The solitary fibrous malignant tumour of the kidney: clinical and pathological considerations on a case revisiting the literature.

The solitary fibrous tumours (SFT) are rare spindle cell neoplasms which generally originate from the pleura; also described are cases of SFT in other locations, included the genital-urinary tract. Described in the ambit the kidney are 19 cases of SFT and such rarity of localisation makes rather unknown the histogenesis and the prognosis of the lesion. We report the case of a 72 year old lady who attended our Unit for a mass which was clinically palpable at the level of the left hemiabdomen. Following an abdominal ultrasound scan a neoformation was highlighted which a successive tomodensitographic test indicated as being of likely pertinence of the middle third of the left kidney; the mass had a diameter of approximately 19 cm. A radical nephrectomy has been conducted. The histological examen highlighted a solitary fibrous tumour: the presence of hypercellularity, of cellular pleiomorphism and of a high number of mitosis has led to a histopathological diagnosis of malignancy of the neoplasm under examination. Departing from this case a review of the literature is carried out. The SFT of the kidney can have an aggressive character and more the present has hystopathological characters and clinical results are still rather unknown.

Low cadmium concentration in whole blood from residents of northern Sardinia (Italy) with special reference to smoking habits.

INTRODUCTION: The present study was initiated to investigate the cadmium concentrations in whole blood of Northern Sardinian, non-occupationally exposed adult subjects. Sardinia is a large Italian island which differs genetically and environmentally from other mainland Italian areas. METHODS: Two hundred and forty-three adults (157 females and 86 males) were selected in the study area from subjects who were undergoing blood collection for laboratory analysis during the period January 2005-May 2005. Whole blood was analysed by graphite furnace atomic absorption spectrometer equipped with a Zeeman-effect background corrector (Perkin Elmer ZLS5100) and an auto sampler. The adopted analytical procedure uses the Stabilized Platform Temperature Furnace (STPF) technique. RESULTS: The mean value of Blood Cadmium Concentration (BCdC), expressed as Geometric Mean, was 0.32 pg/l (CI 95%: 0.31-0.34 l) in non-smokers to 034 pg/l (CI 95%: 0.30-0.39 pg/l) in ex-smokers up to 0.47 gg/ll(CI 95%: 0.42-0.53 pg/l) in smokers (p < 0.0001). DISCUSSION: The results show that BCdC levels in Northern Sardinian non-occupationally exposed adults are lower than levels found in many other regions, including those within Italy. Nevertheless, similar values have been detected in other European countries and cities. CONCLUSIONS: In relation to other reports in which data were analysed by strata for smoking habit and age, we found similar BCdC values among non smokers. However, Sardinian smokers seem to show lower levels of blood cadmium.

[Solitary fibrous tumor of the kidney. A propos of a case].

Solitary Fibrous Tumors (SFT) are rare spindle cell neoplasm that typically originate from the pleura. However, cases of the SFT are described with origin in other organs, including the urinary and genital apparatus. Within the kidney, except from the renal pelvis, only 19 cases of SFT are described and such rarity of localization makes the histogenesis and the prognosis of the tumor rather unknown. We report the case of a 72-year-old lady who attended our Unit for a mass that was clinically palpable at the level of the left hemiabdomen. The tomodensitographic test indicated a 19cm-diameter mass of likely pertinence of the middle bystender of the left kidney. She had undergone left radical nephrectomy. The histological examination highlighted a solitary fibrous tumor (SFT): the presence of hypercellularity, of cellular pleiomorphism and of a high number of mitosis has led to a histological diagnosis of malignancy for the neoplasm analyzed. The SFT are of rare clinical comparison: this does not allow for a deep knowledge of the lesion histogenesis and prognosis; moreover, the clinical behavior should be more precisely defined.

[Scrotal masses: considerations on two cases of epididymal tumors].

The scrotum is a fibromuscular sac that contains the testis, epididymis, spermatic cord and the associated fibrous coatings. All these components can be affected by different variety of pathologic phenomena, including congenital, inflammatory and neoplastic events. When a scrotal mass is observed, there are two basic questions to be answered, i.e. if the mass is intratesticular or extratesticular, and if it is of cystic or solid nature. Apart from a few rare exceptions, intratesticular solid masses should be considered malignant, while extratesticular masses with liquid content are generally benign. CASE REPORTS. Two cases of tumor are hereby presented: they originated from the epididymis, and their clinical presentations did not allow making a differential diagnosis between benign and malignant tumor during the preoperative examinations. After presenting the diagnostic doubts to patients, and once obtained their informed consent, surgeries were performed allowing for a precise histological diagnosis, and at the same time, proving to be also valid therapeutic tools.

[A case of particular diffusion of prostate cancer].

