Agenesis of the bladder: a case report and review of the literature.

Agenesis of the bladder is a rare congenital anomaly, recorded most often in stillborn infants. Renal agenesis and other severe malformations are frequently associated. An apparent failure of the infraureteral tissue of the mesonephric duct to develop into trigone and proximal urethra seems to be the cause of this anomaly. We report a case of bladder agenesis with anal atresia, left renal dysplasia, and bicornuate uterus.

Primary cultures of neonatal rat liver as an assay system to identify compounds belonging to the tumor promoters class.

A single exposure to a low concentration (10-10 mol/L) of tumor promoters (like 12-0-tetradecanoylphorbol-13-acetate (TPA), phenobarbital, and nafenopin) or of hormones (as epidermal growth factor (EGF), glucagon and insulin) or of drugs (like imidazole and indomethacin) stimulated the 24-h flow into DNA synthesis and mitosis of primary neonatal rat hepatocytes incubated in high-calcium (1.8 mmol/L) Eagle's MEM-FBS medium. However, only tumor promoters acted as enhancers of hepatocytic DNA synthesis when a low-calcium (0.1 mmol/L) FBS-MEM medium was used. The tumor promoters' activity was completely suppressed by the simultaneous (or nearly such) addition of low doses (from 25.0 to .25 micrograms/ml; activity, from 100 to 1.0 unit/ml) of exogenous bovine liver Cu,Zn-superoxide dismutase (SOD), whatever the medium's calcium concentration. By contrast, SOD did not inhibit the growth stimulation elicited by hormones and drugs in hepatocytes exposed to the high-calcium FBS-MEM medium. Moreover, several tumor promoters (namely TPA, phenobarbital, nafenopin, saccharin, teleocidin, benzoyl peroxide, BHT, DDT, lindane, clofibrate, and melittin) stimulated DNA synthesis even when the hepatocytes were incubated in the serumless HiWoBa2000 medium, whatever its calcium concentration. In this synthetic medium, the tumor promoter's stimulatory activity was again completely written off by the simultaneous administration of exogenous (superoxide dismunate) SOD. These results disclose the existence of two quite different mechanisms by which neonatal rat hepatocyte growth can be stimulated: (i) the physiological-pharmacological extracellular calcium-dependent SOD-insensitive machinery, mediating the effects of EGF, glucagon, insulin, imidazole, and indomethacin; and (ii) the pathological extracellular calcium-independent SOD-suppressible mechanism operated by agents belonging to the tumor promoters class and involving, as a critical step, the generation of superoxide anions at the surface of the hepatocyte's plasma membrane. The present results also indicate that primary cultures of neonatal rat hepatocytes may constitute a useful tool for promptly and safely identifying compounds endowed with tumor promoters' capabilities.

[Gastric trichobezoar: a case report (author's transl)]. / Uno caso di tricobezoario gastrico.

We describe the case of an 11 years old girl admitted to investigate an abdominal mass. The patient presented with abdominal pain, halitosis, exhaustion, started about 1 year prior to admission. An upper gastrointestinal tract with barium and a gastric endoscopy showed a massive trichobezoar which was then surgically removed. A detailed medical history revealed a prolonged habit of trichophagia.

Esophageal perforation in the newborn.

Two cases of esophageal perforation in the newborn are reported. The first case underwent surgery after suspected diagnosis of a traumatic perforation of a superior atresic esophageal stump. The second case was treated with supportive therapy. Both cases were cured and discharged in good health. The possible mechanisms of spontaneous and iatrogenic perforation are discussed.

Primary intestinal lymphangiectasia. Comparison between endoscopic and radiological findings.

Two children with primary intestinal lymphangiectasia (PIL) are presented, both of whom had been prescribed an MCT supplemented diet low in long chain fatty acids. The hypoproteinemic edema improved in one patient, but persisted in the other. Following several years of dietary therapy, both subjects were re-evaluated, and a duodenoscopy and radiography of the digestive tract were performed. The duodenoscopic procedure evidenced two types of lymphangiectatic plaques on the surface of the duodenal mucosa: one form had a diameter of less than 1 mm, while the other exceeded 3 mm. The smaller lesions were seen in the child with the more favorable clinical course, whereas both types were observed in the other patient. Radiological examination disclosed the typical anomalies of intestinal lymphangiectasia only in the subject who had not responded to the dietary regimen. These results suggest that endoscopy affords a more precise assessment of the anatomic injury and could play an important role in formulating an accurate clinical diagnosis.

Clinical and aortographic assessment of the complications of arterial catheterization.

Catheterization of the umbilical artery for the treatment of critically ill neonates provides a convenient method for monitoring blood gas tension and chemistry. The most important complications are thrombotic. Thirty eight aortographs were carried out in infants who underwent umbilical artery catheterization. 17/38 of the aortographs were pathological. Bacterial cultures were positive in 11/17, but only 4 coincided with pathological aortographs. Clinical signs indicating complications due to the presence of the catheter wwere observed in 10 cases. Post-mortem examination of eight subjects--three of whom had pathological aortographs--during the course of the investigation revealed only one case of thrombosis. This baby was considered to have died as a direct result of a thrombotic complication. In our experience the clinical signs of vascular complications and evaluation of the peripheral circulation in the ipsilateral leg remain the most important ways of assessing the indication for catheter-withdrawal.