Influences on blink reflex induced by IA afferents in human subjects

The effects induced by IA volleys, evoked with H reflex, on the blink reflex elicited upon electric activation of supraorbital nerves were investigated in 14 healthy subjects as well as in 4 cerebrovascular patients. In both groups a significant increase in amplitude of the early component (R1) of ipsilateral blink reflex has been observed. A brief discussion of possible neural systems which might be involved in these effects is given.     

Hepatitis G virus infection in chronic dialysis patients and kidney transplant recipients

Background: The cloning of the hepatitis G virus (HGV), a novel RNA virus of the Flaviviridae family, has been very recently developed. HGV is known to be parenterally transmitted and has been detected in several patients with cryptogenic hepatitis. However, little information exists about the epidemiology of HGV infection in renal patients. We studied 178 chronic dialysis patients and 11 renal transplant individuals to evaluate prevalence risk factors and clinical manifestations of HGV infection in this population. Method: Hepatitis G virus infection has been detected by a modified PCR technology which incorporates digoxigenin-labelled nucleotides into the amplicon. Primers from the non-coding region and the NS-5 region of HGV are utilized for a single round amplification. Using a streptavidin surface and a biotin-labelled capture probe the labelled nucleic acid is bound through the capture probe to the surface, and the amplified nucleic acid is detected using antibody to digoxigenin. Results: HGV RNA was detected in 6% of chronic haemodialysis (HD) patients (11/172), 36% of renal transplant recipients (4/11), and 17% (1/6) of patients on peritoneal dialysis treatment (CAPD). There were no significant differences between HGV positive and negative patients on chronic HD treatment with regard to several demographic, biochemical and virological features. However, the frequency of anti-HCV antibody was significantly higher in HGV-positive than HGV-negative patients (9/11 (82%) vs 51/161 (32%), P=0.006). In the whole group of HGV RNA-positive patients, 78% (11/14) had a history of blood transfusion requirements, 14/16 (87%) had co-infection with HCV, and 1 (6%) had co-infection with HBsAg. There was no significant association between HCV genotypes and HGV RNA positivity. Six (27.5%) of 16 HGV RNA-positive patients showed raised aminotransferase values in serum. Conclusion: Patients on maintenance dialysis and kidney transplant recipients are at increased risk of HGV infection; HGV is very frequently associated to hepatitis C co-infection, regardless of HCV genotype. HGV may be transmitted by blood transfusions but transmission routes other than transfusion are possible; 37.5% of HGV RNA-positive patients showed raised serum amoinotransferase levels. Further investigations are necessary to clarify the role of HGV infection in the development of liver disease in this clinical setting.     

Evaluation of penicillin susceptibility in clinical isolates of Streptococcus pneumoniae oxacillin resistant

Antibiotic resistant pneumococci have been reported from all continents. Because of the importance of pneumococci in the aetiology of life-threatening diseases, the screening for penicillin resistance with oxacillin disc on all clinically significant isolates is suggested. However, discrepancy between the determination of penicillin resistance by oxacillin disc diffusion and the determination of penicillin minimum inhibitory concentration (MIC) has been reported. On this basis we have examined seven strains of Streptococcus pneumoniae isolated from patients recovered for the exacerbation of chronic bronchitis which were oxacillin-resistant. The assay of penicillin MICs showed that three isolates were moderately resistant to this agent, while four isolates resulted sensitive to penicillin as well as to cefotaxime. These results suggest that a further evaluation of penicillin MIC should be performed on those strains of S. pneumoniae resulting oxacillin-resistant.     

