Endometriosis and Glanzmann’s thrombasthenia.

Glanzmann’s thrombasthenia (GT) is a rare bleeding syndrome characterized by deficiency or defect of platelet aggregation complex. The pathogenesis of endometriosis is controversial but the strongest evidence leans towards retrograde menstruation. GT probably predisposes to endometriosis. The management of women affected by this disease can be difficult due to the risk of bleeding complications, especially during surgical treatment. We describe the cases of three sisters affected by endometriosis and GT, referred to our Department, who received different therapeutic management.

Role of environmental organochlorinated pollutants in the development of endometriosis.

Endometriosis is a gynecological disease, which involves the growth of endometrial tissue outside the uterine cavity, commonly in the pelvic region. The etiology of the disease is unclear, but multiple factors may contribute to its pathogenesis. Environmental organochlorinated pollutants, particularly dioxins and polychlorinated biphenyls (PCBs), are thought to play a role in the development of this disease; however, the results of clinical trials are discordant, and it is not clear how the effect of exposure to these compounds is linked to endometriosis. Their effects on cytokines, immune system, hormones, and growth factors are thought to increase the risk of endometriosis. The purpose of this review is to provide an overview of epidemiological studies, which have evaluated the relationship between endometriosis and exposure to persistent organochlorinated pollutants.

Predicting aneuploidy in human oocytes: key factors which affect the meiotic process.

BACKGROUND: To estimate the incidence of aneuploidy in relation to patients' characteristics, the type of hormonal stimulation and their response to induction of multiple follicular growth, 4163 first polar bodies (PB1s) were analyzed. METHODS: Five hundred and forty four infertile couples underwent 706 assisted conception cycles (640 with poor prognosis indications and 66 controls) in which chromosomal analysis of PB1 for the chromosomes 13, 15, 16, 18, 21 and 22 was performed. Results were evaluated in a multivariate analysis. RESULTS: The proportion of normal oocytes was directly correlated (P < 0.01) with (i) the number of mature oocytes and (ii) the establishment of a clinical pregnancy; and inversely correlated (P < 0.01) with (i) female age, (ii) causes of female infertility (endometriosis, abortions, ovulatory factor), (iii) poor prognosis indications (female age, number of previous cycles, multiple poor prognosis indications), (iv) number of FSH units per oocyte and (v) number of FSH units per metaphase II oocyte. There was a weak significance of frequency (P < 0.05) between type of abnormality (originated by chromatid predivision, chromosome non-disjunction or combined mechanisms in the same oocyte) and groups of the studied variables, rather than to a specific abnormality or a specific chromosome. CONCLUSIONS: The type of infertility had a significant effect on errors derived from the first meiotic division, whose incidence was significantly higher in the presence of endometriosis or of an ovulatory factor, and in women that experienced repeated abortions. Each aneuploidy event was found to be dependent not on a specific variable, but on groups of variables. In addition, the tendency of chromosomal abnormalities to occur simultaneously implies that the deriving aneuploidies can be of any type.

Microspheres leaching for scaffold porosity control.

Scaffold morphology plays a key role in the development of tissue engineering constructs. The control of pore size, shape and interconnection is needed to achieve adequate nutrient transport and cell ingrowth. Several techniques are available for scaffold manufacturing, but none allows easy control of morphology and is, at the same time, applicable to a wide variety of materials. To investigate the possibility of processing a wide range polymers by solvent casting/particulate leaching with accurate control of scaffold morphology, three different porogens (gelatin microspheres, paraffin microspheres and sodium chloride crystals) were used to fabricate scaffolds from commonly employed biodegradable polymers. The outcome of processing was evaluated in terms of scaffold morphology and structure/properties relationships. Highly porous scaffolds were obtained with all porogens and well defined spherical pores resulted from microspheres leaching. Furthermore, scaffolds with spherical pores showed better mechanical performance and lower flow resistance. Cytocompatibility tests performed showed no evidence of processing residuals released from the scaffolds. Solvent casting/microspheres leaching, particularly gelatin microspheres leaching, can be used to process a large number of polymers and enables to tailor scaffold pore size, shape and interconnection, thus providing a powerful tool for material selection and optimization of scaffold morphology.

Clinical, histological, and virological features of hepatitis C virus carriers with persistently normal or abnormal alanine transaminase levels.

This study was aimed to evaluate demographic, clinical, histological, and virological characteristics of 46 hepatitis C virus (HCV) carriers with persistently normal alanine transaminase (ALT) levels and to compare the results with those obtained in a group of 52 HCV-RNA-positive patients with elevated ALT levels. Subjects with normal ALT were more often females (P < .001), were more likely to be asymptomatic (P < .001), and have a lower incidence of risk factors for HCV transmission (P < .01). All patients with normal ALT had significant histological liver damage. The mean grading and staging did not differ between patients with normal and those with raised ALT concentrations. Moderate to severe hepatitis was more frequently found among subjects with normal than with elevated ALT. HCV genotype 2a was far more common in subjects with normal (43%) than with abnormal ALT levels (6%; P < .002), genotype 1b being more frequent in these latter (50% vs. 17%; P < .001). Patients with normal ALT levels had similar serum HCV-RNA titers than subjects with raised ALT. Neither HCV genotype distribution nor viral load correlated with the severity of liver damage. We conclude that significant liver disease may occur irrespective of clinical symptoms, ALT levels, HCV genotypes, and viral load.

Written expression in boys with attention deficit disorder.

