Determination of azithromycin in gastric biopsy samples.

Objectives: To measure the concentration of azithromycin in gastric biopsy samples of gastritis patients undergoing Heliobacter pylori eradication treatment with azithromycin as one antibiotic constituent of the medication.

Patients: Seven male outpatients, non-smokers, non-alcoholics, aged 25-40 years (mean 32 years), suffering from gastritis with involvement of H. pylori.

Size fractionation of bacterial capsular polysaccharides for their use in conjugate vaccines.

We have developed a chromatographic method suitable for the fractionation of polysaccharides having a negatively charged group. The method permits the removal of all those polysaccharide fragments having a short sequence and which are likely unsuitable for conjugate vaccine construction. The selected polysaccharide fragments can be used to produce glycoconjugate vaccines containing a restricted saccharide polydispersion.

[Quality evaluation in psychiatric services: a regional system of indicators].

Objective: This work proposes a series of indicators, based on routine data collection system adopted in the Emilia Romagna Region, with the aim of describing the quality and quantity of psychiatric care and the connections of psychiatric structures. We are bearing in mind the Plan aimed to Mental Health Care 1994-1996 and the Efficiency and quality indicators of National Health System (SSN) devised by the Department of Health of national government.

Method: A working group has been instituted by the regional authority to define the indicators (definition of meaning, formula, danger level, finality, level od utilisation, data source and frequency of survey, congruent with the regional information system.

[The use of allografts in the surgical treatment of patients with infected vascular prostheses].

The article is devoted to analysis of surgical treatment of patients with such a dangerous complication as infection of the vascular prosthesis. The authors have performed 25 operations for substituting the infected prostheses for allografts. In 18 patients the infected prostheses were located in the aorto-iliac segment, in 5 patients in the femoro-popliteal segment, 1 patient had it in the aorta, and 1 in the subclavian segment.

[Percutaneous positioning of port catheter in the hepatic artery for chemotherapy of metastases using the Arai technique].

Introduction: Liver metastases from colorectal, gastric and breast cancers are a very frequent event; these metastases are treated with cycles of intraarterial chemotherapy with a permanent catheter positioned in the hepatic artery or with surgical or interventional radiology techniques. We tested Arai's technique and its feasibility and evaluated the efficacy of this chemotherapy schedule.

Material And Methods: Four patients with liver metastases from colorectal carcinoma were treated with combined systemic and locoregional chemotherapy with a permanent catheter placed in the hepatic artery according to Arai's technique.

Radiofrequency resection of bronchial tumours in combination with cryotherapy: evaluation of a new technique.

Background: A number of treatments, including Nd-YAG laser therapy, brachytherapy, cryotherapy, electrocautery, and photodynamic therapy, can re-open the obstructed bronchial lumen in patients with inoperable obstructive bronchial tumours. None of these is considered to be a "gold standard".

Methods: The results of a retrospective study of 98 patients treated by radiofrequency tissue ablation and subsequent cryotherapy between January 1994 and June 1995 are reported.

Bactericidal monoclonal antibodies that define unique meningococcal B polysaccharide epitopes that do not cross-react with human polysialic acid.

The poor immunogenicity of the Neisseria meningitidis group B polysaccharide capsule, a homopolymer of alpha(2-->8) sialic acid, has been attributed to immunologic tolerance induced by prenatal exposure to host polysialyated glycoproteins. Substitution of N-propionyl (N-Pr) for N-acetyl groups on the meningococcal B polysaccharide, and conjugation of the resulting polysaccharide to a protein carrier, have been reported to yield a conjugate vaccine that elicits protective Abs with minimal autoantibody activity. To characterize the protective epitopes on the derivatized polysaccharide, we isolated 30 anti-N-Pr meningococcal B polysaccharide mAbs.

[Measurement of cardiac output with continuous thermodilution. b1 Clinical experience with the Intellicath-Vigilans system].

Background: Thermodilution cardiac output measurements are commonly obtained by a manual bolus technique with a pulmonary artery catheter.

Methods: A new thermodilution catheter has been developed which utilizes an integral thermal filament and provides semicontinuous online cardiac output. The response of this new device in 25 patients undergoing coronary artery bypass grafting was examined.

Revisiting the prognostic role of gallium scintigraphy in low-grade non-Hodgkin's lymphoma.

The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin's lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the 67Ga uptake by the tumour, and to establish the contribution of 67Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic 67Ga score at diagnosis.

