A novel cell line, named LSA, has been obtained, stabilized, and characterized from a human liposarcoma. These cells have morphological and biochemical features strongly resembling the adipocytes and were able to grow in the Ham's F12 medium, in presence or absence of FCS. A conditioned medium (LSA-CM) was obtained by growing the LSA cells in the F12 medium in the absence of FCS. LSA-CM had cytostatic and cytotoxic effects (apoptosis and necrosis) associated with down-regulation of c-myc and upregulation of p53 in several human cell lines (breast, lung, glioblastoma, etc. ). The MCF-7 and glioblastoma cells were killed by LSA-CM in 5-6 days, whereas the same cells were killed by LSA-CM co-incubated with low doses of cisplatin in 30 h. LSA-CM peri-tumoral injections for 15 days in Balb-c-fc3H mice affected by mammary tumors, resulted in the rapid disruption of tumors and absence of metastases. In contrast, in the untreated animals the tumor masses were 4 times larger than initial lesions, and numerous metastases were found in the lungs. The toxicity analysis of LSA-CM, performed on three different animal species, showed that LSA-CM is absolutely free of acute, subacute, and subchronic toxicity. The possible use of LSA-CM/cisplatin for cancer treatment is discussed.

Animals↗

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[New issues in surgery of adrenal pheochromocytoma].

The adrenal pheochromocytoma still arouses great interest among the experts. The Authors give here a report of a study carried out on the personal case history of 32 patients and the concerning literature. A correct clinical and diagnostic approach is important to detect, at a preoperative level, the benign forms from the malignant ones (10-15% of cases according to literature) and the polyendocrine syndromes (21% of our series). Video-laparoscopy technique is recommended in pheochromocytomas surgery, mainly in asymptomatic and incidental forms and in all benign symptomatic forms less than 5 cm in size. At least, uni- or bilateral adrenalectomy associated with total thyroidectomy is also suggested in case of a polyendocrine syndrome.

Adolescent↗

PubMedDate not supplied

[Backache from exertion in health personnel of the Istituti Ortopedici Rizzoli in Bologna. A case-control study of the injury phenomenon in the 10-year period of 1987-1996].

Low-back (lumbosacral) injuries are known as one of more important occupational health problems in health care workers, because of high prevalence and impact of socioeconomic costs. To investigate the risk of low-back pain in hospital workers into the Istituti Ortopedici Rizzoli in Bologna (Italy), a retrospective study was carried out. The adapted study design was the matched (1:1 for age) case-control, enlisting the first injuries occurred in the hospital staff like cases, and personnel in force, matched for age and year of happened case, like controls. Information about diagnoses and occupational data was obtained from the current informative systems. Comparison with a control group suggests the validity of the work-relatedness of low-back pain in nursing and health aides (OR: 21.67; LC: 4.69-196.56), in nurses (OR: 20.21; LC: 4.81-177.95), in therapists (OR: 16.36; LC: 2.80-163.54) and in X-ray technicians (OR: 13.64; LC: 2.25-138.99). The risk of occupational injury is not homogeneously allocated into the hospital, and significatively prevails in the orthopaedic wards, in the plaster-rooms, in the operating blocks and in the sterilization plants. Specific manual handling were associated with an increased risk of back pain, while some non occupational factors like cigarette smoking, previous trauma leading to hospital admission, and number of children in female, were resulted weakly associated.

Adult↗

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[Current indications of bilateral adrenalectomy in Cushing's syndrome: discussion of personal experience].

Since 1975 we have observed 68 patients with Cushing syndrome, 48 out of which with an ACTH-independent disease and 20 with an ACTH-dependent one, due to hypophisary adenoma. Out of the latter group of patients, which had a relapse of the disease after a previous trans-sfenoidal procedure, 16 underwent an open bilateral adrenalectomy and 4 a laparoscopic monolateral or bilateral adrenalectomy. Patients from the former group had an open or laparoscopic adrenalectomy, or a bilateral adrenalectomy in case of the rare bilateral diseases, as McCune-Albright syndrome. All patients had a complete healing, except for 2 patients affected by McCune-Albright syndrome who died for cardiopulmonary complications. We conclude that bilateral adrenalectomy plays a fundamental role in the treatment of Cushing disease, after the failure of the trans-sfenoidal procedures. This surgical therapy has been certainly improved by the introduction of the laparoscopic techniques, which allowed us to exert bilateral adrenalectomies in two times with a significant reduction of perioperative morbidity and mortality because of the less severe traumatism and the absence of addisonian complications.

Adrenalectomy↗

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[Laparoscopic approach to the "acute" and "chronic" bowel obstruction].

