Acrofacial dysostosis syndromes: a relevant prenatal dilemma. A case report and brief literature review.

The acrofacial dysostosis (AFD) syndromes are an heterogeneous group of disorders with undefined classification and inheritance. We report the sonographic and clinical features of an AFD fetus with predominantly pre-axial forms. We made a prenatal diagnosis of Nager syndrome but postnatal examination showed post-axial defects previously undetectable by ultrasound.

Minilaparotomy vs laparotomy for uterine myomectomies: a randomized controlled trial.

AIM: To evaluate the efficacy and applicability of the minilaparotomy technique in abdominal myomectomies and to compare it with traditional laparotomy. METHODS: We enrolled 99 women, suffering from symptomatic uterine myomas, to be operated for myomectomy. Through computer randomization, 55 women were assigned to the study group (minilaparotomy) and 44 women to the control group (traditional laparotomy). Women assigned to the study group were operated using a recently modified minilaparotomy technique. Statistical evaluation was performed through Mann-Whitney U test, chi2 test, Student's t-test. RESULTS: Duration of surgery, time for spontaneous recanalization and days of postoperative hospital stay were significantly lower in the study group, as well as treatment satisfaction reported by the patients (p<0.05). Moreover, each minilaparotomy operation ended by saving 620 Euro. CONCLUSIONS: Minilaparotomy seems to be a valid alternative to the removal of symptomatic uterine myomas. The objective and subjective advantages in operated patients, as well as the reduction in sanitary costs are underlined.

Computed tomographic scans in posttraumatic epilepsy.

The occurrence of posttraumatic epilepsy was studied in 219 patients who had had a computed tomographic (CT) scan within three days after a civilian head trauma. Posttraumatic epilepsy was observed in 13 patients. All of them had focal brain damage shown by CT scan. The predicting power of both clinical risk factors and CT scans was analyzed by multiple logistic regression. Only an intracerebral hemorrhage and intracerebral hemorrhage plus satellite extracerebral hematoma proved significantly associated with posttraumatic epilepsy. This result has important implications in the design of posttraumatic prophylaxis trials.

The prevalence of lingual-facial-buccal dyskinesias in the elderly.

We examined an unselected sample of 398 subjects aged 67 to 87 years. Only six (1.5%) subjects presented lingual-facial-buccal dyskinesias (LFBD). LFBD, therefore, are rare neurologic manifestations. They are more frequent in women than in men and in more elderly subjects. Furthermore, in three of six cases, they were associated with senile dementia. Previous studies performed on hospital-based populations probably overestimated the prevalence of LFBD.

Prevalence of Parkinson's disease in the Republic of San Marino.

A prevalence survey on Parkinson's disease (PD) was performed in the Republic of San Marino, which is the smallest independent state in the world, and is located near the Adriatic coast, within Italy. On April 30, 1986, it had a population of 22,322. We found 34 cases of PD (17 men, 17 women). Crude prevalence ratio per 100,000 population was 152 (154 for men, 150 for women) with an age-adjusted ratio of 185 (both sexes). This study shows that the prevalence of PD in the Mediterranean area of South Europe is similar to that in North Europe and the United States.

Abscess formation at the ischiorectal fossa 7 months after the application of a synthetic transobturator sling for stress urinary incontinence in a type II diabetic woman.

A 50-year-old diabetic woman was referred to our unit because of high fever, foul-smelling vaginal discharge and pain in the leg, 7 months after undergoing surgery for application of a transobturator suburethral sling. Patient evaluation revealed erosion of the tape through the vaginal wall; the infection had spread to the region of the internal obturator muscle and then up to the anterior recess of the ischiorectal fossa. The patient underwent surgery for sling removal, antibiotic therapy and, finally, surgical incisions to facilitate drainage of the abscess. All these passages were necessary to obtain complete resolution of the symptoms. Infectious complications are possible after transobturator sling procedures. Patients should then be informed about the risks of erosion and infection and be warned that the appearance of pain and foul-smelling vaginal discharge may indeed be the first symptom of subsequent and much more severe infectious complications.

[Release of antigens into the culture medium by LS fibroblasts in culture]. / Cessione di antigeni al terreno da parte di fibroblasti LS in coltura.

