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Biomedical subjects

L Spiga

Publications and source records attributed to L Spiga.

At least 19 recordsLinked to original sources
PubMed1996

[Efficacy of bronchoscopic Nd:YAG laser therapy for laryngotracheal stenoses after long-term intubation].

From 1987 to 1993, 38 patients with laryngotracheal stenosis due to prolonged intubation were treated with the Nd:YAG-laser. A total of 45 stenoses were identified and classified according to endoscopic assessment. Patients who had an asymptomatic airway for at least 8 months and did not require further intervention were considered treatment successes. The best results were found in the diaphragmas and granulomas (86% and 65%), in stenoses less than 1 cm in length (61%) and in cases with less than 70% obstruction of the tracheal lumen (61%).

Adolescent↗
PubMed1994

Acute lung inflammation: neutrophil elastase versus neutrophils in the bronchoalveolar lavage--neutrophil elastase reflects better inflammatory intensity.

OBJECTIVE: To test the hypothesis whether PMN-Elastase in bronchoalveolar lavage fluid (BALF) could reflect neutrophil activity in the lower respiratory tract. DESIGN: Prospectively, morphologic findings of acute and chronic inflammation in the transbronchial lung biopsy specimens were compared with the numbers of neutrophils in the BALF and the concentration of PMN-Elastase in the same. SETTING: Ambulatory outpatient service of bronchology and respiratory physiopathology and intensive care unit of a communal hospital. PATIENTS: 50 ambulatory outpatients and 10 critically ill patients of the ICU, presenting infiltrative lung diseases. INTERVENTIONS: Transbronchial lung biopsies and bronchoalveolar lavage were performed through a fiberoptic bronchoscope. Venous blood samples were obtained after bronchoscopy. MEASUREMENTS AND RESULTS: Biopsy specimens and cell count in the BALF were examined by light microscopy. PMN-Elastase and albumin were measured in the BALF-supernatant and in the plasma. C-reactive protein (CRP) and a1 proteinase inhibitor (a1-PI) were measured in the plasma. Intrapulmonary originating PMN-Elastase was calculated with reference to albumin. The results concerning acute inflammation obtained by transbronchial lung biopsy (TBLB) (n = 16) correlated better with the levels of PMN-Elastase in the BALF (n = 21) than with the neutrophil count (n = 28) (p < 0.5 versus p < 0.025 for chi 2). The sensitivities and specificities of the above methods were respectively 76.9%, 100%, 100% and 100%, 95.2%, 63.1%. The intrapulmonary originating PMN-Elastase was about 99.7% of the measured BALF-Elastase. CONCLUSION: The PMN-Elastase concentration in the BALF is a more accurate indicator of the inflammatory intensity in the alveolar structures than in the number of neutrophils. It may therefore be useful to the clinician in his attempt to detect acute inflammation in the lower respiratory tract.

Acute Disease↗
PubMed1992

Diffuse panbronchiolitis observed in an Italian male.

We describe a case of a 43 year old man who presented with productive cough, dyspnea, severe obstructive ventilatory failure and diffuse micronodular shadows on chest roentgenogram. Bronchoalveolar lavage fluid analysis showed an increased total cellularity sustained by a huge neutrophilia. Sweat test was negative. Transbronchial lung biopsy and autopsy showed unit lesion of diffuse panbronchiolitis. This report represents, to the best of our knowledge, the first case of diffuse panbronchiolitis observed in Europe.

Adult↗
PubMed1992

[Unilateral gynecomastia induced by the use of anabolic steroids. A clinical case report].

The authors studied a case of left unilateral gynecomastia occurring in a 26-year-old body-builder after anabolic steroids assumption. The mammal features were found by echography and mammography and they showed the presence of a 3 cm diameter retroareolar area of gland tissue surrounded by fibrotic tissue. After excluding every likely cause giving gynecomastia through laboratory tests, it was clear a relationship with the assumption of high doses of anabolic hormones, with particular regard to methyltestosterone. Therefore, also this substance which on its own is not aromatized by extrasplanchnic tissues, can be responsible for man's mammal hypertrophy, if joined to a slight iatrogenic liver cytolysis.

Adult↗
PubMed1991

Alveolar macrophages from patients with AIDS and AIDS-related complex constitutively synthesize and release tumor necrosis factor alpha.