Use of Manganese(II)-Schiff Base Complexes for Carrying Polar Organometallics and Inorganic Ion Pairs.

This report concerns the carrier properties of [Mn(acacen)]-derived compounds toward polar organometallics, inorganic ion pairs, and salts. Such properties are the consequence of Mn(II) behaving as a Lewis acid and the O&arcraise;O bite of the bidentate Schiff base ligand toward alkali cations. The starting compounds, which occur in a dimeric form, [Mn(acac-L-en)](2) [L' = CH(2)CH(2) (1); L" = C(6)H(10) (2); L"' = R,R-C(6)H(10) (3)] have been synthesized either via a metathesis reaction from MnCl(2) or using [Mn(3)Mes(6)].

Suppression of in vitro maintenance of non-promyelocytic myeloid leukemia clonogenic cells by all-trans retinoic acid: modulating effects of dihydroxylated vitamin D3, alpha interferon and 'stem cell factor'.

In a liquid culture system, all-trans retinoic acid (ATRA), alone and in combination with dihydroxylated vitamin D3 (D3) or alpha interferon (alphaIFN) at concentrations achievable in vivo, could significantly suppress the maintenance of non-promyelocytic myeloid leukemia clonogenic cells (CFU-L) in 9/20, 9/18 and 7/11 cases, respectively. That suppression was counteracted only slightly by the addition of 'stem cell factor', a cytokine which promotes CFU-L expansion in vitro. Differentiated cells slightly increased in 5/17 cases only, suggesting the prevalence of anti-proliferative rather than differentiating mechanisms.

Combined differentiating therapy for myelodysplastic syndromes: a phase II study.

An in vitro synergism between different inducers of AML cell differentiation has been previously observed. Therefore, we treated 53 myelodysplastic (MDS) patients with a low dose combination of cis-retinoic acid (cRA, 20-40 mg/day) and 1,25 alpha (OH)2 cholecalciferol [(OH)2D3, 1-1.5 micrograms/day] +/- intermittent 6-thioguanine (30 mg/m2/day).

Intraoperative monitoring of motor evoked potentials: a review of 116 cases.

We reviewed the results of motor evoked potential (MEP) and somatosensory evoked potential (SEP) monitoring during 116 operations on the spine or spinal cord. We monitored MEPs by electrically stimulating the spinal cord and recording compound muscle action potentials from lower extremity muscles and monitored SEPs by stimulating posterior tibial or peroneal nerves and recording both cortical and subcortical evoked potentials. We maintained anesthesia with an N2O/O2/opioid technique supplemented with a halogenated inhalational agent and maintained partial neuromuscular blockade using a vecuronium infusion.

Extrarenal involvement in diarrhoea-associated haemolytic-uraemic syndrome.

A review of extrarenal involvement in diarrhoea-associated haemolytic-uraemic syndrome (HUS) is based on 64 of our autopsied patients and an update of the literature. Large bowel pathology was the commonest (29 cases), followed by the central nervous system (21 cases), the heart (19 cases) and the pancreas (19 cases). The severity of systemic involvement was associated with the magnitude of renal compromise and the prognosis of the acute phase.

Robot-assisted microscope for neurosurgery.

We describe the implementation of a robotic arm connected to a neurosurgical operative microscope. A force feedback sensor drives the motors of the arm in response to the positioning of the microscope by the surgeon. Computer graphic techniques allow tracking of the current position of the microscope within the volumetric reconstruction of the brain.

Haematological support of high-dose sequential chemotherapy: clinical evidence for reduction of toxicity and high response rates in poor risk lymphomas.

The toxicity and feasibility of a high-dose sequential (HDS) chemotherapy programme delivered with growth factor support were evaluated in patients with intermediate and high-grade non-Hodgkin's lymphoma (NHL) or with progressive Hodgkin's disease. The scheme includes the sequential administration of single cytotoxic drugs at very high doses followed by intensified treatment with circulating progenitor autograft. In some instances, the original HDS scheme, initially designed at the Milan Cancer Center, was partially modified and intensified with a preliminary debulking phase.

[Clinical considerations in Raynaud's phenomenon. How many and which patients are treated?].

