Experimental colitis in IL-10-deficient mice ameliorates in the absence of PTPN22.

Interleukin (IL)-10 plays a key role in controlling intestinal inflammation. IL-10-deficient mice and patients with mutations in IL-10 or its receptor, IL-10R, show increased susceptibility to inflammatory bowel diseases (IBD). Protein tyrosine phosphatase, non-receptor type 22 (PTPN22) controls immune cell activation and the equilibrium between regulatory and effector T cells, playing an important role in controlling immune homoeostasis of the gut. Here, we examined the role of PTPN22 in intestinal inflammation of IL-10-deficient (IL-10-/- ) mice. We crossed IL-10-/- mice with PTPN22-/- mice to generate PTPN22-/- IL-10-/- double knock-out mice and induced colitis with dextran sodium sulphate (DSS). In line with previous reports, DSS-induced acute and chronic colitis was exacerbated in IL-10-/- mice compared to wild-type (WT) controls. However, PTPN22-/- IL-10-/- double knock-out mice developed milder disease compared to IL-10-/- mice. IL-17-promoting innate cytokines and T helper type 17 (Th17) cells were markedly increased in PTPN22-/- IL-10-/- mice, but did not provide a protctive function. CXCL1/KC was also increased in PTPN22-/- IL-10-/- mice, but therapeutic injection of CXCL1/KC in IL-10-/- mice did not ameliorate colitis. These results show that PTPN22 promotes intestinal inflammation in IL-10-deficient mice, suggesting that therapeutic targeting of PTPN22 might be beneficial in patients with IBD and mutations in IL-10 and IL-10R.

Recent advances in the synthesis of natural multifunctionalized decalins.

This review highlights recent innovative synthetic strategies developed for the stereoselective construction of natural complex decalin systems. It offers an insight into various synthetic targets and approaches and provides information for developments within the area of natural products as well as synthetic methodology.

Bacteriologic findings in ostrich (Struthio camelus) eggs from farms with reproductive failures.

From January 2001 to December 2002, 543 ostrich eggs were submitted for bacteriologic investigation. The eggs were laid by 387 domesticated ostriches that suffered fertility disorders and that came from 44 farms located in different areas of Northern and Central Italy. Microbiologic investigations showed bacterial isolation in 105 (19.3%) of 543 eggs examined, with a high prevalence of enterobacteria from albumen and yolk. In only a few cases did bacterial isolation result from yolk or albumen alone. An antibiotic sensitivity test was conducted on isolates by the Kirby-Bauer disc diffusion method. This is the first report regarding the microbiologic status of eggs from ostrich farms located in different Italian regions.

Isolation of Bartonella henselae from domestic cats in an Italian urban area.

Bartonella henselae is the causative agent of Cat Scratch Disease (CSD) in humans. Cat is considered the reservoir of the bacterium. Identification of bacteriemic cats is the basic tool in the prophylaxis of CSD. Blood samples were collected between January 1999-December 2000 from 248 domestic cats living in an urban area (Reggio Emilia) in Northern Italy and tested for Bartonella henselae bacteriemia. Cultural and PCR methods were used. PCR was used directly on cat blood as well as to identify the Bartonella strain growth in culture. 24 (9.7 %) cats were found bacteriemic, most of which aged <1 year. A higher sensitivity was demonstrated by cultural method compared with PCR.

An immunogenetic map of Lombardy (Northern Italy).

For this study we consulted the Bone Marrow Donors' Registry of Lombardy (Italy) and analyzed 43937 HLA-A,B phenotypes and 13922 HLA-A,B,DR phenotypes. We estimated the HLA-A,B and HLA-A,B,DR haplotype frequencies via the maximum-likelihood method. We analyzed the genetic structure of the 11 provinces of Lombardy by means of Principal Component Analysis and Correspondence Analysis, and estimated the variety of the different haplotypes at provincial level and the percentage of unique phenotypes at village level. We found 11189 different HLA-A,B phenotypes, 661 different HLA-A,B haplotypes and more than 4000 different HLA-A,B,DR haplotypes. We identified 20 villages, in Western Lombardy, very rich in unique/rare phenotypes. Here we report a formula which allows the identification of a putative donor matched for two haplotypes with a recipient. This result may be of great importance for the genetic study of the population of Lombardy and, even more, for bone marrow transplantation programs.

