Clinical subgroups and HLA antigens in Italian patients with psoriatic arthritis

The frequencies of HLA antigens were studied in 101 Italian patients with psoriatic arthritis. The total group showed a significant increase in frequency of A1 and B38, and a reduction of B5 when compared to healthy controls. No association between DR and/or DQw antigens and PA were demonstrated. The comparisons between the clinical subgroups and normal controls revealed a significant association of B38 with asymmetric peripheral arthritis, B27 and B39 with spondylitis (with or without peripheral involvement). When intergroup comparison were made, the patients with spondylitis had an increase in frequency of B27 and DQw3 as compared to those with symmetric and asymmetric peripheral disease. DR4 and DRw53 were associated with earlier age of onset of arthritis. There were also significant associations between DQw3 and severe disease, and between A9, B5 and presence of erosions and joint space narrowing. No association with DR4 was showed in a subgroup of patients with symmetric polyarthritis without DIP involvement.     

Delayed wound healing in aged skin rat models after thermal injury is associated with an increased MMP-9, K6 and CD44 expression

Age-related differences in wound healing have been documented but little is known about the wound healing mechanism after burns. Our aim was to compare histological features and immunohistochemical expression of matrix metalloproteinase-9 (MMP-9), collagen IV, K6 and CD44 in the burn wound healing process in aged and young rats.     

Development and characterization of rhVEGF-loaded poly(HEMA–MOEP) coatings electrosynthesized on titanium to enhance bone mineralization and angiogenesis

Osteointegration of titanium implants could be significantly improved by coatings capable of promoting both mineralization and angiogenesis. In the present study, a copolymeric hydrogel coating, poly-2-hydroxyethyl methacrylate-2-methacryloyloxyethyl phosphate (P(HEMA–MOEP)), devised to enhance calcification in body fluids and to entrap and release growth factors, was electrosynthesized for the first time on titanium substrates and compared to poly-2-hydroxyethyl methacrylate (PHEMA), used as a blank reference. Polymers exhibiting negatively charged groups, such as P(HEMA–MOEP), help to enhance implant calcification. The electrosynthesized coatings were characterized by X-ray photoelectron spectroscopy and atomic force microscopy. MG-63 human osteoblast-like cell behaviour on the coated specimens was investigated by scanning electron microscopy, MTT viability test and osteocalcin mRNA detection. The ability of negatively charged phosphate groups to promote hydroxyapatite-like calcium phosphate deposition on the implants was explored by immersing them in simulated body fluid. Similar biological responses were observed in both coated specimens, while calcium-phosphorus globules were detected only on P(HEMA–MOEP) surfaces pretreated with alkaline solution. Testing of the ability of P(HEMA–MOEP) hydrogels to entrap and release human recombinant vascular endothelial growth factor, to tackle the problem of insufficient oxygen and nutrient delivery, suggested that P(HEMA–MOEP)-coated titanium prostheses could represent a multifunctional material suitable for bone restoration applications.     

New methods in arthroscopy: preliminary investigations.

The microhysteroscope, which affords direct in vivo observation of otherwise inaccessible surfaces, can be used to great advantage in arthroscopy. Although conventional arthroscopy can distinguish between 'inflammatory' and 'reactive' (post-traumatic) synovial changes, the microendoscope offers the possibility of more precise differentiation. Synovial membranes, joint cartilage, and menisci were studied at four different magnifications, including microscopic observation of vitally stained cells. Frankly pathological synovia (e.g., rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis) were compared and distinguished from examples of less florid synovial changes. The fibrocartilaginous structure of the menisci and secondary undulations and tertiary depression of joint cartilage become visible in vivo with the microendoscope; these may well point to early damage to these structures. The authors believe that the three dimensional images at the magnifications provided by this microendoscope go some way towards bridging the gap between the conventional arthroscope, the light microscope, and the scanning electron microscope. This report presents preliminary findings with this new technique.     

