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Biomedical subjects

L Cozzi

Publications and source records attributed to L Cozzi.

49 records · Page 3Linked to original sources

Diarrhetic shellfish poison in mussels: comparison of methods of detection and determination of the effectiveness of depuration.

The lack of specificity of the Yasumoto mouse bioassay for Diarrhetic Shellfish Poisoning (DSP) toxin and the possibility of obtaining false positive results, prompted a search for a suitable method to confirm doubtful results. The mouse bioassay, an enzyme-linked immunoassay (ELISA) and a tissue culture bioassay were compared; in addition the efficiency of depuration of toxic mussels in ozonized water was evaluated. DSP assay using tissue cultures was found suitable for confirming results obtained using the mouse bioassay, particularly where interpretation was difficult. The ELISA kit gave satisfactory results, but it responded only to okadaic acid and dinophysistoxin 1. Depuration reduced toxicity in some cases after 3 days of treatment.

Animals↗

Prospective sonographic and arthroscopic evaluation of proliferative knee joint synovitis.

The objective of this study was to verify the accuracy of ultrasonography in assessing the topography, morphology, and extent of synovial proliferation in rheumatoid and psoriatic knee joint synovitis. Findings were compared to those obtained using prospective arthroscopy as the gold standard; in addition, topographically defined sonographic findings before and after arthroscopic synovectomy were compared. Sonographic examination was performed in 12 patients with rheumatoid arthritis (13 knees) and 13 patients with psoriatic arthritis (14 knees) who had synovitis of the knee using an electronic linear transducer (7.5 MHz) or a mechanical sector transducer (10 MHz). This examination was followed within 1 week by arthroscopy, to compare the topography (intra-articular localization) and the morphology (sonographic patterns) of synovial proliferation. In 15 knees undergoing arthroscopic synovectomy, preoperative sonographic measurement of synovial thickness in the suprapatellar, medial parapatellar, and lateral parapatellar recesses was compared with arthroscopic visualization of synovial proliferation; 13 knees were reevaluated 2 months after arthroscopic synovectomy by sonography at the same sites. Three distinct sonographic patterns of synovial proliferation were confirmed by arthroscopic examination: a villonodular aspect in 12 knees; uniform thickening in eight knees, and overlapping layers in seven knees. About 50% of the knees showed more than one sonographic pattern, with no differences in pattern distribution between rheumatoid arthritis and psoriatic arthritis patients. A significant correlation was found between sonographic and arthroscopic evaluations of synovial thickness in the suprapatellar (P < 0.02) and medial parapateoffr recesses (P < 0.02), the sites of maximal synovial proliferation in our patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Early phenotypic activation of circulating helper memory T cells in scleroderma: correlation with disease activity.

OBJECTIVES: The differential expression of several accessory/activation molecules (CD26, CD29, CD45RA, CD25, MLR4, HLA-DR) on peripheral blood CD4+ and CD8+ T lymphocytes in patients with scleroderma was compared with that in controls and patients with other connective systemic diseases to look for evidence of the involvement of T cells in the disease process of scleroderma. METHODS: The two colour expression of surface molecules by circulating T cells was analysed with a panel of monoclonal antibodies and flow cytometry in 17 patients with scleroderma, 10 patients with systemic lupus erythematosus, and five patients with rheumatoid arthritis, and the results compared with those for 10 normal controls. The two colour T CD4+ phenotype was further compared between patients with active and quiescent disease in these patients with scleroderma. The coexpression of surface molecules by CD4+ T cells was also analysed by three colour flow cytometry in eight patients with scleroderma. RESULTS: Patients with scleroderma showed increased CD4+CD26+ and CD4+CD25+ percentages and absolute numbers and decreased CD8+CD29+ percentages compared with controls. Moreover, a significant correlation between the higher CD4+CD26+ T cell percentage and absolute cell numbers with disease activity was observed. Most of the CD4+ peripheral blood T cells from patients with scleroderma showed the CD26+CD45RA- phenotype by three colour flow cytometry analysis. CONCLUSIONS: The distinctive pattern of early helper memory T cell activation in these patients with rapidly evolving scleroderma supports the role of a T cell mediated mechanism in the progression of scleroderma.

