Circulating immune complexes in patients with usual interstitial pulmonary fibrosis: partial characterization and relationship with Thermoactinomyces vulgaris.

Sixty-six sera were analysed by solid-phase conglutinin binding assay, to detect the levels of circulating immune complexes (CIC), and by enzyme-linked immunosorbent assay (ELISA) to show a correlation with antibodies to Thermoactinomyces vulgaris. Sixty per cent of patients with usual interstitial pulmonary fibrosis (UIP), were positive for CIC; and T. vulgaris antibodies were detected in 60% of the same patients. In comparison, there was a low frequency of positive results in bronchitis patients (5% for CIC and 35% for T. vulgaris), and in normal blood donors (0% for CIC and 30% for T. vulgaris). Furthermore 31% of patients with lung cancer were found positive for CIC, but not for T. vulgaris. Immune complexes purified on Protein A-Sepharose and by sucrose density gradient from patients with UIP, showed a sedimentation coefficient higher than 19 S. The purified material was found to contain IgG and IgM as antibodies. Binding of immune complexes, purified by sedimentation on sucrose gradient, to conglutinin was inhibited by the presence of T. vulgaris antigen; thus suggesting that this antigen might be present in the complexes.     

Analysis of orthologous gene expression between human pulmonary adenocarcinoma and a carcinogen-induced murine model

Human adenocarcinoma (AC) is the most frequently diagnosed human lung cancer, and its absolute incidence is increasing dramatically. Compared to human lung AC, the A/J mouse-urethane model exhibits similar histological appearance and molecular changes. We examined the gene expression profiles of human and murine lung tissues (normal or AC) and compared the two species' datasets after aligning approximately 7500 orthologous genes. A list of 409 gene classifiers (P value <0.0001), common to both species (joint classifiers), showed significant, positive correlation in expression levels between the two species. A number of previously reported expression changes were recapitulated in both species, such as changes in glycolytic enzymes and cell-cycle proteins. Unexpectedly, joint classifiers in angiogenesis were uniformly down-regulated in tumor tissues. The eicosanoid pathway enzymes prostacyclin synthase (PGIS) and inducible prostaglandin E(2) synthase (PGES) were joint classifiers that showed opposite effects in lung AC (PGIS down-regulated; PGES up-regulated). Finally, tissue microarrays identified the same protein expression pattern for PGIS and PGES in 108 different non-small cell lung cancer biopsies, and the detection of PGIS had statistically significant prognostic value in patient survival. Thus, the A/J mouse-urethane model reflects significant molecular details of human lung AC, and comparison of changes in orthologous gene expression may provide novel insights into lung carcinogenesis.     

Characterization of an influenza A virus from seals

An influenza A virus antigenically similar to A/FPV/Dutch/27 (Hav1Neq1) [H7N7] was isolated from harbor seals (Phoca vitulina) that had died of acute hemorrhagic pneumonia on Cape Cod Peninsula, beginning in the winter of 1979–1980. High titers of virus were obtained from the lungs and lower titers from the brains of the seals. Although antigenic analyses and characterization of the RNAs show that all of the genes and gene products are closely related to different avian influenza viruses, biologically the virus behaves more like a mammalian strain. The seal virus replicated and produced pneumonia in experimentally infected harbor seals, but the clinical course and pathology were less severe than in the natural infection; the virus also replicated in ferrets, cats, and pigs but produced no disease. In avian species, the seal influenza virus replicated poorly, produced no disease signs, and was not shed in the feces. Although the seal influenza virus can cause conjunctivitis in humans who have known contamination of the eyes from infected animals, serological studies detected no evidence of seroconversion among persons working with infected seals or with the virus. Preliminary studies detected antibodies to this virus in harbor seals on the New England coast but not in harbor seals, gray seals, or fur seals from other areas, suggesting that this virus may be a new introduction to this species. An Hav1Neq1 [H7N7] virus was also isolated from feral ducks in Iceland in 1980, but the two viruses could be distinguished by analysis of their RNAs and host range. The A/Seal/Mass/1/80 influenza virus provides the first evidence suggesting that a strain deriving all of its genes from one or more avian influenza viruses can be associated with severe disease in a mammalian population in nature. Whether this breach of species specificity represents a unique event in influenza evolution remains to be determined, but raises the possibility that human or animal influenza viruses may be derived directly from avian strains.     

