PubMed Health⌕ Search

Biomedical subjects

G Todeschini

Publications and source records attributed to G Todeschini.

At least 55 records · Page 3Linked to original sources

Natural killer cell function and lymphoid subpopulations in acute non-lymphoblastic leukaemia in complete remission.

A long term follow-up study has been undertaken in 33 patients with acute non-lymphoblastic leukaemia (ANLL) in order to establish whether a correlation exists between the clinical course and the immunologic pattern of lymphoid subpopulations. Peripheral blood lymphoid cells have been investigated longitudinally (each 1 to 4 months) during complete remission (CR), by morphologic, phenotypic and functional analyses. Particular attention has been paid to the evaluation of the natural killer (NK) cell compartment, by the detection of cells expressing an NK-related phenotype and by NK in vitro assay. Among the patients so far evaluable, 20 relapsed (R) and 10 are long survivors in CR 'off therapy' (LS). The most relevant finding was represented by statistically higher values of NK activity observed in LS vs. R patients (P less than 0.01). The removal of adherent cells before the NK assay, performed to investigate the possible inhibitory effect on NK function played by the macrophage component, abolished this difference, due to a selective increase of NK function in the R group. The longitudinal study revealed that NK activity tended to decrease in individual patients who subsequently relapsed. These data suggest a possible role of NK cells in the relapse control of ANLL, although it cannot be excluded that the low level of NK activity observed in the R group is the result of impending relapse rather than its cause.

Adolescent↗

[Angiographic diagnosis in intestinal angiodysplasia. Series of 13 cases].

The authors report 13 cases of intestinal bleeding; while serials endoscopic and radiological examinations had been negative, arteriography allowed intestinal angiodysplasia to be diagnosed, and detected 18 lesions (12 of the right colon, 6 of the small bowel), confirming the fundamental role of arteriography in the diagnosis the localization and extension of these lesions. The importance of accuracy is emphasized both in the performance and in the evaluation of angiographic findings, in order to avoid missing multiple localizations (colon and small bowel). The authors illustrate and evaluate the different angiographic findings. Among these, the collection of contrast medium into parietal vascular lacunae and the early and dense opacification of the draining veins appear to be the most specific and frequent findings of angiodysplasia. In their series of patients the authors have also observed how the dilatation of the feeding artery, up to the antimesenteric side (a sign which is hardly ever reported in literature), was often present in the cecal localizations but could never be observed in the small bowel. Finally the surgical results and follow-up are considered.

Adolescent↗

Immunologic abnormalities in angioimmunoblastic lymphadenopathy.

In this study we describe the results of phenotypic, serologic, and functional analyses performed in nine patients with angioimmunoblastic lymphadenopathy (AILD). The study investigates the nature of the T-cell defects which seem to represent a consistent feature in this disease. The study, based on the analysis of T-cell subsets with monoclonal antibodies and on functional in vitro tests, showed the following main abnormalities: reduction of the absolute number of circulating T-cells; inversion of the CD4/CD8 ratio, both in the peripheral blood and in the involved lymph nodes; high percentages of activated T-cells (CD8+/HLA-DR+); defective T-cell response in vitro to the PHA mitogen; and minimal helper and enhanced in vitro suppressor functions. Some of these immunologic dysfunctions are also observed in acquired immune deficiency syndrome (AIDS) which has in common with AILD several clinical features. However, no evidence of HTLV-III infection could be demonstrated in our patients with AILD.

Acquired Immunodeficiency Syndrome↗

[Intestinal angiodysplasias. Diagnostic and therapeutic problems].

The cases are presented of 9 patients with intestinal angiodysplasia observed in 1979-85 in the surgery departments of San Carlo Borromeo Hospital, Milan. Diagnostic problems are discussed with particular reference to angiographic and endoscopic methods. Surgical treatment gave good results. Recurrent bleeding may depend on the inadequate assessment of the extension of the lesion or on the existence of other unrecognised intestinal sites.

Adolescent↗

Mediastinal large-cell lymphoma of B-type, with sclerosis: histopathological and immunohistochemical study of eight cases.

