[Syndrome of cholesterol crystal embolism: clinical case].

Cholesterol crystal embolization syndrome is a multiorgan disease that frequently occurs as a complication of invasive cardiovascular procedures and of thrombolytic or anticoagulant therapy. The symptoms are due to the displacement of atheromatous material dislodged from unstable or injured, by mechanical manipulation, plaque to arteriolar vessels. The real incidence of cholesterol embolization is not known.

Heart rate variability in cluster headache.

Eight patients with cluster headache were studied by evaluating the heart rate variability on the basis of 24-hour ECG monitoring performed during attacks (critic periods) to demonstrate if any imbalance of the autonomic nervous system was present and to determine its temporal correlation, if any, with the attack. The same monitoring allowed us to compare the patients' data during headache-free periods (intercritic periods) with those of normal controls. Our investigation demonstrated a severe sympathovagal imbalance during spontaneous attacks: the parasympathetic drive is at once increased at the onset with a mild reduction of the sympathetic drive, and all these modifications slowly disappear at the end of each attack.

[Small intestine tumors: our experience in emergencies].

Small bowel tumours are relatively rare neoplasms; unusual occurrence associated with nonspecific symptoms, and low-sensitivity tests availability, are responsible for diagnostic delay. A retrospective study was performed on 42 cases with acute presentation, from 1972 to 2001; median age was 52 years (range 14-79) and there was a slight female prevalence (57.1% vs 42.

[Duodenal villous adenoma: a case report].

Small bowel tumours are rare neoplasms representing just 1% of all the gastrointestal tract lesions. Adenomas are the benign forms which, developing in the duodenum, tend to localize in periampullary region, with high incidence of malignant degeneration. The authors report a case of a fifty-five-years old woman with a periampullary villous adenoma.

Calcium oxalate precipitates in a renomedullary interstitial cell tumor.

We report a case of calcium oxalate deposition in a renomedullary interstitial cell tumor (RICT) in a patient dying of full-blown AIDS. The precipitates showed birefringence using a partially polaris ed light and were stained black in Yasue's silver nitrate-rubeanic acid method. The combination of calcium oxalosis and RICT has not been reported before and might possibly be due to systemic biochemical alterations of the glycosaminoglycans as a result of profound metabolic disturbances in AIDS patients.

Metal speciation and pH effect on Pb, Cu, Zn and Cd biosorption onto Sphaerotilus natans: Langmuir-type empirical model.

Biosorption data of lead, copper, zinc and cadmium onto Sphaerotilus natans at different equilibrium pH (3-5 units) were here reported and analysed. Experimental results outlined the positive effect of pH increase on pollutant uptake and also the biomass affinity series (Pb > Cu > Zn > Cd) reflecting the hydrolytic properties of metals. An original empirical model was proposed to represent the effect of pH on heavy metal biosorption inserting q(max) vs.

[Periareolar subcutaneous quadrantectomy: a new approach in breast cancer surgery].

Plastic and oncological breast surgery are becoming more and more closer as one surgical treatment. The term "oncoplastic surgery" refers to the use of plastic surgery techniques in breast cancer surgery, in order to avoid and to correct the adverse aesthetic findings. The care of cosmetic sequelae of breast cancer surgery has reached an important therapeutic role for psychological consequences of disease and because of the higher patients expectations of a good aesthetic result.

[Atrial fibrillation and hyperthyroidism: results after thyroidectomy].

Hyperthyroidism patients can develop atrial fibrillation (AF) with a frequency range between 10 and 25%. The Authors consider 256 hyperthyroid patients operated in their Department, from 1985 to 2001. Before and after surgery, thyroid examination, routine blood tests and common diagnostic evaluations were performed.

[Cecal volvulus].

A retrospective study on 18 patients with cecal volvulus surgically treated was made. Demographics and clinical data, as well as treatment were determined from clinical reports. The operative procedures employed were cecostomy (56%), cecopexy (22%) and right colectomy (22%).

[Effects of drug abuse on sexual response].

Drugs of abuse, like alcohol, opiates, cocaine and cannabis, are used by many young people for their presumed aphrodisiac properties. It is well known, instead, that, apart from the subjective effects, they negatively affect the sexual response. Alcohol has direct toxic effects on the gonads (testes and ovaries) and the liver (it increases the catabolism of testosterone and its transformation in estrogens).

[Drugs and pregnancy].

The evidence of the transplacental transfer of most of the drugs administered to the mother has changed the old concept of the invulnerability of the fetus due to the placental barrier protection. The commonly used drugs act on the fetus by means of two different mechanisms: directly after the placental transfer, and indirectly influencing the utero-placental circulation and maternal homeostasis. Fetal effects can be several and they depend on the type of the drug, dosage, route of administration, gestational age in relation to the fetal ontogenesis, and on the amount of drug which reaches the fetus.

[Family communication and primary prevention].

A good communication within the family is the basis for the primary prevention of discomfort and deviance. With the aim of prevention of the frequent acts of violence within the family, the present article responds to the request of behavioural guidelines in schools, families, communities, and other pedagogical settings. Thus, the delicate issue of self-esteem in adolescents, the dysfunctional parental behaviour and the symptoms of discomfort of the teenagers are discussed.

