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Pettenò A, Dotti P, Colucci A, Dallavalle F, Gentilini C, Tralce L. [Renal artery thrombosis]. Urologia 2009; 76 Suppl 15:47-50. [PMID: 21104685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Pettenò A, Dotti P, Coluccio A, Dallavalle F, Gentilini C, Tralce L. Renal Artery Thrombosis. Urologia 2009. [DOI: 10.1177/039156030907604s11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The diagnosis of acute renal infarction is often delayed or failed due to the rarity of the disease and to its non-specific clinical presentation. Cigarette smoking, with its vasoconstrictive and prothrombotic effects, is a known and sure risk factor for the development of the atheroembolic artery disease. Case study This is the report of a case of acute renal infarction in a heavy-smoking patient, a 66-year-old man who arrived at our ward for right worsening backache with vomit and abdominal pain not reacting to the analgesic therapy. A urgent ultrasound showed excretory axes not dilated bilaterally. Therefore, we had to perform further diagnostic tests (CT and then angiography) which highlighted a case of a right massive renal infarction due to complete thrombotic obstruction of the renal artery with patent contralateral ramification. We performed a PTA and then a local infusion of thrombolytic (metalyse 2 mg in 10’). After this treatment the patient showed an immediate stop of the hurting symptomatology, an improvement of the flow and an opacification of the parenchyma. (lower and medium part) with persistence of vision concerning endoluminal thrombosis. A CT angiography 20 days later, after home therapy with LMWH at therapeutic doses, confirmed a restored and normalized vascularization of the lower and medium part of the right kidney. Conclusions In the light of these case results - good revascularization of the lower 2/3 of the right kidney, despite a prolonged time of ischemia from the beginning of the symptoms to the diagnosis and to the further thrombolytic therapy (about 14 hours) -, we assume that a wider use of the Doppler method can be of some usefulness, in case of recurring colics especially not reacting to analgesic therapy with negative ultrasonography check-up for the dilatation of the excretory routes, in order to considerably reduce the diagnosis time of renal diseases of vascular type.
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Affiliation(s)
- A. Pettenò
- Unità Operativa di Urologia, A.O. “Mellino Mellini” Chiari, Brescia
| | - P. Dotti
- Unità Operativa di Urologia, A.O. “Mellino Mellini” Chiari, Brescia
| | - A. Coluccio
- Unità Operativa di Urologia, A.O. “Mellino Mellini” Chiari, Brescia
| | - F. Dallavalle
- Unità Operativa di Cardiologia, A.O. “Mellino Mellini “ Chiari, Brescia
| | - C. Gentilini
- Unità Operativa di Cardiologia, A.O. “Mellino Mellini “ Chiari, Brescia
| | - L. Tralce
- Unità Operativa di Urologia, A.O. “Mellino Mellini” Chiari, Brescia
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Penack O, Fischer L, Stroux A, Gentilini C, Nogai A, Muessig A, Rieger K, Ganepola S, Herr W, Meyer RG, Thiel E, Uharek L. Serotherapy with thymoglobulin and alemtuzumab differentially influences frequency and function of natural killer cells after allogeneic stem cell transplantation. Bone Marrow Transplant 2007; 41:377-83. [DOI: 10.1038/sj.bmt.1705911] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ganepola S, Gentilini C, Hilbers U, Lange T, Rieger K, Hofmann J, Maier M, Liebert UG, Niederwieser D, Engelmann E, Heilbronn R, Thiel E, Uharek L. Patients at high risk for CMV infection and disease show delayed CD8+ T-cell immune recovery after allogeneic stem cell transplantation. Bone Marrow Transplant 2007; 39:293-9. [PMID: 17262060 DOI: 10.1038/sj.bmt.1705585] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Human cytomegalovirus (CMV) is a major cause of death after transplantation. The frequency of pp65-specific T cells was examined in 38 HLA-A2+ stem cell recipients during the first year after transplantation. Patients were divided into four groups based on donor/recipient serostatus: d+/r+ (n=17), d+/r- (n=7), d-/r+ (n=9) and d-/r- (n=5). Peripheral blood mononuclear cells were stimulated with the CMVpp65 peptide NLVPMVATV, and the specific T-cell frequency was assessed by interferon gamma (IFN-gamma) ELISPOT assay. Responding T cells were characterized by flow cytometry revealing a terminal differentiated effector phenotype. Surveillance of CMV infection was carried out by real-time polymerase chain reaction (n=26) or immunofluorescence (n=12). Infection was present in 7/9 d-/r+ high-risk patients, and CMV disease occurred exclusively in this group with delayed or absent virus-specific T-cell recovery. In contrast, 16/24 intermediate-risk patients showed CMV-specific T cells. Our data suggest that CMV infection and disease rates are elevated in high-risk patients with delayed CMV-specific T-cell immune reconstitution and lower in those with early recovery of T-cell immunity. We recommend preferring CMV seropositive donors for CMV seropositive recipients, as this should lead to durable CMV-specific T-cell responses soon after transplantation with consecutive protection from CMV disease.
