Well-differentiated lipoma-like liposarcoma of the caecum.
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Aged↗
Biomedical subjects
A Licata
Publications and source records attributed to A Licata.
Immunohistochemical localization of calcium-binding proteins (CaBPs) in the epidermis of the earthworm Lumbricus terrestris (Annelida, Oligochaeta).
The present immunohistochemical study provides the first evidence of the presence of calcium-binding proteins (CaBPs) in the epidermis of the earthworm Lumbricus terrestris (Annelida, Oligochaeta) a lower invertebrate. The entire epidermis was labelled for calmodulin which is in agreement with its ubiquitous occurrence. Immunopositivity for calbindin D28K was limited to mucous cells, while that for S-100 protein was present only in neuroendocrine-like small granular cells. Finally, labelling for parvalbumin was specifically present in the subcutaneous nerve plexus. S-100 protein is considered to be a marker of neuroendocrine cells, at least in lower invertebrates such as Annelida. Although calbindin D28K is considered to be a marker of these cells in vertebrates, the same function cannot be attributed in Lumbricus terrestris. However, we can conclude that S-100 protein, as a regulatory protein, is phylogenetically older than calbindin D28K. We assume that the latter has an autoregulatory function in secretory processes. In agreement with previous data, we suggest that small granular cells exert a paracrine action in osmoregulatory and secretory processes.
Animals↗
Patient survey of trichloroacetic acid treatment of facial actinic keratoses.
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Caustics↗
Neuronal nitric oxide synthase (nNOS) expression in the epithelial neuroendocrine cell system and nerve fibers in the gill of the catfish, Heteropneustes fossilis.
We studied immunohistochemically the localization of neuronal nitric oxide synthase (nNOS) in gills of an Indian catfish species, Heteropneustes fossilis. It is shown that most of the epithelial neuroendocrine cells that are present in gill filaments and lamellae stained positively. Co-localization of nNOS and endothelin was also shown in neuroendocrine cells. A dense plexus of nNOS-containing nerve fibers was present beneath the gill epithelium, associated with efferent filament arteries and the basal side of neuroendocrine cells. nNOS immunopositive neurons were not found in gill areas. nNOS immunopositive neuroendocrine cells appeared to differ from neuroepithelial cells in gills of various teleost species, which are considered as oxygen-sensitive receptors and are present in the distal halves of gill filaments. Other types of neuroendocrine cells have been identified previously in other areas of gills using antibodies to serotonin and endothelin peptides. These cell types are likely to be involved in chemical regulation of the physiology of gill cells. In relation to the function of the other cell types, our data on nNOS localization suggest that NO is a wide-spread transmitter in the gill of the Indian catfish. It may play a role both in the local regulation of vascular tone and in inhibitory innervation of the gill.
Animals↗
Colorectal follow-up planning modified on the basis of our personal experience.
BACKGROUND: The authors, evaluating the disappointing follow-up results in patients suffering from colorectal carcinoma who had undergone surgery for cure, tried a more rational follow-up. METHODS: In a retrospective review about 232 patients who adhered to the follow-up protocol, we evaluated the accuracy rates of CEA, liver ultrasonography and abdominal CT. In the same group of patients. we evaluated the type of correlation between the neoplastic recurrence rate and Astler-Coller's classification. RESULTS: (1) In detecting hepatic metastases CEA levels furnished sensitivity and negative predictive value more than liver ultrasonography (83.3 vs. 77.8% and 98.4 vs. 98%, respectively); (2) in our series, we obtained a lower recurrence rate in classes A+B1 (7.5%) and B2 (20.8%) and higher in C1+C2 (44.4%) and D (66.7%) (p < 0.0 1). CONCLUSION: According to these data we decided to eliminate postoperative liver ultrasonography and customize follow-up protocol on tumor staging and timing of cancer relapse. The authors believe that these changes will not modify the results, but cause less psychophysical stress for the patients and reduce costs by 50%.
Biomarkers, Tumor↗
Immunohistochemical localization of bioactive substances in the epidermis of the earthworm, Lumbricus terrestris (Annelida, oligochaeta).
