests that the presence or absence of protease inhibitors could play a role in controlling tumour progression in PTC.

Adolescent↗

Patent foramen ovale size and embolic brain imaging findings among patients with ischemic stroke.

BACKGROUND AND PURPOSE: Although the cause of stroke among patients with patent foramen ovale (PFO) may be due to paradoxical cerebral embolism (PCE), this mechanism is often difficult to prove. The aim of our study was to evaluate the association between brain imaging findings suggestive of embolism and PFO among ischemic stroke patients. METHODS: As part of the Northern Manhattan Stroke Study, 95 patients with first ischemic stroke over age 39 underwent transesophageal echocardiography (TEE) for evaluation of a cardiac source of embolism. The stroke subtype was determined by modified NINDS Stroke Data Bank criteria. Stroke subtype and MRI/CT imaging data were evaluated blind to the presence of a PFO. These findings were compared between two groups: patients with medium to large PFO (> or =2 mm) and small (<2 mm) or no PFO. RESULTS: Of the 95 patients who underwent TEE, 31 (33%) had a PFO. The frequency of PFO was significantly greater among patients with cryptogenic infarcts (19 of 42; 45%) compared with patients with determined cause of stroke (12 of 53, 23%; P=0.02). Medium to large PFOs were found more often among cryptogenic strokes than among infarcts of determined cause (26% versus 6%; P=0.04). Superficial infarcts occurred more often in the group with larger PFOs than in the group with small or no PFOs (50% versus 21%; P=0.02). Patients with medium or large PFOs more frequently had occipital and infratentorial strokes (57% versus 27%; P=0.02). CONCLUSIONS: Stroke patients with larger PFOs show more brain imaging features of embolic infarcts than those with small PFOs. Larger PFOs may be more likely to cause paradoxical embolization and may help explain the stroke mechanism among patients with no other definite cause.

Aged↗

Transesophageal echocardiography-guided transvenous biopsy of a cardiac sarcoma.

Transvenous endomyocardial biopsy is a well established procedure to diagnose rejection after heart transplantation as well as to assess for other cardiomyopathic processes. However, it is rarely used to obtain samples of unidentified cardiac masses. We report a case of a primary cardiac sarcoma in which the histologic diagnosis was provided by transesophageal echocardiography-guided transvenous biopsy. This procedure is accurate and can avoid the potential risk of a diagnostic thoracotomy.

Biopsy↗

Late pulmonary venous complications after lung transplantation.

Although abnormalities of the pulmonary venous anastomosis in the early postoperative period after lung transplantation have been reported from several centers, late complications related to the pulmonary venous anastomosis have not been described. In the present study, we describe the clinical and transesophageal echocardiographic findings of pulmonary vein anastomotic complications in two patients at 1.9 and 2.3 years after lung transplantation. Both pulmonary venous abnormalities, stenosis in the first instance and thrombosis in the second instance, impaired venous outflow on the affected side causing unilateral edema and pleural effusion. Pulmonary venous abnormalities late after lung transplantation can mimic allograft rejection, opportunistic infection, or heart failure and are best diagnosed by transesophageal echocardiography.

Anastomosis, Surgical↗

[Surgery for familial polyposis of the colon. A functional follow-up].

Functional assessment of pelvic pouch procedures for FAP is not different from that of UC and consists of clinical, manometric and radiologic investigations. Ileo-rectal anastomosis and pelvic pouch operation are equally effective for the disease, but function is still questionable after restorative proctocolectomy. Based on a personal series of 43 patients, relevant technical aspects influencing functional results are discussed and guidelines for a correct follow-up of these patients are presented.

Adenomatous Polyposis Coli↗

Biphasic response of complement to heparin: fluid-phase generation of neoantigens in human serum and in a reconstituted alternative pathway amplification cycle.

We describe a study of the effects of heparin on complement activation through the use of assays for fragment C4d, fragment Bb, and the S-C5b-9 complex (S-MAC). In sera from healthy volunteers, virtually no change was observed in C4d either as a function of time or of heparin concentration, whereas changes in Bb and S-MAC were biphasic. This observation was explored in greater detail in the heparin concentration range 0.001-5.0 u/ml (5 x 10(-3) to 25 micrograms/ml). For both Bb and S-MAC, a significant (P < 0.05) increase in production was noted in the heparin concentration range, 0.01-0.5 u/ml (5 x 10(-2) to 2.5 micrograms/ml). At higher heparin concentrations, Bb and S-MAC production decreased markedly (P < 0.05). We reconstituted the alternative pathway amplification cycle (C3, factor B, and factor D) and studied Bb generation. With reactants at concentrations one tenth those of normal serum, we observed a maximum generation of 13.2 micrograms/ml Bb. Control and heparin at 5 x 10(-4) micrograms/ml generated Bb concentrations of 6.8 and 6.1 micrograms/ml, respectively, for a 2-min incubation; at 5 x 10(-3) micrograms/ml heparin, Bb was increased to 9.8 micrograms/ml. Using isoelectric focusing to study anionic pI shifts in heparin-bound factors B and D, it was found that factor B bound heparin only at the highest heparin concentration studied, i.e., 50 micrograms/ml; factor D, however, bound heparin at a much lower concentration (0.05 micrograms/ml). We conclude that, at low concentrations, heparin activates complement due to potentiation of the alternative pathway amplification cycle in the fluid phase.

Adult↗

[Rehabilitation of the colostomy patient].

