1,721,129 research outputs found
L. Allegra, La citta' verticale. Usurai, mercanti e tessitori nella Chieri del Cinquecento
No full textCerutti Simona. L. Allegra, La citta' verticale. Usurai, mercanti e tessitori nella Chieri del Cinquecento. In: Annales. Économies, Sociétés, Civilisations. 46ᵉ année, N. 3, 1991. pp. 683-685
Fibrosi polmonare idiopatica
No full textThe pulmonary interstitial disease denominated Idiopathic Pulmonary Fibrosis (or Cryptogenetic Fibrosing Alveolitis) is a specific form of chronic interstial pneumonitis, mostly associated with hystologic features defining the Usual Interstitial Pneumonitis. Between the other Idiopathic Interstitial Pneumonites this is the first by frequency and also the one characterised by the worst prognosis. A generally lethal disease (except in the unfrequent cases where a gastroesophageal reflux can be recognized as a pathogenetic determinant) which shows a fast, evident, unexplained increase worldwide, more frequent in males and in presenile age although diffuse enough in the feminine gender as well as in different ages. Potential risks and pathogenetic factors are described; the numerous acute and chronic conditions needing a differential diagnosis (in particular the other forms of idiopathic interstitial pneumonitis) are examined; the symptoms, both clinical (particularly the Velcro-like crepitations) and instrumental, such as cellular and biochemical information obtained by the bronchoalveolar lavage, hystopathology obtained by lung biopsy but specially imaging coming from high resolution computerized tomography are described. The last features, to be substantially distinguished in "ground glass" and "honeycombing", lead to the interesting observation of a better response to the specific medical treatment (essentially corticosteroids associated or not with azathioprine or cyclophosphamide) in those patient (often positively responding to the therapy, in some way) who are characterized by prevalence of "ground glass" lung images, compared with the patients characterized by "honeycombing" images, who undergo a more rapidly lethal, prognosis. Other pharmacologic agents have been submitted to trials, namely colchicine, pirphenidone, interferon, anti-TNFalpha, bosentan, but the results are temporary or ambiguous; although a very recent observation with an antioxidant (NAC in relatively high doses) leads to some interesting new interpretations. Good enough, anthough obviously "numerically" limited, are the results of the lung transplantation, with several kinds of overall advantages, at least in the experience of our Hospital, for the monolateral transplant
Aerosolized hyaluronic acid prevents exercise-induced bronchoconstriction, suggesting novel hypotheses on the correction of matrix defects in asthma
No full textHyaluronic acid (HA), a biopolymer, member of the family of the glycosaminoglicanes (GAGs) is one of the major natural components of the connective amorphous matrix. The lungs, together with skin and intestine, contain >50% of HA of the body: it provides to several biologic functions and presents the unique capacity to link and retain a particularly relevant number of water molecules. Since other GAGs have been proven to be provided with anti-asthmatic properties and HA has been employed with positive results by intra-tracheal instillation in experimental models of lung emphysema and COPD, we have explored the efficacy of the pre-administered aerosol of HA (compared to placebo) in preventing in asthmatic patients the bronchoconstriction induced by a challenge test such as that obtained with muscular exercise. In a randomised, cross-over, single-blind study design, saline as placebo (P) or HA have been administered by aerosol, in two non-consecutive days, 30 min prior to the beginning of the challenge (10 min free running), to 14 patients (13-36 years old; 7 teenagers, 7 young adults; 11 males, 3 females; 12 allergic, 2 non-allergic), all suffering from mild bronchial asthma. The bronchoconstrictive effect induced by the muscular exercise has been relevant and statistically significant. With the P pre-treatment, the average FEV1 measured 5 min after the end of exercise was reduced by 36.14% from the baseline FEV1. Pre-treatment with HA determined a partial but clear-cut protection of the FEV1 impairment due to the challenge: the average post-challenge FEV1 resulted to be 12.43% less than the pre-challenge baseline value. No significant difference was observed in the level of HA protection in the subgroup of teenagers when compared to that of young adults. The protection induced by HA, when compared with P, resulted particularly significant by the statistical point of view (p<0.0001). We conclude that aerosol HA administration significantly reduces the bronchial hyper-reactivity to muscular exercise in asthmatics. Such effect could be attributed to the correction of the pathological remodelling, one of the main features of asthma: a correction which could be attributed to the unique physicochemical properties of this major component of the loose connective amorphous matrix of the airways, which is undoubtedly involved in the remodelling process
Clearance mucociliare per immagini
No full textThe main steps of the optical and electronic magnification are described in the article, from the simple lens to the modern microscopy. To the aim of the paper (consisting in furnishing images clarifying features dealing with cells and secretions characterising the capacity of the bronchial mucosa to clear damaging or anyhow extraneous inhaled substances) better images are furnished by the scanning electron microscope, the only able to give " tridimesional" views of the examined sample, thank to the freeze fracture technique. Images are so presented dealing with the ciliated carpet covering the epithelial surface of the bronchial mucosa, as well as with individual ciliated cells with apical appendices (cilia) catched in most different expressions of their metacronal movement (ciliary beating) aimed, in physiologic conditions, to pin and move with aise the supra-ciliary gel-layer of mucus due to the fact that they beat into a watery sol-layer. Other images represent non-ciliated cells, some of which provided with surface appendices much smaller than cilia (brush cells), some located at the base of the epithelium not reaching its surface (basal cells), and other provided with secretory activity, named goblet cells, in cartilagineous bronchi and in non-cartilagineous bronchioli, while in the most peripheral bronchioli the latter progressively decrease in number, while other more globous secretory cells named Clara cells progressively take their place. Rather rare images of goblet cells are here published, catched in the very moment of the mucus secretion, followed by emptying of the cell itself, with the mucus collected by the nearby cilia, phenomenon which initiates the important mechanism of mechanical airway defense known under the name of muco-ciliary clearance
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