[Proapoptotic effect of propofol on T cells].

Background: Surgery and general anesthesia induce excessive apoptosis on peripheral lymphocytes and this phenomenon significantly contributes to the postoperative lymphocytopenia. However, the role played by anesthetic agents on this event remains to be elucidated. In this study we examined whether an anesthetic compound such as propofol is able to exert, in vitro, a proapoptotic effect on T cells.

[Indication for short stripping of the great saphenous vein. Results and indications].

Background: The aim of surgical therapy of varicose veins is the elimination of reflux from the deep to superficial system at the saphenous crosse and perforant vessel and conservation of the superficial venous system due to possible surgical procedures for arterial revascularization. This latter condition leads to an extension of indications for short stripping procedures, although the venous distal segment may undergo hypoplastic degeneration not compatible for revascularization purposes. Another important reason is the minor incidence of neurologic complication due to saphenous nerve lesion which may occur during long saphenous stripping.

[Heredity and urologic tumors].

Most human malignant tumours derive from a series of several mutations in cell growth regulatory genes. Neoplastic transformation is a multistep, or at times multigenic event where several mutations must intervene. Hereditary forms have been identified for a number of human neoplasias.

[Neoadjuvant chemotherapy and conservative surgery in invasive bladder cancer. Personal experience].

Background: To evacuate the efficacy of conservative treatment in invasive stage T2 bladder tumours by means of deep transurethral resection of the bladder (TURB) followed by three cycles of chemotherapy with methotrexate, vinblastin, adriamycin and cisplatin (M-VAC).

Methods: Between September 1998 and March 2000, 5 patients have been submitted to transparietal TURB for endovesical neoplasia. Following histological confirmation of muscle involvement (stage T2), all patients were assigned to the M-VAC chemotherapy protocol after having established clinical stage with chest, abdominal and pelvic computed tomography (CT) and bone scintiscan.

An unusual case of sub-condylar bilateral fracture and bilateral post-traumatic temporomandibular ankylosis.

A case of bilateral sub-condylar fracture with wide stump dislocation associated with a central facial trauma, fracture-intrusion of the rhino-orbital-maxillary complex and a parasymphyseal mandibular fracture, is reported. After surgery and inter-maxillary fixation an unusual temporo-mandibular ankylosis developed. Maximum mouth opening, lateral and protrusive movements were severely limited.

[CIN: multicentric study of therapeutic strategies].

Background: Cervical Intraepithelial Neoplasia (CIN) is a dysplastic lesion that precedes cervical cancer. The diagnosis is made by colposcopic, cytologic and bioptic exams. Therapy may be physical, pharmacological or surgical.

[Use of adhesives in emergency surgery].

In a prospective study, the Authors present an analysis on the use of surgical adhesives in the wounds treatment. In sixteen months we have treated 157 patients exclusively with a surgical tissue adhesive 2-octylcianoacrylate to repair traumatic wounds and surgical ones. In the Emergency Department were treated 110 patients (70%) with 2-octylcianoacrylate for skin incisions, lacerations and the length of lesion.

[Ambulatory closed surgery for the treatment of pilonidal sinus].

Pilonidal disease (PD) is a common chronic disorder of the sacrococcygeal region afflecting young people. Despite several methods for treating PD have been described, the management remains controversial. Recent reports have advocated different surgical approaches such as open or closed technique, but recurrence plagues all forms of therapy.

[Role of sonography in the evaluation of parotid gland in HIV+ children undergone highly active antiretroviral therapy (HAART)].

Purpose: To evaluate the role of sonography (US) in the evaluation of parotid gland alterations in HIV+ children, in order to show their presence, severity, specificity, relationship with clinical and laboratory data and sensitivity to new drugs.

Material And Methods: From June 2000 to December 2000 twenty-two consecutive HIV+ children (12 males and 10 females, mean age 9.7) undergoing HAART were prospectively examined with US.

[Multislice spiral CT angiography in the evaluation of the anatomy of splanchnic vessels: preliminary experience].

