Abdominal pain in children: a case of acalculous cholecystitis.

Acalculous cholecystitis is a rare disease in children. Most cases are associated with systemic infections or with autoimmune pathologies, but it may also occur without predisposing factors. A case observed in an otherwise healthy child is reported.

[Conservative treatment of post-traumatic hepatic hematoma. Case reports]. / Trattamento conservativo dell'ematoma epatico post-traumatico. Casistica clinica.

Post-traumatic hepatic haematomas may need surgical or conservative treatment. TC allows exact stadiation of hepatic lesions, detecting those mandatory for surgical approach. Haemodinamic unsteadiness and/or necessity of > 40 ml/kg blood transfusion suggest serious uncontrollable bleeding, that is surgical emergency. Three cases of post-traumatic heapatic haematomas recovered after conservative treatment (clinical, haematological and radiological survey) are described.

[Recto-cutaneous penile fistula. A description of a clinical case and review of the literature]. / Fistola retto-cutanea peniena. Descrizione di un caso clinico e revisione della letteratura.

This describes a newborn with an imperforate anus associated to a fistulous track extending along the scrotal raphe and opening at the penis top. This variant appears to be a low anomaly. The surgical treatment of this pathology is discussed.

Apparent preferential loss of heterozygosity at TSC2 over TSC1 chromosomal region in tuberous sclerosis hamartomas.

To investigate the molecular mechanisms of tuberous sclerosis (TSC) histopathologic lesions, we have tested for loss of heterozygosity the two TSC loci (TSC1 and TSC2) and seven tumor suppressor gene-containing regions (TP53, NF1, NF2, BRCA1, APC, VHL, and MLM) in 20 hamartomas from 18 TSC patients. Overall, eight angiomyolipomas, eight giant cell astrocytomas, one cortical tuber, and three rhabdomyomas were analyzed. Loss of heterozygosity at either TSC locus was found in a large fraction of the informative patients, both sporadic (7/14) and familial (1/4). Interestingly, a statistically significant preponderance of loss of heterozygosity at TSC2 was observed in the sporadic group (P < 0.01). Among the possible explanations considered, the bias in the selection for TSC patients with the most severe organ impairment seems particularly appealing. According to this view, a TSC2 defect might confer a greater risk for early kidney failure or, possibly, a more rapid growth of a giant cell astrocytoma. None of the seven antioncogenes tested showed loss of heterozygosity, indicating that the loss of either TSC gene product may be sufficient to promote hamartomatous cell growth. Finally, the observation of loss of heterozygosity at different markers in an astrocytoma and in an angiomyolipoma from the same patient might suggest the multifocal origin of the second-hit mutation.

[The human tail. Report of a case of coccygeal retroposition in childhood]. / Osservazione di un caso clinico di retroposizione coccigea in età pediatrica.

The authors explain a little patient's case of coccydynia by back-position of the coccyx; the patient underwent an operation of partial resection with favourable clinical outcome. According to classification, the treated case corresponds to vestigial tail.

Renal and hepatic angiomyolipomas in a child without evidence of tuberous sclerosis.

A renal neoplasia, displaying the typical features of angiomyolipoma (an admixture of smooth muscle cells, mature adipocytes and tangles of thick-walled blood vessels) was found in a nine-year-old boy. In addition, cytoplasmic crystalloid structures and HMB 45 positivity were found in smooth muscle cells. Similar findings were also observed in a small nodule of the liver. According to literature data, angiomyolipoma is very rare in children and almost exclusively associated with tuberous sclerosis. Our case suggest that the diagnostic hypothesis of angiomyolipoma can not be disregarded when a renal mass is identified in a young patient even in a clinical setting other than tuberous sclerosis.

[Intrahepatic gallbladder. Particulars of a case]. / Colecisti intraepatica. Particolaritá di un caso.

The Authors report a rare case of abnormal position of the gallbladder; the major therapeutical and diagnostic problems are pointed out.

[Transverse mesocolon herniation. Description of a clinical case]. / Ernia trans-mesocolica. Descrizione di un caso clinico.