[Acute pancreatitis: resultos of a diagnostic-therapeutic protocol in 80 consecutive cases]. / Pancreatiti acute: risultati di un protocollo diagnostico-terapeutico in 80 casi consecutivi.

The treatment of acute pancreatitis cannot be standardized in the absence of a prompt diagnosis and of an accurate severity and prognostic score. This study, based on 80 consecutively observed patients, compared the aetiological, clinical, diagnostic (laboratory and imaging) and prognostic data used to select the most appropriate therapy for each patient. The results confirm that the Ranson score shows a satisfactory prognostic relationship between the number of positive parameters and the severity of the disease. Ultrasound, which is useful for defining the aetiologic factors and in the follow-up of peripancreatic effusions, has proved to be limited as a means of imaging abnormalities of the pancreatic parenchyma. CT scans are confirmed as being the only method of accurately demonstrating the presence of necrosis and of evaluating its effective extent. ERCP was performed as soon as possible in the presence of biliary stasis or of suspect ultrasonographic signs. Surgical treatment proved necessary only in 7.5% of cases, on each occasion to drain infected necrotic foci. Promptness of the surgical indication plays an important role in the outcome of necrosectomy and drainage performed with the closed technique. Mortality was limited to 1.25% in our series. A correct diagnostic approach together with prompt treatment can reduce the mortality rate of this disease to a minimum.

Suprarenal aortic cross-clamping in elective abdominal aortic aneurysm surgery.

INTRODUCTION: this retrospective study was undertaken to evaluate whether suprarenal aortic cross-clamping increased the perioperative mortality and morbidity as compared to infrarenal clamping, in order to create the rationale for a more extensive application of this apparently more traumatic manoeuvre. MATERIALS AND METHODS: in a series of 734 elective aortic substitutions for abdominal aneurysm (AA), performed consecutively from January 1992 to June 1999, aortic cross-clamping was performed at a suprarenal level in 56 juxtarenal aneurysms, i.e. aneurysms extending to the lower edge of the renal arteries (8%, Group 1), and at an infrarenal level in 634 subrenal aneurysms (92%, Group 2). When analysing preoperative data, the diameter of aneurysms was larger in Group 1 than in Group 2 (p<0. 005). No significant differences were found between the two groups as regards age, sex, postinfarction cardiomyopathy, chronic obstructive pulmonary disease, chronic renal insufficiency and ASA classification of operative risks. RESULTS: the average time of renal exclusion in the juxtarenal aneurysms was 20 min (range 12-35 min). There is no difference between the two groups as regards the time of aortic clamping (mean 50 vs. 60 min) or the need for homologous blood transfusion (7% vs. 11% of patients). Perioperative (30 days) mortality did not differ: 3.6% vs. 1.9% (n.s.); nor did the incidence of acute myocardial infarction (3.6% vs. 2.3%). Renal function deteriorated in 8 (14%) vs. 0 (0%) (p<0.001) and 1 patient (2%) required permanent dialysis, as compared to 0% in Group 2. The incidence of ischaemic colitis was also significantly higher in Group 1 (7%) than in Group 2 (2%, p<0.01). CONCLUSION: this data shows that suprarenal clamping, which is necessary for the radical treatment of juxtarenal aortic aneurysms, can be performed with a low risk.

Hepatitis C infection in an Italian population not selected for risk factors.

AIMS/BACKGROUND: This study estimated the prevalence of HCV infection and relationship with viremia in a general population. The inhabitants of Albavilla town were personally invited to participate. METHODS: Out of 3997 inhabitants falling within the age range 18-85 years, 2403 (participation rate 60.1%) were examined for transaminases, HCVAb, HCVRNA, genotype and immunoblot assay. The following information was collected: sex, age, blood transfusions, surgery, use of glass syringes, drug addiction, alcohol consumption, tattoos and body mass index. RESULTS: 115 (4.8%) were HCVAb+, the prevalence being 1.2% under 40 years. Transfusion in the past was the only risk factor for HCV infection. Among the HCVAb+ subjects, 71 (61.7%) were HCVRNA+. 40.8% of the HCVAb+/HCVRNA+ group had normal ALT, compared with 68% of those with HCVAb+/HCVRNA-. The HCV genotypes in the 71 HCVRNA+ subjects were: 2a/2c in 58 (81.7%), 40% of them with normal ALT;1b in 11 (15.5%), none with normal ALT; genotype 3 in two (2.8%). CONCLUSION: The prevalence of HCVAb in this general population was 4.8%. About 3% were HCVRNA positive and of these genotype 2a/ 2c was present in 81.6%.