Neoplastic diffusion can occur due to dissemination, continuity, through lymphatic or haematic vessels, or, more rarely originate from surgical instruments. We report a particular case of prostate cancer spread. A 64-year-old man was diagnosed with undifferentiated prostate cancer through prostate biopsy. The patient was treated with a total androgenic block allowing a decrease in PSA blood level. The patient, wishing to regain his sexual activity compromised by hormonal therapy, interrupted the treatment spontaneously and unchecked. 19 months later he contacted us again: we had to hospitalize him due to a 12-hour anuresis. A urgent right transcutaneous nephrostomy was carried out, yielding an improvement in the patient's condition. A descending pyelography carried out by means of nephrostomy revealed a completely reduced urethral lumen. During the following surgery for transcutaneous urinary derivation we observed the two ureters entangled in whitish tissue, spreading bilaterally up to the renal pelvis. The histological examination of tissue samples showed the presence of neoplastic metastasis of prostatic origin. We assume that this neoplastic diffusion has occurred due to permeability through the lymphatic vessels of the urethral wall, producing a subsequent neoplasm growth: this has been limited by the urethral connective sheath, thus preventing its wide diffusion to the surrounding tissues, but fostering its spreading upwards along the ureter pathway.

First stereocontrolled synthesis of (S)-cleonin and related cyclopropyl-substituted amino acids.

[reaction: see text]. Enantiomerically pure (S)-cleonin, a key component of the antitumor antibiotic cleomycin, was prepared starting from (R)-serine. The Kulinkovich cyclopropanation of the methyl ester of N-Cbz serine acetonide gave the hydroxycyclopropyl moiety. The amino alcohol region was further oxidized to amino acid. The Kulinkovich cyclopropanation allowed also the preparation of other non-natural substituted cyclopropylglycines.

[Report of a case of traumatic avulsion of the penile skin with amputation of the glans]. / A propósito de un caso de avulsión traumática de la piel del pene con amputación del glande.

OBJECTIVES: A case of traumatic avulsion of penile skin with amputation of the penis and sectioning of the urethra is described. METHODS/RESULTS: Surgical management included embedding the penis without scrotal skin and subsequent reconstruction utilizing scrotal skin. The patient has recovered sexual activity, although sensitivity has been reduced as a consequence of penile amputation. Six months postoperatively, the patient has reported orgasm during intercourse. CONCLUSIONS: The surgical technique of embedding the penis is safe and preserves elasticity for subsequent reconstruction of the urethral meatus.

[Partial cystectomy versus TUR in T1G3 tumors]. / Cistectomia parziale versus turv nei tumori T1G3.

Authors report their experience in conservative treatment of 41 patients with bladder cancer and they compare partial cytectomy with turv. They hold that partial cystectomy can represent a good therapeutical option in treatment of bladder cancer T1G3.

[Usefulness of echography in the diagnosis of urachal cancer]. / Utilità dell'ecografia nella diagnosi del cancro dell'uraco.

Authors report a case of urachal carcinoma diagnosed with ultrasonography linear probe 7.5 mhz. With this work they want underline the importance to use a superficial probe in all those situation in which the sonography shows a neoformation in the posterior wall of the bladder; it should be the spy of a urachal neoformation.

[Penile metastasis of bladder cancer]. / Metastasi peniena da cancro della vescica.

The Authors mark a case of penile metastasis in a man 70 years old suffering from bladder cancer. They emphasize the rarity of this manifestation. They discuss about symptomatology, diagnosis and pathogenesis even today debated. They mark therapeutical indications about the short expectation of life, that these patients have from appearance of the metastases.

CHIRBASE, a graphical molecular database on the separation of enantiomers by liquid-, supercritical fluid-, and gas chromatography.

In order to cope with the increasing number of publications on the separation of enantiomers by chromatography on a chiral stationary phase, the graphical molecular database CHIRBASE was created. In the present state, the database package covers information (structural, bibliographic, and chromatographic data) on liquid-, supercritical fluid-, and gas chromatography; other methods will follow. CHIRBASE, running on the MDL software Chembase, meets the requirements of contemporary information management in the chemical and pharmaceutical industry. (Detailed information including a demo-version of each part of CHIRBASE can be obtained from the authors on request).

Health in strip cartoons.

Strip cartoons are among the most vivid means of communication at our disposal, and they are particularly popular with the young. Medical matters have featured in many stories, though usually in a peripheral role. Could more be done to use this powerful medium, or would deliberate exploitation destroy it?

PIP: Health is often seen in strip cartoons (SCs). However, its images convey their own properties. SCs are distributed globally. They are produced in Algiers, Dakar, and Bangui. The SC generally goes from humor to adventure stories. Health enters SCs in 3 ways: 1) the portrayal of life styles; 2) health as a suspenseful element; and 3) medical adventures emphasizing a doctor. Adventure stories with doctors for heroes are common. WHO is the basis for many SCs. Humor and adventure are the 2 basic themes in SCs; they are not mutually exclusive. 1 way that SCs portray health is the "stretched-out time of soap opera." These are stories of poor, talented doctors and devoted nurses. The SC is a graphic expression of world concerns. Healthy or unhealthy life styles may be seen in SCs. Food, tobacco, and alcohol are just parts of a story. Positive heroes are never alcoholics, because alcoholism is a potential vice. Habitual drinkers are usually secondary characters. Early in the 20th century, tobacco played a big role in developing SCs in Mexico. Breaking society's rules for a healthy life style leads to all kinds of consequences in SCs. There was no educational intent to having Popeye eat spinach. Spinach contains iron and is associated with strength. Scurvy is an enemy of many sailors, and this shows up in SCs on disease. It alternates with cholera as an element of adventure in sea stories. An imaginative story devoted to health education shows a medical and social confrontation with naval captains who are not too bright. SCs are neither good nor bad in themselves.