[High resolution computerized tomography in the diagnosis of asbestosis]. / La tomografia computerizzata ad alta risoluzione nella diagnosi di asbestosi.

The clinical observation, the work history, the analysis of pulmonary function tests and, mainly, the conventional x-ray chest radiograms have represented, til now, the diagnostic basis for pneumoconiosis (silicosis, mixed dust pneumoconiosis, asbestosis). Recently, the high resolution chest tomography (HRCT) has been introduced into the diagnostic procedures: such method seems to have its main application in the assessment of incipient clinical pictures of pneumoconiosis, particularly when characterized by normal pulmonary function tests. Asbestos fibers exposed workers were submitted to both radiologic methods. The great majority of them had already been recognized to be affected by asbestosis. A considerable statistical agreement (Cohen K) was observed between radiographic and tomographic I.L.O. classes. In conclusion, high resolution chest tomography doesn't appear to be an indispensable test for the diagnosis in admitted subjects, but we underline its importance in the evaluation of pleural thickenings.

[High resolution computerized tomography in the diagnosis of silicosis and mixed dust pneumoconiosis]. / La tomografia computerizzata ad alta risoluzione nella diagnosi di silicosi e di pneumoconiosi da rischio misto.

The clinical observation, the work history, the analysis of pulmonary function tests and, mainly, the conventional x-ray chest radiograms have represented, til now, the diagnostic basis for pneumoconiosis (silicosis, mixed dust pneumoconiosis, asbestosis). Recently, the high resolution chest tomography (HRCT) has been introduced into the diagnostic procedures: such method seems to have its main application in the assessment of incipient clinical pictures of pneumoconiosis, particularly when characterized by normal pulmonary function tests. 75 silica- and mixed dust exposed workers were submitted to both radiologic methods. The great majority of them had already been recognized to be affected by asbestosis. The statistical analysis (Cohen K) showed a satisfactory agreement between radiographic and tomographic I.L.O. classes. However, high resolution tomography appeared to be more accurate in the assessment of less severe clinical pictures. In conclusion, we underline the importance of high resolution chest tomography in the evaluation of individual clinical cases, particularly when forensic problems are involved.

Multilineage long-term engraftment potential of drug-resistant hematopoietic progenitors.

Peripheral blood progenitor cells (PBPCs) are increasingly used instead of bone marrow for autologous or allogeneic transplantation. In this study PBPCs mobilized in cancer patients by chemotherapy and granulocyte-colony stimulating factor were collected by apheresis and first enriched by immunoaffinity removal of lineage positive cells. When these cells were exposed to both cyclophosphamide and taxol or cultured for 7 days in the presence of 5-fluorouracil, stem cell factor, and interleukin-3, 88% to 93% of the enriched PBPCs were killed and short-term clonogenic capacity in methylcellulose assays was lost, but week-5 cobblestone area-forming cell (CAFC) enrichment was higher than 10-fold in comparison to enriched PBPCs and higher than 700-fold in comparison to unmanipulated apheresis cells. After drug exposure, most of the progenitors displayed a CD34+, CD38-, multidrug-resistance (MDR+), Rhodamine 123 low, Hoechst 33342 low phenotype, and as few as 180 of these drug-resistant cells were able to generate a stable multilineage human hematopoiesis in sublethally irradiated immunodeficient mice. In these animals, the level of human hematopoietic engraftment was significantly increased by cotransplantation of irradiated cells from the human L87/4 stromal cell line. These observations are consistent with the functional isolation of a population of very early hematopoietic progenitors and might help to design new protocols for the removal of neoplastic cells from autografts.

Sex hormones and bone metabolism in postmenopausal rheumatoid arthritis treated with two different glucocorticoids.

To investigate the effect of low doses of 2 different glucocorticoids on bone mass, sex hormone status and bone metabolic indices, a study was undertaken in 16 postmenopausal women with rheumatoid arthritis (RA) receiving < 15 mg/day of deflazacort and in 16 patients with RA matched for age, years postmenopause and disease duration, receiving < 10 mg/day of prednisone. Sixteen healthy postmenopausal women and 16 nonsteroid treated patients with RA were also studied as control groups. Vertebral bone density (vBMD) was lower (mean +/- SD: 0.65 +/- 0.07 vs 0.73 +/- 0.09 g/cm2; p < 0.02) in prednisone treated patients than in deflazacort treated patients, whose vBMD values were similar to those of nonsteroid treated RA. No significant difference was found as for radial bone mineral content. Circulating levels of estradiol, dehydroepiandrosterone sulfate, androstenedione and progesterone were low in all patient groups with RA when compared with healthy controls. The prednisone treated patients showed significantly lower values of all sex hormones with respect to deflazacort treated patients. Osteocalcin values were also lower (3.0 +/- 1.4 vs 3.9 +/- 1.6 ng/ml; p < 0.05) in prednisone treated patients with respect to deflazacort treated group. Glucocorticoid treated patients showed a direct correlation (r2 = 0.39) between vBMD and plasma estradiol levels, while no correlation was found with osteocalcin values. In conclusion, our postmenopausal patients with RA treated with low dose prednisone had reduced levels of sex hormones and osteocalcin and reduced vertebral bone mass. Comparable doses of deflazacort showed only a mild inhibitory effect on sex hormones and osteocalcin, and did not show any detectable effect on bone mass.

