[Pathogenesis of neoplasms]. / Riflessioni sulla patogenesi delle neoplasie.

The Authors discuss the aspect and the function of the Microcirculatory Unit and the chronic reduction of circulation in true capillaries and therefore of tissue perfusion increasingly evident with the advancement of age, the structural simplification of proteins, the instability of the cells' genome and the increasing remoteness of the immunity system's control. In view of these considerations, they propose the possibility that the onset of tumours may be due to the accentuation of mutageneous substances and the reduction of tissue perfusion with age. When perfusion is maintained of periodically resumed, hypoxy only determines hyperplasia but not cell degeneration or mutations.

[Compromised tissue perfusion for defective microcirculation in children]. / Difetto di perfusione tessutale da carenza microcircolatoria nel bambino.

After a brief review of the anatomic and physiological features of the microcirculatory system, the Authors describe a new interpretation of skin edema in acute diffuse infantile glomerulonephritis, in Henoch-Schönlein's purpura, in epidemic parotitis and in Kawasaki's disease. They attribute the cellular swelling typical of elastic oedema of these diseases to respiratory deficiency due to reduced tissue perfusion following insufficient circulation in real capillaries. The ensuring drop in energy is rapidly resolved by use of very small doses of a calcium antagonist, chloropromazine, which also affects hemorheology. The Authors refer to works which regard the microcirculatory hypothesis in encephalic pathology (similar to that arising in subjects who live at high altitudes where oxygen is scarce), in cranial trauma and in psychic depression. The Authors describe the surprising find, following a fortuitous observation, that in certain forms of hepato-splenomegaly--among which a case of splenomegaly with hepato-megaly and initial cirrhosis--three hours after the administration of doses of chloropromazine ranging from 0.5 to 1.0 mg/kg, the liver and spleen considerably reduced in volume, followed by the patients' ensuing excellent general conditions and functionality of their organs. The article then references many other Authors who in the course of time have acknowledged the fact that hypoxia stimulates proliferation, even of osteoblasts. Mention is made of the fact that many medications and therapeutic measures may cause vasoconstriction at microcirculatory system level, similarly to several antineoplastic drugs, X-rays, hyperbaric oxygen treatment, as well as traumas, low environmental temperatures and surgical operations. For this reason, in order to contrast vasoconstriction in many pathological conditions and in certain therapies, the Authors suggest the addition of the use of calcium antagonists to usual therapy. This conclusion is reached in consideration of the fundamental fact that the energy deficiency arising in the hypoperfused tissue areas allow an accumulation of amino acids, mainly deriving from protein disgregation, used with a low consumption of energy to synthesize a great number of simplified proteins. Final reference is made to the concept expressed on hypoxia and simplified structural proliferation in an article published in "Medical Hypotheses" of 1995 referring to neoplastic promotion.

[Edema in acute diffuse glomerulonephritis, rheumatic peliosis and epidemic parotitis]. / L'edema nella glomerulonefrite acuta diffusa, nella peliosi reumatica e nella parotite epidemica.

The Authors present a substantial series of infant APING in which the venous blood gas analysis shows poor use of oxygen, due to a probably reduced cellular combustion associated with low pCO2, high pH, which are characteristic of arterial blood travelling through anastomotic paths and preferential channels at the microcirculation level. They emphasize the contemporaneous increase in volemia, even with oedema present, and the poor permeation of the capillary wall found with the Landis test, contrary to what happens in glomerulonephrosis with minimal changes which features increased systematic capillary permeation with hypovolemia. The look of the oedema, together with the hypervolemia, led to the suspicion that the nephritic oedema was a sign of mainly intracellular oedema. In the opinion of the Authors these nephritic forms would seem to show systemic cellular respiratory suffering sensitive to the action of chlorpromazine, which has also dealt swiftly and cleanly with the oligoanuresis. The Authors consider 52 cases of Schöenlein-Henoch vasculitis which showed very rapid detumescence of periarticular swelling and those on the back of the hands and feet, as well as the disappearance of skin petechias and melena following treatment with chlorpromazine. They also mention two cases of Kawasaki's disease which seemed to react favorably to the combination of the action of chlorprmazine with acetylsalicylic acid. The effects obtained with chlorpromazine in 27 cases of epidemic parotitis with periscialoadenitis elastic tumescence are reported, with the focus on the reduction of the perisalivary tumescence. It is important to point out the very rapid disappearance of epigastrial pain, probably pancreatic in origin.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical course and therapy in 94 cases of rheumatic peliosis hospitalized at the Trento Pediatric Center from 1967 to 1986]. / Evoluzione clinica e terapia di 94 casi di peliosi reumatica ricoverati al Centro Infantile di Trento dal 1967 al 1986.

Therapy and clinical evolution are described in 94 cases of rheumatic peliosis accepted in about twenty years in the second division of the pediatric department. In 52 cases (55 per cent) at the first stage of the disease chlorpromazinic treatment only was performed and gradually replaced by prednisonich therapy; in other 36 lighter cases, (37 per cent) the treatment was prednisonic only. Other six cases were not treated at all. It is pointed out the chlorpromazine capacity to make every clinical sign vanish in a few days only allowing to practise prednisonic treatment and therefore obstaining remarkable reduction of the child's pain. It is also remarked the harmloness of the treatment performed which is therefore recommended in the therapy of Schoenlein Henoch disease.

Cystic nephroma in children. Report of a case.

A case of cystic nephroma is described in a 20-month-old female. The diagnosis of this rare renal pathologic lesion is essentially based on its pathologic features. The treatment consisted of nephrectomy followed by a brief course of chemotherapy. The literature is reviewed with regard to the pathologic features and treatment of this lesion, which has a favorable prognosis.