Biomedical subjects
Publications and source records attributed to M Spinelli.
Neurofibromatosis evolution is described in relation to the factors that may favour its expansion and immune modifications. NF1 monitorization should employ periodic clinical and immune surveillance. Such an approach would allow the application of immunomodulating treatment (e.g. adapted therapy) only when indicated, thereby reducing its duration and potentiating its efficacy.
Neurofibromatosis, in all its variant forms, is a hereditary disease characterized by dysplasia, neoplasia, and the tendency to expand and undergo malignant transformation. We underline the presence of chronic inflammation and of immunologic interdependency. The immune reactions against the non-self have been investigated histologically in light of the concepts of immunosurveillance and immunotolerance. Such investigations would ameliorate subsequent studies and favour the employment of immunomodulatory treatments.
The authors describe the long-term sequelae of chondroblastoma in 15 patients with open growth plates, whose age at operation ranged from 8 to 15 years. At follow-up, the youngest patient was 21 and the oldest 48 years old. Upper limb length discrepancy ranging from 2 cm to 10 cm was present in the four patients who had a proximal humeral epiphyseal location; in three of them, the range of motion of the shoulder was also limited and X-rays showed marked irregularities of the humeral head. Lower limb length discrepancy ranging from 0.5 cm to 2 cm was found in five of the eight patients in whom the tumor affected lower limb epiphyses. One patient with proximal tibial epiphyseal involvement also had mild genu valgum. Radiographic osteoarthritis was present only in the trapeziometacarpal joint of a patient in whom the first metacarpal bone affected by the tumor was replaced by a free fibular graft. The abnormalities observed did not cause important functional loss in either the everyday or the working activities of any of our patients.
To study outflow obstructions Schafer (1989) has recently proposed a simplified method based on a graph derived from over 1000 pre and post-op. P/F studies. 42 patients with BPH were evaluated according to this method. 11 patients had no outlet obstruction (26%). Surprisingly, only 15 had a normal detrusor, while 27 had a weak detrusor. The second part of the study concerns 24 patients with post-prostatectomy frequency-dysuria syndrome. Only 21% of these patients showed an outlet obstruction; while 58% showed a weak detrusor as responsible for their symptoms.
A multidisciplinary study was performed on cases of neurofibromatosis to highlight the immunological reaction using broad-spectrum hematic tests and multiphase evaluation together with clinical and instrumental monitoring. The aim of the study was to focus attention on this rare disease and prompt further sequential immunological studies. A greater knowledge of the disease would allow the promising potential of new drugs to be exploited, in particular selective immunomodulatory drugs, in the hope of controlling the symptoms of disease (and overcoming further obstacles to the surgical removal of any neurofibromas that the patient wishes.
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From 1982 to 1988 we have evaluated 283 patients affected by Peyronie's disease. 81 of these complained erectile disfunction. Semirigid penile prosthesis were inserted in 38 patients with severe induratio penis plastica. Following surgery the patients were given a sexual questionnaire in order to determine whether they had realised their expectations as well as partner acceptance. Our results appear to be favourable and prosthesis insertion in selected patients with Peronie's disease seems to be the safest, most economical and best accepted choice.
By differential sucrose gradient centrifugation of pig kidney chromatin in the presence or absence of Na-EDTA and under varying ionic strength conditions, three nucleosome-like subpopulations with different buoyant densities can be obtained. These particles, on the basis of their histones and HMG protein pattern, of the 5-methylcytosine level of their DNA and of the RNA polymerase activity associated with them, can be considered as originating from chromatin fractions differently involved in gene expression. Two-dimensional electrophoresis of the tightly-bound non-histone proteins shows a distinct pattern for each subpopulation, such protein components being notably present in restricted numbers but in high amounts in the subpopulation which was apparently derived from condensed heterochromatin.
Functional results of resection arthroplasty are currently considered poor. In 104 hip prosthesis removals after either septic or aseptic loosening, pain, walking, joint motility, life style, and patient's opinion were evaluated. A satisfactory result was recorded in 72% of cases. Prognosis is poorer in patients who are young, have septic loosening, and have poor residual mobility. Resection arthroplasty should be considered a salvage procedure in cases of septic loosening and/or bone stock deficiency after a failed total hip arthroplasty.
