[Thoughts of a "conservative" clinician on diagnostic methodology].
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Biomedical subjects
Publications and source records attributed to L Villa.
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We report a case of primary epidermoid carcinoma of the frontal sinus associated with cholesteatoma. We postulate that the carcinoma is secondary to malignant degeneration of the cholesteatoma. The literature review revealed 38 cases of cholesteatoma of the frontal sinus. Four were associated with carcinoma. To the best of our knowledge, this is the fifth such case in the world literature.
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We report application of a novel immunohistochemical procedure for the staining of apoptotic (AP) cells in paraffin sections using monoclonal antibody (MAb) to single-stranded DNA. MAb differentiated between apoptosis and necrosis and in contrast to in situ end labelling specifically stained only AP cells. AP carcinoma cells stained with the antibody were detected in 32 of 58 infiltrating human breast carcinomas and in 9 of 15 colon adenocarcinomas. Stromal cells stained with the MAb were observed in all carcinomas, including those in which no AP carcinoma cells were detected. There was a strong positive correlation between the presence of AP cells, loss of hormone receptors and a high proliferation rate in breast carcinomas. AP cells were present in 80-87% of receptor-negative carcinomas, while most of receptor-positive breast carcinomas did not contain AP cells. Apoptosis in tumor cells was detected significantly more frequently among breast carcinomas with high, than among carcinomas with low S-phase fraction. AP cells were present in 93-95% of breast carcinomas which were receptor-negative and had a high S-phase fraction. Immunostaining demonstrated a strong positive correlation between the loss of bcl-2 protein and intensive apoptosis in breast carcinomas. Association between apoptosis and markers of poor prognosis in breast cancer (loss of hormone receptors, intensive proliferation, loss of bcl-2 protein) indicates that apoptotic cell death is typical of more aggressive carcinomas.
OBJECTIVE: This work studies the effects of Cyclosporine A (CsA) upon the activation and proliferation of mononuclear cells (MNC) from the peripheral blood (PB) of patients with chronic autoimmune arthritis and from healthy controls, and from the synovial fluid (SF) of patients. METHODS: In vitro studies of activation, proliferation, mRNA expression and lymphokine production were carried out. RESULTS: We found in the PB and SF MNCs from patients with autoimmune arthritis that CsA inhibits the proliferative response, activation antigen expression, IL-2 mRNA expression and IL-2 production induced by polyclonal mitogens in a dose dependent manner. CONCLUSION: CsA blocks lymphocyte activation in PB and SF MNCs from patients with autoimmune arthritis.
The improper use of pesticide waste containers is a significant risk in rural areas, especially where appropriate systems of draining off refuse are lacking. A case is reported of an eight-year-old child who had played with the abandoned Paraquat container. After contamination with the pesticide she showed several II degree caustic lesions on both thighs and knees, associated with a mild erythemato-desquamative cheilitis and a "strawberry tongue". Common laboratory findings did not reveal any kidney, liver and/or red/white cell alterations and the chest X-ray was normal even several months after the accident. No physical consequences ensued, except for hyperchromic pigmentation on the legs. Where empty pesticide containers are not properly collected, they can represent a risk of pesticide exposure for the general population. They can also be a potential source of pollution for superficial water and soil. In the district where the accident was reported it was estimated that empty containers made up 7% of the weight of the 146,330 kg of pesticides sold to local farmers in 1993, of which about 10,400 kg was burned, buried and dispersed in the soil. Within the framework of a global pesticide prevention programme launched by the Regional Government of Lombardy, local health authorities, with the contribution of farmers, are carrying out a project for the proper collection of empty pesticide containers.
This article reviews the adverse effects of exposure to antineoplastic drugs in workers producing or administering them. Many antineoplastic drugs are carcinogenic or mutagenic to humans and exposure and absorption have been shown to occur during production in pharmaceutical industries or during the preparation and administration in veterinary and health practice. At present few studies have been made on the increased risk of cancer for workers handling these chemicals. However, available data suggest an increased risk of cancer due to exposure to antineoplastic drugs and increased risk of spontaneous abortions and offspring malformations among women workers. This poses a major problem since the majority of health care workers exposed to antineoplastic drugs are women. Therefore, because of these reported effects, it is of the utmost importance to avoid any contact with, and any absorption of these chemicals by using adequate protective equipment during their preparation and administration and by organizing preventive educational programs for the workers.
The guidelines must guarantee that occupational exposure to antineoplastic chemotherapeutic drugs is kept at the lowest level possible. Occupational exposure to these drugs can involve different categories of workers and different job tasks, such as stocking, preparation, administration, disposal, maintenance of safety cabinets and room cleaning where these activities are performed. Preventive measures should include the institution of "Centralized Units for handling antineoplastic chemotherapeutic drugs", where only specifically trained personnel are employed. Cleaning and decontamination procedures must be easily feasible and specific safety cabinets should be used in the rooms. Personnel must use adequate protective equipment and follow standardized working procedures. Information programs for the personnel should be carried out covering occupational risks, safe preventive measures and the explanation of environmental and biological monitoring.
Serial decompressive amniocenteses were performed at 18-23 weeks of gestation in 23 pregnancies referred due to echographic signs typical of twin-twin transfusion syndrome. The procedures were repeated until delivery or permanent normalization of the amniotic fluid volume both in the donor and the recipient twin sac. The overall survival rate was 57%, but in only 39% of the pregnancies did both twins survive without handicaps. The absence of end diastolic flow in the umbilical artery of the donor twin was associated with poor chances of survival for both fetuses; in contrast, the presence of hydrops or ascites in the recipient twin did not worsen the prognosis. A policy of aggressive amniotic fluid decompression may achieve permanent resolution of the fluid in over 50% of the pregnancies complicated by twin-twin transfusion syndrome.
The automated stochastic docking procedure BioDock has been applied to a series of inhibitors of PGH synthase, the key enzyme in the synthesis of eicosanoids from arachidonic acid. Some PGHS-2 selective inhibitors have been docked to the structure of the ovine PGHS-1 enzyme, as recently obtained by means of X-ray crystallographic analysis, in order to highlight possible structural bases for selectivity.
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