[A sign of the changing times: neonatal scabies]. / Un segno dei tempi che cambiano: scabbia neonatale.

Scabies is an itchy-parasitic cutaneous infection; it can spread from person to person directly or through clothing, sheets or mattresses. The incidence had fallen a lot during the last ten years, but recently it is growing up again; this is due to immigration of people coming from countries where local hygienic and social conditions are very poor. In this contest it is more frequent to observe the infection in pediatric age, sometimes also newborn. In this particular case the diagnosis can be more difficult because the clinical manifestations are different from pathognomonic lesions we usually see in adult age. We report the clinical case of a newborn, 30-day-old, born in Italy from an Indian family. When the baby was admitted in our department she looked in good physical conditions but she presented a pustular dermatitis all over the body, scalp excluded. The presence in the mother of typical skin lesion and baby's eosinophilia at blood test, induced us to suspect the diagnosis of scabies. However, both the search for acarus at optical microscope on a skin sample obtained with "scarification" and clinical response to a treatment with PAF, were unsuccessful. Moreover, we found in the baby a persistent trombopenia; this fact induced us to think of other hypothesis. Finally the child's positive response to permethrina topical treatment and normalization of the number of platelets let us confirm the initial diagnosis of scabies.

[Linear IgA bullous dermatosis: the importance of a correct differential diagnosis]. / Dermatosi bollosa a IgA lineari: l'importanza di una corretta diagnosi differenziale.

Linear IgA bullous dermatosis is an acquired subepidermal blistering disease which belongs to bullous autoimmune diseases, along with dermatitis herpetiformis and bullous pemphigoid. Inflammatory blisters are the main clinical characteristics and the areas of common involvement are: perioral region, abdomen, perineum, buttocks and the interior side of thighs. Essential for the diagnosis is to find by direct immunofluorescence the presence of a linear band of IgA antibodies at the level of the basement membrane. We present the case of a 5 year-old Moroccan girl which arrived at our First Aid Department for bullous dermatitis, localized mainly on the abdomen, legs and thighs. During a short stay in Morocco, a month before, the little girl was stung by an insect and developed bullous dermatitis by a residual lesion. The child was in a good state of health but blood exams showed an increase of total IgE antibodies. The girl was admitted and during her hospitalisation we made a skin biopsy which led to a diagnosis of linear IgA dermatosis. She began a steroid therapy and there was a progressive regression of the lesions. At present, she does not take medicines anymore, she feels well and is submitted to ambulatory medical follow-up.

Anal carcinoma occurring in Crohn's disease patients with chronic anal fistula.

This paper reports six patients with perianal Crohn's disease (CD), who developed anal cancer in chronic anal fistulas. Tumors have been often diagnosed at an advanced stage and had a worse prognosis than cancers arising in the general population as tumor symptoms may mimic symptoms of CD, resulting in delay in diagnosis. Patients with perianal CD should undergo a careful surveillance program for ano-rectal carcinoma, including routine biopsy of any suspected lesion. When malignancy is found, an aggressive surgical approach and complementary therapy are mandatory.

[Sarcoidosis and clear cell carcinoma of the kidney: the sixth case?]. / Sarcoidosi e carcinoma renale a cellule chiare: il sesto caso clinico?

The Authors report a very rare case of clear cell renal cancer associated with sarcoidosis, incidentally discovered in a 39 year-old man, admitted for a not correlated pathology (multiple left rib fractures due to automobile crash). Problems related to a proper assessment of sarcoidosis are discussed as well as potential arising of a neoplasm during the entire follow-up period: for that, it must always be complete and accurate.

Syngeneic consecutive rat spleen transplantation bearing infantile testis.

Seventy-seven Lewis adult rats received autologous testicular implants in the spleen. These spleens were retransplanted in a consecutive transplant fashion as we described earlier. Some were observed as long as 26 to 27 months. Although earlier splenic-testicular transplants showed benign granulosa cell tumors, some of the long-term follow-ups showed a seminoma-like transformation.

[Current role of traditional endoscopy and prospects for virtual colonoscopy in the management of colorectal neoplastic lesions]. / Ruolo attuale dell'endoscopia tradizionale e prospettive della colonscopia virtuale nel management delle lesioni neoplastiche del colon-retto.

The Authors, reviewing their surgical experience with colo-rectal cancer in the last 13 years, conclude that, in the management of this condition, the routine use of traditional endoscopy will continue to have a crucial role in terms of prevention, cure and/or survival. It is possible that in the future present limits of endoscopic techniques will be seperated by routine use of endoscopic ultrasounds and virtual colonoscopy.

