Biomedical subjects
Publications and source records attributed to C U Casciani.
The authors report several modified techniques derived from Parks haemorrhoidectomy. They operated on 81 patients with II and III degree haemorrhoids with this technique and they present why they did it and the good results obtained.
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Changes in lymphocyte subsets in whole blood of normal pregnant women were examined by flow cytometry. From the first trimester and throughout pregnancy, the count of B cell subset remain unchanged. On the contrary, the percentage of "helper" lymphocytes decreased in the first trimester, increase in the third. These changes of lymphocyte subsets may indicate suppression of immunological activity during pregnancy.
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In vitro gangliosides exert inhibitory effects on cellular immune responses, largely relying on an impairment of the IL-2/IL-2 receptor interaction. In a previous study we have demonstrated synergistic effects of gangliosides and cyclosporin A (CyA) in the inhibition of the generation of in vitro allospecific immune responses in humans. To evaluate the possibility of using these drugs in immunosuppressive therapy in organ transplantation, we investigated the effects of the combination of a gangliosides mixture (GAMIX) and suboptimal doses of CyA on rat skin allografts in vivo. Sprague-Dawley rats were implanted with skin grafts from Lewis rats and treated for 21 days by intraperitoneal administration of either GAMIX or CyA or a combination of the two drugs. Untreated, GAMIX-treated or CyA-treated rats rejected skin allografts. In contrast, when a combined GAMIX CyA treatment was administered, successful grafting could be obtained in 8 rats out of 10 tested. Cells derived from spleens on day 21 post graft were stimulated in vitro with PWM mitogen. We found that cells from transplanted rats, untreated or treated with low-dose CyA or GAMIX alone, showed comparable responses to PWM. Cells from rats treated with the combination of the two drugs were found to be virtually unresponsive to stimulation by PWM mitogen. Taken together, our results indicate that GAMIX potentiate in vivo and ex vivo immunosuppressive effects of low-dose CyA.
Donor-specific anti-HLA antibodies were studied by cytotoxicity crossmatching (CTXM) and flow cytometry crossmatching (FCXM) in 117 kidney transplant candidates; the same study was carried out in 33 cadaver-donor kidney recipients, during the first 3 post-transplant months, for which donor cells were available. Pre-transport evaluation showed that 82.9% of subjects were CTXM negative/FCXM negative, 6.8% of patients were positive in both tests, and 10.3% were CTXM negative/FCCM positive. Post-transplant monitoring for donor-specific antibodies (Abs-DS) showed that nine recipients (27.3%) were FCXM positive; six of them were IgG+ and three IgM+. In comparing these results with the clinical course, a significant association between FCXM IgG+ and rejection episodes was observed (P < 0.01).
We treated some patients with severe generalized myasthenia gravis (MG) with semi-selective adsorption by plasma perfusion(PP) on IM-T350 column. We studied efficiency and undesired effects of the employed material to verify the safety and effectiveness of methodology. Thus a treatment protocol has been prepared: 6 PP per treatment cycle; 3-7 days between PP sessions; plasma to treat per session 1,2 lt; only one adsorbent column for every cycle. Our experience, on 13 cycles of treatment, showed that PP in autoimmune MG has provided good clinical results without any improvement in genetic MG.
Evaluation of mediastinal lymph nodes in patients with lung cancer is fundamental for their treatment and prognosis. Chest computed tomography (CT) is presently the most utilized diagnostic modality. In recent years endoscopic ultrasound (EUS) is being employed for this purpose. We retrospectively compared the results of CT and EUS staging of 35 selected patients with postsurgical stage. A total of 175 lymph node sites were examined. Results CT vs EUS were as follows: specificity 92% vs 98%, sensitivity 88% vs 84%, positive predicted accuracy 80% vs 96%, negative predicted accuracy 95% vs 94%, overall accuracy 92% vs 95%. The region most accessible by EUS evaluation were the paraesophageal lymph nodes; the most difficult were the right superior mediastinal nodes which cannot be imaged for anatomic reasons. EUS not only allows one to arrive at correct diagnosis with less false positive results, but also permits evaluation of lymph nodes which are not enlarged. We think that EUS, in combination with CT, is an appropriate modality for staging of mediastinal lymph nodes in patients with lung cancer.
The authors underline the efficacy of peritoneovenous shunting with LeVeen's valve in the treatment of refractory ascites in cirrhotic patients. Selection and appropriate preoperative management of patients are essential to assure good immediate and long-term results.
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