Structure and properties of an under-sulfated heparan sulfate proteoglycan synthesized by a rat hepatoma cell line.

A rat hepatoma cell line was shown to synthesize heparan sulfate and chondroitin sulfate proteoglycans. Unlike cultured hepatocytes, the hepatoma cells did not deposit these proteoglycans into an extracellular matrix, and most of the newly synthesized heparan sulfate proteoglycans were secreted into the culture medium. Heparan sulfate proteoglycans were also found associated with the cell surface. These proteoglycans could be solubilized by mild trypsin or detergent treatment of the cells but could not be displaced from the cells by incubation with heparin. The detergent-solubilized heparan sulfate proteoglycan had a hydrophobic segment that enabled it to bind to octyl-Sepharose. This segment could conceivably anchor the molecule in the lipid interior of the plasma membrane. The size of the hepatoma heparan sulfate proteoglycans was similar to that of proteoglycans isolated from rat liver microsomes or from primary cultures of rat hepatocytes. Ion-exchange chromatography on DEAE-Sephacel indicated that the hepatoma heparan sulfate proteoglycans had a lower average charge density than the rat liver heparan sulfate proteoglycans. The lower charge density of the hepatoma heparan sulfate can be largely attributed to a reduced number of N-sulfated glucosamine units in the polysaccharide chain compared with that of rat liver heparan sulfate. Hepatoma heparan sulfate proteoglycans purified from the culture medium had a considerably lower affinity for fibronectin-Sepharose compared with that of rat liver heparan sulfate proteoglycans. Furthermore, the hepatoma proteoglycan did not bind to the neoplastic cells, whereas heparan sulfate from normal rat liver bound to the hepatoma cells in a time-dependent reaction. The possible consequences of the reduced sulfation of the heparan sulfate proteoglycan produced by the hepatoma cells are discussed in terms of the postulated roles of heparan sulfate in the regulation of cell growth and extracellular matrix formation.

Cooperative effect of exogenous heparin-like compounds and secreted glucocorticoid-induced inhibitor on plasminogen activator in 3T3 cell cultures.

Balb/c 3T3 cultures grown in the absence of serum release both plasminogen activator and plasminogen activator inhibitor in the culture medium. Cellular transformation with SV-40 virus increased the level of the activator, whereas dexamethasone increased the level of the inhibitor. Heparin added to the medium potentiated the glucocorticoid-induced inhibitory activity, strongly decreasing or completely abolishing the activity of plasminogen activator. Heparin sulfate showed similar effects to heparin, although at higher concentrations. It is suggested that heparin-like compounds are involved in the regulation of plasminogen activator, acting as inhibitory cofactors.

[Usefulness of continuous duodenal catheterization and drainage in the postoperative period after papillosphincteroplastic operations]. / Utilità del sondaggio duodenale continuato nel decorso post-operatorio degli interventi di papillosfinteroplastica.

The Authors claim the continuous emptying of the duodenum after papillosphincteroplastic useful in preventing APP. In order to prove it they present 27 running cases of sphicteroplastic so treated in which the postoperative amylasemy did not exceed the normal values.

[Value of axillary lymphadenectomy in malignant tumors of the breast. Apropos of 135 controlled cases]. / Valore della linfoadenectomia ascellare nel tumore maligno di mammella. A proposito di 135 casi controllati.

Personal experience in the treatment of breast cancer is reported along with the results of 135 cases in which long-term follow-up was carried out. The results are in line with what has been observed in the recent literature. Study of therapeutically removed axillary lymph nodes proved to be the main factor on which to base prognostic judgment and programmes of multidisciplinary treatment, if applicable. Further elements derive from hormonal receptors and, in future, from the study of cell kinetics with tritiated thymidine.

[Incidentally discovered masses: diagnostic and therapeutic features]. / Gli incidentalomi: aspetti diagnostici e terapeutici.

