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Biomedical subjects

L Marchi

Publications and source records attributed to L Marchi.

At least 37 records · Page 2Linked to original sources

[Angiitis caused by hypersensitivity or microscopic polyarteritis nodosa. Recent findings. I. Nosographic aspects].

Hypersensitivity angiitis or microscopic polyarteritis nodosa is one of the necrotising angiitis and was not distinguished from classic polyarteritis nodosa until the Fifties. The present study examines the nosographic aspects of necrotising angiitides with reference to the anatomohistological, aetiopathogenic and clinical criteria proposed by various Authors for their identification and with emphasis on the fact that all these factors must be borne in mind for the purpose of diagnosis. The factors that make it possible to distinguish hypersensitivity angiitis from other necrotising angiitides are, at clinical level, the presence of skin lesions, and in anatomohistological terms the involvement of the small blood vessels and leucocytoclasia.

Humans↗

[Rubber-band ligation of hemorrhoids].

In the last few years there has been a considerable reduction in surgical treatment of piles; on the other hand a series of therapeutic outpatient treatments has developed aiming at a conservative management of piles. This new approach is mainly due to high costs in surgical treatment. In accordance also with the experience of the most important proctologic centres, nowadays only 26% of our patients suffering from piles undergo operation, since we regard rubber band ligation as a more rational and economical method for the treatment of hemorrhoids. The instruments and the technique related to band ligation have been described together with some modifications suggested by our personal experience. Indications and contraindications for rubber band ligation have been analyzed pointing out that, in our opinion, such an approach is advised also in the management of stage 3 and 4 hemorrhoids; on the other hand the surgical treatment has its role when band ligation is contraindicated. We have then reported about the good results obtained with 162 patients suffering from stage 2, 3 and 4 hemorrhoids, by using band ligation. Our experience, in accordance with international literature, enables us to emphasize the almost complete absence of complications and the satisfactory results of band ligation, even if compared to other methods.

Hemorrhoids↗

[Use of anal dilators in the conservative therapy of anal rhagades].

The AA. refer their results in the treatment of anal fissure, using surgical and conservative methods. In their experience, internal lateral sphincterotomy, according to the literature, is the best treatment. The use of anal dilators is effective, but it always needs the patient's compliance.

Anal Canal↗

[Endobrachyesophagus as a sequel of esophagitis due to caustics].

Caustic ingestions show, nevertheless medical progress, many clinical and therapeutical problems; particularly risk factors of stenotic and neoplastic evolutions as well as of functional outcome are little known. A case of Barrett's esophagus after acid sulphuric ingestion is the starting point of some personal considerations, after revision of literature.

Burns, Chemical↗

[Blood hypereosinophilias. IV. Symptomatic hypereosinophilias: connective tissue diseases, neoplasms, blood diseases, various causes].

Among the symptomatic hypereosinophilias and apart from pathologies covered in Note III, diseases of the connective tissue, neoplasias, blood diseases and other conditions are also examined. Two connective tissue diseases often accompanied by hypereosinophilias are Churg and Strauss angiitis and eosinophilic fascitis. Churg and Strauss angiitis (of which 2 personal cases are reported) is a systemic vasculitis usually seen in combination with bronchial asthma and haematic eosinophilia. Eosinophilic fascitis is quite rare and poorly understood. Its symptoms include hardening of the skin and eosinophilia and it is difficult to differentiate from progressive systemic sclerosis. The possible reasons why hypereosinophilia sometimes accompanies benign and more often malignant tumours are discussed. The pathogenesis of the hypereosinophilias encountered in diseases of the blood is still controversial. One hypothesis is that hypereosinophilia is an intrinsic symptom of the blood disease, others believe it to be an immunological response. In this context two personal cases are reported as examples: one of hypereosinophilia in a malignant non-Hodgkins lymphoma, the second in an IgG plasmacytoma. Particular attention was paid to the hypereosinophilia that accompanies the rare blood disease known as angioimmunoblastic lymphoadenopathy with dysproteinaemia (LAID) of which a personal case is reported.

Aged↗

[Blood hypereosinophilias. III. Symptomatic hypereosinophilias: allergic, cutaneous, parasitic, infective, pulmonary and gastro- intestinal diseases].

The most frequently observed of the symptomatic hypereosinophilias are those caused by allergic, cutaneous, parasitic, infectious, pulmonary and gastroenteric conditions. Among the allergic conditions, particular attention is paid to the hypereosinophilias caused by allergic asthma, gastroenteritis and reactions to drugs. The most common skin conditions linked to hypereosinophilias such as bullous dermatites and angio-oedema are considered. Turning to the parasitic conditions, the various types of parasite that may produce hypereosinophilias by infesting the organs are examined. The aetiology of tropical eosinophilias and the pathogenetic mechanism that may trigger hypereosinophilias are discussed. It has been thought advisable to group the lung pathologies associated with hypereosinophilias under a separate heading, despite the indubitable importance of the allergic element in these events. Among gastroenteric conditions, the one considered is eosinophilic gastroenteritis whose clinical, anatomopathological and aetiopathogenic features are still not quite clear. Examples of certain forms of secondary hypereosinophilias are given in the form of four unusual personal cases of bronchial asthma, filariasis, an exceptional infestation by Hypoderma bovis and eosinophilic gastroenteritis.

