Epidemiology of hepatitis D virus (HDV) infection in an urban area of northern Italy.

OBJECTIVES: The introduction of vaccination against hepatitis B initially reduced the number of HBV (hepatitis B virus) and HDV (hepatitis delta virus) infections, but the decreasing trend of HDV infection seems to have stopped. The aim of this study was to assess the prevalence of HDV infection in the general population living in the catchment area of Legnano Hospital in northern Italy. METHODS: Of the 22,758 subjects tested in 2007-2008, the 488 who were HBsAg (hepatitis B surface antigen)-positive [including 107 (21.9%) of non-Italian origin] were subsequently tested for anti-HDV antibodies. RESULTS: Of the 488 subjects who tested positive for HBsAg, 24 (4.9%) were anti-HDV positive, all aged between 30 and 60 years. The difference in prevalence between males (7.1%) and females (1.9%) was statistically significant (p < 0.05), but not that between Italian (5.0%) and non-Italian patients (4.7%). The differences in anti-HDV seropositivity between the patients with acute (0%) and chronic infections (6.3%), and between the incident (2.5%) and prevalent cases (7.4%), were not statistically significant, but there was a significant difference (p < 0.01) between those with asymptomatic (2.1%) and clinically symptomatic infections (10.3%). Intravenous drug abuse was the main source of infection. CONCLUSIONS: In the catchment area of our hospital, the prevalence of HDV infection does not seem to be due to patients of non-Italian origin, but to Italian patients who are not vaccinated against HBV and who survived the HDV epidemic of the 1970s and 1980s. Nevertheless, the increase in the number of immigrants from non-EU countries in recent years is soon likely to lead to a change in the epidemiology of HDV.

[Work schedule and accidents among subjects digging tunnels for the new high speed railway network in Toscana]. / Orario di lavoro e fenomeno infortunistico nella costruzione della Tratta toscana dell'Alta Velocità ferroviaria.

We analysed the temporal distribution of all the accidents occurred in the last 4 years among the workers engaged in tunnel digging for the new high speed railway network. The frequency and severity rates show significant differences according to work shifts and time of occurrence, with particular reference to hour of the day, hour of duty, day of the week, day of duty, and month of the year).

Sporadic fundic gland polyps: an immunohistochemical study of their antigenic profile.

Fundic Gland Polyps (FGPs) are small sessile (2-5 mm), usually multiple polyps arising in the gastric, acid-secreting mucosa of disputed histogenesis. They have been described in a sporadic form, prevalently in middle aged females, or associated with familial adenomatosis coli-Gardner's syndrome. We performed an immunohistochemical study on 24 sporadic FGPs, using monoclonal antibodies (MAbs) against differentiation markers, class II MHC antigens (HLA-DR), oncofetal and proliferation antigens, aimed to characterize the antigenic profile of the polyps. A preliminary cytogenetic study on five polyps was also done, using an in situ culture method after collagenase treatment. Cytokeratins 8-18 (CAM 5.2 MAb) and 20 (IT-Ks 20.8 MAb), Epithelial Membrane Antigen (EMA) and Chromogranin A were normally expressed by FGPs. FGPs did not express HLA II DR. FGPs did not react with an anti-CEA MAb (F6), but they were frequently positive (22/24, 91.6%) with B72.3 MAb (reacting with the cancer-associated mucin epitope sialyl-Tn). The PC10 MAb (against PCNA or cyclin) showed enhanced expression in the deep glandular-cystic compartment of FGPs; the PCNA index of FGPs was significantly higher than in normal fundic mucosa. The cytogenetic study on the 5 cases analysed, revealed a normal karyotype. We have demonstrated that FGPs express in the paranuclear zone the sialyl-Tn epitope, a side-chain sugar normally masqued in adult gastric mucins, thus revealing an alteration in mucin synthesis; FGPs' higher proliferation index as compared with normal fundic mucosa supports the hypothesis of their hyperproliferative nature.

Synthesis, platelet anti-aggregating activity and anti-inflammatory activity of a series of beta-aminoxypropionic acids.