The term "incidentaloma", which was first used to indicate a mass discovered by chance at an adrenal level, is currently used to indicate any lesion identified accidentally, namely in the absence of specific symptomatology, during echographic or tomographic examination. The authors report their experience of just over one year and, through a review of the literature, draw attention to the fact that these incidentalomas raise unresolved problems both from a diagnostic and therapeutic point of view. They hope that routine abdominal echography will be extended at least to a selected hospital population given that these lesions, diagnosed by chance, may be malignant or even if benign may have a potential evolution. Obviously surgery in these cases would lead to a marked prognostic improvement.

[Approach methods to the central venous system]. / Modalità di aggressione del sistema venoso centrale (S.V.C.).

Personal experience in the aggression of the CNS for various purposes is considered. It is thought that the internal trans-jugular route is the easiest approach and procedures the fewest complications with appropriate techniques.

[Treatment of acute cholecystitis and its complications]. / Terapia della colecistite acuta e delle sue complicazioni.

Forty cases of acute cholecystitis and its complications have been reviewed. Examination of the literature and a study of the personal series leads to a discussion on the need or otherwise for early surgery, particularly in those patients in whom a more unfavourable course for the clinical picture can be objectively presumed.

[Treatment of septic complications in diverticular disease of the colon]. / Trattamento delle complicanze settiche della malattia diverticolare del colon.

Eight years' experience in the treatment of the septic complications of diverticular disease of the colon is examined and 44 cases treated in the period 1980-1988 are considered. The Hartman procedure gave good results in the majority of cases; other procedures such as drainage with colostomy, or anastomosis resection during a single intervention are reserved for particular cases. In addition, on examining the case histories and the current literature it seems that it is correct to treat DD (diverticular disease) surgically whenever the typical manifestations of the overt disease appear; waiting often represents nothing more than a postponement of the surgical treatment until an emergency arises.

[Postoperative acute pancreatitis (PAP). Direct personal experience]. / Pancreatite acuta post-operatoria (PAP). Nostra esperienza diretta.

Eight different cases of APP observed after intervents made near the pancreas (partial gastrectomy for ulcer, papillosphincteroplasty, DCP) are presented. The clinical stage, the therapeutic attempts, the results are studied. The clinical stage, the therapeutic attempts, the results are studied. In order to value the role of the pancreatic trauma in causing the APP the Authors have checked in addition 14 cases in which a direct action on the pancreas was present. In these cases noticeable amylasemic increases have not been observed except one cases of APP after DCP. Hypothesizing the role of a duodenal hyperpressure in causing the reflux of duodenal juice into the Wirsung then in causing an APP, the Authors report the results obtained after the introduction of a catheter into the duodenum in order to make it empty untily the renewal of peristalsis, during the papillosphincteroplasty and partial gastrectomy for ulcer. The Authors suggest that the duodenal emptying could be a method to prevent the APP. The prevention by the usually adopted drugs as aprotininum and glucagonum was ineffective, as well as other surgical techniques. High mortality: 5 cases on 8.

[Study of postoperative amylasemia. Its diagnostic value in postoperative acute pancreatitis (PAP)]. / Lo studio della amilasemia post-operatoria. Suo valore diagnostico nella pancreatite acuta post-operatoria (P.A.P.).

A study of the postoperative amylasemia levels on 375 different intervents is presented. Three different behaviours have been observed: 1) in 44 cases there has been a rapid increase of the amylasemia gone on for less than 4 days without any clinical sign of pancreatitis; 2) in 6 cases the increase, sometimes less marked than the previous cases, developed and continued for longer time, showing oscillations with a slow return to the normality. At the same time there was a slow recovery in the general conditions; the cause of that has been interpreted as a pancreatic affection; 3) in 8 cases the amylasemia increase developed for many days with large and long oscillation and clinical signs of APP. The opinion of Authors is that the APP is characterised by amylasemia increases presenting large oscillations life times exceeding 4 days, and that they are joined with clinical signs of pancreatitis (pain, sickness, hypotension, ec.). The study of the amylasemia plotting is considered to be a rather good method to emphasize a pancreatic disease.

[The rational use of drains in surgery]. / Uso razionale dei drenaggi in chirurgia.

The authors report their clinical experience in 100 cases in which various kinds of drainage were used. They outline the best present techniques, when it is wished to apply this free drainage in the abdominal cavity, at the end of the operation.

