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Biomedical subjects

M Castelli

Publications and source records attributed to M Castelli.

At least 37 records · Page 2Linked to original sources

In-vitro studies of two 5-nitroimidazole derivatives.

This paper reports the findings obtained using two new compounds belonging to the 5-nitroimidazole family: sulphuridazole (V1) and sulphonidazole (V2). We first assessed their antimicrobial activity on Clostridia spp. and then extended the study to Gram-positive and Gram-negative aerobic microorganisms and to Candida albicans. Their MICs were compared with those of metronidazole. The findings show that the antibacterial and antimycotic activity of sulphonidazole is greater than that of sulphuridazole, while metronidazole is not active against any aerobic organism. It also emerges that the NO2 group is indispensable for all the microorganisms assayed and that sulphuridazole and sulphonidazole are the first two 5-nitroimidazoles active against C. albicans. The redox potentials of the 5-nitroimidozoles studied suggest that their action mechanism is mainly based on redox processes.

Anti-Bacterial Agents↗

Ethanol, growth hormone and testosterone in peripubertal rats.

The deleterious effects of ethanol on the hypothalamic pituitary growth hormone axis in adult male humans and animals have been well documented. It is also well established that ethanol has toxic effects on testicular function in adult humans and animals. Much less is known, however, about the effects of ethanol on the growth hormone (GH) axis and testicular function in adolescence. Recent studies have established that adolescent problem drinking is a widespread and growing threat to the health of young people in the United States. In the present study, therefore, we investigated if acute ethanol exposure in peripubertal male Sprague-Dawley rats altered normal pituitary and testicular function. Serum levels of GH and testosterone were measured at 1.5, 3, 6, and 24 h after a single i.p. injection of either saline or 3 g/kg body weight ethanol. Histologic analysis as well as serum testosterone levels allowed us to assign animals to either early puberty (35-day-old animals), mid-puberty (41-day-old animals), or young adult (51- and 66-day-old animals) status. Ethanol produced significant decrements in serum testosterone in the 51- and 66-day-old animals, with a trend toward suppression in the 41-day-old group. Furthermore acute ethanol administration significantly decreased serum GH (P < 0.0001 by 3 way ANOVA) demonstrating a significant effect of ethanol on serum GH in all age groups and at all time points studied when compared with saline injected controls (P < 0.01 by Turkey's studentized range test). Despite this significant fall in peripheral GH levels, there was no decrease in either GH mRNA or growth hormone-releasing factor (GRF) mRNA levels nor in hypothalamic concentration of GRF peptide. We conclude that, as in adult animals, acute exposure to ethanol causes a prolonged and severe decrement in serum GH which is possibly mediated at the level of secretion. In addition, there is attenuation in testosterone secretion. These data are all the more important since GH and testosterone play critical roles in organ maturation during this stage of development.

Analysis of Variance↗

Anti-heat shock proteins autoantibodies in autoimmune thyroiditis. Preliminary study.

No data are currently available on the humoral autoimmune response against self heat shock proteins (hsps) possibly occurring in patients suffering from autoimmune thyroid disorders. Therefore, a preliminary research was carried out to assess whether anti-self hsps autoantibodies are present in human autoimmune thyroiditis (AIT). Serum samples from 14 patients with AIT were tested both in western blotting and in ELISA for antibody binding to protein extracts of human cultured cells (both unstimulated and heat-shocked) as well as to purified hsp 73 and hsp 72. It was found that 7 out 14 (50%) patients with AIT have autoantibodies of the IgM isotype strongly reacting with hsps 73/72. By contrast, autoantibodies to hsps 73/72 were detected only occasionally in sera from patients suffering from non-autoimmune thyroid disorders (1 out 11) as well as in sera from healthy individuals (2 out 9). No obvious clinical differences were detected between AIT patients who had autoantibodies to hsps 72/73 and those who did not. Clearly, more patients would have to be examined to determine whether the anomalous anti-hsps 73/72 autoimmune response occurring in a significant proportion of patients with AIT is in some way related to the pathogenesis and/or to the progression of the disease.