Eight cases of mediastinal non-lymphoblastic large-cell lymphoma have been studied by histopathological and immunohistochemical methods. A common clinical, morphological and immunophenotypic pattern was identified. Six of eight cases proved to be of B-cell origin by the expression of B-associated antigens detected by specific monoclonal antibodies. Cells of large size with nuclei of varying morphology and a peculiar type of fine compartmentalizing fibrosis were observed in all specimens. Clinically the disease was characterized by the young age of the patients, primary mediastinal involvement, aggressive behaviour and spread to unusual sites (kidneys in four cases). This seems to be a hitherto unrecognized entity in the field of non-Hodgkin's lymphomas, often misdiagnosed because of location and a morphology uncommon for B-cell malignancies. Immunohistochemical analysis on frozen tissue sections appears to be mandatory for a correct diagnosis. Nevertheless, this type of lymphoma could be suspected also on the basis of its peculiar clinicopathological characteristics.

Adolescent↗

Blastic OKT6-positive proliferation preceding malignant histiocytosis.

A 45-year old male presented latero-cervical lymphoadenopathy. Biopsy revealed a malignant proliferation of immature "lymphoid" cells bearing T6 antigen and HLA-DR but negative for other lymphoid markers, suggesting a phenotype similar to Langerhans cells. The patient did not receive any therapy and six months later developed a histologically typical malignant histiocytosis, involving spleen and liver. Other reported cases of lymphoid malignancies (two bearing the T6 antigen on blast cells) preceding malignant histiocytosis were found and compared with ours. Most of these cases were characterized by the pediatric age of the patients and were presented as acute leukemias exhibiting, in at least some of them, reliable T-cell markers. Our case appears to represent, on the other hand, a blastic proliferation of precursors of both histiocytes and Langerhans dendritic cells which eventually progressed to malignant histiocytosis. The relevance of this observation in the debate on the origin of Langerhans cells and the relationships existing between macrophages and dendritic cells is discussed.

Antigens, Differentiation, T-Lymphocyte↗

[A case of lingual thyroid].

A case of thyroid lingual ectopy is reported. Medical therapy was at first sufficient to control the progressive increase in thyroid volume, but adolescence and pregnancies induced a further increment in the volume of the lingual goiter, accompanied by an impairment of swallowing and respiration. Such obstructive symptoms were resolved by surgical intervention followed by continued substitutive medical therapy.

Adult↗

Pseudomonas septicaemia. A review of 60 cases observed in a university hospital.

Epidemiological, clinical features and the pathogenesis of 60 cases of pseudomonas septicaemia, observed over a period of 7 years from 1975 to 1981, are described. The mean frequency of occurrence was 0.40 episodes per 1000 admissions and an incidence of 66 per cent was observed in patients with serious underlying diseases, such as haematological malignancies and neoplasia. Thirty-seven patients had received cytotoxic and immunosuppressive therapy and showed a marked leukopenia, and whenever the leukocyte count fell below 2000/mm3, the prognosis was significantly worse. The most common portals of entry were the respiratory and gastrointestinal tracts. The overall mortality was very high (75 per cent) and mainly related to septic shock. Apart from the very high frequency of this complication (24 patients, 40 per cent of all cases), a typical clinical picture, distinguishing pseudomonas from other Gram-negative septicaemias, did not emerge.

Adolescent↗

Gram-negative septicemia in patients with hematologic malignancies.

The clinical records of 66 consecutive episodes of Gram-negative bacteremia occurring in 60 patients with hematologic malignancies during a 66-month period were reviewed to assess the major prognostic factors. The bacteremia-related mortality was 53%. Overall, Pseudomonas aeruginosa (54%) and Escherichia coli (24%) were the predominant isolates (fatality rate 78 and 31% respectively). The majority of patients (58/66) were granulocytopenic (PMN less than 1000/microliters). Among the 18 patients whose circulating granulocytes increased by one log10 or to above 1000/mmc during therapy, the fatality rate was 39%, as opposed to 70% in the 40 patients without such an increase. Pneumonia-associated bacteremia (56%) had a high fatality rate (73%) compared to isolated bacteremias (27%). Septic shock and inappropriate antibiotic therapy accounted for the highest mortality. Our data suggest that Pseudomonas etiology, persistent neutropenia, associated pneumonia, septic shock and inappropriate antibiotic therapy account for a bad prognosis in Gram-negative bacteremia in hematologic malignancies.

