Expression of genes associated with apoptosis in the porcine corpus luteum during the oestrous cycle.

The corpus luteum (CL) of the pig lacks luteolytic sensitivity (LS) to prostaglandin (PG) F-2α until after day 12 of the oestrous cycle, but the mechanisms underlying this phenomenon are poorly understood. As luteolysis involves apoptosis, we hypothesized that critical apoptotic proteins may be deficient in CLs that lack LS. The specific aim of these studies was to examine mRNA expression and protein levels of apoptosis genes/proteins (BAX/Bax, BCLX/Bcl-x, CASP3/Caspase-3, CASP8/Caspase-8, NFΚB1/NFκB, TP53/p53) in porcine CLs collected at different stages of the oestrous cycle. CLs were collected surgically, mRNA and protein extracted, and expression/levels analyzed by semi-quantitative (SQ) PCR and Western blots, respectively. At the mRNA expression level, only BAX (maximal on day 4) and TP53 (maximal on day 7) showed significant variations during the oestrous cycle. At the protein level, only Bcl-x and Caspase-3 showed significant changes during the cycle; Bcl-x decreased on day 13 and Caspase-3 increased on day 13. It is concluded that apoptosis-associated proteins (i.e. Bcl-x and Caspase 3) may play a critical role in luteolytic sensitivity in the pig.

[Human intestinal parasitosis: role of Dientamoeba fragilis in human infections]. / Parassitosi intestinali autoctone: ruolo di Dientamoeba fragilis nelle infezioni umane.

The Authors report prevalences of intestinal parasitosis among home children and adults during 2002-2004, as in O&P as in acute or prolonged diarrhoea, with particular attention to the role of Dientamoeba fragilis, because often undervalued. Among 3139 subjects, 116 cases of dientamoebiasis (3.7%) and 62 of giardiasis (2.0%) were observed; not typical pathogenic protozoa were reported in 71 cases (2.3%); helminths were identified only in 8 cases (0.5%). Particularly, inside O&P group D. fragilis prevailed in 5.2% of cases (7.8% in adults and 0.5% in children) and G. duodenalis in 2.7% (3.5% and 1.3% respectively); inside acute diarrhoeas D. fragilis prevailed in 1.6% (3.9% and 0.3%) and G. duodenalis in 0.6% (1.3% and 0. 1%); inside prolonged diarrhoeas D. fragilis prevailed in 3.5 % (2.6% and 5.4%) and G. duodenalis in 3.9% (5.8% in adults and never in children). D. fragilis was more often observed among adults (6.3% of all) than among children (0.6%), like G. duodenalis (3.1% versus 0.6%). So, 107 strains of D. fragilis (92.2%) and 53 strains of G. duodenalis (85.5%) were identified in adults. D. fragilis was more frequent among females (24/39 cases, 61.5%, in the last year) while G. duodenalis was more frequent in males (13/23 cases, 56.5%). The Authors conclude underlining the importance of a permanent stain, as Giemsa stain, for a good and complete diagnosis of protozoal intestinal infections, particularly for D. fragilis.

[Enterobiasis during 2002-2003 in Perugia province: beyond diagnostics]. / Enterobiasi nel biennio 2002-2003 nel perugino: considerazioni non soltanto diagnostiche.

Between 2002 and 2003 we examined cellophane tapes of 119 children, both symptomatic and apparently asymptomatic. Eggs of Enterobius vermicularis were observed in 13.4% of children. This helminth is the most frequent in Italy, but it is as yet unrecognized, probably due to parasitological laboratories not being consulted, resulting in incomplete epidemiological data. We recall the biological aspects of this nematode and suggest the need for sound diagnosis to ensure proper surveillance of this exclusively human infection.

Liver metastases from breast cancer: the role of surgical treatment.