LS fibroblasts cultivated for 1 or more days in unsupplemented Eagle's MEM release antigens into the medium, without showing any evidence of lysis, but on the contrary continuing to proliferate. These antigens give up to three precipitation lines when tested by means of immunodiffusion and immunoelectrophoresis against specific rabbit antisera; one or two of them give identity reactions with antigens obtained by repeatedly washing the fibroblasts with balanced salt solutions. Evidence has been obtained that they are surface components, easily stripped or spontaneously shed by the cells.

[Growth of the Yoshida ascites/hepatoma in co-culture with rat fibroblasts]. / Osservazioni sulla crescita dell'epatoma--ascite di Yoshida in cocoltura con fibroblasti di ratto.

Ascites hepatoma cells (Y) co-cultured with rat fibroblasts (F) in Dulbecco-Eagle's MEM (DMEM) proliferate rapidly in suspension, at a rate consistent with that shown in vivo after intraperitoneal injection; the population doubling time is about 1 day. The log phase of growth may be retained indefinitely, provided fresh medium is supplied regularly and the F monolayer is changed when necessary. The tumorigenicity is preserved. To maintain a high rate of growth the presence of F seems important: in this study, culturing without F in various media at best only sustained slow proliferation rates; this is in keeping with the notion of normal tissue components supplying useful factors to the neoplastic cells. Adding minced polyester surgical thread (Mersilene - M) into the co-cultures slowed down the growth of Y to some extent, yet no evidence has been obtained of toxic compounds released by M.

[Interaction of the 3rd component of complement (C3) with the surface of LS murine fibroblasts]. / Interazione tra terzo componente del complemento (C3) e superficie di fibroblasti LS di topo.

LS fibroblasts grown in suspension culture fix C3 on their surface when they are incubated with human or guinea pig complement as shown by reacting te cells with FITC-labelled anti C3c sera or immunoglobulins. At the same time the lytic activity of complement is lowered and aliquots of C3 are subtracted from the sera following incubation with the cells. EDTA - EGTA experiments and other observations suggest that C3 fixation requires activation, which proceeds via the alternative pathway, in much the same manner as it has been reported for limphoid cells and thymocytes.

[Action of high temperature on the integrity of LS fibroblasts. I. Effect of culture in the presence of sucrose]. / Azione di temperature elevate sulla integrità dei fibroblasti LS. Nota I: Effecto della coltura in presenza di saccarosio.

LS fibroblasts which have accumulated sucrose into cytoplasmic vacuoles during 4 days are more fragile than normal controls when they are exposed to temperatures between 45 degrees C and 60 degrees C. Continuing to cultivate for 6 more days in the presence of sucrose apparently improves the resistance of the vacuolated cultures to the damaging temperatures, possibly because of a selective enhancement of the more resistant cells.

[Action of high temperature on the integrity of LS fibroblasts. II. Effect of duration of presence in a medium containing sucrose]. / Azione di temperature elevate sulla integrità dei fibroblasti LS. Nota II: Effetto della diversa durata di permanenza in terreno contenente saccarosio.

The resistance to high temperatures of LS fibroblasts starts lowering quite rapidly when the cells have been suspended in a culture medium containing sucrose. On the other hand, transferring back to normal medium for increasing times cells cultivated for 4 days in the presence of sucrose seems to gradually improve their resistance.

Lowered resistance to lytic agents in sucrose vacuolation.

Vacuolation in fibroblasts cultivated in the presence of sucrose is associated with progressive accumulation of the undigestible sugar. In radioisotope experiments the process lasted several days, and when the cells were subcultured back into a medium devoid of sucrose the label was also lost after several days. This type of vacuolated cells is more fragile when it is challenged with lytic agents. 51Cr-labelled LS fibroblasts released more radioactivity when they had been growing in the presence of sucrose, whether they were suspended in media of decreasing osmolarity, in dilutions of various surfactants, exposed to high temperatures, or subjected to mechanical stress. It is concluded that these cells exhibit a lower resistance when exposed to unfavourable environments, but retain their viability in growth media despite some morphological and biochemical alterations.

[Observations on cytolysis by cobra venom. Effect of sucrose loading]. / Osservazioni sulla citolisi da veleno di cobra. Effetto del carico con saccarosio.