Adult↗

Two preproendothelin 1 mRNAs transcribed by alternative promoters.

Endothelin-1, initially identified as potent vasoconstrictor secreted by vascular endothelial cells, was subsequently found to have many effects on both vascular and nonvascular tissues. We have identified from a human placenta cDNA library a clone (cDNA-2) which corresponds to a novel 5'-extended preproendothelin 1 (preproET-1) mRNA. Comparison with the known preproET-1 mRNA (cDNA-1), showed that the two molecules share the same coding sequence but differ in the 5'-untranslated region. Interestingly, cDNA-2 extends upstream of promoter regions previously shown to be essential for full preproET-1 expression. Primer extension and PCR analysis of human placenta RNA demonstrated the presence of additional transcription initiation sites located upstream of the previously identified preproET-1 CAP site. Moreover, the two mRNAs show different pattern of expression. To elucidate the mechanisms controlling the production of alternative transcripts we transfected COS-1 cells with a series of preproET-1 promoter deletion mutants. This analysis revealed that the human preproET-1 gene can be transcribed from a proximal and a distal promoter element which has hitherto been undetected. In addition, we demonstrate the presence of a region in the down-epithelial specific expression.

Amino Acid Sequence↗

Human preproendothelin-1 is converted into active endothelin-1 by baculovirus-infected insect cells.

To investigate biochemical and biological parameters involved in preproendothelin-1 (preproET-1) maturation we infected Spodoptera frugiperda (Sf21) cells with a suitable engineered baculovirus vector carrying the cDNA encoding the entire human 212 amino acids precursor. Culture supernatants were tested by RIA using an anti-ET-1 serum, ET-1-like immunoreactive material (IRM) was detected in the infected Sf21 cells but not in control, wild-type or mock-infected cells. Fractionation of the culture supernatant by RP-HPLC coupled to an ET-1 specific RIA yielded two main peaks corresponding to the retention times of human bigET-1 and ET-1. Furthermore, culture supernatant of preproET-1 expressing Sf21 cells elicited a characteristic dose-response vasoconstrictive activity on rabbit vena cava, consistent with the amount of ET-1 as estimated by RP-HPLC coupled to RIA. These results suggest that insect cells possess the enzymatic activities necessary for human preproET-1 full maturation even though no such peptide has ever been found in insect cells.

Animals↗

Metronidazole in head and neck surgery--the effect of lengthened prophylaxis.

Previous studies of antibiotic prophylaxis have shown that treatment for 24 hours has been beneficial for head and neck surgery and that longer periods of antibiotic therapy have not improved results. Metronidazole (Flagyl), unlike other antibiotics tested, has been shown to be effective in an experimental abscess, even if treatment is begun up to 120 hours after administration of inoculum. This article presents a prospective, randomized, multifactorial study comparing a brief vs. a prolonged duration of metronidazole and cefazolin prophylaxis in 50 consecutive patients with a head and neck cancer undergoing operation. Patients receiving 2 days vs. 7 or more days of antibiotic prophylaxis were compared. Statistical analysis of data demonstrated a striking reduction in severity of wound complications and a reduced incidence of wound infections in the group treated with 7 or more days of antibiotic prophylaxis.

Adult↗

Adenotonsillectomy. A safe outpatient procedure.