Mortality study of cancer risk among oil refinery workers

The mortality experience of 1595 male workers employed in one of the largest Italian refineries in the period from 1949-1982 was examined. From the comparison with national and local death rates, increases in mortality owing to lung and kidney cancers, brain tumors, and leukemias emerged. No definite trends according to duration of exposure and years since first exposure were apparent. The increases regarding cancer of the lung, kidney and brain appeared to be associated with the early period of operations. Analysis by exposure category suggested an association of the increased mortality from leukemias with working in production (observed = 2; expected = 0.61). Kidney cancer mortality was elevated among maintenance workers (obs. = 2; exp. = 0.18). Small numbers prevented firmer conclusions. Workers in the moving department had a significantly increased mortality from all cancers (obs. = 22; exp. = 11.7), and lung cancer (obs. = 11; exp. = 3.6). Confounding by smoking could be excluded as sufficient explanation of the three-fold increase in lung cancer deaths. It was in moving that highest airborne levels of polynuclear aromatic hydrocarbons had been discovered in an independent environmental investigation.     

Serologic survey for control of hepatitis C in haemodialysis patients: third-generation assays and analysis of costs

There is little information about the serologic survey for control of hepatitis C by using third-generation assays among chronic haemodialysis (HD) patients, and no analysis of costs has been made to this end. A serologic survey for control of hepatitis C was performed in 190 HD patients attending a single dialysis unit, using second- and third-generation assays. Costs of both serologic surveys were calculated. Anti-HCV prevalence tested by third-generation assays increased from 25% (48/190) to 28% (53/190) compared to second-generation testing; 56% (9/16) of patients showing uncertain findings by second-generation tests gave unequivocal results by third-generation assays; median duration of HD treatment and raised amino transferase levels were positively associated (P=0.004 and P=0.012, respectively) with anti HCV detected by third-generation assays. The serologic survey for control of hepatitis C in HD patients at our centre was slightly more expensive by third-generation assays compared to second-generation testing (US&buck;18 866 vs US&buck; 17200 per year). In summary, the use of third-generation tests largely clarified the uncertain results of second-generation tests; new additional positive patients were detected by third-generation assays compared to second-generation testing. Third-generation assays showed the association of duration of HD treatment and raised aminotransferase levels with anti-HCV antibody, as previously found by first- and second-generation assays. To date, third generation screening and confirmatory assays seem extremely useful in the serologic survey for control of hepatitis C in HD centres without a considerable outlay.     

Influence of gingival crevicular washing on the expression of polymorphonuclear leukocyte membrane receptors before and after periodontal therapy

Abstract. Extensive data demonstrate that polymorphonuclear leukocytes (PMN) are the predominant cell type involved in periodontal disease and that gingival crevicular fluid constituents are influenced by the inflamed gingiva. The aim of the present study was to evaluate the ability of gingival crevicular washing (GCW) (a dilution of gingival crevicular fluid) from periodontal sites in different clinical conditions of modulating the PMN membrane receptors involved in motility, adhesion and phagocytosis before and after periodontal treatment. 10 patients affected by adult periodontitis (AP) were selected. From each patient. 2 test sites (TS) were chosen on the basis of a probing depth > 5 mm and attachment loss, and 2 control sites (CS) with probing depth < 3 mm without attachment loss. Modifications of membrane receptor density of PMN from healthy donors incubated with GCW harvested from TS and CS was evaluated using fluorescent probes and flow cytometry. Compared to CS-GCW. TS-GCW before therapy increased the expression of the β2 integrin CD 11b and the chemotactic receptor for the oligopeptide N-formyl methionyl leucyl phenylalanine (FMLP-R) while it reduced the expression of L-selection. GCW collected from the same TS after the successful completion of periodontal treatment did not influence PMN receptors, indicating that the clinical improvement paralleled the disappearance of the PMN modulating capability contained in TS-GCW before therapy. In conclusion, the present data illustrate the relevant modifications occurring at PMN membrane in chronic adult periodontitis exerted by GCW obtained by a simple fluid collection technique. Thus, monitoring gingival crevicular fluid PMN activating capability may help disclose the presence of chronic periodontitis and may be useful in assessing successful treatment.     

