Reduction of cognitive and motor deficits after traumatic brain injury in mice deficient in poly(ADP-ribose) polymerase.

Poly(ADP-ribose) polymerase (PARP), or poly-(ADP-ribose) synthetase, is a nuclear enzyme that consumes NAD when activated by DNA damage. The role of PARP in the pathogenesis of traumatic brain injury (TBI) is unknown. Using a controlled cortical impact (CCI) model of TBI and mice deficient in PARP, the authors studied the effect of PARP on functional and histologic outcome after CCI using two protocols. In protocol 1, naive mice (n = 7 +/+, n = 6 -/-) were evaluated for motor and memory acquisition before CCI. Mice were then subjected to severe CCI and killed at 24 hours for immunohistochemical detection of nitrated tyrosine, an indicator of peroxynitrite formation. Motor and memory performance did not differ between naive PARP +/+ and -/- mice. Both groups showed nitrotyrosine staining in the contusion, suggest ing that peroxynitrite is produced in contused brain. In protoco 2, mice (PARP +/+, n = 8; PARP -/-, n = 10) subjected to CCI were tested for motor and memory function, and contusion volume was determined by image analysis. PARP -/- mice demonstrated improved motor and memory function after CC versus PARP +/+ mice (P < 0.05). However, contusion volume was not different between groups. The results suggest a detri mental effect of PARP on functional outcome after TBI.

Elevated plasma levels of vasoactive intestinal polypeptide in short bowel syndrome.

Short bowel syndrome is a complex disease that is almost always seen with diarrhea. VIP is known to act powerfully on gut motility, and elevated VIP plasma levels have been reported in several diarrheal conditions. In this study VIP plasma levels were measured by radioimmunoassay in 8 patients with short bowel syndrome versus 30 healthy control subjects under basal conditions. VIP plasma levels were significantly higher in the short bowel syndrome group (p less than 0.05). The explanations that could account for these elevated levels are (1) an increased gastric acid load in the residual bowel, (2) a compensatory increase in blood supply to the gut, (3) removal of an inhibitory factor arising from the small intestine, or (4) mucosal stress due to unadsorbed food. An etiologic role of VIP in the occurrence of diarrhea in patients with short bowel syndrome seems to be an unproved hypothesis.

Relationship between pancreatic and serum amylase in basal conditions and during stimulation in man. Report of a new intraoperative technique.

The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to (1) a standard meal, (2) duodenal acidification, (3) scalar doses of cholecystokinin, (4) scalar doses of secretin, and (5) scalar doses of secretin with simultaneous infusion of cholecystokinin. Blood samples were collected during the tests to measure serum amylase. No significant correlation was shown between blood concentration and output of amylase in any of the tests. Our findings show that under normal conditions serum amylase levels are not influenced by pancreatic secretion and suggest that serum amylase concentration is not related to pancreatic exocrine secretion.

Traumatic brain injury in mice deficient in poly-ADP(ribose) polymerase: a preliminary report.

Poly (ADP-ribose) polymerase (PARP) is a ubiquitous nuclear enzyme that, when activated by free-radical induced DNA damage, contributes to energy failure and cell death in models of central nervous system ischemia and reperfusion. PARP contributes to neuronal cell death in vivo after cerebral ischemia/reperfusion, however, the role of PARP in the pathogenesis of traumatic brain injury (TBI) is unknown. We hypothesized that, compared to wild type mice (+/+), mice deficient in PARP (-/-) would have reduced motor and cognitive deficits after TBI. Mice underwent controlled cortical impact (CCI) (6 m/s, 1.2 mm depth) and were tested for motor (d 1-5) and cognitive (d 14-18) function after CCI. PARP -/- mice demonstrated improved motor performance and improved cognitive function after CCI (both p < 0.05 compared to +/+). This is the first study to evaluate a role for PARP in functional outcome after TBI. The results suggest a detrimental role for PARP in the pathogenesis of TBI.

Action of famotidine and ranitidine on prostaglandin E2 (PGE2) content of fundic and duodenal mucosa in duodenal ulcer patients.

