Generation of a novel antibody probe to the apical sodium-dependent bile acid transporter that inhibits ileal bile acid absorption.

Intestinal bile acid absorption is mediated by a sodium-dependent transporter located in the brush border apical membrane of ileocytes. The transmembrane topology and the role of individual amino acid residues in the bile acid transport process have been investigated by means of various experimental approaches, leading to multiple hypotheses. We raised a monoclonal antibody against a segment of the transporter comprising vicinal cysteine residues, in order to evaluate its functional role. A 14 amino acid peptide, corresponding to amino acids 104-117 of the transporter, was synthesized, and a monoclonal anti-peptide antibody was raised. In vitro uptake-inhibition studies in the presence of the monoclonal anti-peptide antibody were performed using ileal brush border membrane vesicles. Rabbit ileum was perfused in vivo with 5 mM taurocholic acid in the presence of the monoclonal antibody, and bile acid absorption inhibition was evaluated. The anti-peptide monoclonal antibody significantly reduced the in vitro uptake and in vivo absorption of taurocholic acid. The present data demonstrate the functional relevance of the 104-117 peptide segment and report the generation of a novel antibody against the apical sodium-dependent bile acid transporter (ASBT) that may be used as a therapeutic agent in hypercholesterolemia and in cholestatic pruritus.

Ten years experience in the treatment of pseudomyxoma peritonei by cytoreduction, peritonectomy and semi-closed hyperthermic antiblastic peritoneal perfusion.

BACKGROUND: In the literature good results have been reported for the treatment of Pseudomyxoma peritonei (PMP) by cytoreduction, peritonectomy and hyperthermic antiblastic peritoneal perfusion (H.A.P.P.). Forty-eight patients affected by PMP have been treated with this technique over the past ten years. PATIENTS AND METHODS: Peritoneal perfusion has been performed with the original semiclosed tecnique after complete surgical cytoreduction in 188 patients affected by peritoneal carcinomatosis. In 48 of the cases the patients were affected from PMP. Aggressive surgical cytoreduction was performed with multiple visceral resections and peritonectomies. RESULTS: Seventeen patients (38%) presented major perioperative complications, and in five cases the reoperation of the patient was required. In spite of this high complication rate, there was no perioperative mortality. The results of the Kaplan-Meier 5- and 10-year survival analysis, were 94% and 82%, respectively, with a disease-free survival of 80% at 5 years and 70% at 10 years. Thirty-nine patients (81.2%) had no evidence of disease at follow-up (range 1-120 months). DISCUSSION: Up to date, the most effective treatment for PMP has been aggressive cytoreduction plus H.A.P.P.

[Complications of cytoreductive surgery associated with intraperitoneal chemohyperthermia: prevention and treatment]. / Complicanze della chirurgia citoriduttiva associata a chemioipertermia intraperitoneale (CIIP) prevenzione e trattamento.

New approach to peritoneal carcinomatosis combining cytoreductive surgery and hypertermic intraperitoneal chemotherapy suggest improved survival when it is possible to achieve a complete cytoreduction. In this study we consider the major complications related to this procedure and purpose our approach for their prevention and treatment.

[Cytoreduction and intraoperative peritoneal chemohyperthermia in carcinomatosis from colonic carcinoma and in peritoneal pseudomyxoma]. / Citoriduzione e chemioipertermia intraoperatoria peritoneale (CIIP) nella carcinosi da carcinoma del colon e nello pseudomixoma peritonei.

New approach in treatment of peritoneal carcinomatosis combining cytoreductive surgery and intraperitoneal chemotherapy suggests improved survival when it is possible to achieve a complete cytoreduction. In this study we consider the carcinomatosis from colorectal and appendiceal adenocarcinoma. In all cases, patients in whom cytoreductive surgery was complete had a median survival much longer compared with patients in whom was not possible and, as perfusion works on minimal residual disease, peritonectomy is the only surgical technique that aim at total removal of parietal and visceral peritoneal lesions.

Treatment of pseudomyxoma peritonei with two times--cytoreduction and hypertermic antiblastic peritoneal perfusion (HAPP).