LS cells cultivated for 4 days in sucrose-containing medium (Su) are more fragile than cells cultivated in medium devoid of this sugar (TN) when they are incubated with Naja-Naja venom; in fact the 51Cr radioactivity released into the medium by previously labelled cells is increased for the sucrose ones. Phospholipase does not seem to contribute to the lytic activity of the venom, which is dependent on the direct lytic factor: neither varying the temperature of incubation nor adding EDTA to the incubation medium modifies the results. Adding Ca++ decreases the 51Cr radioactivity released particularly by the cells grown in TN, suggesting a stabilizing action of this cation.

Slowly progressive ischemic stroke as first manifestation of essential thrombocythemia.

We report a case of essential thrombocythemia, the only clinical manifestation of which consisted of neurologic symptoms, including anomic aphasia, tactile and painful hypesthesia in the right hand, headache, and Gerstmann syndrome, with a relatively benign and slowly progressive clinical course. Neuroradiologic examination disclosed a large ischemic area in the left temporoparietal region. Cerebral angiography revealed an occlusion of the cortical branches of the left middle cerebral artery with total sparing of the carotid vessel. These findings are discussed in relation to the possible pathogenetic mechanisms of the vascular occlusion due to abnormal platelet function in essential thrombocythemia.

[Interference of inflammation caused by polyester with the growth of Yoshida ascite hepatoma. IV. Modifications of the sedimentation profile of the hepatoma cells]. / Interferenza dell 'infiammazione da poliestere con la crescita dell'epatoma ascite di Yoshida. IV. Modificazioni del profilo di sedimentazione delle cellule dell'epatoma.

It was previously shown that Yoshida's ascites-hepatoma cells (Y cells) intraperitoneally injected into rats carrying chronic inflammation caused by polyester thread rapidly disappear. In this paper the sedimentation rate in a continuous Percoll gradient at unit gravity (1 g) using the CELSEP apparatus (Sorvall), the mean diameter and volume of the Y cells harvested from the peritoneal cavity of untreated (NT) and polyester-treated (TM) animals were determined at 6-12-18-24 hours after the inoculum. At 6 hours a number of Y cells appeared enlarged both from TM and NT rats, while afterwards, and notably at 18 and 24 hours, their size was decreased and their sedimentation rate was reduced only in TM animals. It seems that the chronic inflammation causes alterations both in the size and in the density of the Y cells and probably one of the mechanisms of their death is through shrinkage and apoptosis.

[Interference of inflammation caused by polyester with the development of Yoshida ascite hepatoma in rats. V. Study of cytotoxicity in vitro]. / Interferenza della infiammazione da poliestere con lo sviluppo dell'epatoma-ascite di Yoshida nel ratto. V. Ricerca di citotossicita' in vitro.

It has been known for some years that rats developing a granulomatous inflammation following the intraperitoneal injection of fragments of a polyester suture thread (Mersilene, M) reject a graft of 10(8) Yoshida's ascites hepatoma cells, which on the contrary rapidly grow in M-uninjected animals, originating an ascites tumor and killing the rats in a few days. In this paper granulomatous (TM) and normal (control, C) small pieces of peritoneum (omentum, mesentery and parietal) have been cultivated for 15 h in Eagle-Dul becco's medium together with 10(5) 51Cr-labelled hepatoma cells: the release of the label, an index of cell lysis, was considerably higher in the TM cultures, suggesting a cytotoxic activity of some components of the granulomas. Differences have been observed in the amount of radioisotope released among the TM cultures, suggesting that the particular composition of the cell population may be relevant to the cytotoxicity versus the hepatoma cells.

Dementia in subjects over 65 years of age in the Republic of San Marino.

A study on neurological conditions was performed in the Republic of San Marino, which is the smallest independent state in the world (60 km2, 21,792 people). We personally examined or collected information on all people born in 1898, 1903, 1908, 1913 and 1918 and living in the Republic of San Marino on 31 July 1985. We found 29 people out of 488 with mild to severe dementia. Frequency of dementia increased progressively with age, from 1.8% among 67-year-olds to 25% among 87-year-olds. In women the increase was due mainly to primary degenerative dementia, whereas in men other types of dementia were involved. Our study shows a female/male ratio of more than 2:1 for primary degenerative dementia even considering mild dementia, and this form of dementia represents about 50% of all types of dementia. We found an association between severe auditory loss and primary degenerative dementia.