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Biomedical subjects

L Vago

Publications and source records attributed to L Vago.

106 records · Page 6Linked to original sources
PubMed1989

HIV encephalopathy and lymphadenopathy: cells associated with viral antigens.

HIV associated subacute, micronodular encephalitis and lymphadenopathy were compared with regard to demonstrable HIV antigens and characterization of HIV antigen expressing cells. In the brain, both gag- and env-coded antigens were confined to cells of micronodular lesions with immunophenotype of monocyte/macrophages (KiM6+, 9.4+, CD4+/-). The micronodular lesions were also infiltrated by some lymphoid cells, predominantly CD8+. In lymphadenopathic nodes, gag-encoded antigens were demonstrable almost exclusively in follicles/germinal centres in association with follicular dendritic cells, whereas env-antigens usually were not found. Follicular involution was related to destruction of follicular dendritic cells and infiltration of CD8+ lymphocytes within the germinal centres. During follicular involution, HIV-gag antigens diminished in parallel with destruction of the network of dendritic reticulum cells. These findings indicate important tissue related differences in HIV expression. In addition, a possible participation of CD8+ cells in the pathogenesis of HIV induced tissue lesions is suggested.

AIDS-Related Complex↗
PubMed1989

Ovarian and cervical thyroid struma. A case report.

A case of associated ovarian and cervical thyroid struma in a 24-year old female, is reported. The patient was affected by a right thyroid cold nodule which at fine needle aspiration biopsy showed the cytological pattern of benign follicular adenoma; as the nodule was increasing after one year of suppressive therapy, the patient was selected for surgery. At admission during routine physical examination a previously undetected left pelvic mass was discovered: at laparotomy it proved to be a cystic tumor consisting of benign thyroid tissue at the level of left ovary. Histology confirmed the diagnosis of follicular adenoma of the right thyroid nodule after right lobectomy. Albeit cases of thyroid tissue in the ovary have been reported, true struma ovarii is a rare occurrence. A concomitant hyperthyroidism is seen in only 1/4 of cases and the patients can be divided into three groups: hyperthyroid, ascitic and asymptomatic: our patient was in the asymptomatic group.

Adenoma↗
PubMed1988

Defective chemotaxis of human alveolar macrophages.

Human pulmonary alveolar macrophages (PAM) from normal subjects, unlike peripheral blood monocytes (PBM), are unable to migrate in response to various chemoattractants, such as C5a,f-Met-Leu-Phe (fMLP) and phorbol myristate acetate (PMA). Inflammatory PAM obtained from sarcoid patients also failed to exhibit a chemotactic response. Binding studies using [3H]PDBU demonstrate high affinity receptors for phorbol esters on PAM surface, in a comparable amount (1.5-2.4 X 10(6) receptors/cell) to PBM (8-15 X 10(5) receptors/cell). Moreover, PAM were comparable to PBM in terms of superoxide anion (O2-) release in response to PMA. Therefore, the defective locomotory response of PAM cannot be accounted for by lack of chemoattractant receptors, at least for phorbol esters. Worthy of note, PMA receptors on PAM are able to transduce activating signals for O2- generation. These findings show that competence for chemotaxis is heterogeneously distributed among mononuclear phagocytes.

Antigens, Surface↗
PubMed1987

Brain pathology induced by infection with the human immunodeficiency virus (HIV). A histological, immunocytochemical, and electron microscopical study of 100 autopsy cases.

