Mechanism underlying superantigen-induced clonal deletion of mature T lymphocytes

We observed that peripheral T cells activated in vivo or invitro by superantigens are susceptible to cell death when theirantigen receptor is cross-linked with the appropriate anti-ßTCR mAb. TCR ligation by mAbs specifically drove the T cellclonal deletion in both CD4⁺ and CD8⁺ cell subsets. An IL-2/1L-2Rinteraction seems to be a critical step In predisposing superantigenactivated cells to death; In fact, in vivo IL-2R bockade reversedT cell deletion In superantlgen plus anti-ß TCR mAbtreated mice. TCR ligatlon by mAbs also produced cell deathof the relevant targets in in vitro IL-2 activated T cells.Surprisingly, no T cell deletion was demonstrable in IL-2 activatedcells following staphylococcal enterotoxin B - TCR Interaction,ruling out the possibility that superantigen in Itself can inducecell death. Thus, while superantigen activation opens the celldeath program, a subsequent TCR-antigen (self) Interaction appearsnecessary to produce clonal deletion in mature T lymphocytes.     

Adult respiratory distress syndrome

Summary The results of an anatomohistopathologic study carried out on subjects who died from various causes in resuscitation centers are reported with specific reference to the evolutive phases of the adult respiratory distress syndrome (ARDS). While a precise anatomohistopathologic diagnosis of non-clinically diagnosed ARDS in its initial phase is considered possible, the importance of recognizing this pathology in cadavers and living patients is emphasized because of the medico-legal implications involved.      

Incidence of endophthalmitis in a large series of 23-gauge and 20-gauge transconjunctival pars plana vitrectomy

Background  To study the incidence of endophthalmitis after 23-gauge pars plana vitrectomy and to compare it with the endophthalmitis rate after 20-gauge pars plana vitrectomy performed in the same ophthalmology department. Methods  The charts of 4,021 consecutive 20-gauge or 23-gauge pars plana vitrectomies performed at a single institution, between August 1 2003 and April 1 2008, were reviewed to search for the occurrence of postoperative endophthalmitis. This is a retrospective, interventional, comparative cohort study. Results  Endophthalmitis developed in one of 3,078 eyes after 20-gauge vitrectomy (0.03%) and in none of 943 eyes after 23-gauge vitrectomy. Conclusions  We did not find an increased risk of endophthalmitis after 23-gauge sutureless vitrectomy. No financial relationship exists. The authors have full control of all primary data, and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data upon request.     

Reduced startle reflex and aversive noise perception in patients with orbitofrontal cortex lesions

In the present study, the primary emotional response represented by the acoustic startle reflex was investigated in a group of six male patients, selected with lesions of the orbitofrontal cortex, and twenty matched healthy controls. Accurate neuropsychological assessment and lesion mapping showed relatively spared cognitive functioning in the patient group, most of the lesions being confined to the bilateral polar orbitofrontal cortex. Patients had significant inhibition of startle amplitude, together with a reduced self-evaluated perception of the unpleasantness of the acoustic probe stimulus. Results add to current literature on the circuit of the human startle reflex, by suggesting cortical-limbic down-regulation of the orbitofrontal cortex on the main startle pathway, probably at the level of the activating reticular system. The orbitofrontal cortex, together with the amygdala, is confirmed to represent the main center organizing both primary and secondary learned aspects of emotions.     

Temporal variation of optical coherence tomography biomarkers as predictors of anti-VEGF treatment outcomes in diabetic macular edema

Graefe's Archive for Clinical and Experimental Ophthalmology - To report a longitudinal analysis of specific optical coherence tomography (OCT) features in eyes with diabetic macular edema...     

Elevated 25-hydroxy and normal 1,25-dihydroxy cholecalciferol serum concentrations in a successfully-treated case of vitamin D3 toxicosis in a dog.

A 4-y old, 27 kg spayed female German Shepherd dog was observed to ingest one 1-oz package of a rodenticide containing cholecalciferol. An initial serum calcium concentration of 15.7 mg/dl was successfully reduced to normal during 10 d using calcitonin and prednisolone. During that time, the serum 25-hydroxy and 1,25-dihydroxy cholecalciferol concentrations ranged from 637 to 315 ng/ml (normal 32 +/- 6 ng/ml) and 64 to 29 pg/ml (normal 34 +/- 19 pg/ml), respectively. Serum mid-molecule parathyroid hormone concentrations (76 to 97 pcmol/L) were within the normal range (85-140 pcmol/L). These data indicate that hypercalcemia seen in dogs following field exposures to cholecalciferol-containing rodenticides may be associated with elevated 25-hydroxy rather than 1,25-dihydroxy cholecalciferol. Consequently, serum 25-hydroxy cholecalciferol concentrations may be the most conclusive method for diagnosing hypervitaminosis D3 toxicosis in the live dog.     

Static and dynamic efficiency of irreversible health care investments under alternative payment rules

The paper studies the incentive for providers to invest in new health care technologies under alternative payment systems, when the patients' benefits are uncertain. If the reimbursement by the purchaser includes both a variable (per patient) and a lump-sum component, efficiency can be ensured both in the timing of adoption (dynamic) and the intensity of use of the technology (static). If the second instrument is unavailable, a trade-off may emerge between static and dynamic efficiency. In this context, we also discuss how the regulator could use control of the level of uncertainty faced by the provider as an instrument to mitigate the trade-off between static and dynamic efficiency. Finally, we calibrate the model to study a specific technology and estimate the cost of a regulatory failure.     

Der pneumothorax als komplikation langanhaltender atmungs-reanimation

Zusammenfassung Es werden die wichtigsten Veränderungen während der Intensivtherapie anhand von 500 Todesfällen auf der Intensivstation des Städtischen Krankenhauses von Padua von 13. Dezembe 1971 bis 9. September 1974 diskutiert. 36 Fälle mit Pneumothorax, der durch automatische Beatmung verursacht wurde, werden speziell unter klinischen und pathologischen Gesichtspunkten untersucht.

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The pneumothorax as complication of continuous artificial ventilation

Summary The authors discuss briefly the main lesions produced during intensive therapy in 500 patients who died under treatment in the Intensive Care Unit of Padova during the period Dec. 13, 1971 — Sept. 9, 1974. Specifically 36 cases of pneumothorax induced by automatic respiration are analyzed from a clinical and pathological viewpoint.

     

Preliminary experience using oncoplastic techniques of reduction mammaplasty and intraoperative radiotherapy: report of 2 cases

Background  

Since 2004 in the Department of Oncological Integrated Surgery at the National Institute for Cancer Research of Genoa, we have applied different techniques of reduction mammaplasty for a subgroup of 26 patients with medium- to large-sized and ptotic breasts who are candidates for conservative surgery.