Ascorbic acid enhances bone parameter expression in human gingival mesenchymal stem cells.

Ascorbic acid (AS), also known as vitamin C or ascorbate, is an essential dietary nutrient which plays a vital role in biological processes through various different mechanisms, in particular for the biosynthesis of collagen. The aim of the study was to establish the possibility of enhancing the osteogenic differentiation potential by manipulating the cellular micro-environment, through AS supplementation in human gingival mesenchymal stem cells (hGMSCs) at different concentrations, such as 60 and 90 µg/mL, for three weeks. Human GMSCs are considered a stem cell population, easily obtainable and displaying a remarkable immunotherapeutic potential and regenerative repair expression. Osteogenic differentiation level induced from AS was assayed by histochemical characterization, using light microscopy through Alizarin red S staining. The transcript levels of Collagen 1A1 (COL1A1), runtrelated transcription factor 2 (RUNX2), bone morphogenetic protein 2/4 (BMP2/4), osteopontin (OPN) and osteonectin (SPARC) were determined by quantitative RT-PCR. Protein expression of COL1A1, RUNX2, BMP2/4, OPN, SPARC were studied through Western blotting and confocal laser scanning microscopy (CLSM). Our results demonstrate that AS supports osteogenic differentiation in stem cells from gingiva niche as shown by osteogenic marker upregulation and by de novo production of calcium phosphate deposits as revealed by Alizarin red S staining. In summary, the results of the current study provide evidence that hGMSCs undergo osteogenic differentiation with AS treatment, for that reason AS could be a promising candidate for the prevention and healing of bone-related diseases.

Does optical coherence tomography identify arterial healing after stenting? An in vivo comparison with histology, in a rabbit carotid model.

OBJECTIVE: To verify whether optical coherence tomography (OCT) can accurately monitor the occurrence of arterial healing after stenting. SETTING: Delayed stent endothelialisation may predispose to stent thrombosis. OCT is a high-resolution intravascular imaging technique that accurately identifies stent struts and arterial tissues. DESIGN AND INTERVENTIONS: Eight New Zealand white rabbits underwent the implantation of single bare metal stents (diameter 2-2.5 mm, length 8-13 mm) in the right common carotid artery through the external carotid artery. After a median of 11 days (range 2-28), the stented arteries were visualised by OCT, with images acquired at a pull-back speed of 0.5 mm/sec. The rabbits were then euthanised, vessels were formalin-fixed and finally processed for histopathology. RESULTS: We analysed 32 cross-sections from eight stented carotid arteries, for a total of 384 stent struts. OCT detected all of the stent struts in 30 of 32 cross-sections (93.7%), and correctly identified the presence/absence of tissue for every strut. Histological and OCT measurements of mean neointima thickness (0.135 (SD 0.079) mm and 0.145 (SD 0.085) mm, respectively, p = NS) were similar and closely related (r = 0.85, p<0.001). Neointima area progressively increased with longer time intervals from stent deployment to sacrifice; histological and OCT measurements were similar for each time interval. The intra-observer and interobserver reproducibility of OCT neointima measurements were excellent (R2 = 0.90 and 0.88, respectively). CONCLUSIONS: OCT is a promising means for monitoring stent strut coverage and vessel wall healing in vivo, the relevance of which will become even more significant with the increasing use of drug-eluting stents.

Human dirofilariasis in Italy: a new case in the spermatic cord.

A new case of human dirofilariasis associated with Dirofilaria (Nochtiella) repens (Nematoda, Filarioidea, Onchocercidae) located in the spermatic cord is reported in a 71-year-old man from the province of Campobasso (Central Italy). When clinical signs pointed to a testicular tumor, a monolateral orchifuniculectomy was performed. According to the scientific literature, this case appears to be exceptional in its location, being only the eighth such case recorded in the world until now. The nematode, as well as the presence of vectors suitable for its transmission, had already been observed both in dogs and in humans (3 subcutaneous cases) in the same geographical area.

[Villograndular adenocarcinoma of uterine cervix: a case report]. / Adenocarcinoma villoghiandolare ben differenziato della cervice uterina: descrizione di un caso.

We report a case of villoglandular adenocarcinoma of the uterine cervix, discovered in a 69-year-old woman. The patient underwent a radical Wertheim hysterectomy and bilateral pelvic lymphoadenectomy and is alive and well, with no evidence of recurrent disease after 5 years from diagnosis. 13 reports totaling 70 patients with diagnoses of villoglandular adenocarcinoma have been published. The patients ages ranged from 22 to 61 years. Well-differentiated villoglandular adenocarcinoma of the uterine cervix has been recently recognized and described as a distinctive histologic entity which develops in young women. It is possible that cases of villoglandular adenocarcinoma in older women, as our case, were previously considered to represent different histologic types of adenocarcinoma. The differential diagnosis of villoglandular adenocarcinoma is important for prognostic and treatment reasons.

