Biomedical subjects
Publications and source records attributed to C Marcarino.
Inflammatory pseudotumours of the liver are rare: over 40 cases had been reported up to 1992, the majority of which are surgical or laparoscopic findings. In this paper we describe two additional cases in which diagnosis was acquired by fine needle biopsy under ultrasonographic guidance. This approach allowed sufficient sampling of tissue for diagnostic purposes.
Des-gamma-carboxyprothrombin level was measured by enzyme immunoassay in the plasma of 39 patients suffering from hepatocellular carcinoma and 26 controls. Two of these were anticoagulated by warfarin and revealed very high positive values; the remaining 24, 8 healthy subjects and 16 patients with cirrhosis or chronic hepatitis, were negative. Values indicating pathology were found in 56.40% of patients suffering from hepatocellular carcinoma. All malignancies presenting diameter < or = 3 cm were negative, while high positive levels were found in patients with more advanced neoplasia. The alpha-fetoprotein was increased in 43.58% of the patients with hepatocellular carcinoma and in 6.25% of controls with chronic liver diseases. Positive values for both des-gamma-carboxyprothrombin and alpha- fetoprotein were detected in 12/39 patients. An increase of sensitivity (from 43.58 to 69.23%) in detecting hepatocellular carcinoma was found by the complementary use of the two markers relative to sole use of alpha-fetoprotein.
Andrologic problems were considered as nutrition is concerned: vitamin and oligo-element deficiencies, metabolic alterations, and toxic intake. Ethanol role was examined and discussed for its relevance in psychological and organic impairment due to both chronic abuse and acute intake, mainly for its role on hypothalamic-pituitary-gonadal axis. Rational nutrition is a clue in sexual disturbance prevention, correction and integrated care.
Urinary enzyme excretion was investigated in healthy volunteers before and after infusion of single low doses of aminoglycoside (gentamicin, tobramycin and amikacin) in the same subjects. Significant increases were detected in urinary leucine aminopeptidase, lactate dehydrogenase and alkaline phosphatase following gentamicin infusion; after amikacin administration only urinary release of leucine aminopeptidase was found to be increased. No difference was detected compared to basal values in enzyme excretion after tobramycin infusion. Urinary enzyme release in our conditions suggests low tubular damage after single doses of gentamicin and amikacin.
Blood lithium (Li) levels, renal functional parameters and urine excretion of enzymatic activities having different intracellular sites were investigated on rats submitted to acute and subacute Li chloride administration. In acute experiments increased levels of all detected enzymes were assayed following Li single doses of 5 and 10 mEq/kg b.w. In subacute poisoning, urine output of lactate dehydrogenase, aspartate transaminase and alanine transaminase was significantly over the basal ranges following 15 days in concomitance with marked elevation of plasma Li levels and exhibited progressive increase until 30 days; on the 10th day following Li withdrawal, elevated excretion of enzymatic activities was still assayed. The results are in agreement with data about the localization of the histologic lesions involving different sites of the nephron in acute Li poisoning and the distal tubular tract in subacute toxicity. In subacute administration the output of cytoplasmic and mitochondrial activities can be assumed as an index of damage of the nephron cells which can persist following Li withdrawal. Our findings indicate that the urine enzyme assay is a valuable tool to detect renal damage in experimental Li nephropathy.
Granulomatous hepatitis is not a uniform disease entity but a generic histopathologic diagnosis. The present review of aetiology and epidemiology of granulomas in the liver, shows that in the past tuberculosis and sarcoidosis were the most frequent but there remained a large percentage of "undiagnosis" cases; at the present drug-induced granulomatous hepatitis are frequently reported and "undiagnosed cases" are rare. Analysis of the hystological features of the most common granulomas is presented.
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The activity of several enzymes with different intracellular sites was determined in urine at various times following nonfatal acute tubular necrosis induced by mercuric chloride administration. The excretion rate of all tested enzymes rose on the 1st and 2nd day; in the next observations (days 7-15) enzymatic values approached the basal values. The lactate dehydrogenase isoenzyme pattern of the renal cortical zone showed an early shift towards cathodic fractions and later (7 days) an increase of middle ones; the normal anodic zymogram recovered after a suitable time interval (30 days). The isoenzymatic changes are related both to the renal hypoxia and to the appearance of less differentiated cells. The behaviour of functional parameters (urine flow, osmolality, urea clearance, creatinine clearance) were well in agreement with the observed enzyme and renal isoenzyme changes.
The incidence of immunological disorders seems to play a primary, significative role in the genesis of insulin-dependent diabetes mellitus (IDDM). Auto-immunological anti-pancreas alterations, both cell-mediated and humoral, have been detected in course of IDDM; moreover, the presence of antipancreatic antibodies seems to correlate with progressive destruction of islet cells and increased insulin deficiency. Animal models and human studies, revealing the pathologic entity of "insulitis", are consistent with an autoimmune component playing a part in the pathogenesis of diabetes mellitus. Furthermore, genotypic factors may be considered: recent studies prove the association between HLA system and IDDM; specifically, HLA antigens B8 and BW15 are found in significantly higher frequencies in juvenile onset insulin-dependent diabetics. Therefore, it can be hypothesized, in the pathogenesis of the disease, an altered immune response to an additional environmental diabetogenic factor; it has been postulated, on the ground of epidemiologic and experimental studies, the interference of a viral infection, that may act as a triggering event to pancreatic cell damage with a latent period of variable duration.
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A solitary late recurrence of renal cell carcinoma is very unusual. A case of triple pancreatic metastases of renal carcinoma is presented in a male patient who 9 years previously had undergone left radical nephrectomy. Although there are no specific signs, arteriography, computed tomography and intraoperative ultrasonography can give additional information to detect this rare localization. Surgical resection, when possible, is the most useful treatment for this metastatic lesion.