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Biomedical subjects

P Serafini

Publications and source records attributed to P Serafini.

At least 19 recordsLinked to original sources
PubMed2002

Pitfalls in pituitary diagnosis: peculiarities of three cases.

Due to the increasing availability and sensitivity of diagnostic methods, biochemical and imaging abnormalities of pituitary function and anatomy are becoming more frequent. Hyperprolactinaemia was found in three women without any prolactin (PRL) related clinical features. All three patients had normal libido, regular menses with evidence of ovulation, no galactorrhoea, and normal FSH, LH, TSH and free T4 serum levels. Magnetic resonance imaging (MRI) of the sellar region showed images that were compatible with pituitary microadenomas in all three cases. Due to the discordance between laboratory and clinical features, we searched for the presence of PRL aggregates with high molecular weight and low biological activity (macroprolactinaemia). Initially, we screened with a polyethylene glycol precipitation method, and then confirmed the presence of macroprolactinaemia by chromatography. All three cases screened positive for the presence of macroprolactinaemia. MRI alterations, compatible with pituitary microadenomas, may be due to true microincidentalomas, normal anatomical variations or imaging artefacts. In conclusion, we have described the presence of double diagnostic pitfalls that might lead to unnecessary medical or surgical intervention.

Adenoma↗
PubMed2000

Immortalized myeloid suppressor cells trigger apoptosis in antigen-activated T lymphocytes.

We described a generalized suppression of CTL anamnestic responses that occurred in mice bearing large tumor nodules or immunized with powerful recombinant viral immunogens. Immune suppression entirely depended on GM-CSF-driven accumulation of CD11b(+)/Gr-1(+) myeloid suppressor cells (MSC) in secondary lymphoid organs. To further investigate the nature and properties of MSC, we immortalized CD11b(+)/Gr-1(+) cells isolated from the spleens of immunosuppressed mice, using a retrovirus encoding the v-myc and v-raf oncogenes. Immortalized cells expressed monocyte/macrophage markers (CD11b, F4/80, CD86, CD11c), but they differed from previously characterized macrophage lines in their capacities to inhibit T lymphocyte activation. Two MSC lines, MSC-1 and MSC-2, were selected based upon their abilities to inhibit Ag-specific proliferative and functional CTL responses. MSC-1 line was constitutively inhibitory, while suppressive functions of MSC-2 line were stimulated by exposure to the cytokine IL-4. Both MSC lines triggered the apoptotic cascade in Ag-activated T lymphocytes by a mechanism requiring cell-cell contact. Some well-known membrane molecules involved in the activation of apoptotic pathways (e.g., TNF-related apoptosis-inducing ligand, Fas ligand, TNF-alpha) were ruled out as candidate effectors for the suppression mechanism. The immortalized myeloid lines represent a novel, useful tool to shed light on the molecules involved in the differentiation of myeloid-related suppressors as well as in the inhibitory pathway they use to control T lymphocyte activation.

3T3 Cells↗
PubMed2000

Identification of a CD11b(+)/Gr-1(+)/CD31(+) myeloid progenitor capable of activating or suppressing CD8(+) T cells.

Apoptotic death of CD8(+) T cells can be induced by a population of inhibitory myeloid cells that are double positive for the CD11b and Gr-1 markers. These cells are responsible for the immunosuppression observed in pathologies as dissimilar as tumor growth and overwhelming infections, or after immunization with viruses. The appearance of a CD11b(+)/Gr-1(+) population of inhibitory macrophages (iMacs) could be attributed to high levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) in vivo. Deletion of iMacs in vitro or in vivo reversed the depression of CD8(+) T-cell function. We isolated iMacs from the spleens of immunocompromised mice and found that these cells were positive for CD31, ER-MP20 (Ly-6C), and ER-MP58, markers characteristic of granulocyte/monocyte precursors. Importantly, although iMacs retained their inhibitory properties when cultured in vitro in standard medium, suppressive functions could be modulated by cytokine exposure. Whereas culture with the cytokine interleukin 4 (IL-4) increased iMac inhibitory activity, these cells could be differentiated into a nonadherent population of fully mature and highly activated dendritic cells when cultured in the presence of IL-4 and GM-CSF. A common CD31(+)/CD11b(+)/Gr-1(+) progenitor can thus give rise to cells capable of either activating or inhibiting the function of CD8(+) T lymphocytes, depending on the cytokine milieu that prevails during antigen-presenting cell maturation. (Blood. 2000;96:3838-3846)

Animals↗
PubMed2000

Losses of heterozygosity in oral and oropharyngeal epithelial carcinomas.

