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Biomedical subjects

M Torre

Publications and source records attributed to M Torre.

At least 19 recordsLinked to original sources

Effect of SCH 37224 on anti-IgE-induced formation of sulfidopeptide leukotrienes in human lung parenchyma.

SCH 37224, 1-(1,2-dihydro-4-hydroxy-2-oxo-1-phenyl-1,8-naphthyridin-3-yl) pyrrolidinium, is a structurally novel compound that had been shown to inhibit leukotriene D4 formation in guinea pig lung in vitro. We tested whether SCH 37224 is able to inhibit both the formation of eicosanoids from human lung parenchyma in vitro and the binding of sulfidopeptide leukotrienes to membranes of lung parenchyma and bronchi. SCH 37224, at a concentration of 30 and 100 microM, was able to inhibit antigen-induced formation of sulfidopeptide leukotrienes, measured as leukotriene E4, while it did not significantly affect the formation of prostaglandin D2. At concentrations up to 100 microM, it did not affect either the binding of [3H]leukotriene C4 to membranes of human lung parenchyma or human bronchi, or the binding of [3H]leukotriene D4 to the parenchyma. In conclusion, SCH 37224 is a selective inhibitor of leukotriene formation in human lung in vitro, which might be of potential therapeutic interest in the treatment of asthma.

Eicosanoids

Endocrine complications associated with human immunodeficiency virus infection.

The causes and management of endocrine disorders associated with human immunodeficiency virus (HIV) infection are reviewed. Endocrine disorders observed in HIV-positive patients include adrenal abnormalities, hyporeninemic hypoaldosteronism, pituitary insufficiency, pancreatic abnormalities, thyroid and parathyroid disorders, and testicular abnormalities. Opportunistic pathogens implicated in these disorders include cytomegalovirus, Cryptococcus, Toxoplasma, mycobacteria, Candida, and Aspergillus. Neoplasma such as Kaposi's sarcoma and lymphoma can also cause endocrine abnormalities. Several drugs used in patients with the acquired immunodeficiency syndrome (AIDS) are associated with the development of endocrine disorders. These drugs include ketoconazole, itraconazole, rifampin, vidarabine, pentamidine, trimethoprim-sulfamethoxazole, didanosine, and ganciclovir. Severe patient debilitation can contribute to the development of endocrine abnormalities. Monitoring of adrenal gland function may be prudent in HIV-infected patients who have nonspecific symptoms of adrenal insufficiency. If adrenal insufficiency is diagnosed, replacement therapy with oral hydrocortisone is required. Administration of fludrocortisone can rapidly alleviate the signs and symptoms of hyporeninemic hypoaldosteronism. Fluid restriction is the first step in managing the pituitary abnormality known as the syndrome of inappropriate secretion of antidiuretic hormone. Drug-induced endocrine abnormalities often resolve after withdrawal of the offending agent. Endocrine complications in HIV-infected patients may be caused by infection, malignancy, or drugs. Adjusting or instituting drug therapy may be necessary to control symptomatic endocrine abnormalities.

Adrenal Gland Diseases

Eicosanoid release and mepyramine, LTC4 and LTD4 binding in passively sensitized human lung parenchyma in vitro.

In vitro passive sensitization of human lung parenchyma with hyper-immune serum did not affect the release of prostaglandin D2 (PGD2) or leukotriene (LT)-like activity upon challenge with anti-IgE antibody with respect to control lung, despite a marked difference in IgE levels between control (C) and sensitized (S) tissue. Binding studies with [3H]LTC4, [3H]LTD4 and [3H]mepyramine (a histamine H1 antagonist) showed a statistically significant increase in the amount bound in sensitized vs control lung for [3H]mepyramine only. Contractile response to 5 x 10(-5) M histamine (H) in C and S lung parenchymal strips did not correlate with binding data. It is concluded that in vitro elevated IgE levels do not affect the interaction of sulfidopeptide leukotrienes with their putative receptors. As for the observed increase in [3H]mepyramine binding, this might not represent a true increase in histamine receptors on lung smooth muscle cells.

Animals

Effects of dietary fiber and phytic acid on mineral availability.