A case of herniation of small bowel through a defect of the transverse meso-colon with secondary herniation through the gastrocolic ligament and re-entry into the greater peritoneal cavity is reported. This form of lesser sac hernia is rare and only one hundred half cases have been reported in literature.

[The autologous splenic reimplant in the rat]. / Reimpianto splenico autologo nel ratto.

In order to evaluate the clinical utility of autologous splenic transplantation in the omental pouch, a pneumococcal challenge was performed in 3 groups of rats, after demonstration of vitality of the intraperitoneal inoculum: Group A: splenectomized rats; Group B: reimplanted rats; Group C: sham operation. No statistically significant difference was found between the first two groups regarding resistance against infection (p less than 0.982), while normal rats proved more resistant (p less than 0.031). Between group A and B significant differences (p less than 0.001) exists only for a more precocious mortality in the first group. The poor clinical utility of the technique is demonstrated.

[Adnexal torsion in childhood]. / Torsione degli annessi in età pediatrica.

Five cases of torsion of normal uterine adnexae are reported in children aged 9 to 13 years. From this series, the authors review the clinical and ultrasonographic features of the torsion of normal uterine adnexa. Ultrasonography should be performed in emergency as the conservation of the ovary depends on the precocity of diagnosis and treatment.

[The multilocular cystic nephroma in childhood. A case report]. / Nefroma cistico multiloculare in età pediatrica. Presentazione di un caso.

A recently observed case of multilocular cyst of the kidney is reported. The differential diagnosis between Wilm's tumor and multilocular cyst of the kidney is pointed out.

[Amniotic band syndrome. Clinico-therapeutic considerations on 3 cases]. / Sindrome da briglie amniotiche. Considerazioni clinico-terapeutiche su tre casi.

In three patients with "Congenital Annular Constricting Bands Syndrome" the monstrous leg and foot lymphedemas were aesthetically and functionally cured using the two-stage Ombredanne's crown-like operation. Plaster splints were useful in curing and consolidating the tibia and fibula pseudoarthrosis present in one case and in curing the clubfeet present in the other two cases. Some consideration is made to the different etiopathogenetic theories, proposed in the past and recently, to explain this syndrome.

[Apple-peel syndrome. A clinical case report and therapeutic considerations]. / Apple-peel syndrome. Osservazione su un caso clinico e considerazioni terapeutiche.

A recently observed case of proximal jejunal atresia with apple-peel syndrome and associated multiple ileal atresia is reported. Some clinical and anatomopathological features are pointed out. Surgical techniques and medical care are analysed.

Study on the ATPasic lymphocytic activity during menstrual cycle.

We previously studied ATPasic activity in the lymphocyte according to sex, age and in pregnant women. Now we considered it is interesting to go on with out study with the dosage of ATPasic lymphocytic activity during menstrual cycle, monitored with basal temperature method. The methodology we followed is Ellegaard and Dimitrov one of 1972, with modifications and simplifications while the proteins dosage in the supernatant has been effected with biuret method. Our data showed a decrease of the ATPasic lymphocytic activity at the middle of cycle for ovulatory cycles, while there is no difference between data at the middle of the cycle and in menstruation for cycle without ovulation. We suppose a connection between ATPasic lymphocytic activity and the hormones which stimulate ovulation.

Study of the ATPasic lymphocytic activity in the woman at the end of fertile age.

The object we propose to ourselves is to define mean values of ATPasic lymphocytic activity in different physiological conditions. This study considers the ATPasic lymphocytic activity in the woman at the end of prolific age. The methodology we followed is Ellegaard and Dimitrov one of 1972 with some modifications and simplifications; the proteins dosage in the overfloating has been effected with biuret method. No correlation between the number of months from last reported menstruation and the ATPasic lymphocytic activity has come out. Furthermore, the data woman at the end od fertile age similar to the ones of the young woman in menstrual cycle or at the middle of a cycle without ovulation. Data of aged woman, on the contrary, draw away from the data of young woman at the middle of an ovulatory cycle. Our present intention is, at this point, to turn attention to peculiar hormonal situations, for instance in presence of an estroprogestinic therapy.