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Affiliation(s)
- S Ganepola
- Department of Internal Medicine III, Charité, Campus Benjamin Franklin, Hindenburgdamm, Berlin, Germany.
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Wolff D, Wilhelm S, Hahn J, Gentilini C, Hilgendorf I, Steiner B, Kahl C, Junghanss C, Hartung G, Casper J, Uharek L, Holler E, Freund M. Replacement of calcineurin inhibitors with daclizumab in patients with transplantation-associated microangiopathy or renal insufficiency associated with graft-versus-host disease. Bone Marrow Transplant 2006; 38:445-51. [PMID: 16951692 DOI: 10.1038/sj.bmt.1705454] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Transplantation-associated microangiopathy (TAM) or renal insufficiency (RI) after allogeneic hematopoietic stem cell transplantation is associated with a high mortality. As calcineurin inhibitors (CI) may contribute to TAM or RI, we evaluated the efficacy of replacing CI by daclizumab in patients with graft-versus-host disease (GVHD). Thirteen patients with GVHD-associated TAM and five patients with RI were treated with daclizumab 1 mg/kg intravenous (i.v.)/week, discontinuation of the CI and continuation of the remaining GVHD treatment. All patients had acute GVHD (steroid-sensitive (n=4), steroid-refractory (n=10)) or chronic GVHD (n=4) and were treated with CI before the start of daclizumab. Nine of 13 patients with TAM treated with daclizumab and discontinuation of CI achieved complete remission of TAM, two had stable disease, and one patient did not respond. Patients receiving daclizumab for RI without TAM showed stabilization (2/5) or improvement (3/5) of renal function. Four of 14 patients with acute GVHD achieved CR, two partial remission, eight patients did not respond and 11/14 died at a median of 39 days after start of the daclizumab. Our data demonstrate that replacement of CI by daclizumab can improve TAM and RI. However, mortality remains high in patients with acute GVHD.
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Affiliation(s)
- D Wolff
- Department of Haematology and Oncology, University of Rostock, Rostock, Germany.
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Fietz T, Uharek L, Gentilini C, Muessig A, Rieger K, Marinets O, Sandrock D, Munz DL, Glass B, Thiel E, Blau IW. Allogeneic hematopoietic cell transplantation following conditioning with 90Y-ibritumomab-tiuxetan. Leuk Lymphoma 2006; 47:59-63. [PMID: 16321828 DOI: 10.1080/10428190500260478] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Radioimmunotherapy (RIT) of relapsed lymphoma is gaining increasing importance. Especially the commercially available anti-CD20 antibody 90Y-ibritumomab tiuxetan is currently under investigation in various trials including dose escalation and autologous hematopoietic progenitor cell support. It is not clear, however, whether the implementation of this radiolabeled antibody into another treatment option for relapsed or poor risk lymphoma patients-allogeneic hematopoietic cell transplantation-interferes with or delays successful engraftment. This study reports encouraging results with 2 relapsed lymphoma patients (1 transformed marginal zone lymphoma and 1 mantle cell lymphoma) who underwent allogeneic hematopoietic cell transplantation from HLA-matched donors. The conditioning regimen consisted of Rituximab 250 mg m(-2) on days -21 and -14, 0.4 mCi kg(-1) body weight 90Y-ibritumomab tiuxetan on day -14 and fludarabine (30 mg m(-2)) plus cyclophosphamide (500 mg m(-2)) on days -7 to -3. The data demonstrate that engraftment is fast and reliable with leukocytes >1 x 10(9) L(-1) on day 12 and platelets >50 x 10(9) L(-1) on day 10. Thus, the incorporation of radioimmunotherapy into allogeneic transplant protocols combines established modalities with proven anti-lymphoma activity and, hence, offers an attractive new therapeutic option for relapsed lymphoma patients.