BACKGROUND/AIMS: To evaluate short- and long-term outcomes in the surgical treatment of liver metastases from breast cancer METHODOLOGY: Between 1984 and 1999 we observed 26 patients with secondary liver localization (25 metachronous) from breast cancer. The median disease-free interval was 70 months (4-136). Median age at the time of liver surgery was 56 years (36-76). The 18 patients included: 1 patient at stage 1, 10 at IIA, 6 stage II B and 1 patient at stage IV. Seven patients were found to have axillary lymph nodes metastases. Fifteen patients had infiltrating ductal carcinoma, 2 a lobular carcinoma and 1 patient a mixed-component carcinoma. The grading was G3 in 10 and G2 in 8 patients. Regarding the recettorial status, 5 patients were ER+ PR-, 8 patients were ER+PR-, 4 patients were ER-PR-. In 9 cases the patients underwent adjuvant chemotherapy (5 of them following postoperative radiotherapy) and in 14 cases Tamoxifen was used. Surgery was conservative in 13 cases and demolitive in 5 cases. RESULTS: The follow-up (3-70 months) was completed in 15 patients out of 18 observed cases. Nine patients died; six patients are still living, 4 of them "disease-free", 2 having advanced metastatic disease, in treatment. There was neither long-term or perioperative major morbidity nor mortality in our group. The overall 5-year-survival was 25% in patients whose liver metastases developed within 3 years after breast surgery compared with 40% in those ones with metastatic disease diagnosed more than 3 years after. CONCLUSIONS: Surgery of liver metastases from breast cancer can be performed with low morbidity and mortality in selected patients.

Dientamoeba fragilis is more prevalent than Giardia duodenalis in children and adults attending a day care centre in Central Italy.

Giardia duodenalis is a well recognised enteropathogen, while Dientamoeba fragilis is rarely detected and consequently it is not recognised as an important human pathogen. In 2002-2003, a survey has been carried out on enteroparasites in faecal samples of outpatients attending a day care centre in the town of Perugia (Central Italy). To improve the detection level, at least three samples from each patient were collected at different days and within two hours from defecation. The coproparasitological examination has been carried out by direct microscopic examination, faecal concentration, and Giemsa and modified Ziehl-Nielsen stainings of faecal smears. The genotypes of Giardia duodenalis isolates were determined by PCR of the beta-giardin gene. Of 1,989 enrolled people (966 children, 1,023 adults), 165 persons (8.3%; 153 adults, 15.0%; 12 children, 1.2%), were positive for parasites, but only 1 12 adults (73.2% of those infected) and eight children (66.7% of those infected) harboured D. fragilis and G. duodenalis. Both the Assemblages A and B were detected in 18 G. duodenalis isolates examined at the beta-giardin gene. The higher prevalence of D. fragilis infections than that of G. duodenalis is probably related to the method used, a procedure, which is rarely followed in laboratories for the diagnosis of enteric parasites. These epidemiological data suggest that when faecal samples are examined after a period of time and without Giemsa staining, most D. fragilis infections goes undetected.

[Isolated resection of the caudate lobe in metastasis of colorectal cancer]. / Resezione isolata del lobo caudato per metastasi da cancro colorettale.

The presence of metastatic lesions confined to the caudate lobe (CL or segment I) is quite a rare event. Even more rare is the decision to perform an isolate CL resection. Segmental resection in the liver is justified by the evidence that primary and secondary lesions, in early stage, are confined to the originating segment, and therefore a segmentectomy can be considered for the CL as well. Anatomy of the CL was deeply studied through the years since the surgical approach to this liver segment requires a detailed knowledge of its surgical anatomy and only after 1985 the surgical technique for CL isolate resection was established. We report our experience with 1 case of isolate colo-rectal metastasis confined to the caudate lobe and describe the surgical technique employed.

[Dientamoeba fragilis and dientamoebiasis: aspects of clinical parasitology and laboratory diagnosis]. / Dientamoeba fragilis e dientamoebosi: aspetti di parassitologia clinica e diagnostica di laboratorio.

The flagellate Dientamoeba fragilis is a potential intestinal pathogen of humans. It is probably undervalued overall because its identification relies on permanent stains directly on fresh fecal specimens (Giemsa) or preserved in PVA or SAF (Trichrome or Iron-hematoxylin). During 1999 we processed stoll samples of 151 subjects and we searched also D. fragilis. We processed 105 cases of enteritis (82 children and 23 adults) and 46 samples of formed stools to investigate only for intestinal parasites (12 children and 34 adults). The microscopical observations were made on smears directly in saline solution, and after Dobell solution, MIF and Giemsa stained. Iron hematoxylin and trichrome stains were performed in some circumstances only. D. fragilis was observed in 11.3% of cases, 7.6% among the group of enteritis and 13.8% among the other subjects. These positive 17 cases were observed more often among adults (76.5% of cases) than among children (23.5%). In our study area D. fragilis seems more frequent than Giardia intestinalis and represents the third important intestinal parasite, following Enterobius vermicularis (children) and Strongyloides stercoralis (elders).