We analyzed 25 oral and oropharyngeal epithelial carcinomas for loss of heterozygosity (LOH) and microsatellite instability by using 55 oligonucleotide repeat markers located in 45 chromosomal regions. The aim was to identify which chromosomal regions and tumor-suppressor genes (TSGs) are preferentially lost in these tumors and to relate LOH at specific loci to clinicopathologic data. The analysis was performed on tumor tissue and on a corresponding normal tissue (blood lymphocytes) with the use of the polymerase chain reaction technique followed by microsatellite allele separation with denaturing gel electrophoresis. Thirty-two of 45 chromosomal regions demonstrated a significant (>/=20%) incidence of LOH. An allelic loss of >/=50% was found in 9p21 (77.8%), 8p22-23 (70%), 3p12 (61.5%), 1p36.1 and 12q22 (60%), 3q28 (57.1%), 5q23.3 (54.5%), 3p25-26, 3p24, and 7q35 (50%). We did not find any microsatellite instability. Our results suggest that in addition to a group of TSGs, pleiotropic for several tumor types, other suppressor genes are specifically involved in oral and oropharyngeal carcinogenesis.

Adult↗
PubMed2000

Losses of heterozygosity in endometrial adenocarcinomas: positive correlations with histopathological parameters.

We analyzed 37 samples of endometrial adenocarcinoma for loss of heterozygosity (LOH) by using a panel of 44 microsatellites located in 29 chromosomal regions. The aim of our study was to investigate the existence of a possible preferential involvement of some tumor suppressor genes in endometrial carcinogenesis. The analysis was performed on tumoral tissue and on a corresponding normal tissue by the use of polymerase chain reaction (PCR) and the comparison of the amplified alleles. We observed significative LOH (>20%) in the chromosomal regions of 2q14 (33.33%), 7q35 (24.00%), 10q22.1 (37. 50%), 11q13-q14 (44.12%), 15q26 (40.63%), 17p13 (25.71%), and 17q21. 3 (37.04%). We defined a 1-cM minimal common deletion in 11q13-q14 between D11S911 and D11S937 markers. A statistical analysis revealed a positive correlation between LOH of 11q13-q14 and clinicopathological data.

Adenocarcinoma↗
PubMed1999

Perinatal outcome after in-vitro fertilization-surrogacy.

The perinatal outcome of pregnancies (both single and multiple) established after in-vitro fertilization (IVF)-surrogacy was evaluated and compared to the outcome of pregnancies that resulted from standard IVF. Analysis of medical records and a telephone interview with physicians, IVF-surrogates, and commissioning mothers were conducted to assess prenatal follow up and delivery care in several hospitals. 95 IVF-surrogates delivered 128 liveborn (65 singletons, 27 sets of twins and two sets of triplets). The commissioning mothers and the IVF-surrogates average ages were 37.7 +/- 5.0 and 30.4 +/- 4.7 years old respectively. IVF-surrogates carrying twin and triplet gestations delivered substantially earlier than those who gestated singleton pregnancies (36.2 +/- 0.4 versus 35.5 versus 38.7 +/- 0.3 weeks gestation respectively; P < 0.001). Twin newborns were significantly lighter than singleton infants born through IVF-surrogacy (2.7 +/- 0.06 versus 3.5 +/- 0.07 kg; P < 0.001). The incidence of low birth weight infants rose from 3.3% in the single births to 29.6% (P < 0.01) in the twins and to 33.3% in the triplets born through IVF-surrogacy. The incidence of prematurity was significantly greater in both twins delivered by IVF-surrogates (20.4%) and infertile IVF patients (58%). The occurrence of pregnancy-induced hypertension and bleeding in the third trimester was four to five times lower in the IVF-surrogates, independently of whether they were carrying multiples. The incidence of Caesarean section was 21.3% for singleton gestations, while two times higher in the IVF-surrogates carrying multiples (56.3%). Postpartum complications occurred in 6.3% of patients and the incidence of malformation was similar to those reported for the general population. The results provide general reassurance regarding perinatal outcome to couples who wish to pursue IVF-surrogacy.

Adult↗
PubMed1998

Host response to EBV infection in X-linked lymphoproliferative disease results from mutations in an SH2-domain encoding gene.

X-linked lymphoproliferative syndrome (XLP or Duncan disease) is characterized by extreme sensitivity to Epstein-Barr virus (EBV), resulting in a complex phenotype manifested by severe or fatal infectious mononucleosis, acquired hypogammaglobulinemia and malignant lymphoma. We have identified a gene, SH2D1A, that is mutated in XLP patients and encodes a novel protein composed of a single SH2 domain. SH2D1A is expressed in many tissues involved in the immune system. The identification of SH2D1A will allow the determination of its mechanism of action as a possible regulator of the EBV-induced immune response.

Antigens, CD↗
PubMed1998

Absence of hepatitis C virus and detection of hepatitis G virus/GB virus C RNA sequences in the semen of infected men.