Neuropathological examination of brain tissue of 100 patients with infection by the human immunodeficiency virus (HIV), including 98 with clinically manifest acquired immune deficiency syndrome (AIDS), revealed distinct multifocal-disseminated and diffuse brain tissue lesions, which can be regarded as HIV-induced brain lesions: multifocal giant cell encephalitis (MGCE; 4) and progressive diffuse leukoencephalopathy (PDL; 25). These lesions were found in 38 brains, and in 17 in absence of infectious, necrotizing or inflammatory changes of other types. In 13 brains, a combination of MGCE with PDL was seen, suggesting a spectrum of HIV-induced brain lesions. MGCE is characterized by perivascular accumulations predominantly of rod cells, monohistiocytes and macrophages, all of which are strongly labeled with a monoclonal antibody to macrophages. Most conspicuous are multinucleated giant cells which are also labeled by anti-macrophage antibody, and which can be regarded as evidence of the local presence of HIV, as confirmed by electron microscopical detection of HIV particles in four MGCE brains, and by immunocytochemical detection of HIV proteins in two MGCE brains. PDL is characterized by a triad: diffuse myelin loss, astroglial proliferation, and infiltration by mono- and multinucleated macrophages. HIV-induced lesions can be morphologically differentiated from histopathological brain lesions known in immunosuppression, including what is called here nodular encephalitis ["subacute encephalitis" of the literature, in most cases attributable to cytomegalovirus (CMV) or toxoplasmosis], by their characteristic histopathology including the hallmark presence of multinucleated giant cells, by direct immunocytochemical and electron microscopical demonstration of HIV in the lesions, and by the absence of opportunistic agents (bacteria, fungi, Toxoplasma, CMV, HSV or papovaviruses). Diffuse poliodystrophy (diffuse proliferation of astroglia with swollen nuclei, occasionally minor neuronal loss and rod cell proliferation) was found in the cerebral cortex and other gray matter in half of all brains, including cases with gyral atrophy, and may be another correlate of HIV damage to the brain. Morphological delineation of HIV-induced brain lesions is a necessary prerequisite for a meaningful clinical definition of HIV-induced cerebral disease.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Immunohistochemical reactivity of anti-LAV p18 monoclonal antibody in lymph nodes from PGL and AIDS patients.

This study deals with the immunohistochemistry of a monoclonal antibody (Mab) raised against the p18 protein of the LAV virus in lymphnodes from 20 cases of persistent generalized lymphoadenopathy (PGL) (2) and 6 of acquired immunodeficiency syndrome (AIDS) (3). In all the PGL cases that have been studied, we observed a very important disruption of the follicular dendritic cell's (FDC) framework in the germinal centers which is associated with the presence of an increased number of Leu2a+ lymphocytes inside the germinal centers. This observation is consistent with the main morphological feature of the lymphnodes in the PGL syndrome which is mainly characterized by lesions of FD cells.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Ultrastructural study of renal involvement in two females with Anderson-Fabry disease.

Anderson-Fabry disease (AFD) is a rare X-linked lipid storage disorder due to a deficient lysosomal a-galactosidase A (a-Gal) activity. In males with the classic form of the disease the enzymatic defect leads to progressive accumulation of glycosphingolipids (GL) in different organs, mainly in the kidney, heart, and brain, causing severe multisystem failure. AFD is usually mild in heterozygous females, but severe cerebrovascular, renal, and cardiac manifestations have been rarely described. The aim of this study is to describe renal involvement of mild symptomatic female carriers by ultrastructural analysis focusing to microvascular lesions, considered to be one of the major causes of systemic disease in AFD. Resin-embedded renal biopsies from 2 sisters with isolated mild proteinuria and belonging to a family group with AFD were observed by light and electron microscopy. In spite of the mild clinical symptoms, diffuse GL storages were demonstrated in all types of glomerular cells and in interstitial endothelial cells. Moreover, platelets were frequently observed in glomerular vassels, a feature coherent with a possible role of prothrombotic state, and platelet activation, in early glomerular lesions.

Fabry Disease↗
PubMedDate not supplied

Polymerase chain reaction for Mycobacterium tuberculosis complex DNA. Use on negative archival Ziehl-Neelsen cytologic samples.