32 boys, between the ages of 8 and 13 years, were identified on four teachers' and parents' rating scales (including the diagnostic criteria of the DSM-III for ADD) as showing attention deficits and hyperactivity (ADD + H; n = 10), attention deficits without hyperactivity (ADD-H; n = 11), or without ADD (attention deficits controls; n = 11). All subjects were administered Bender's Visual-motor Gestalt test and the Written Language Assessment. The ADD + H children produced significantly more errors on the Bender-Gestalt test, and both groups with attention deficits had lower (poorer) scores on most of the written language subtests. Results were interpreted as providing evidence that these children possessed significant limitations in their writing, copying, and composition.

A controlled trial of ganciclovir to prevent cytomegalovirus disease after heart transplantation.

BACKGROUND: Because of the immunosuppression required, heart-transplant recipients frequently have complications caused by cytomegalovirus (CMV), including pneumonia, esophagitis, gastritis, and a syndrome of fever, hepatitis, and leukopenia. We undertook a controlled trial to evaluate the prophylactic administration of ganciclovir to prevent CMV-induced disease after heart transplantation. METHODS: This randomized, double-blind, placebo-controlled trial was conducted at four centers. Before randomization, the patients were stratified into two groups: those who were seropositive for CMV before transplantation and those who were seronegative but who received hearts from seropositive donors. Ganciclovir was given intravenously at a dose of 5 mg per kilogram of body weight every 12 hours from postoperative day 1 through day 14, then at a dose of 6 mg per kilogram each day for 5 days per week until day 28. RESULTS: Among the seropositive patients, CMV illness occurred during the first 120 days after heart transplantation in 26 of 56 patients given placebo (46 percent), as compared with 5 of 56 patients treated with ganciclovir (9 percent) (P less than 0.001). Among 37 seronegative patients, CMV illness was frequent in both groups (placebo, 29 percent; ganciclovir, 35 percent; P not significant). From day 15 through day 60, the patients who took ganciclovir had significantly fewer urine cultures positive for CMV, but by day 90 there was no difference. More of the ganciclovir-treated patients had serum creatinine concentrations greater than or equal to 221 mumol per liter (2.5 mg per deciliter) (18 percent vs. 4 percent in the placebo group), but those elevations were transient. CONCLUSIONS: The prophylactic administration of ganciclovir after heart transplantation is safe, and in CMV-seropositive patients it reduces the incidence of CMV-induced illness.

Human cytomegalovirus glycoprotein-receptor interactions.

The HCMV envelope glycoprotein having a molecular weight of 86 kd, gH, has been shown to react with a 92 kd protein that can be extracted from HEL fibroblasts. This HCMV-gp86 membrane receptor appears to be present on the surface of both HCMV-permissive and HCMV-non-permissive cells, suggesting that there are factors in addition to viral attachment governing the intracellular replicative process. Another HCMV envelope glycoprotein (gp130/55; gB homologue) binds predominantly to a 31 kd protein with minor bands at 180, 96, and 90 kd. HCMV-gp86 does not bind to the principal gp130/55 receptor.

Cytomegalovirus: where have we been and where are we going?

Nearly 30 years have elapsed since Rowe and Weller and their colleagues discovered human cytomegalovirus (CMV). Because of its complex structure, long replicative cycle, low yield in vitro, and highly species-specific cell-substrate requirement, the cellular and molecular biologic analyses of human CMV have been slow, but recombinant DNA and monoclonal antibody technologies are bringing about rapid changes. Because of the long period of latency and wide range of disease presentations, epidemiologic and medical insights have also come slowly. However, the clinical events that occur during iatrogenic immunosuppression (transplantation and cancer therapy) and as a result of immunocompromise due to human immunodeficiency virus infection are currently promoting our understanding of the epidemiology of CMV disease and the definition of its clinical spectrum. Rapid diagnostic methods, antiviral drugs, and vaccines for CMV are becoming available. We may not yet understand completely the impact of this agent on the nonimmunosuppressed or aspects of its pathogenesis: e.g., the immune functions controlling recrudescence and the possibility of increased disease severity in those with no detectable immune defect. With the availability of new approaches, other issues should be clarified, such as the functions of host and virus involved in the mechanism of persistence.

Isolation and propagation of a human enteric coronavirus.

Coronavirus-like particles were found by electron microscopy in stools from infants with necrotizing enterocolitis. Stool samples from these infants as well as control specimens were passaged in cultures of human fetal intestinal organs. Two samples yielded virus-like particles and these have now been passaged 14 times (HEC 14). Gradient-purified HEC 14 strains had typical coronavirus morphology on electron microscopy and contained five major proteins with molecular sizes ranging from 190 to 23 kilodaltons. Infants with necrotizing enterocolitis developed specific antibody to the viral antigens between the acute and convalescent stages of the disease, as shown by examining serum specimens by single radial hemolysis, immunoenzymatic assay, and Western immunoblotting. No cross-reactivity was shown with other coronavirus strains tested, or with the newly isolated viruses of the Breda-Berne group, responsible for calf or horse diarrhea.

[Antibody response to trivalent anti-influenza vaccination (inactivated virus) A/Texas/1/77 H3N2), A/URSS/90/77 (H1N1), B/Hong Kong/8/73]. / Risposta anticorpale alla vaccinazione anti-influenzale trivalente (A virus inattivato) A/Texas/1/77 (H3N2), A/URSS/90/77 (H1N1), B/Hong Kong/8/73.

Seventy-five young recruits received an intramuscular dose of anti-influenza virus vaccine containing 300 U.I. of A/Texas/1/77 (H3N2), A/URSS/90/77 (H1N1), B/Hong Kong/8/73 strains. Antibody responses were detected by HI and SRH tests: immunogenicity of the preparation was different for the individual vaccine strain in spite of the similar amount of antigenic content, and the immunity conferred by vaccine strains did not significantly extend to new influenza virus strains which prevailed in 1979/80 winter season with the exception for A/Brazil/11/78 (H1N1).