Immunocytochemical evidence for ACTH- and beta-endorphin-like molecules in phagocytic blood cells of urodelan amphibians.

Using immunocytochemical procedures and RIA tests, the presence of immunoreactive ACTH and beta-endorphin molecules in the basophils and neutrophils of urodelan amphibians (Salamandra s. salamandra, Triturus c. carnifex, Speleomantes imperialis) has been established. Moreover, it was observed that not only neutrophils but also basophils have phagocytic activity. The findings reported suggest that: 1) a relationship exists between the immune and neuroendocrine systems, and 2) the opioid-like molecules play a physiological role in the process of phagocytosis. Indeed, ACTH increases the phagocytic activity.

Histomorphological and cytochemical changes induced in the liver of goldfish Carassius carassius var. auratus by short-term exposure to lead.

The cellular and molecular effects of experimental lead intoxication (5 mg l-1/24 h and 48 h) were studied in hepatocytes of Carassius carassius var. auratus. Significant lead storage was not detected by atomic absorbance spectroscopy after treatment. Cell morphology appeared only poorly impaired. A decrease of glycogen content was observed. Glycolysis, Krebs cycle and pentose shunt were altered in their enzymatic activities. Lysosomal activities were strongly increased. All enzymatic activities tested were altered 24 h after lead treatment.

Immunocytochemical study of endocrine cells in the gut of goldfish Carassius carassius (L.) var. auratus submitted to experimental lead intoxication.

In the present study, the effects of experimental lead pollution on gut endocrine cells have been determined in the goldfish Carassius carassius (L.) var.auratus by immunocytochemical reactions. In the mucosa and submucosa, only vasoactive intestinal polypeptide- and 5-HT-like immunoreactive nerve fibers were observed. Endocrine cells displaying immunoreactivity against gastrin, CCK8, metenkephalin, bombesin, neuropeptide Y, pancreatic polypeptide, substance P, secretin, somatostatin and vasoactive intestinal polypeptide antibodies were detected. No immunoreactivity against glucagon, insulin and 5-HT antibodies was revealed in the endocrine cells. Some modifications appeared evident in the endocrine cells 48-96 h after lead intoxication, and can be summarized as follows: 1) discharge of secretory granules (secretin- and vasoactive intestinal polypeptide-like peptides), up to the extent that the cells appeared to be depleted of secretory material; 2) increase of immunoreactivity in the endocrine cells (met-enkephalin- and pancreatic polypeptide-like peptides) or in the frequency of positive cells (met-enkephalin-like peptide); 3) no variations (gastrin-, CCK8, bombesin-, somatostatin- and substance P-like peptides). The alterations were not enhanced by long term treatment. Nerve fibers did not show modifications.

[Pancreatic trauma: a rare but severe event]. / Traumi del pancreas: evenienza rara ma temibile.

INTRODUCTION: High-speed motor vehicle accidents have contributed to an increasing incidence of pancreatic trauma. Early mortality is generally due to associated vascular and other intra-abdominal injury. MATERIALS AND METHODS: The authors report their experience on pancreatic trauma. Six cases were treated during the last five years. Isolated pancreatic injury was observed only in one case. Two patients received simple external drainage. Two patients required distal pancreatectomy. One patient was mistreated with ligature of distal pancreatic duct and, postoperatively, developed pseudocyst. One patient, with associated duodenal injury, died. COMMENTS: Serum amylase is often unreliable, whereas abdominal CT scans have the best sensitivity and specificity in detecting pancreatic injury. Abdominal exploration is always recommended in retroperitoneal trauma evaluation; complete pancreas mobilisation is needed to determine the integrity of the major pancreatic duct. Treatment protocols are based on severity of injury: they range from simple drainage to distal pancreatectomy (in presence of distal transection or parenchymal injury with duct injury) and to pancreaticoduodenectomy (in presence of massive injury, devascularisation, destruction of ampulla). Complications are seen in 20 to 35% of patients and the overall mortality secondary to complications ranges from 10 to 20%. Fistulas and pseudocysts are the most common complications.

[Peridural anesthesia for cesarean section in a patient with inoperable cerebral angioma]. / Anestesia peridurale per taglio cesareo in paziente con angioma cerebrale inoperabile.

Anaesthesia for caesarean section in patients with cerebral artero-venous malformations (CAVM) is a controversial matter. We describe a case of a primiparus woman with an inoperable CAVM delivered by CS under epidural anaesthesia. Epidural anaesthesia can be a valid alternative to general anaesthesia as it provides excellent analgesia allowing an accurate assessment of the neurological conditions of the mother and avoiding opioids and/or hypotensive drugs, potentially dangerous to the foetus, to blunt the hypertensive response to intubation. The accidental dural puncture is to be avoided with extra-careful technique. The epidural injection must be made either very slowly or with an incremental technique to avoid any increase in intracranial pressure. Hypotension must be corrected promptly to maintain cerebral perfusion pressure.

Histomorphological and histochemical researches on the digestive tract of the freshwater grass carp, Ctenopharyngodon idella (cypriniformes).

Ctenopharyngodon idella does not have a stomach, as is shown by the absence of gastric glands. The intestine is a simple coiled tube about twice the length of the body, having no valves and no ceca, and it is joined directly to the esophagus. The mucosa is fairly uniform in appearance, being thrown into folds which give it a mesh-like appearance. No multicellular glands can be detected in any part of the alimentary canal. Goblet cells are present: no differences are found in young specimens. Mucous in the goblet cells from young animals shows no differences in the various parts of the intestine. In the adult animals the mucous is markedly acidic in the first part of the intestine. In the young animals some migrant cells are present in the mucosa and in the connective tissue; these being more numerous in the fingerlings of 6--7 cm in length.

