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Biomedical subjects

M Capuano

Publications and source records attributed to M Capuano.

14 recordsLinked to original sources

Human herpesvirus 8 in Italian HIV-seronegative patients with Kaposi sarcoma.

OBJECTIVE: To evaluate the prevalence of human herpesvirus 8 (HHV-8) DNA detection in a large series of human immunodeficiency virus-seronegative patients with and without Kaposi sarcoma (KS) from the central and southern regions of Italy where classic KS is prevalent. DESIGN: Samples of lesional, peripheral unaffected, and distant normal skin and peripheral blood mononuclear cells (PBMCs) from 33 patients with KS and PBMCs from 42 control subjects were analyzed using single and nested polymerase chain reaction techniques for the presence of HHV-8 DNA. PATIENTS: A total of 33 patients with KS not related to acquired immunodeficiency syndrome (26 patients with classic KS and 7 patients with iatrogenic KS) were studied. Furthermore, 2 control groups were enrolled. The first group consisted of 13 healthy volunteers, the second of 29 patients affected by different dermatological diseases. RESULTS: Human herpesvirus 8 sequences were found in 100% of lesional and perilesional specimens, in 33% of the distant normal skin samples, and in 69.6% of the PBMCs from patients with KS. A possible correlation between HHV-8 DNA in PBMCs and the clinical stage of the disease was observed. Moreover, the prevalence of viral DNA in PBMCs from the total control group was 23.8%. No viral DNA was detected in tissue biopsy specimens taken from the control group. CONCLUSIONS: Our data suggest that HHV-8 could be a widespread virus, at least in Mediterranean regions where KS is more prevalent, such as southern and central Italy. As with other herpesviruses, it may be present lifelong in latent form somewhere in the body and may contribute to the pathogenesis of KS when other predisposing conditions are present.

Aged

Kaposi's sarcoma cells express the macrophage-associated antigen mannose receptor and develop in peripheral blood cultures of Kaposi's sarcoma patients.

The mannose receptor (MR) is a surface 175-kd C-type lectin expressed by macrophages and dendritic cells. MR is involved in removal of effete cells, phagocytosis of mannose-coated particles, pinocytosis, and antigen presentation. Expression of MR was investigated in 17 biopsies of Kaposi's sarcoma (3 AIDS KS, 13 classical KS, and 1 transplant-associated KS) using three anti-MR monoclonal antibodies (3.29, D547, and PAM1). Immunostaining for MR was detected in 94 +/- 7% KS cells with spindle morphology. In normal tissues, MR was expressed by sinus-lining cells of spleen and lymph nodes, but it was not detected in endothelial cells lining normal hematic and lymphatic vessels, hemangioma, hemangioendothelioma, and lymphangioma. Expression of MR in KS cells prompted us to investigate the possibility that they derive from a circulating precursor cell. Peripheral blood mononuclear cells from 16 patients with KS (10 classical, 1 transplanted, and 5 AIDS) were cultured in PHA-conditioned medium for 10 to 14 days. Confluent monolayers of adherent spindle cells were detected in 8 of 11 classical KS, in 5 of 5 AIDS KS patients, and in 0 of 34 control patients. Peripheral-blood-derived KS-like cells were characterized by co-expression of macrophage and endothelial antigens being positive for CD45 (60%), CD68 (98%), MR (70%), CD14 (25%), VE-cadherin (70%), and von Willebrand factor (10%). When the immunophenotype of peripheral-blood-derived adherent cells was compared with that of KS spindle cells of tissue biopsies, it was found that both cell types are VE-cadherin+/MR+/CD68+, that peripheral-blood-derived spindle cells are CD34- and are less frequently stained for CD31 and von Willebrand factor, and that lesional KS cells do not express the leukocyte markers CD45 and CD18. Our findings are consistent with the possibility that KS lesions derive from tissue accumulation and local proliferation of a special subset of macrophages with endothelial features the normal counterpart of which are the sinus-lining cells of spleen and lymph nodes.

Acquired Immunodeficiency Syndrome

Correction of posterior crossbite.

Posterior teeth exhibiting a transverse discrepancy are said to be in crossbite. This abnormal bucco-lingual relationship is usually viewed as affecting one side, but it is really a bilateral problem. There is a multifactorial etiology for this. Early diagnosis by the treating dentist is essential for proper treatment. If not detected early, surgically assisted rapid palatal expansion is needed to correct the transverse discrepancy. Through a series of osteotomies, along with orthodontic appliance therapy, it can be corrected. On such case is presented here. The three main objectives of this treatment are to correct the posterior crossbite; to reduce crowding, and to form a stable occlusion. As shown by this case example, surgically assisted rapid palatal expansion is a safe and effective means of correcting posterior crossbites.

Adolescent

Justifying and tracking BMET training.

We have outlined the importance of BMET training and how it is a crucial investment for not only the health care facility but also clinical engineering and individual BMETs. Training methods and funding mechanisms are also important aspects of the continuing education process. Being aware of the alternatives helps to achieve the goals of the clinical engineering program. We have also demonstrated management techniques of acquiring training, evaluating courses, and keeping statistics. Courstat manages statistics of training intensity among BMETs. This kind of tool provides managers with an overall picture of departmental expertise.

Biomedical Engineering

Cystic fibrosis: genetics and clinical applications.

The most recent advances about cystic fibrosis genetics are revised. Their clinical applications are reviewed: prenatal diagnosis, heterozygote screening, genotype and phenotype correlation, gene therapy.

Cystic Fibrosis

Risk-oriented maintenance.

Responding to information has become the most critical aspect of technology management. With ROMSYS we gain significant ability to exercise this ideology. Accessing reports in real-time provides instant knowledge of any aspect concerning equipment support. This kind of resource can give management the confidence of having a system that virtually takes care of itself. Managers can spend their time making informed decisions rather than wasting it searching for information. The philosophy of doing only what needs to be done, when it needs to be done, becomes reality when systems such as PM Interval Adjustment, PM Index, and % PM Effectiveness are utilized. These elements of ROMSYS also prevent the tying up of expensive expertise (biomedical equipment technicians) in mundane activities that are primarily ineffective. The system helps to enhance the pride of work among BMETs by elevating the importance of the PM inspection. The health care facility stands to gain from a system that monitors itself and continues to adjust to improve the process. This is the fundamental principle of total quality management, where the goal is to improve patient outcome while being cost-effective.

Biomedical Engineering