[The complications of pulmonary resection surgery: the experience of 200 consecutive cases]. / Le complicanze della chirurgia resettiva polmonare: esperienza su 200 casi consecutivi.

Postoperative complications observed in 200 patients after pulmonary resection (66 pneumonectomies--30%, 106 lobectomies--53% and 28 wedge resections--17%) are presented. Surgical operations were carried out in 86% of cases for cancer, in 16% for benign lesions. Major complications were: lobar atelectasis, bronchopneumonia, pulmonary embolism, respiratory insufficiency, bronchial fistula, ventricular tachyarrhythmia, altogether they concerned 21% of the cases. Their incidence was not significantly influenced by the extension of resection (the latter, on the contrary, influenced postoperative mortality as much as 4.5% after pneumonectomy, 2.8% after lobectomy and 0% after wedge resection), age of patients under or over 70 years, functional respiratory reserve, or associated cardiovascular diseases. On the contrary, the advanced stage of disease in neoplastic patients was significant for major complications. An adequate monitoring of minor respiratory and cardiac complications is recommended to reduce the incidence of major ones and their control when present. In authors' experience, in fact, postoperative mortality was overall 3% following such behaviour.

Hospitalization: CAPD versus hemodialysis and transplant.

We studied morbidity in 648 patients treated in our center in a ten-year period as indicated by duration of hospitalization: 232 patients were on CAPD, 188 on hemodialysis (HD) and 228 had cadaveric kidney transplants (Tx). Duration of hospitalization was divided into four groups according to its causes. The age of the patients on CAPD was 61 +/- 14 years, 53 +/- 17 on HD and 36 +/- 10 in the Tx group. The total follow-up was 629 patient-year (p-y) on CAPD, 458 p-y on HD and 928 p-y on Tx. The first admission was longer on CAPD (30 +/- 18 days) and on Tx (36 +/- 18 days) than on HD (18 +/- 12). After the first admission, the total days of hospitalization (days/patient-year, d/p-y) were more for CAPD than HD and Tx. Analysis of these data showed that the difference was due to peritonitis and to the different percentage of elderly patients in the CAPD group. With a reduction in the incidence of infectious complications (peritonitis, tunnel or exit-site), hospitalization in CAPD could be reduced to a length of time similar to that currently needed by HD and Tx patients. This can result in important cost-saving.

[Staging of lung cancer by computerized tomography: evaluation based on surgical experience]. / La stadiazione del cancro polmonare con tomografia computerizzata: valutazioni emergenti dall'esperienza chirurgica.

One hundred seventy patients with M0 bronchogenic carcinoma were preoperatively evaluated by CT staging whose results were correlated with surgical findings. A number of over and understaging were observed in assessing mediastinal nodes involvement, chest wall invasion, mediastinal pleura and vessels invasion as well as pulmonary vessels involvement. In conclusion, the Authors believe that no patient surgical indication should be excluded on the basis of CT evidence of intrathoracic invasion, in the light of the demonstrated potential for false-positive diagnoses.

[Splenic autografts in omental and subcutaneous pouches. An experimental study]. / Autoinnesti splenici in tasche omentali e sottocutanee. Studio sperimentale.

An accurate morphological study has been done on splenic grafts in rats after 7-15-30 days from their implant in omental or subcutaneous pouches. Observation after 7 days confirmed the necrosis of all the central portion of the implants. Anyway, marginal parts of the graft survived to ischaemia and showed to be supplied by vessels, coming from the contiguous tissues. In these parts the rigenerative process had begun from the structures of red residual pulp, by reticular cells proliferating so to rigenerate the capsula limiting the place of the central necrotic area. After 15 days the neocapsula was completed and from it neoformed trabecolae departed accompanied with chords, sinus capillary, venular and arteriolar vessels which reformed the structure of red pulp both in peripheral and central area, now undistinguishable. After 30 days lymphocytes aggregating around the neoformed vessels promoted a rudimental reconstruction of the white pulp too. In conclusion, splenic implants are able to get over the ischaemic phase and after 30 days the red pulp is morphologically reconstructed and probably functioning, while the white pulp is still primordial.