The identification of hepatitis C virus (HCV) in semen remains controversial and that of hepatitis G virus (HGV) or GB virus C (GBV-C) has never been investigated. Serum and semen from 90 anti-HCV-positive drug users were tested (27 infected with HIV) for HCV and HGV/GBV-C RNAs by polymerase chain reaction (PCR) assay, hybridization, and sequence analysis. Semen was processed into round cells, seminal plasma, and spermatozoa. Fifty-six patients were HCV-viremic, but HCV-RNA was not identified in their seminal fractions. However, PCR inhibitors were found in the semen of 34 of these men. Twenty-eight patients had HGV/GBV-C RNA in their blood and for 24 of them, ejaculates were available for analysis. HGV/GBV-C RNA was found in the seminal plasma of 6 of 12 samples free from PCR inhibitors. These results agree with the low risk of sexual transfer of HCV and provide preliminary evidence for the presence of HGV/GBV-C in semen.

AIDS-Related Opportunistic Infections↗
PubMed1997

Successful birth after intrafallopian transfer of microhatched embryos.

OBJECTIVE: To present a successful transfer of microhatched embryos to the fallopian tubes via microlaparoscopy. DESIGN: Case report. SETTING: Private practice affiliated with a medical university. PATIENT: A 40-year-old woman with primary infertility, mildly elevated baseline FSH levels, and a history of poor ovarian response to ovulation induction. Her husband had severe oligoospermia after vasectomy reversal. INTERVENTION(S): Late luteal leuprolide acetate to pituitary down-regulation followed by pure FSH, 300 IU, and hMG, 300 IU, daily for ovulation induction. Transvaginal oocyte retrieval, intracytoplasmic sperm injection, assisted embryo hatching, microlaparoscopic intrafallopian ET. MAIN OUTCOME MEASURE(S): Amniocentesis at the 14th week of gestation revealed a normal karyotype (46,XX), birth of a normal female infant (3700 g). RESULT(S): Establishment of a single, viable intrauterine gestation followed by a vaginal delivery at term. CONCLUSION(S): This case shows the possibility of using assisted-hatched embryos for laparoscopic intrafallopian tube transfer.

Adult↗
PubMed1997

[Home delivery in Italy and the Netherlands. Experience and comparison].

The study of the emerging "phenomenon" of home birth calls, to a greater extent than for other forms of assistance provided by health workers, for a sophisticated analysis capable of integrating a knowledge of legal norms, economic and sociocultural aspects, technical assistance procedures, professional and corporative aspects, and in particular medicolegal aspects. The first part of this study outlines the legislative evolution of assistance in a hospital setting and the professional training of midwives and other operators involved in the birth process in Italy. These dispositions reveal the distinct characteristics and responsibility of the various types of health operators in this specific area of the health service, as well as the formulation and development of legislation on home birth, with special reference to Piedmont Region. This is followed by an analysis of home birth in Holland, giving a description of the context, the professional figures involved and the organisational and procedural set-up (based on economic considerations and on a territorial health planning through a series of very detailed networks that differ considerably from the form of obstetric and gynecological assistance in Italy related to pregnancy and birth). In the discussion the authors examine the evolution and topicality of informed consent, which is then referred to the specific theme of assistance for pregnant women opting for a home birth; they comment on the current state of affairs and highlight the lacunae in the proposed regional legislation that correctly offers a choice between hospital and home birth, but does not present the instruments for the prior verification of the midwife's capacity to perform the specific method or even the indications for providing an adequate level of information and collaboration from the pregnant woman. The authors conclude by presenting a series of suggestions and hypotheses regarding both training aspects for those assisting home birth in obstetric schools and for the institution of control mechanisms regarding this particular freelance profession within the context of the appropriate guild.

Female↗
PubMed1996

Automated method for the measurement of amino acids in urine by high-performance liquid chromatography.

An automatic and sensitive HPLC method for the determination of primary and secondary amino acids included cystine and homocystine in urine samples is described. After a simple ultrafiltration, urine samples were subjected to reduction of disulfides, carboxymethylation of free thiols and double precolumn derivatization with o-phthalaldehyde-3-mercaptopropionic acid and 9-fluroenylmethyl chloroformate. All reactions were fully automated by means of an injector programme and were accomplished in 10 min. Since urine samples contain a large number of amino compounds, a good resolution was required. By optimization of the conditions, separation of 40 amino acids in 92 min was achieved. The recovery of amino acids ranged from 83% for TRP to 105% for CIT. The within-run and between-run R.S.D.s of urinary amino acid concentrations were below 10% for most amino acids except for HYL, LYS and ORN. The method was applied to the diagnosis of genetic disorders of amino acid metabolism.

Amino Acid Metabolism, Inborn Errors↗
PubMed1995

Selective salpingography with an insemination catheter in the treatment of women with cornual fallopian tube obstruction.