To verify the hypothesis that alveolar macrophages (AMs) from patients infected with HIV-1 could synthesize and release TNF alpha, AMs recovered from the BAL fluid of 11 patients with seropositive HIV-1 (six with AIDS and five with ARC) were tested in vitro for their ability to destroy TNF alpha-susceptible targets. Furthermore, the presence of TNF alpha was assessed in AM-conditioned supernatants on the basis of their cytotoxic activity and by using an immunoenzymatic test and immunoblotting. Transcription of the TNF alpha gene in AMs was also studied by means of the Northern blot analysis. AMs freshly recovered from patients infected with HIV-1 exhibited high levels of cell-mediated cytotoxicity against U937 targets, and the addition of a polyclonal anti-TNF alpha antibody resulted in a significant inhibition of the target lysis. Cell-free supernatants conditioned by unstimulated AMs exerted high levels of cytotoxic activity against TNF alpha-sensitive targets, whereas duplicate, neutralization experiments performed in the presence of an anti-TNF alpha antibody proved that the observed cytotoxic activity was mostly mediated by TNF alpha. The presence of high amounts of TNF alpha in the conditioned media was confirmed by the immunoenzymatic test. In addition, the immunoblot analysis showed that the TNF alpha released by AMs has a Mr 17,000 band, identical to a standard preparation of recombinant TNF alpha. The Northern blot demonstrated that unstimulated AMs express detectable levels of mRNA transcripts for TNF alpha. Taken together, our data support the concept that AMs from patients with HIV-1 infection constitutively release TNF alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Complex↗
PubMed1991

Prognostic significance of the evaluation of bronchoalveolar lavage cell populations in patients with HIV-1 infection and pulmonary involvement.

To investigate the prognostic utility of the morphologic and immunologic evaluation of BAL cell populations in determining mortality risk, we analyzed BAL data obtained from 115 patients infected with HIV-1. Forty fatal outcomes occurred within 73 patients with OI. The OI patients who died showed a significant increase in neutrophils with respect to surviving patients. Furthermore, the finding of a BAL neutrophilia in HIV-1-infected patients with OI strongly correlated with a high risk of death. Among 42 cases without OI, 11 patients died. Patients without OI who had a fatal outcome showed an increase in CD3+ and CD8+ BAL lymphocytes with respect to the survivors. The presence of a lymphocytic alveolitis was associated with a significant increase in the mortality rate. Taken together our data suggest that the evaluation of the BAL cell populations might be useful in predicting the risk of fatal outcome in patients with HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Cytotoxic events taking place in the lung of patients with HIV-1 infection. Evidence of an intrinsic defect of the major histocompatibility complex-unrestricted killing partially restored by the incubation with rIL-2.

To characterize the cytotoxic events taking place in the lung of patients with HIV-1 infection, we studied the cells recovered from the bronchoalveolar lavage (BAL) of nine patients with AIDS, seven patients with AIDS-related complex, and two patients with lymphadenopathy. Phenotypic analysis was coupled to a series of functional evaluations of nonspecific cytotoxic abilities performed on lung effectors, including their property to bind K-562 targets, to release natural killer cytotoxic factor (NKCF), and to become cytotoxic following in vitro activation with rIL-2. Our results demonstrated that lung cells bearing the NK-related CD16, CD56, and CD57 antigens were quantitatively increased, irrespective of the disease stage. The majority of the cells also coexpressed the CD3 molecule and the alpha/beta T cell receptor (TCR), notably the phenotype characterizing MHC-unrestricted cytotoxic T cells. From a functional point of view, a severe impairment of the spontaneous cytotoxic ability was demonstrated in most patients. Evaluation at the single cell level showed a normal percentage of the effector/target conjugates formed by HIV-1 lymphocytes. The release of NKCF was undetectable in patients with AIDS even following lectin stimulation, whereas BAL cells from patients with earlier infection produced and/or could be triggered to release discrete amounts of NKCF by incubation with PHA. Studies designed to activate lung cytotoxic cells with rIL-2 showed that in most patients the stimulation of effector cells with rIL-2 enhanced the spontaneous killing and elicited a lymphokine-activated killer (LAK) phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1988

Transbronchial lung biopsy and bronchoalveolar lavage in diagnosis of diffuse infiltrative lung diseases.

We investigated 801 patients with lung infiltrates who underwent transbronchial lung biopsy (TBB) and performed cytologic studies of lavage fluid of 491 patients who also underwent bronchoalveolar lavage (BAL). A specific histopathological diagnosis was made in 232 cases (29%). Histopathological changes consistent with the clinical pattern were present in 296 cases (37%). The diagnostic yield of TBB was 66%. Routine evaluation of BAL fluid allowed us to make a specific diagnosis in 49 cases. The role of the pulmonary pathologist in the interpretation of TBB and BAL specimens is discussed.