Purpose: The aim of this study was to optimize the protocol for multislice spiral CT angiography and to assess the ability of the technique to detect the anatomy of splanchnic vessels, using volume rendering as reconstruction algorithm.

Material And Methods: The anatomy of splanchnic vessels was studied in 19 patients (11 men, 8 women, age range 38-83 years) undergoing CT of the abdomen and pelvis. All examinations were performed with a multislice spiral CT scanner (Somatom Plus 4 Volume Zoom; Siemens, Erlangen, Germany) using the following parameters: collimation, 1 mm; slice width, 1 mm; table feed, 8 mm/sec; reconstruction interval, 1 mm; mAs, 120; kVp, 120.

[High circulating levels of adrenomedullin and endothelin-1 in obesity associated with arterial hypertension].

Background: The aim of the study was to investigate the behavior of two endothelial vasoactive peptides, adrenomedullin (vasodilator) and endothelin-1 (vasoconstrictor), in human obesity with and without arterial hypertension.

Methods: The study was carried out on 30 obese subjects (body mass index > 27 kg/m2) divided into two groups: 15 normotensive obese patients (10 males, 5 females, mean age 42 +/- 12 years) and 15 hypertensive obese patients (9 males, 6 females, mean age 42 +/- 13 years). The control group consisted of 21 normal subjects (12 males, 9 females, mean age 38 +/- 12 years) and of 16 patients with essential hypertension (10 males, 6 females, mean age 41 +/- 12 years) but without organ damage.

p53 over-expression identifies a subset of nodal peripheral T-cell lymphomas with a distinctive biological profile and poor clinical outcome.

Peripheral T-cell lymphomas (PTCL) are usually characterized by aggressive clinical behaviour and poor clinical outcome, but their biological background has not been extensively investigated to date, due to their low incidence, about 10% of all non-Hodgkin's lymphoma cases in Western countries, and also to the paucity of specific molecular-genetic abnormalities. Neverthless, there is increasing biological and clinical evidence that primary nodal PTCL should be considered separately from extra-nodal cases, but little is known about biological factors of possible clinical and prognostic impact. This immunohistochemical study has analysed the expression of p53, Mdm2, p21(WAF1), BCL-2 and p-glycoprotein (MDR-1 gene product) in a series of 45 cases of nodal peripheral T-cell lymphomas (PTCL) with 'high-grade' histology.

[Philosophical and historical values of medicine].

History of Medicine has pointed its higher attention on both great physicians and relevant medical schools. The hieratic person of the physician has been pre-eminent and conditioning the relationship between patients and doctor, the latter in a paternalistic dominant position. Changes occurred in medicine during the last century, mainly related to the technological advancements and a new ethiopatogenetic view.

[Teaching humanities to the students of the medical faculties, reasons and why].

There are many reasons to include a programme of human sciences, literature and art in the undergraduate medical curriculum. In the present text, the implications of three reasons are described, namely the increasing demand of health by a rapidly changing society, the need for practising whole person medicine and for improving the doctor the rational and moral awareness of his/her clinical objectives. The possible ways of introducing humanities in the medical curriculum, some international experiences and the role of Medical faculites in interacting with other University disciplines are discussed.

Capsuloplasty for the treatment of recurrent anterior dislocation of the shoulder: long-term evaluations of the Putti-Platt method and Bankart method with anchors.

The authors compare two methods used for the treatment of recurrent anterior shoulder dislocations: Putti-Platt capsulomyoplasty, based on an overlapping suture of the free margins of the joint capsule and of the subscapularis muscle, and the Bankart method that uses anchors, based on the repair of the glenoid labrum, that is kept in site, together with the medial flap of the joint capsule, by suturing with the anchors previously stabilized to the neck of the glena. In this method, the subscapularis muscle is re-approximated without any overlapping or shortening. The Bankart method with anchors thus allows us to obtain anatomical repair of the lesion, with doubtless advantages for mobility, function and stability of the shoulder; this is confirmed by the comparison with results obtained out of 34 patients in this study, 15 of which submitted to the Putti-Platt method, 19 to the Bankart method with anchors.

