Oxidative muscles have better mitochondrial homeostasis than glycolytic muscles throughout life and maintain mitochondrial function during aging.

Preservation of mitochondrial function, which is dependent on mitochondrial homeostasis (biogenesis, dynamics, disposal/recycling), is critical for maintenance of skeletal muscle function. Skeletal muscle performance declines upon aging (sarcopenia) and is accompanied by decreased mitochondrial function in fast-glycolytic muscles. Oxidative metabolism promotes mitochondrial homeostasis, so we investigated whether mitochondrial function is preserved in oxidative muscles. We compared tibialis anterior (predominantly glycolytic) and soleus (oxidative) muscles from young (3 mo) and old (28-29 mo) C57BL/6J mice. Throughout life, the soleus remained more oxidative than the tibialis anterior and expressed higher levels of markers of mitochondrial biogenesis, fission/fusion and autophagy. The respiratory capacity of mitochondria isolated from the tibialis anterior, but not the soleus, declined upon aging. The soleus and tibialis anterior exhibited similar aging-associated changes in mitochondrial biogenesis, fission/fusion, disposal and autophagy marker expression, but opposite changes in fiber composition: the most oxidative fibers declined in the tibialis anterior, while the more glycolytic fibers declined in the soleus. In conclusion, oxidative muscles are protected from mitochondrial aging, probably due to better mitochondrial homeostasis ab initio and aging-associated changes in fiber composition. Exercise training aimed at enriching oxidative fibers may be valuable in preventing mitochondria-related aging and its contribution to sarcopenia.

A case of failure of tubal sterilization using Pomeroy's technique.

With reference to a case of pregnancy of a patient formerly subjected to tubal sterilization using Pomeroy's technique, the authors define the possibility for tubal stumps to recanalise. Despite the low percentage of failure in tubal sterilization using Pomeroy's technique, the authors conclude that it is advisable to make the earliest possible diagnosis of both intrauterine and extrauterine pregnancy on the basis of suspected symptoms in order to, especially for tubal pregnancies, avoid any tubal sterilization.

PIP: The Pomeroy technique of tubal sterilization is widely used and considered highly effective. Reported in this paper is a case of a pregnancy in a woman from Naples, Italy, who underwent this procedure. The patient requested sterilization during her third cesarean section delivery in 1992 and tubal occlusion was confirmed by a hysterosalpingograph conducted 3 months later. When the patient presented 19 months later with a missed period, an intrauterine pregnancy was found. During the subsequent cesarean section delivery, bilateral tubal exploration revealed that some tubal residual products from the sterilization were still bound by the thread and the stumps graphing. It was assumed that recanalization of the two stumps below the tubal binding was responsible for the conception. A new sterilization was performed after removal of the stumps by the Pomeroy technique 0.5 cm below the canalization.

Ovarian pregnancies treated with methotrexate.

Medical therapy in ectopic and ovarian pregnancies in particular, can be a valid alternative to the surgical approach, since it can guarantee the reproductive function in a better way. More and more attempts with methotrexate, which can induce the death of both embryo and trophoblastic tissue, are being made. Both its administration and results are still under debate. In our case histories, three clinical cases are reported and two of them proved to be successful. In our opinion, apart from the method of administration, the prerequisites for a therapeutic success are: a small ovular sac (max 30 mm), no echographically visible embryo which corresponds to a six-week pregnancy. The success of the therapy, therefore, depends on the precociousness of the diagnosis.

[Ultrasonic identification of foreign bodies in superficial soft tissues]. / Identificazione con ecografia dei corpi estranei nei tessuti molli superficiali.

The authors investigated US capabilities in detecting foreign bodies retained in superficial soft tissues. Ten patients were studied: 5 of them with history of recent trauma and 5 with painful superficial swelling where US revealed the presence of foreign matter. US findings were confirmed by subsequent surgical specimens. In the first group of patients, a hyperechoic stripe was observed, whereas a hyperchoice nodule with a hyperechoic core was detected in the second group of patients. The latter US pattern may be explained by the presence of a reactive granuloma. US has shown to be very useful in diagnosing this kind of lesion, and it can thus be considered as the only reliable imaging modality to identify radiolucent foreign bodies.

[Hürthle cell tumor of the thyroid: which surgical approach?]. / Tumori a cellule di Hürthle della tiroide: quale tattica chirurgica?

Hürthle cell tumors are a very particular thyroid disease. Controversies exist about the most adequate treatment. Radical surgery is sometimes advocated also for benign lesions, due to their malignant potential, but conservative surgery is thought to be adequate in most cases. The Authors' experience consists of 8 Hürthle cell tumors: 7 adenomas and 1 carcinoma. The latter has been treated by total thyroidectomy and the patient died after 6 months. Adenomas have been always treated by conservative procedures and there is no recurrence at a 2-6 year follow-up.