AIM OF THE STUDY: To retrospectively evaluate a series of patients with acute and chronic small bowel obstruction and discuss the indications of laparoscopic vs laparotomic approach and the outcome of both these techniques. PATIENTS AND METHOD: 85 patients with acute and chronic small bowel obstruction who underwent to either emergency or elective surgery since January 1999 up to October 2001 were enrolled. Subjects were divided into three groups: 39 treated with emergency laparotomy (group I), 13 with emergency laparoscopy (group II) and 33 with elective laparoscopy for chronic/subacute obstructions (group III). RESULTS: 1) the most frequent indication of the laparotomic approach was either multiple or major previous surgery as well as neoplastic diseases; 2) patients of the second group had frequently previous either minor or laparoscopic surgery; 3) the incidence of previous emergency surgery were maximum among the III group; 4) both post-operative ileus and mean hospital stay lasted less in the II than in the I group. The mean operative time and the morbidity was equal in the two groups; 5) we observed more intra-operative complications, a higher conversion rate and a longer both post-operative ileus and mean hospital stay in the II than in the III group. CONCLUSIONS: Our data support the role of laparoscopy in patients with chronic/subacute small bowel obstruction. Patients with acute obstruction may undergo laparoscopy after a careful selection, excluding subjects with previous either multiple or major surgery as well as neoplastic diseases. Such results need future confirmations from prospective randomized studies.

Acute Disease↗

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[Videolaparoscopic adrenalectomy in Conn syndrome. Analysis of 39 case observations].

The authors retrospectively analyse 39 patients affected by Conn's syndrome, which have been observed since 1985, and discuss the results of surgical approach using the new technologies. In particular, the introduction of laparoscopy, technique that has been applied almost exclusively since the last seven years, has revealed being the "gold standard" for the surgical treatment of this disease. The adrenal underlying lesions are indeed almost always monolateral, small in size and present very rarely malignancy in their biological behaviour. Furthermore, the authors, although lacking of personal experience, propose the possibility of a more conservative treatment of the adrenal lesions with a simple "enucleation", whose feasibility also in laparoscopy has recently been shown by some authors. Anyway, the Authors believe that this technique of a partial adrenalectomy could be chosen in selective cases of bilateral adenomas or hyperplasia or in those lesions which are placed in an easily accessible peripheral site.

Adrenalectomy↗

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[Surgical strategy in the treatment of adrenal cortex cancer. Expanded and repeated interventions].

AIM OF THE STUDY: To analyze our patients affected by adreno-cortical carcinoma (ACC) considering in particular the therapeutical approach in case of local recurrence or metastasis, and to compare our results with those from literature. PATIENTS AND METHODS: Since 1975 up to 2001, 35 patients with ACC were observed, 27 female and 8 male, aged between 3 and 76 year. All patients were surgically treated, 3 out of which laparoscopically. Thirty patients underwent radical and 5 palliative surgery. Twenty-two patients had extended resections to surrounding infiltrated organs, such as spleen, pancreatic taIl, vena cava, left colon and liver. The intervention was always completed by regional lymphadenectomy. Adjuvant treatment was administered in 17 patients, 4 out of which were re-operated. RESULTS: Only one patient died in the perioperative period for hyperacute adrenal failure. The survival rate was 85.7% at one year, 76.5% at two years, 70.8% at three and 28.3% at five years. Out of the 30 patients radically treated, only 3 are disease-free up to now. Local recurrence or metastatic disease was observed in 27 patients, out of which only 9 were eventually surgically treated, once or more times. All non-operated patients died between 1 and 6 months from the recurrence. The survival rate of the 9 re-operated patients was 51% at 2 years, and 22.1% at 5 years. Interestingly, one patient who has been re-operated three times, is still alive and disease-free after 7 years from the first recurrence. No significant difference was observed between Mitotane-treated and non-treated patients. CONCLUSIONS: According with data from literature, we conclude that surgical therapy of recurring local or metastatic ACC is up to now the best treatment, independently from the original stage of the disease. Controversies still remain about the utility of adjuvant chemotherapy in the primary and the recurrent disease.

Adolescent↗

PubMedDate not supplied

[Symptomatic Kimmerle anomaly. Clinical case].

After mentioning the most common forms of vertigo in childhood, the Authors quote a case come into their observation showing anomalies of the Kimmerle symptomatic.

Cervical Atlas↗

PubMedDate not supplied

[Margagni-Larrey diaphragmatic hernia. Description of a clinical case].

A clinical case report of a Morgagni-Larrey hernia is presented. The finding was made at the age of four months by means of x-ray of the thorax, performed because of recurrent respiratory symptoms regressed after surgical intervention. The rarity of this type of hernia, without a herniary sac and accompanied by the late appearance of respiratory symptomatology, is stressed. It is suggested that x-ray of the thorax should be performed when recurrent respiratory disease is the presenting complaint, even in the first few months of life.

Bronchitis↗

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[Comparative studies of AFP in the maternal blood and the birth weight of twins].

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Adult↗

PubMedDate not supplied

[Urinary tract infections and malformations].

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Adolescent↗

PubMedDate not supplied

[A case of persistent fever].

The Authors report a case of difficult diagnosis, clinically characterised by long-term persistent fever. Clinical and laboratory tests led to a first conclusion of a tubercular infection; later of a perisplenic hematoma and the persistence of high inflammatory indices directed to a different diagnosis.

Child↗