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Affiliation(s)
- T Fietz
- Department of Hematology, Oncology and Transfusion Medicine, Charité-Campus Benjamin Franklin, Berlin, Germany.
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Penack O, Gentilini C, Fischer L, Asemissen AM, Scheibenbogen C, Thiel E, Uharek L. CD56dimCD16neg cells are responsible for natural cytotoxicity against tumor targets. Leukemia 2005; 19:835-40. [PMID: 15744340 DOI: 10.1038/sj.leu.2403704] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2004] [Accepted: 12/07/2004] [Indexed: 11/09/2022]
Abstract
The activation of natural killer (NK) cells leads to degranulation and secretion of cytotoxic granula. During this process, the lytic granule membrane protein CD107a becomes detectable at the cell surface. Based on this phenomenon, we have analyzed by a novel flow cytometry-based assay, the number and phenotype of NK cells responding to tumor targets. Using human leukemia and lymphoma cell lines, we observed a close correlation between CD107a surface expression and target cell lysis, indicating that NK cell cytotoxicity can be assessed by this method. The number of degranulating NK cells was closely related to the ratio of effector and target cells and showed a maximum at a ratio of 1:1. Moreover, we were able to show that the population of CD56(dim)/CD16(neg) NK cells is primarily responsible for the cytotoxic activity against tumor targets whereas neither CD56(dim)/CD16(pos) nor CD56(bright) NK cells degranulated in response to the cell lines. Our results indicate that the CD107a assay represents a promising new method for the quantification and characterization of cells exhibiting natural cytotoxicity.
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Affiliation(s)
- O Penack
- Department of Hematology, Oncology, and Transfusion Medicine, Charité-Campus Benjamin Franklin, Berlin, Germany.
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Niederwieser D, Gentilini C, Hegenbart U, Lange T, Moosmann P, Pönisch W, Al-Ali H, Raida M, Ljungman P, Tyndall A, Urbano-Ispizua A, Lazarus HM, Gratwohl A. Transmission of donor illness by stem cell transplantation: should screening be different in older donors? Bone Marrow Transplant 2005; 34:657-65. [PMID: 15334048 DOI: 10.1038/sj.bmt.1704588] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With increasing donor age, the potential of transmitting diseases from donor to recipient reaches new dimensions. Potentially transmittable diseases from donors include infections, congenital disorders, and acquired illnesses like autoimmune diseases or malignancies of hematological or nonhematological origin. While established nonmalignant or malignant diseases might be easy to discover, early-stage hematological diseases like CML, light-chain multiple myelomas, aleukemic leukemias, occult myelodysplastic syndromes and other malignant and nonmalignant diseases might not be detectable by routine screening but only by invasive, new and/or expensive diagnostic tests. In the following article, we propose recommendations for donor work-up, taking into consideration the age of the donors. In contrast to blood transfusions, stem cells from donors with abnormal findings might still be acceptable for HCT, when no other options are available and life expectancy is limited. This issue is discussed in detail in relation to the available donor and stem cell source. Finally, the recommendations presented here aim at harmonized worldwide work-up for donors to insure high standard quality.
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Affiliation(s)
- D Niederwieser
- Department of Internal Medicine II, Division of Hematology and Oncology, University of Leipzig, Philipp Rosenthalstr. 23-25, Leipzig D-4103, Germany.