Autoantibodies↗

Effects of granulocyte colony-stimulating factor in severe pancreatitis.

BACKGROUND: The effect of granulocyte colony-stimulating factor (G-CSF) on the rate of secondary infections in acute pancreatitis was evaluated in a canine model. Infectious complications are the major determinant of morbidity and mortality in severe pancreatitis. Bacterial translocation has been shown to be a cause of these secondary infections. The relative immunosuppression found with pancreatitis may promote translocation and the spread of bacteria to the pancreas. METHODS: Thirty-four mongrel dogs were studied. Pancreatitis was induced in 18 dogs; 9 were treated with 100 micrograms G-CSF/day and 9 were given only saline solution. Laparotomy alone was done in 16 dogs of which one half were given 100 micrograms G-CSF/day and one half were given saline solution. Daily blood counts and cultures were obtained. All dogs were killed on day 7, and the mesenteric lymph nodes, pancreas, liver, spleen, and peritoneal fluid were cultured and studied histologically. RESULTS: G-CSF caused a significant and sustained increase in mature granulocytes in dogs given pancreatitis. No difference was found in the rate of translocation to mesenteric lymph nodes in dogs given G-CSF (n = 4) versus dogs given saline solution (n = 6). However, a significant decrease occurred in the spread of bacteria to distant sites in dogs given G-CSF (1 versus 15, p < 0.05). CONCLUSIONS: Although G-CSF does not decrease the rate of translocation, it does decrease the rate of distant infection in severe acute pancreatitis.

Acute Disease↗

Bilateral varicocele: impact of right spermatic vein ligation on fertility.

The most frequent cause of male infertility is left varicocele. The surgical or laparoscopic approach for spermatic vein ligation is considered the best method of treatment. The approach to a clinically significant left varicocele associated with a right varicocele (frequently of a smaller size) is not univocal. We analyzed the seminal responses obtained in 65 patients with bilateral varicocele (grades 2 to 3 on the left side and grade 1 on the right side) assigned randomly to undergo unilateral or bilateral ligation. There were no significant differences between the 2 groups with regard to seminal recovery.

Humans↗

[Kinetics of hepatic enzymes in anorexia nervosa].

Nervous anorexia in advanced stage causes a generalized deterioration of organs' and apparatuses' functions. In particular, well-known are disorders of both CNS and PNS, changes of the haematic crasis and worsening of the metabolic-endocrine axis. Less well-known, however, is the compromission of function. Analysis of the data obtained in this trial points out a statistically significant correlation between the loss of weight and the variation of level of some liver enzymes (SGPT, SGOT, LDH). These indexes of hepatic necrosis in our opinion, can therefore, be regarded as sound markers not only for a more careful evaluation of the clinical evolution of the anorexic patient, but also for a better monitoring of the effectiveness of diet therapy.

Adult↗

Simultaneous fine-needle aspiration and core-needle biopsy of thyroid nodules.

To evaluate the efficacy of simultaneous fine-needle aspiration (FNA) and core-needle (CN) biopsies of thyroid nodules, the clinical course and operative findings in 100 patients having both tests were reviewed. Each patient had a diagnosis made with this approach. Both specimens were adequate for diagnosis in 95 patients. In the remaining 5 patients, a diagnosis was provided by FNA in four and CN biopsy in one. FNA and CN biopsies gave the same diagnosis of either a benign nodule in 53 patients or neoplasia in 30 patients. When both FNA and CN biopsies showed a benign nodule, a nonoperative approach was taken in 43 of the 53 patients. Forty-two patients were operated on either because of biopsy findings (32) or clinical indications (10). The surgical specimens were used to determine the false positive and false negative rates, the sensitivity, specificity, and accuracy for the diagnosis of neoplasia. The false (+) and false (-) rates in diagnosing neoplasia were 33 per cent and 7 per cent for FNA, 20 per cent and 4 per cent for CN biopsy, and 20 per cent and 0 per cent for both. The sensitivity, specificity, and accuracy for FNA were 93 per cent, 67 per cent, and 83 per cent, for CN biopsy 96 per cent, 80 per cent, and 90 per cent, and 100 per cent, 80 per cent, and 93 per cent for both FNA and CN. All neoplasms were detected, and no thyroid carcinomas were missed by this combination. There was only one complication: bleeding after a CN biopsy. Combined FNA and CN biopsies allow most patients with thyroid nodules to avoid an unnecessary operation and accurately diagnose those with thyroid carcinoma. These two procedures are safe and complementary.