Omeprazole versus ranitidine: short-term triple-therapy in patients with Helicobacter pylori-positive duodenal ulcers.

AIM: To compare the results of two short triple-therapy regimens, different only in the antisecretory drugs used, in patients with active duodenal ulcer and Helicobacter pylori infection. METHODS: All patients received a combination of clarithromycin 250 mg b.d. and tinidazole 500 mg b.d. for 1 week, in addition to an antisecretory drug: omeprazole 20 mg (50 patients) or ranitidine 300 mg (50 patients) twice daily for 1 week, followed by a single daily dose for a further 3 weeks. Upper gastrointestinal endoscopy, with rapid urease test and histological examination of antral and corpus biopsies, was performed prior to the treatment and at least 2 months after the discontinuation of the antisecretory therapy. RESULTS: Duodenal ulcer healing was documented in all patients at the endoscopic examination after therapy. H. pylori eradication was achieved in 46 of 50 patients (92%, 95% CI = 85-99%) in the omeprazole group and in 43 of 50 patients (86%, 95% CI = 76-96%) in the ranitidine group: the difference is not significant. CONCLUSION: Omeprazole or ranitidine, in combination with clarithromycin and tinidazole, are equally effective in the eradication of H. pylori infection and healing of duodenal ulcers.

[The role of Enterobius vermicularis in etiopathogenesis of appendicitis]. / Il ruolo dell'Enterobius vermicularis nell'etiopatogenesi dell'appendicite.

The authors present 14 cases of enterobiasis of appendix observed between 1991-94, on a total of 1093 appendectomies. The presence of the parasite was associated, in the majority of cases, to a chronic appendicitis. The symptomatology imitates an attack of acute appendicitis, but the true nature of the disease is diagnosed only through a histological examination. There is probably an etiopathogenic relationship between. E. vermicularis and chronic appendicitis, whereas the relationship between the parasite and acute appendicitis is rare and very disputed.

[Malignant Brenner's tumor of the ovary: description of a case]. / Tumore di Brenner maligno dell'ovaio: descrizione di un caso.

A case of malignant Brenner tumor (MBT) in a 42-year-old woman is described. According to the literature it is evident how rare this type of MBT is as well as the histogenetic problems arising in this neoplasia deriving from the coelomic epithelium. The malignant histologic criteria are those adopted in 1973 by Hull and Combell who showed as unquestionable signs the association of benign and malignant Brenner tumor, the invasion of the stroma on behalf of the malignant Brenner elements and the absence of mucinous cystadenoma or the association with the above mentioned.

[Peritoneal mesothelioma]. / Il mesotelioma peritoneale.

Peritoneal mesothelioma is a quite rare tumor with an incidence of one or two cases per million inhabitants; approximately in the 30-45% of the cases diagnosed it is associated with the corresponding pleural mesothelioma. A predisposing factor is a previous occupational exposure to materials containing asbestos. Clinical symptomatology and instrumental findings may be confusing. Diagnosis is often possible only after direct vision and histologic examination during laparoscopy or laparotomy but it is always tardy, whereas therapy is still unsuccessful. Surgical excision and radiotherapy are less effective than intraperitoneal chemotherapy which seems to lengthen the average survival rate.

Adenomyoepithelioma of the breast associated with low-grade adenosquamous and sarcomatoid carcinomas.

Six cases of invasive breast carcinoma with unusual morphological features are reported. The ages of the female patients ranged from 46 to 79 years (mean 60.5). All tumours had areas typical of an adenomyoepithelioma. In three cases adenomyoepithelioma gradually merged with low-grade adenosquamous carcinoma. In the other three patients a sarcomatoid carcinoma was associated with adenomyoepithelial areas. A common origin is proposed for these neoplasms, which extends the morphological spectrum of epi-myoepithelial cell tumours.

[Immuno-histopathologic changes in the gastrointestinal mucosa in patients with nickel contact allergy]. / Modificazioni immuno-istopatologiche della mucosa gastro-intestinale in pazienti con allergia da contatto al Nichel.

