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Biomedical subjects

E Fazzini

Publications and source records attributed to E Fazzini.

At least 37 records · Page 2Linked to original sources
PubMed1994

Neuropsychiatric and neuropsychological findings in conduct disorder and attention-deficit hyperactivity disorder.

Neuropsychiatric and neuropsychological evaluations were performed in a pilot study of adolescents with DSM-III-R disruptive behavior disorders, including conduct disorder (CD) and attention-deficit hyperactivity disorder (ADHD). The following comparisons were made: 1) CD comorbid with ADHD vs. CD only; 2) all subjects with ADHD vs. all non-ADHD; and 3) all subjects with CD vs. all non-CD. The CD + ADHD group had increased left-sided soft signs compared with the CD group. CD + ADHD subjects significantly underperformed CD subjects on several executive functioning measures, with no differences on Verbal IQ subtests. Results are discrepant with previous findings of deficient verbal functioning in delinquent populations. However, findings may not be generalizable because of sampling limitations.

Adolescent↗
PubMed1993

Striatal hypometabolism distinguishes striatonigral degeneration from Parkinson's disease.

Regional and global metabolic rates for glucose were estimated using 18F-fluorodeoxyglucose and positron emission tomography in 10 patients with a clinical likelihood of striatonigral degeneration (2 men and 8 women; mean age, 61.8 +/- 6.9 years; mean disease duration, 4.7 +/- 2.2 years; mean Hoehn and Yahr score, 3.5 +/- 0.8). Measures of brain glucose metabolism in these patients were compared with those for 10 age-matched normal volunteers, 10 disease severity-matched patients with Parkinson's disease (PD), and 10 disease duration-matched patients with PD. Normalized glucose metabolism was significantly reduced in the caudate (p < 0.03) and putamen (p < 0.003) as compared with that in normal and PD control subjects, and discriminated patients with striatonigral degeneration from control subjects (p < 0.002). Putamenal hypometabolism in patients with striatonigral degeneration correlated significantly with quantitative ratings of motor disability (p < 0.02). These results suggest that quantitative 18F-fluorodeoxyglucose positron emission tomography techniques may be useful in supporting a diagnosis of striatonigral degeneration in life, and in objectively assessing disease severity and potential therapeutic interventions.

Aged↗
PubMed1992

Cerebrospinal fluid antibodies to coronavirus in patients with Parkinson's disease.

The etiology of Parkinson's disease remains unknown, and a search for environmental agents continues. In 1985, Fishman induced infection of the basal ganglia by a coronavirus in mice. Although coronavirus is recognized primarily as a respiratory pathogen in humans, its affinity for the basal ganglia led us to investigate its possible role in human Parkinson's disease. The cerebrospinal fluid of normal controls (CTL) (n = 18), and patients with Parkinson's disease (PD (n = 20) and other neurological disease (OND) (n = 29) was analyzed in a blinded manner by enzyme-linked immunosorbent assay [measurements in optical density (OD) units] for antibody response to four coronavirus antigens: mouse hepatitis virus JHM (J) and A59 (A), and human coronavirus 229E (E) and OC43 (O). When compared with CTL, PD patients had an elevated (p less than 0.05) mean OD response to J (0.0856 vs. 0.0207) and A (0.1722 vs. 0.0636). Response (p greater than 0.05) to O (0.0839 vs. 0.0071) was greater than that to E (0.1261 vs. 0.0743). When compared to OND, PD patients had an elevated mean OD response to J (0.0856 vs. 0.0267, p less than 0.05). Responses (p greater than 0.05) to A (0.1722 vs. 0.0929) and O (0.0839 vs. 0.0446) were greater than that to E (0.1261 vs. 0.0946). These results suggest that there may be an association between coronavirus and PD.

Antibodies, Viral↗
PubMed1992

Hexamethylmelamine and low or moderate dose cisplatin with or without pyridoxine for treatment of advanced ovarian carcinoma: a study of the Eastern Cooperative Oncology Group.