OBJECTIVE: To evaluate the usefulness of a nested polymerase chain reaction (PCR) for Mycobacterium tuberculosis complex on routinely stained cytologic samples from patients with extrapulmonary tuberculosis. STUDY DESIGN: Nested PCR for the detection of a fragment of the IS6110 insertion sequence of M tuberculosis complex was applied to Ziehl-Neelsen-negative archival cytologic slides of serous effusions (pleural [n = 7], peritoneal [n = 1] and pericardial [n = 1]) and a lymph node fine needle aspirate (n = 1) from nine human immunodeficiency virus (HIV)-positive patients with autopsy-proven active extrapulmonary tuberculosis. Malignant effusions and aspirates from nine HIV-positive patients with non-Hodgkin's lymphoma and pleural effusions from seven HIV-negative patients with heart failure were used as controls. DNA was extracted after removing the coverslip and gently scraping the cytologic sample from the slides. RESULTS: In all cases, enough DNA was obtained for PCR without any significant loss of integrity, as demonstrated by PCR positive for HLA-Dq. PCR for M tuberculosis was positive in 8 of the 10 samples (80%) from patients with tuberculosis but also in three samples (30%) from HIV-positive patients in the control group. None of the samples from the HIV-negative patients was positive. CONCLUSION: PCR for M tuberculosis can be reliably performed on archival cytologic slides from extrapulmonary samples, but although it is highly sensitive, it may lead to positive results in immunocompromised patients without any sign of active tubercular disease.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Local impairment of immunoreactivity in HIV-infected women with HPV-related squamous intraepithelial lesions of the cervix.

AIMS AND BACKGROUND: The aim of this study was to compare the local immune response in two groups of patients with high-grade cervical intraepithelial squamous lesions (SIL): one with HIV infection and the other with HPV infection alone. MATERIALS AND METHODS: 16 conization specimens (8 from HIV-infected and 8 from non-HIV-infected patients) of HPV-related, high-grade SIL were selected. The specimens from non-HIV patients were considered as controls. The total number of Langerhans cells, CD4 and CD8 cells present in 10 field areas (3.120 mm2) was recorded in each case. In HIV patients CD4 and CD8 peripheral counts were performed immediately before surgery. RESULTS: The CD4/CD8 ratio never exceeded 0.71, whereas the lowest ratio in controls was 0.81: this difference was statistically significant (P = 0.0009). The mean number of Langerhans cells was markedly reduced in the high-grade SILs in the HIV patients in comparison with controls (P = 0.001). The number of CD4 cells and the CD4/CD8 ratio correlated with the peripheral CD4 count (P = 0.001 and 0.02). CONCLUSIONS: In our study a marked local impairment of cervical immunoreactivity was observed, which may play a major role in the progression of these lesions in HIV-infected women.

Adult↗
PubMedDate not supplied

Ultrastructural studies in the lytic phase of progressive multifocal leukoencephalopathy in AIDS patients.

Brain fragments from eight cases (four autopsies and four biopsies) of patients with acquired immune deficiency syndrome (AIDS) with JC virus (JCV) lytic infections were examined ultrastructurally. Particular efforts were made to look for virions and their subcellular distribution in cells not usually involved by papovavirus infection. The cellular and subcellular distribution of virions was investigated with emphasis on cell types not normally associated with papovavirus infection. The pattern of JCV infection was as follows: 1) oligodendrocytes; nucleus only, 7 cases; cytoplasm only, no cases; 2) astrocytes (normal and "bizarre"); nucleus and cytoplasm, two cases; cytoplasm only, four cases; 3) macrophages; nucleus and cytoplasm, one case; cytoplasm only, four cases; and 4) neurons; nucleus and cytoplasm, two cases; cytoplasm only, three cases. Perivascular, endothelial, ependymal, and microglial cells were never infected. Our ultrastructural data indicate that cell types other than oligodendrocytes can be involved productively by JCV in the lytic phase of progressive multifocal leukoencephalopathy (PML) in AIDS patients. Neuronal cells, especially, can be infected productively by the JCV, and this should be considered in clinical interpretation of cortical symptoms and signs in suspected or proven cases of PML.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Disseminated histoplasmosis in patients with AIDS. 2 case reports].

Histoplasmosis is endemic in some areas of United States and in South America, and generally causes an acute self-limiting respiratory infection. In elderly and immunosuppressed patients the infection can spread through the blood, causing a severe systemic illness. Here we describe two cases of disseminated histoplasmosis in AIDS patients. The first was observed in an Italian woman who had never visited endemic countries, and was recognized only at autopsy; the second was observed in a trans-sexual patient, arrived in Italy from Brazil. Clinical suspicion of histoplasmosis is important in immunocompromised patients of non-endemic areas as symptoms are often aspecific and misdiagnosis is frequent.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Rantes distribution and cellular localization in the brain of HIV-infected patients.

