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Biomedical subjects

T Motta

Publications and source records attributed to T Motta.

At least 19 recordsLinked to original sources

Gonadotropin releasing hormone agonist treatment for severe menorrhagia in patients with contraindications to surgery.

Four patients with heavy menorrhagia, severe iron-deficiency anemia and contraindications to surgery were treated with a gonadotropin-releasing hormone agonist in a depot formulation. At 2 months of therapy they were all amenorrheic, and at 6 months the hematologic values had improved markedly. Gonadotropin-releasing hormone agonists may obviate emergency surgery in patients at high surgical risk or could constitute the first line of sequential therapeutic regimens, once general health conditions have improved.

Adult

[Primary malignant lymphoma of the parotid gland. Report of a case].

Primary malignant lymphoma of the parotid gland is often correlated, in literature data, with inflammatory autoimmunological disease of the salivary gland. Finding of blasticlymphoid cells in myoepithelial scialoadenitic areas in a case of parotid disease is described by the Authors. Needle may be useful in detecting these high radio-chemosensitive neoplasms to reduce the occurrence of complications of total parotidectomy.

Aged

Abnormal uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile in a primary cardiac lymphoma.

Abnormally high uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile (99mTc-SESTAMIBI) in the right ventricle and in the septum was observed in a 47-year-old woman initially presenting with dysarthria and left hemiparesis. Endomyocardial biopsy demonstrated a high-grade malignant non-Hodgkin's lymphoma. Complete remission was achieved by combined cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy and radiotherapy of the heart and mediastinum. The post-remission single photon emission tomography (SPET) 99mTc-SESTAMIBI study showed a homogeneous distribution pattern, in agreement with echocardiography computed tomography and magnetic resonance imaging. Increased uptake of 99mTc-SESTAMIBI, a myocardial perfusion agent, has been observed in some benign and malignant tumours. It may prove to be useful in the diagnosis and follow-up of malignancies.

Antineoplastic Combined Chemotherapy Protocols

Flutamide in the treatment of hirsutism.

Ten hirsute women were treated with flutamide (250 mg/day) for 6 months to evaluate its effect. Hair growth as assessed by the Ferriman and Gallwey hair score was significantly reduced in all patients (P less than 0.01). The only significant change in endocrine levels was an increase in serum androstenedione (P less than 0.01). Acne and seborrhea improved markedly. No side effects were noted during the treatment. Our data suggest that the antiandrogenic properties of flutamide render it a suitable single agent in the treatment of hirsutism.

Adolescent

Cabergoline versus bromocriptine in suppression of lactation after cesarean delivery.

We evaluated the efficacy of cabergoline, a new ergoline derivative, in blocking puerperal lactation in a group of women delivered by cesarean section. In a single-blind controlled trial 36 women were randomly allocated to treatment with cabergoline 1 mg in a single dose p.o. (n = 18) or bromocriptine 5 mg/day p.o. for 14 days (n = 18). Treatment was started about 50 h after delivery. Clinical assessment of breast signs and determination of serum prolactin were performed just before treatment and at 3, 5, 7 and 14 days. In the cabergoline-treated group milk secretion was inhibited in 17 women (94.4%). Maximum decrease of serum prolactin was -89.7% at 5 days, and the prolactin-lowering effect of cabergoline was still present at 14 days. In the bromocriptine group milk secretion was inhibited in 16 women (88.9%). Maximum prolactin decrease (-86.9%) was reached at 3 days. Persistent side effects were comparable in the two groups. This study demonstrates that a single oral dose of 1 mg cabergoline is as effective in suppressing puerperal lactation as a full treatment with bromocriptine, even in women delivered by cesarean section.

Administration, Oral

Monoclonal lymphocytosis with villous lymphocytes: a chronic lymphoproliferative disease of CD11c+ B-cells.

