The association between abdominal aortic aneurysms and chronic leg ischaemia. Prevalence in 125 consecutive patients.

A study was carried out to see if in patients with atherosclerotic lesions of the lower limbs the percentage of abdominal aneurysms is higher than in the general population. One hundred twenty five consecutive patients were studied in two different hospitals and compared with a control group. In the two groups with peripheral vascular diseases the patients had a prevalence of aneurysms of 12%, while in the control group the prevalence was of 3%. All patients were operated on successfully except two of them who are now in follow up with regular ultrasound assessment, one with an aortic aneurysm of 3.2 cm and the other with an aortic diameter of 4 cm and moderate liver failure.

Fluorocytometric analysis of anti-HLA class 2 autoantibodies in patients with lupus nephritis.

Systemic lupus erythematosus (SLE) patients are known to produce a variety of autoantibodies (AAb), some of which may be directed against immunocompetent cells. Anti-B cell autoimmunity may encompass reactivity against HLA-class 2 molecules, which are also expressed on kidney tissue. We studied 15 patients with moderate to severe renal involvement and 5 lupus patients with no clinical renal disease, in order to detect the presence of anti-HLA class 2 AAb. Flow cytometry was employed in an inhibitory assay using patient sera, autologous cells and two anti-class 2 monoclonals, to establish the specificity of anti-B cell AAb. Seven out of 15 nephritis patients had detectable anti-class 2 AAb with an epitopic heterogeneity, as demonstrated by different degrees of inhibition on the binding of non-overlapping monoclonals. The specificity of the reaction was confirmed by the lack of inhibition of non-class 2 antibody binding. The presence of such AAb was not correlated with disease activity but with the presence of a diffuse proliferative glomerulonephritis on renal biopsy. Anti-class 2 AAb may be a marker of SLE diffuse proliferative nephritis.

Acute ischemia of the lower limb in a case of persistence of the primitive sciatic artery.

A rare case of persistent primitive sciatic artery with a small aneurysm in its proximal part is reported. The occlusion of this artery caused extensive lower limb ischemia which called for amputation. The diagnostic difficulties are stressed out.

Atherosclerotic aortic-bisiliac aneurysms in two monocorial twins.

Two cases of aorto-bisiliac aneurysms in monocorial twins in their sixties were observed. We report experimental and clinical data from the literature about genetic involvement in the formation of aneurysms, especially when associated with other risk factors. In addition to the genetic factors in the twins we studied, we also found other risk factors, such as hypertension and smoking, which took a long time to affect the patients before the aneurysms were detected.

[Diagnostic algorithms. Analysis of the factors conditioning their definition. An illustrative case (bilio-pancreatic pathology)]. / Algoritmi diagnostici. Analisi dei fattori condizionanti la loro definizione. Caso esemplificativo (patologia bilio-pancreatica).

A case of biliopancreatic pathology studied with traditional (the old algorithm) and the latest (new algorithm) diagnostic techniques is examined. A comparative analysis reveals the second to be simpler, less expensive and less dangerous to the patient. The hope is expressed that doctors will become better informed of the diagnostic criteria to employ for the purpose of cost reduction.

[Screening and follow-up of patients with arteriopathies of the lower limbs using the test proposed by Laing]. / Screening e follow-up dei pazienti con arteriopatia agli arti inferiori con l'impiego del test proposto da Laing.

The Authors tested a standard exercise suggested by Laing in 1980 for the screening and the follow-up of patients with atherosclerotic lesions of the arteries of the lower limbs. Were included in this study 44 patients with monolateral symptoms and was studied the asymptomatic limb. The results were compared with the ones obtained by the traditional exercise proposed by Strandness and with the ones of a control group studied with the two tests. The excellent correlation of the data gives us the opportunity to reaffirm the utility of the Laing's standard exercise in the clinical investigation of potentially arteriopathic patients.

[Personal experience in the treatment of intestinal carcinoids]. / Nostra esperienza nel trattamento dei carcinoidi intestinali.

The authors report 7 cases of intestinal carcinoids. They examine the clinical aspects and describe and discuss both surgical and medical treatment strategies. They also critically evaluate the value of monitoring some oncological markers and their prognostic significance. Each patient underwent an in-depth evaluation of tumour evolution (CAT, ultrasonography, NMR, angiography) and urinary 5HIAA and platelet 5HT were monitored. Surgery took the form of ileal or ileocolic resection, gastric resection, exeresis of the tumour using a transanal route, ligature of the right branch of the hepatic artery afferent to the metastasised lobe of the liver. Five patients were treated using chemotherapy and three, also suffering from carcinoid syndrome, with octreotide. On the basis of their personal experience the authors underline the limited value of the study of 5HT and 5HIAA tumour markers in the diagnosis of small carcinoid tumours. This is compensated by the outstanding role of these markers in the diagnosis of the hepatic and/or lymphoglandular diffusion of the tumour. These markers were not influenced by octreotide treatment in cases in which longastatin was successfully used to combat carcinoid syndrome. Their behaviour allowed useful information to be acquired regarding the tumour evolution following surgery.

