Biomedical subjects
Publications and source records attributed to G Manara.
On the basis of more than 10 years' clinical experience of 122 patients operated on for cancer of the right colon, stress is laid on intestinal occlusion which is one of the most frequent complications of this pathology. The factors that make the event to be avoided and that lead to the poor short and long-term results are analysed.
The long-term urogenital dysfunctions in 46 of 104 surviving patients submitted to abdominoperineal resection for rectal carcinoma between 1972 and 1986 were collected and assessed. Urinary retention was present in 41 percent of the men and 35 percent of women, while incontinence was present in 10 percent of men and 29 percent of women. Impotence was reported by 59 percent of the males, all sexually active before surgery. Dyspareunia was present in 50 percent of the women in the study. The possibility of treating prostatic hypertrophy concurrently with abdominoperineal resection in selected cases to avoid urinary retention is discussed. The limited number of responders to the survey may interfere with the global statistical significance.
Expression of integrins, a superfamily of glycoprotein alpha/beta heterodimers which integrate the cytoskeleton with the extracellular matrix and/or mediate cell-cell adhesive interactions, was examined on normal and leukaemic bone marrow cells by immunohistochemistry and immunotransmission electron microscopy (immuno-TEM). Among the beta 1/VLA molecules studied, VLA-2 and 6 were expressed on megakaryocytes and platelets, while VLA-4 was present on 40% of haemopoietic cells, including monocytes, erythroblasts and immature cells; this molecule was typically localized at sites of intercellular contact, as seen by immuno-TEM, suggesting it may be involved in interactions among haemopoietic cells during differentiation. In human long-term bone marrow cultures (LTBMC), VLA-1 and 3 were present respectively on 35% and 40% of the adherent cells which included fibroblasts and endothelial cells, as shown by double-labelling experiments; VLA-2 was expressed only on a subpopulation of fibroblasts. beta 2/LeuCAM molecules were absent from platelets, megakaryocytes and HLA-DR+/myeloperoxidase- early myeloid precursors, and appeared progressively during maturation in both lymphoid and myeloid cells. Expression of beta 3/cytoadhesin molecules was restricted to megakaryocytes and platelets and, in the adherent layer of LTBMC, to endothelial cells. The regulated expression and specific localization of integrins in the bone marrow suggest that these molecules may have a role in normal haemopoiesis.
Personal experience in seven cases of ischaemic colitis that required surgery is reported. The aetiological, pathological and clinical features of the disease are then considered.
The clinical efficacy of roxithromycin, administered at the daily dosage of 300 mg (150 mg every 12 hours), was evaluated in 25 patients with respiratory tract infections, mostly infectious exacerbations of chronic bronchitis. Pathogens isolated before treatment were Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus beta-haemoliticus, Haemophilus influenzae. Clinical cure or improvement was achieved in 21 out of 22 evaluable patients. The eradication rate was 91%. Tolerability was good: two patients reported gastrointestinal side effects which caused treatment discontinuation. These preliminary data suggest that roxithromycin may have a place in the treatment of respiratory infections.
Leiomyosarcoma of the lung is a type of tumour rarely found in childhood. It arises from smooth muscle either of bronchial or arterial walls, has a variable pattern of local growth, blood-borne metastatic spread with lymph nodes sparing and a clinical course characterized by fever, cough and worsening dyspnea. We report a case which occurred in a 14-year-old girl, reviewing all the other cases found in the literature.
Double layer immunocytochemical procedures were performed on fresh frozen serial sections of lichen planus (LP), using three monoclonal antibodies: OKT3 (T-cells) and two anti Ia-like antigens, monoclonal antibodies. Lymphocytes in dermal LP infiltrates were OKT3 positive and Ia-like positive; lymphocytes in the paracortical area of human normal lymph-node were OKT3 positive and Ia-like negative. Unstimulated peripheral blood-OKT3 positive, E-rosette forming cells of normal donors were Ia-like negative, while the same T-cells, when mitogen-stimulated, became Ia-like positive. Therefore, in dermal infiltrates of LP, T-lymphocytes are Ia-like positive cells, representing an antigen-stimulated T-cell population. The in situ presence of activated T-lymphocytes seems to support the hypothesis of an immunological nature of LP.
Immunoenzymatic (in light and in electron microscopy) and immunofluorescence techniques were performed, using monoclonal antibodies, on tissue sections of early lichen planus (LP) lesions versus late LP lesions from 20 patients. Control procedures were carried out in peripheral blood T cells from the same patients and from healthy donors. The OKT4-Leu3A/OKT8-Leu2A ratio in peripheral blood from LP patients and from donors was lower than in dermal infiltrate of early LP lesions, but higher than in dermal infiltrate of late LP lesions. It is conceivable that in early LP lesions OKT4-Leu3A-positive cells may be antigen-specifically 'educated' by immunostimulatory cells. In late LP lesions, OKT8-Leu2A-positive cells could be cytotoxic to keratinocytes; it is likely, however, that this latter population may moreover have immunoregulatory, resolutional functions.
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An apparently healthy boy was suffering from recurrent Aspergillus infections. No classical conditions of immunodeficiency were found. Studies on the patient's phagocytic system revealed neutrophils and monocytes to function normally except in Aspergillus killing (microbicidal activity for bacteria and Candida was normal). Aspergillus killing mechanisms may be complex and peculiarly selective, possibly involving both oxygen-dependent and independent mechanisms.
The combination of sulbactam (S) plus ampicillin (A) extends the activity of ampicillin (Amp) against beta-lactamase producing strains. This combination is therefore useful in many clinical situations including LRTI. A clinical trial was carried out to evaluate the clinical and bacteriological efficacy of S-Amp in LRTI in comparison with Amp alone. Concerning clinical outcome the results were satisfactory in 83.3% of cases for S-Amp group and 82.3% of cases for Amp group. Pathogen eradication was achieved in 87.5% and 70.5% of cases respectively for the S-Amp and Amp group.
A clinical trial was performed to evaluate the efficacy of ciprofloxacin by iv administration in the treatment of respiratory infections. Twenty-two in-patients affected with acute lower respiratory tract infections, mainly infectious exacerbations of chronic obstructive lung disease (COLD), were treated with ciprofloxacin at the daily dosage of 400 mg iv, in two administrations. Overall clinical results were satisfactory (15 patients cured, 7 patients improved). Concerning bacteriological results, pathogen eradication was achieved in 83.3% of cases. Tolerability was good: no adverse events were observed.
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