Estrogen receptor polymorphism, estrogen content and idiopathic scoliosis in human: a possible genetic linkage.

Idiopathic scoliosis (IS) is a largely diffused disease in human population but its pathogenesis is still unknown. There is a relationship between scoliotic phenotype and the patient age, since in the early stage the pathology shows a ratio of 50% between male and female teenagers. During puberty the sex ratio is 8.4/1 (female/male), suggesting a sex-conditioned manifestation of the disease. Genetic inheritance of idiopathic scoliosis is still unclear although some authors claim for its X-linked dominant inheritance. There is large agreement in considering the IS as a sex-conditioned disease, in terms of steroid content and their receptor activity, although no evidence has been found yet. The blood content of 17beta-estradiol in teenagers with IS shows lower levels than teenagers of the same age without IS. Also testosterone and progesterone content are lower in IS girls with respect to the control girls. Furthermore, we extracted DNA from white blood cells of IS patients and their relatives until the third generation in order to examine estrogen receptor alpha polymorphisms, considering this tool a plausible molecular marker for IS prognosis. In this respect, we identified four polymorphisms in the exons encoding for the steroid binding domain and two other in the trans-activation domain. Our results show a clear relationship with clinical manifestation of IS.

[Laparoscopic cholecystectomy. Our experience]. / La colecistectomia laparoscopica. Nostra esperienza.

BACKGROUND AND AIMS: The authors analyse their first two years of experience regarding the use of laparoscopic cholecystectomy and report the results of this series and their observations. METHODS: A total of approximately 200 cholecystectomies have been performed using a laparoscopic technique at S. Paolo Hospital in Naples (Department of Surgery; Head: Prof. R.A. Caliendo) since October 1996. Initially patients were rigorously selected in accordance with international criteria. At present, after the good results obtained, the real contraindications to laparoscopic cholecystectomy are considered to be: a) the patient's refusal; b) general conditions that do not allow the use of general anesthesia in surgery. RESULTS: None of these 200 patients was converted to open surgery, although six complications occurred: four of these were cases of bleeding in which it was decided to choose a carefully monitored wait-and-see approach. Mean postoperative hospitalisation was two days. No major postoperative complications were observed and it was not necessary to keep any patient for more than five days. CONCLUSIONS: On the basis of this experience, the authors underline the value of laparoscopic surgery versus open cholecystectomy (reduced morbidity, shorter hospitalisation with marked social and economic advantages). Furthermore, the authors emphasise that, when laparoscopy is first introduced, it is important for the same operating team always to be present in order to ensure a good learning curve and increasing familiarity with the technique.

[Colonic angiodysplasia: an important cause of digestive hemorrhage]. / Le angiodisplasie del colon: un'importante causa di emorragia digestiva.

Angiodysplasia of the colon is one of the most common causes of lower gastrointestinal bleeding in elderly patients. The diagnosis can be made by colonscopy or angiography. The best treatment, endoscopic coagulation or surgical resection, is still being debated. Over a period of nearly seven years, 5 patients with angiodysplasia of the colon were treated in our Department. The treatment was right hemicolectomy for all patients with localization at the caecum or ascending colon; in the only patients with segmoid localization a segmentary resection was performed. During a mean follow-up of 22.8 months no patient had any further bleeding. In our opinion surgery is a satisfactory treatment, even if for localization on the left colon a conservative treatment should be preferred.

[Leiomyosarcoma of the mesenteric root. A case report]. / Leiomiosarcoma della radice del mesentere. Presentazione di un caso clinico.

Although smooth muscle tumors are the most common mesentery neoplasms, they are lesions of infrequent occurrence. The main clinical features of these malignancies are an insidious onset and an aspecific symptomatology, usually presenting themselves as quite large masses. The preoperative diagnosis is difficult, but selective angiography and CT scan may be of great value for this purpose. Since these malignancies are usually not responsive either to radiotherapy or chemotherapy, once diagnosed, the only hope of cure lies in surgical resection. The authors report case of leiomyosarcoma of the mesentery root, treated with radical surgery and still alive and disease free 12 months after resection.

Combined effects of immunity and antitumor drugs against cancer. II. In vitro studies with cis-diamminedichloroplatinum in a human leukemia system.

Human K562 leukemic cells were exposed in vitro to cis-diamminedichloroplatinum (DDP) followed by addition of intact or irradiated mononuclear cells (MNC) obtained from peripheral blood of normal donors. tumor inhibition provoked by DDP was significantly enhanced by normal MNC, but not by irradiated cells at the effector: leukemic cell ratio of 2:1. In contrast MNC alone did not show appreciable effects on K562 cells. The NK activity of MNC was also inhibited by exposure to gamma rays. The combined effects of DDP + MNC do not appear to be due to increased susceptibility of DDP-pretreated K562 cells to NK-mediated cytolysis. Actually leukemic cells treated with 10 micrograms/ml of DDP and cultured for 48 h at 37 degrees C, showed decline of susceptibility to the cytotoxic effects of MNC. These studies suggest that natural immunity could be of potential value in the clinical use of DDP.

Natural cell-mediated cytotoxicity: a micro assay suitable for clinical tests.

A micro version (microtest, MIT) of the 51Cr release assay for detecting Natural Killer activity (NK) has been developed. The test retains the sensitivity and the efficiency of conventional macroassay (macrotest, MAT) and provides a 5-fold reduction in the number of effector and target cells employed. In experiments performed with peripheral blood mononuclear cells (MNC), untreated or treated with interferon (IFN) or with hydrocortisone (Hy), comparable values of the percentage of specific lysis and of the number of lytic units were obtained using both MAT and MIT methods. Therefore MIT appears to be useful in monitoring the NK function of patients characterized by low MNC counts.