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

The funds to grant for a scientific research project are more and more interesting public and private administrations. A quantitative analysis of experimental research prices in all its phases is mandatory for an optimization process. The aim of this paper is to define practical and economical aspects of the experimental 'in vivo' models designed for the validation of biomaterials, with particular respect to the managerial bookkeeping of consumer goods, based on the experience of our Institute. Some tables were realized in order to quantify the resources needed to perform experimental 'in vivo' models. These tables represent a reliable tool for a continuous monitoring of managerial costs for the current year and for an accurate budget planning for the future years considering the experimental projects in progress and the planned researches. A business organization of public research facilities may lead to an optimization of costs and an easier national and international funds achievement increasing, also, the partnership with private appointers.

The tumors of the small bowel are uncommon. About one-third are jejunal, for the most part adenocarcinomata. From 1976 to 1994 we operated on 8 patients affected by jejunal adenocarcinoma, mean age 59 years (+/- 15.2), range 37-78, which are 0.33% of all the malignant epithelial neoplasms of the digestive tract, treated in the same period. In six cases the diagnosis was preoperative, by x-ray or instrumental investigations. In the other two patients the neoplasm was found intraoperatively. Only five operations were curative. In six cases the neoplasm invaded the serosa and, in three, also the mesenterium. A chemotherapy was carried out in the last five patients. One of these underwent right hepatectomy for single metastasis, 26 months after the primary operation. Until now we registered three deaths, one of which for causes unrelated to the cancer. After discussing epidemiology and diagnostics, the authors evaluate the therapeutical possibilities, mainly consisting of surgery, and dwell upon technical aspects and results.

Electrocochleography (ECoG) is an electrophysiologic approach to the study of hearing. In ECoG, electrical activity that originates within the cochlea or the auditory nerve is recorded. ECoG represents an evoked or stimulus dependent measure. The electrical potentials which can be analyzed in ECoG are: the cochlear microphonic potential (CM), the summating potential (SP) and the acoustic nerve potential (AP). Two major types of electrocochleography electrodes can be used, transtympanic and extratympanic. Transtympanic ECoG is performed by inserting a long needle electrode, placed through the tympanic membrane onto the promontory. Extratympanic ECoG is recorded by using electrodes placed within the external meatus near the tympanic membrane. At the ENT Department of the University of Parma, ECoG was performed in 10 normal hearing subjects (4 males and 6 females. Their ages ranged from 21 to 29 years (mean 26 years). All subjects underwent ECoG recording simultaneously with extratympanic and transtympanic technique.

Hepatitis B virus (HBV) infection usually leads to self-limited acute hepatitis with complete recovery of the patients and clearance of the virus from the circulation. However some patients (5 to 10%) do not clear the virus and they become chronic carriers, with or without evidence of liver disease. The sequence of events leading to clearance or persistence of HBV in the infected organism are still largely unknown. Based on available data derived from studies in HBV and in other viral systems, it is generally assumed that a human leucocyte antigen (HLA) class I-restricted cytotoxic T lymphocyte (CTL) response to one or more HBV-encoded antigens displayed at the hepatocyte membrane is a major effector mechanism of hepatocellular injury and clearance of infected cells. Elucidation of the immunological and virological basis for HBV persistence may yield immunotherapeutic strategies to terminate chronic HBV infection.

We present our experience in the treatment of middle-lower rectal cancer particularly in reference to the use of those operative techniques which permit to save the sphincteric system. From 1990 to April 1995 seventy-two patients were operated on for middle-lower rectal cancer applying the Knight-Griffen technique. Such a method has already demonstrated the characteristics of a valid anastomosis, being simple, fast and safe. The introduction of stapler devices in the rectal surgery, particularly in its middle-lower tract has significantly modified the quality of life of such patients, reducing drastically the number of colostomies. The possibility to extend the rectal resection towards the anus with colo-anal anastomosis has showed a loco-regional recurrence rate not different from abdominal-perineal resection, even though with some sphincteric troubles due to incontinence. The satisfying surgical results obtained with low and ultra-low recta resections, by now widewordly accepted, should not anyway mask the importance of an early diagnosis as the main factor governing the prognosis (i.e. the overall mortality).

