CD1a and antitumour immune response

Primary immune response is based on the capacity of local professional antigen-presenting cells (whose prototype is represented by dendritic cells, DCs) to take up and present antigens to selected clones of T cells, but also to non-specific effector cells such as macrophages or natural killer cells. The four CD1 proteins, all of which share a limited homology to class I MHC proteins, are differently expressed in various cell types, of both mesenchymal and, as recently described, epithelial lineage. Regarding the role of CD1 molecules in the anti-tumour response, it has been reported that CD1+ dendritic cells are involved in the first steps of the primary immune response in a number of malignancies. Moreover, the presence of a high number of DCs in the tumoral or peritumoral area, as well as in the draining lymph nodes, has been shown to correlate with a better prognosis. A recent report on the presence of CD1a in metaplastic epithelial cells of Barrett esophagus introduced new questions about CD1a expression patterns. Moreover, the strong correlation between the lack of CD1a+ cells and the malignant evolution of the lesion may indicate a possible role of non-professional APCs in mediating and/or potentiating immune responses to tumours.     

Identification of the three-element windkessel model incorporating a pressure-dependent compliance

A new one-step computational procedure is presented for estimating the parameters of the nonlinear three-element windkessel model of the arterial system incorporating a pressure-dependent compliance. The data required are pulsatile aortic pressure and flow. The basic assumptions are a steadystate periodic regime and a purely elastic compliant element. By stating two conditions, zero mean flow and zero mean power in the compliant element, peripheral and characteristic resistances are determined through simple closed form formulas as functions of mean values of the square of aortic pressure, the square of aortic flow, and the product of aortic pressure with aortic flow. The pressure across as well as the flow through the compliant element can be then obtained so allowing the calculation of volume variation and compliance as functions of pressure. The feasibility of this method is studied by applying it to both simulated and experimental data relative to different circulatory conditions and comparing the results with those obtained by an iterative parameter optimization algorithm and with the actual values when available. The conclusion is that the proposed method appears to be effective in identifying the three-element windkessel even in the case of nonlinear compliance.     

Mature teratoma of the uterine corpus with thyroid differentiation

A case of a clinically silent mature teratoma of the uterine corpus is reported. A 55-year-old woman presented with multiple uterine leiomyomas. The discovery was incidental, because the patient was asymptomatic. Macroscopically, a colloid-hemorrhagic-looking nodule was present. Histologic and immunohistochemical studies showed that this tumor was a small thyroid mass. Key words:,     

Swelling behavior of a genetically engineered silk-elastinlike protein polymer hydrogel

The influence of environmental conditions such as pH, temperature, and ionic strength on the equilibrium swelling ratio of physically crosslinked networks of a genetically engineered silk-elastinlike protein-based copolymer (SELP) with an amino acid repeat sequence of [(GVGVP)4GKGVP(GVGVP)3(GAGAGS)4]12 was investigated. The effects of gelation cure time and initial polymer concentration on the equilibrium swelling ratio and soluble fraction of the hydrogels were also studied. It was found that the soluble fraction linearly correlated with the initial polymer concentration at higher gelation times. Soluble fraction results suggest that final hydrogel water content may be controlled by both initial polymer concentration and gelation time. Equilibrium swelling studies demonstrated that these hydrogels are relatively insensitive to environmental changes such as pH, temperature, and ionic strength. Over the concentration range studied, it was found that an increase in gelation time at 37 degrees C resulted in lower hydrogel weight equilibrium swelling ratios, which corresponds to less soluble polymer released post-gelation. Together, these results have implications for the controlled delivery of bioactive agents from silk-elastinlike hydrogels.     

The action of interferons on the morphology of mononuclear elements of human peripheral blood. S. E. M. observations

Scanning electron microscopy has been used to study the surface of lymphocytes and monocytes before and after treatment with interferon in vitro. Aliquots of peripheral blood isolated cells have been tested using either human leucocytic interferon (HuIFN-alpha) and human fibroblast interferon (HuIFN-beta) and both types combined. The investigation has been performed at various incubation times. The freshly isolated untreated lymphocytes exhibit a rough and villous surface. The smooth forms are uncommon. The treatment by various interferon types induces a new distribution of villous and rough structures as well as the forming of new elements called "uropods" and "pseudopods". At the same time, the binding of lymphocytic elements is enhanced by "cytoplasmic bridges" coming even to real "cellular fusions". Later, macrophages are also involved in these phenomena. These observations seem to confirm the hypothesis that the lymphocyte surface performs significant functions in detecting its surroundings and clearly underlines this cell capacity of reacting to specific substances such as interferons.     