Among the multiple aspects about which little is still known about Raynaud's phenomenon (RP), is that, in the author's opinion, regarding the question: how many and which patients are sufficiently troubled by this pathology to seek medical treatment from their own GP or specialist, and what are the results of any treatment commenced. The following questions were put to a group of 180 patients affected by RP attending the out-patient clinic for the first time: 1) how many had already received treatment; 2) which patients were receiving pharmacological treatment and/or had undergone surgery. In this context, the authors assessed the influence of the following parameters on the fact that they had or had not been treated: a) the age of patients; b) the duration of disease; c) the presence of stenosing or obliterating arterial lesions (RP on an organic basis); d) the co-presence of pathologies considered to be the possible etiological cause of RP in literature; e) the severity of symptoms; 3) what results were obtained by medical and/or surgical treatment; 4) what was the course of RP which failed to respond to therapeutic measures.

Generation of anti-tumour activity by OKT3-stimulation in multiple myeloma: in vitro inhibition of autologous haemopoiesis.

T cells in multiple myeloma (MM) patients are highly susceptible to activation with the anti-CD3 monoclonal antibody (mAb) OKT3. When short-term OKT3 stimulation is carried out on bone marrow mononuclear cells (BMMC), large numbers of CD3+ CD25+ HLA-DR+ cells are rapidly generated and autologous malignant plasma cells are killed. OKT3 may thus be exploited in autologous bone marrow transplantation (ABMT) to purge residual plasma cells and simultaneously activate T cells to induce graft-versus-leukemia-like (GVL-like) activity upon reinfusion.

Stem cell factor improvement of proliferation and maintenance of hemopoietic progenitors in myelodysplastic syndromes.

Human recombinant stem cell factor (rSCF) was tested for its capability of improving the defective growth of hemopoietic progenitors in 28 cases of myelodysplastic syndromes (MDS). In vitro growth and response to rSCF were quite variable. However, in most cases, rSCF stimulated CFU-GM growth induced by rG-CSF, rGM-CSF, rIL-3, 5637 conditioned medium (50-1400% enhancement).

[The incidence of Raynaud's phenomenon in 1920 residents in Milan].

We use the term Raynaud Phenomenon (RP) to define episodic digital ischemia with colour changes involving the digits of the hands and feet, induced by cold or emotional stresses. Surprisingly little information is available concerning the incidence of RP in the general population. In Italy, studies of this purpose have never been carried out and the few investigations, we find in literature, are discording, showing an incidence between 0.

High-dose sequential (HDS) chemotherapy with blood and marrow cell autograft as salvage treatment in very poor prognosis, relapsed non-Hodgkin's lymphoma.

We tested the feasibility and efficacy of a novel high-dose sequential chemoradiotherapy programme (HDS) in 14 relapsed or refractory non-Hodgkin's lymphoma patients with very poor prognostic features, i.e. transformed histology, marrow invasion, low performance status.

Monitoring of intraoperative motor-evoked potentials under conditions of controlled neuromuscular blockade.

Motor-evoked potentials were recorded after electrical spinal cord stimulation in 19 patients undergoing neurosurgical or orthopedic procedures. Anesthesia was maintained with nitrous oxide, opioids, and inhaled anesthetics. Vecuronium was infused sufficient to eliminate 90% of twitch tension.

Magnetic resonance imaging and different levels of iron overload in chronic liver disease.

The need for accurate and noninvasive evaluation of liver iron stores prompted us to evaluate the reliability of high-field magnetic resonance imaging equipment in liver patients with low or moderate siderosis, given the poor results obtained using systems operating at low field strength in such cases. Twenty patients with sporadic porphyria cutanea tarda and 28 with comparable chronic liver diseases (chronic hepatitis or cirrhosis) and moderate siderosis were compared with 10 patients with idiopathic or secondary hemochromatosis and 10 healthy controls. Plasma iron profile, ferritin concentration and liver iron concentration, determined with atomic absorption spectroscopy, were matched with the magnetic resonance parameters-namely, transverse relaxation time and the signal intensity for a given proton amount, obtained with equipment operating at a field strength of 1.

Cryosurgery in bronchoscopic treatment of tracheobronchial stenosis. Indications, limits, personal experience.

Cryosurgery is one of the techniques available for bronchoscopic treatment of malignant and nonmalignant tracheobronchial stenosis; other techniques are electrosurgery, laser therapy, and endobronchial brachytherapy. Our experience began in 1976 and includes more than 300 patients treated with bronchoscopic cryosurgery either for malignant (the majority) or for nonmalignant tracheobronchial lesions. This study was performed on 234 patients treated in the years 1979 to 1988 subdivided as follows: 183 malignant tumors, 44 benign tumors, and 7 tumors of uncertain prognosis (adeno).