Persistent pleural space must be considered a possible complication after lung resection surgical treatment. Although in most cases the evolution is favourable, the authors suggest the use of the "pleural tent" technique, that compared to others thoracoplasty procedures offers some advantages. A short historical review of the thoracoplasty techniques is presented together with a detailed description of the above-mentioned technique.

Open adrenalectomy needs surgical incisions often large and traumatic, with a not negligible morbidity. Laparoscopic adrenalectomy, according to the experiences reported in the literature, certainly initial, but nevertheless considerable, seems to offer a sound option and will probably become one of the strongest indications of the minimal-access surgery of the retroperitoneal space. Operative times are certainly longer initially than in open surgery but morbidity is very low and mortality almost nil. The authors make a review of the literature about laparoscopic adrenalectomy with about 400 operations collected, analyzing the results and the technical details. The collected data support the conclusion that the adrenal pathology, with the exception of the malignant tumors, will be treated in the future mainly laparoscopically. Even the size of the tumor, in case of a not malignant mass, can not be considered probably a true contraindication.

The cells of vallate, foliate and fungiform papillae were studied in insectivore hibernating bats (Pipistrellus pipistrellus and Rhinolophus ferrumequinum) in the various epochs of the year in order to show cell types the seasonal changes. On the basis of the ultrastructural aspects and the relationships with nerve endings, besides the few basal cells, three types of sensorial cells can be identified: dark type I cells, light type II cells and light type III cells. All gustatory cells, long and narrow shaped, extend from the epithelial basal lamina to the gustatory canal, where they send long microvillous expansions of the apical cytoplasm. These expansions, except those of the fungiform papillae which never extend beyond the lower two thirds, usually reach the external opening of the taste pore, always completely void of dense substance. Dark type I cells are characterized by a developed RER and large granules. Light type III cells show peculiar dense core light vesicles, labelled protein A-gold particles immunoreactive to 5-HT. These cells only in the foliate and fungiform papillae also have bundles of microtubules whose function is still unknown. After comparative evaluation and discussion of topographical and ultrastructural aspects with those of other mammals and humans, the Authors states that bats are provided with a valid gustatory system and that all cell types are involved in taste transduction.

After a brief historical view, we describe the basic technique currently used to create percutaneous portosystemic shunt. Between September 1992 and March 1995, TIPS was achieved in 50 out of 52 patients; main indications included bleeding from esophageal or gastric varices and refractory ascites. The mean portal pressure reduction was 14.9 mmHg and the mean residual portosystemic gradient was 10.5 mmHg. The average follow-up time was 11.8 months; in this period the overall mortality rate was 28%, while rebleeding occurred in 8 patients and new onsets of encephalopathy occurred in 4 cases. The major problems were due to shunt related complications observed in 46% of the patients; close follow-up and reintervention are required to keep the shunt previous. TIPS, developed ad an alternative to surgery and endoscopic sclerotherapy, is an effective and relatively safe procedure for the treatment of symptomatic portal hypertensive patient.

A total of 118 patients entered into a pharmacological erection program using prostaglandin E1 (PGE1) from September 1994 to November 1995. Of the men 20 (16.9%) used PGE1 on a regular basis, median duration of drug use was 4 months with a range of 2 to 14 months, while 66 (55.9%) failed to continue in the program after the dose titration period, (median duration of drug use 6 weeks), 32 (27.1%) failed to initiate PGE1 pharmacological erection program. There have been no instances of cavernous fibrosis, systemic reaction, penile pain after injection or priapism (erection present longer than 4 hours) in any patient; 24 (20.3%) men were unable to achieve an adequate erection with PGE1 intracavernous injections. PGE1 appears to have a lower risk of prolonged erections than other intracavernous agents and will continue to increase in popularity. However we report an interesting number of men who fail to continue (55.9%) or fail to initiate (16.9%) PGE1 therapy.