Adenocarcinoma, Follicular↗

Cytologic patterns of metastatic thymoma: diagnosis by fine-needle aspiration biopsy.

Thymomas are the most frequent primary tumors of the anterior mediastinum. These lesions are slow growing and can be locally invasive, but extrathoracic metastases are rare, occurring in less than 2% of cases. Fine-needle aspiration biopsy (FNAB) may be helpful in making the diagnosis of metastatic thymoma, with or without a clinical history of primary mediastinal thymoma. We report three cases of metastatic thymoma diagnosed by FNAB. Each case illustrates a distinctive cytologic pattern. While two of the patients had a history of histologically confirmed thymoma 11 and 13 years previously, a third patient presented with an enlarged supraclavicular lymph node and pulmonary nodules, and no prior diagnosis of thymoma. These cases demonstrate that based on distinctive cytologic patterns and features, a diagnosis of metastatic thymoma can be made with FNAB. Ancillary studies will often confirm the diagnosis.

Aged↗

Flow cytometry as a prognostic predictor in gastric linitis plastica.

UNLABELLED: Gastric linitis plastica (GLP) is a diffusely infiltrating carcinoma of the stomach that is usually diagnosed in an advanced stage and associated with poor prognosis. Recent studies to evaluate ploidy of these tumors are not conclusive. We undertook a retrospective study of 43 surgically treated patients with GLP (27 males, 16 females, mean age 65 years) to see if ploidy could be used to predict outcome. Flow cytometric DNA analysis was performed on paraffin-embedded tissue using the modified Hedley technique. Mean follow-up interval was 11 months (1-72 months) with 18 (42%) alive at end of study. The remaining 25 (58%) died with a mean survival of 7 months. Lymph node status was positive in 31 (70%) and negative in 12 (30%) of patients. Twenty-nine (67%) of tumors were diploid; 14 (33%) were aneuploid. Statistical analysis revealed overall survival correlated significantly (P = 0.04) only with lymph node status. Diploid tumors had 18 (60%) positive and 11 (40%) negative lymph nodes, whereas aneuploid tumors had 13 (93%) positive and 1 (7%) negative nodes. DNA content correlated significantly (P = 0.05) with lymph node status, but not with overall survival. Tumors with positive lymph nodes were 18 (51%) diploid and 13 (42%) aneuploid; tumors with negative nodes were 11 (92%) diploid and 1 (8%) aneuploid. CONCLUSIONS: The majority of GLP tumors manifest diploid characteristics, and the presence or absence of lymph node metastasis is a major determinant in overall survival.

Adult↗

Immunosuppressive acidic protein (IAP) and squamous cell carcinoma antigen (SCC) in patients with cervical cancer.

Immunosuppressive acidic protein (IAP) and squamous cell carcinoma (SCC) serum levels were assayed in a group of 63 primary cervical cancer patients. IAP serum levels were significantly higher in cancer patients (median, 630 micrograms/ml; range, 290-1150) than in controls (median, 290 micrograms/ml; range, 135-775) (P < 0.01). The percentage of IAP-positive (> 613 micrograms/ml) cases was 50.7%. SCC serum levels were found to be above 2.5 ng/ml in 73% of cervical cancer patients, and in 6% of controls. A statistically significant correlation was observed between IAP and SCC levels in cancer patients (r = 0.35, P < 0.004). When IAP and SCC were considered together the overall sensitivity was 87.3% and an improvement of both predictive value of negative test and accuracy without any significant reduction of predictive value of positive test was found. IAP status correlated with metastatic lymph node involvement. A statistically significant association between a shorter survival and high serum LAP levels was observed. The 24-month overall survival (OS) was 92% for IAP- cases with respect to 65% for IAP+ cases (P = 0.036). In the univariate analysis, advanced stage of disease, clinical parametrial involvement, and lymph node involvement were also associated with poor survival. In the multivariate analysis IAP status showed a statistically significant association with poor survival (P = 0.049), together with lymph node involvement (P = 0.007) and advanced stage of disease (P = 0.008).

