A simple method to obtain pure granule-rich eosinophil fragments (cytosomes) from normal human blood.

This paper describes a simple, rapid and reproducible method to obtain pure granule-rich eosinophil fragments (cytosomes) with a high yield from normal human blood. The method is based on the treatment of whole blood with saponin and subsequent purification of the cytosomes on Percoll gradient. The enzymatic analysis of the cytosomes shows that the content of 3 granular enzymes is of the same order of magnitude already reported by others for intact eosinophils. This finding suggests that the cytosomes can be employed as starting material for studying the content of the granules or for the isolation of the granular components. The advantages offered by this method over those currently used to obtain eosinophil granules are discussed.

[Magnetic resonance in the assessment of perianal fistula]. / La Risonanza Magnetica nella valutazione delle fistole perianali.

This study was aimed at investigating the effectiveness of Magnetic Resonance Imaging (MRI) in the diagnosis of perianal fistulas, by comparing imaging findings with those provided by rectal examination (RE) or surgery. The present data refer to 20 patients with anorectal fistulas in whom 24 main fistulous tracks were found. The fistulas were classified according to Parks and Kennedy's criteria, based on their relationship to the sphincters. In the 15 surgical patients, 15 of 17 fistulas were correctly identified by MRI (88.2%). In one case the submucous path of the fistula was missed, while another patient was misdiagnosed as having an intersphincter fistula which turned out to be a transphincter one at surgery. In the 5 non-surgical patients, only 4 of 7 MR-detected tracks were identified at RE. An intersphincter fistula was missed on rectal examination but demonstrated by both MRI and endoscopy. A suprasphincter track in a patient who was initially asymptomatic and thereafter developed a perianal abscess, was missed at clinics but became apparent on MR images. In one case anorectal examination underestimated the extent of the fistulous track, which was thought to be low while MRI demonstrated it to be high. Twelve abscesses were seen on MR images, all of them classified at surgery. One posterior pararectal suppurative collection in a non-surgical patient was apparent only at MRI. In our experience, in agreement with the latest literature reports, MRI has proved to be a very reliable method in the assessment of anorectal inflammatory diseases. We believe that MRI may play a valuable role in the preoperative assessment of the complex conditions causing a high risk of recurrence or anal incontinence as a result of inadequate treatment.

[A comparison between echography and computed tomography in assessing neoplastic recurrences in superficial soft tissues]. / Confronto tra ecografia e tomografia computerizzata nella valutazione delle recidive neoplastiche dei tessuti molli superficiali.

Thirty-seven superficial soft-tissue recurrences were evaluated with ultrasonography (US) and computed tomography (CT) to assess the correct diagnostic approach. US and CT examinations were performed at the same time. High-frequency US probes and a third-generation CT scanner were employed; all the lesions underwent also histology or cytology. US correctly identified as recurrences or fibrous tissue all the 37 lesions, whereas CT diagnosed 30 lesions only. Seven of the 14 recurrences < 2 cm diameter were not demonstrated. In conclusion, US provides more reliable information than CT relative to small lesions, which suggests that US must be performed just after therapy. Nevertheless, when bone involvement is suspected, CT is required and its use is also suggested to monitor distant metastases.