Is there an association between severity of illness and psychiatric symptoms in patients with chronic renal failure?

Chronic renal failure (CRF) is a frequent condition in elderly subjects, and it is associated with psychiatric comorbidity, especially depressive symptoms. Purpose of the present research was to compare patients with different severity of chronic kidney disease (CKD) in terms of psychiatric symptoms. One hundred CKD subjects were randomly selected among those attending the Department of Nephrology, University of Milan. The patients were evaluated through the following rating scales: Mini-Mental State Examination (MMSE), Beck Depression Inventory (BDI), Symptom Checklist (SCL-90), Kidney Disease Quality of Life- Short Form (KDQOL-SF) and Cumulative Illness Rating Scale (CIRS). A multivariable linear regression analysis was performed considering eGFR as continuous-dependent variable and rating scale scores as independent variables. A worse eGFR significantly correlated with the score about the effects of kidney disease on daily life (r = 0.25, p = 0.01) and the burden of kidney disease (r = 0.18, p = 0.05). Statistical significance of kidney disease on daily life persisted also in the final multivariate model (t = 2.04, p = 0.04). Severity of renal dysfunction seems to influence few psychiatric outcomes, particularly those related to quality of life and daily functioning. This result might depend on the over-worrying derived from the necessity to start a renal replacement therapy in the near future.

Calcium sulfate stimulates pulp stem cells towards osteoblasts differentiation.

Calcium sulfate (CaS) is a highly biocompatible material and enhances bone formation in vivo. However, how CaS alters osteoblast activity to promote bone formation is poorly understood. To study how CaS can induce osteoblast differentiation in mesenchymal stem cells, the expression levels of bone related genes and mesenchymal stem cells marker were compared in normal osteoblasts and dental pulp stem cells, using real time Reverse Transcription-Polymerase Chain Reaction. Gene differentially expressed between the two cells type were the trascriptional factor RUNX2, osteopontin (SPP1), COL1A1 (collagen type 1α1) and alkaline phosphatase (ALPL). The obtained results demonstrated that CaS strongly influences the behavior of DPSCs in vitro enhancing proliferation, differentiation and deposition of matrix.

Polylactide-polyglycolide resorbable plates stimulates adipose tissue-derived stem cells towards osteoblasts differentiation.

Polylactide, polyglycolide materials or devices have been utilized routinely during maxillofacial, craniofacial, and orthopaedic reconstructive surgical procedures.(1) These materials combine the benefits of rigid fixation with the advantages of biodegradation, avoiding the need for implant removal and minimizing the risk of other complications.(2) To study how polylactide, polyglycolide acids plates (PLPG plates) can induce osteoblast differentiation and proliferation in mesenchymal stem cells, the expression levels of bone related genes (RUNX2, SP7, ALPL, SPP1, COL1A1, COL3A1 and FOSL1) and mesenchymal stem cells marker (ENG) were measured in adipose derived stem cells (ADSCs) and normal osteoblast (NO) cultivated on PLPG plates after 15 and 30 days of treatment using real time Reverse Transcription-Polymerase Chain Reaction. Significantly differentially expressed genes among ADSCs and NO were SP7, ENG, FOSL1, RUNX, ALPL and SPP1 in the first 15 days of treatment and SP7, ENG FOSL1, COL3A1 COL1A1, SPP1 and ALPL after 30 days. The present study demonstrated that PLPG plates strongly influences the behavior of ADSCs in vitro by enhancing proliferation, differentiation and deposition of matrix.

Characterization of Rhynchosia yellow mosaic Yucatan virus, a new recombinant begomovirus associated with two fabaceous weeds in Yucatan, Mexico.

