Exposure to chronic stress impairs the ability to cope with an acute challenge: Modulation by lurasidone treatment.

Chronic stress represents a major contributor for the development of mental illness. This study aimed to investigate how animals exposed to chronic mild stress (CMS) responded to an acute stress (AS), as a vulnerability's challenge, and to establish the potential effects of the antipsychotic drug lurasidone on such mechanisms. Adult male Wistar rats were exposed or not (controls) to a CMS paradigm for 7 weeks. Starting from the end of week 2, animals were randomized to receive vehicle or lurasidone for 5 weeks. Sucrose intake was used to measure anhedonia. At the end, half of the animals were exposed to an acute stress before sacrifice. Exposure to CMS produced a significant reduction in sucrose consumption, whereas lurasidone progressively normalized such alteration. We found that exposure to AS produced an upregulation of Brain derived neurotrophic factor (Bdnf) in the prefrontal cortex of controls animals. This response was impaired in CMS rats and restored by lurasidone treatment. While in control animals, AS-induced increase of Bdnf mRNA levels was specific for Parvalbumin cells, CMS rats treated with lurasidone show a significant upregulation of Bdnf in pyramidal cells. Furthermore, when investigating the activation of different brain regions, CMS rats showed an impairment in the global response to the acute stressor, that was largely restored by lurasidone treatment. Our results suggest that lurasidone treatment in CMS rats may regulate specific circuits and mechanisms, which will ultimately contribute to boost resilience under stressful challenges.

[Crossectomy combined with sclerosis in the ambulatory treatment of varicose veins]. / Crossectomia associata a sclerosi nel trattamento ambulatoriale delle varici.

This paper focuses on the advantages of an outpatient technique in the treatment of the 1st various syndrome based on crossectomy and complementary sclerotherapy to eliminate the proximal reflux. In addition to the speed, low costs and total absence of discomfort for the patient, this method results in a low percentage of easily correctable failures provided the patients to be treated are carefully chosen. Selection involves a preoperative screening phase based on anamnesis, semeiological tests, Doppler and evaluation of tibial venous pressure, as well as careful topographical mapping of proximal refluxes which allow a correct postoperative follow-up in the event of possible recidivation (14.3% based on the authors' experience). The surgical technique used entails an accurate crossectomy with full exposure of the SF crosse (??) and its affluent branches, and subsequent sclerotherapy with atoxysclerol in a variable quantity and % as required. Of a total of 91 cases treated with a 3-year follow-up, 5 cases of recidivation were observed during the first year and 8 during the third. In both cases postoperative pressure values in the tibial veins were considerably higher than in other patients and recidivation occurred through perforating sclerosed recanalised vessels.

[Lipiodol chemoembolization in the treatment of hepatic carcinoma. Our experience]. / La chemioembolizzazione con Lipiodol nel trattamento del carcinoma epatico. Nostra esperienza.

Of the alternative methods of treatment to surgery in the treatment of liver cancer, chemoembolization with Lipiodol appears to have obtained encouraging results. After a preoperative study to confirm the diagnosis and staging of the tumour, lipiodolisation is performed: a mix of Adriamycin, Iopamidol and Lipiodol is injected using selective catheterism of the hepatic artery; gelfoam is then added. Lipiodol selectively localises in the hepatocarcinoma and has a distal embolising effect on the vessels of the tumour, thus necrotising it, acting as a carrier for chemotherapy. Since july 1990 a total of 15 hepatocarcinoma have been observed: 6 in healthy livers and 9 in cirrhotic livers; 3 patients recovered after radical surgery, 1 patient underwent associated surgery and chemoembolization, whereas in 11 the only therapy was chemoembolization, at six monthly intervals. Lipiodolisation enabled a better diagnosis to be made and was found to be a valuable therapeutic aid both when used alone in Inoperable patients and in association with non-radical surgery.

[Laparoscopic cholecystectomy. Our experience]. / La colecistectomia laparoscopica. Nostra esperienza.