[Problems of diagnostic origin in tumors of the small intestine developing in the smooth muscle. Report on 7 cases]. / Problemi di origine diagnostica nei tumori dell'intestino tenue ad origine dalla muscolatura liscia. Osservazioni su 7 casi.

The smooth muscle tumors of the small intestine are particularly interesting for the difficulty and the delay of their diagnosis. This usually happened for the poor and indefinite symptomatology and the problematic exploration of the organ. Starting up from the observation of 7 patients between 1986 and 1989 the Authors critically examined the literature about this problem to value the diagnostic opportunities of the principal clinical exams, suggesting as resolutive investigation, if indicated, the angiographic selective study of the visceral abdominal arteries.

[Heterotopia of the gastric fundus wall in bilobate gallbladder associated with dilatation of the main bile duct. Description of a case]. / Eterotopia di parete gastrica fundica in colecisti bilobata associata a dilatazione della via biliare principale. Descrizione di un caso.

On the basis of a recent case of fundic gastric heterotopia in the gallbladder, the principal, possible embryogenetic hypotheses of the malformation are described and discussed. The possibility that acid secretion of the gastric glands contained in the ectopic fundic mucosa determined part of the symptomatological and clinical picture accompanying signs of lithiasic cholecystopathy is also evaluated.

[Importance of Staphylococcus epidermidis in the bacterial colonization of abdominal drains in surgical patients]. / Rilevanza dello Staphylococcus epidermidis nella colonizzazione batterica dei drenaggi addominali in pazienti chirurgici.

Bacterial adherence to biomaterials as an element of clinical relevance is a well-known factor in the pathogenesis of sepsis. Drainages, intravascular catheters, surgical prostheses and other devices are susceptible to bacterial colonization with clinical consequences. In the last few years attention has been paid to coagulase-negative Staphylococcus (S. epidermidis), mainly to some strains able to produce a highly adhesive polysaccharide substance, called glycocalix or slime. This promotes adherence either interbacterial either between bacteria and biologic tissues or synthetic materials acting as a pathogenetic factor in sepsis being able to increase bacterial resistance to phagocytes and antibiotics. Bacterial contamination of 40 abdominal drainage tubes in patients operated in elective and in emergency surgery for various pathology has been evaluated. Sonication of the tip of the drainage was utilized in order to promote the detachment of adherent colonies and its effectiveness was compared to that of microcentrifugation. Culture of 25 drainages (62.5%) showed no bacterial contamination; 7 drainages (17.5%) have proved to be colonized by S. epidermidis, in 4 cases the isolated strains were also methicillin-resistant, 2 of which slime-producing. Out of the 7 drainages colonized by S. epidermidis, 4 were removed from patients operated in emergency: none of the isolated strains was slime-producing. Six drainages (15%) were colonized by Gram+ bacteria (S. fecalis, P-sensible cocci, rods), 1 (2.5%) by E. coli and 1 (2.5%) by P. aeruginosa, S. epidermidis appears to be the chief contaminant of abdominal drainages, especially in emergency surgery; slime production has always been observed in methicillin-resistant strains: this confirms the hypothesis that slime production is typical of specialized, virulent strains.(ABSTRACT TRUNCATED AT 250 WORDS)

AUTOCOUNTER, an ImageJ JavaScript to analyze LC3B-GFP expression dynamics in autophagy-induced astrocytoma cells.

An ImageJ JavaScript, AUTOCOUNTER, was specifically developed to monitor and measure LC3B-GFP expression in living human astrocytoma cells, namely T98G and U373-MG. Discrete intracellular GFP fluorescent spots derived from transduction of a Baculovirus replication-defective vector (BacMam LC3B-GFP), followed by microscope examinations at different times. After viral transgene expression, autophagy was induced by Rapamycin administration and assayed in ph-p70S6K/p70S6K and LC3B immunoblotting expression as well as by electron microscopy examinations. A mutated transgene, defective in LC3B lipidation, was employed as a negative control to further exclude fluorescent dots derived from protein intracellular aggregation. The ImageJ JavaScript was then employed to evaluate and score the dynamics changes of the number and area of LC3B-GFP puncta per cell in time course assays and in complex microscope examinations. In conclusion, AUTOCOUNTER enabled to quantify LC3B-GFP expression and to monitor dynamics changes in number and shapes of autophagosomal-like vesicles: it might therefore represent a suitable algorithmic tool for in vitro autophagy modulation studies.

Syphilitic aneurysm of the abdominal aorta: report of two cases.

We have described two histologically confirmed syphilitic abdominal aortic aneurysms arising below the renal arteries. Serological tests were negative and the patients had in the past been treated with penicillin and bismuth. We consider that there may be a correlation between atherosclerosis and syphilis in the natural history of some abdominal aortic aneurysms and the hazard of indiscriminate use of antibiotics for the treatment of other inflammatory vessel disease may allow syphilis to develop insidiously.