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Biomedical subjects

L Marchi

Publications and source records attributed to L Marchi.

At least 55 records · Page 3Linked to original sources

[Hutchinson-Horton giant cell arteritis and rhizomelic polymyalgia. II. Rhizomelic polymyalgia. Arteritic polymyalgia].

Rhizomelic polymyalgia is an inflammatory form. Its site of choice is the shoulder girdle and it is almost solely observed in elderly subjects. An account is given of its epidemiological, clinical and anatomopathological aspects. Its aetiology is also discussed with particular reference to its possible immunological or vascular origin. The rheumatic symptoms of rhizomelic polymyalgia are similar to those observed in temporal arteritis. Since artery lesions are found in most cases, the name "polymyalgia arteritica" has been suggested as an alternative clinical description by Hamrin .

Adrenal Cortex Hormones↗

[Hutchinson-Horton giant cell arteritis and rhizomelic polymyalgia. I. Hutchinson-Horton arteritis].

Temporal arteritis (also known as Horton's or giant cell arteritis) is a panarteritis of the large and medium-calibre cranial vessels. An account is given of its epidemiological, clinical and anatomopathological aspects and its involvement of the locomotor apparatus (Horton's rheumatism). Reference is also made to the close relationship between temporal arteritis and pulseless disease. Some workers are of the opinion that they share the same aetiology, and that their clinical expression in different areas is dictated by age and constitutional factors.

5'-Nucleotidase↗

[Amyloidosis. II. Current pathogenetic and clinico-nosographic aspects].

Amyloidosis is due to the overproduction of a precursor protein and its conversion into products capable of polymerisation into fibrils. The primary form, or that associated with multiple myeloma or Waldenström's macroglobulinaemia, marked by the presence of protein AL, includes the overproduction of Ig light chains followed by conversion on the part of lysosome enzymes. The forms can thus be classified as immunoproliferative diseases (plasma-cell dyscrasias). Secondary amyloidosis is primarily associated with neoplasia or chronic inflammation. Its biochemical label is the AA protein. Initially, there is overproduction of protein SAA, while the formation of AA-amyloid fibrils may theoretically be attributed to a variety of factors: changes in the amount of circulating SAA, the presence of amyloidogenetic SAA, variations in the activity of SAA catabolic systems, insufficient removal of acculated fibrils. The way in which the immunocompetent system intervenes is a controversial subject. Lesser froms of amyloidosis are known in which there are local deposits of amyloid: APUD-amyloidosis, amyloidomas. In some forms, the features of systemic accumulation are maintained, but only one organ is primarily involved. They are rarely of clinical significance (e.g. senile amyloidosis). Current biochemical techniques enable a clinical and nosographic distinction to be drawn between an Ig (AL)-amyloidosis and non-Ig (AA, APUD and AS) forms.

Amyloid↗

[Amyloidosis. I. Recent findings concerning amyloid substance].

The considerable progress made recently in the study of amyloid substance have led to the identification of numerous organised protein components in typical microfibrillar structures. In spite of the biochemical heterogeneity of fibril proteins, it is still possible to find similar chemicophysical and tintorial features in the various types of amyloid, probably due, at least in part, to the common Beta type molecular configuration, a structure proper to fibril proteins. In so-called primary amyloidosis and in that associated with myelomatous diseases, the principal protein component consists of AL protein, correlated with the light immunoglobulin chains, with which analogies have been observed both in the amino acid sequence and in antigenic characteristics. In secondary amyloidosis, AA protein, which is unrelated to immunoglobulins or other known human proteins, is prevalent. AA protein probably derives from a serum globulin, SAA, whose blood levels increase during numerous pathological processes, particularly in those of neoplastic or inflammatory type. The origin of serum protein, which might be either a normal tissue component released under stimulus or a reagent of the acute phase synthesised ex novo, and its function, which is probably of immunomodulator or more specifically immunosuppressive type, are still to be defined. In all forms of amyloidosis studied, a common observation is the presence of AP protein, organised in pentagonal structures. This protein would appear to derive from a serum component defined as SAP, with a marked affinity for amyloid fibrils. Also identifiable are other forms of amyloid such as APUD-amyloid, which probably derives from polypeptide hormones, and AS amyloid, which is present in some organs of elderly patients and is biochemically identifiable at cardiac level with A(SCA) protein. Still awaiting definition in amyloid tumours or amyloidomas is the precise chemical composition of deposited proteins.

Amyloid↗

[Immunopathology of the hepatic damage caused by alcohol. Recent acquisitions].

Recent findings in the pathogenesis of alcoholic liver disease suggest that immunological factors play a leading part in addition to the damaging action of alcohol. Immunological phenomena affected by Mallory's bodies take on considerable importance with respect to humoral immunity. As regards cell immunity, the leucocyte migration inhibition test shows that the lymphocytes of liver-diseased alcoholics can produce the migration inhibiting factor. Deposit of collagen in the liver appears to be induced by lymphocytes sensitized by Mallory's bodies. Recent experimental studies based on the use of collagen synthesis inhibitors (colchicine and penicillamine) may have therapeutic implications.

Antibody Formation↗

[Osteopetrosis (Albers-Schoenberg disease). III. Current nosographic aspects and relations to other condensing osteopathies].

A malignant paediatric variety and an adult variety of Albers-Schönberg disease are normally distinguished. On the basis of recent findings and personal observation it would appear advisable to accept two different courses of Albers-Schönberg disease in adults: one resembling the malignant infant form and the other with slow, practically asymptomatic (apart, obviously, from the skeletal lesions) course allowing for prolonged survival. This classification is of considerable practical importance for prognosis and therapeutic purposes. Other hereditary-familial and constitutional condensing osteopathy pictures exist that present radiological stigmata similar to those seen in Albers-Schönberg disease. The interest of the relations between A-S disease and certain of these condensing osteopathic conditions is obvious.

Diagnosis, Differential↗

[Osteopetrosis ( Albers-Schönberg disease ). II. Personal contribution].

Five cases of marble bones in two families living near Brescia are presented. Case 1 (42-yr-old female) was a typical malignant form with deep and extensive eburnation, many pathological fractures, concomitant osteitis and the formation of many fistulae, massive spleen enlargement and infarct, and marked anaemia with clear signs of extra-medullary haemopoiesis. The patient died 5 yr after her first admission. Two of her brothers had had an identical, fatal form. Case 4 (28-yr-old male) was much the same: virtually general osteosclerosis despite the difference in age, marked spleen enlargement, a history of fractures, serious anaemia and extramedullary haemopoiesis. Benign pictures were seen in cases 2 and 3 (73- and 68-yr-old females). In case 5 (25-yr-old male), typical bone condensation was the only significant pathological sign. It is suggested that this, too, may be seen as a "benign" form.

Adult↗

[Osteopetrosis (Albers-Schönberg disease). I. Clinico-radiological and pathogenetic aspects].

An account is given of recent clinical and radiological findings with respect to Albers-Schönberg disease. Reference is made to its hereditary transmission modality and clinical picture (skeletal lesions and haematological distress), and to its radiological aspects. Suggestions are made with respect to the aetiopathogenesis of disease. Stress is laid on the as yet undefined mechanism of "genotypical condensing dysplasia". The relation between osteopetrosis and thyrocalcitonin is discussed, though no definite conclusions could be drawn from the hormone levels determined in a personal series.

Adult↗