Traditionally, adenotonsillectomy in children and tonsillectomy in adults have been performed as inpatient procedures. Our experience with this procedure as outpatient started in 1975 at the University of Miami-Jackson Memorial Medical Center. From 1975 to 1987, 1428 cases performed in Florida and Cleveland were reviewed to evaluate the safety and efficacy of the technique used. Bismuth subgallate and epinephrine mixture for hemostasis is used without relying on electrocautery, ties, or suture technique to control bleeding. The incidence of immediate and delayed postoperative bleeding in a series of patients was extremely low (four [0.28%] of 1428 cases). Our technique has good hemostatic properties allowing vessels to contract and retract into the muscle of the tonsillar fossae and adenoid bed. Bismuth subgallate activates factor XII (Hageman factor) and, therefore, markedly accelerates the cascade of blood clotting. Outpatient adenotonsillectomy is safe, cost-effective, and minimizes psychologic implications, which may be an important factor, especially in children. Ambulatory adenotonsillectomy has not been well emphasized in the literature.

Adenoidectomy↗

[Myelography in obstetrical paralysis of the brachial plexus].

The use of myelography in obstetric palsies of brachial plexus is aimed at diagnosing root avulsion. This kind of lesion appears as the disappearance of the slightly transparent nerve roots which might be combined either with pseudomeningocele or with deformation of radicular pouch. In our study we considered 69 operated patients who had previously undergone myelography. In 74.2% of cases myelographic findings were confirmed at surgery. False positives and false negatives were 9.7% and 3.2%, respectively. Incorrect diagnoses were made in 12.9% of cases, because of misread lesions and incorrect evaluation of their location, usually at the cervico-dorsal junction. No side-effects were observed. Myelography appears thus to be extremely useful for both the preoperative evaluation and the choice of surgery in newborn children with obstetric palsy of the brachial plexus.

Brachial Plexus↗

The effectiveness of biofeedback-assisted relaxation in modifying sickle cell crises.

Eight outpatients with sickle cell disease received six EMG and six thermal half-hour biofeedback training sessions. Statistically significant changes in the desired directions were obtained for the following variables: (a) frontalis muscle tension, (b) digital temperature, (c) frequency of headache as a crisis symptom, (d) frequency of analgesic use, (e) perceived pain intensity, (f) frequency of self-treated crises, and (g) state anxiety. Nonsignificant changes in hospital chart data were found. A 6-month posttreatment follow-up questionnaire revealed the continued effectiveness of the training received regarding headaches and mild pains.

Adolescent↗

[IL-1Ra (recombinant human IL-1 receptor antagonist) in the treatment of rheumatoid arthritis: the efficacy].

Interleukin 1 receptor antagonist (IL-1Ra) is a naturally occurring IL-1 inhibitor, acting as a "receptor antagonist", which blocks IL-1 mediated signal transduction. In 1990 IL-1Ra was cloned and later on, a large numbers of studies led to disclosure of the crucial importance of the imbalance between IL-1 and IL-1Ra in the pathogenesis of rheumatoid arthritis (RA). In 1991, almost 8 years after the initial isolation of IL-1, recombinant IL-1Ra (IL-1ra, Kineret) was introduced in clinical trials involving patients with RA. Between 2001 and 2002 IL-1ra was approved by the US Food and Drug Administration and by the European Agency for the Evaluation of the Medicinal Products and in 2003 it was registered in Italy, too. In RA recombinant IL-1ra has been evaluated in 5 randomized, placebo-controlled clinical trials involving more than 2900 patients. Two of the trials involved the use of IL-1ra as monotherapy versus placebo and two trials in combination with methotrexate (MTX); the last trial explored the use of a fixed 100 mg/day IL-1ra dosage in a RA patient population including a wide array of co-morbid conditions as well as concomitant medications. The studies confirmed both the efficacy and the safety of IL-1ra in patients with active and severe RA. 43% of patients receiving 150 mg/day IL-1ra achieved a 20% response according to the American College of Rheumatology criteria (ACR20), compared to 27% in the placebo group. In the MTX combination therapy study, 42% of the patients receiving 1 mg/Kg/day of IL-1ra achieved an ACR20, 24% an ACR50 and 10% an ACR70. In each study, significant improvements in the Health Assessment Questionnaire scores (HAQ) were observed. There were rapid gains in the number of days at work or domestic activity in the treated patients, and the increases in productivity were dose related. At early 24 weeks, there was significant reduction of both the score for progression of joint space narrowing (JSN) and the Total modified Sharp-Genant score (a combination of erosion and JSN) in all treatment groups (30,75 and 150mg/day). The clinical benefits of treatment with daily subcutaneous injections of IL-1ra in active RA patients were maintained for up to 48 weeks. IL-1ra, a selective inhibitor of the IL-1 pathway, represents an important new biologic approach to treating patients with RA, that significantly reduces clinical signs and symptoms of the disease and joint destruction and has proved safe and well tolerated also in combination with other DMARDs and concomitant medications.