PGE2 plays an important role in gastric cytoprotection. Previous experience has shown that H2-blocker drugs may have a role in gastric cytoprotective mechanisms. The effects have been compared of ranitidine and famotidine on PGE2 content in duodenal ulcer patients. Twenty patients were treated for 4 weeks as follows: group A, ranitidine (150 mg twice daily); group B, famotidine (40 mg daily). The patients underwent EGDS before and after therapy. The results show that both famotidine and ranitidine significantly increase the PGE2 content of fundic mucosa (from 112.3 +/- 73 to 210.7 +/- 106 ng/g wet wt and from 109.6 +/- 52.4 to 230.2 +/- 104.6 ng/g wet wt, respectively) in duodenal ulcer patients (p less than 0.01). Similarly, the PGE2 content of duodenal mucosa significantly increases after famotidine treatment (from 51.9 +/- 27.5 to 105.3 +/- 55.6 ng/g wet wt) as well as ranitidine treatment (from 53.8 +/- 24 to 172.6 +/- 72.9 ng/g wet wt) (p less than 0.01). It is concluded that these drugs play an important role in gastric and duodenal cytoprotection.

[Digestive hemorrhage in a patient with multiple neurofibromatosis]. / Emorragia digestiva in paziente con neurofibromatosi multipla.

Neurofibromatosis is an autosomal dominant trait with variable expressivity clinically defined by the coexistence of multiple cafè au lait spots, subcutaneous neurofibromas and Lisch nodules. Hemorrhage from intestinal neurofibromas or related tumors may be life-threatening because often inaccessible and therefore difficult to locate. The Authors report a case of gastrointestinal hemorrhage in a 68 year old patient with neurofibromatosis who had an episode of melena from duodenal ulcer endoscopically detected 5 years earlier. Endoscopy failed to discover the site of bleeding; this was successfully demonstrated by angiography: superior mesenteric arteriography disclosed 32 hypervascular masses supplied by a digiunal branch and by the oleo-colic artery. Because of continuing hemorrhage the patient was submitted to surgery. The exploration demonstrated ulcerated neurofibromatous neoplasms at the level of the digiunum and terminal ileum, with a Meckel's diverticulum and gallbladder stones. Intestinal resection, right emicolectomy, Meckel's diverticulum resection and colecystectomy were performed. Review of the literature demonstrates angiography is the most reliable imaging modality for detecting such tumors.

[Carcinoid of Meckel's diverticulum: presentation of a clinical case]. / Carcinoide del diverticolo del Meckel: presentazione di un caso clinico.

Clinical findings and surgical treatment of a 68 years old man with carcinoid tumor of Meckel's diverticulum are reported. Carcinoids in Meckel's diverticula are rare tumors, commonly discovered incidentally during surgical procedures for different indications. Symptoms are frequently expression of a metastatic disease. Specific diagnostic and therapeutic tools are discussed.

[Celiac artery aneurysm: urgent surgical case report]. / Aneurisma del tripode celiaco. Presentazione di un caso clinico in urgenza.

Visceral artery aneurysm account for up to 5-10% of overall artery aneurysm. Celiac artery aneurysm are reported in 4% of these patients. The most common etiologic findings are atherosclerosis and tunica media infective degeneration. The radiological imaging led to more accurate morphological and anatomical definitions of this pathology and improved elective and urgent surgical treatment of selected patients. The Authors report a case of celiac artery aneurysm.

[Hyperamylasemia or macroamylasemia? A clinical case]. / Iperamilasemia o macroamilasemia? Caso clinico.

The authors report a case of macroamylasaemia and discuss diagnostic implications especially in surgical emergencies. In fact, laboratory findings of hyperamylasaemia may lead to erroneus diagnosis or even to useless surgical operations.

[Arteriovenous brachio-basilic fistula as hemodialysis port. Original technique and long term results]. / La fistola artero-venosa brachio-basilica come accesso per emodialisi. Tecnica originale e risultati a distanza.

The authors report a prospective series of patients with-long term vascular access for chronic hemodialysis fashioned with a transposed brachio-basilic fistula. Over a three-year period (1998-2000), 14 patients underwent creation of the arteriovenous fistula. Demographic and clinical data were registered and a length of follow up more than 12 months was in all cases obtained. Of the 14 fistulas performed, 7 were successfully used for dialysis without complication. In seven patients late revision of fistulas was performed. The primary and secondary patency actuarial rates at two years were 50% and 75% respectively. The results of this series highlight as the basilic vein fistula provides reliable vascular access for chronic hemodialysis therapy. The low cost and the low morbidity rates suggest the brachial artery-transposed basilic vein fistulas as a valuable part of vascular access history of patients with chronic renal failure.

[Primary muscular echinococcosis: a clinical case]. / Echinococcosi primitiva muscolare: caso clinico.

Muscular localization of echinococcosis is considered unusual. The authors report a case of such uncommon hydatid localization. Pathogenetic hypotheses are discussed.