This study analysed 90 cases of symptomatic cholelithiasis treated with laparoscopic cholecystectomy. 27% of the cases studied suffered from microlithiasis, 44% from multiple calculosis with calculi measuring 1 to 2 cm in diameter, 25% from single calculi measuring up to 4 cm in diameter, and 4% from a benign proliferative pathology of the cholecystic wall. Calculosis of the main biliary tract was also found in 3 patients and was treated by preoperative endoscopic papillosphincterotomy. In addition to routine tests and ultrasonography, endovenous cholangiography, or retrograde cholangiography (ERCP) in cases of suspected calculosis of the biliary tract, was always performed prior to surgery. Mean operating time was 60 min. Two procedures were converted into laparotomy due to laceration of the cystic artery. In one case laparotomy was performed on day two due to choleperitoneum following a lesion of the cystic duct. Pneumoperitoneum could not be performed in three cases. Mean hospital stay was 48 hours. No other intra- or postoperative complications were reported. These results support the opinion that laparoscopic cholecystectomy is a safe method, with few limitations and represents the treatment of choice in the therapy of symptomatic cholelithiasis.

[Sutures without sutures in digestive surgery. Experimental study of the rat intestine]. / Suture senza suture in chirurgia digestiva. Studio sperimentale sull'intestino del ratto.

The aim of the experimental study was to evaluate the possibility of performing an end-to-end anastomosis by using fibrin adhesive as the only means of suture. To this end, 24 Wistar rats were used, of which 16 underwent ilear resection and 8 underwent colotomy, and they were divided respectively into two groups. On the rats of the first group the anastomosis was performed by using only fibrin adhesive; on the rats of the second group operated the anastomosis was performed by using fibrin adhesive in association with non adsorbable suture material, while on those operated of colectomy the anastomosis was performed by fibrin adhesive and adsorbable suture material. The anatomo-phatological studies on the anastomosis have shown a similar healing process in the cases treated only with fibrin adhesive and by using absorbable material and has demonstrated the trange material from the suture, which are a possible causes of complication.

[Pancreatic pseudocysts: a rare complication of the Warren distal splenorenal shunt]. / Pseudocisti del pancreas: rara complicazione dello shunt spleno-renale distale sec. Warren.

The authors report a case of distal splenorenal shunt with splenopancreatic disconnection complicated by a huge pancreatic pseudocyst. This complication has not been described in the literature so far. The etiology and the opportunity of the splenopancreatic disconnection are discussed.

[Minimally invasive surgery and neoplasms of the inferior third of the rectum: personal technique]. / Chirurgia miniinvasiva e neoplasie del terzo inferiore del retto: tecnica personale.

In the last decade minimally invasive surgery has gained an increasing success and was firstly applied to the treatment of benign pathologies, and recently to the malignant ones. The Authors report two cases of inferior rectal neoplasm treated with Miles operation through a video-laparoscopic-perineal approach. The abdominal phase of the operation was performed only through 5 small laparoscopic incisions. The perineal phase and the stoma were performed using traditional technique. The method appears feasible and oncologically correct; however, further trials are needed to evaluate long-term results.

Preliminary reports on morphological and ultrastructural changes in the corpora cavernosa of the rat after chronic arterial obstruction.

OBJECTIVES: Various authors have investigated the pathological findings of penile tissue after chronic arterial obstruction, but the significance of these changes in the corpora cavernosa remains unclear. In order to evaluate the possible damages in the erectile tissue after chronic arterial obstruction at different levels, we utilized an experimental model in rats to determine the changes in smooth muscle cells and elastic fibers of the erectile tissue by microscopic immunohistochemical and ultrastructural studies. METHODS: Twelve adult male Wistar rats were employed in this study. Ten were used for the experiments and two as control. The rats were anaesthetized with ether and intraperitoneal 10% chloral hydrate. Microsurgical isolation of the involved vessels was performed with the aid of a Zeiss dissecting microscope. Partial stenosis was achieved with 11/0 nylon and amputation of the penis was performed at previously established time periods. The partial stenosis was carried out at the level of the aortic below the renal vessels (Group A), the common iliac artery on both sides (Group B) and the hypogastric artery on the left side (Group C). Arterial obstruction was maintained in each group for 50, 40 and 25 days, respectively. RESULTS/CONCLUSIONS: In comparison with normal controls, the histological findings revealed discrete and diffuse interstitial hyalinosis with reducted elastic fibers, while dilated vascular lacunae were also present on TEM (Transmission Electron Microscope) and SEM (Scanning Electron Microscope) examination. The greatest ultrastructural damages were observed in the group with obstruction of the common iliac artery on both sides. The foregoing confirms that an eventual chronic obstruction of these arteries does not allow the formation of collateral vessels for the corpora cavernosa.