Solitary plasmacytoma of the tonsillar site associated with actinomyces infection: the possible role of IL-6.

ExtraMedullary Plasmacytoma (EMP) is a rare plasma cell tumor. It can occur in the upper aerodigestive tract and presents as a large nodule causing local compressive symptoms. A 79-year old woman presented to Otorhinolaryngology Department with progressive hearing loss and no other symptoms. Following PET/TC examination due to the suspicion of a lymphoproliferative disease, the patient underwent tonsillectomy and the diagnosis of solitary EMP was formulated. In addition to that, the histological examination of the tonsillar tissue revealed large colonies of filamentous bacteria, showing abundant sulphur granules and Splendore-Hoeppli phenomenon; these evidences indicating the presence of a chronic Actinomyces infection. Immunohistochemical analysis demonstrated a marked IL-6 immunoreactivity of the neoplastic plasma cells. Interestingly, a marked IL-6 immunoreactivity was also found in the tissue surrounding the Actinomyces colonies. In the present study we report for the first time a solitary EMP associated with Actinomycosis. It is tempting to speculate that the unsuspected and untreated Actinomyces infection, through chronic IL-6 production, could contribute to the neoplastic transformation of plasma cells.

Is HPV-DNA testing a useful tool in predicting low-grade squamous intraepithelial lesion outcome? A retrospective longitudinal study.

HPV-DNA testing has entered in clinical practice. Three important questions remain controversial: 1) which is the best HPV-DNA technology? 2) Which age group should be targeted? 3) Is HPV-DNA testing predictive of disease outcome? The answers to these queries represent the endpoints of this study. The population of this retrospective study consisted of 272 women, each one having: baseline cytological diagnosis of Low-grade Squamous Intraepithelial Lesion (LSIL); baseline HPV-DNA reports by Hybrid Capture 2 (HC2) and MY09/11 consensus primers PCR; follow-up duration over 3-years; cytological report of disease status at follow-up time. Firstly, we assessed the concordance and the performances of both HPV-DNA testing, then we correlated, respectively HPV-DNA results and age of patients to disease outcome. DNA testing methods agreed in 83.4 percent of cases (K=0.66). Baseline HPV-DNA result was not significantly associated to disease outcome (p=0.06). Within HPV-DNA positive group, we found no evidence of correlation between age and LSIL prognosis (p=0.89). Confining the analysis to age-stratified HPV-DNA negative women, the differences were statistically significant (p=0.01). In conclusion, HPVDNA testing gives no information about the real behaviour of cervical abnormalities. These findings suggest the demand for additive markers, reflecting the risk of progression, in prevention strategy and clinical approach.

Serum and mucosal cytokine profiles in patients with active Helicobacter pylori and ischemic heart disease: is there a relationship?

This study is designed to investigate, for the first time, circulating and gastric mucosal levels of IL1-alpha, IL-6, IL-8 and TNF-alpha in patients with ischemic heart disease (IHD) and matched controls, according to the presence or absence of active Helicobacter pylori infection. Furthermore, in order to evaluate whether modified lipid profile was associated to an increased cardiovascular risk, this was determined in the same groups. Cytokine levels were measured using ELISA in 58 patients with IHD and 52 controls. Active H. pylori infection was assessed if either culture of H. pylori or rapid urease test gave a positive result. Our findings indicate increasing cytokine mucosal levels in H. pylori-positive patients compared to H. pylori-negative subjects. However, the increase was statistically significant only for IL-6 and TNF-alpha in the gastric mucosa of IHD patients. In H. pylori-positive controls, IL-8 mucosal levels positively correlated with both IL1-alpha (r = 0.98; P = 0.0003) and IL-6 (r = 0.83; P = 0.03) levels. Circulating cytokine levels were comparable in IHD and healthy subjects, regardless of H. pylori status. There were no correlations between mucosal and circulating cytokine levels. Active H. pylori infection was not associated with a modified lipid profile in either controls or IHD patients, although ApoAI levels were significantly higher in H. pylori-positive controls compared to those H. pylori-negative. Taken together, the results of the present study provide evidence that active H. pylori infection may play a role as a trigger factor in the pathophysiology of IHD by inducing an inflammatory cascade concentrated on gastric mucosa.

Management and triage of women with human papillomavirus infection in follow-up for low-grade cervical disease: association of HPV-DNA and RNA-based methods.

Type-specific persistent infection with Human Papillomavirus (HPV) is a significant risk factor for the development of cervical diseases. Persistent infection could be further refined by a sequencing approach to detect early cervical lesions that are at high risk of developing an invasive squamous cervical cancer. The aim of the present study is to investigate the clinical utility of detecting mRNA transcripts of HPV oncogenes E6/E7 by using a Real-time NASBA technology (mRNA test) and to identify women with low-grade cytological disease but with an increased risk of developing high-grade cervical abnormalities or invasive squamous cervical cancer. Our preliminary results show that E6/E7 is detected in only a subset of HR-HPV-positive cases. Since viral persistence is considered to be the true precursor of neoplastic progression, only the detection of E6/E7 mRNA can identify the infection which is more likely to persist and induce neoplasia in future. For these reasons we believe that this test would be useful for the characterization of women with HR-HPV DNA positivity who should be effectively treated because at high-risk of developing a high grade cervical lesion or an invasive squamous cervical cancer.