Adrenal Cortex Hormones↗

[Hypereosinophilia of the blood. II. Classification. Benign essential hypereosinophilia. Eosinophilia caused by systemic eosinophilic hemopathies].

Following a previous note on the latest development in the study of eosinophilic granulocytes, a nosographic classification scheme is proposed for the problematic group of haematic eosinophilias. The scheme is based on the division of hypereosinophilias into three basic groups: benign idiopathic hypereosinophilias, hypereosinophiliasis caused by systemic eosinophilic blood diseases and symptomatic hypereosinophilias. Two rare events, hereditary familial eosinophilia and bening, non-familial idiopathic eosinophilia may be added to the benign idiopathic hypereosinophilias group. The group of hypereosinophilias caused by systemic eosinophilic blood diseases is still controversial and difficult to interpret. Particular attention is paid to the so-called "idiopathic hypereosinophilic syndrome" (HES), an umbrella term under which there is a current tendency to group a heterogeneous series of disorders characterised by long-lasting hypereosinophilia where there is no known reason for the increased eosinophilic granulocyte rate. Clinical and physiopathological features are then described to decide whether a given condition lies within the scope of this still little known syndrome.

Eosinophilia↗

[Hypereosinophilias of the blood. I. Eosinophilic granulocytes].

A knowledge of eosinophil granulocytes is indispensable for the study of hypereosinophilia. For this reason, the most recent findings relating to eosinophil morphology, production/regulation mechanism, and function are reported. Particular attention is given to enzyme populations, local control mechanisms and eosinophil cell surface receptors. Among the various enzymes present in the eosinophil, major basic protein (MBP), with its capacity to damage the cells of many organs, plays an important part; other enzymes include eosinophil peroxidase (EPO), arylsulphatase B, phospholipase D, histaminase and cationic proteins (ECP). Factors influencing eosinophil tissue concentrations and mode of action are considered. Recent findings agree on the role of eosinophils in immunological reactions and parasitic infestations: eosinophil plays a part in an immunological physiopathological sequence: it may, act as a killer cell with selective action against invading parasites, or it may be an immune modulator, anti-inflammatory cell able to surround inflammatory reactions and prevent them from spreading.

Amine Oxidase (Copper-Containing)↗

Immunological studies on the origin of the precursor cells in Waldenström's macroglobulinemia.

Preliminary results obtained with OK anti-T and FMC anti-B monoclonal antibodies in a study of peripheral blood lymphocytes from eight patients with Waldenström's macroglobulinemia and of bone marrow lymphocytes from three patients, are reported. Endocytoplasmic immunofluorescence revealed a 1 to 3% marrow plasma cell fraction in all three cases, together with an approximately 10% increase in the monoclonal precursor compartment. Displacement of the peripheral blood helper: suppressor ratio was also observed using anti-T-lymphocyte monoclonal antibodies.

Humans↗

[Behçet's disease. II. Etiopathogenetic and therapeutic aspects. Personal observations].

The aetiopathogenesis of Behcet's disease is still not known. In the light of current knowledge, the most likely hypothesis seems to be that of an autoimmune reaction set off by viral, bacterial or other antigens. The reaction may manifest itself in the vascular system, and cause vasculitic conditions in genetically susceptible subjects. The existence of a constitutional susceptibility factor would seem to be confirmed by the high and significant incidence of determinant histocompatibility antigens: HLA-B5 in Japan and in Mediterranean countries, HLA-A2 and HLA-A28 in Great Britain and the United States. Corticosteroids are most commonly used to treat the disease; immunosuppressants are also recommended--possibly in association with corticosteroids. Three personally observed cases of Behcet's disease are reported. The first was an example of the disease in its complete form (oral and genital aphthae, ocular lesions); the second case incomplete (no genital aphthae); and the third characterised by severe neurological involvement (neuro-Behcet).

Adult↗

[Behçet's disease. I. Clinical and histopathological aspects].

Behçet disease is characterised by a triple symptom picture (genital and oral aphthae, ocular lesions) named after the Turkish dermatologist, Hulusi Behçet. It is found all over the world, but is particularly frequent in Japan and the Mediterranean basin. Adult males are primarily affected. The classic symptomatological triad may be accompanied by other manifestations involving the skin (hypersensitivity to microtrauma is a peculiar feature), joints, nervous system, gastroenteric system, cardiovascular system (phlebitis, phlebothrombosis), lungs and kidneys. There is a chronic course marked by periods of exacerbation and remission, which may last for years. Diagnosis is clinical only, since neither the laboratory data nor the histopathological signs of vasculitis are truly pathognomonic. The prognosis quoad valetudinem is uncertain with regard to the eye lesions, which may result in blindness. The prognosis quoad vitam is usually good, though it is poor if the nervous system is involved, or in the event of lung and large vessel lesions, since death may occur from haemoptysis or the rupture of aneurysms.

Behcet Syndrome↗

[Hutchinson-Horton giant cell arteritis and rhizomelic polymyalgia. III. Current pathogenetic and nosographic aspects].

There is much evidence to suggest that temporal arteritis and rhizomelic polymyalgia are both immunological diseases. The classic results of experimental pathology are discussed, together with the relations between rhizomelic polymyalgia and both virus hepatitis B and the HLA system. From the clinical standpoint, it is now agreed that differences in individual response may lead to either a synovial or an arteritic response in both forms. Their association in what Hamrin has called "polymyalgia arteritica" is also common.

Antigen-Antibody Complex↗