Serotonin (5HT), endothelin-big (ET-big) and neuron-specific enolase (NSE) are present in some epithelial paraneuronal cells of vertebrates. In the invertebrates, we show for the first time, by immunofluorescence and immunoperoxidase methods, the immunoreactions to antibodies raised to ET, 5-HT and NSE in the epidermis of the Lumbricus terrestris. It is assumed that the reactive cells are small granular cells that may have a paracrine action in the mechanisms of cell proliferation and secretory processes. The function of these bioactive substances in the epidermis of the earthworm awaits investigation. Phylogenetically it is very interesting that paraneuronal-like type of cells appear in such an ancient species of invertebrate which uses the epidermis for various functional activities.
Animals↗
Micro-albuminuria in obese subjects: relationship among body fat distribution, blood pressure and left ventricular structure and function.
OBJECTIVE: To evaluate the relationships among micro-albuminuria, blood pressure and measurements of left ventricular structure and function in centrally and peripherally obese subjects compared with members of a lean control group. METHODS: Centrally obese subjects were subdivided according to whether they had levels of micro-albuminuria higher than 30 mg/24 h (micro-albuminuric group) or lower than or equal to 30 mg/24 h (normo-albuminuric group). For all the subjects we measured heart rate, casual mean blood pressure (MBP), 24 h MBP, total cholesterol level, high-density lipoprotein cholesterol, lipoprotein (a) level, fasting immunoreactive insulin level, plasma renin activity, plasma aldosterone level and micro-albminuria (UAE) by current methods. Left ventricular mass indexed for body height, left ventricular diastolic and systolic diameters, interventricular septal thickness and left ventricular ejection fraction were measured by echocardiography. Peak filling rate was also calculated by radionuclide study. Family history of cardiovascular disease was evaluated for all the obese subjects.RESULTS: Lipoprotein (a) level, total cholesterol level, 24 h MBP and interventricular septal thickness were significantly (P < 0.05) greater for micro-albuminuric than they were for normo-albuminuric centrally obese subjects, whereas high-density lipoprotein cholesterol level and left ventricular ejection fraction were significantly (P < 0.05 lower. In addition, UAE levels of centrally obese subjects were significantly (P < 0.05) higher than those of peripherally obese subjects. UAE of all the centrally obese subjects was correlated directly to lipoprotein (a) level (r = 0.33, P < 0.009), 24 h MBP (r = 0.41, P < 0.002), interventricular septal thickness (= 0.36, P < 0.005) and family history of cardiovascular disease (r = 0.33, P < 0.007). Multiple regression analysis indicated that UAE was independently related to 24 h MBP and family history of cardiovascular disease. CONCLUSION: Our data indicated that measurement of micro-albuminuria is useful for evaluating cardiovascular risk profiles of obese subjects with a central fat distribution.
Journal Article↗
Usefulness of echocardiography in the assessment of internal medicine inpatients. An analysis according to ACC/AHA guidelines.
BACKGROUND: We aimed to analyze the importance of echocardiography in our Internal Medicine Institute. We think that this technique could have a large impact in the evaluation of the internistic inpatient who is usually affected by multiple pathological problems. METHODS: Analysis was performed according to the ACC/AHA guidelines for the application of echocardiography. The data of 1211 consecutive inpatients were analyzed. RESULTS: Sixty-three per cent of all the patients had two or more associated diseases. Moreover, patients in whom echocardiography could be considered appropriate or useful were 67%. Our results point out that echocardiographic examination is generally a technique of great importance for the evaluation of internistic inpatients. CONCLUSIONS: This study could represent a useful background for a cost/benefit analysis that should evaluate the utility of a specifically-dedicated echocardiographic laboratory for optimal, autonomous management of internal medicine inpatients.
Adult↗
Paraneurons in the gills and airways of fishes.
This chapter describes the distributional patterns of the neuroendocrine cells in the respiratory surfaces of fishes and their bioactive secretions which are compared with similar elements in higher vertebrates. The neuroendocrine cells in the airways of fishes differentiate as solitary and clustered cells, but the clusters are not converted into neuroepithelial bodies which are reported in terrestrial vertebrates. The dipnoan fish Protopterus has innervated neuroendocrine cells in the pneumatic duct region. In Polypterus and Amia the lungs have neuroendocrine cells that are apparently not innervated. Two types of neuroendocrine cells are found in the gill of teleost fishes. These cells are very different by their location, structure and immunohistochemistry. Advanced studies on functional morphology of neuroendocrine cells in fish airways are still necessary to increase our understanding of their multifunctional role in the gill area.