Epidemiology of tuberculosis in immigrant patients hospitalised in Infectious Diseases Units in Italy: multicentric study

In order to retrospectively evaluate the prevalence of immigrant patients affected by active tuberculosis, we analysed the clinical data of 2255 immigrant patients hospitalised during 2002 in ordinary admission or in Day Hospital in 48 Clinics of Infectious Diseases. In all, 303 patients were affected by active tuberculosis (13.4% of the total immigrant hospitalised patients); 30 patients (9.9%) were also HIV-positive. There was a considerable male gender bias (62.5%); the mean age was 29.7 years; 144 patients were from Africa (47.5%), 72 (23.7%) from Asia, 47 (15.5%) from eastern Europe and 40 (13.2%) from South America. The clinical variants were: pulmonary (57.7%), lymph node (15.8%), meningitis (13.8%), intestinal (4.2%), bone (3.3%), pleurical (2.3%), peritoneal (2.3%) and renal (0.6%). We conclude that tuberculosis is a very frequent disease among immigrants, especially of African origin. The high percentage is due to several factors, such as no vaccine prophylaxis and poor, overcrowded living conditions. It is fundamental to focus on the need to provide better health support for all subjects by setting up screening plans to estimate the real incidence of this pathology and ensure medical treatment to prevent the spread of this infection among immigrants and the local host population.     

Evidence for hypothalamo-growth hormone dysfunction in panic disorder: profile of growth hormone (GH) responses to clonidine, yohimbine, caffeine, glucose, GRF and TRH in panic disorder patients versus healthy volunteers.

Given the abrupt and time-limited nature of daytime-awake and nocturnal-sleep panic attacks, several chemical and neuroendocrine challenge tests have been employed to investigate the neurobiology of "spontaneous" panic attacks. Previously we demonstrated that panic disorder patients have blunted growth hormone (GH) responses to clonidine, an alpha 2-adrenergic agonist. However, the mechanism of this blunted response and the role of hypothalamic-GH dysfunction, if any, remains unclear. To further delineate the status of hypothalamic-GH function in panic disorder, we review the literature and present original data on the GH responses to a number of different chemical and neuroendocrine challenge paradigms. Although stress-mediated increases in GH are thought to be a common correlate of stress in humans, our findings indicate that panic disorder patients have significantly blunted GH responses to clonidine, yohimbine, growth-hormone releasing factor, and caffeine compared to normal control subjects. A similar trend was noted in the delayed rise in GH after glucose challenge. There was no difference in the rate of abnormal GH responses to thyrotropin-releasing hormone in panic disorder compared to normal control subjects. No drug or neuroendocrine challenge, even if associated with marked increases in anxiety, produced a significantly enhanced GH response compared to normal control subjects. These findings provide support for a hyporesponsive hypothalamic-GH system in panic disorder. These observations, combined with preliminary observations from our clinic of short stature in several cases of prepubescent children with anxiety disorders, also underscore the need for assessing early growth patterns in individuals with panic disorder. Strategies for investigating the site(s) of possible neurotransmitter or hypothalamic-GH-somatomedin dysfunction are discussed.     

The treatment of inguinal hernia in a one-day surgery protocol. Our experience

BACKGROUND: Personal experience in the treatment of inguinal hernia in "One day Surgery" is reported. METHODS: Design: retrospective evaluation of cases treated in a twelve months period. The follow-up has been programmed at 1, 3, 6 and 12 months after the treatment. Setting: general, thoracic and oncological surgery, Department of Surgical and Anatomical Disciplines. Polyclinic, University of Palermo. Subjects: 54 patients aged between 17 and 86 years (middle age 51.9), 48 male have been treated; in 3 cases recurrent hernias were found. Interventions: in every case Trabucco's procedure with local anaesthesia has been performed. Premedication with Midazolam 10 mg i.v. has been associated. Main outcome measures: postoperative course and morbidity have been valued. RESULTS: Twice general anaesthesia has been necessary. No case of allergic reactions has been found. All the patients but three have been discharged before the sixth hour. Wound infections, seromas, deep hematomas, neuralgias and short-time recurrences have not been observed. CONCLUSIONS: Tension-free procedures and local anaesthesia, in personal experience, are mandatory to perform the treatment of inguinal hernia in "One Day Surgery".     

A New Method to Detect Directly in Culture Cell Surface Membrane Immunoglobulins

Abstract

An ELISA assay is described for the measurement of the smIgG. The method is based on the detection of cell-smIgG directly on the same microplate used for the culture. The cells, preincubated at 37°C for one hour, were cultured in the presence of S-ConA and serum-free medium for two days. Using this strategy, the background noise due to non specific adsorbtion of IgG to plastic wells and cytophilic antibodies was eliminated. The cells in the presence of S-ConA and serum-free medium adhered to the plastic wells, and the cell-smIgG were detected using an anti-human IgG covalently linked to alkaline phosphatase or its F(ab')₂ fragment. The possibility of measuring the modulation of the expression of the cell-smIgG without any additional manipulation is stressed.