Biological effects of magnetic fields.

The literature about the biological effects of magnetic fields is reviewed. We begin by discussing the weak and/or time variable fields, responsible for subtle changes in the circadian rhythms of superior animals, which are believed to be induced by same sort of "resonant mechanism". The safety issues related with the strong magnetic fields and gradients generated by clinical NMR magnets are then considered. The last portion summarizes the debate about the biological effects of strong and uniform magnetic fields.

[Treatment of ovariectomized patients with intramuscular and nasal-spray synthetic calcitonin]. / Trattamento di pazienti ovariectomizzate con calcitonine sintetiche per via intramuscolare e spray nasale.

The activity of different formulations of synthetic calcitonins on the prevention of bone loss was evaluated in young women after oophorectomy. In the 1st study patients were treated or with salmon calcitonin (CTs) intramuscularly (100 I.U. every second day; 10 patients) either with CTs nasal spray (100 I.U. daily; 10 patients). In the 2nd study patients received or CTs i.m. (100 I.U. every second day; 10 patients) either a synthetic analogue of eel calcitonin (eCT) given i.m. (80 I.U. every 2nd day; 10 patients). All calcitonins formulations were given for 9 months with oral calcium supplement (1 g daily). In the 1st study no significant changes of bone mineral content (BMC) was found at the end of the treatment in both groups. In the 2nd study a statistically significant decrease of BMC was observed in the group treated with eCT while non relevant changes were found in the CTs treated patients. Slight side effects were observed in some patients treated with calcitonin formulations given i.m. Since salmon calcitonin nasal spray was well tolerated and prevented bone loss after oophorectomy its use might be recommended in the treatment of postmenopausal osteoporosis.

[Radiographic and xeroradiographic case finding in asbestosis]. / Depistage radiografico e xeroradiografico dell'asbestosi.

Statistical researches were carried out on subject samples exposed to asbestosis risk with the aim of investigating the advantages of xeroradiographic methods when applied to the early diagnosis of this occupational disease. In the initial phase of the research, the aim was to quantify the statistical incidence of minimum asbestosis. Thus the frequency of initial forms was compared with developed forms in 750 subjects working with amianthus cement. These subjects had been homogeneously exposed to asbestosis risk (as research on the environment in the factory confirmed), and over a period of 10 years had been checked radiographically at the Clinica del Lavoro of the University of Pavia. This first phase of the research confirmed the remarkable incidence of the disease. In the subsequent phase, the radiographs of 200 subjects with asbestosis were studied. The aim was to quantify the frequency of the different radiological symptoms of the disease. In the final phase of the research, both traditional radiographs and xeroradiographs were obtained on 51 subjects exposed to asbestosis risk with pulmonary alterations, although with no (or not significant) radiographic techniques in the early diagnosis of asbestosis would thus become clear. For protective reasons, the use of xeroradiography is proposed not for mass screening but only for controlled investigations. Xeroradiography can evidence plaques or pleural fibrous alterations, which would not be shown on traditional radiographs. It also allows more satisfactory examination of the small fibrous parenchymal opacities at the base of the lungs. On the other hand, additional controlled examinations of the same subjects, even when use was made of projections for pleural backgrounds and lordotic projections for the parietal pleurae, reduced earlier favorable statistics by half. However, the wide range of xeroradiography can evidence nearly all radiographic symptoms in a single xeroradiograph. This greatly facilitates routine examination while providing more satisfactory iconographic data for subsequent medico-legal discussion.

[Effect of x-rays on the hemolytic substances of the Yoshida ascites tumor]. / Effetto dei raggi X sulle sostanze emolitiche del tumore ascite di Yoshida

Ricinoleic-like haemolytic substances were isolated from tumour cells and peritoneal liquid fractions in rats with Yoshida's ascities hepatoma. Their activity was measured by means of photometric techniques. Crossed haemolytic tests showed differences in the choice expressed by these substances for the red cells of animals of various species. Whole body irradiation led to changes in the quantity of these substances. Their metabolism was examined by administering 3H2- and 14C6-labelled oleic acid. A variety of results was observed. Microscopic examination of target red cells in a study of the oleic acid-lysine-membrane bond confirmed the results given by the densitometer.