Wakefulness and sleep autonomic dysfunction in diabetics

Parasympathetic and sympathetic controls on cardiovascular systems were studied during wakefulness and sleep in 8 diabetic patients (3 IDDM and 5 NIDDM), in order to detect the presence of autonomic dysfunction. In particular, cardiovascular assessment during sleep allowed to detect minimal autonomic abnormalities in the absence of a documented pathology during wakefulness.     

Chromosome 20 Ring: A Chromosomal Disorder Associated with a Particular Electroclinical Pattern

Summary: Purpose: The chromosome 20 ring [r(20)] is a rare chromosomal disorder without clear phenotypical markers. We describe the electroclinical pattern in a group of patients with r(20).
Methods: We observed 3 patients (a boy, patient 1; his mother, patient 2; and an unrelated man, patient 3), performing prolonged video-EEG and cytogenetic studies and fluorescent in situ hybridization (FISH) with chromosome-specific telomeric probes.
Results: All 3 patients had a very similar abnormal electroclinical pattern characterized by long bursts or trains of rhythmic theta waves, which were sharply contoured or had a notched appearance (with no detectable clinical correlate), and generalized spike waves (SW) associated with seizures of probable frontotemporal origin (SFT). In all 3 patients, the cytogenetic analysis of T lymphocytes showed mosaicism with a normal cell line and a second cell line with a chromosome 20, although the latter was little represented in patients 2 and 3. A few cells with a single chromosome 20 were also found. The same cytogenetic findings were confirmed in the lymphoblastoid cell line of patient 1 and in the fibroblasts of patient 3. FISH with chromosome-specific telomeric probes and TTAGGG sequences demonstrated the integrity of the ring chromosomes.
Conclusions: The clinical picture of these patients appears to be related to the instability of the r(20)-generating cells monosomic for chromosome 20 and is thus haploinsufficient for a gene. In these patients, the electroclinical pattern of theta waves (probably unrelated to epilepsy) and the SW and SFT, even with mild mental retardation (MR) or no MR and without dysmorphic features, suggest that the r(20) syndrome may be present.     

18F–FDG PET/CT in solitary plasmacytoma: metabolic behavior and progression to multiple myeloma

Purpose

Solitary plasmacytoma (SP) is a rare plasma-cell neoplasm, which can develop both in skeletal and/or soft tissue and frequently progresses to multiple myeloma (MM). Our aim was to study the metabolic behavior of SP and the role of 18F–FDG-PET/CT in predicting progression to MM.

Materials and methods

Sixty-two patients with SP who underwent 18F–FDG-PET/CT before any treatment were included. PET images were qualitatively and semiquantitatively analyzed by measuring the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVlbm), body surface area (SUVbsa), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and compared with age, sex, site of primary disease, and tumor size.

Results

Fifty-one patients had positive 18F–FDG-PET/CT (average SUVbw was 8.3 ± 4.7; SUVlbm 5.8 ± 2.6; SUVbsa 2 ± 1; MTV 45.4 ± 37; TLG 227 ± 114); the remaining 11 were not 18F–FDG-avid. Tumor size was significantly higher in patients avid lesions compared to FDG not avid; no other features are associated with FDG-avidity. Progression to MM occurred in 29 patients with an average of 18.3 months; MM was more likely to develop in patients with bone plasmacytoma and in patients with 18F–FDG avid lesion. Time to transformation in MM (TTMM) was significantly shorter in patients with osseous SP, in 18F–FDG avid lesion, for SUVlbm > 5.2 and SUVbsa > 1.7.

Conclusions

18F–FDG pathological uptake in SP occurred in most cases, being independently associated with tumor size. PET/CT seemed to be correlated to a higher risk of transformation in MM, in particular for 18F–FDG avid plasmacytoma and SBP. Among semiquantitative features, SUVlbm > 5.2 and SUVbsa > 1.7 were significantly correlated with TTMM.