[Polyomavirus BK nephropathy in renal transplant: 2 cases with different clinical expressions and review of the literature]. / Nefropatia da Poliomavirus BK nel trapianto renale: 2 casi con espressione clinica diversa e revisione della letteratura.

INTRODUCTION: Polyomavirus BK nephropathy is emerging as a significant cause of interstitial nephritis and allograft dysfunction (1-2). CASE REPORT: Two patients with renal transplants from cadaveric kidneys were treated with Tacrolimus plus Mycophenolate Mofetil (MMF) and Cyclosporine plus MMF, respectively. Their renal function gradually deteriorated eight to twelve months after the transplant. The renal biopsy of the first patient showed signs of significant interstitial tubulite, which necessitated the anti-rejection therapy with intravenous steroid pulses. After the pulses there was an additional dramatic increase in plasmatic creatinine, which suggested a revaluation of the kidney biopsy because of suspected Polyomavirus BK (BKV) nephropathy. In fact, after a more careful review, the suspicion of BKV infection was confirmed by the presence of intranuclear inclusions of tubular epithelium cells and marked denudation of the tubular basal membrane. The subsequent screening in both cases confirmed the presence of decoy cells in the urine, while the immunohistochemical analysis of the renal biopsy was strongly positive for the SV40 antigen. Our diagnosis was that of interstitial nephritis due to Polyomavirus BK that, in the first patient, was expressed by more aggressive clinical progress, probably due to enhanced immunosuppression from incorrect diagnosis of the interstitial rejection. The pre-transplant clinical outcome of the first patient was characterised by proteinuric nephropathy without any histological confirmation. Furthermore, we observed abundant pre-transplant residual diuresis and glucose intolerance. All these elements led us to hypothesise that native kidneys could have a fundamental role as viral reservoirs. CONCLUSION: Even though we reconfirm the decisive role of the immunosuppressive therapy and of the donor s kidney as the fundamental causes of Polyomavirus reactivation, we believe that it cannot be the result of a possible active role by the native kidney. In fact, as already noted, the SV40 genome is important in the pathogenesis of focal gomerulosclerosis. Furthermore, reports of polyoma nephropathy in not-yet-transplanted patients could accredit the role of the native kidneys as important viral reservoirs capable of inducing nephropathy in renal transplant patients.

[Thyroid pathology: evaluation of the average value of NORs and its potential diagnostic and prognostic application]. / Patologia tiroidea: valutazione del valore medio dei NORs e sua possibile applicazione diagnostica e prognostica.

Argyrophilie technique to identify nucleolar organizer regions (NORs) applied in formalin-fixed paraffin sections of thyroid tissue allow us to reveal NORs as block dots in the nuclei of cells. In the present study the relationship between number of NORs and cellular activation emphasize significant statistical data: it was found that the number of AgNORs in malignant thyroid lesions significantly exceeded those of benign thyroid lesions. This objective assessment associated with easily method show an advantage in thyroid diagnostic histopathology an adjunct to routine methods.

The role of monocytes in rheumatoid synovitis.

In non-specific and rheumatoid synovitis, the use of specific monoclonal antibodies against antigenic determinants of cells of the immune system showed that the characteristic changes of rheumatoid synovitis are located in the synovial internal layers. The monocytes were OKM1, OKM5, S100, OKDR positive, while the subintimal monocytes in non-specific synovitis were OKDR negative. We suggest that, in rheumatoid synovitis, the previously activated monocytes are transported by the bloodstream and pass through the so-called "sinovial barrier" to arrive in the subintimal layers ready to interact with T helper lymphocytes and initiate the immune response mechanisms responsible for lesions in rheumatoid synovitis.

[Human dirofilariasis in southern Italy. II. The Calabria Region]. / La dirofilariasi umana nel sud d'Italia. II: Regione Calabria.

A new case of subcutaneous Human Dirofilariasis, in a 42-year-old woman from the province of Cosenza, is described. It is the first reported in Calabria. The nematode, an immature female of Dirofilaria repens, was clinically diagnosed as a "Fibrolipoma". In a collateral research on dogs in different areas of the same province, microfilariae of D. repens in 2 out 134 individuals were detected.

[Immunohistochemical study of reserve cells: hypotheses on their origin]. / Studio immunoistochimico delle cellule di riserva: ipotesi sulla loro origine.

The location of reserve cells make it possible the understanding of cervicovaginal repair by metaplasia process better, really some have studied the potentiality of such cells. Now we believe that totipotent stromal cell, which can evolve towards the epithelial cells, give origin to reserve cells. Immunohistochemistry methods point out stain positively for cytokeratin (DW 45-56,5 KD) present in reserve cells, confirmed the stromal origin of them.