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Biomedical subjects

M Valli

Publications and source records attributed to M Valli.

At least 19 recordsLinked to original sources

Mild dominant osteogenesis imperfecta with intrafamilial variability: the cause is a serine for glycine alpha 1(I) 901 substitution in a type-I collagen gene.

The molecular defect responsible for a case of mild osteogenesis imperfecta (OI) with repeated femoral fractures was investigated. The proband and his mother, who presented minor OI signs but no bone fractures, were shown to produce normal and abnormal type-I procollagen molecules in their dermal fibroblasts. The molecular defect was localized in about half of the proband's pro alpha 1(I) mRNA molecules by chemical cleavage with piperidine of hydroxylamine-reacted mRNA:cDNA heteroduplexes. The corresponding region was reverse-transcribed and amplified by polymerase chain reaction (PCR). Cloning and sequencing of the amplified products revealed in both subjects a G-to-A transition in the first base of codon 901 of the alpha 1(I) triple helical domain, which led to a serine for glycine substitution. Allele-specific oligonucleotide hybridization to amplified genomic DNA from fibroblasts and leukocytes confirmed the heterozygous nature of both patients and proved the absence of mosaicism. The presence of the mutation was excluded in other healthy family members, who were reported to have bluish selerae. The mild phenotypic outcome of this newly characterized mutation contradicts previous findings on glycine substitutions in the C-terminal region of collagen triple helix, most of which caused lethal OI.

Base Sequence

Evolutionary somatic cell changes in cervical tumour progression quantitatively evaluated with morphological, histochemical and kinetic parameters.

The somatic cell changes which characterise malignancy evolution in human cervical preneoplastic and neoplastic lesions have been assessed on histological sections by means of a computerised image analyser. Many features have been simultaneously measured on each cell of the lesions studied, and the following results have been obtained: Some features, mainly kinetic, show continuously increasing values which express changes correlated to the increasing malignancy; other features, especially related to nuclear atypia, cellular heterogeneity and the degree of aneuploidy, have values dropping at the level of early stromal infiltration, which can be morphometrically characterised as composed of relatively homogeneous phenotypes; these features seem to express the degree of genetic instability and relate to the evolutionary somatic cell changes; tumour progression evolves through sequential discontinuous steps, each of them characterised by specific phenotypical features of the neoplastic cell population; the neoplastic cells in the foci of early stromal infiltration and vascular invasion, phenotypically more homogeneous than the parent cell populations of carcinoma in situ and infiltrating carcinoma, seem to possess a greater genetic stability.

Aneuploidy

Cytometric evidence that cervical intraepithelial neoplasia I and II are dysplasias rather than true neoplasias. An image analysis study of factors involved in the progression of cervical lesions.

Image analysis was performed on 40 Feulgen-stained histologic samples and 48 Feulgen-stained cytologic preparations representing normal squamous epithelium and all grades of cervical lesions (from mild dysplasia to invasive carcinoma) in order to characterize the evolutionary progressive changes in cervical epithelial proliferative disease toward malignancy. Quantitative studies included the analysis of proliferative features, differentiation features, nuclear morphology and DNA content. The data obtained on the histologic sections showed that the various features, to a different extent, detected a gradual increase in phenotypic cellular disarrangements related to the progression of the cervical lesions toward malignancy--that is, the modifications to nuclear area, perimeter, DNA content, percentage of nuclei with nucleoli, nuclear/cytoplasmic ratio and percentage of cells with no membrane positivity for soybean agglutinin lectin were progressively greater, moving from normal epithelium and mild dysplasia toward infiltrating carcinoma. In particular, all the morphologic and histochemical features appeared to parallel a diploid reduction and the appearance of aneuploidy. The simultaneous evaluation of proliferation- and differentiation-related features, together with those of nuclear DNA content, showed two main successive preneoplastic lesions: one characterized by an increase in cell turnover without alterations in its organization and another by a true neoplastic disorder. The data obtained on sequential cytologic examinations showed that individual cell changes are detectable and seem basically to be characterized by the appearance of clusters of cells with somatic characteristics not observed in previous cytologic checks. From the results of our study, the cervical intraepithelial neoplasia (CIN) concept appears to be inaccurate. In fact, only CIN III (severe dysplasia/carcinoma in situ) lesions have the morphologic and proliferative alterations of true neoplasia. In contrast, CIN I and some cases of CIN II lesions lack these characteristics and seem to be properly classified as dysplasia, thus avoiding the term neoplasia, implicit in CIN. Moreover, the multivariate study of data sets of features related to the progressive somatic changes, both in histologically and cytologically studied cases, allows us to detect the steps of progression; they are marked by the appearance of cell clusters with qualitatively different phenotypic characters when compared to the cell populations from which they presumably arise. These results seem to provide a further argument against the CIN theory, which stresses the concept that progression is related only to a gradual numerical increase in an initially established phenotype with the characteristics of malignancy.