Animals↗
Frequency dependent effects on Cai transients and cell shortening in myocytes that survive in the infarcted heart.
UNLABELLED: Myocytes that survive in the epicardial border zone of the healing canine infarcted heart provide the substrate for inducible reentrant ventricular arrhythmias. These myocytes have been shown to have altered Ca2+ currents which could impact on Cai homeostasis in these cells. OBJECTIVE AND METHODS: To directly measure and compare intracellular Ca2+ transients and cell shortening in myocytes dispersed from control noninfarcted hearts with those from epicardial border zone of 5 day infarcted canine hearts using the Ca2+ sensitive indicator fura-2/AM. Studies were designed to determine and compare the effects of rate and premature stimulation on intracellular Ca2+ in the two cell types. RESULTS: Epicardial cells from noninfarcted hearts (1) exhibited an increase in amplitude of the fura-2 ratio with decreasing pacing cycle length (CL), while cells from the infarcted heart showed the opposite effect; (2) showed more marked acceleration of relaxation of the Cai transient with decreasing CL than myocytes from the infarcted heart; (3) exhibited little or no post rest potentiation in contrast to cells from the infarcted heart; and (4) showed a more rapid recovery during restitution protocols than cells from the infarcted heart. Cell shortening differences were also observed between cell populations in that most cells from the infarcted zone did not show any degree of cell shortening despite the reasonable intracellular Ca2+ transient. CONCLUSIONS: The handling of intracellular Ca2+ in myocytes that have survived in the epicardial border zone is very different from that of normal epicardial myocytes suggesting that there may exist marked heterogeneity in intracellular Ca2+ handling in cells in the in situ healing infarcted heart. Electrophysiologic implications of these findings are discussed.
Animals↗
Sulodexide versus calcium heparin in the medium-term treatment of deep vein thrombosis of the lower limbs.
Thirty adult patients with distal, monolateral deep vein thrombosis of the lower limbs were randomly treated for sixty days either with subcutaneous Ca-Heparin or with Sulodexide, administered IM for ten days and orally for fifty days. The thrombus accretion above the knee, the venous pressures of the affected leg, the clinical symptomatology, and some laboratory coagulative tests were monitored throughout the administration period. Local tolerability of the two treatments was also evaluated. The two applied treatments evidenced a net antithrombotic activity, preventing thrombus accretion above the knee, improving with the same efficacy the venous pressures in the affected legs, and similarly reducing clinical symptoms, with a quick and statistically significant trend toward normalization. Blood fibrinogen was significantly lowered by both drugs, while only Ca-heparin yielded a prolongation of activated partial thromboplastin time. Local tolerability of treatments was better for the mainly oral Sulodexide administrations, while subcutaneous Ca-heparin often induced small, though transient, hematomas.
Adult↗
[Therapeutic strategy in thymomas].
Between July 1989 to February 1994 eight patients with thymoma were operated in the First surgical Clinic of University of Catania; in seven the neoplasia was associated with myasthenia gravis, the severity of which was evaluated according to the Osserman's classification. The surgical treatment has been: total thymectomy in four patients, in two total and partial resection was carried out respectively, and in two a macrobiopsy was performed. The postoperative staging was carried out according to Masaoka. The neoadjuvant chemotherapy and postoperative radiation therapy have been analyzed. The authors concluded that a rigorous anatomo-surgical and histopathological classification is the best way for the right use of postoperative adjuvant therapies to reduce the incidence of local and distant recurrence of these tumors.
Adolescent↗
Comparison of nonrandomized trials with slow-release sodium fluoride with a randomized placebo-controlled trial in postmenopausal osteoporosis.
