[Necrotizing fasciitis after laparoscopic adhesion surgery. A clinical case]. / Fascite necrotizzante dopo adesiolisi laparoscopica. Caso clinico.

A case of a fulminating necrotizing cellulitis after a laparoscopic adhesiolysis performed for ileal obstructive disease, is presented. During operation, a very little intestinal perforation was caused by an "atraumatic grasper", and intestinal fluid flooded into the peritoneum; the lesion was sutured. A copious peritoneal lavage was performed and the operation ended by positioning a peritoneal drain. The patient was going well, passing flatus on the second postoperative day; on the fourth postoperative day erythematous edema close one of the trocar wound appeared. In spite of an aggressive medical and surgical therapy the infection had a very rapid spreading and the patient died six days later. A literature review is reported and simple intraoperative remedies are proposed.

Perspectives into factors limiting in vivo digestion of legume proteins: antinutritional compounds or storage proteins?

The in vivo protein digestibility of raw and cooked common bean (Phaseolus vulgaris L.) and faba bean (Vicia faba L.) and of protein fractions extracted from them was determined with growing rats. Overnight-fasted rats were intubated with a protein suspension or fed the same amount of protein added to a basal diet. The rats were killed 1 h later, the contents of stomach and small intestine were washed out, and their protein contents were measured. The in vivo digestibility of proteins of raw common bean flour was 72.4% and not significantly improved after cooking. In contrast, the digestibility of faba bean proteins was decreased from 86.5 to 60.6% by the thermal treatment. Globulins from either species had similar digestibilities (approximately 70%). Proteins in the soluble fraction of cooked beans were more digestible than those in the insoluble fraction, which contained the bulk of the proteins. Hemagglutination assay and trypsin inhibitor determination indicated that after the thermal treatment only very low, nonharmful, levels of both lectin and inhibitor remained. Faba bean contained more polyphenols than common bean samples, with most of the polyphenols being bound to globulins. However, protein-bound polyphenols were markedly decreased after cooking. SDS-PAGE characterization of the gastrointestinal digesta of globulins and amino acid analysis of undigested proteins of whole cooked common bean and faba bean suggested that it is mainly the structural properties of the storage proteins and not their binding of polyphenols, which determines the extent of protein aggregation on autoclaving and may therefore be responsible for their low digestibility.

Physicochemical, nutritional, and microstructural characteristics of chickpeas (Cicer arietinum L.) and common beans (Phaseolus vulgaris L.) following microwave cooking.

Microwave cooking of legumes such as chickpeas and common beans was evaluated by assessing the cooking quality (cooking time, firmness, cooking losses, and water uptake) and the physicochemical, nutritional, and microstructural modifications in starch and nonstarch polysaccharides. Compared to conventional cooking, microwave cooking with sealed vessels enabled a drastic reduction in cooking time, from 110 to 11 min for chickpeas and from 55 to 9 min for common beans. The solid losses, released in the cooking water, were significantly less after microwave cooking than after conventional cooking (6.5 vs 10.6 g/100 g of dry seed in chickpeas and 4.5 vs 7.5 g/100 g of dry seed in common beans). Both cooking procedures produced a redistribution of the insoluble nonstarch polysaccharides to soluble fraction, although the total nonstarch polysaccharides were not affected. Increases in in vitro starch digestibility were similar after both cooking processes, since the level of resistant starch decreased from 27.2 and 32.5% of total starch in raw chickpeas and beans, respectively, to about 10% in cooked samples and the level of rapidly digestible starch increased from 35.6 and 27.5% to about 80%. SEM studies showed that the cotyledons maintained a regular structure although most of the cell wall was broken down and shattered by both cooking procedures. In addition, the ultrastructural modifications in the cotyledon's parenchima and cells are consistent with the chemical modifications in NSP and the increase in starch digestibility after cooking.

Relationship between in vitro Fe and Zn dialysability and peptide composition of albumin and globulins extracted from cooked bean (Phaseolus vulgaris L.).

In vitro dialysability of iron, zinc and protein was determined from whole bean (Phaseolus vulgaris), albumin and globulin (G1, G2) after cooking. Albumin showed the highest iron, zinc, protein and phytic acid content. Cooking increased iron and protein dialysability only in whole bean and albumin. Compared to globulins, albumin also presented a higher in vitro protein digestibility and cystine chemical reactivity. HPLC analysis of peptides in dialysates of bean and protein fractions suggested that some aggregation occurred during dialysis. The percentage of amino acids in dialysed peptides was found to be different between albumin and globulins. The difference in iron and zinc dialysability between albumin and globulins seems to depend on the phytic acid content of the albumin fraction and the protein properties of globulins.

[Primary suppurated splenic cysts. A case report]. / Cisti splenica primaria suppurata. Presentazione di un caso.

The authors describe a case of an epidermoidal cyst of the spleen, which they were able to observe in an emergency case, due to suppuration of the cyst. Primary cysts of the spleen represent a rare dysontegenetic pathological condition which is, for this reason, often underestimated. The general clinical summary is related here, with particular reference to supporative complications, which cause problema of differential diagnosis with patients suffering from abscess of the spleen. The diagnosis can be made as a result of standard X-ray procedures and computed tomography and above all, following a simple scan. The treatment recommended in this case is an open splenectomy, in order to check the allarming clinical symptoms of the patient, which can deteriorate. The use of laparoscopical techniques or trans-cutaneous draining is reserved for salected cases.

Food fiber choices for diabetic diets.

The use of dietary fiber (DF) in the diet of diabetics, although recommended, is often prevented by a limited tolerance and/or by the high cost and unpalatability of fiber supplements. Knowing that only or mainly the water soluble fraction of DF is effective in modulating postprandial hyperglycemia, the DF content (soluble, insoluble, and total) of a variety of common foodstuffs was determined. Such data were then utilized in the formulation of two complete meals, isocaloric and isoglucidic, characterized by a high-soluble, low-soluble, and total fiber content. The meals were administered to 13 NIDDM patients in good metabolic control. The data confirmed a significant reduction (p less than 0.001) of postprandial hyperglycemia and a moderate less significant reduction of insulinemia after the high fiber meal.