Sialic acid content in erythrocyte membranes from pregnant women affected by gestational diabetes.

Sialic acid (SA) content, membrane fluidity, and Na(+)/K(+)-adenosine triphosphatase (ATPase) activity were determined in erythrocyte membrane from 10 nonpregnant women (HNPW), 16 pregnant women affected by gestational diabetes mellitus (GDM), and 25 healthy pregnant women (HPW). In GDM patients the membrane erythrocyte SA content was significantly increased compared with HNPW and membrane fluidity was significantly increased in comparison with HPW. Erythrocyte membrane Na(+)/K(+)-ATPase activity was significantly reduced in GDM patients compared both to HNPW and to HPW subjects. A significant inverse correlation was found between 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH) anisotropy and erythrocyte membrane SA content in HNPW and in HPW, while this significant correlation was not observed in GDM. The present results indicate that in comparison with normal pregnancy GDM is characterized by deep alterations of the erythrocyte plasma membrane physicochemical properties (increased fluidity) and functional activities (reduced Na(+)/K(+)-ATPase activity). These modifications might be at the basis of the altered blood viscosity and placental perfusion observed under such conditions. Moreover, these results show that in physiological pregnancy and in the nonpregnant state, the erythrocyte surface membrane fluidity is inversely correlated with SA content, while in GDM there is an unbalance of this relation, which might be associated with the microcirculatory abnormality present in this disease.

Recurrent reflux caused by vesicoureteral fistula.

We present an unusual case of recurrent reflux on the right side after bilateral vesicoureteroplasty with modified Hutch I technique.

Pyelovesicostomy: an alternative to ureteropelvic junction-plasty in pelvic ectopic kidneys.

Pyelovesicostomy was performed in 2 cases of hydronephrosis in pelvic kidneys secondary to ureteropelvic junction obstruction. In the first patient, who presented with a solitary kidney, the procedure was done after failure of a dismembered pyeloplasty, while in the second patient the procedure was performed electively. Both patients had sterile urines and stable renal function, although some dilatation persisted in the first case. The indications and the functional aspects of this surgical solution are discussed.

Periurethral neurofibroma.

A periurethral neurofibroma presenting as a midline perineal mass was removed in a three-year-old boy. An immunohistochemical study of S-100 protein distribution within the tumor tissue was performed.

Retroperitoneal germ cell tumor in postmenopausal woman.

A fifty-four-year-old woman presented with right renal colic and three months later a retroperitoneal tumor was diagnosed. After explorative laparotomy with biopsy, which showed a germ cell tumor, the patient received external beam radiotherapy, but died of metastatic diffusion nine months later. We believe this is a rare occurrence of a germ cell tumor in a postmenopausal woman.

Cyclophosphamide, epidoxorubicin and Carboplatin as treatment for advanced-carcinoma of the bladder - a phase-ii study.

In advanced carcinoma of the bladder, the M-VAC chemotherapy schedule can yield positive results, but at the cost of very high toxicity. Recent studies have shown epidoxorubicin and to a lesser degree, carboplatin to be active against urothelial tumors, with cardiac, haematological and renal toxicity lower than that observed with CISCA or M-VAC chemotherapy regimens. In this study, we determined the toxicity and efficacy of cyclophosphamide 400 mg/m(2), epidoxorubicin 75 mg/m(2) and carboplatin 300 mg/m(2) in a 28-day course. From February 1990 to December 1991, we enrolled 33 advanced bladder cancer patients (25 males, 8 females), mean age 63 years. 31 patients were evaluable for toxicity and response. The major disease localizations were: locoregional 15 (48%), lymph nodes 6 (20%), liver 5 (16%), lung 3 (10%) and bone 2 (6%). A total of 186 cycles of therapy were administered, with a mean of 5.4 per patient. Six patients (19%) had a complete response (CR): 2 locoregional, 3 lymph node and 1 lung. Eleven patients (36%) had a partial response (PR), for an overall response rate of 55%. The median duration of response was 53 weeks and median survival for the entire group of patients was 40 weeks. No delays or interruptions due to sepsis occurred during therapy; haematological, cardiac and renal toxicity were below WHO grade 3. The efficacy of this chemotherapy regimen proved to be comparable to that of more aggressive schedules, while its toxicity was markedly lower.

[Posttraumatic functional exclusion of the kidney of nonvascular origin. Description of a case and review of the literature]. / Esclusione funzionale post-traumatica del rene da causa non vascolare. Descrizione di un caso e revisione della letteratura.