Biopsy

A de novo G to T transversion in a pro-alpha 1 (I) collagen gene for a moderate case of osteogenesis imperfecta. Substitution of cysteine for glycine 178 in the triple helical domain.

Cultured fibroblasts from a patient affected with a moderate form of osteogenesis imperfecta were defective for the synthesis of type I collagen molecules; about half of the alpha 1(I) chains contained a cysteine residue in the triple helical domain and a disulfide link formed when two mutant alpha 1(I) chains were incorporated into a type I collagen heterotrimer. The proband's parents were clinically and biochemically normal. The cysteine was localized within peptide alpha 1(I)CB8 between residues 170 and 200 of the triple helical domain using a chemical procedure with 2-nitro-5-thiocyanobenzoic acid (Tenni, R., Rossi, A., Valli, M., Mottes, M., Pignatti, P. F., and Cetta, G. (1990) Matrix 10, 20-26). Type I procollagen heterotrimers containing either one or two mutant chains showed (i) a slight abnormality in secretion from cells; (ii) a low degree of post-translational overmodifications; (iii) the same, but lower than normal, thermal stability. Total RNA was isolated from the proband's dermal fibroblast cultures, and cDNAs for pro-alpha 1(I) were prepared d using total RNA. A portion of cDNA, coding for the region encompassing residues 119-193 of alpha 1(I) triple helical domain, was amplified by polymerase chain reaction. A single base pair mismatch was identified by chemical cleavage of DNA.DNA heteroduplexes, indicating a possible substitution of a guanine in the triplet coding for glycine 178 or 181. The same unique mismatch was detected by chemical cleavage in about one-half of the molecules in heteroduplexes formed between patient's pro-alpha 1(I) mRNAs and a normal cDNA probe. The amplified products were cloned and sequenced, confirming the heterozygous nature of the patient and demonstrating the presence and the location of a missense mutation; a single T for G substitution was found in the first base of the triplet coding for residue 178 of alpha 1(I) triple helical domain, leading to a cysteine for glycine substitution. Allele-specific oligonucleotide hybridization to amplified DNA confirmed a de novo point mutation in the proband's genome. The findings in this patient are in accord with the phenotypic gradient model, which correlates the localization of the structural defect with the clinical outcome of osteogenesis imperfecta. The mutant protein has some properties that differ from the caused by the cysteine for glycine 175 substitution, suggesting a direct influence of the neighboring amino acids on the effects of the mutation.

Alleles

Anomalous cysteine in type I collagen. Localisation by chemical cleavage of the protein using 2-nitro-5-thiocyanobenzoic acid and by mismatch analysis of cDNA heteroduplexes.

A method is presented for the localisation of an anomalous cysteine inside the triple helical domain of type I collagen from a patient affected with Osteogenesis Imperfecta. The chemical cleavage used relies on the specificity and reactivity of the thiol side chain versus 2-nitro-5-thiocyanobenzoic acid, to yield cyanocysteine; in mild alkaline conditions this derivative will undergo the breakdown of its N-side peptide bond. This method could allow a more precise localisation of anomalous cysteine in both type I collagen alpha chains, alpha 1(I) and alpha 2(I), compared to previous analytical methods on CNBr peptides. For the mutant alpha 1(I) chains from a patient affected by Osteogenesis Imperfecta, we found a location of cysteine in the peptide alpha 1(I)CB8, between amino acids 170-200. Biochemical localisation was confirmed by a chemical cleavage method for mismatched cytosines on heteroduplexes obtained after denaturation and annealing of a 233 bp cDNA fragment amplified by PCR from the heterozygote patient.

Base Sequence

Moderately severe osteogenesis imperfecta: biochemical studies showing variable defect localization in the triple-helical domain of type I collagen.