Fibre-optic awake intubation for caesarean section in a parturient with predicted difficult airway.

Anaesthetic management of a parturient with predicted difficult airway presenting for caesarean section (CS) is not a straightforward decision: general anaesthesia should be avoided because intubation can be impossible and a "cannot intubate, cannot ventilate" scenario might ensue, on the other hand regional techniques can be unsuccessful or, though rarely, have complications that require emergency intubation. The case is presented of a primigravida admitted to hospital at 37 weeks' gestation with hypertension, intrauterine growth retardation and oligohydramnios. After a few days' observation, it was decided to proceed with an elective CS. The preoperative airway examination revealed a poor mouth opening with an interdental distance of 20 mm and a Mallampati class IV. The patient was classified as a case of difficult intubation and the following anaesthetic options were considered: epidural anaesthesia, spinal anaesthesia and awake fibreoptic intubation followed by general anaesthesia. The pros and the cons of these techniques were explained to the patient and it was suggested that awake fibreoptic intubation was the safest option. The patient gave her consent, so an uneventful nasal awake fibreoptic intubation was carried out under local anaesthesia. This case report offers the opportunity to underline the risk to perform a central blockade in a parturient with predicted difficult intubation, arguing that the safest course of action is an awake fibrescopic intubation, besides some controversial points to safely perform awake fibreoptic intubation in obstetric patients are discussed.

Quality of post-anesthetic care in a hospital without a Post-Anesthetic Care Unit. A clinical audit.

AIM: The majority of Italian hospitals are not equipped with a Post- Anesthetic Care Unit. The aim of this study is to evaluate whether it is possible to guarantee post-anesthetic care according to current international quality and safety standards in the absence of such a structure. METHODS: Our hospital is not equipped with a Post-Anesthetic Care Unit and post-anesthetic assistance is assured by the anesthetist and anesthetic nurse themselves. In order to evaluate the quality of the post-anesthetic care a Recovery Chart was devised and strict discharge criteria defined: Recovery Score (modified Aldrete's score) = or >7; systolic blood pressure within 20% of the preoperative values; nausea/vomiting and shivering absent; pain absent/mild. A retrospective audit was conducted in 2 orthopedic operating rooms from January 10, 2000 to January 31, 2001 in order to evaluate major complications, observance of discharge criteria, postanesthetic care time. RESULTS: Incidence of complications was 2.6%. Observance of discharge criteria was 74%. In 26% of cases (69/261 cases) discharge criteria were not completely respected: 14 cases with unstable vital parameters; 46 cases with pain not under control; 6 cases with nausea/vomiting; 3 cases with shivering. In these cases monitoring and treatment was continued on the ward according to the anesthetist's prescriptions. None of these patients died or suffered major complications because of a quick discharge to the ward. Mean post-anesthetic care time was 40+/-18 minutes (median 35 minutes). CONCLUSION: Where the Post- Anaesthetic Care Unit is not available it is virtually impossible to guarantee post-anesthetic care according to current international quality and safety standards, because production pressure can lead the anesthetist to discharge the patient to the ward before he/she is completely stabilized. In these cases the anesthetist must accurately prescribe the necessary postoperative monitoring and treatment (analgesics, antiemetics, fluids, etc.) that must be continued in the surgical ward to guarantee the patient's safety, but it must be underlined that the surgical ward is not the appropriate place to carry on immediate post-anesthetic care.

Pigmentary system of the adult alpine salamander Salamandra atra aurorae (Trevisan, 1982).

The pigmentary system of skin from adult specimens of the amphibian urodele Salamandra atra aurorae was investigated by light microscope, electron microscope, and biochemical studies. Yellow (dorsum and head) and black (flank and belly) skin was tested. Three chromatophore types are present in yellow skin: xanthophores, iridophores, and melanophores. Xanthophores are located in the epidermis whereas iridophores and melanophores are found in the dermis. Xanthophores contain types I, II, and III pterinosomes. Some pterinosomes are very electron-dense. Black skin has a single type of chromatophore: the melanophores. Some melanophores are located in the epidermis. In contrast to the dermal melanophores, these present, in addition to typical melanosomes, organelles with different morphology and vesicles having a limiting membrane and containing little amorphous material. Both skin types present some pteridines and flavins, though they are qualitatively and quantitatively more abundant in yellow skin extracts.

Pigmentary system of the adult alpine salamander Salamandra atra atra (Laur., 1768).

The pigmentary system of the skin from adult specimens of the black alpine salamander Salamandra atra atra was investigated by light microscope, electron microscope, and biochemical studies. Results were compared with those obtained in previous study of the subspecies Salamandra atra aurorae. Unlike Salamandra atra aurorae, which presents epidermal xanthophores and iridophores, Salamandra atra atra is completely melanized, presenting only epidermal and dermal melanophores. The melanosomes in both the epidermis and the dermis appear to derive from a multivesicular premelanosome similar to that in the goldfish, and the epidermal melanosomes are smaller than those in the dermis. Premelanosomes with an internal lamellar matrix were not observed. The biochemical results have shown that in the ethanol extracts obtained from the skin in toto and from the melanosomes, pteridines and flavins are always present and are the same as those extracted from the black skin areas of Salamandra atra aurorae.