Büschke-Lowenstein tumour in pregnancy.

During pregnancy a localised human papillomavirus (HPV) lesion may, in rare cases, develop into a Büschke-Lowenstein tumour. The choice of treatment is crucial as standard systemic treatment is teratogenic. We performed laser CO2 microsurgery because it has a low incidence of complications.

Myxopapillary ependymoma of the ischioanal fossa.

Ependymomas outside the confines of the cranium and spinal cord are rare. Direct extension into the soft tissues of the sacrococcygeal area may occur from a primary ependymoma of the spinal cord, cauda equina or filum terminale. Alternatively they may occur as a primary pre-sacral, pelvic and abdominal tumour, or as a primary tumour of the skin and subcutaneous tissue of the sacrococcygeal area without any demonstrable connection with the spinal cord. The Authors report a case of myxopapillary ependymoma of the ischioanal fossa, demonstrated by MRI. To our knowledge, our case is the first lesion reported at this site.

Prevalence and chemosusceptibility of Neisseria meningitidis and Haemophilus influenzae in a population of central Italy.

The purpose of this study was to determine the prevalence of nasopharyngeal carriers of Neisseria meningitidis and Haemophilus influenzae, and to evaluate their chemoresistance. N. meningitidis was more frequently isolated in adolescents (10-15 years). All of meningococci were susceptible to ceftriaxone and rifampin, only one isolate showed reduced susceptibility to chloramphenicol and four strains showed reduced penicillin susceptibility. The results show that these drugs are still effective for prophylaxis and treatment in our area. All strains of H. influenzae were susceptible to penicillin, ceftriaxone, chloramphenicol, rifampin, azithromicin and gentamicin. 6 nontypeable strains were resistant to sulfamethoxazole-trimethoprim, 7 strains of type a and c-f, and 3 non-typeable strains showed reduced susceptibility to tetracycline. In contrast with the current trend in the world, in our area the susceptibility of H. influenzae to betalactams was 100%, therefore these antibiotics are still the drugs of choice for treatment of invasive diseases.

Case report. Ultrasound and CT findings in lipoma of the inferior vena cava.

Several cases of a fat mass-like lesion adjacent to and/or projecting into the inferior vena cava have been presented as a normal variant of perioesophageal fat distribution or as intravascular lipoma. We report a case of a lipoma of the inferior vena cava, studied with coronal reformatted CT images, ultrasound and colour Doppler imaging, in a 78-year-old female patient.

Evaluation of PCR methods for 5S-rDNA and p30 genes to detect Toxoplasma gondii in blood and other clinical samples.

During the last few years the direct diagnosis of Toxoplasma gondii infection has taken advantage of PCR. The present work tested the sensitivity and specificity of PCR for rDNA and p30 genes. Using ascitic fluid from infected mice rDNA PCR detected 0.5 tachyzoite/ml, while nested p30 PCR 1 tachyzoite/ml. The rDNA amplification was positive in all clinical samples from a single immuno compromised patient (blood, urine and bronchoalveolar fluid). In the same patient nested p30 PCR was positive only in urine and bronchoalveolar lavage (BAL) fluid. The rDNA and p30 amplicons were never found in any amniotic fluids tested. These results could prove the usefulness of rDNA amplification to detect T. gondii in blood.

Cytotoxin production by Campylobacter pylori strains isolated from patients with peptic ulcers and from patients with chronic gastritis only.

A total of 66.6% of Campylobacter pylori strains isolated from patients with peptic ulcers produced a cytotoxin active against mammalian cells in vitro, versus 30.1% of strains isolated from patients with chronic gastritis of various degrees of severity only. This difference was statistically significant and suggests that the toxic substance could be involved in the development of peptic ulcers.

Viral childhood gastroenteritis.

Viruses were detected in 150 hospitalized subjects with gastroenteritis during the years 1983-1984. The samples were collected on admission in the day care unit and after three and seven days. The research was carried out using electron microscopy (E.M.) and isolation in cell cultures in vitro. Faecal samples were also collected from 70 control subjects. Observed and/or isolated viruses were identified by structural features at E.M. and by typical cytopathic effects in cultures. Rotavirus and not cultivable adenovirus proved the most widespread agents in the aetiology of acute viral gastroenteritis in infants.

Prevalence, species differentiation, and toxigenicity of Aeromonas strains in cases of childhood gastroenteritis and in controls.

In a 1-year period (January to December 1984), Aeromonas strains were isolated from feces of 21 of 561 (3.7%) children with gastroenteritis and from 12 of 576 (2.1%) children without intestinal disturbances (controls). The difference between the two isolation rates was not significant (X2 = 2.2; P greater than 0.05). In five cases of illness other intestinal pathogens were isolated together with Aeromonas in the same stool sample. A total of 39 Aeromonas strains were detected since in some cases aeromonads with different biochemical characteristics were obtained from the same stool sample. Of the 39 Aeromonas isolates, 6 strains (5 from patients) were Aeromonas hydrophila, 5 strains (3 from patients) were Aeromonas sobria, and 26 strains (18 from patients) were Aeromonas caviae; 2 strains isolated from controls did not ferment sucrose and were considered a distinct group of Aeromonas. We found no significant difference between the prevalence of each of these species from patients and the prevalence from controls. We found no significant difference in the prevalence of enterotoxin-producing strains (suckling mouse model), cytotoxin-producing strains (HEp-2 cell model), or hemolysin-producing strains (rabbit erythrocyte model) between patients and controls. In our geographical region there is no evidence that Aeromonas species are primary intestinal pathogens in children.