The results of slow-release sodium fluoride (SR-NaF) treatment in two nonrandomized trials involving 65 patients with postmenopausal osteoporosis from the primary site and 121 patients from collaborative sites were compared with those obtained from 54 treated patients and 56 patients taking placebo from a randomized controlled trial. Spinal fracture data were analyzed separately in mild to moderate bone loss of lumbar spine (baseline L2-L4 bone density [BD] > or = 65% young normal) and in severe bone loss (BD < 65%). Since demographic and fracture data were similar among fluoride-treated patients from the three trials at each stratum of bone loss, their data were combined. In mild to moderate bone loss, SR-NaF treatment in the combined group virtually eliminated new spinal fractures with 96.6% of patients remaining fracture-free. The Fluoride group had a markedly lower individual vertebral fracture rate (0.025 vs. 0.188/patient year, p = 0.0001) and group vertebral fracture rate (0.029 vs. 0.175/patient year, relative risk [RR] 0.12, p = 0.0001) than the Placebo group. In severe bone loss, the combined treated group had a significantly lower new spinal fracture rate than the Placebo group, although the differences were not as marked (group vertebral fracture rate of 0.150 vs. 0.276/patient year, RR 0.54, p = 0.03). In the combined fluoride-treated group, the L2-L4 bone mass rose by 4-6%/year for 4 years, and the femoral neck BD increased by 1-2%/year during first 2 years. The radial shaft BD did not change. The Placebo group did not show a change in bone mass at any site. The prevalence (percentage) of patients with related gastrointestinal side effects and nonvertebral fracture rates did not differ significantly between the combined SR-NaF group and the Placebo group (hip fracture rate of 0.0045/patient year in SR-NaF and 0.0053/patient year in Placebo; appendicular fracture other than hip (see text) rate of 0.0193/patient year in SR-NaF and 0.0159/patient year in Placebo). A subgroup analysis showed a low baseline L2-L4 BD, high prevalent spinal fractures, and reduced body weight to be important determinants of the development of spinal fracture during SR-NaF treatment. Concomitant medications (estrogen, vitamin D, thiazide and thyroid hormone) were not independent predictors of the spinal fracture risk. Only 17% of fluoride-treated patients were nonresponders (new spinal fractures or a fall/no change in L2-L4 bone mass). Thus, the effects of SR-NaF treatment on the spinal fracture rate from nonrandomized trials were similar to those of the treated group of the randomized trial but different from those of the Placebo group. The similarity of response of nonrandomized trials with that of the randomized controlled trial and the resultant combined analysis further validate the efficacy and safety of SR-NaF in the treatment of postmenopausal osteoporosis.
Bone Density↗
Calibration of papillotomy in the surgical treatment of papillary stenosis: the "little train".
Although laparoscopic and endoscopic surgery have brought about an indisputable revolution in biliary surgery, many surgeons still prefer open surgery for lithiasis of the common bile duct, and if it is associated with a papillary pathology, they perform a papillotomy. However, great controversy regarding the site, modalities, and extension of the papillary section has now developed among surgeons. Our technique is not original; however, we do propose a "calibration" of the papillotomy, carried out by constructing a "little train" made up of several consecutive Nélatons of increasing caliber to identify the sphincter fibers and to obtain sections proportionate to the size of the bile duct. Of the 115 patients in this series who were treated by open papillotomy, only 1 developed acute pancreatitis; 2 demonstrated bleeding, 1 of whom required surgical exploration.
Cholecystectomy↗
Favourable anatomical variation for the resection of a Klatskin tumour.
The liver and the biliary tract are rich in anatomical variations, knowledge of which is important for the surgeon. A case of an anatomical variation is reported, which allowed easy and oncologically correct resection of a Klatskin tumour. The variation consisted of abnormally long right and left extrahepatic ducts and an abnormal distal bifurcation, with a cystic duct joining the distal end of the right duct. A favourable modification of surgical strategy could be obtained by an oncologically correct resection of a Klatskin tumour avoiding a liver resection and also allowing easy reconstruction. Complete biliary exposure was necessary to reveal the rare, pre-operatively unrecognized, but favourable situation. In the absence of clear contraindications extended biliary dissection is to be recommended to avoid errors in the evaluation of the resectability of hilar biliary cancers.
Aged↗
Central obesity and hypertension: the role of plasma endothelin.
