[Upper limb work-related musculoskeletal disorders (UL-WMSDs) in a large factory of the upholstered furniture industry: risk management]. / La gestione del rischio di UL-WMSDs in una grande azienda del mobile imbottito.

BACKGROUND: The industrial production of upholstered furniture exposes workers to significant risk of occupational disorders due to ergonomics-related problems, such as repetitive strain and movements of the upper limb, manual load lifting, prolonged static postures. OBJECTIVE: This paper describes the main measures taken by the biggest company in the "sofa sector" in southern Italy in order to solve such problems in the years 1996-2004. METHODS: the classic instruments of ergonomics were used such as risk assessment, medical surveillance, training and information programmes, technological reorganization of the manufacturing process and of single working tasks. RESULTS: The accident rate (number of accidents per million working hours) which showed an increasing trend in the previous years, rose from a value of 31 in 1996 to 51 in the years 1999-2000 (with a percentage of accidents related to load lifting in the range 25-35%). At the same time the incidence rate of work-related upper limb musculoskeletal disorders (UL-WMSDs) in the population of workers (which had increased in the meantime from 2500 to 3500 employees) reached nearly 5% in 2001, with peaks of 8-9% in the work tasks with higher exposure. Accident rates progressively fell in the following three years until a value of 20 was reached in 2004 and 2005, while the mean incidence rate of WMSDs reached a value of nearly 1%. The data need to be compared with the trends in the other companies of the sector in the same period, with an average incidence rate of WMSDs around 2% and a generally increasing trend. CONCLUSIONS: Ergonomic interventions not only concur in the management and control of negative events for workers health but also in achieving advantages in terms of lower costs and greater productivity.

Progression on metastatic neuroendocrine carcinoma from a recurrent prolactinoma: a case report.

A 54 year old man was referred to the department of neurosurgery for frontal headache and vomiting. The patient was known in the department because of previous multiple surgery for a locally invasive pituitary prolactinoma (eight years, three years, and one year previously). The neurological examination revealed a frontal mass, which adhered to the dura, suggesting a meningioma. One year later, a left temporal metastasis was removed. Three months later, the patient died, with spinal metastases, of massive lung embolism. Histology revealed a progression of adenohypophyseal prolactinoma on neuroendocrine carcinoma, with an increase in proliferating indexes and modification of hormone production. This study documents a 10 year history of a rare prolactin producing pituitary carcinoma, which metastasised via liquoral flow.

Hemangioma of the ovary. A case report.

BACKGROUND: Ovarian hemangioma is extremely rare. CASE: We report a case of a 32-year-old woman who complained of pelvic pain due to a large right adnexal mass. On color Doppler sonography the mass showed very rich and complex vascularity, with prominent blood flow. A 10 x 8-cm hemangioma of the right ovary was resected. CONCLUSION: Hemangiomas should be considered when a richly vascularized tumor with prominent blood flow is detected on color Doppler sonography or magnetic resonance imaging.

[Squamous cell carcinoma in oral lichen ruber planus. A clinico-pathological and immunohistochemical study of 11 cases]. / Carcinoma squamoso su lichen ruber planus orale. Studio clinico-patologico ed immunoistochimico di 11 casi.

The malignant transformation of lichen ruber planus (LRP) is a quite frequent event for which, at present, no clear pathogenetic explanation has been given. Recently, attention has been paid to growth factors and growth factor receptors as possible pathogenetic factors of malignancy, even if not enough studies have been performed to exploit their role in oral diseases. Aim of the present study was to investigate the expression of epidermal growth factor receptor (EGFr) in squamous carcinomas arising in patients with LRP. The study has been performed on formalin-fixed, paraffin-embedded tissue biopsies obtained from 11 patients with previous diagnosis of LRP in which squamous carcinoma had developed. A monoclonal anti-EGFr antibody has been used, with the ABC technique, on histological sections. EGFr has been immunolocalized in basal and suprabasal epithelial layers in LRP with the highest intensity of staining in the areas with strong inflammation. EGFr immunostaining could be detected in dysplastic areas as well, even if the intensity of staining seemed to decrease with severity of dysplasia. In well-differentiated squamous carcinoma EGFr was intensely expressed, especially in mature keratinized cells. Weaker or absent EGFr immunoreaction was detected in moderately and poorly differentiated carcinomas. The results of the present study seem to show that EGFr is expressed in squamous carcinomas arising from LRP. The variability of EGFr expression in inflamed oral mucosa, in dysplastic areas and in tumors with different degrees of differentiation seem to point out that EGFr might somehow regulate the maturation and replication of epithelial cells in LRP and in its malignant counterpart. The speculations achieved from the present study need further evaluation on wider series of cases and, possibly, with different antibodies which would allow the identification of mutant forms of the receptor.

[Association of infantile nephroblastomatosis and Wilms' tumor: discussion of a clinical case and therapeutic problems, analysis of the literature]. / Associazione della nefroblastomatosi infantile e tumore di Wilms: discussione di un caso clinico e delle problematiche terapeutiche, analisi della letteratura.

This is a case report of bilateral nephroblastomatosis in a 19 month child, who underwent a unilateral nephrectomy and chemotherapy. Further review of the nephrectomy specimen and biopsies of the contralateral kidney revealed mature features of nephrogenic rests progressing to Wilms' tumor. We have reviewed the literature and discuss the presentation and different therapeutic approaches.

Secretory meningioma, a rare meningioma subtype with characteristic glandular differentation: an histological and immunohistochemical study of 9 cases.

AIM: We studied the immunophenotype of 9 cases of secretory meningioma (SM), a rarely reported meningioma variant, characterized by small gland-like lumina filled with a PAS-positive, diastase-resistant substance. METHODS: Three samples of arachnoid tissue and 9 SMs were studied with a panel of monoclonal antibodies (MoAbs) against cytokeratins (Ck) 7,8, 20, vimentin, EMA, CEA and the mucin epitopes sialyl-Tn, Tn, CA19.9, CA125, against the BerEP4 and CD15; 3 colonic adenocarcinomas metastatic to the brain and a case of meningioma with metastasis from a gastric signet-ring cell carcinoma were also studied with the same panel of MoAbs for comparison. RESULTS: The 3 samples of arachnoid cap cells were positive only for EMA and vimentin in the supportive stroma. All 9 SMs resulted Ck7+, Ck8+, Ck20-, EMA+, CEA and mucin epitopes+, confirming at an immunohistochemical level the glandular differentiation. Notable exceptions were the negativity for BerEP4 and CD15 antigens. Conversely, the 3 metastatic colonic adenocarcinomas to the brain were Ck7-, Ck8+, Ck20+, CEA and mucin epitopes+, BerEP4 and CD15+; the gastric signet-ring cell carcinoma metastatic to a meningioma showed the same immunophenotype as the other metastatic adenocarcinomas with the exception of BerEP4 negativity. CONCLUSION: The different pattern of cytokeratin expression (Ck7+/Ck20- for SMs, and Ck7-/ Ck20+ for adenocarcinomas) and the negativity for BerEP4 and CD15 epitopes of SMs, could be relevant for the distinction between SMs and metastatic adenocarcinomas.