[Diverticulitis of the right colon. Description of our experience]. / Diverticolite del colon destro. Descrizione delle nostre esperienze.

Two cases of diverticultis of the right colon are described which received surgical treatment. These lesions often simulate acute appendicitis and thus represent a intraoperative surprise Differential diagnosis using a neoblastic mass is often impossible. The paper stresses the importance of surgical treatment which in general terms is the same as the treatment of the diverticular mass of the left colon. In cases where it is difficult to decide between a phlogostic and neoblastic pathology, it is advised that a right hemicolectomy should be performed in line with criteria for oncological requirements.

[Double hydatid cyst of the liver, one of them with a fistula and causing stenosis of the pyloric canal associated with calculous cholecystitis]. / Cisti di echinococco duplice del fegato, una fistolizzata e provocante stenosi del canale pilorico ed associazione di colecistite calcolosa.

A case of double hydatid cyst of the liver (one fistulised into the pyloric canal where it had caused stenosis) and its association with calculous cholecystitis is reported. The therapy chosen to treat this rare phenomenon had a very satisfactory outcome in view of the complexity of the case given the need to perform several operations in contemporary (enucleation of the cyst, gastric resection and cholecystectomy) and the age of the patient.

[Bilaminar technic in the treatment of gingival recessions]. / Tecniche bilaminari nel trattamento delle recessioni gengivali.

Bilaminar procedures represent an evolution in the treatment of marginal tissue recessions. A connective tissue graft removed from the palate and over which a pedicle flap is sutured, is used in these procedures. The advantages of these new procedures are: 1) sure predictability of graft survival to which a double-blood supply is guaranteed; 2) primary intention healing at the donor site, with minimum post-operative discomfort; 3) excellent esthetic results consisting of better color blending between graft and adjacent tissues and absence of keloid- like scars, very common after free gingival grafts.

[Nimesulide: multicenter clinical study for evaluation of its therapeutic effect in odontostomatology]. / Nimesulide: studio clinico multicentrico per la valutazione dell'attività terapeutica in odontostomatologia.

A Polycentric Study was carried out so as to assess the anti-inflammatory effectiveness and pain-killing activity of Nimesulide in Odontostomatological practice, in 78 patients suffering from alveolo-gingival and parodontal abscesses, consequences of tooth extraction, suppurated radicular cysts, dysodontiasis, osteitis, periodontitis, periostitis. The results obtained confirm the anti-inflammatory and analgesic effect as well as the good tolerability of this drug.

Isolated and complete traumatic rupture of the pancreas: A case report and a review of the literature.

INTRODUCTION: Pancreatic trauma without injuries to other organs is uncommon, as reported in the reviewed literature. Diagnosis of pancreatic trauma might be difficult, due to unspecific signs and symptoms. The integrity of the main pancreatic duct is the crucial point in the management and outcome of patients with pancreatic trauma. PRESENTATION OF CASE: The authors report a case of delayed diagnosis after a complete traumatic rupture of the main pancreatic duct, successfully managed by surgical treatment. The authors performed a laparotomy with complete removal of necrotic pancreatic tissue at the site of rupture. The proximal pancreatic stump was hand-sewn with detached stitches and a disposable catheter was positioned into Wirsung's duct, a diversion of the distal stump with a Roux-en-y pancreato-jejunal anastomosis was performed. The postoperative course was uneventful. DISCUSSION: Traumatic injuries of the pancreas occur after blunt abdominal traumas or penetrating wounds with a ratio of 3:1. Isolated traumatic injuries of the pancreas are uncommon; and they are usually associated with injuries to other organs. Surgical solutions for the treatment of pancreas lesions vary and it is well known that a surgical procedure performed after a delayed diagnosis is associated with high mortality and morbidity, especially in pancreatic duct rupture. CONCLUSION: Pancreatic trauma is a diagnostic and therapeutic challenge for the trauma surgeon. The integrity of the main pancreatic duct is the most important determinant of outcome after injury to the pancreas and, in Wirsung's duct rupture, early surgery may improve it.