Tumores de la cavidad oral y huesos maxilares en pediatría. Revisión de 122 pacientes / Oral cavity and maxillary bone tumors in pediatrics. Review of 122 patients

Se presenta un estudio retrospectivo de 122 pacientes con tumores que se manifestaron en la cavidad oral, con localización inicial en maxilares o partes blandas (se excluyeron los tumores de la cara sin compromiso bucal). La edad promedio fue 9 años y 6 meses (rango de 1 día a 17 años). El 62 por ciento se presentó en varones. La localización inicial de los tumores fue en hueso en el 53 por ciento de los casos y en partes blandas en el 47 por ciento; 82 pacientes tuvieron lesiones benignas y 40 lesiones malignas. Las manifestaciones al ingreso fueron: tumor palpable o visible (39 por ciento), tumor más dolor (22 por ciento), dolor (19 por ciento) y otros como caída de dientes, parálisis, fiebre o asímetría facial (20 por ciento). La rutina de estudio comprendió radiografía panorámica de maxilar, centellografía ósea (gammacámara con Tecnesio 99), tomografía axial computada (TAC) y resonancia nuclear magnética (RNM). Los pacientes fueron tratados en forma multidisciplinaria siendo la cirugía (punción aspiración con aguja fina, biopsia y/o resección)el procedimiento inicial en la mayoría de ellos. De acuerdo al algoritmo todos los pacientes con lesión ósea fueron estudiados con Rx simple y TAC, 89 por ciento de positividad en ambas, previas a la biopsia por punción. De igual menera en los tumores de partes blandas la TAC mantuvo su utilidad, no así la Rx simple que fue reeplazada por la ecografía cuando se detectó ausencia de compromiso óseo. Las lesiones benignas predominaron (78/122) a nivel de hueso o de partes blandas. la curación en ella fue la regla. En lo que respecta a los tumores, primarios de la región (11/40) correspondieron inicialmente a partes blandas y raramente a hueso, en los que fue frecuente el compromiso metastático o multicéntrico.(AU)

Tumores de la cavidad oral y huesos maxilares en pediatría. Revisión de 122 pacientes / Oral cavity and maxillary bone tumors in pediatrics. Review of 122 patients

Se presenta un estudio retrospectivo de 122 pacientes con tumores que se manifestaron en la cavidad oral, con localización inicial en maxilares o partes blandas (se excluyeron los tumores de la cara sin compromiso bucal). La edad promedio fue 9 años y 6 meses (rango de 1 día a 17 años). El 62 por ciento se presentó en varones. La localización inicial de los tumores fue en hueso en el 53 por ciento de los casos y en partes blandas en el 47 por ciento; 82 pacientes tuvieron lesiones benignas y 40 lesiones malignas. Las manifestaciones al ingreso fueron: tumor palpable o visible (39 por ciento), tumor más dolor (22 por ciento), dolor (19 por ciento) y otros como caída de dientes, parálisis, fiebre o asímetría facial (20 por ciento). La rutina de estudio comprendió radiografía panorámica de maxilar, centellografía ósea (gammacámara con Tecnesio 99), tomografía axial computada (TAC) y resonancia nuclear magnética (RNM). Los pacientes fueron tratados en forma multidisciplinaria siendo la cirugía (punción aspiración con aguja fina, biopsia y/o resección)el procedimiento inicial en la mayoría de ellos. De acuerdo al algoritmo todos los pacientes con lesión ósea fueron estudiados con Rx simple y TAC, 89 por ciento de positividad en ambas, previas a la biopsia por punción. De igual menera en los tumores de partes blandas la TAC mantuvo su utilidad, no así la Rx simple que fue reeplazada por la ecografía cuando se detectó ausencia de compromiso óseo. Las lesiones benignas predominaron (78/122) a nivel de hueso o de partes blandas. la curación en ella fue la regla. En lo que respecta a los tumores, primarios de la región (11/40) correspondieron inicialmente a partes blandas y raramente a hueso, en los que fue frecuente el compromiso metastático o multicéntrico.