A total of 248 analyzable patients with Stages III-IV ovarian epithelial cancer (114 with and 134 without prior chemotherapy) were randomized to one of four cisplatin (DDP)-hexamethylmelamine (HMM) regimens. In each, HMM, 200 mg/m2 was given orally daily on days 8-21 of each 21-day cycle. DDP was given i.v. on Day 1 at a dose of 37.5 mg/m2 (regimens A and B) or 75 mg/m2 (regimens C and D). In addition, since pyridoxine administration has been reported to reduce the neurotoxicity of HMM, that agent was given at a dose of 300 mg/m2 orally on Days 1-21 in regimens B and D. Randomization was stratified for performance status (0-1, 2-3) and largest tumor diameter at entry (greater than 2- less than or equal to 10 cm, greater than 10 cm) for previously untreated patients, and for performance status and time from initial diagnosis to entry on study (less than or equal to 1 year, greater than 1 year) for previously treated patients. The overall response rate (PR + CR) was 54%, with 25% of patients achieving a complete response. The 61% response rate with the higher dose DDP regimens was significantly greater than the 47% response rate with the lower dose regimens (p = 0.031). Multivariate analysis identified higher DDP dose, age less than 60 years, no prior chemotherapy, small tumor bulk and favorable tumor grade as significant prognosticators for response. The overall median response duration was 8.3 months (range 1-70 months). Prior chemotherapy, pyridoxine administration, recent diagnosis, and large tumor size were identified by multivariate analysis as factors adversely affecting response duration. Patients treated with the higher dose DDP regimens had more severe nausea, vomiting, and neurotoxicity. This study demonstrates that the combination of DDP + HMM is an effective regimen for advanced ovarian carcinoma that yields response rates comparable to other more complex regimens, and that there is a dose-response relationship for DDP in ovarian cancer. Although pyridoxine administration significantly reduced neurotoxicity, its adverse effect on response duration suggests that the agent should not be administered with DDP or HMM. The mechanism by which pyridoxine may unfavorably affect response duration deserves further investigation.

Altretamine↗
PubMed1992

Transplantation in the treatment of paralysis agitans (Parkinson's disease).

Over the past 3 years, there has been great interest in transplantation therapy in the treatment of Parkinson's disease. Following the impressive results reported by Madrazo in the spring of 1987, more than 350 cases of adrenal medullary implantation have been performed worldwide. There has been a significant reduction in "off" time and an increase in "on" time without chorea in 40% of patients having this procedure. The duration of effect is 1 year in half of these cases, with the other half (20% of all patients) still demonstrating significant improvement 3 years after the procedure. The mechanism of the bilateral beneficial improvement is unknown. The survival of adrenal medullary tissue has not been demonstrated at autopsy. It is thought that the mechanism of improvement involves either regenerative sprouting of the remaining dopamine producing neurons as a consequence of the release of neurotrophic factors or an interruption of the striatal pallidal output inhibitory influence of the basal ganglia on the thalamus (or both). Fetal mesencephalic implantation has also been attempted in more than 100 cases worldwide. The improvements when seen are not any more dramatic than those following the best results of adrenal medullary implantation. Graft survival has not been proved; it remains a possibility that interruption of the putamino-subthalamic pallidal pathway or a trophic influence of the tissue provides an alleviation in parkinsonism. The ethical controversy, need for long-term immunosuppression, and difficulty with obtaining tissue of the appropriate age and delivering the appropriate quantity to the putamen have made this technique less than adequate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Medulla↗
PubMed1991

Stereotaxic implantation of autologous adrenal medulla into caudate nucleus in four patients with parkinsonism. One-year follow-up.

Four patients with levodopa-responsive parkinsonism (aged 26, 35, 45, and 49 years) received autologous adrenal medullary implants into or near the left caudate nucleus by stereotaxic implantation after flank adrenalectomy. All patients had an immediate response to implantation lasting several days, during which parkinsonian signs and symptoms decreased. This period was followed by a gradual reappearance of symptoms in all but one patient. This patient had had a dramatic increase in "on" time without dyskinesias and a decrease in the severity and duration of "off" time. He died of multifocal glioblastoma 1 year after transplantation. Autopsy revealed no surviving adrenal cells. In one case, the stereotaxic implantation missed the basal ganglia, resulting in the placement of the adrenal medullary tissue into the medial thalamus and near the third ventricle; the patient did not improve. In the other two cases, a modest but definite increase in "on" time without dyskinesia and a reduction in the severity and duration of "off" time has been observed. The role of autologous adrenal medullary transplantation in patients with parkinsonism remains to be determined. Patients with a family history of cerebral malignancy may be at increased risk for the development of transplant-induced malignancy.

Adrenal Medulla↗
PubMed1991

Experience with selegiline and levodopa in advanced Parkinson's disease.