Rubella in teenagers: epidemiology and prophylaxis in Siena, Italy.

Six hundred and fifty-three teenagers (aged 11-13 year) living in Siena and its surroundings (Tuscany, Italy) were the sample for serological screening intended to ascertain immunity to rubella. It was found that 324 of the teenagers (49.62%) lacked antibodies and, hence, were unprotected against the infection. Out of the 324 girls, 196 (around 3/5) were vaccinated using live vaccine. Post-vaccinal complications, with clinical signs of rubella infection, were recorded in almost one third of the vaccinees. Virus isolation from the blood was, in every case, not possible after either 10 or 30 days from vaccination. The serological findings, expressed in hemagglutination inhibition antibodies, could be summarized in the following way: (i) antibodies at low titre were found in only eight out of 184 girls (4.35%) ten days after vaccination; (ii) serological conversion was recorded in 187 out of 188 girls (99.47%) 30 days after vaccination; (iii) the titres were moderately high but much lower than those recorded for the natural infection. The results are discussed in the context of their implications for the strategies of rubella vaccination as far as the safety and the effectiveness of the vaccine are concerned, with emphasis on the duration of the protective immunity.

[Vaccination against rubella]. / La vaccinazione antirubeolica.

The infection caused by the rubella virus is a mild disease usually with no or rare complications in children and adults. On the contrary, intrauterine fetal infection may result in defects of the child, which may either be present at birth or become apparent later in life. Such a risk led to the preparation and use of active immunoprophylaxis against rubella in females of child-bearing age, in order to prevent congenital rubella. Three rubella viruses are employed to prepare the vaccine, all derived from the same viral strain. Doubts however, exist about vaccination, in particular about (1) its teratogenic potential in pregnancy; (2) the duration of protection. As a matter of fact, congenital malformations in the fetus exposed to vaccine virus through the mother have been reported in 3% of cases. As to the second point, the data on the protective immunity in time of the vaccine are very controversial. It is clear, anyhow, that protection against infection is associated not only with persistence of adequate serum levels of antibody, but also with other immunological parameters which are still unknown. These considerations, together with the observation that a relative high percentage of vaccine recipients do not respond, lead us to suggest modifications in the present scheduling of immunization against rubella.

[Neonatal meningitis (personal contribution)]. / Meningite neonatale (contributo personale).

The authors, after a review of the literature about etiology, pathogenesis, epidemiology, pathological anatomy and clinic of newborn meningitis, report a personal experience of 15 cases. The more frequent etiological agents were Gram-positive bacteria (60%) and in particular Listeria monocytogenes type 4 and Streptococcus agalactiae. Gram-negative bacteria were isolated in 40% of cases and E. coli presented the highest ratio. All patients were treated with ampicillin-CAF association intravenous for the first 3-5 days and then i.m. or oral. The survival ratio was 77% in case of Gram-positive meningitis and 83% in case of Gram-negative meningitis. Sequeles were observed only among patients with Gram-negative meningitis; it's important to remark that in these cases the etiological agent was CAF-resistant.

[Effects of streptococcal toxin on hepatic regeneration in the rat]. / Effetti della tossina streptococcica sulla rigenerazione epatica nel ratto.

The liver regeneration percentage, mytotic activity and protein content were used to demonstrate the effects of streptococcal toxin on regenerating rat liver. No statistically significant difference was showed between controls and toxin treated animals. Serum level of C, resulted on the contrary, considerably reduced in the animals treated with streptococcal toxin.

[Effects of diphtheria and tetanus toxins on liver regeneration in the rat]. / Effetti delle tossine difterica e tetanica sulla rigenerazione epatica nel ratto.

The effects of diphtheria toxin and tetanus toxin on the regenerating rat liver were studied. The following parameters were used: liver regeneration percentage, mitotic index, protein content and serum complement C3 fraction level. Diphtheria toxin does not affect the liver regeneration, that what confirms the poor sensitivity of the rat to this toxin. Tetanus toxin inhibits the cellular division, while causes an increase in the cell protein content, resulting in hepatocyte hypertrophy. Both toxins cause a fall of the serum complement C3 fraction.

[Effects of cholera toxin on the regenerating rat liver (author's transl)]. / Effetti della tossina colerica sulla rigenerazione epatica nel ratto.

Two groups of animals were treated with cholera toxin respectively with 10,000 B.D. and 20,000 B.D. soon after hepatectomy. The parameters used were: the percentage of liver regeneration, mytotic activity and the liver protein content. The resulting differences between the controls and the two groups of animals treated were not statistically significant. The Authors conclude that cholera toxin does not affect the liver regeneration in the rat.