This paper reports the platelet anti-aggregating activity induced by arachidonic acid (AA) and by adenosine-diphosphate (ADP), together with the anti-inflammatory activity evaluated by the carrageenan-induced rat paw edema method, of a series of beta-aminoxypropionic acids which were projected and synthesised as analogues of non-steroidal anti-inflammatory drugs with an arylacetic structure B, in which the aromatic group is substituted by a methyleneaminoxymethylic moiety. Some of the beta-aminoxypropionic acids were evaluated for their capacity to inhibit the cyclooxygenase enzyme by measuring the malondialdehyde (MDA) produced by incubation of sodium arachidonate with platelet-rich plasma (PRP).

[Splenic arteriovenous fistula (a clinical case)]. / Fistola artero-venosa splenica (un caso clinico).

A splenic arteriovenous fistula is a situation often presenting with signs of portal hypertension and with a characteristic murmur. Though rare, the possibility of a splenic arteriovenous fistula must be borne in mind in differential diagnosis, since it can be corrected surgically by resolving the portal hypertension.

"In vitro" fibrinolytic activity of a new low molecular weight heparan sulfate.

The fibrinolytic activity, effect on the fibrinolytic activity of plasmin, anticoagulant activity and anti platelet aggregation activity of a low molecular weight heparan sulfate (LMW HS Bal) were investigated "in vitro" on blood plasma obtained from rats and rabbits. LMW HS Bal at concentrations as low as 0.25-2 micrograms/ml prevented thrombin-induced platelet aggregation. At concentrations 25 to 50 times larger it showed no significant anticoagulant activity but a marked fibrinolytic effect. At still larger concentrations LMW HS Bal also potentiated the fibrinolytic activity of plasmin. Conversely, unfractionated heparan sulfate (UHS) at concentrations of 25 to 50 micrograms/ml, only showed anticoagulant activity with no fibrinolytic activity.

Molecular design, synthesis, and antiinflammatory activity of a series of beta-aminoxypropionic acids.

Previous experimental and theoretical studies carried out on the mechanism of action of adrenergic drugs have shown that the (methyleneaminoxy)methyl moiety (C = NOCH2, MAOMM) can be considered as a "bioisostere" of an aryl group (Ar). On this basis, a series of substituted beta-aminoxypropionic acids (AOPAs) were synthesized as analogues of antiinflammatory arylacetic acids (ArAAs), in which the Ar portion is substituted by the MAOMM, with the aim of evaluating whether any antiinflammatory activity could be obtained from this class of drugs after the substitution of the Ar with the MAOMM. The antiinflammatory activity of the AOPAs synthesized was determined by carageenan-induced rat paw edema, using diclofenac as the reference drug. The pharmacological data showed that most of the AOPAs examined exhibit a significant antiinflammatory activity, which in the case of the (E)-3-(benzylideneaminoxy)propionic acid (7q) is very close to that of the reference drug. Structural and theoretical studies were carried out in order to compare the conformation and the molecular reactivity of the AOPAs with those of the ArAAs. Pharmacological results showed that the ArAAs also generally exhibit an antiinflammatory activity after the substitution of the Ar with the MAOMM, thus supporting the hypothesis of a bioisosterelike relationship between these two moieties in this class of NSAIDs.

[Retroperitoneal lymphangiomyomatosis. Immunohistochemical and ultrastructural study of a case]. / Linfangiomiomatosi ad esordio retroperitoneale. Studio immunoistochimico ed ultrastrutturale di un caso.

A case of retroperitoneal lymphangiomyomatosis occurring in a 34-year-old woman is reported. Alpha-smooth muscle actin and desmin were localized in the proliferating cells. Electron microscopy showed the presence of many thin perinuclear myofilaments with dense bodies. The differential diagnosis with leiomyosarcoma has been taken into consideration.

On the effects of tranexamic acid and its isobenzedrine ester on plasminogen activation and streptokinase induced fibrinolysis.

A comparison between the inhibitory capability of Tranexamic acid (AMCA) and its isobenzedrine ester (IB-AMCA) on the streptokinase and urokinase induced plasminogen activation, indicated in vitro a higher potency of the ester derivative. A peculiar activatory rather than inhibitory effect on the plasminogen activation was exerted by AMCA and aminocaproic acid at relatively low concentrations. Attempts to show in vivo the in vitro observed differences between AMCA and IB-AMCA action are reported.

Massive neuronal destruction in human immunodeficiency virus (HIV) encephalitis. A clinico-pathological study of a pediatric case.

