HLA class I residue mismatch and renal graft outcome.

Donor-recipient HLA matching was retrospectively evaluated in 111 cadaveric renal transplants using Takemoto's ten-residue model in which HLA class I antigens are clustered by crossreactive group (CREGs) on the basis of amino acid sequence homology and the sharing of a particular public epitope. The grade and type of HLA residue mismatching were correlated to posttransplant, class I donor-specific antibody production (monitored by flow cytometry crossmatch), rejection occurrence and clinical outcome during the 1st year posttransplant. In 52 patients with 0 mismatchings (MMs) we observed a low incidence of rejection (11.1%) and antibody production (11.1%) for 0 CREG MM grade, while 1 MM was enough to increase immune response against graft (rejection 35%; antibodies 30%). Moreover, a significant correlation was observed between Q144, E163, Q62 and L82/R82 epitopes and the incidence of acute rejection and antibody production ("immunogenic" residues) in patients grouped for a single residue mismatch.

[Double-contrast gastrography and gastroscopy in the diagnosis of gastric polyps. Personal experience]. / La gastrografia a doppio contrasto e la gastroscopia nella diagnosi dei polipi gastrici. Esperienza personale.

Gastric polyps are benign tumors which have been less uncommonly detected in recent years, due to the refinement of both radiologic and endoscopic investigations. From 1981 through 1985 gastric polyps were detected in 102 patients (1.9%) out of 5368 radiologic examinations. In the same period, 98 cases (3.3%) were detected out of 2942 endoscopic examinations. The comparison of data in these two series shows a superimposition. Despite an increased percentage of endoscopic findings (to some extent due to previous radiologic reports), the authors assert the diagnostic efficacy of double contrast radiologic investigation as a first approach to benign polypous lesions of the stomach. As far as histology is concerned, a clear prevalence is shown of hyperplastic versus adenomatous polyps (90 and 8 cases respectively).

Clinical course of ulcerative colitis in Italy.

The prognosis of ulcerative colitis has been studied in 122 patients with this disease who had been referred to Bolgna from various parts of Italy and were then followed up. The overall mortality rate was 4.9% and the percentage of patients who were treated by total colectomy was 15.5%. Postoperative mortality was 10.5%, and the percentage of patients who developed carcinoma of the colon was 0.8%. All these figures fall within the range of values for the relevant variables quoted by previous authors from different countries. It is concluded that the prognosis of ulcerative colitis in the 122 Italian patients in the present study was similar to that reported previously in patients of other nationalities.

Motor effect of dopamine on human sigmoid colon. Evidence for specific receptors.

The effect of dopamine on human sigmoid motility has been studied in 26 subjects. To record mechanical activity of the sigmoid colon, two small, air-filled balloons mounted on a probe introduced through a sigmoidoscope were used. The recordings were made at a distance of 25 and 15 cm from the anal edge. Dopamine was infused for 10 min after a 30-min control infusion of physiologic solution. Mean amplitude, mean duration, mean frequency, percentage of motor activity, and motility index of the pressure waves were determined. The motor response to dopamine was characterized by an increased baseline pressure with phasic waves superimposed. Dopamine produced a significant response at the dose of 5 microgram/kg/min. Alpha and beta antagonizing agents failed to oppose the effect of dopamine, while anticholinergic drugs enhanced its motor action. These studies suggest that dopamine may stimulate the motor function of human large bowel through specific receptors.