Adult↗

Laparoscopic ureteral reanastomosis using fibrin glue.

Using 10 female pigs, an open ureteral resection and suture anastomosis (5 pigs) was compared to a laparoscopic resection and a fibrin glue anastomosis (5 pigs). The fibrin glue technique was performed by laparoscopically excising a ureteral segment, placing 2 transmural sutures over a stent and sealing the anastomosis with tissue adhesive, a mixture of concentrated fibrinogen and thrombin. At 4 weeks the stent was removed. At 8 weeks, the animals underwent antegrade pyelograms and Whittaker renal pelvis perfusion test and then were sacrificed. The experimental group had 1 anastomotic breakdown; all others had patent ureters. Radiographically, both groups demonstrated mild to moderate hydroureteronephrosis. Renal pelvis perfusion tests were higher in the fibrin glue group (12.6 cm. H2O versus 3.0 cm. H2O); however, all were normal for the porcine model. Histologic evaluation demonstrated increased muscular and serosal fibrosis and inflammation in the fibrin glue group when compared with the control group. Laparoscopic ureteral reanastomosis with fibrin glue is feasible; however, further research is needed to understand its full potential in urology.

Anastomosis, Surgical↗

A new method to obtain a tissue diagnosis of proximal bile duct tumors.

Klatskin tumors often pose a challenge for diagnosis and treatment. Most of these neoplasms are diagnosed clinically because of the difficulty in obtaining tissue that will provide histologic proof of the disease. When a non-operative course is sought, exhaustive attempts should be made to obtain a tissue diagnosis because of the potential for a false-positive clinical diagnosis. We describe a new way to obtain tissue for diagnosis by placing a laparoscopic choledochoscope through a percutaneous transhepatic cholangiogram track, thus allowing the tumor to be directly visualized and biopsied.

Bile Duct Neoplasms↗

Ventricular remodeling and infarct expansion.

Infarct expansion, defined as an alteration in the ventricular topography due to thinning and lengthening of the infarcted segment, develops within the first few hours of the acute symptoms, mostly in patients with a large, transmural, anterior myocardial infarction. Shape changes, peculiar to risk region location and due to disparity in regional ventricular architecture, could be posited as the first step in the process of infarct expansion, with various cellular mechanisms contributing to subsequent continued early and late ventricular dilation. Because the increase in left ventricular volume is expected to be linearly dependent on the extent of the infarction, limiting infarct size, by thrombolysis, would proportionally reduce enlargement of the cavity. The effect of thrombolysis on left ventricular volume, however, seems not to be completely accounted for by the lessening effect of reperfusion on infarct size, because data suggest a restraining effect of reperfusion on the process of ventricular dilation in addition to the lessening effect on infarct size. If this turns out to be true, then the achievement of a patent vessel even beyond the time period when that patency may be expected to salvage myocardium would be further justified. Theoretical predictions substantiate the potential effectiveness in restraining ventricular dilation of stiffening of the necrotic region alone, independently of myocardial salvage in infarcted patients. The process of progressive ventricular dilation involves not only a primary alteration in function of the infarcted region, but also a time-dependent secondary change in the noninfarcted tissue itself, finalized to restore stroke volume despite a persistently depressed ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Nevomelanocytic proliferations in the central nervous system of children.