Tissue polypeptide antigen (TPA) in urinary bladder cancer cytology: a follow-up study

Tissue polypeptide antigen (TPA) has been detected by immunocytochemical assay on urine cytological samples from 28 asymptomatic patients, who previously had a histological diagnosis of papillary transitional cell carcinoma (PTCT) of the urinary bladder (UB), in order to evaluate its role in follow-up controls. TPA staining intensity (SI) in urothelial cells was evaluated to improve the diagnostic accuracy of cytology. Differentiated tumor cells were strongly stained for TPA, heavier than normal urothelial cells. Undifferentiated neoplastic cells were less stained for TPA with a wide range of SI. TPA detection revealed positive cytology in 21 (75%) of the considered cases. The accuracy of our cytological findings compared with both routine examinations and subsequent histopathological diagnosis was of 95.2%. Follow-up urinary cytology limits could be reduced by TPA searching in differentiated tumor cells, deriving from low-grade neoplasms.     

Epidemiologic and immunogenetic aspects of polymyalgia rheumatica and giant cell arteritis in northern Italy

We studied the epidemiology of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in a Mediterranean population. Ninety-nine patients with PMR and/or GCA were identified over a 9-year period (1980-1988) in Reggio Emilia, Italy. The average annual incidence of PMR and GCA was 12.7/100,000 and 6.9/100,000, respectively, in a population aged 50 years or older. Frequencies of HLA antigens were determined in 49 patients with PMR and/or GCA who were followed by staff at our rheumatology unit during the 1980-1988 period. When compared with HLA findings in 242 healthy controls, DR4 was not found to be significantly associated with PMR (24% in PMR patients versus 14% in controls). Patients with GCA also showed an increased frequency of DR4 compared with controls (36% versus 14%), but this difference was also not statistically significant. The immunogenetic features of PMR and GCA and the relationship between the immunogenetic and epidemiologic patterns in different populations are discussed.     

Ulnar artery cannulation for coronary angiography and percutaneous coronary intervention: case reports and anatomic considerations.

Transradial artery cannulation is a useful alternative approach to the performance of diagnostic and interventional coronary procedures. However, its utility can be limited by incomplete palmar collateral support, access site failure, and anatomic variations. We report on five patients in whom percutaneous cannulation of the ulnar artery was primarily chosen, based on preprocedure examination, for coronary angiography in three patients and percutaneous coronary intervention in two others. The transulnar artery approach to coronary procedures is feasible and may be preferable in selected cases. Anatomic considerations are discussed.     

Immunohistochemical expression of vascular endothelial growth factor (VEGF) in different types of odontogenic cysts

The objective of the present study was to evaluate vascular endothelial growth factor (VEGF) expression in different types of odontogenic cysts. A total of 25 parakeratotic odontogenic keratocysts (POKCs), 16 orthokeratotic odontogenic keratocysts (OOKCs), and 28 follicular cysts (FCs) were evaluated semiquantitatively for immunohistochemical analysis of VEGF in epithelial cells, endothelial cells of blood vessels, inflammatory cells and focally stromal cells. A significant different expression of VEGF in all cell components was found in keratocysts compared to FCs. The POKCs (80%) and OOKCs (68%) showed more than 50% VEGF positive epithelial cells, whereas the majority of FCs (71%) were either negative in the epithelium or showed less than 10% positive cells. Similarly, the POKCs (88%) and OOKCs (68%) showed more than 50% positive endothelial cells, whereas the FCs (75%) were either negative or showed less than 10% VEGF positive endothelial cells. The highest percentage of cases with score 2 positivity in the stromal cells was observed in POKCs (68%); OOKCs showed a score 2 positivity in 44%, score 1 in 31% and score 0 in 25%, whereas 68% of FCs showed a score 0, 25% a score 1 and only 7% of cases showed a score 2. No statistically significant differences were observed between POKCs and OOKCs in VEGF expression in the epithelial and endothelial cells, whereas the positivity score in stromal cells was significantly higher in POKCs compared to OOKCs. The present results can support the hypothesis that angiogenesis is an active mechanism in the invasive growth of the OKC.