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Lange T, Deininger M, Brand R, Hegenbart U, Al-Ali H, Krahl R, Poenisch W, Uharek L, Leiblein S, Gentilini C, Petersdorf E, Storb RF, Niederwieser D. BCR-ABL transcripts are early predictors for hematological relapse in chronic myeloid leukemia after hematopoietic cell transplantation with reduced intensity conditioning. Leukemia 2004; 18:1468-75. [PMID: 15241437 DOI: 10.1038/sj.leu.2403425] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Kinetics of BCR-ABL transcript elimination and its prognostic implications on relapse were analyzed in patients with chronic myeloid leukemia (CML) after reduced intensity hematopoietic cell transplantation (HCT). In all, 19 CML patients were conditioned with 2 Gy total-body irradiation in combination with (n=14) or without (n=3) fludarabine 3 x 30 mg/m(2) (Flu) or 4.5 Gy total lymphoid irradiation (TLI) with Flu and OKT3 3 x 5 mg (n=2) and were treated with cyclosporine (CSP) and mycophenolate mofetil after allogeneic HCT. BCR-ABL transcripts were analyzed by nested RT-PCR and Taqman((R)) RT-PCR on days +28, +56 and +84 after HCT and were evaluated for their association with relapse. Of the 19 patients, 14 achieved sustained remissions of which six had a negative RT-PCR 28 days after HCT. Five patients relapsed +41, +54, +57, +136 and +234 days after HCT. Predictors for relapse were advanced disease stage (P=0.02) and slow reduction of BCR-ABL transcripts at day 28 (P=0.006) and day 56 (P=0.047) post-transplant. We conclude that a complete clearance of BCR-ABL transcripts is achievable within 4 weeks from HCT even after minimal conditioning and that early kinetics of BCR-ABL transcripts significantly correlate with the probability of hematological relapse.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Combined Modality Therapy
- Cyclosporine/administration & dosage
- Female
- Fusion Proteins, bcr-abl/genetics
- Hematopoietic Stem Cell Transplantation
- Hematopoietic System/drug effects
- Hematopoietic System/radiation effects
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Mycophenolic Acid/administration & dosage
- Mycophenolic Acid/analogs & derivatives
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/therapy
- Prognosis
- RNA, Messenger/analysis
- RNA, Neoplasm/genetics
- RNA, Neoplasm/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Sensitivity and Specificity
- Transplantation Conditioning
- Transplantation, Homologous
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
- Whole-Body Irradiation
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Affiliation(s)
- T Lange
- Division of Hematology and Oncology, University of Leipzig, Germany.
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Simoncelli U, Coppola V, Gentilini C. Single-lead VDD pacing. A case of cross-talk. Minerva Cardioangiol 1997; 45:435-8. [PMID: 9436351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The haemodynamic and electrophysiological benefits of dual chamber pacing are well recognized at the cost of a more complex and expensive implant. In selected groups of patients VDD-mode dual chamber pacing offers the advantages of dual chamber pacing with the use of a single catheter and is nowadays gaining increasing popularity. The following report describes an uncommon and potentially harmful pacemaker malfunction secondary to the dislodgement of the catheter.
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Affiliation(s)
- U Simoncelli
- Divisione di Cardiologia, Ospedale S. Orsola Fatebenefratelli, Brescia
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Zanella B, Frenguelli R, Gentilini C. [A case of congenital multiple arthrogryposis. Considerations]. Minerva Pediatr 1990; 42:201-5. [PMID: 2199811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The paper describes the diagnosis, clinical, anatomopathological and etiopathogenetic aspects of a case of congenital multiple arthrogryposis. The importance of the dialogue between the obstetrician and the parents is underlined in terms of the latters' psychological preparation. The obstetrician must also prepare for an atraumatic delivery, in addition to planning the treatment protocol for the neonate.
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Affiliation(s)
- B Zanella
- Divisione di Ostetricia e Ginecologia, Ospedale Civile di Cles Trento
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Fossati G, Izard D, Leclerc H, Pommier J, Espriet G, Gentilini C, Vermeersch M. A propos d'une endocardite à Haemophilus aphrophilus sur insuffisance mitrale. Med Mal Infect 1981. [DOI: 10.1016/s0399-077x(81)80018-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fossati G, Izard D, Leclerc H, Pommier J, Espriet G, Gentilini C, Vermeersch M. A propos d'une endocardite à Haemophilus aphrophilus sur insuffisance mitrale. Med Mal Infect 1981. [DOI: 10.1016/s0399-077x(81)80134-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Krivosic-Horber R, Scherpereel P, Gentilini C, Liagre A. [Gas chromatography study of the variations of blood ketamine in general anesthesia]. Lille Med 1977; 22:379-81. [PMID: 895363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Leleu JC, Liagre A, Bégard P, Gentilini C, Laget-Corsin L. [A new method for the titration of ketamine]. Anesth Analg (Paris) 1976; 33:297-302. [PMID: 1008279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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