Phytosterol compounds having antiviral efficacy.

The present study is focused on the antiviral action patterns obtained in vitro with synthetic sterolester comprising compositions on virus-bearing host cell-lines. Appropriate cell-lines were infected with HIV-1, human Cytomegalovirus (HCMV) and Herpes simplex virus (HSV). There appears to exist a clear anti-infective efficacy for a selected number of such ester compounds, provided they are formulated into spontaneously dispersible concentrates, which in aqueous dilution engender ultramicro-emulsions having micelles in the lowest nanosize region. A significant protection against HIV-induced cytopathogenic effect was demonstrated employing a methyltetrazolium salt reduction assay on HIV-infected MT4 cells when they were incubated with such concentrates. A similar effect was evidenced with the same concentrates, when preincubating concentrated virus, but not the target cells. Antiviral activity appeared to be remarkable also on HCMV infections in vitro, where a blocking effect on immediate-early antigen expression in fibroblast monolayers could be observed. Similarly, HSV-associated glycoprotein antigen in VERO cells also suggests that virus-cell interaction and/or virus multiplication could have been blocked at a very early point of time. This would be quite different from antiviral action-patterns studied so far and imputed into the current models of explanation. Proper solubilization of the employed phytosterol compounds is essential for achieving the described activity modes. The often recommended liposome formulations would not be well suited for such compounds and such purpose, since after dilution they produce aqueous macro-emulsions, only. Furthermore, liposome formulations tend to coalesce and exhibit Marangoni effects.

Comparison of different in vitro tests for evaluating immune reactivity.

We performed some in vitro tests for the detection of the immune state and compared the results. In particular we studied the production of various cytokines obtained by stimulating peripheral blood mononucleated cells (PBMC) with different inducers, using optimal and suboptimal doses. This was compared with the results of blastic transformation of lymphocytes, and with the evaluation of the capping effect of macrophages, and of the Multitest Merieux. The correlation between the different investigations was generally good. This permits a simplification of the study of immune reactivity, selecting some of the tests proposed. The use of suboptimal doses of inducers improves the evaluation of very moderate deficits and supplies an in vitro model for the study of immunomodulant drugs.

Serum cytokine profiles in acute primary HIV-1 infection and in infectious mononucleosis.

Serum cytokine profiles, T-cell subsets, and general parameters of immune activation were evaluated in 15 patients with acute primary HIV-1 infection, and compared with those obtained from 18 patients with acute primary Epstein-Barr virus (EBV) infection and from 18 control subjects in order to elucidate possible defects of immune response to HIV in early phases of virus-host interaction. Mean CD4+ cell count, serum concentrations of interleukin (IL)-2, IL-4, soluble IL-2 receptor (sIL-2R), tumor necrosis factor (TNF)-alpha, 5'-neopterin, and beta 2-microglobulin were significantly lower in acute HIV-1 infection than in EBV infection. Both acute HIV-1 and EBV infections were characterized by significantly higher mean CD8+ cell count and soluble CD8 antigen (sCD8) levels compared to control subjects, while acute HIV-1 infection was accompanied by the highest interferon (IFN)-gamma serum concentrations. In primary HIV-1 infection, significant impairment of CD4+- mediated T-helper function may lead to viral escape and persistence of infection despite an early and vigorous CD8+ T-lymphocyte activation.

Altered adrenocorticotropin and cortisol response to corticotropin-releasing hormone in HIV-1 infection.

Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are common in HIV infection. To characterize further the site of these derangements and their possible causes, eight male drug addicts with symptomatic HIV infection (stage IV C2) underwent the following investigations: repeated baseline determinations of cortisol, adrenocorticotropin (ACTH), interleukin 1 beta (IL-1 beta), IL-6 and interferon alpha (IFN-alpha); and ovine corticotropin-releasing hormone (CRH) test (100 micrograms IV) for ACTH and cortisol determinations. Baseline cortisol levels were either normal or elevated in all patients. A significant linear correlation was found between baseline levels of cortisol and both IL-6 (r = 0.955; p < 0.001) and IL-1 beta (r = 0.863; p < 0.005), but not between cortisol and ACTH or between ACTH and circulating cytokines. Both ACTH and cortisol responses to CRH were nearly absent in six out of eight patients, and delayed in the others. The areas under the curves of both ACTH and cortisol after CRH were significantly lower in HIV patients than in a group of eight healthy control subjects (p = 0.0157 for ACTH and p = 0.046 for cortisol). Out data suggest the possibility of an inappropriate stimulation of the HPA axis in symptomatic HIV infection by HIV-induced release of cytokines, with a blunted pituitary and adrenal response to CRH.

Effect of Aspergillus terreus extract on neoplastic and non-neoplastic cell replication.

There are very few and unconfirmed data regarding the antineoplastic activity of mycotic derivates in human cells. The effects on neoplastic and non-neoplastic cell replication of Aspergillus terreus extracts have been tested. In fact, among different species of Aspergillus mycotoxin producers. A terreus seems to be more suitable for hypothetical therapeutic purposes because of its low mycotoxin toxicity. Very evident antiblastic activity of alcoholic crude extract of A. terreus on tumor cells has been demonstrated. Doses between 3.1 and 6.2 inhibited more than 50% of tumor cells; the same effect was obtained with doses > 25 micrograms/ml on non-neoplastic cells. The action of the crude extract does not influence cellular cAMP in either neoplastic or non-neoplastic cells. The antiblastic action seems to depend primarily on the inhibitory effect of DNA duplication. Some chromatographed fractions of the mycotic extract showed inhibiting or enhancing effects on cell growth.

Cytokine network and acute primary HIV-1 infection.

OBJECTIVE: To investigate the relationship between cytokine serum levels, peripheral blood lymphocyte subsets and clinical picture in acute primary HIV-1 infection. PATIENTS AND METHODS: Absolute number/microliters total lymphocytes, CD4+, CD8+ and natural killer (NK) cells, as well as serum levels of soluble CD8 receptor, interleukin (IL)-1 beta, IL-2, IL-4, IL-6, tumour necrosis factor (TNF)-alpha, interferon (IFN)-gamma, beta 2-microglobulin and 5'-neopterin were determined in 15 patients with acute primary HIV-1 infection, 16 asymptomatic HIV-1-seropositive individuals and 18 HIV-1-seronegative individuals at risk for HIV-1 infection. RESULTS: Acute primary HIV-1 infection was characterized by significant CD4+ lymphocytopenia with low IL-2 serum concentrations, and by high absolute number of circulating CD8+ and NK cells, with elevated serum levels of soluble CD8 receptor, IL-1 beta, IFN-gamma and 5'-neopterin. Follow-up of acute seroconverters showed a significant decrease in NK cell counts and IL-1 beta levels, with an increase of IL-6. CONCLUSIONS: In acute primary HIV-1 infection, significant alteration of cytokine release, possibly induced by viral antigens, could be responsible for both clinical picture and activation of cytotoxic cells through abnormal mechanisms.

Alveolar immune mediators in HIV-related pneumonia. Different role of IL-2 and IL-1 in inducing lung damage.