A review of published series about 56 cases with unilateral nonvisualization on excretory urography after external trauma have been described: the renal injury causing the nonvisualization was contusion in 8 patients, laceration in 13, rupture in 12 and renal pedicle in 19. The acquisition of the most important methods has allowed a total view as about minimal lesions (contusion, laceration), as rupture or fragmentation of the kidney and renal pedicle. We have evaluated 32 cases of renal traumatic injuries and we have studied one case with unilateral nonvisualization stressing the diagnostic, etiopathogenetic and therapeutic problems.

[Clinical experience in patients with chronic peripheral obliterating arteriopathy: defibrotide versus definite molecular weight heparan sulfate (MW 7500-15000 dalton)]. / Esperienza clinica in pazienti affetti da arteriopatia obliterante cronica periferica (AOCP): defibrotide versus eparan-solfato a peso molecolare definito (P.M. 7500-15000 dalton).

In a controlled study of 100 patients, mean age 65 years old, suffering from chronic peripheral obliterative arterial disease, Leriche's stage II, were randomised in two groups treated respectively with defibrotide (400 mg bid) or heparan-sulfate (40 mg bid) by the oral route for a period of 6 months. At basal and after 30, 90 and 180 treatment days, patients were assessed for pain, paresthesias, rigidity and or tiredness in the leg, Winsor index (WI) relative and absolute walking distance (RWD, AWD), and time of recovery from pain. In order to evaluate microcirculation the following parameters were tested: resting flow (RF), standing flow (SF), veno-arteriolar reflex (VAR) and a capillaroscopy study was conducted. All patients showed an improvement in the clinical and instrumental parameters but more pronounced in the defibrotide group; the difference between the beginning and the end of the therapy was significantly better for defibrotide (p < 0.01). The tolerability observed was good, no side-effects were reported during the study.

[Cystic renal disease in childhood]. / La malattia cistica renale nell'infanzia.

In the last five years, in the Surgery Pediatric Department and in the Pediatric Nephrology and Dialysis Service of the Florence University, have been observed 13 patients with cystic renal diseases. In every single case, for the diagnosis we have considered the age of the patients and the examinations made to them. We payed attention mostly to the echography considered the main diagnostic examination, even in prenatal age.

Interlateral asymmetry in the time course of the effect of a peripheral prime stimulus.

Evidence exists that both right and left hemisphere attentional mechanisms are mobilized when attention is directed to the right visual hemifield and only right hemisphere attentional mechanisms are mobilized when attention is directed to the left visual hemifield. This arrangement might lead to a rightward bias of automatic attention. The hypothesis was investigated by testing male volunteers, wherein a "location discrimination" reaction time task (Experiments 1 and 3) and a "location and shape discrimination" reaction time task (Experiments 2 and 4) were used. Unilateral (Experiments 1 and 2) and unilateral or bilateral (Experiments 3 and 4) peripheral visual prime stimuli were used to control attention. Reaction time to a small visual target stimulus in the same location or in the horizontally opposite location was evaluated. Stimulus onset asynchronies (SOAs) were 34, 50, 67, 83 and 100 ms. An important prime stimulus attentional effect was observed as early as 50 ms in the four experiments. In Experiments 2, 3 and 4, this effect was larger when the prime stimulus occurred in the right hemifield than when it occurred in the left hemifield for SOA 100 ms. In Experiment 4, when the prime stimulus occurred simultaneously in both hemifields, reaction time was faster for the right hemifield and for SOA 100 ms. These results indicate that automatic attention tends to favor the right side of space, particularly when identification of the target stimulus shape is required.

Fertility in unilateral cryptorchidism: review of 104 cases.

Testicular maldescent adversely affects spermatogenesis, therefore the primary purpose of its correction is to preserve subsequent fertility. However, many patients, even with unilateral cryptorchidism, are infertile in spite of successful prepubertal orchidopexy. Out of our 104 patients treated for unilateral cryptorchidism before puberty, a decreased sperm density (spermatic concentration less than 20 X 10(6)/ml) was observed in 64 cases (61.54%), a normal sperm count in 32 cases (30.77%) and azoospermia in the remaining 8 cases (7.69%). Both congenital and acquired abnormalities may be associated with development of bilateral testicular impairment in unilateral cryptorchid males.

Varicocele in adolescents: ultrastructural aspects.

Twenty-four boys age 11-17 with moderate to large sized varicocele were studied. The duration of varicocele ranged from 11 to 20 months prior to surgery. Histological and ultrastructural studies of testicular specimens demonstrated bilateral abnormalities and the detrimental effect of varicocele on the future fertility of these young patients. These findings strongly support the necessity of an early surgical treatment of varicocele.

[A rapid method for the isolation of Salmonellae from faeces (author's transl)]. / Metodo rapido per l'isolamento delle salmonelle nelle feci.