The effectiveness of selective tubal cannulation using a simple and inexpensive tubal insemination catheter was evaluated in 23 infertile patients with cornual obstruction demonstrated by hysterosalpingography. Selective fluoroscopic tubal catheterization was accomplished in 95% of the patients with resulting tubal patency in 70% of the procedures (28 recanalizations out of 40 Fallopian tubes). Eight patients (34.8%, eight out of 23) became pregnant, six went on to full-term deliveries and two experienced spontaneous first-trimester abortions. One women conceived twice, and delivered a singleton pregnancy after the first recanalization and a twin gestation after the second salpingography. No complications were reported. The results of this study emphasize the ease, cost effectiveness and safety of this method, encouraging its use in patients with cornual Fallopian tube obstruction either as the sole therapeutic approach or in association with other assisted conception treatment alternatives.

Adult↗
PubMed1995

Preovulatory sonographic uterine receptivity index (SURI): usefulness as an indicator of pregnancy in women undergoing assisted reproductive treatments.

To evaluate the uterine component as a determinant variable in the probability of establishing a pregnancy after assisted reproductive treatments, we introduced a mathematical formula derived from standard endovaginal uterine monitored color Doppler imaging parameters. We analyzed 102 cycles of ovarian stimulation with leuprolide acetate and exogenous gonadotropins resulting in 52 clinical pregnancies by stepwise logistic regression analysis. Sonographic endometrial pattern, thickness, diastolic blood flow, and resistive index variables were transformed into categorical variables and forced to yield a regression equation. Sonographic uterine receptivity index was calculated as a summation of four times endometrial pattern, five times resistive index, and two times diastolic blood flow. This index yielded values for each patient in a range of 0 to 15. Scores > or = 13 were associated with a successful outcome in 79.4% of the patients, whereas scores between 8 and 12 were accompanied by 45.8% pregnancy rates (P = 0.01), and scores < or = 7 had successful treatment outcome in only 7.7% (P = 0.0001). The scores obtained by this mathematical equation provide the ability to make reliable predictions about the outcome of assisted reproductive treatments in women undergoing ovulation induction with leuprolide acetate and human menopausal gonadotropins.

Adult↗
PubMed1994

Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments.

OBJECTIVE: To determine preovulatory uterine sonographic predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. DESIGN: Prospective evaluation of uterine sonographic and vascular flow profiles in women stimulated with leuprolide acetate and hMG. SETTING: Private fertility center and tertiary-care academic center. PATIENTS: Ninety-six women underwent 102 cycles of ovulation induction for IVF (46), GIFT (20), and zygote intrafallopian transfer (36). MAIN OUTCOME MEASURES: Endometrial texture, thickness, resistance index at the first branch of uterine artery, diastolic blood flow, and pregnancy outcome (no conception, spontaneous abortion, and delivery). RESULTS: Triple-lined pattern was predominant in women who delivered liveborn infants (P < 0.005). Endometrial pattern and diastolic blood flow were the only predictive markers of term pregnancy (P < 0.001 and P < 0.05, respectively). CONCLUSION: Preovulatory triple-lined sonographic endometrial texture and the presence of end diastole blood velocities at the first branch of uterine artery are the most important uterine predictors of conception.

Adult↗
PubMed1994

Resection of large uterine septum during early pregnancy and at the oocyte retrieval--peculiarities of two cases.

Two cases of hysteroscopic metroplasties for large septate, one performed at the time of oocyte retrieval, and the second at the time of curettage for early first trimester spontaneous pregnancy loss, are reported. The peculiarities of medical circumstances and surgical approaches are discussed. Each patient had an excellent post-surgical result and a successful pregnancy. The notion that the performance of hysteroscopic surgery in women presenting with supraphysiological serum oestradiol concentrations or an early miscarriage would increase intra-operative bleeding and post-operative complications respectively is challenged by this report. The authors emphasize that thorough counselling, meticulous planning, appropriate follicular phase timing and excellent surgical techniques remain the mainstay for success.

Abortion, Spontaneous↗
PubMed1993

Osteocartilaginous flap technique for acquired and congenital saddle nose deformities.

This paper illustrates the objective possible applications of the osteocartilaginous flap technique in solving the functional and aesthetic problems associated with saddle nose deformities, the pathogenesis of which essentially relates to: (1) congenital saddle noses; (2) post-traumatic saddle noses; and (3) saddle noses resulting from previous surgery on the septum. This technique is suggested as an alternative to a combination of other methods (such as septoplasty, bone, or cartilage grafts) to restore the inhalatory function of the internal nasal valve and the integrity of the nasal support structures using locally available tissues. The authors prefer to use this technique in the treatment of serious congenital or acquired saddle nose deformities and to assign composite grafts a supplementary function only. The different stages of this surgical procedure are analyzed and the results are assessed during short- and medium-term follow-up.

Adult↗