OBJECTIVE: To study the immunochemical distribution ofRantes chemokine and its correlation with HIV-p24 expression, in brains with HIV-related lesions. MATERIAL AND METHODS: 17 HIV-positive cases of HIV-related brain lesions, 7 HIV-positive cases without cerebral HIV-related lesions (5 with opportunistic brain diseases), and 7 HIV-negative cases as controls (4 with brain lesion) were selected. RESULTS: High expression of Rantes was observed in the cases with inflammatory brain lesions (22/24 HIV-positive and 2/7 HIV-negative patients). Positivity was observed in the diffuse and nodular microglial cells and lymphocytes. In the patients with HIV-related lesions, the presence of Rantes-stained microglia did not correlate with that of HIV-p24-positive cells. Positive astrocytes were only found in the HIV-positive patients. Multinucleated giant cells were always Rantes-negative. CONCLUSIONS: Our results seem to demonstrate the role of Rantes chemokine in inducing inflammatory brain perivascular and microglial reactions both in HIV-positive and -negative patients.

AIDS Dementia Complex↗
PubMedDate not supplied

[Anatomo-pathological features of JCV infection in patients with acquired immunodeficiency syndrome (AIDS). Histological, immunohistochemical, and ultrastructural study including the in situ hybridization technique of 54 AIDS autopsies].

Anatomopathological aspects of the JCV infection in subjects with AIDS. An histologic, immunohistochemical, ultrastructural and in situ hybridization study of 54 AIDS autopsies. Among 700 AIDS autopsies performed in our institute from 1984 till 1991 54 brain tissue of definite PML cases were extensively studied. In 10 cases formalin-fixed paraffin sections were immunostained with genus-specific anti-simian virus (SV) 40 antiserum and hybridized in situ with DNA probes for JCV respectively. Labeling patterns were generally similar in ICC and ISH: in early and typical cases mainly oligodendroglia harbored virus, whereas labeling of neurons and endothelia was absent. Nuclei and cytoplasmic processes of bizarre astrocytes were occasionally labeled by ICC and ISH in typical and lytic lesions. Electron microscopic study performed in 7 cases demonstrated round and rod-shaped particles of papovavirus in the nuclei of oligodendrocytes; membrane-bound cytoplasmic collections of papovavirus were seen in few astrocytes. In 4 brain biopsies of "possible" PML on histology, a definite diagnosis was performed only using ICC, ISH and EM: therefore, we stress the utility of all these techniques as a diagnostic tool in HIV-related brain lesions. Pathogenetic hypothesis on the development of PML in HIV-infected patients are also reported.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Transcatheter arterial chemoembolization in cytoreduction of inoperable hepatocarcinomas.

Transcatheter arterial chemoembolization (TAE) is often considered a mean of palliation for inoperable liver carcinomas. A few centers use a sequential treatment (TAE followed by surgery). However the role of TAE in bringing to surgery patients with hepatocarcinomas (HCC) considered inoperable at first diagnosis is debated. We report on the case of a 57 y.o. male diagnosed as having HCC, inoperable because of bilateral location and size. The patient was treated with repeated TAEs and the results were monitored with CT scans. After three TAEs, the main tumor mass volume was reduced 2.2 fold and the patient could undergo surgery; the postoperative period was uneventful, with no clinical signs of liver failure. Our experience leads us to suggest that TAE, further to being an option for palliation, can be a valuable tool to lead to surgery otherwise inoperable HCC patients.

Antineoplastic Agents↗
PubMedDate not supplied

Clinical, ultrasonographic and tomographic features on the natural evolution of primary mesenteric fibromatosis: a case report.

Primary mesenteric fibromatosis is a rare, histologically benign, pathology which is characterized by fibrous proliferation in the mesentery and made more serious by biological malignancy as it has a high inclination towards involving the visceral abdominal structures in its growth. While the cases reported in the literature describe the attempts to cure and reduce the tumor growth, this report describes the clinical, ultrasonographic and tomographic features during the natural growth rate of a case of inoperable primary mesenteric fibromatosis during a 20 month follow-up.

Adult↗