Poly-L-lactic acid beta-tricalcium phosphate screws: a preliminary in vivo biocompatibility study.

The aim of this study is to assess the biocompatibility of two types of Poly-L-lactic acid (PLLA) screws (with either hydroxyapatite (HA) or beta-tricalcium phosphate (beta-TCP)) implanted in the left femur of four sheep euthanized at 42, 50, 57 and 84 days after surgery. Titanium screws were also implanted for comparison purposes. No signs of inflammation were seen in the 240 specimens. A rating of "+/-" for macrophages and "-" for neutrophils was assigned to all specimens. All specimens were assigned a rating which ranged from "+/-" to "+++" for fibroblasts and osteoblasts. The presence of macrophages, neutrophils and fibroblasts/osteoblasts was not statistically different for the four implantation periods. PLLA implants with beta-TCP have a biocompatibility comparable to PLLA implants with HA.

Liposome-induced exfoliation of graphite to few-layer graphene dispersion with antibacterial activity.

Few-layer graphene aqueous dispersions are obtained by exploiting liposomes as effective exfoliating agents for graphite. Raman measurements evidence the presence of non-oxidized double layer graphene as well as amphiphilic phospholipid molecules organized in bilayers in the samples. TEM analyses confirmed that the obtained homogeneous graphene nanosheets are embedded in the liposomal bilayer. The as-prepared graphene aqueous dispersion is stable for days and demonstrates significant antibacterial activity against both Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) strains, with a reduction in the growth of S. aureus and E. coli as high as 60 and 78%, respectively.

[Primary malignant schwannoma of the uterine cervix: a malignant tumor with unusual behaviour. A case report]. / Schwannoma maligno primitivo della cervice uterina: un tumore maligno a comportamento inusuale. Caso clinico.

Malignant tumors of peripheral nerves (MPNST) represent approximately 5-10% of all soft tissue sarcomas and usually are in relationship with a major nerve. Primary cervical malignant Schwannomas are very rare neural sheat tumors that, grossly and clinically, are misdiagnosed for other more frequent lesions of the uterine cervix. We report a case of primary cervical malignant Schwannoma in a 27 years old female with atypical bleeding. The lesion is characterized by densely packed spindle cells with nuclear atypia and high mitotic rate. Immuno-histochemical stains are positive for vimentin and S-100 but negative for HMB-45, keratins, desmin and actin. After 34 months the patient is disease free. To our knowledge, this is the seventh case described.

[Retroperitoneal Pacinian neuroma: report of a rare lesion in an uncommon location]. / Neuroma paciniano retroperitoneale: una lesione rara a localizzazione inusuale.

Pacinian neuroma is an extremely rare benign tumor which has only occasionally been reported in the literature. To date, this lesion has usually been observed in the hand and foot; only one had intra-abdominal localization. Local trauma is reported in the most of these cases. We describe the first case of retroperitoneal pacinian neuroma. The lesion was observed as an incidental finding in a 75-year-old man who underwent laparotomy for aortic aneurysm. Here are discussed the differential diagnosis and a complete literature review on the topic.

[Angiodysplasia of the gastrointestinal tract: description of 2 cases]. / Angiodisplasia del tratto gastroenterico: descrizione di due casi.

Gastrointestinal angiodysplasia is an acquired and degenerative lesion characterized by proliferation and ectasias of the vessels of the mucosa and submucosa. It's thought to be one of the most common causes of lower gastrointestinal bleeding in the elderly. We describe two cases of angiodysplasia and review the related literature.

Salivary carcinoma in HER-2/neu transgenic male mice: an angiogenic switch is not required for tumor onset and progression.

Morphologic examinations of salivary gland neoplasias arising in male BALB/c (H-2d) mice carrying the activated HER-2/neu (BALB-NeuT) indicate that expression of the oncogene product in the ductal-acinar structures results in a very human-like acinic cell adenocarcinoma with a smoldering course and infrequent metastatization. Typical and then atypical hyperplasia of ducts and acini preceded the rise of salivary tumors that originated from the confluence of multiple ductal hyperplastic foci, while hyperplastic acini behaved as an abortive preneoplastic lesion. The vascular network in normal, hyperplastic and neoplastic salivary tissue was analysed to see whether activation of the angiogenic process is essential in salivary gland carcinogenesis. Immunostaining with anti-endothelial cells (anti-CD31), anti-beta3 integrin and anti-laminin antibodies revealed that microvessel density was significantly higher in normal and hyperplastic than in neoplastic tissue, in which no signs of new vessel sprouting were found. Assessment of angiogenic factor expression indicates a low presence of VEGF in normal, hyperplastic and neoplastic epithelium, while bFGF was preferentially produced but not exported by neoplastic cells and remained in a cell-associated form. Our data suggest that normal salivary gland vascularization is able to support tumor onset and development with no need for an angiogenic switch.