[Current clinical features of septic abortion in Western countries. A series of cases observed during 1998 at the 1st and 2nd department of obstetrics and gynecology of the University of Rome La Sapienza].

Background: Advances in diagnostic techniques and therapy and the institution of both legislative measures and Centres for the protection of mother-infant health are major factors to which the reduced incidence of septic abortion in should probably be ascribed in Western Countries, where it reaches approximately 10%. The aim of this study was to analyse the current problems related to this pathology in a Western Country, such as Italy.

Methods: Cases of septic abortion observed at the I and II Department of Obstetrics and Gynaecology of University of Rome La Sapienza during 1998 were retrospectively analysed.

[Gardner's syndrome. A case report].

Gardner's syndrome is a congenital condition characterised by diffuse intestinal adenomatous polyposis (IAP) associated with maxillary osteomas, odontomas, hypertrophy of the retinal epithelium and skin tumours. It may affect subjects of all ages with equal frequency in males and females. The fact that diffuse adenomatous polyposis, the most serious clinical aspect of the syndrome, is treated surgically, has led to improved survival in patients and, consequently, an increased incidence in associated lesions, particularly maxillary osteomas.

[Circadian variations in the onset of acute myocardial infarction].

Background: Several studies have observed a circadian pattern in the onset of acute myocardial infarction (AMI), with a peak incidence in the morning hours. It has been suggested that different circadian rhythms may exist in various subgroups of patients.

Methods: This study sought to determine whether the circadian incidence of AMI varied by sex, age, cardiovascular risk factors, previous history of ischemic accidents, the site of AMI, and the short-term outcome.

[The PiCCO system with brachial-axillary artery access in hemodynamic monitoring during surgery of abdominal aortic aneurysm].

Background: The haemodynamic monitor PiCCO System, based on transpulmonary arterial thermodilution, has been used with a brachial-axillary access instead of the femoral arterial access during abdominal aortic aneurysm surgical repair. Accuracy and limitations of pulse contour continuous cardiac output (PCCO) were evaluated on the basis of arterial thermodilution cardiac output. The patterns of cardiac index, preload, afterload and cardiac function parameters were also studied in the different phases of the surgical procedure.

[Our experience with the appropriate use of esophagogastroduodenoscopy].

Many studies emphasize the right indications about the execution of an EGDS showing that a lot of requests are inappropriate. We have wanted to report our experience too, that showed more comfortable results than that checked, by other Authors moreover we have emphasized that the inappropriate requestsare justly divided between generical and specialized physicians.

[Fournier syndrome: report of a clinical case].

The case of a Fournier's syndrome in a 58 years old patient is reported from the Authors that describe the ethiopathogenetic and therapeutic aspects. They analyse the importance of an early surgical treatment associated with antibiotic therapy and later a riparation of the lesions with a myocutaneous skin flap of TLF.

[Single asymptomatic splenic metastasis of breast carcinoma: report of a clinical case].

The spleen is rarely involved from metastatic disease. Metastases from breast cancer are extremely rare although described in the Literature. The Authors report a case of a woman who had undergone to radical mastectomy for breast cancer nine years previously and admitted to the hospital because of a single splenic lesion shown by U.

[Structure of the venous wall of the pampiniform plexus in idiopathic varicocele].

The Authors discuss about some histologic patterns observed in 100 pampiniform plexus specimens of patients who underwent direct scrotal surgery for idiopathic varicocele. Tunica media was involved in all of 81 specimens in which Authors observed a vascular wall thickening. Out of these, localized hypertrophic phenomena, leading to segmental vascular obliteration, prevailed (74%) on widespread forms (26%).

Opiomelanins synthesis and properties.

Opiomelanins represent a new class of synthetic pigments produced by the tyrosinase-catalyzed oxidation of opioid peptides and other tyrosine aminoterminal peptides. In contrast with dopamelanin, these polymers are fully soluble in hydrophilic media, due to the presence of the peptide moiety. Opiomelanins show paramagnetism as demonstrated by the EPR spectrum identical to that of dopamelanin.