Pseudomyxoma peritonei is a rare neoplasia with a low grade of clinical malignity in which neoplastic masses product large amount of mucinous material. Its treatment advocates an aggressive cytoreduction of all visceral and peritoneal lesions and Hyperthermic Antiblastic Peritoneal Perfusion (HAPP). In three cases we programmed a two stage surgical approach for the massive amount of peritoneal implants. Two times we achieved our aim, while one time, the wide progression of the disease during the two surgical procedures made useless our efforts to have a complete cytoreduction and the following HAPP. This last patient refused systemic chemotherapy between the two surgeries and we think that this should be one of the reasons of the failure.

Combined pharmacotherapy in children and adolescents in a residential treatment center.

OBJECTIVE: To investigate characteristics of children and adolescents with a history of combined pharmacotherapy (CPT) and compare them with a group with no history of CPT. METHOD: Eighty-three consecutive admissions to a residential treatment center were divided into a CPT and a no-CPT group based on treatment history and compared by chart review. Prevalence of lifetime psychiatric medication use and CPT exposure were assessed. Demographic, diagnostic, treatment, behavioral, and medication variables were compared across the two groups. RESULTS: Medication use was present in the treatment history for 89.2% and a history of CPT was found for 60.3% of subjects. Admission to current placement from inpatient psychiatry, lifetime number of psychiatric placements, lifetime number of psychiatric diagnoses, and nonseizure neuropsychiatric comorbidity were significantly associated with CPT. Aggression and neuroleptic use were also significantly associated with CPT. Admission psychiatric diagnostic comorbidity was not associated with CPT. CONCLUSIONS: A high prevalence of psychiatric medication use and CPT was found in this population. Variables assessing illness severity, aggressive behavior, and nonseizure neuropsychiatric comorbidity may identify youths in psychiatric treatment settings with a high prevalence of past or current CPT exposure. Further research on the CPT of aggression is warranted.

[Acute intestinal ischemia. Review of the literature and personal experience]. / Ischemia intestinale acuta. Revisione della letteratura ed esperienza personale.

The authors report the experience of their surgical department in the diagnosis and treatment of acute arterial mesenteric ischaemia. Their results are similar to those of the literature. Stress is laid on early diagnosis and interest of mesenteric angiography, laparoscopy and color flow ultrasound. Arterial revascularisation must be the surgical aim but the prognosis of acute mesenteric ischaemia remains very severe.

[Carotid vessels studied by Doppler color echography and digital angiography. Results of meta analysis]. / Studio dei vasi carotidei mediante eco color-Doppler ed angiografia digitale. Risultati di una meta-analisi.

Twenty patients were studied by color Doppler flow imaging and digital angiography. According to the literature the results support necessity of color flow in the study of the patients with plaque. The authors emphasize the role of angiography only in the surgical patients for the anatomic evaluation of the carotid territory.

[Changes in carcinoembryonic antigen and tissue polypeptide antigen in monitoring the post-operative course of some tumor types]. / Il comportamento del CEA e del TPA nel monitoraggio del decorso post-operatorio di alcuni tipi di tumore.

The authors tested TPA in association with CEA in colon rectal, breast and stomach cancer. The results proved the reliability of TPA in these neoplasms and the correct use of TPA in association with CEA test in monitoring breast cancer. It's use proved to be typical screening test both for the high percentage of true positive and the lack of false negative.

[Association of ferritin with the CEA test in post-operative monitoring of colo-rectal, breast and stomach carcinomas]. / L'associazione della ferritina al CEA test nel monitoraggio post-operatorio dei carcinomi del colon-retto, della mammella e dello stomaco.

On the basis of more than 3,000 tests carried out on 1,561 patients suffering from suspected or certain malignant tumours, the authors established the necessity of CEA test in post-operative follow-ups, according to the plentiful literature regarding this matter. New tumoral markers led the authors to verify if it was useful to associate the ferritin to CEA test. From the results and the statistical data, they concluded that it was useful to associate the two markers only in negative CEA test when confronted with clinical suspected metastatic diffusion.

Determination of the sequence of writing on both sides of a paper.

One of the most difficult subjects the Examiner of Questioned Documents had to deal with is the determination of the sequence of written materials. As far as this author knows, techniques are available only for cases where the relevant writings are placed on the same side of the paper. Numerous experiments have been made on a range of papers varying in weight. In all of these tests both sides of the paper were typewritten as well as handwritten (pencil, pen, ball-point pen and fountain pen). Several samples are shown where the possibility of such determination is seen to be feasible, especially in cases where both sides are typewritten and where one is typewritten and the other is handwritten with pencil, ball-point pen and fountain pen.