We compared the results of treatment with selegiline (deprenyl, Eldepryl) in 17 patients with advanced Stage 4 Parkinson Disease (PD) who were on levodopa (as Sinemet) with 65 Stage 2 or 3 patients with early PD who were also on levodopa. The first group consisted of 17 patients with advanced Stage 4 PD without response fluctuations ("wearing off" or "on off" phenomena). Their mean age was 72.1 +/- 7.5 years, their mean duration of PD was 7.4 +/- 3.2 years. The second group consisted of 65 patients with Stage 2 or 3 PD who had recently been started on levodopa. Their mean age was 63 +/- 12.1 years, their mean duration of PD was 7.4 +/- 3.2 years. The mean dose of selegiline was 10.0 +/- 1.8 mg per day (range 5-20 mg). The mean duration of treatment was 1.5 +/- 0.8 years. During the four years of observation 55.3 +/- 8.0% of the Stage 2 or 3 patients improved while only 14.3 +/- 13.5% of the Stage 4 patients improved. This difference was significant (p less than 0.05). During this time 22.0 +/- 6.7% of the Stage 2 or 3 patients worsened and 60.7 +/- of the Stage 4 patients worsened. This degree of worsening was significant (p less than 0.05). Adverse effects were minor and reversible. Our observations suggest that selegiline is more effective (higher percent of patients improving, lower percent of patients worsening) when it is added earlier with patients on levodopa than when it is added later.

Aged↗
PubMed1990

GM1 gangliosides alter acute MPTP-induced behavioral and neurochemical toxicity in mice.

We investigated the effect of GM1 gangliosides on a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) animal model of Parkinson disease. Five groups of mice (saline, GM1 (30 mg/kg), MPTP, MPTP + GM1 (15 mg/kg), MPTP + GM1 (30 mg/kg] were compared. GM1 was given daily via intraperitoneal injection before and during 13 daily doses of MPTP (30 mg/kg). Mice were tested for locomotion (1) within 2 h of an MPTP dose (to measure reduced motor activity), and (2) within 24 h of an MPTP dose (after animals had recovered and exhibited hyperactivity). We found that mice given GM1 gangliosides exhibited significantly less MPTP-induced behavior. This effect was most evident with the 15 mg/kg GM1 dose. GM1 also appeared to attenuate MPTP-induced neurochemical changes. GM1 effects indicating enhancement of DA turnover and preservation of DA, DOPAC and HVA concentrations in the striatum were found after the 8th MPTP dose. These latter neurochemical changes, however, were transient and not present after the 13th MPTP dose. Our data would suggest that gangliosides may reduce acute MPTP-induced neurotoxicity in mice either through an increase in DA neuron survival and/or the augmentation of striatal DA activity.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1987

Pulmonary manifestations of Kaposi's sarcoma.

Pulmonary Kaposi's sarcoma is an unusual pre-mortem diagnosis in AIDS patients. During a four-year period, 318 patients with AIDS-associated Kaposi's sarcoma presented to New York University Medical Center; 19 patients were found to have pulmonary involvement. All 19 patients were homosexual men; 18 of these patients presented with cutaneous and/or visceral Kaposi's sarcoma. Seventy-nine percent of patients had previous or concurrent pulmonary opportunistic infections. Clinical presentation of pulmonary Kaposi's sarcoma was indistinguishable from opportunistic pneumonia with respect to symptoms, physical examination results, and laboratory findings. Chest roentgenograms revealed a typical nodular pattern in only five patients. In contrast to AIDS-associated opportunistic pneumonia, the yield from fiberoptic bronchoscopy (24 percent) and open lung biopsy (56 percent) was low. Pathologically, Kaposi's sarcoma of the lung is less cellular than the cutaneous lesion. It is focal and scattered throughout the pulmonary interstitium, which may explain the difficulty in pre-mortem diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Percutaneous fine-needle aspiration biopsy in malignant lymphoma: a case report of an unusual cytologic presentation.

A case of an elderly Hispanic male who presented with clinical findings suspicious for lymphoma and cytologic evidence suggestive of carcinoma is presented and discussed. Percutaneous fine-needle aspiration biopsy of a group of mesenteric lymph nodes and a pleural fluid specimen showed clusters of tumor cells suggestive of carcinoma. Electron microscopic analysis of the pleural fluid showed comparable clusters of tumor cells, which proved to be lymphoma cells enveloped by macrophages. Histologic, electron microscopic, and histocytochemical examination of an enlarged inguinal lymph node confirmed the diagnosis of lymphoma with several alpha-naphthyl acetate esterase-positive macrophages interspersed among the tumor cells. To date, the phenomenon of macrophages enveloping lymphoma cells, so as to simulate tumor cell clustering, has not been reported. It is, however, an important possibility to keep in mind with cytologically distinguishing a lymphoma from a carcinoma.

Aged↗
PubMed1986

Bone scan appearance of osteogenesis imperfecta in an adult.