Arthritis, Rheumatoid↗

[Intra-articular treatment with the TNF-alpha antagonist, etanercept, in severe diffuse pigmented villonodular synovitis of the knee].

Pigmented villonodular synovitis (PVNS) is a rare pre-malignant disease that require aggressive treatment as surgical synovectomy, eventually followed by radiosynovectomy. Nevertheless, the disease often reoccurs after these treatments. To determine the safety and efficacy of intra-articular (IA) TNFalpha blockade with etanercept (ETN), before extended arthroscopic synovectomy, in severe PVNS of the knee, two patients, (a 26-year-old man with B27+ undifferentiated spondylarthropathy and a 32-year-old femal with seronegative oligoarthritis), affected by diffuse knee PVNS (diagnosis made by histological examination), resistant to IA corticosteroid injections and to repeated arthroscopic synovectomy, were submitted, after protocol approval by human research committee and patient's written informed consent to intra-articular etanercept (IA-ETN) treatment with a different dosage schedule: 12.5 mg weekly IA-ETN injection for 4 weeks, followed by extended arthroscopic synovectomy and of 25 mg IA-ETN injection for 4 weeks, respectively. Previous DMARDs treatment was continued in stable appropriate doses. Any adverse events were recorded throughout the study. The following parameters were considered as clinical endpoints: 1) Knee Joint Index (KJI: range 0-14); 2) Thompson index (THI: range 0-9) At the study entry and at the end of follow-up, high frequency ultrasound grey scale synovial thickening (US-ST) was also assessed. No adverse events were observed due to IA-ETN and to arthroscopic synovectomy. Marked improvement of knee disease activity over time and sustained functional recover was obtained. US-ST evaluation before treatment initiation and at the end of follow-up confirmed the regression of knee joint synovial proliferation.

Adult↗

Effect of D-penicillamine on the T cell phenotype in scleroderma. Comparison between treated and untreated patients.

To investigate the possible immunomodulatory mechanism of D-penicillamine in Scleroderma (Scl), we analysed the surface phenotype of circulating T lymphocytes in 17 Scl patients, 6 of these studied before and after D-penicillamine treatment, 8 only before and 3 only after treatment. The drug was administered for 6 to 24 consecutive months with a median daily dose of 500 mg. The study of peripheral blood purified T cells was carried out using single-colour immunofluorescence and flow cytometry analysis (Ortho Diagnostic System) with monoclonal antibodies such as OKT4 (CD4, helper/inducer), OKT8 (CD8, cytotoxic/suppressor), OKDR and MLR4 (activated T cells), and Tec-5/9 (CD26, activated T cells with specific helper function for B cell differentiation). All of the patients showed lower CD8+ and higher MLR4+ and DR+ T cells than the controls, while CD26+ and CD4+ circulating T lymphocytes were lower in all of the treated in comparison with all of the untreated patients. A decrease in CD26+, CD4+ and total T cells was also observed after treatment in the 6 patients studied pre- and post-therapy. These results support the hypothesis that D-penicillamine selectively impairs the helper T cell subset in Scl patients.

Adult↗