In order to elucidate the role played by alveolar cytokines in the pathogenesis of HIV-related lung damage, levels of interleukin (IL) 1 beta, IL-2, IL-6, tumor necrosis factor (TNF)-alpha, and interferon (Ifn) were assessed on supernatant of bronchoalveolar lavage fluid from 30 consecutive HIV-1 seropositive (HIVAb+) patients with clinical and radiologic evidence of pneumonia, from 20 HIV- seronegative (HIVAb-) patients with pulmonary sarcoidosis, and from 10 HIVAb- healthy control subjects. Cytokine levels were expressed as picogram (IL-1, TNF), nanogram (IL-6), and international unit (IL-2, Ifn) per milligram of albumin per deciliter. Total and differential cell counts, cytofluorimetric enumeration of CD3+, CD3+/DR+, CD4+, CD8+, and CD8+/CD16+ cells, as well as microbiologic investigations for opportunistic agents were performed on lavage pellets. HIV-related pneumonia was characterized by higher mean alveolar level of IL-2 (12 +/- 5 IU), and by more elevated mean counts of T cells (109 +/- 16), activated T cells (60 +/- 12), and CD8+ cells (90 +/- 13)/microliters if compared with both active sarcoidosis and control subjects, where respective values of 0.2 +/- 0.1 and 0.3 +/- 0.2 IU IL-2/mgAlb/dl, of 52 +/- 11 and 7 +/- 2 T cells, of 20 +/- 5 and 1.2 +/- 0.3 activated T cells, and of 11 +/- 2 and 3 +/- 0.6 CD8+ cells per microliter were found. HIV-infected patients with opportunistic lung infections (OIs) showed the highest mean IL-2 level (21 +/- 4 IU), and higher counts of both CD8+ (117 +/- 20) and CD8+/CD16+ (36 +/- 7) cells per microliter if compared with patients without evidence of OIs (respectively, 62 +/- 13 CD8+ and 18 +/- 3 CD8+/CD16+ cells per microliter). By contrast, extremely high IL-1 levels (1,463 +/- 760 pg), and IL-2 levels similar to control subjects (3.4 +/- 1.2 IU), were found in the absence of OIs. Different mechanisms depending respectively on IL-2-mediated cytotoxic cell recruitment and activation, or IL-1-mediated tissue injury may account for HIV-related lung damage, depending on the presence or absence of opportunistic agents.

Meningoencephalitis caused by Toxoplasma gondii diagnosed by isolation from cerebrospinal fluid in an HIV-positive patient.

Toxoplasmosis of the central nervous system is a frequent opportunistic infection in AIDS patients, usually presenting as a mass brain lesion detected by computerized axial tomography scanning or magnetic resonance imaging. A case of diffuse meningoencephalitis with no radiological evidence of brain lesions is described. Diagnosis was made by culturing cerebrospinal fluid (CSF) on THP1 cells where tachyzoites of Toxoplasma gondii were demonstrated after 8 days of incubation by both direct observation and immunofluorescence. CSF examination with culture should be considered in AIDS patients with neurological signs and symptoms but without radiological evidence of cerebral lesions.

Spontaneous release of interferon as a predictor of clinical evolution in HIV-positive subjects.

In order to establish a correlation with disease progression we prospectively evaluated ten clinical and immunologic parameters in 102 consecutive HIV-positive subjects. The eight immunologic variables were: in vitro spontaneous interferon release by peripheral blood monocytic cells, alpha- and gamma-interferon production induced by Newcastle Disease Virus and PHA, Multitest Mérieux score, PHA- and CON-A-induced lymphocyte transformation, absolute number of CD4+ cells and CD4/CD8 ratio, respectively. The two baseline clinical variables were risk factor and disease presentation. Generalized Wilcoxon analysis indicated a significant correlation of one clinical (disease presentation at entry) and three immunologic variables (spontaneous interferon release, CD4+ cell number, Multitest Mérieux) with disease progression. Baseline spontaneous release of alpha, acid-labile interferon showed the best correlation with disease progression, and appeared to be significantly associated with CD4+ cell loss. Spontaneous release of acid-labile alpha interferon by mononuclear cells in vitro could be highly predictive of disease evolution in HIV-Ab positive, AIDS-free subjects.

Effects of long-term zidovudine treatment on cell-mediated immune response and lymphokine production.

