Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma最新文献

We examined retrospectively the records of 108 patients with blunt renal trauma to determine the importance of echography as radiological investigations in minor renal trauma. Of patients 62 (66.6%) had a minor renal injuries, 21 (22.5%) had a moderate injuries and 10 (10.7%) had a major renal renal injuries. All patients who had microscopic hematuria without shock or other associated injuries had minor injuries. Echography and excretory urogram (IVP) confirmed the injuries except in 5 cases who presenting with only gross hematuria and the IVP don't confirmed the presence of a subcapsular hematoma identified by echography. Echography was more sensitive and specific than an IVP in minor renal trauma. Radiological investigations are not needed in those with microscopic hematuria and no shock or associated injuries, however we prefer performing ever an echography for medical and legal risk because a microscopic hematuria may include a neoplasm or other lesions.

The authors report a clinical case of endometriosis the abdomen rectum muscle, in woman 28 years old, after a cesarean section delivery. On the basis of literature on the topic, the following are taken into consideration, the incidence, the pathogenesis, the clinical characteristics of this kind of pathology and the aspects which might facilitate the diagnostic approach and correct therapeutic to be given or follow. Parietal endometriosis is an extremely rare disease with incidence in feminine population of 0.03-1%. The pathogenesis is still ill-known. Lack of the classical symptoms and the unusual site can make diagnosis difficult. Pathognomonics but not always present are the presence of tumescence palpable of the abdominal wall near or proximity of preceding surgical scar, the cyclic character of painful symptomatology, the augmentation of volume and the bleeding in period menstrual or premenstrual. The ultrasonography, the computerized axial tomography, the nuclear magnetic resonance can facilitate the preoperative diagnosis but they do not always furnish reports of certainty. The aspirate-needle in ultrasonography control can furnish one of orientation diagnosis. The diagnosis of certainty is founded on the histologic examination after biopsy or excision. The treatment of the abdominal wall endometriosis is surgically essential. The excision of tumescence, easy usually, it is the only means to obtain the definitive recovery. The medical therapy postoperative is adjuvant in the treatment of unrecognized pelvic centres of endometriosis.

Laser energy is widely used in medical sciences nowadays. Recently it has gained importance in urology as an alternative treatment, less invasive than conventional surgical approaches, to benign prostatic hypertrophy (BPH). The Authors present a review of the literature describing the different approaches to the laser treatment of BPH: visual laser ablation of the prostate (VLAP), TULIP, contact vaporization and interstitial laser therapy. They try to show vantages and limitations of this technique respect to conventional surgery. They also present their personal experience with VLAP. They conclude that prostate laser therapy is an alternative to TURP for patients suffering for uncomplicated BPH of small to medium volumes (< 40 ml). According to literature's data and personal experience, it seems that VLAP, the easiest technique, is able to achieve the best results.

Lipid peroxidation plays an important role in the pathogenesis of several neonatal complications. To improve the knowledge on the antioxidant lipid-soluble defenses in neonatal age, we investigated a group of healthy full-term infants and their mothers measuring by high-pressure liquid chromatography the levels of vitamin E and carotenoids. Our data demonstrate that neonatal levels of lipid-soluble anti-oxidants are lower than the maternal ones. Moreover we show that neonatal Vitamin E and carotenoid concentrations are respectively unrelated and strictly related to maternal levels of the same lipid-soluble anti-oxidants.

Objectives: To analyze the presence of bovine beta-LG in breast milk.

Methods: Human milk samples from 14 healthy non-atopic women on diets with different cow's milk contents were examined. The total concentration of beta-LG immuno-like proteins (beta-LGIP) was determined by enzyme linked immunosorbent assay (ELISA). Identification of antigens was done by N-terminal sequencing.

Results: beta-LGIP reactivity of the milk from subjects on different diets was not significantly different. Human lactoferrin, beta-casein and alpha-lactalbumin, were identified as cross-reacting antigens.

Conclusions: False-positive results in ELISA determinations of bovine beta-LG in human milk might be due to cross-reactions between polyclonal antibodies and different protein antigens.

Several studies have focused on the composition of macro- and micro-nutrients of human milk in order to define a gold standard for the composition of infant formulas. Human milk contains animal-fats mainly characterized by the presence of long-chain polyunsaturated fatty acids (LCPUFA) of both the n-6 and n-3 series which have structural and functional roles, particularly in preterm infants. It is still discussed whether dietary LCPUFA may have positive effects on the neurodevelopmental steps of term infants too. Nucleotides are low-molecular weight compounds. They seem to enhance the intestinal growth and maturation as well as the immune function, and play a role in energy metabolism. Selenium is involved in protective reactions. Despite there is no scientific consensus to support the use of LCPUFA in term formulas, it is advisable to improve formulas just to approach more closely the composition of human milk. As long as nucleotides are concerned further studies must be carried out in order to define their efficacy and safety. The potential generation of hydroxy radicals from the new molecules added to formulas point out also the protective role of antioxidant molecules such as selenium in infant nutrition.