A rapid and simple method for detecting Salmonellae in faeces was developed. It was based on the motility of Salmonellae through a semi-solid medium in a U-tube. The migration of other intestinal bacteria was retarded by means of a magnesium salt concentration. 474 stool specimens were examined for Salmonellae in parallel with the usual isolation method. A total of 39 Salmonella strains were isolated, 37 (94.9%) by means of the selective migration procedure, 26 (66.7%) when the routine method was applied. Two strains of patients in chemo-therapy were missed by the rapid method, which was moreover inefficient in detecting S. typhi, due to its slow motility. However, the rapid method is recommended in addition to conventional mediums in screening of carriers for its higher frequency of positive isolations compared with multistep procedure (+27.3%).

[Recurrent cystitis in young girls. Clinical and radiologic aspects]. / Les cystites récidivantes chez les petites filles. Aspects cliniques et radiologiques.

The authors emphasise the importance of radiological investigation of all children with urological infections. The key studies are complete intravenous urography and retrograde cystography. A broad sub-division of situations may be used to draw a distinction between recurrent cystitis in the young girl with an organic cause (urethral stenosis) and recurrent cystitis of functional origin. Organic urethral stenosis may be diagnosed immediately on the basis of radiological findings of an association of vesical hypertrophy and a permanent narrowing of the distal urethra with proximal dilatation, persisting during the different phases of micturition. This possibility is rare. By contrast, functional causes are much more common: spasm of the striate sphincter, absence of inhibition of the bladder, neurological dysfunction resulting in a non-neurogenic neurogenic bladder. There remains recurrent cystitis due to insufficiently frequent micturition. Analysis of the factors actually responsible for recurrent infections in any given child may be made difficult when they are present in association.

Ultrastructural changes of Leydig cells in prepubertal varicocele.

Testicular biopsies from 25 boys, aged 11-17, with left clinically evident varicocele were studied. Electron microscopic observations documented diffuse histological changes of smooth endoplasmic reticulum, Golgi apparatus and mitochondria of Leydig cells. Ultrastructural modifications of these subcellular structures related to steroid hormone synthesis may impede the normal growth and maturation of the testis and impair fertility potential.

[Ultrastructural modifications of the tunica muscularis in congenital obstruction of the upper urinary tract. Physiopathological interpretations and anatomo-clinical correlations]. / Modifications ultrastructurales de la tunique musculaire dans les obstructions congénitales des voies excrétrices urinaires hautes. Interprétations physiopathologiques et corrélations anatomo-cliniques.

Upper excretory pathway musculature was studied by electron microscopy, both at the level of the obstruction and proximally. Two types of lesion were investigated: pyelo-ureteral junction anomalies and primary obstructive mega-ureter. Two types of muscle cell are recognized in the excretory pathway walls, typical and atypical cells, the latter being considered as possessing pace-maker activity and constituting almost total population of muscles of calices and pelvis. However, they were few in number in the pyelo-ureteral region and were practically absent from the ureter. Various conclusions can be drawn from the findings in this study. Both typical and atypical cells are modified in the obstructed upper excretory pathways. Ultrastructural appearances of lesions are identical at the site of an proximal to the obstruction. Modifications in these cells were: a rich sarcoplasmic reticulum, an increase in number of mitochondria and glycogen particles, disorganized distribution of contractile or cytoskeletal filaments, altered contact zones between contiguous smooth muscle cells, increased richness of granular endoplasmic reticulum and excessive development of the Golgi apparatus. More chronic lesions show enhanced fibrosis with reduced muscle contractility, the fibrosis affecting mainly elastic fibers in young patients and collagen fibers in more elderly subjects. The development of fibrosis may be due to changes in the granular endoplasmic reticulum and the Golgi apparatus. From the practical point of view, increase in fibrosis with duration of course of obstruction is an argument for as early as possible surgical intervention.

Therapeutic value of citicoline in the treatment of glaucoma (computerized and automated perimetric investigation).

The favourable neurotrophic effects obtained by means of the intramuscular administration of citicoline, one of the intermediate compounds of phospholipids, on the visual field of patients suffering from open-angle glaucoma are referred. The drug was administered at the dose of 1 gm for ten consecutive days. Visual field was examined by means of central computerized perimetry and automated perimetry. All patients had well controlled intraocular pressure through beta-blockers, but presented characteristic glaucomatous perimetric defects. It is suggested that citicoline might be administered as a useful complement to conventional hypotensive therapy, since it acts positively on the glaucomatous optic nerve damage.

Polyorchidism and seminoma in a child.

A case is reported of a neoplasm involving a supernumerary testicle in a 9-year-old boy. The histologic diagnosis was anaplastic seminoma. We have not been able to find a similar case in the literature.