The effects of long-term zidovudine treatment on functional parameters of cell-mediated immunity were investigated in 15 symptomatic HIV-antibody-positive patients with clinical evidence of opportunistic infections. Mononuclear leukocytes were obtained before administering the drug, and after 3 and 6 months of treatment. The cells were stimulated with lectins in order to assess variations of mitogen-induced lymphocyte proliferation and production of gamma-interferon (IFN) and interleukin-2 (IL-2), and with Newcastle disease virus (NDV) to assess variations of alpha-IFN production. Mean proliferative responses to PHA and Con-A did not show any significant change between baseline, 3 months, and 6 months values (25,158 +/- 11,763, 24,662 +/- 8,955, and 34,924 +/- 16,283 D-cpm, respectively, for PHA, p greater than 0.05; and 5,470 +/- 1,890, 4,953 +/- 2,518, and 4,539 +/- 3,286 D-cpm, respectively, for Con-A, p less than 0.05). Mean response to PWM (9,707 +/- 4,429 D-cpm at entry) increased significantly after 3 months, but returned to baseline values at 6 months (17,039 +/- 5,123 and 10,314 +/- 3,855 D-cpm, respectively, p = 0.016). IL-2 production (5.51 +/- 4.0 I.U. at entry) rose particularly at 3 months and persisted at the same levels at 6 months (9.6 +/- 4.8 and 9.5 +/- 6 I.U., respectively, p less than 0.05). By contrast, a moderate but significant decrease in gamma- and alpha-IFN production was observed (65 +/- 2.2, 35.1 +/- 1.6, and 22 +/- 2 I.U., respectively, for gamma-IFN, p less than 0.05; 60 +/- 3, 64 +/- 2.6, and 12 +/- 1.5 I.U., respectively for alpha-IFN, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of ofloxacin on cell-mediated immune response and lymphokine production.

The effects of orally administered ofloxacin on functional parameters of cell-mediated immunity were investigated in 15 patients with respiratory or urinary tract infections. Mononuclear leucocytes were obtained before administering the drug, 1 h after the first dose, and five days later. The cells were stimulated with lectins, tetanus toxoid and Newcastle Disease virus in order to assess mitogen- and antigen-induced lymphocyte proliferation and production of gamma-interferon, interleukin-2 and alpha-interferon. An increase in proliferative response to pokeweed mitogen and a slight but significant decrease in alpha-interferon production were observed, while other parameters remained unaffected by treatment.

[Biological properties of an alcoholic extract of Aspergillus terreus]. / Proprietà biologiche di un estratto alcoolico di Aspergillus terreus.

The following effects of Aspergillus terreus alcoholic extract are investigated: antiblastic and antiviral effect, and the ability of modification of interferon production and lymphocyte blastic transformation. In particular the extract showed more evident antiproliferative effect on transformed or EBV immortalised cells and lower effect on normal cells. Moreover doses from 12.5 +/- micrograms/ml depressed significatively the in vitro interferon production and lymphocyte blastic transformation induced by PHA on human cells. Mengo and Semliki Forest viruses replication was reduced, although temporarily, in the presence of 50 +/- micrograms/ml of the extract. Eventually the study of some fractions separated on chromatographic column demonstrated the contemporary presence of fractions able to inhibit or stimulate K-562 erythroleukemic cells replication.

Effect of erythromycin on the immune response and interferon production.

The influence of erythromycin on some aspects of humoral and cell-mediated immunity has been examined employing human as well as murine models, both in vivo and in vitro. No significant differences in antibody synthesis, alpha- and gamma-interferon yield, cutaneous delayed hypersensitivity or lymphocyte blastogenic response to mitogens have been detected between erythromycin-treated subjects and controls. Similarly, in vitro tests on interferon production and blastogenic response to mitogens showed no significant differences when performed with and without erythromycin. Therefore, in contrast with many other antibacterial drugs, erythromycin seems to be devoid of any adverse effects on the immune system.