Rhynchosia minima (L.) DC. (Fabaceae) plants exhibiting bright golden mosaic symptoms were previously associated with begomovirus infection in Yucatan, México [1]. To characterize the begomovirus infecting these plants, the complete bipartite genome was cloned and sequenced. Sequence comparisons indicated that the virus was distinct from all other begomoviruses known to date, including those previously identified from symptomatic R. minima, and the name Rhynchosia yellow mosaic Yucatan virus (RhYMYuV) is proposed. Pairwise comparisons indicated that RhYMYuV DNA-A [2,597 nt, (EU021216)] and DNA-B [2,542 nt, (FJ792608)] components shared the highest nt sequence identity with Cabbage leaf curl virus (CaLCuV), 87% for component A and 71% for component B. Phylogenetic analysis indicated that both components of RhYMYuV are most closely related to other New World begomoviruses, having as closest relatives immediate outliers to the major Squash leaf curl virus (SLCV) clade. Recombination analysis of the RhYMYuV genome indicated that the DNA-A component has arisen through intermolecular recombination. R. minima plants inoculated with the monomeric clones developed a bright yellow mosaic similar to symptoms observed in naturally infected plants, confirming that the clones were infectious. Nicotiana benthamiana plants biolistically inoculated with monomeric clones developed curling and chlorosis in the newly emerging leaves. RhYMYuV was also detected in symptomatic Desmodium sect. Scorpiurus Benth. (Fabaceae) that were collected near the RhYMYuV-infected plants.

[Survival of 184 patients with hepatocellular carcinoma in cirrhotic liver treated with chemoembolization. A multicenter study]. / La sopravvivenza di 184 pazienti con carcinoma epatocellulare nel fegato cirrotico trattati con chemioembolizzazione. Studio multicentrico.

INTRODUCTION: We report the results of a multicenter study of 184 cirrhotic patients with hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE) and compare our results with those reported in the literature. MATERIAL AND METHODS: We treated 184 cirrhotic FNB-proved HCC patients with TACE in a 2 years' period; 159 were men and 25 women and their mean age was 59 years (range: 46-75 years). TACE was performed with selective or superselective injection of Doxorubicin chlorhydrate (20-50 mg) mixed with Lipiodol Ultrafluid before embolization with Spongostan. This procedure was repeated after 4-6 weeks for at least 3 cycles. Follow-up was performed by means of periodic US, CT and MR scans and by assessment of the clinical status and serum biochemical tests--alpha-fetoprotein, platelet and blood cell counts, protein electrophoresis, bilirubin and other standard liver and renal function tests. TACE results were assessed comparing site, size and local spread of tumor and TACE technique (lobar or segmental, number of performed procedures) with survival in each patient. The lesion was single in 85 (46.2%) and multiple in 99 (53.8%) patients. It exceeded 5 cm in 128 patients (69.5%) and was < 5 cm in 57 (30.5%). RESULTS: Angiography, CT and MRI showed complete necrosis in 148 patients (80.4%) and an unchanged pattern in 36 (19.6%). Overall survival rates were 95.7% at 6 months, 78.3% at 1 year, 46.0% at 2 years, 40.0% at 3 years. The best responses were obtained with lesions < 5 cm--with 100% survival at 6 months, 94.8% at 12 months, 71.4% at 18 months, 54.7% at 24 months and 50.0% at 36 months. Other factors affecting treatment response were singleness of lesion (96.4% at 6 months, 93.9% at 12 months, 71.4% at 18 months, 58.9% at 24 months, and 50.0% at 36 months) and at least 3 cycles of TACE (100% at 6 months, 87.8% at 12 months, 70.1% at 18 months, 48.7% at 24 months and 37.5% at 36 months). Abdominal pain and fever were the most frequent complications, particularly in the first TACE procedure, but both were mild and transient. Lipiodol cholecystitis was found in 3 patients but they were asymptomatic. No patients had evidence of cardiac toxicity or experienced significant leukopenia or thrombocytopenia as a result of systemic toxicity from Doxorubicin. CONCLUSIONS: We can conclude that TACE proves to be an efficacious treatment in the HCC patients who cannot undergo surgery.

[Our experience in the treatment of intrathoracic and intraspinal hourglass neurogenic neoplasms]. / Nostra esperienza nel trattamento delle neoplasie neurogene a clessidra, intratoraciche ed intraspinali.

The authors describe their experience in the treatment of dumbbell neurogenic tumours, intrathoracic and intraspinal, with particular reference to clinical presentation, diagnostic for imaging, anatomo-pathological classification and surgical treatment, comparing their clinical cases (9) with the international literature, accurately reviewed. The authors think that the best surgical treatment is the combined approach, in only one stage, of thoracic surgeon and neurosurgeon by hemilaminectomy and extended costotrasversectomy, reserving hemilaminectomy and thoracotomy only for the tumours with big dimension of intrathoracic portion.

[Obturator hernia]. / L'ernia otturatoria.