The early stages of acute acalculous cholecystitis (ACC) have been difficult to investigate due to the animal models developed and utilized over the past years. A new model of animal AAC induced by intra-abdominal sepsis is presented. Under general anesthesia 35 guinea pigs underwent laparotomy. The designed model included ligation and prick of the caecum in 25 animals (group A), while 10 animals served as control group (group B). Seven days after these experimental procedures animals underwent relaparotomy and were submitted to cholecystectomy and sacrifice. Histological studies of the specimen revealed various degrees of cholecystitis in all the gallbladders of survived animals from group A. Gallbladders of animals from group B were histologically normal. Gallbladder bile of 15 survived animals from group A were cultured. Bile cultures were negative in 10, while culture of gallbladder bile were positive in 5; the pathogen cultured were Streptococcus Faecalis and Streptococcus Sp. The results of this study suggest that intra-abdominal sepsis induces gallbladder inflammation of various degrees. This directly supports the theoretical relationship indicating that sepsis and shock could produce AAC. Moreover this model proved that AAC, in early stages, is primarily induced by inflammatory processes, while infection of the bile do represent a late event.

The ability of (R)-alpha-methylhistamine, the selective agonist of histamine H3 receptors, to reduce ethanol-induced gastric damage was examined in the rat. (R)-alpha-methylhistamine (1-100 mg/kg intragastrically) caused a dose-related reduction in the amount of damage produced by ethanol. This protective effect was not shared by the S enantiomer of alpha-methylhistamine. Thioperamide, selective H3 receptor antagonist, inhibited the protective effect of 10 but not 100 mg/kg of (R)-alpha-methylhistamine. Pretreatment with (R)-alpha-methylhistamine, 100 mg/kg i.g., resulted in a significant increase in the thickness of adherent mucus gel layer, which may contribute to the protective action of the compound.

Brainstem evoked responses audiometry was performed on 10 newborn infants. They ranged in postnatal age from 19 hours to 5 days and in estimated gestational age from 39 to 42 weeks. Clicks of 0.1 msec duration were presented at a rate of 11.4 per second. Measurements were made at 50, 80 and 100 dB. Wave V latencies were evaluated at 50, 80 and 100 dB HL in order to measure the auditory threshold. The latency of wave V is the datum of interest. Wave V responses were obtained bilaterally at 50 dB HL. Waves I and III latencies were measured at 100 dB HL.

Despite the tendency toward sphincter-saving surgical procedures, a small proportion of rectal cancers must still be treated by abdominoperineal resection (APR). The physical, psychological and social consequences of a permanent abdominal stoma are a challenge to perform a continent perineal colostomy. Most of the attempts originate from experiences with gracilis muscle transposition in the treatment of fecal incontinence, in particular Pickrell's operation. Functional results are however conditioned by the fact that the transposed muscle takes up a different function and its natural evolution, if not adequately stimulated, consists of atrophy and fibrosis. The most important series of graciloplasty in APR is reported by Cavina and coworkers (75 cases from 1985 to 1993), who at first obtained good functional results by external electromyostimulation (EMS) and biofeedback, then registered a further improvement using internal, continuous low-frequency EMS by implantable pulse generators (IPG). The surgical technique involves, after APR: bilateral dissection of the gracilis up to the proximal neurovascular pedicle and detachment of the distal tendon; mobilization of the muscles, through the subcutaneous tissue, into the perineum, where the colonic stump is drawn out; positioning the right gracilis behind the colonic stump, as a puborectalis sling, and the left gracilis around it, in a sort of "alpha" configuration; suturing the colonic stump to the perineal skin; optionally, temporary diverting loop colostomy. The operation is completed by the insertion of two electrodes near the nerve, for external or internal EMS (in the last case: implantation of IPG). The external EMS may be carried out by current cardiac temporary electrodes, drawn up through the skin of the iliac area. It is aimed at preserving the trophism and the contractility of the muscle and enabling the patient to learn a new function of continence (actually, it is a "pseudocontinence"), thanks to a program of intermittent stimulation and biofeedback. Electrodes and other devices are not expensive. The internal EMS requires specific electrodes, connected to an IPG, implanted in a subcutaneous abdominal pocket. The continuous stimulation gives rise to a tonic activity of the gracilis, resulting in higher resting anal pressure and "true" continence. The IPG is programmed under telemetry control, step by step until the most suitable EMS parameters are reached. A magnet allows the patient to turn the IPG "off" of "on", according to the necessity to void the bowel. A complete set of 1 IPG and 2 electrodes costs about $10,000. Cavina reports good continence in 71% of the cases treated by external EMS and 100% of the patients with IPG. Our first graciloplasty in APR was performed in April 1994. Since then we have carried out 6 operations. Because of its high cost, we decided that, at least at a first phase, the IPG should be implanted, from the 7th month on, only in disease-free patients,