Human immunodeficiency virus (HIV) encephalitis in children with AIDS includes a diffuse white matter disease associated with an inflammatory cell infiltrate that features multinucleated giant cells. Cerebral cortex is relatively preserved and only focal loss of Purkinje cells in the cerebellum has been observed. We describe a case of encephalitis in a child with AIDS in which there was massive and diffuse destruction of the cerebral cortex with severe neuronal loss, marked inflammatory perivascular infiltrate with abundant multinucleated cells and large pleomorphic reactive astrocytes. Similar findings were present in the basal ganglia. Moreover, the cerebellum disclosed a complete loss of Purkinje and granule cells. These findings could not be related to an ischemic mechanism or to an associated opportunistic infection. Electron microscopy showed numerous HIV particles. This case illustrates a different pattern of CNS involvement by HIV and emphasizes the destructive capacity of this neurotropic virus for neural tissue.

Decrease of bleeding time by a peptide fraction from bovine factor VIII in laboratory animals.

A peptide fraction of low molecular weight prepared from bovine Factor VIII by enzymatic hydrolysis (Vueffe) reduces bleeding time in laboratory animals. In this study the haemostatic action in mice, rats and rabbits was investigated using different experimental conditions. This action was observed in animals with either normal or experimentally prolonged bleeding time, thus suggesting better efficacy in pathological situations. The evidence obtained following different routes of administration confirmed the activity of the compound. The efficacy was present at very low doses in all animal species without interfering either with platelets or with blood coagulation.

Polypeptide fraction from bovine factor VIII used in fluorangiography.

We report a new method of fluorangiography employing a polypeptide fraction from bovine factor VIII that has shown remarkable affinity to the endothelial surface of microvessels. Rabbits injected with this compound, labeled with fluorescein isothiocyanate, show a very delayed disappearance time of fluorescence in retinal vessels when compared with those injected with ordinary fluorescein. This allows a good observation of the late time, which is of great diagnostic advantage for several pathological conditions.

Polypeptide fraction from bovine factor VIII does not influence human platelet aggregation and blood coagulation.

It is well known that high molecular weight bovine factor VIII is able to aggregate human platelets and possesses procoagulant activities. There is also growing body of evidence that the hydrolysis of bovine factor VIII abolishes its aggregating and coagulative properties. We have shown in this paper that a polypeptide fraction (molecular weight 1000-25000 daltons) from bovine factor VIII does not aggregate platelets nor affect blood coagulation. In this study we investigate the action of the polypeptide fraction derived from bovine factor VIII and suggest that its effect may occur only at endothelium level without an involvement of platelets as well as blood coagulation.

Effects of the "vascular factor" on platelet and vascular arachidonic acid metabolism in man.

The effects of a drug with hemostatic action, "Vascular Factor" (V.F.), on platelet and vascular arachidonic acid metabolism were evaluated in man to establish the lack of side effects on platelet aggregation. Plasma levels of 6-keto PGF1 alpha and thromboxane B2 were determined by RIA in healthy volunteers undergoing treatment with V.F. Results indicate that basal values obtained in these compounds do not present significant variations following treatment with V.F. On the basis of these results, the possibility of administering this drug in atherosclerotic patients is further confirmed.

Increases in aggregation by and uptake of 5-hydroxytryptamine with platelets from rabbits treated with chlorpromazine.

1 Citrated platelet-rich plasma was prepared from New Zealand white rabbits before, during and after administration of chlorpromazine (2 mg/kg) intramuscularly once daily for 3 to 4 weeks. 2 In these plasmas, the velocity of platelet aggregation by 5-hydroxytryptamine (5-HT) added at 1, 3 and 10 microM increased greatly, beginning 3 to 4 days after the start of chlorpromazine injections and lasting for a similar period after they were terminated. The increase had two maxima, the first after 6 to 10 days and the second after 17 to 24 days. Chlorpromazine treatment did not affect aggregation by adenosine diphosphate (ADP). 3 The uptake of 5-HT by rabbit platelets was very fast and linear for less than 10 s. In platelets from untreated rabbits the uptake had a Km of 0.35 +/- 0.08 microM and a Vmax of 39.8 +/- 6.1 pmol 10(-8) platelets 10(-1) (n = 5). 4 In platelets from rabbits injected with chlorpromazine (see (2) above) both kinetic constants increased significantly, the Km to 0.88 +/- 0.08 microM and the Vmax to 67.8 +/- 5.5 pmol. 10(-8) platelets. 10(-1) s (n = 9).