An adult patient with undiagnosed osteogenesis imperfecta presented with a history of multiple fractures. Radiographs could not definitively diagnose the underlying abnormality. The radionuclide bone image suggested the presence of a skeletal dysplasia, and prompted the histopathologic review of fracture fragments. The scan appearance of osteogenesis imperfecta in the adult and possible underlying mechanisms for the radiopharmaceutical distribution are discussed.

Adult↗
PubMed1985

A role for radiotherapy in the treatment of solid and papillary neoplasms of the pancreas.

Solid and papillary neoplasms of the pancreas are rare tumors that usually occur in young women as enlarging abdominal masses. These lesions almost never metastasize but may be locally destructive. Although the usual treatment is surgery, the authors herein report a case that was treated solely by radiotherapy. They conclude that solid and papillary neoplasms of the pancreas are radiosensitive and can be successfully treated by radiation therapy.

Adolescent↗
PubMed1985

Cytomegalovirus colitis in AIDS: radiographic findings in 11 patients.

Radiographic findings in 11 proved cases of cytomegalovirus (CMV) colitis were reviewed and correlated with colonoscopic and pathologic findings. Patients were chronically ill homosexual men with multiple systemic opportunistic infections. Endoscopies showed focal or diffuse inflammation, hemorrhagic plaques, and superficial colonic ulcers. Biopsies revealed inflammatory cells associated with cytoplasmic and intranuclear inclusion bodies. Barium enema examinations showed mucosal granularity, superficial erosions, thickened folds, and spasticity. Disease was either diffuse (four patients) or segmental (two patients), or it involved the cecum exclusively (three patients). Two patients had normal barium enema studies. Computed tomography scans in two patients demonstrated marked colonic wall thickening and mucosal ulcerations. In the homosexual population with acquired immunodeficiency syndrome, CMV colitis should be part of the differential diagnosis of diffuse colitis, segmental colitis, or typhlitis.

Acquired Immunodeficiency Syndrome↗
PubMed1985

4'Epidoxorubicin (epirubicin): activity in hepatocellular carcinoma.

Doxorubicin provides the most consistent response rate in hepatocellular carcinoma. We therefore initiated a trial with its analog 4'epidoxorubicin. Eighteen patients, all without prior treatment, were given the drug as a single agent every 3 weeks with dose escalation whenever possible. Five patients were treated by six-hour infusion and 13 by intravenous (IV) bolus injection, with the median dose being 90 mg/m2. The patients were of diverse ethnic background and included some with underlying cirrhosis and hepatitis B surface antigenemia. Three patients had partial remissions (6, 12, 48 weeks) for a response rate of 17%. Four patients also had prolonged stable disease (14, 26, 27, 38 weeks). Toxicity was mild, although cardiac toxicity developed in three patients at 685, 825, and 1,460 mg/m2 cumulative dose. The response to 4'epidoxorubicin in this study appears to be equivalent to the reported response rates for doxorubicin, with decreased toxicity.

Adult↗
PubMed1982

Giant lymph node hyperplasia. An immunopathologic and ultrastructural study of a case of the multicentric plasma cell variant.

A case of the multicentric plasma cell variant of giant lymph node hyperplasia (Castleman's disease) was studied. The left supraclavicular and axillary lymph nodes were affected. The parafollicular region of the lymph nodes was greatly expanded by sheets of mature plasma cells and by regionally concentrated as well as singly occurring immunoblasts. Both plasma cells and immunoblasts were polyclonal, as judged by the heterogeneity of immunoglobulin light-and heavy-chain components documented by immunofluorescence microscopy and immunohistochemistry. Ultrastructurally, free ribosomes and polyribosomes were the predominant cytoplasm organelles seen in immunoblasts. In plasma cells, rough endoplasmic reticulum was typically abundant and often contained electron-dense secretory product.

Female↗
PubMed1982

Reduction of N-methyl-N-nitrosourea-induced colon tumors in the rat by cholesterol.

Patient populations with a propensity to develop colon cancer have increased amounts of fecal cholesterol (and/or cholesterol metabolites). In this study, we report the effect of increased colonic concentrations of cholesterol and its metabolites on colon tumor promotion. The chemical carcinogen N-methyl-N-nitrosourea was instilled intrarectally into rats to initiate colon tumor formation. Following initiation, a cholesterol-supplemented diet was given. Despite a 2-fold elevation of fecal cholesterol, the number of colon tumors found was significantly reduced. These studies suggest that under certain conditions cholesterol may inhibit colon carcinogenesis.

Animals↗