Most of the circulating lymphocytes from three asymptomatic adults (one male, two female, age range 61-67 years) with isolated persistent lymphocytosis of between 7.1 and 10 x 10(9)/l possessed characteristic villous projections of the cell membrane. Morphological, histochemical, ultrastructural, immunological, and genotypic studies confirmed a clonal proliferation of tartrate-resistant acid phosphatase (TRAP)-negative CD5-CD10-CD25- and CD11c+ B-cells. In addition to CD11c, these cells expressed other adhesion receptors (LFA-1/CD11a, VLA-4/CD29/49d, ICAM-1/CD54, and LAM-1) and produced detectable amounts of interleukin-1 beta, interleukin-6, and in one case tumour necrosis factor-alpha mRNA. This monoclonal villous lymphocytosis (MVL) could be differentiated from B-cell chronic lymphocytic, prolymphocytic, and hairy cell leukaemias, and from previously recognized CD11c+ chronic B-cell leukaemia. A rare splenomegalic non-Hodgkin's lymphoma variant with circulating villous B-lymphocytes (SLVL), usually CD10+ and sometimes CD11c- and TRAP+, appears to be a closely related disorder. In all three patients the lymphocyte count increased very slowly, at a rate less than 5 x 10(9)/l per year, over 3-7.5 years of follow up, and a moderate splenomegaly eventually developed in one of the patients. Chemotherapy was never required. MVL may be a relatively benign clinical entity akin to SLVL within the group of CD11c+ B-cell lymphoproliferative disorders.

Aged

Evaluation of histological and ultrastructural aspects of endometrium during treatment with gestrinone in women with amenorrhea or spotting.

Nineteen patients with a laparoscopic diagnosis of endometriosis were treated with gestrinone at a dosage of 2.5 mg twice a week for 6 months. In 7 who reported spotting in the first 3 months, the dose was increased to 2.5 mg three times a week during the second trimester. An endometrial sample was obtained from each patient at the time of laparoscopy (basal) and at 3 and 6 months of treatment. Endometrial structure and ultrastructure were studied. Areas of hemorrhage and of loss of surface epithelium and a lesser degree of involution of the surface epithelium were observed in the 3-month samples of 7 patients with spotting, compared with 12 with amenorrhea. It is hypothesized that incomplete endometrial involution could be due to differences in gestrinone pharmacokinetics in individual patients, in the quality and/or quantity of endometrial cytosolic receptors for sex steroids, or in endocrine compensation to administration of the drug.

Adult

Growth hormone and ACTH secretory dynamics in Turner's syndrome.

The secretory dynamics of GH and ACTH were studied in 14 patients with Turner's syndrome. The parameters investigated were plasma GH and cortisol responses to hypoglycemia, plasma cortisol circadian rhythm and suppressibility by dexamethasone, and response of urinary Porter-Silber chromogens to metyrapone. The results were mostly normal. These data do not support the hypothesis suggesting an abnormality of hypothalamic-pituitary function in Turner's syndrome.

17-Hydroxycorticosteroids

Unusual radiological presentation of a primary CNS lymphoma.

The Authors report a case of primary cerebral lymphoma occurred in a 62 years old lady, who came to observation for headache and mood alterations. An enhanced CT showed a lesion recalling a meningeal sarcoma. Points of interest in this case are the unusual radiological appearance and the infrequent localization. Main anatomical and clinical characteristics of primary CNS non-Hodgkin lymphomas are recalled, even with regard to modern immunohistochemical techniques.

Brain Neoplasms

Male pseudohermaphroditism due to 17-hydroxylase deficiency.

A 27-year-old phenotypic female presented with primary amenorrhea, severe hypertension, and hypokalemia. At the age of puberty sexual development had not occurred; in particular, sexual hair had not grown. Past history revealed an episode of subarachnoid hemorrhage and several episodes of ventricular tachyarrhythmia. Karyotype was 46, XY. The steroids requiring 17-hydroxylation (cortisol, testosterone, pregnanetriol, 17-ketosteroids, 17-hydroxycorticosteroids) were low, while those not requiring 17-hydroxylation (progesterone, deoxycorticosterone, corticosterone) were high, demonstrating 17-hydroxylase deficiency. The corticosterone/deoxycorticosterone ratio was relatively low, suggesting an associated partial deficiency of 11-hydroxylase.