Surgery of gastric cancer: treatment of post-operative enterocutaneous fistulas

Anastomosis dehiscences after gastrectomy are a major post-operative complication often resulting in the death of the patient. 13 patients with dehiscences resulting in enterocutaneous fistulae have been treated with parenteral and/or enteral nutrition. Spontaneous closure rate was 84.6% and mean time for fistula closure was 22.4 days from the onset of nutritional treatment. On the base of nutritional effectiveness no difference could be found between enteral and parenteral nutrition in this series.     

The role of radiology in assessing patients with pathological obesity submitted to modified Mason's vertical gastroplasty. A study of 322 cases

PURPOSE: Mason's vertical banded gastroplasty (VBG) is one the most popular surgical techniques for the treatment of morbid obesity because it is effective and easy to perform and presents a low incidence of long-term complications. We report our personal results in 322 Mason's VBG patients who were followed-up radiologically. MATERIAL AND METHODS: 322 patients submitted to modified Mason's VBG underwent radiological follow-up, preferably with single contrast, to assess the shape and volume of the pouch and the presence of postoperative complications. The patients were 272 women and 50 men whose average weight was 124 kg (range: 78 to 218 kg). The women's average age was 37 years (range: 17 to 69) and the men's 36 (range: 19 to 64). We performed a double contrast examination, adapting the dosage of effervescent powders to the gastric pouch capacity, only in particular cases where a more detailed study of pouch surface was required. The examinations were performed at 1 month and 12 months postoperatively to evaluate the pouch shape and volume, in order to correlate surgical results with weight loss. Premature or unscheduled examinations were necessary only in some cases due to suspected complications or unsatisfactory weight loss. First we perform right anterior oblique projections with the patient standing, with a direct preliminary study of the epigastric region to locate the two metal clips. The patient is given barium in small swallows because large amounts might obscure the pouch by filling the fundus of the excluded stomach. Then we take left anterior oblique views to depict the neopylorus and the staple lines, and left posterior oblique projections in lateral and supine recumbency. RESULTS: We observed early postoperative complications such as pseudopylorus edema (8 patients) and intragastric hemorrhage (1 patient), and late complications such as pseudopylorus adherence to the gallbladder bed (1 patient), pseudodiverticular extroversion (1 patient), and axial enlargement (4 patients) of the pouch. The only two cases of staple-line dehiscence were both identified radiographically. In 305 patients with satisfactory weight loss no complications were observed with a pouch size of 45-70 mL (at 1 month) and 58-70 mL (at 12 months). DISCUSSION AND CONCLUSIONS: Upper gastrointestinal radiological studies permit to detect both early and late postoperative complications in Mason's VBG patients. They also provide data on the neostomach and permit to correlate the pouch volume with weight loss.     

An improved technique for the extraction of stochastic parameters from stabilograms

An improved characterization of the dynamics of postural sway can provide a better understanding about the functional organization of the postural control system as well as a more robust tool for postural pattern recognition. To this aim, a novel parameterization was applied to the stabilogram diffusion analysis formerly proposed by Collins and De Luca [Collins JJ, De Luca CJ. Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories. Exp Brain Res 1993;95:308–18] that considered the act of maintaining posture as a stochastic process. The main purpose of the present technique was to overcome some drawbacks of the model presented by Collins and De Luca that may restrain its potential application in clinical practice. The approach uses a unique non-linear model to describe the center of pressure (COP) dynamics that reduces the number of parameters and decreases their intra-subject variability; consequently, fewer trials are required to perform reliable estimates of stochastic parameters and this is of particular importance for subjects that cannot afford many repeated measurements because of age or pathology. Four new statistical mechanics parameters (NSMP) were computed on the log–log stabilogram diffusion plots and their estimates were compared in terms of reliability and sensitivity to the visual conditions with: (1) a minimal set of four summary statistic scores (SSS); and (2) the six statistical mechanics parameters (SMP) proposed by Collins and De Luca. All four NSMP showed at least a fair-to-good reliability (intraclass correlation coefficient, ICC>0.49) while SMP (ICC>0.20) showed some poor reliability. A better overall reliability was also observed with respect to SSS. Moreover, only NSMP had a similar score for eyes open and eyes closed conditions. Three out of four NSMP were also significantly sensitive to eyes open or closed conditions (P<0.001) while only three out of six SMP were sensitive to operating conditions (P<0.01).