BACKGROUND: Melanocytic proliferations affecting the central nervous system (CNS) of children may be classified as meningeal melanocytosis, primary melanoma, or metastatic melanoma. Meningeal melanocytosis often is associated with giant congenital pigmented nevi (preferentially involving the midline, the head and neck) representing the lethal condition neurocutaneous melanocytosis. Primary or metastatic melanomas, although extremely rare in children, can occur in the brain and its coverings and are associated with a poor prognosis. METHODS: A retrospective study of five patients with nevomelanocytic proliferations of the CNS was performed. RESULTS: There was characteristic enhancement in the magnetic resonance imaging (MRI) with gadolinium contrast, abnormal cerebral spinal fluid (CSF) cytology with neoplastic cells showing cytoplasmic prolongations, and nevomelanocytic proliferation in the meninges expressing HMB45 positivity and exhibiting ultrastructural features of melanocytes. CONCLUSIONS: Because of the rarity of these lesions, awareness of their existence is crucial for their recognition. Clinical, radiologic, and cytologic, correlation may allow an opportune diagnosis, which would allow avoidance of brain biopsy. Melanin production is not restricted to melanocytic neoplasms, and other CNS tumoral lesions occasionally may feature melanin as part of their histologic findings.

Adolescent↗

[Reevaluation of impotence following TURP].

Impotence following transurethral prostatectomy is one of the main complications that still has a controversial origin. Many authors, reporting their experience, have demonstrated that this complication is due both to psychological problems and to organic causes. We review retrospectively 68 patients submitted to TURP. All patients (53 to 65 years old) were asked about their sexual efficiency before and after TURP, 6-12 months after surgery. Those who complained of erectile failure have been studied using this diagnostic protocol: plasmatic dosage of FSH, LH, Testosterone and Prolactin; penile Doppler ultrasound, polysomnographic recording of nocturnal tumescence test (NPT Test); angiography of the pudenda arteries has been performed in only one patient with pathological penile Doppler ultrasound (IPP < 0.7). The examinations demonstrated an organic impotence not secondary to vascular damage in 10 patients following surgery (incidence 15.6%). Our high incidence of this complication is, according to us, significant even if it should be considered in excess since in our study we used anamnestic criteria alone in the evaluation of sexual efficiency before surgery. In 1984 T. Lue demonstrated, through accurate histological preparations, that cavernous nerves run contiguously to the prostatic capsule at 5 and 7 hours in correspondence of the glandular apex. He suggested that impotence following TURP is due to iatrogenic lesions of these nervous structures during endoscopic resection. Similarly, we have conducted an anatomopathological study on prostate specimens taken from autopsies. We demonstrated the presence of nervous structure contiguously to the prostatic capsule in correspondence with the glandular apex. Thus, impotence following TURP probably occurs after an iatrogenic heat lesion of the periprostatic plexus caused by resection.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Is fine needle aspiration biopsy of salivary gland masses really necessary?

The use of fine needle aspirate biopsies (FNAB's) in the outpatient setting has progressively escalated, particularly in the area of head and neck pathology. An increasing percentage of these are for salivary gland masses. We present our experience with salivary gland FNAB's at our institution for four years, from 1988-1992. One thousand and twenty-two (1,022) FNAB's of superficial masses were performed by two pathologists. One hundred sixty-three (15.9%) were salivary gland biopsies. Of these 163 cases, 21 (12.9%) were normal tissue, 77 (47.2%) were inflammatory processes, 50 (30.7%) were benign tumors, and 15 (9.2%) were malignant tumors. None of the aspirates were unsatisfactory. Tissue correlation was possible in 47 (28.8%) cases. Two false negative cases (4.3%) were identified; these were a Warthin's tumor diagnosed as chronic sialoadenitis by FNAB; and a poorly differentiated squamous cell carcinoma diagnosed as adenocarcinoma by FNAB. There were no false positive cases. Overall sensitivity was 95.7% and specificity was 100%. Our experience indicates that FNAB of salivary glands is an effective screening procedure in evaluating salivary gland masses. The cytologic diagnosis may assist the clinician in allaying patients' anxieties, as well as in further collateral workup prior to definitive therapy.

Adolescent↗