The Authors report their experience concerning the rehabilitation of patients with temporary or definitive colostomy. Mechanical and psychosocial implications as well as different rehabilitative methods are discussed and literature data are reviewed. Surgery should play a major role in this rehabilitation programme, either in terms of prevention or definitive treatment; nonetheless only through a multidisciplinary approach these patients will achieve a better quality of life.

Aged↗

Therapy of chronic non-A, non-B hepatitis with alpha interferon. A comparison between natural and recombinant alpha interferon.

We studied the effects of two different types of interferon alpha (natural interferon from human leukocytes vs. recombinant interferon 2b) in 64 patients with chronic Non-A, Non-B hepatitis; other finalities were: definition of the optimal duration of therapy with interferon alpha (IFN alpha), entity of side effects, cost-benefit ratio. Patients were randomly assigned to one of three groups, according to duration of IFN alpha treatment: Group I was treated for 12 months, Group II for six months, Group III for 3 months. Each group consisted of two subgroups, divided on the basis of the type of IFN used: subgroup A was administered natural IFN alpha, and subgroup B received recombinant IFN alpha 2b. Each patients was given 3 million units of IFN alpha by intramuscular injection on alternate days. At the end of treatment, a decrease in serum ALT activity was achieved in 39 cases (65%). The response rate was higher in Group I (89%) than in Group II (54%) and Group III (55%). Natural and recombinant IFN alpha 2b induced similar effects in patients treated for twelve months (Group I); recombinant IFN was more effective than natural IFN alpha in patients treated for six and three months. We conclude that the 12-month treatment with 3 million units of intramuscular recombinant IFN alpha, administered on alternate days, might be the optimal therapy schedule. This proposal is also supported by the evaluation of the cost benefit ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Evaluation↗

[Recent experience in the short-term etizolam treatment of irritable colon syndrome].

Twenty-two subjects (8 males, 14 females, mean age 36 years, range 21-57) with symptoms of diffuse pain or fullness in a lower abdominal quadrant, without repercussions on general health but with chronic anxiety of which the subjects complained or which emerged during confidential conversation with the physicians, were enrolled in our outpatient department for liver and gastroenterologic pathology at the Institute of Internal Medicine and Metabolic Disorders, II Faculty of Medicine, Naples University. After an average 30-day wash-out period, patients were treated with etizolam, a new psychoactive drug for somatized anxiety. Mean dosage and duration of treatment were 1 tablet twice daily for 25 days. Painful symptoms disappeared in 16.3% of patients, decreased in 38.3% and remained stationary in 22.7% and became worse in 22.7%. Number of bowel motions decreased in 14 patients (63.6%, from an average of 2.04 to 1.56). It can therefore be concluded that etizolam treatment was effective in subjects with colon disorders accompanied by chronic anxiety syndrome or that became acute as result of stressful socio-economic or affective situations or personal disappointment.

Adult↗

Copper distribution within and between newborn livers.

Copper concentration was determined in different liver samples (blocks, needle biopsy and bile) obtained from 9 newborns and 3 infants at autopsy. Tissue blocks, sampled at ten equally spaced intervals between the left and the right lobe, revealed in newborns high copper concentrations, ranging from 93 to 335 mg/Kg of dry tissue with an upward trend from the right to the left lobe. The situation differed in infants where a lower and more evenly distributed copper content, ranging from 49 to 123 mg/Kg of dry tissue, was found, which seemed to approximate the situation found in adults. Copper concentration was generally high in bile, with an overall range from 99 to 413 mg/Kg of dry material. This fact was particularly significant in infants, considering their low hepatic copper content. Copper content determined in percutaneous biopts was significantly correlated to (P less than 0.01), though only moderately predictive of (r2 = 0.54), the average copper content calculated from the ten liver blocks.

Bile↗

Liver cell proliferation induced by the mitogen ethylene dibromide, unlike compensatory cell proliferation, does not achieve initiation of rat liver carcinogenesis by diethylnitrosamine.

The purpose of this investigation was to determine whether mitogen-induced cell proliferation is as effective as compensatory cell proliferation in achieving initiation of carcinogenesis in rat liver. Male Wistar rats were injected with a single non-necrogenic dose of the hepatocarcinogen diethylnitrosamine (DENA) during the peak of DNA synthesis following the administration of the hepatic mitogen ethylene dibromide (EDB) or a necrogenic dose of CCl4. After subjecting the animals to a promoting procedure, the rats were sacrificed and the initiated hepatocytes were monitored as gamma-glutamyltranspeptidase (gamma-GT) positive foci. The results indicate that while DENA administration during compensatory cell proliferation results in the formation of GT positive foci, no enzyme-altered foci were produced when the carcinogen was given during liver hyperplasia induced by EDB, despite the fact that at the time of carcinogen administration, the extent of cell proliferation, as monitored by thymidine incorporation into DNA, was the same in both the groups.

Animals↗

Immunoperoxidase localization of HSV2 antigens in cervical dysplasia and carcinoma.

The AA. have evaluated by means of the immunohistochemical technique the incidence of herpetic phlogosis in 76 women with neoplastic pathologies of the uterine cervix. The patients were submitted to cytologic, colposcopic and histologic examination for CIN. The HSV2 positivity by immunohistochemical method was demonstrated in 53 (35.3%) cases of CIN and invasive carcinoma. The results confirm the frequent association between HSV2 and cervical carcinoma and they support a specific therapeutic approach to be made in the prevention and clinical management of the carcinoma.

Adult↗