Association of macroamylasemia and type I macro-creatine kinasemia. A case report.

Context: Macroenzymes are serum enzymes presenting a higher molecular mass than the corresponding enzymes normally found in physiologic conditions or specific diseases, causing falsely increased total serum enzyme levels. The occurrence of macroenzymes represents a rare event in clinical practice, leading to unnecessary and often invasive additional diagnostic procedures. Macroamylase and macro-creatine kinase belong to this category and may generate diagnostic confusion in the differential diagnosis between acute pancreatitis and acute myocardial infarction.

Fetuin-A gene expression, synthesis and release in primary human hepatocytes cultured in a galactosylated membrane bioreactor.

This paper reports on human hepatocytes cultured in a galactosylated membrane bioreactor in order to explore the modulation of the effects of a pro-inflammatory cytokine, Interleukin-6 (IL-6) on the liver cells at molecular level. In particular the role of IL-6 on gene expression and production of a glycoprotein, fetuin-A produced by hepatocytes, was investigated by culturing hepatocytes in the membrane bioreactor, both in the absence and presence of IL-6 (300 pg/ml). IL-6 modulated the fetuin-A gene expression, synthesis and release by primary human hepatocytes cultured in the bioreactor.

Inflammation may modulate IL-6 and C-reactive protein gene expression in the adipose tissue: the role of IL-6 cell membrane receptor.

Only few studies have been addressed to the presence and regulation of C-reactive protein (CRP) gene expression in different districts of adipose tissue, and no study has investigated the role of adipose tissue in presence of inflammation. Therefore, the aim of this study was to investigate the inflammatory involvement of either adipose tissue or adipose cells (adipocytes and stromal cells, respectively) in patients with chronic inflammatory disease, focusing on regional adipose tissue CRP gene expression. Eighteen patients with inflammatory disease and 14 healthy controls were enrolled.

Synthesis and pharmacological analysis of a morphine/substance P chimeric molecule with full analgesic potency in morphine-tolerant rats.

Background: We have previously explored the functional role of the tachykinin substance P (SP) in the mediation of opioid-dependent antinociception and now describe the formulation, synthesis, and initial pharmacological characterization of a hybrid chimeric molecule, designated MSP9, containing the mu opioid receptor (MOR) agonist morphine covalently attached through a succinic acid linker to the SP receptor (SPR) agonist domain SP3-11.

Material/methods: Pharmacological characterization of MSP9, administered by the intramuscular route, was achieved in naive and morphine-tolerant male rats utilizing the tail-flick test.

Results: MSP9 produced significant antinociceptive responses across a wide concentration range and displayed an atypical bell-shaped analgesic dose response relationship with peak effect of 40+/-10% reached at 0.

Predictive value of MRI vertebral end-plate signal changes (Modic) on outcome of surgically treated degenerative disc disease. Results of a cohort study including 60 patients.

Objective: To assess the predictive value of MRI vertebral end-plate changes (Modic) on clinical outcome of surgically treated lumbar single-level degenerative disc disease (DDD).

Methods: A cohort of 60 patients was included. Patient groups were similar in respect of age, gender and clinical presentation, allowing comparisons.

Towards a definition of the "practical" epileptogenic zone: a case of epilepsy with dual pathology.

Presurgical evaluation for patients with drug-resistant epilepsy requires the definition of various zones that have a variable spatial relationship with the epileptogenic zone. All the available methods to directly measure the actual seizure-onset zone and to define "the minimum amount of cortical tissue that must be resected to produce seizure-freedom" have significant limitations. We report on the case of a patient with dual pathology (hippocampal sclerosis and a post-traumatic scar) and discuss the contribution of the various presurgical investigations that led to surgery and seizure-freedom.

Radiocontrast media cause dephosphorylation of Akt and downstream signaling targets in human renal proximal tubular cells.

Radiocontrast medium induced nephrotoxicity is a major clinical problem. There is considerable interest in reducing the incidence of acute renal failure due to the use of radiocontrast media (RCM). Reduction of renal blood flow and direct toxic effect on renal tubular epithelial cells have been postulated as major causes of RCM nephropathy.

Prevalence of dental caries in schoolchildren living in rural and urban areas: results from the first region-wide Italian survey.

Purpose: The collection of comprehensive epidemiological data for dental caries of Italian schoolchildren in both rural and urban areas.

Materials And Methods: The dft and DMFT indices were recorded from 27163 6-to-9-year-old children attending the primary schools of Abruzzo, a region of Central Italy, according to the World Health Organization recommendations.

Results: The number of surveyed children were 5413, 8359, 8362 and 5026 in the 6-, 7-, 8- and 9-year-old groups respectively; the percentages of children positive for caries were 39.

[Subthalamic stimulation in a patient with multiple system atrophy: a clinicopathological report].

Introduction: Efficacy of high frequency subthalamic nucleus (STN) stimulation has been demonstrated in idiopathic Parkinson's disease (IPD). However, since it may be difficult to differentiate IPD from multiple system atrophy with parkinsonian presentation (MSA-P), a few cases of MSA-P has been treated by deep brain stimulation (DBS) and showed no sustained improvement of clinical signs. We report a patient with a clinical misdiagnosed MSA-P, later confirmed by neuropathological study, who was improved by DBS for one year.

Case reports: osteonecrosis of the capitate: a pediatric case report.

We present what we think is the first documented occurrence of osteonecrosis of the capitate in a skeletally immature patient. Atraumatic osteonecrosis of the capitate is rare, and all reported cases have occurred in adults. Our pediatric patient was treated with observation and limited immobilization.

Whipple's disease. Description of a case and survey of the literature.

A case of Whipple's disease (WD) personally observed is described. A 28-year-old male was admitted to hospital for evaluation of weakness, intermittent fever and weight loss arisen since a month. On clinical investigation, he complained of vomit and diarrhea since three months.