Agranulocytosis↗

Empiric therapy of infections in hematologic malignancies: a prospective, randomized trial.

Patients with hematologic malignancies were randomly assigned to receive cefuroxime (group A) or tobramycin plus ampicillin (Group B) during 86 febrile episodes. In both regimens carbenicillin was added during neutropenia (71% of all episodes: groups C and D). The most common type of infection was pneumonia (48% alone; 72% with other sites involved), which accounted for a high fatality rate (15%); the highest rate occurred during septicemia with pneumonia (50%). The overall response rate to initial therapy was 63% without significant differences among the four regimens. The worst prognosis was observed in neutropenic patients without granulocyte recovery. When initial and cross-over trials were combined, there were favorable outcomes in 90% of all cases. Cefuroxime alone seems to be as effective as tobramycin plus ampicillin in the treatment of infections in hematologic malignancies. No side effects could be attributed to the cefuroxime-containing regimens.

Adolescent↗

Immunocompetence and dietary protein intake in early infancy.

Forty-one normal full-term infants were fed from birth, during the first 4.5 months of life, different diets based on two formulas similar in rough composition but basically different, the one being constituted only of cow milk protein and the other of soy protein. From each of the two formulas two different dilutions were prepared so that all diets supplied about 100 kcal/kg/day, but, respectively, 2.0 and 4.0 g/kg/day of cow milk protein and 2.0 and 5.0 g/kg/day of soy protein. After 4.5 months, growth in weight, length, and head circumference was normal and very similar in all infants. Gammaglobulin, immunoglobulin, transferrin, and some complement fractions (particularly C'3, C'1 INA, C'3 PA) were lower in infants receiving soy protein diets than in those receiving cow milk protein diets, and, within each type of diet, in those infants receiving lower amounts of protein. In particular, values of infants receiving 5.0 g/kg/day of soy protein were roughly comparable to those of infants receiving 2.0 g/kg/day of cow milk protein. B lymphocyte markers and reactivity did not show significant differences among the various groups. T lymphocyte markers and reactivity showed an impairment in soy protein diets (and in particular in 2.0 g/kg/day protein diets) with respect to cow milk diets. It was also observed that morbidity (mainly infections of upper respiratory tract) was higher in those infants who took soybean protein and in those who took lesser amount of protein.

B-Lymphocytes↗

[HBV serologic markers in the chronic alcoholism (author's transl)].

The prevalence of serum markers, HBsAg, anti-HBsAg, HBcAg and anti-HBeAg in a group of subjects affected by chronic alcoholism with fatty liver or with cirrhotic stages is reported. An incidence of chronic HBsAg carriers, similar to that found in healthy subjects, was noticed, while an elevated incidence of other serological markers of previous contact with HBV were found. The Authors discuss the significance of this report, on the basis of a greater possibility of contact with HBV, for social-economic situations of those patients. The etiopathogenetic role of HBV in the cirrhotic evolution of alcoholic liver diseases was excluded.

Alcoholism↗

The diagnostic value of serum copper levels and other hematochemical parameters in malignancies.

An increase in the serum copper (Cu++) level has been described as a sensitive index of disease activity in several hematologic and nonhematologic malignancies. In order to explore the diagnostic value of Cu++ compared to other hematochemical parameters frequently abnormal in malignancies, Cu++, serum alpha2 globulin (alpha2), plasmatic fibrinogen (Fibr), the erythrocyte sedimentation rate (ESR), and serum iron (Fe++) have been detected and evaluated in 267 patients affected with the following diseases: Hodgkin's lymphoma (HL), non-Hodgkin's Lymphomas (NHL), Acute Leukemias (AL), Chronic Myeloid Leukemia (CML), Chronic Lymphocytic Leukemia (CLL), Myeloma (MM), and Breast Cancer (BC). The best correlation between Cu++ increase and disease activity has been found in HL, NHL, AL, and BC. In these diseases, when the considered parameters were compared, Cu++ and ESR showed a similar pattern, i.e., a high frequency of abnormalities in active disease. It is concluded that Cu++ represents a good complement to some other aspecific parameters in evaluating the activity and diffusion of neoplasias and the therapeutic results, particularly in HL, NHL, AL and BC.

Alpha-Globulins↗