Specific association of human telomerase activity with immortal cells and cancer.

Synthesis of DNA at chromosome ends by telomerase may be necessary for indefinite proliferation of human cells. A highly sensitive assay for measuring telomerase activity was developed. In cultured cells representing 18 different human tissues, 98 of 100 immortal and none of 22 mortal populations were positive for telomerase. Similarly, 90 of 101 biopsies representing 12 human tumor types and none of 50 normal somatic tissues were positive. Normal ovaries and testes were positive, but benign tumors such as fibroids were negative. Thus, telomerase appears to be stringently repressed in normal human somatic tissues but reactivated in cancer, where immortal cells are likely required to maintain tumor growth.

Diagnosis of HCV related acute hepatitis by serial determination of IgM to HCV: a preliminary observation.

OBJECTIVE: To verify whether serial determination of titre of IgM to HCV core protein (HCV IgM) may be useful to distinguish acute hepatitis C (AHC) from reactivation of chronic hepatitis C (r-CHC), we studied 18 consecutive patients with AHC (identified by seroconversion to anti-HCV) and 15 consecutive patients who had been anti-HCV positive for at least one year at the time of reactivation. METHODS: Samples of serum were obtained from all patients on hospitalisation and every 5 days during the follow-up and stored at -80 degrees C: 54 samples of serum for the AHC group and 41 for the r-CHC group. Titres of HCV IgM were calculated as Index values by a commercially available enzyme immunoassay (HCV-IgM EIA 2.0, Abbott Laboratories, North Chicago, IL, USA). RESULTS: No difference was observed between the two groups of patients as regards age, sex, risk factors for the acquisition of HCV infection, clinical and biochemical data on presentation, prevalence of cases with detectable viremia or distribution of HCV genotypes. HCV IgM was detected with an Index value of 350 or more in only 1 (6.7%) in the r-CHC group and in 17 (94.4%) in the AHC group (p<0.01). Moreover, during the early phase of the illness we observed a wide variation in the HCV IgM Index values in AHC and consistent values in r-CHC. CONCLUSIONS: Our data indicate that AHC is characterised by high and variable titres of HCV IgM during the acute phase of the illness, which may be considered diagnostic, whereas in r-CHC the IgM titre remains stable and rarely reaches a high level.

Clinical, laboratory and radiological findings in pulmonary fibrosis with and without connective tissue disease.

Uncertainty exists over whether to consider "lone" idiopathic pulmonary fibrosis (LIPF) and pulmonary fibrosis associated with connective tissue disorders (PFCTD) as significantly different entities. We retrospectively analysed data collected at the time of first diagnosis in 17 patients with LIPF and in 14 patients with PFCTD and compared survival in the two groups. At first evaluation, the time from onset of respiratory symptoms, spirometric volumes and the diffusing capacity for carbon monoxide were not significantly different between the two groups. However, arterial oxygen tension was significantly lower in LIPF than in PFCTD (63 +/- 3 vs 88 +/- 3 mmHg, p < 0.001). The radiological profusion scores relative to the upper and middle lung fields were significantly higher in LIPF than in PFCTD (upper regions: 6.9 +/- 0.6 vs 3.4 +/- 0.6, p < 0.005 - middle regions: 7.1 +/- 0.5 vs 4.8 +/- 0.7, p < 0.025), whereas the scores relative to the lower fields were similar (7.4 +/- 0.4 in LIPF and 8.4 +/- 0.6 in PFCTD). Survival since onset of respiratory symptoms was significantly better in the PFCTD than in LIPF patients, with a hazard ratio of 4.16 (95% CI 1.12-15.58, p=0.034). Thus, in our series of patients, those with LIPF had a more severe disease than those with PFCTD as shown by the higher frequency of hypoxaemia, the more diffuse pulmonary involvement demonstrated by the chest X-ray and the decreased survival.

Involvement of atlanto-axial joint in rheumatoid arthritis: rare or frequent?