Intestinal permeability and diabetes mellitus type 2.

Background: Intestinal permeability can be investigated by means of molecular probes which are able to cross the intestinal wall through tight junctions of villi (smaller probes) and/or of crypts (larger probes). Intestinal permeability is altered in the majority of uncomplicated diabetes mellitus type 1 patients, due to the augmented absorption of the smaller probe. The aim of this work was to investigate if any similar alteration of intestinal permeability is present in diabetes mellitus type 2.

Inhibition of Ras/ERK1/2 signaling protects against postischemic renal injury.

The small GTPase p21 Ras and its downstream effectors play a central role in the control of cell survival and apoptosis. We studied the effects of Ras/ERK1/2 signaling inhibition on oxidative damage in cultured renal and endothelial cells and on renal ischemia-reperfusion injury in the rat. Primary human renal tubular and human endothelial ECV304 cells underwent significant cell death when subjected to oxidative stress.

Staphylococcus aureus septicemia in non-neutropenic adult patients hospitalized in internal medicine units.

Purpose: Staphylococcus aureus septicemia (SAS) is usually described in immunocompromised patients and during serious weakening diseases, associated with a neutropenic condition. Over the last recent years, clinic relevance of SAS has become more prominent owing to the progressive rise of methicillin-resistent strains in hospital-acquired infections and to its development in non-neutropenic patients.

Material And Methods: The aim of our study was to evaluate the clinical features and outcome of non-neutropenic patients with positive blood culture for Staphylococcus aureus (SA) hospitalized in Internal Medicine Wards of our hospital during 1 year of observation.

[Systemic Candida albicans infection with neuromeningeal complication in a premature infant].

Introduction: Systemic maternal-fetal Candida albicans infections are uncommon diseases with a poor outcome. An associated cerebromeningeal infection increases morbidity. We present a case of neuromeningeal candidiasis following systemic neonatal infection in a premature infant.

Mortality in acute pancreatitis: is it an early or a late event?

Context: Many prior studies have suggested that the majority of deaths in severe acute pancreatitis occur late in the course of the disease as a result of pancreatic sepsis or pancreatic septic-like syndrome. Other have observed that at least half of the deaths occur early as a result of multisystem organ failure.

Objective: The aim of the present study was to determine the timing of mortality of severe acute pancreatitis and to analyze the course of the disease in a large series of patients.

The use of thiolated polymers as carrier matrix in oral peptide delivery--proof of concept.

It was the aim of this study to develop an oral delivery system for the peptide drug antide. The stability of the therapeutic peptide towards gastrointestinal peptidases was evaluated. The therapeutic agent and the permeation mediator glutathione were embedded in the thiolated polymer chitosan-4-thio-butylamidine conjugate (chitosan-TBA conjugate) and compressed to tablets.

Worse clinical course of disease in Crohn's patients with previous appendectomy.

Objectives: The aim of the present study was to assess the effect of previous appendectomy in a series of Crohn's disease (CD) patients on the clinical characteristics and course of disease.

Methods: Demographic and clinical data were retrospectively analysed for 129 consecutive outpatients (68 men and 61 women, median age 38 years) with CD. For each patient, information concerning appendectomy, indication for surgery (acute/chronic) and the date of surgery were recorded.

Copper-zinc superoxide dismutase activity in healthy and inflamed human dental pulp.

Aim: To examine copper-zinc superoxide dismutase (Cu, Zn-SOD) activity in clinically healthy and symptomatic human dental pulps.

Methodology: Twenty-five systemically healthy patients, 14 females and 11 males (age: 13.1-34.

In vivo modulation of soluble "antagonistic" IL-6 receptor synthesis and release in ESRD.

Soluble gp130 (sgp130) is a soluble circulating receptor of IL-6 with "antagonistic" biologic activity. It is generated independently by either shedding of the extracellular domain of membrane gp130 or alternative mRNA splicing. This study was addressed to clarify the mechanisms underlying sgp130 synthesis and release in patients who undergo regular dialysis treatment (RDT) using dialytic membranes with different biocompatibility.

Primary non-Hodgkin's lymphoma of the mandible. Report of a case.

A case of a 45-year-old white man admitted for an osteomyelitis and subsequently diagnosed affected by an IE stage, diffuse high grade large B cell non-Hodgkin's lymphoma of the mandible is reported. The patient presented a swelling in the right mandibular region with paraesthesia of the ipsilateral lower lip without nodal involvement of the neck. After an incisional biopsy, which showed a diffuse high grade large B-cell non-Hodgkin's lymphoma, the patient was staged and treated with CEOP protocol for six courses and subsequently external beam radiation therapy with complete remission of the lesion.

The role of interleukin-6 and of its soluble receptors in the biocompatibility of dialysis treatment.

Proinflammatory cytokines, in addition to their role in host defence, may be considered mediators of disease; a reduction of cytokine synthesis or effects is, therefore, becoming a target of many diseases. IL-6 is a pro-inflammatory cytokine that may play a role in several clinical problems related to dialysis treatment. An enhanced spontaneous production of IL-6 by Peripheral Blood Mononuclear Cells (PBMC) harvested from ESRD patients dialyzed with a poor biocompatible membrane has been first demonstrated by our group.

Total stapled, total intra-abdominal (TSTI) laparoscopic Roux-en-Y gastric bypass: one leak in 1000 cases.

Background: Variations in technique of laparoscopic Roux-en-Y gastric bypass (LRYGBP) have been reported. These changes, mainly in the construction of the gastro-jejunostomy, are intended to decrease complications.

Methods: 1000 consecutive LRYGBPs were performed using the Total Stapled Total Intra-abdominal (TSTI) technique antecolic and antegastric approach.