Adrenal Hyperplasia, Congenital

Ultrastructure of endosalpingeal biopsies in infertile patients: correlation with reproductive success.

We calculated the percentage of ciliated cells (PCC) in salpingeal microbiopsies of 41 patients with tubal infertility and ampullary microbiopsies of 36 fertile women, using the planimetric method at 500-1000 x at the scanning electron microscope. No relation was found between PCC and fertility after surgery. Thus normal ciliation does not seem to be essential for reproductive success and other factors such as the state of preservation of the tubal wall may be important.

Biopsy

Increased forearm bone mineral content after bromocriptine treatment in hyperprolactinemia.

We studied 15 hyperprolactinemic women to evaluate possible modifications of bone mineral content after pharmacological treatment. Patients received a dopamine agonist (bromocriptine) for six months after which there was a significant decrease of prolactin plasma levels (P less than 0.01) and a significant increase of bone mineral content (P less than 0.05).

Adolescent

A role for dopamine in growth hormone regulation in the dog.

The role of dopamine (DA) in the secretion of GH in most animal species is still controversial. We examined in the dog the effect on GH release of nomifensine, a drug which activates both noradrenergic and dopaminergic neurotransmission. Nomifensine (0.4-2.8 mg/kg, iv), administered into 12 unanesthetized male and female beagles, induced short-dose-related rises in canine GH (cGH) levels. Blockade of alpha-adrenergic receptors by phentolamine prevented the GH stimulatory effect of 2.8 mg/kg nomifensine, and an iv bolus injection of haloperidol (a neuroleptic which antagonizes both norepinephrine and DA receptor function) given 45 min before was equally effective. Selective blockade of DA receptors by pimozide significantly reduced the GH-releasing effect of nomifensine. In sum, these data indicated that the effect of nomifensine was the consequence of an enhanced noradrenergic and dopaminergic-neurotransmission. Pretreatment with domperidone, a DA receptor blocker unable to cross the blood-brain barrier, failed to modify the GH-releasing effect of nomifensine, suggesting that the DA component subserving the neuroendocrine effect of the drug lies within the blood-brain barrier. Further evidence for a stimulatory role of DA on GH release was the fact that apomorphine, a direct stimulant of DA receptors, induced a rise in cGH levels when administered to dogs pretreated with domperidone. The latter drug was used to prevent emesis and distress due to activation of peripheral DA receptors by apomorphine. However, apomorphine was only active in the dog at doses (250 and 500 microgram/kg, sc) greatly exceeding those active in releasing GH in man, suggesting that the role of DA in cGH regulation is ancillary to that exerted by noradrenergic neurotransmission. In a final study, atropine, a muscarinic cholinergic receptor antagonist, abolished the neuroendocrine effect of nomifensine, a finding which suggests that cholinergic medication plays an important role in cGH regulation.

Animals

Gonads and genital ducts in a case of male pseudohermaphroditism.

We describe a patient with a 46,XY karyotype, ambiguous external genitalia and partial 17a-hydroxylase deficiency in whom we performed a light microscopic study of the gonads and genital ducts. The right and left testes and epididymides were hypoplastic whereas the right vas deferens was normal, the left one was atretic and a left infundibular remnant was also present, which could be due to a concomitant deficiency in testicular secretions in the early stages of embryonic development or to the possibility of receptor insensitivity for testicular hormones or to a concomitant gonadal dysgenesis.

17-Ketosteroids

[Tuberculous peritonitis: extra-community immigrants at risk?].

Two cases of tuberculosis peritonitis are here reported. Two young black males, who had recently immigrated from Senegal to Italy, were admitted to the Hospital because of aspecific, acute abdominal pain and underwent exploratory laparotomy. In both cases a flare-up of quiescent, post-primary chronic intestinal tuberculous infection was found at surgery. Extra-European immigrants often live in poor hygienic conditions in our country and are exposed to infectious ailments, which are unusual for the Italian population. In the differential diagnosis of acute abdominal pain in African immigrants, tuberculosis peritonitis should be always considered.

Adult