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The ultrastructural study carried out in a case of tonsillar malakoplakia confirmed that granulomatous lesions consisted mainly of macrophages containing peculiar calcified inclusions (Michaelis-Gutmann bodies) considered pathognomonic for the disease. Moreover macrophages frequently contained ingested Gram-negative bacilli and presented aspects of mitochondrial degeneration and autophagy. These latter features were probably the consequence of bacterial infection rather than the expression of primary cellular defects, as the clinical evolution of this case of malakoplakia did not support the existence of generalized macrophage alterations.
Three new cases of benign lipomatous lesions of the uterus are described, with particular attention to the possible relation between symptomatology and the presence of mast cells in the neoformation. The literature is reviewed, a brief history is presented of important stages in the study of these forms, and a new histogenetic theory proposed based on a different concept from those accepted to date.
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An endoscopic series of 4610 patients examined for dyspeptic symptoms has been reviewed. The purpose was to verify the prevalence of gastric stump cancer. In 266 patients previously gastrectomized for benign peptic ulcer, 10 cases of gastric carcinoma were found (3.61%) whereas in 4344 not previously gastrectomized patients 157 gastric carcinomas were diagnosed (3.75%). Among the 10 patients affected from gastric stump carcinoma, 5 had been operated before, and 5 after, the age 45. The statistical comparison between the two groups showed a significant difference (p less than 0.02) as for the mean time intervals between surgical intervention and onset of gastric stump carcinoma, whereas the mean ages of onset of gastric stump carcinoma resulted substantially identical. We conclude that advanced age, rather than a previous gastrectomy, confers a major risk of gastric carcinoma.
The interaction of Cu(II) with the native and heat-denatured DNA complexes of daunomycin (1) and N-(trifluoroacetyl)daunomycin (3) has been examined by using absorption and circular dichroism spectroscopies. At low rt, where rt is the input molar ratio of drug to DNA phosphate, Cu(II) interacts with the native and heat-denatured calf thymus DNA complex of daunomycin to form a ternary complex involving the aglycon portion of the antibiotic, Cu(II), and DNA. A Job plot of the titration involving Cu(II) and heat-denatured DNA shows that the Cu(II)-drug stoichiometry in the ternary complex is less than or equal to 1. Although the N-(trifluoroacetyl)daunomycin-native DNA complex does not form a ternary complex, the denatured DNA complex with the antibiotic does. Copper(II) titrations of the daunomycin-native DNA complex, at high rt, where both strongly and weakly bound antibiotic molecules are very likely present in solution result in the formation of both the ternary species as well as a binary complex involving only the metal ion and the antibiotic. The spectroscopic results indicate that in the ternary complex, the Cu(II) ion is bound to the unintercalated aglycon portion of the antibiotic and very likely also to the heterocyclic bases of DNA.
Differentiation of the cells of the dental bud which produce the hard tissues of teeth was studied at the ultrastructural level; the activity of these cells (odontoblasts and ameloblasts), the laying down of organic matrices elaborated by them, the mineralization of these matrices, and the maturation of dentine and enamel are described. Injections of tritiated proline enabled us by the autoradiographic method, to confirm and to indicate more precisely the activity of these cells. Dental calcified tissues of Rana exhibit the general properties of these tissues among Vertebrates: high content of apatite, low content of organic materials (collagenous in dentine, non-collagenous in enamel), precise orientation of crystals, and true but non-prismatic enamel. The enamel of Anura as well as enamel of Urodela is a true enamel of epithelial origin.
The speech therapy in fifteen aphasic patients was studied. The group consisted of 8 male and 7 female patients and their ages ranged from less than ten to more than fifty years. In eleven cases the aphasia was due to cerebrovascular disease and in the remaining four cases to traumatic injury to the brain. Predominantly expressive aphasia accounted for five patients while in the others a comparable degree of receptive and expressive deficits existed. Six patients had their therapy programme started within the first three months after the acute phase and the rest of the group started it after more time had elapsed. Eleven patients showed a satisfactory recovery regardless the inicial deficit severity, the patients age, the pathology of the lesion or the period of time which elapsed from the beginning of the disease to the start of the therapy. The speech therapy in aphasic patients is effective although a firm prognosis cannot be established at the beginning of the programme. Useful information concerning prognosis only can be taken from the follow-up and after thoroughly retesting the patients.
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