[Current role of endoscopic ultrasonography in the treatment of colorectal neoplastic lesions]. / Ruolo attuale dell'ecografia endoscopica nel trattamento delle lesioni neoplastiche colo-rettali.

The Authors examined the value of endoscopic ultrasounds in the tmanagement of colo-rectal lesions, particularly neoplastic ones, on the basis of their surgical experience, concluding that to date such technique cannot substitute traditional endoscopy, but surely can be a valid complementary tool for imaging diagnostics, expecially to study wall tumoral infiltration or extra-parietal relapses.

Cell cycle variations in azoxymethane-induced rat colorectal carcinogenesis studied by flow cytometry.

Cell cycle variations and DNA aneuploidy, were investigated in different phases of azoxymethane (AOM)-induced colon carcinogenesis in rats by flow cytometry. K-ras gene mutations (transitions Gright curved arrow A) were frequently detected in aberrant crypt foci (ACF) initial pre-neoplastic lesions. The fraction of cells in the G2M-phase of the cell cycle was higher in ACF compared to the normal mucosa of control rats. A similar modification of the cell cycle was found in adenomas and adenocarcinomas but, unexpectedly, also in morphologically normal mucosa from AOM-treated animals indicating that AOM treatment permanently modifies cell cycle control in rat colon mucosa. These alterations, however, were not associated with DNA aneuploidy as reported in human sporadic colorectal cancer, suggesting that tumour development in AOM-treated rats is less dependent on aneuploidy.

Extracellular signal-regulated kinase activation differentially regulates platelet-derived growth factor's actions in hepatic stellate cells, and is induced by in vivo liver injury in the rat.

Upon liver injury, hepatic stellate cells (HSC) show increased proliferation, motility, and extracellular matrix (ECM) production. The extracellular signal-regulated kinases (ERK) control different functions in a cell-specific manner. In this study, we evaluated the role of ERK activation in cultured HSC stimulated with platelet-derived growth factor (PDGF) and after induction of liver injury in vivo. HSC were isolated from normal human liver tissue, cultured on plastic, and used in their myofibroblast-like phenotype. In in vivo experiments, HSC were isolated from normal rats or at different time points after a single intragastric administration of CCl(4). Nontoxic concentrations of PD98059, a specific inhibitor of ERK activation, reduced PDGF-induced activation of ERK in a dose-dependent fashion. Suppression of ERK activation was associated with complete inhibition of HSC proliferation and with a 57% reduction in chemotaxis. In the presence of the ERK inhibitor, binding of the AP-1 complex and of STAT1 to the related regulatory elements was inhibited. The inhibition of the DNA binding activity of STAT1 was mediated by a reduction in PDGF-induced tyrosine phosphorylation. Expression of c-fos in response to PDGF was also reduced, but not suppressed, by treatment with PD98059. In HSC isolated from CCl(4)-treated rats, ERK activity increased as early as 6 hours following liver damage, and declined thereafter. The results of this study indicate that ERK activation regulates proliferation and chemotaxis of HSC, and modulates nuclear signaling. Acute liver damage in vivo leads to activation of ERK in HSC.

Migration of mesothelioma cells correlates with histotype-specific synthesis of extracellular matrix.

Three human pleural malignant mesothelioma cell cultures (MM) of epithelioid (E1), fibrous (F1) and byphasic (B1) histotype were studied in their synthesis of the extracellular matrix (ECM) components laminin (LM), fibronectin (FN), type IV collagen (cIV), and in their chemotactic and haptotactic migration towards the ECM produced proteins. MM-B1 showed the highest FN synthesis and release; MM-E1 produced the highest quantity of basement membrane constituents LM and cIV; MM-F1 weakly produced and released FN, LM and cIV. MM-B1 had the highest chemotactic and haptotactic motility, MM-F1 migrated toward the lowest concentration of LM while had reduced chemotactic activity toward FN and cIV; MM-E1 had the lowest migratory activity toward each ECM substrate. We demonstrated that three MM of different histotype are characterized by different ECM production and that these differences determine a variable ability of each MM to spread and migrate towards ECM substrates.

Update on sequential isologous rat organ transplantation: pancreaticoduodenal and kidney transplantations.

This periodic report includes intermittent results of consecutive pancreaticoduodenal (Pd) and kidney (Kt) transplants in inbred rats and results on double kidney transplants that did not follow sequential transplant protocol. Eight 24-month-old Lewis pancreas, kidney, and aorta served histological controls showing normal histological architecture with no atherosclerosis developed in the aorta. Thirty-four month old pancreas and thirty-two month old kidneys, which resided in young hosts for at least three occasions, appeared as youthful Pd and Kt grafts. They show normal histological appearance for more than the expected life span of a Lewis rat. The fact that not only pancreases but also kidneys outlived their host leads to the study of other different organs' viability as aged valuable grafts. Nevertheless, the threats by the development of atherosclerosis in graft-associated aortas resulted in slow progression of the follow-ups.