[Double diagnosis or comorbidity? Definition and clinical observation].

There is a high prevalence of a comorbid substance use disorder in subjects with psychotic or mood disorders. Psychiatric patients are reported to abuse alcohol or drugs. This comorbidity raises the question whether one disorder is a consequence of the other.

[Weakness of will].

Addictive behaviours raise the issue how it is possible that a free agent is not able to act according to his own will. Indeed an agent can be defined as "addicted", to a substance or a behaviour, only when he does not succeed in discontinuing despite his will. Namely in the very idea of addiction it is involved the idea of weakness of will.

[Drug addiction: definition and classification].

Basic aspects of drug abuse are discussed, from a semantic and physiopathologic point of view: drug definition; drug abuse and drug addiction; drug as a tool, that produces adverse or beneficial effects according to its use, rather than its intrinsic features. Simple and complicated drug-related problems are discussed in some depth, the former being associated with external factors, the latter with organic or mental disease. Practical implications of this concept are exposed.

[Esophageal perforations and fistulas: clinical management].

Aim of this study was the literature review regarding esophageal perforations and fistulas. We examined the most common causes, clinical findings (symptoms and signs), laboratory and imaging studies for differential diagnosis and complications. Finally, we examined the surgical or endoscopic treatment and the prognosis.

Use of mesh to repair the submuscolar pocket in breast reconstruction: a new possible technique.

The reconstruction of the female breast after mastectomy has become a crucial part of primary breast cancer therapy. Setting of an implant is possible only in case of locally abounding soft tissue coverage and when no radiation has before performed. It is necessary a complete integrity of the submuscolar pocket and good blood supply of the skin to avoid failure of the procedure.

[Peritoneal papillary serous carcinoma: clinical report].

Peritoneal papillary serous carcinoma (PPSC) is a rare tumour that involves the surface of the peritoneum, with prevalence in female patients and can originate from a single or multicentric focus is here described. A primary peritoneal serous carcinoma is here described. The patient has been treated with paclitaxel 175 mg/m2 and carboplatinum AUC 6.

[Hyperhomocysteinemia and thrombosis: clinical case and literature's review].

Patients with homocystinuria have an increased risk for both venous and artherial thrombosis but it has been found that even moderate increase in homocysteine levels are associated with heightened risk of thromboembolism. The Authors report a case of juvenile vasculopathy in a patient with hyperomocysteinemia. In this case the patient presented both venous and artherial thromboembolism in the absence of the most important risk factors.

An efficient palladium-catalyzed synthesis of cinnamaldehydes from acrolein diethyl acetal and aryl iodides and bromides.

The reaction of aryl iodides and bromides with acrolein diethyl acetal in the presence of Pd(OAc)(2), (n)()Bu(4)NOAc, K(2)CO(3), KCl, and DMF, at 90 degrees C until the disappearance of the acetal followed by the addition of 2 N HCl to the crude reaction mixture, affords cinnamaldehydes in good to high yields. A variety of functional groups are tolerated in the aryl halides, including ether, aldehyde, ketone, ester, dialkylamino, nitrile, and nitro groups. The presence of substituents close to the oxidative addition site does not hamper the reaction.

The QDE-3 homologue RecQ-2 co-operates with QDE-3 in DNA repair in Neurospora crassa.

The post-transcriptional gene silencing mechanism in Neurospora crassa, called quelling, was shown to involve the products of three genes termed quelling-defective. A homologue to the qde-3 gene encoding a putative RecQ-type DNA helicase was isolated and was named RecQ-2. Characterisation of the RecQ-2 gene has revealed that it is not involved in quelling, but may co-operate with the qde-3 gene product in a pathway that repairs damage to DNA caused by the chemical mutagens methyl methanesulfonate and N-methyl- N'-nitro- N-nitrosoguanidine.

[Cutaneous Merkel cell carcinoma: case report].

Merkel cell carcinoma is an unusual cutaneous malignancy with a propensity for spreading to regional lymph nodes, with recurrence at original site or/and in lymph node. Occurring most often on the head and neck of the elderly patients. Complete surgical resection is the mainstay of treatment of the primary tumor.

[Carcinoma of the male breast. Prognostic factors and outcome of surgical treatment].

A retrospective study was made on 18 male patients with breast carcinoma treated at the Department of Surgery "Pietro Valdoni" of the University "La Sapienza" of Rome, Medical School. Demographics, pathology, stages, and treatment were determined from clinical reports. All patients but one underwent modified radical mastectomy.

[Superior vena cava syndrome].

Superior vena cava syndrome is due to an intrinsic or extrinsic caval obstruction that evolves in acute or subacute way with distinctive clinical feature such as respiratory symptoms and venous stasis. Since 1998 we have treated three cases of spontaneous superior vena cava thrombosis in neoplastic patients who underwent several infusion of chemotherapy, respectively for a breast, uterine and rectum cancer. All patients was female, 52, 58 and 70 years old.

[Cystadenocarcinoma in situ of the urachus: a clinical case].

Urachal carcinoma is a rare neoplasm which represents 0.01% cancers in adults. If this neoplasm is unusual, the development of cystadenocarcinoma on a urachal cyst is still more rare.