In general, it has been shown that dietary fiber may bind metallic cations in both in vitro and in vivo studies. However, there clearly are many unresolved questions on the effects of high-fiber diets on mineral availability. On one side, the effects of fiber on the utilization of nutrients vary greatly with the amount and type of fiber. In addition, there are many agents in both food and the digestive tract that may affect the mineral binding to fiber: some agents may inhibit binding, while others will enhance it. Also, there are several major difficulties in drawing conclusions from the in vitro and in vivo studies due to the different experimental conditions, methods used to follow the mineral balance, etc. Finally, it must be borne in mind that fiber and phytic acid occur together in fiber-rich diets and, thus, it is difficult to separate the effects of fiber and phytate in the utilization of most essential polyvalent metallic ions. The studies summarized in this review show that the recommendation for increasing dietary fiber in Western communities would not be expected to have any adverse effect on mineral absorption if we increase not only the intake of fiber, but also the dietary intake of other food components such as protein (both vegetable and animal protein) and ascorbic, citric, and oxalic acids (in fruits and vegetables). The adequate intake of minerals, fat, and simple sugars are maintained with this type of diet. The recommendations should be best interpreted in such a way as to prevent the consumption of excessive amounts of phytate, particularly for those whose mineral needs are great. Further studies are still needed in this field in order to understand the conflicting results published in the literature regarding the effects of fiber on the utilization of minerals; however, the studies reviewed in this article may give us an idea of the complexity of mineral availability in fiber-rich, phytate-rich diets.

Animals

Primary cultures of guinea-pig gall-bladder epithelial cells suitable for patch-clamp studies.

Cells derived from explants of guinea-pig gall-bladder maintained in culture for up to 14 days, exhibit a network of cytoskeletal filaments that are labelled by an anti-cytokeratin antibody, but not by an anti-desmin antibody, suggesting that they are of epithelial origin. These cells proved suitable for patch-clamp studies and by using this method channels selective for K+ and Cl- were observed.

Animals

Trace metal lung disease: in vitro interaction of hard metals with human lung and plasma components.

Hard metal pneumoconiosis is an occupational pulmonary disease caused by long-term exposure to dust produced in the hard metal industry. In vitro experiments have been carried out to study the solubility and metabolic behaviour in human lung tissue and plasma of hard metal alloy constituents such as cobalt, tungsten, tantalum, titanium and niobium. The experiments were carried out using 60Co, 187W, 182Ta, 44Ti and 95Nb radiotracers in combination with neutron activation, radio-release tests and gel filtration techniques. Leaching experiments from neutron-irradiated hard metal dust showed that cobalt was highly soluble, especially in the lung cytosol and plasma, in comparison with tantalum and tungsten. The gel filtration experiments showed three biochemical pools of cobalt in both lung and plasma components, in accordance with the hypothesis that cobalt represents the allergic factor in the development of hard metal disease. High affinity for proteins was observed for Nb, Ta and Ti, but not for W, in agreement with the dissimilar biological half-lives of these elements in the body. The different ability of the metals to interact with biochemical components and to be solubilized in biological media may explain the various degrees of retention in the lung, which would influence the metabolic pathways. This would explain the presence of Co, Ta and W in body fluids, as well as in the public hair and toenails of hard metal workers.

Dust

Nd:YAG laser pleurodesis through thoracoscopy: new curative therapy in spontaneous pneumothorax.

From January 1986 to May 1987, 14 patients with spontaneous pneumothorax were treated in our department with a new endoscopic method using neodymium:yttrium-aluminum-garnet laser photocoagulation through thoracoscopy. The 10 male and 4 female patients ranged in age from 14 to 59 years (mean age, 29 years). In all patients, the procedure was performed under general anesthesia. The thoracoscope was introduced through a 1- to 1.5-cm incision in the anterior axillary line of the fourth intercostal space. The fiber of the laser was advanced through the operative channel of the thoracoscope. In all patients, the bleb (or blebs) detected in the apex of the upper lobe was successfully coagulated with low-power laser pulses. Then the parietal pleura of the first five ribs was partially scarified to achieve pleurodesis. There were no side effects. Thirteen patients were successfully treated without recurrence (maximum follow-up, 29 months). We conclude that this new therapy can play an important role in select patients with spontaneous pneumothorax.

Adult

Emergency laser vaporization and helium-oxygen administration for acute malignant tracheobronchial obstruction.

Two patients with malignant airway obstruction and acute respiratory insufficiency were given emergency treatment with yttrium aluminum garnet (YAG) laser tissue vaporization under local anesthesia only. A mixture of oxygen and helium was administered to reduce the respiratory distress. This case emphasizes the rapidity and effectiveness of YAG laser treatment via fiberoptic bronchoscopy under local anesthesia in the management of acute malignant airway obstructions.

Adult

Typical and atypical bronchial carcinoids.