Mutations of the Apc gene in experimental colorectal carcinogenesis induced by azoxymethane in F344 rats.

We investigated in the rat the role of the Apc gene, which is mutated in familial adenomatous polyposis and sporadic colon cancer in the process leading from normal colonic mucosa to aberrant crypt foci (ACF) and finally to adenomas and adenocarcinomas. We analysed mutations in exon 15 of the rat Apc gene using in vitro synthesized protein assay in 66 ACF and in 28 colon tumours induced by azoxymethane. No Apc mutations were found in ACF, whereas five mutations were found in the tumours. The data suggest that mutations of the Apc gene are associated with the transition from ACF to adenoma and adenocarcinoma and not from normal mucosa to ACF.

Aberrant crypt foci in human colon carcinogenesis.

We developed a procedure for the endoscopic visualization in humans of aberrant crypt foci (ACF), preneoplastic lesions of the colon mucosa, and we determined the frequency of ACF in resected sections of human colon. For the endoscopy we studied 12 consenting adults (6 controls and 6 colon cancer cases) by dyeing colon mucosa with 0.5% methylene blue and searching ACF with a magnifying endoscope. ACF of varying dimensions were visualized in all subjects. We also studied colon surgical specimens from patients with colon cancer or diverticulitis. After staining the mucosa with 2% methylene blue, we found approximately the same density of ACF in the colon mucosa of the patients with colon cancer as in that of patients with diverticulitis (ACF/cm2 were 0.124 +/- 0.143 [N = 14] and 0.108 +/- 0.210 [N = 4], respectively [mean +/- SD]). In conclusion, the visualization of ACF with methylene blue in humans does not identify groups at low and high risk of colon cancer.

Modification of azoxymethane intestinal carcinogenesis in rats by feeding sucrose boluses, pasta, and glucose.

We studied whether repeated boluses of sucrose or diets containing carbohydrates with a variable glycemic index (GI) affect intestinal carcinogenesis in rats. Male F344 rats were treated twice (1 wk apart) with 15 mg/kg sc azoxymethane (AOM) and then divided into four experimental dietary groups with different carbohydrate composition and administration schedules: the sucrose group was fed 44% (wt/wt) sucrose (GI = 65), the bolus group was fed sucrose as carbohydrate and 43 boluses of sucrose (10-15 g/kg) at various time intervals, the pasta group was fed pasta [77% (wt/wt) cooked pasta, GI = 55], and the glucose group was fed 44% (wt/wt) glucose (GI = 97). All nutrients, including carbohydrates, were provided in similar amount to the different groups. The experiment was terminated between Day 230 and Day 245 after AOM administration. At this time the pasta group had significantly higher cecal short-chain fatty acids than the other groups. Intestinal adenomas and cancers occurred with the same frequency in the bolus, sucrose, and glucose groups. On the contrary, we observed a significant decrease (p = 0.03) in the cumulative incidence of intestinal adenomas, but not adenocarcinomas, in the pasta group compared with the sucrose group (intestinal adenoma incidence in the pasta group was 31% compared with 63% in the sucrose group, 46% in the bolus group, and 37% in the glucose group). In conclusion, these results do not support the hypothesis that sucrose boluses or carbohydrates with a high GI stimulate colon carcinogenesis, but they indicate that foods such as pasta may exert a protective effect.

[Current trends in the treatment of voluminous eventrations]. / Moderni orientamenti nella terapia delle voluminose eventrazioni.

The authors speak about their experience on the giant incisional hernias. The surgical treatment of these lesions in not always easy, especially when exist some conditions such as the loss of parietal substance and the loss of residence right. In these cases the use of prosthetic meshes and the Goni Moreno's pneumoperitoneum are very helpful. The Authors point out how important is, for a successful treatment, as well as a correct surgical procedure and opportune pre and post operative management.

Assay of linuron and a pesticide mixture commonly found in the Italian diet, for promoting activity in rat liver carcinogenesis.