Obturator hernia, which is a rare cause of intestinal occlusion, generally presents non-specific signs and symptoms. Radiology may be sometimes useful for the diagnosis. Four cases of obturator hernia are described, and the possible surgical access routes are illustrated, emphasizing the use of prosthetic mesh.

[Splenic arteriovenous fistula (a clinical case)]. / Fistola artero-venosa splenica (un caso clinico).

A splenic arteriovenous fistula is a situation often presenting with signs of portal hypertension and with a characteristic murmur. Though rare, the possibility of a splenic arteriovenous fistula must be borne in mind in differential diagnosis, since it can be corrected surgically by resolving the portal hypertension.

[Gastric resection and gastroduodenal anastomosis with mechanical staplers]. / Resezione gastrica ed anastomosi gastroduodenale con suturatrici meccaniche.

The Authors report their experience with stapling devices in gastric resection according to Billroth I. The operative technique for the restoration of the gastroduodenal continuity, the data concerning 39 cases observed from January 1, 1982 to May 30, 1989, and the relative indications are described.

[Cystic mucinous neoplasms of the pancreas]. / Neoplasie cistiche mucinose del pancreas.

The Authors report on three cases of Mucinous Cystic Neoplasms of the pancreas. These tumours are rare and the diagnosis is based on echography and CT scanning. After a radical excision the prognosis is good although these tumours are "all" potentially malignant.

[Treatment of large laparoceles with non-reabsorbable prosthetic material (our experience)]. / La cura dei voluminosi laparoceli con materiale protesico non riassorbibile (nostra esperienza).

A series of 96 patients who underwent "eventration repair" using Mersilene-Mesh, according to Rives technique between jan 1983 and june 1988 is reported. The Authors stress the excellent results and the low cost of this method: there were no recurrences, postoperative complications were rare (18.7%) and their recover was complete, the patient was allowed to return to work earlier after easy and prompt convalescence.

[Rectocolic carcinoma associated with ovarian neoplasms. A clinical study and review of the literature]. / Carcinomi rettocolici associati a neoplasie ovariche. Studio clinico e revisione della letteratura.

Five cases of colorectal cancer associated with ovarian neoplasma are reported: three of them are multiple primary malignant lesions and the others are colorectal carcinoma with ovarian metastasis. Problems of its frequency are then discussed as well as and ethiopathogenesis in multiple primary malignant neoplasma and in ovarian metastasis.

Localization and pattern of the mitotic activity in the central nervous system of developing oviparous and viviparous teleosts.

The subject of this work is an analysis of the mitotic activity in the developing spinal cord and rhombencephalon of the oviparous teleost Jordanella floridae and the viviparous teleost Gambusia affinis (Cyprinodontoidei). In Gambusia there is considerable and long lasting mitotic activity that decreases gradually and is still present 20 days after birth. In Jordanella the mitotic activity is concentrated in the early stages of development, it then decreases drastically and practically disappears even before hatching and reappears 20 days later. These differences are probably due to the variations in speed and pattern of development in the two teleosts. As regard the localization of mitoses, it emerged that migration towards the lumen may be prevented by physiological conditions related to normal development. It emerged moreover, that migration towards the lumen is not a generalised phenomenon in development of the central nervous system since it is related, in the spinal cord of teleosts at least, to the modality and speed of embryo development.

[Circulating immune complexes in a population of subjects seropositive for rheumatoid factor]. / Immunocomplessi circolanti in una popolazione di soggetti sieropositivi per il fattore reumatoide.

The level of immune complexes has been detected with the C1q binding test in 179 subjects positive by Latex agglutination test (titre greater than 1/20). The average of C1q binding was 5.36%, significantly higher than in 30 normal blood donors. A positive correlation was observed between the percent of C1q binding and, respectively, the titre of the latex test and the erythrocyte sedimentation rate. Of the 36 patients with rheumatoid arthritis, 16 (45.7%) showed an high level of C1q binding activity (greater than 5%), as well as 4 of the 8 patients with chronic hepatitis (50%) and 11 of the 31 patients with infectious diseases. No immune complexes were detected among the 11 healthy latex positive subjects.

[Upper urinary tract filling defects (author's transl)]. / I difetti di riempimento della via urinaria superiore.

The distinctive features of true and false filling defects in the radio-opaque image of the upper urinary tract are discussed. The differential diagnosis of intrinsic intraluminal and parietal lacune is examined and several cases are presented by way of illustration.