This report describes the biochemical investigations on six patients affected by a moderate form of Osteogenesis Imperfecta (type IV according to the Sillence classification). Biochemical characterization of type I collagen produced by skin fibroblasts showed considerable heterogeneity: in three patients out of six, collagen appeared normal; while in the three others a structural defect in the protein was present. In these probands the mutations were localized in different regions of the triple helix domain (corresponding to peptides alpha 1(I)CB6 and alpha 1(I)CB7). In two probands showing the defect in alpha 1(I)CB7, a decrease of the thermal stability of the protein was present.

Child

Plasma 3-methoxy-4-hydroxyphenylglycol in manic patients: relationships with clinical variables.

Plasma levels of 3-methoxy-4-hydroxyphenylglycol (MHPG) were found to be significantly higher in manic patients than in age- and sex-matched normal controls (n = 22). In 18 manic patients plasma MHPG correlated with manic symptoms but not with anxiety, depression, motor behaviour, acute psychosis, schizophrenia and severity of illness. A positive correlation between MHPG and grandiosity items on rating scales suggests a link with cognitive contents and therefore a relationship with central factors.

Adolescent

Plasma levels of 3-methoxy-4-hydroxyphenylglycol in depressed patients compared with normal controls.

Plasma levels of total 3-methoxy-4-hydroxyphenylglycol (MHPG) were measured in a group of 104 hospitalized depressed patients and a group of 104 age- and sex-matched normal controls. Plasma MHPG levels were found to be normally distributed in both groups and significantly lower in depressives than in controls. However, this difference could be related to an increase in plasma MHPG levels with age found in controls (r = 0.601, d.f. = 102, p less than 0.01) but not in depressives (r = 0.013, d.f. = 102, NS). Men had significantly higher levels than women in both groups. There was no significant difference in plasma MHPG levels among any DSM-III-R diagnostic subgroups of depressives or between patients who were suppressors on the dexamethasone suppression test and those who were nonsuppressors. Significant correlations were found between AMDP Depression Rating Scale item and total scores and levels of plasma MHPG. Age, sex and clinical symptoms appeared to be main sources of variance in studying depressed patients and comparing them with normal controls.

Adult

Unilateral microfibrillar abnormalities in a case of asymmetric Marfan syndrome.

The Marfan syndrome is a dominantly inherited connective-tissue disorder characterized by ocular, cardiovascular, and musculoskeletal abnormalities. Although the underlying biochemical and molecular defect(s) of this pleiotropic disease is currently unknown, we have consistently observed apparent diminished content of elastin-associated microfibrillar fibers accumulating in skin, or produced by cultured fibroblasts, from patients with the Marfan syndrome and have documented the cosegregation of these immunofluorescent abnormalities of microfibrillar fibers with the Marfan syndrome phenotype in family studies. Recently, an unusual patient has been described with unilateral phenotypic features of the Marfan syndrome, providing an unique opportunity to compare microfibrillar fibers and other connective-tissue components between the affected and nonaffected sides. In the present report, we demonstrate striking differences in apparent content of microfibrillar fibers, as determined by indirect immunofluorescence of skin and fibroblast cultures, that are revealed when multiple homologous samples derived from different sides of the patient's body are compared. In contrast, no differences in apparent content of type III collagen or in the biosynthesis and apparent structure of types I and III (pro)collagens were found. HLA types and chromosome heteromorphisms were identical in fibroblasts from both sides of the body, eliminating the formal possibility of chimerism and suggesting that a postzygotic mutation accounts for the asymmetric manifestation of the Marfan syndrome in this patient. The observation of striking decreases in microfibrillar fibers on the affected side of the body provides further evidence that abnormalities of this component of the elastic fiber system may be central to the pathogenesis and possibly the etiology of the Marfan syndrome.

Cells, Cultured

Treatment failure in cervical cancer: high risk factors of relapse.