The authors studied the incidence of atlanto-axial joint involvement by conventional radiography and CT in 183 patients with classical or definite rheumatoid arthritis (RA). In determining lesions the significance of factors such as age, sex, duration and severity of the disease was evaluated. Atlanto-axial subluxations turned out to be quite frequent (30%) in the series of patients examined and were directly correlated with age, duration and stage of the disease, and extraarticular manifestations. Clinical symptoms were evident in only 70.9% of cases, confirming the correlation reported by other authors between clinical manifestations and radiologically observed lesions. Traditional radiography performed in the dynamic position revealed a prevalence of anterior subluxation, whereas CT gave a precise indication of the entity and type of atlanto-axial lesion. In conclusion, the authors confirm the importance of such investigations in all patients with RA, even those without evident clinical manifestations. They also emphasize the necessity of periodic monitoring in view of the possible risk of mortality in these patients.

Primary neoplasm in vesical diverticulum: comparison of four imaging methods.

In presenting the case of a 61-year-old man with a primary squamous carcinoma in a bladder diverticulum, the authors stress the usefulness of applying all the available modalities of imaging, since it has been found that a bladder diverticulum may harbor a neoplasm more often than a normal bladder.

[MacLeod's syndrome. Observations on 6 cases]. / Sindrome di MacLeod. Osservazioni su sei casi.

Mac Leod's syndrome is a rarely diagnosed disease; that is why an accurate differential diagnosis is needed by means of radiological imaging. This paper is aimed at discussing the differential diagnosis, with a special emphasis on the pathogenesis of the syndrome. The phenomenon of air trapping in absence of central bronchial lesions is a typical radiographic finding. Chest X-ray is performed in both inspiration and expiration. Posterior oblique tomography at 55 degrees of the affected side is also performed. Diffuse bronchiolitis obliterans in infancy or early childhood is a widely accepted pathogenetic pattern. Pulmonary hypoventilation causes vasoconstriction and underdevelopment of pulmonary vessels, that are reduced in caliber. Differential diagnosis includes all the diseases resulting in pulmonary hyperlucency, i.e. pulmonary and pleural alterations, and skeletal anomalies.

[Farmer's lung: comparison of the teleradiographic images and computerized tomographic (CT) images]. / Farmer's lung: confronto tra immagini teleradiografiche ed immagini TC.

A critical and comparative analysis between chest radiograms and CT pictures in pulmonary fibrosis of various degree, occurring in farmer's lung, reveal that the latter are apt to give a somewhat more diversified informations about pulmonary changes as simple radiography. This would prove useful in evaluating the extension and distribution of anatomical changes due to fibrotic process, although as far not able to allow an earlier diagnosis.

Early graft injuries after pancreatic transplantation in syngeneic rats. Cytoprotective effects of gabexate-mesilate.

Failures in experimental and human pancreatic transplantation are mainly attributable to rejection, graft thrombosis, and technical problems. There are, however, problems related to other causes, such as preservation injuries, which we found to exhibit, at least within the first 6 h, the same histological patterns seen in experimental acute pancreatitis. We performed pancreatic transplantation in 110 syngeneic rats under different preservation techniques and administration of gabexate mesilate, a synthetic protease inhibitor. The results showed that antiprotease treatment reduces graft preservation injuries significantly.

Abnormalities in calcium metabolism in sarcoidosis.

In sarcoidosis the excess of calcitriol of extrarenal origin induces changes in calcium metabolism (CM), specifically hypercalciuria and less often hypercalcemia. We report the results of the study of CM in 44 sarcoidosis patients (mean age 43.7 +/- 11 years, M +/- SD, 21 males). 25% were on steroid therapy at the time of the tests. 34% of the patients had hypercalciuria, this figure rose to 39% if only untreated patients were considered. Hypercalcemia was found in only 2.2%. Chronic forms and extrathoracic involvement (mostly skin) were more frequent in the hypercalciuric patients than in the normocalciuric.