Hypertension and central obesity are two conditions closely linked, but the mechanisms responsible for obesity-associated hypertension are still unclear. In the last few years, several studies addressed the role of endothelin-1 (ET-1) in the development and maintenance of hypertension. This study was designed to evaluate plasma ET-1 in normotensive and hypertensive central obese subjects compared with a lean healthy group. Our final goal was to analyze the relationship between plasma ET-1, blood pressure, and left ventricular structure and function in central obese subjects (both normotensives and hypertensives). ET-levels have been assessed by the radioimmunoassay method in 20 lean normotensives and in 57 central obese subjects; 30 of them were hypertensives and 27 of them were normotensives. Twenty-four-hour mean blood pressure (MBP/24 h) by noninvasive ambulatory blood pressure monitoring, left ventricular mass/ height (LVM/H), and left ventricular ejection fraction (LVEF) by echocardiography and peak filling rate (PFR) by radionuclide study were also measured. ET levels were significantly (P < .05) higher in obese hypertensives and obese normotensives than in lean normotensives. In addition, ET levels were significantly (P < .05) higher in obese hypertensives than in obese normotensives. ET were directly related to LVM/ H (r = 0.86; P < .001) and MBP/24 h (r = 0.48; P < .009) but only in obese hypertensives. Multiple regression analysis indicated that ET-1 plasma levels remain an independent predictor of MBP/ 24 h and LVM/H also when age was included in the analysis. These data suggest that obesity-associated hypertension is characterized by an endothelial dysfunction that may contribute to the higher cardiovascular risk detectable in these patients.
Adult↗
Effects of heredity, age, weight, puberty, activity, and calcium intake on bone mineral density in children.
Osteoporosis is a disease that plagues older individuals, particularly women. At the usual age of diagnosis, limited therapy is available. By further delineating the factors that influence bone mineral acquisition before peak bone density is achieved, individuals at risk may be identified at an earlier age when therapies may be more effective. This was a study of 16 family units, 16 mothers, eight fathers, and their 28 children between the ages of 5 and 20 years. The evaluation consisted of a focused history, Tanner staging of adolescents, anthropometric data (height, weight), and spinal bone mineral density (BMD) by DEXA (dual-energy x-ray absorptiometry). Bone mineral density in the children was compared with multiple environmental factors. Bone mineral density Z-scores were then compared between children and their parents. Variables found to be positively correlated with children's BMDs were: age (r = 0.94, P < 0.001), Tanner stage (r = 0.90, P < 0.001), weight (r = 0.88, P < 0.001), height (r = 0.81, P < 0.001), and body mass index (r = 0.77, P < 0.001). No association was found between calcium intake and BMD, owing possibly to increased calcium intake among children with a family history of osteoporosis. Activity was not significantly associated with BMD. Significant correlations were noted between the children's BMD and that of their father's (r = 0.83, P = 0.01), premenopausal mother's (r = 0.58, P = 0.03), and midparental (the mean value of both parents' BMDs) (r = 0.86, P = 0.01). These data suggest that children who have parents affected by low BMD may be at risk for low BMD themselves.
Absorptiometry, Photon↗
Retroperitoneal abscesses--rare causes and atypical manifestations: report of two cases.
Retroperitoneal space abscesses are a life-threatening illness which is difficult to diagnose and treat because of both their rarity and insidious clinical manifestations. The insidious development of this illness is a challenge for all medical and surgical subspecialists. The discovery of the real source of the infection is very important but not always possible, and knowledge of the anatomy and borders of the retroperitoneal space is helpful in understanding all such atypical cases and for establishing a definitive treatment. Two cases are reported that are both characterized by rare causes, uncommon development, and atypical manifestation. The normally undefined inferior borders of some parts of the retroperitoneal space or previous retroperitoneal surgery could have been the cause of the abnormal and misleading development of the abscesses. Chronically infected organs can be the true origin of this abscess, and their discovery in a nonemergency situation is mandatory for complete surgical treatment. These cases show that knowledge of the anatomy of the retroperitoneal space is important to establish the suspicion of an abscess, to understand its manifestations, which are sometimes caused by a rare pathophysiology, and to initiate appropriate treatment.
Abdominal Abscess↗