Actuarial survival in 178 patients treated with radical surgery and lymphadenectomy from 1977 to 1987 have been evaluated. The survival rate at 60 months in the 124p N0 patients was 95%; in the 57 p N1 patients was 20.2%. The survival in patients with only 1 or 2 metastatic lymph nodes was 39.7%, while it was 13.1% with 3 or more lymph nodes involved. Survival rate related to lymph nodal metastatic level was 36%, 32%, 17% respectively when the first, second and third levels were involved. We demonstrated a statistically significant relation between survival and external thirds, CLS, vaginal, parametrial invasion. A multifactorial analysis also showed the remarkable significance of the simultaneous negativity of vaginal, CLS, external third invasion (survival rate 98.4%). When the positivity of the external invasion was associated with simultaneous negativity of vaginal and CLS invasion the survival rate was 79.4%. The survival rate in patients with positive vaginal and external third invasion was 26%. This showed the decisive importance of vaginal invasion in cervical cancer survival.

Female

[Comparative study of sodium valproate and ketoprofen in the treatment of postoperative pain].

Experimental data has shown that sodium valproate has analgesic properties in animals, probably by way of the increase in cerebral and spinal gamma amino-butyric acid (GABA) it induces. A study was therefore designed to assess this analgesia in man in the postoperative period. A first open study was carried out on 12 consenting patients, who were each given 15 mg.kg-1 sodium valproate intravenously over 20 min. A significant decrease in pain intensity, measured by an analogic visual scale, was seen from the 20th min up to the 140th min. A controlled double-blind study was then carried out; it included three groups of 13 patients each. Patients in group 1 were given placebo (5% dextrose); group 2 patients were given 15 mg.kg-1 sodium valproate intravenously over 20 min, and group 3 patients 2 mg.kg-1 ketoprofen intravenously over 20 min also. There was no difference in the pain intensity profile of groups 1 and 2: sodium valproate was no more efficient than placebo in relieving postoperative pain. However, ketoprofen gave a prompt and effective analgesic effect. The clinical data obtained with sodium valproate in man during the postoperative period stand in contrast with the promising animal results. Sodium valproate cannot be recommended for the treatment of postoperative pain.

Adult

Plasma 3,4-dihydroxyphenylethyleneglycol and 3-methoxy-4-hydroxyphenylethyleneglycol as indicators of central noradrenergic activity. A comparative study on control subjects and depressed patients.

Animal studies have suggested interspecies differences in brain norepinephrine (NE) metabolism, especially with regard to the relative proportions of 3,4-dihydroxyphenylethyleneglycol (DOPEG) compared to 3-methoxy-4-hydroxyphenylethyleneglycol (MOPEG). In order to question the value of both glycol metabolites as peripheral indices of central noradrenergic activity, a comparative study of plasma DOPEG and MOPEG (measured by HPLC) related to depression, sex, age and diagnostic categories (DSM-III) was carried out on depressed and control subjects. In addition, two groups of 8 patients were randomly submitted to a desipramine 150 mg/day, or a metapramine 450 mg/day antidepressant treatment influencing the formation of DOPEG and MOPEG in a different way. The study did not demonstrate any difference between DOPEG and MOPEG for most of the experimental factors. We found also a significant positive correlation between plasma levels of DOPEG and MOPEG. Our results support the idea that each of these two biological indices can be used in the assessment of central noradrenergic activity.

Adult

[The role of edema in cerebral ischemia. From physiopathology to therapeutics].

Brain ischemia induces an original form of edema associating a "cytotoxic" component and a "vasogenic" component which is more inconstant. The authors set out a synthesis of fundamental research concerning the different factors of ischemic brain edema. Although anti-edematous drugs (steroids, barbiturates, diuretics) are widely used, there is no serious evidence of their efficacity. New therapies are based on a specific approach of the different disturbances of cerebral ischemia. However, controlled studies are necessary to evaluate the effects of these new drugs.

Blood-Brain Barrier

Hormonal and surgical treatment of endometrial adenocarcinoma.

From January 1st 1980 up to December 31st 1986, 93 endometrial adenocarcinomas were treated at the Chair B of the Institute of Gynecology and Obstetrics. Full anatomopathological and hormonal data are available for 81 cases on whom diagnostic and therapeutic protocols were applied. In this selected group, positive lymph nodes were shown in 10 cases. Lymph node positivity was compared with miometrial infiltration grade: there were only two cases of lymph nodal positivity among 49 adenocarcinomas in which the invasion was more than 10 mm from the serosa, 8 lymph nodes metastases out of 32 adenocarcinomas with a distance between 10 and 5 mm and with distance less than 5 mm.

Adenocarcinoma