Biopsy↗
PubMed1988

Phenotypical and functional analysis of bronchoalveolar lavage lymphocytes in patients with HIV infection.

The lungs of patients with acquired immunodeficiency syndrome (AIDS) are frequently affected by opportunistic and nonopportunistic infections and pulmonary localizations of Kaposi's sarcoma. The aim of this study was to verify whether, in patients with human immunodeficiency virus (HIV) infections, immunologic pulmonary abnormalities set the stage for the lung complications. For this purpose, a phenotypic and functional characterization of lymphocytes recovered from the bronchoalveolar lavage (BAL) fluid of 24 patients with clinical symptoms and signs of HIV infections was performed (six patients with constitutional disease, five patients with neurologic manifestations, and 13 patients with full-blown AIDS). Our data showed that (1) in patients with HIV, the percentage and absolute number of pulmonary CD8 cells were significantly increased over those in control subjects (in 25% of these patients, mostly with full-blown AIDS, CD8 cells sustained an alveolitis); (2) lung CD4 cells were reduced in percentage but not in absolute number, with the exception of patients with AIDS in whom a significant decrease of the absolute number of BAL CD4 cells has been found (further phenotypic analysis of CD4 lymphocytes showed a reduction of the expression of T4A, B, and E with respect to the T4, T4C, T4D, and T4F epitopes); (3) although the number of BAL cells bearing NK-related determinants was increased, we were unable to demonstrate any in vitro natural killer cell activity. We suggest that the impairment of a proper NK activity in the lungs of these patients might be central to the mechanisms leading to the in situ immunodeficiency state and to the pulmonary complications characterizing AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Transbronchial lung biopsy in infiltrative lung disease. The importance of the pathologic approach.

Infiltrative diffuse lung diseases represent a heterogenous group of lesions with overlapping clinical and roentgenological features. Their diagnosis frequently needs a pathologic approach. We report our experience (671 patients with lung infiltrates) with transbronchial lung biopsy (TBB) procedure. The results of morphologic investigation were subdivided into three groups: 1) A specific morphologic diagnosis was made in 192 cases (29%) 2) Histopathologic changes well consistent with the clinical pattern were present in 258 patients (38%) 3) Non-specific lesions were found in 221 cases (33%). The diagnosis yield of the method was of 67%. UIP, DIP, Pulmonary Angiitis and Granulomatosis, Bronchiolitis Obliterans-Organizing Pneumonia and other rarer lung diseases may not be diagnosed on the basis of lesions present in TBB specimens.

Biopsy↗
PubMed1986

Transbronchial lung biopsy in pulmonary sarcoidosis. Is it an evaluable method in detection of disease activity?

To assess the value of transbronchial lung biopsy in the evaluation of disease activity in pulmonary sarcoidosis, lung biopsy specimens obtained from 37 patients with this disease and their cellular patterns of bronchoalveolar lavage were studied. Morphologic analysis has showed peculiar lesions: predominant interstitial alveolitis consisting of mononuclear cells and scattered neutrophils, and eosinophils, diffuse in 13 cases and focal in 11 cases, interstitial nodular clusterings of mononuclear cells (five cases), diffuse intraalveolar infiltration of macrophages (one case), granulomas (27 cases), hyaline membranes (one case), intraalveolar (two cases) and interstitial (six cases) fibrosis, and finally cuboidal metaplasia of alveolar lining cells (eight cases). Hyaline membranes were always combined to a diffuse alveolitis consisting of some neutrophils. Only diffuse alveolitis was significantly associated with a high lymphocytosis in BAL (p less than 0.05).

Adult↗
PubMed1985

[Evaluation of the diagnostic role of the carcinoembryonic antigen in ascitic fluid].

The diagnostic role of carcinoembryonic antigen (CEA) in ascitic fluid was evaluated in order to assess whether or not ascitic haemorrhage is related to cancer. A total of 30 patients with ascitic haemorrhage were analysed (17 had cirrhosis, 5 non-metastasised cancers and 8 metastasised cancers). CEA radioimmunoassay was performed in serum and ascitic fluid. The results showed that CEA in the ascitic fluid highlighted a clear distinction between the average values of the 3 groups examined serum assay did not. Results were respectively: cirrhotic patients 6.11, non-metastasised cancers 38 and metastasised cancers 204.12. Ascitic fluid measurement revealed considerable variation, especially between the first and third groups examined (p = .00000004). Although CEA must be regarded as an aspecific laboratory test for malignancy, these results suggest that CEA determination in the ascitic fluid may be useful for screening patients with ascitic haemorrhage.

Aged↗