From January 1955 to April 1987 111 patients with bronchial carcinoid were operated on in our department. There were 62 males and 49 females with a mean age of 45.5 years. Preoperative histological diagnosis was achieved in 22 cases, while in five patients, a false positive diagnosis of small cell lung cancer was reported. Fifteen patients required pneumonectomy, 70 had lobectomy, 16 bilobectomy, and four segmentectomy. One patient required tracheal resection, while in another patient the tumour was removed through bronchotomy. Four patients were completely treated with YAG laser phototherapy. There were three postoperative deaths. The following variables were analysed and discussed in order to evaluate their influence on prognosis: (1) size of the tumour, (2) typical or atypical appearance, (3) endoluminal or extraluminal growth, (4) vascular invasion, (5) node metastases. Atypical onset, node metastases and extraluminal invasion are significant factors in worsening the prognosis.

Adolescent

Surgical therapy in lung cancer with single brain metastasis.

From January 1975 to April 1987, 27 patients underwent surgical resection of non oat cell lung cancer and a single brain metastasis. There were 25 men and 2 women ranging in age from 37 to 70 years. In 21 cases the brain metastasis was synchronous while in 6 cases the onset was metachronous. In 17 cases, the site of the brain metastasis was supratentorial and in 10 cases it was located in the posterior fossa. The chest X-ray confirmed the primary lung tumour in 24 cases. In 3 cases, only bronchoscopy and cytology revealed the primary focus of the tumour. The lung cancer was located in the upper lobe in 25 patients. Upper lobectomy was performed in 23 patients, pneumonectomy in 3, and lower lobectomy in 1. There were no operative deaths. The cell type was adenocarcinoma in 19 cases, squamous cell carcinoma in 4 patients and large cell carcinoma in 4. Only the tumour and nodes were used for staging at thoracotomy. The classification was: 12 patients in stage I, 2 in stage II, and 13 in stage III. At conclusion of the study the longest survival was 68 months after thoracotomy. There was no significant difference in the duration of survival in patients over or under 50 years old. Better results were obtained in patients without node metastases at thoracotomy (median survival of 30 months and an overall 5-year survival of 35%), and in patients with supratentorial metastases (median survival of 22 months and an overall 5-year survival of 23.4%). Our experience confirms that combined surgery prolongs survival and improves the quality of life.

Adult

Synchronous brain metastasis from lung cancer. Result of surgical treatment in combined resection.

The results of combined surgical resection of brain metastasis and primary lung cancer from January 1976 to April 1986 were evaluated. In all cases the brain metastasis was single and synchronous and was resected first. There were 20 men and one woman, with an average age of 53 years. All patients initially had neurologic symptoms related to an intracranial mass. In 19 patients the primary lung cancer was roentgenologically visible, but in two the lesion was recognizable only by bronchoscopy. There were no operative deaths. Nine of 21 patients had a poor postoperative course and died during the first 6 months. The combined surgical approach improved the short-term survival rate in four patients, who died 11, 12, 18, and 21 months after the thoracic operation. In six patients (28.5%) survival for more than 2 years was obtained (three died after 27, 30, and 40 months, three are alive after 25, 28, and 48 months). Two others patients are alive and well 4 and 16 months after the thoracic operation. Synchronous onset of brain metastasis from lung cancer does not necessarily contraindicate combined operations, which can provide long-term survival in selected patients. The absence of mediastinal node metastasis is a favorable prognostic factor. Computed tomographic screening of the brain improves patient selection.

Adenocarcinoma

Cis-platin and radiotherapy in the treatment of unresectable lung cancer.

The goal of this pilot study was to verify the efficacy of the association of cisplatin plus radiotherapy in the treatment of lung cancer. Thirty-seven consecutive patients entered the study. They were treated with radiotherapy (four weekly doses of 2.5 Gy for a total of 50 Gy) and cis-platin once weekly (12 mg/m2). Partial remission was obtained in 15 patients, and 1 patient had a complete remission. Three patients previously inoperable underwent surgical treatment. The actuarial survival curve of the 29 evaluable patients showed a mean survival of 8.5 months. The mean survival of the latter is not evaluable because half of the patients are still alive after 12 to 30 months. No hematologic or renal toxicity was observed with the above schedule.

Adult

Endoscopic gluing of bronchopleural fistula.

Three patients with postpneumonectomy bronchopleural fistula were treated with endoscopic gluing of the fistula. The technique and the results of this method are described.

Bronchial Fistula