The herbicide linuron and a mixture of 15 pesticides commonly found in the Italian diet have been assayed for promoting activity in rat liver carcinogenesis. Composition of the pesticide mixture was: benomyl (19.55%); dithiocarbamates (20.67%); thiabendazole (14.94%); diphenylamine (14.25%); chlorthalonil (13.13%); procymidone (7.96%); fenarimol (1.95%); chlorpropham (0.70%); vinchlozolin (0.28%); methidathion (2.37%); chlorpyriphos-ethyl (2.09%); parathionmethyl (1.00%); chlorfenvinphos (0.27%); parathion (0.70%); pyrimiphos-ethyl (0.14%). To determine promoting activity we evaluated induction of preneoplastic foci in diethylnitrosamine-initiated hepatocytes, by positive gammaglutamyl-transpeptidase (GGTase) staining in liver slides, and peroxisome proliferation by peroxisomal-dependent catalase and palmitoyl-CoA-oxidase dosage. For the assay, groups of male Sprague-Dawley rats were initiated with 100 mg/kg diethylnitrosamine intraperitoneally and, one week later, given 150 mg/kg/day linuron or 10 mg/kg/day pesticide mixture, administered by gavage three days a week. All rats were 2/3 hepatectomized at the beginning of the 3rd week. All treatments were terminated at the end of the 8th week, and the rats were sacrificed one week later. No significant increases in number and area (mm2) per slide unit area (cm2) of GGTase-positive foci could be observed in linuron-treated rats (5.84 +/- 1.62/cm2; 0.139 +/- 0.041 mm2/cm2) with respect to controls only initiated with diethylnitrosamine (4.47 +/- 1.30/cm2; 0.182 +/- 0.078 mm2/cm2). After treatment with the pesticide mixture, the number of preneoplastic foci was instead significantly increased (6.91 +/- 2.05/cm2) although the area was not (0.188 +/- 0.128 mm2/cm2). Moreover, no increases in the peroxisome proliferation enzymatic markers were observed in either treated groups. The results imply a possible carcinogenic risk for the population stemming from promoting activities of pesticide mixtures.

Effects of GM1 ganglioside on cardiac function following experimental hypoxia-reoxygenation.

Rat hearts made hypoxic for 20 min by perfusion with 95% N2/5% CO2 and reoxygenated for 20 min in a Langerdorff apparatus showed a dose-dependent reduction of lactate dehydrogenase release when incubated with ganglioside GM1 (0.1-10 microM). The decline of contractile force during hypoxia was also reduced dose dependently in the presence of GM1. Similar effects were observed in hearts obtained from animals treated i.p. with 40 mg/kg GM1 for 14 days. The levels of Na+,K(+)-ATPase in ventricular tissue were also reduced after hypoxia-reoxygenation and the reduction was prevented in hearts from GM1-treated animals. GM1 (1-30 microM) reduced the functional response to field stimulation of adrenergic nerve terminals in isolated atria. Rat atria made hypoxic in glucose-free media maintained normal stores of tissue noradrenaline in the presence of 1 microM GM1. In the rabbit, GM1 (40 mg/kg i.p. for 4 days) reduced the alterations of the ST segment of the ECG during acute occlusion of the left descending and circumflex coronaries artery. In conclusion, ganglioside GM1 reduces some effects of hypoxia-reoxygenation in the heart, through still unknown mechanisms.

Effect of caval-portal shunt on ovarian tissue in rats: I. Histological observation.

Forty-three female Sprague Dawley rats were divided into five groups, with groups 1-4 subjected to end-to-side caval-portal shunt (CPS). In addition to CPS, group 1 (n = 13), group 2 (n = 10), and group 3 (n = 7) rats had undergone removal of the right ovary and one-half of the left ovary, the left ovary, and one-half of the left ovary, respectively. Group 4 (n = 6) rats were not subjected to ovariectomy. Group 5 (n = 7) animals were not subjected to CPS but underwent left ovarian hemiresection. The ovarian volume of the hemiresected ovaries increased to 393.00 +/- 4.83 mm3 and 126.00 +/- 44.3 mm3 from 18.40 +/- 0.54 mm3 and 18.40 +/- 0.59 mm in groups 1 and 3, respectively, at the end of three postoperative months. The nonresected ovaries enlarged to 339.98 +/- 5.09 mm3 and 226.3 +/- 46.2 mm3 from 36.79 +/- 1.09 mm3 in groups 2 and 3, respectively. When no ovaries were resected, the CPS animals in group 4 showed an increment of ovarian volume of 1.75-2.2 times as much as the preoperative ones. In the animals that had undergone simple hemiovariectomy (group 5), the contralateral ovaries showed a significant increase in volume (40.2 +/- 8.3 mm3 to 243.1 +/- 114.8 mm3) at 3 months. The hemiresected ovarian volume increased from 27.1 +/- 5.5 mm3 to 44.1 +/- 11.8 mm3.(ABSTRACT TRUNCATED AT 250 WORDS)