[Papillary carcinoma of the thyroid arising on thyroglossal duct cysts: report of a case and review of the literature]. / Carcinoma papillare della tiroide insorto su cisti del dotto tireoglosso: a proposito di un caso e revisione della letteratura.

Thyroglossal duct cysts are the most common congenital disorder of the neck. One percent of cases may degenerate and give rise to a cancer, mainly arising in the pericystic thyroid tissue. Some 250 cases have been reported in the literature to date. We report here on a 39-year-old man with a midline mass in the neck measuring 4 cm max. The patient was examined preoperatively by ultrasonography of the neck and assay of thyroid hormones, which yielded a diagnosis of a thyroglossal duct cyst. On the basis of these findings, the patient underwent surgery to remove the mass and, after an extempore histopathological examination, was submitted to total thyroidectomy owing to the presence of papillary carcinoma of the thyroid arising on the thyroglossal duct cyst with multiple foci in the context of the thyroid gland. Most thyroid cancers at the time of surgery are confined to the thyroid gland, infiltrating the adjacent structures in approximately 20% of cases and the local-regional lymph nodes in 8 to 11.5%. Thyroid papillary adenocarcinoma is multifocal in 21% of cases. The multifocal nature of the cancer makes total thyroidectomy mandatory at the same time as surgery is performed to remove the cyst.

[Thyroid carcinoma: evaluation of prognostic factors]. / Carcinoma della tiroide: valutazione dei fattori prognostici.

Between 1990 and 1997, 36 thyroid cancer patients were observed at the III Department of Surgical Oncology, Regina Elena Cancer Institute in Rome. There were 31 (86.1%) women and 5 (13.9%) men, with a mean age of 47.7 years (range 17-72). Diagnostic data consisted of: papillary carcinoma in 25 patients, follicular carcinoma in 9 and Hürthle cell carcinoma in 1. Twenty patients were less than 45 years old (15 papillary and 5 follicular carcinoma) and 16 were more than 45 years old (10 papillary and 4 follicular carcinoma, 1 Hürthle cell carcinoma and 1 with undifferentiated cancer). We performed total thyroidectomy in 32 cases and isthmectomy in 3 (2 papillary carcinoma, T1, < 45 years, 1 follicular carcinoma with minimal invasion). At the time of diagnosis, 6 patients with papillary carcinoma showed signs of local metastasis. No patients exhibited distant diffusion. A follow-up was performed at mean 41 months (2-84 months). Two patients with follicular carcinomas had been treated with radioiodine and showed disease progression with distant metastasis. Our results coincide with the literature on this topic. Total thyroidectomy is preferred, in low-risk patients as well, because subsequent radioiodine treatment and disease relapse monitoring are facilitated. Lateral cervical lymphadenectomy was performed only in cases when there was clinical evidence of metastasis and recurrent disease at this level has never been observed.

Superselective intra-arterial radiometabolic therapy with I-131 lipiodol in hepatocellular carcinoma.

Superselective transcatheter arterial radioembolization with radioiodinated lipiodol and gelatin sponges was evaluated in 11 patients with nodular hepatocellular carcinoma. Thirteen tumor nodules were treated using 3-5 ml of lipiodol labeled with 259 to 2220 MBq of I-131 followed by gelatin sponge with the following results: 1) there was elevated uptake in 12 tumor nodules with high tumor-to-background ratios: 2) there was excellent clinical tolerance to the treatment (stable cirrhosis in 5 patients and cirrhosis progression in 2 cases); 3) there was good disease control with size reduction in five tumor lesions (41%) and no increase in seven lesions (59%) followed for 2 years; 4) there was a 2-year survival rate of 70%; and 5) three deaths due to hepatic failure at 2, 3, and 20 months after therapy. Superselective arterial radioembolization with I-131 lipiodol is a useful palliative approach to inoperable hepatocarcinoma, providing long-term local control without severe complications in the progression of cirrhosis.

[Chronic splenic tuberculosis. Description of a case]. / La tubercolosi splenica cronica. Descrizione di un caso.

The authors report a case of chronic splenic tuberculosis. They underline the diagnostic difficulties, notwithstanding the remarkable progresses in radiological technics, essentially related to the rarity of this tubercular site and they outlined the exact surgical indication to the splenectomy.