The study concerns the histological and immunohistochemical findings of the gastrointestinal mucosa of 20 patients (group A) suffering from contact allergic dermatitis (CAD) to Ni, with symptom recrudescence due to food ingested Ni. Results were compared with those observed in 20 patients suffering from CAD to Ni (group B), without sensitivity to food ingested Ni, and in 20 normal subjects (controls). The sensitivity to food ingested Ni, as suggested by history, was demonstrated by placebo-controlled oral-Ni challenge. The biopsies for histological and immunohistochemical study were performed during endoscopy and obtained from the antrum and from the duodenal mucosa. In the biopsies obtained from 16 of group A patients there was evidence of inflammatory infiltrate of lymphocytes and plasma cells with oedema and vasodilation in the lamina propria. Slight flattening of the villi and enlongation of the crypts were concomitant. These findings were light in the 4 patients of group A and in 11 of group B and instead were absent in the remaining group B patients and in the controls. Immunohistochemically, lymphocytes in the lamina propria were prevalently CD20 + (B cells) and CD4 + (Th cells), some were CD45RO + (memory) and finally few CD8 + (Tc/s cells). CD45RO + cells was found in cluster in patients of group A and in 4 of group B, whereas in the others were isolated. Since some studies have shown that immunological pattern of skin reaction to Ni is characterized by increased CD45RO + cells, it may be hypothesized that in patients suffering from CAD to Ni, the sensitivity to food-ingested Ni may be induced by a type IV immunological reaction in the gut.

The epidermal growth factor family in pulmonary carcinoids: immunohistochemical evidence of growth-promoting circuits.

Autocrine neoplastic growth circuits are based on excess synthesis of growth factors and/or cognate membrane receptors. We analyzed by immunohistochemistry 19 typical lung carcinoids for the expression of the epidermal growth factor (EGF), transforming growth factor alpha (TGF alpha), EGF receptor (EGFr), and EGFr-related c-erbB-2 protein (p185). Thirteen tumors (68%) were positive for TGF alpha, 11 for EGFr (58%), three for EGF (16%), and four for p185 (21%). Six carcinoids (32%) were consistently negative for these gene products. The following patterns of coexpression could be documented: TGF alpha, EGFr, EGF, and p185: two cases (11%); TGF alpha, EGFr, and EGF: one case (5%); TGF alpha, EGFr, and p185: two cases (11%); TGF alpha and EGFr: six cases (32%); TGF alpha by itself: two cases (11%). Thus, EGFr was coexpressed with its ligands, TGF alpha and EGF, and the receptor encoded by c-erbB-2 was detected in carcinoids positive for EGFr and TGF alpha. Therefore, alterations of EGF/EGFr-related growth control pathways may be implicated in the pathogenesis of pulmonary carcinoids via the establishment of autocrine growth promoting circuits, as documented in adenocarcinomas and squamous cell carcinomas of the lung.

Sodium cromoglycate in the treatment of eosinophilic gastroenteritis.

Two patients suffering from eosinophilic gastroenteritis (EG) were treated with sodium cromoglycate (SCG). Before treatment they showed enteric and cutaneous symptoms, such as abdominal pain, nausea, vomiting, diarrhoea and recurrent urticaria and angioedema. The histological findings were a notable amount of eosinophilic infiltration in the lamina propria and gastric glands, a villous shortening and thickening and weak eosinophilic inflammation in the duodenum. The patients were treated with 300 mg SCG, 4 times daily, for 4/5 months. During treatment, the clinical symptoms disappeared and at the end of treatment a reduced inflammation with an almost complete decrease of eosinophilic infiltration was observed. The results provide evidence of SCG efficacy in the treatment of EG and suggest its employment as an alternative to the steroids commonly used in EG.

[Mucoid carcinoma of the anus and perianal fistula: a clinical case and review of the literature]. / Carcinoma mucoide dell'ano e fistola perianale: caso clinico e revisione della letteratura.

The Authors describe a case of mucoid anal carcinoma occurring in a perianal fistula. Surgical treatment was an abdomino-perineal resection (Miles' operation). On the basis of their experience and of the results reported in the literature, the Authors discuss the clinical and histological aspects of this association.

[Primary lymph node infarct and malignant non Hodgkin's lymphoma. Description of a case]. / Infarto primitivo linfoghiandolare e linfoma maligno non Hodgkin. Descrizione di un caso.

Primary lymph node infarction and malignant non Hodgkin lymphoma. Case report. We describe a case of spontaneous primary lymph node infarction in a patient who had diagnoseable malignant lymphoma on rebiopsy after a period of 35 days. The first node biopsy showed nearly complete homogeneous necrosis with loss of normal architecture and peripheral rim of organizing granulation tissue. A stain for reticulum, however, showed preservation of the nodal reticulum framework. The follow-up biopsy on the same cervical area, approximately one month later, surprisingly showed a large cell lymphoma. Comparison of reticulum stains of this neoplastic node with earlier stains should dispel any doubts that the first lymph node studied was a true case of non-neoplastic infarction. A review of the literature on lymph node infarction is reported.

Dysphagia lusoria: proposal of a new treatment.

Recent observation of one patient suffering from dysphagia lusoria has suggested critical review of treatment of the symptomatic aberrant right subclavian artery. Surgical correction of such an anomaly is difficult and may produce serious complications, and is not always successful. Endoscopic dilatation of the oesophageal stricture, even though it might only produce temporary relief of dysphagia, represents a valid therapeutical alternative because of its favourable cost/benefit ratio, low incidence of complications and patient acceptability.