[Gangrene of Meckel's diverticulum in strangulated left inguinal hernia]. / Ernia inguinale sinistra strozzata con necrosi d'ansa e di diverticolo di Meckel.

We report a case of a 57-year-old woman admitted for abdominal pain and a not reducible mass in left inguino-abdominal region. With a diagnosis of strangulated inguinal hernia, the patient underwent urgent surgery. The surgical exploration showed a gangrenous intestinal loop with a Meckel's necrotic diverticulum. A small bowel resection (20 cm) was performed. The post-operative course was uneventful. This seems the first case reported in the literature of woman with a Meckel's diverticulum involved in a strangulated left inguinal hernia.

The enhancement of avian NK cell cytotoxicity by thymulin is not mediated by the regulation of IFN-gamma production.

Preincubation with either thymulin or IFN-gamma can enhance NK activity. In addition, overnight in vitro pre-treatment with thymulin and IFN-gamma increases NK activity further than either treatment alone. It has been hypothesized that thymulin increases the responsiveness of immune cells to IFN-gamma by either increasing the expression of IFN-gammaR or by increasing the production and/or secretion of IFN-gamma. The effects of thymulin on IFN-gamma production and secretion were examined in this study. While an overnight incubation with the polyclonal activator Con A increased the number of cells positive for intracellular IFN-gamma, a similar incubation with thymulin produced no change in the percentages of cells labeling positive for intracellular IFN-gamma when compared to the media control cells. In addition, IFN-gamma was not secreted by splenocytes following an overnight incubation with thymulin, but increased secretion was induced by Con A stimulation. Taken together, these results suggest that thymulin does not increase IFN-gamma production or induce IFN-gamma secretion by avian splenocytes.

The effects of triodothyronine and thymulin on avian NK cytolytic activity.

The effects of triiodothyronine (T3), thymulin, and recombinant chicken interferon-y (ChIFN-gamma) on natural killer (NK) cell cytotoxicity was investigated using the euthyroid control K and the T3-deficient sex-linked dwarf (SLD) chicken strains. Factorial design experiments were used to investigate the effects of T3 treatments where animals of both strains received either 0 or 0.1 ppm T3 supplementation to the standard chick starter diet. The ChIFN-gamma treatments were administered in vitro by incubation with effector cells overnight prior to the addition of the RP9 lymphoblastoma target cell line. All cytotoxicity assays were run at 50:1 and 25:1 effector/target (E/T) ratios. Treatments were begun at hatching and continued through 7 weeks. NK cells for these assays were enriched by separation of splenocytes over ficoll. Splenocyte preparations from untreated K strain consistently had significantly higher NK-mediated cytolysis than did samples from the untreated SLD at both E/T ratios. T3 treatment alone had no effect on NK activity in cell preparations from the K strain but did significantly enhance that activity in the T3-deficient SLD whereas IFN treatment alone enhanced NK activity in both strains. The combined T3 and IFN treatments resulted in a greater enhancement of NK cytolytic activity in both strains than any separate treatment and resulted in an elimination of differences in NK cell responsiveness between the K and SLD strains. Similar results were obtained when NK cell cultures were incubated in vitro with thymulin prior to assessing cytotoxicity. In vitro thymulin treatments alone significantly enhanced cytolytic activity for NK cells for both K and SLD strains. The greatest effect of in vitro thymulin exposure was to increase the responsiveness to NK cells to ChIFN-gamma stimulation.

Evidence for the direct action of thymulin on avian NK cells.

The ability of thymulin to directly enhance NK cell-mediated cytotoxicity was examined. Specific cell population depletions were done in K and SLD chicken splenocyte preparations using anti-CD3, CD4, and CD8 monoclonal antibodies and secondary complement-fixing polyclonal antibodies. The remaining cells were incubated overnight with in vitro treatments of thymulin and IFN-gamma, either separately or together, followed by an assay for cytotoxicity. Although the control K-strain had higher overall NK cell-mediated cytotoxicity than the thymulin-deficient SLD-strain, the following trends were seen in both strains. Thymulin continued to enhance NK activity following CD4 or CD3 cell depletion, but not after CD8 or CD8 and CD4 cell depletion. Since avian NK cells express CD8 alpha, but not CD3 or CD4 on their surface, these results suggest that the ability of in vitro thymulin treatments to enhance NK activity is not mediated by T-cells but may be due to direct effects on NK cells.

[Unusual case of kidney rupture]. / Un raro caso di rottura di rene.

The Authors report a case of renal rupture in a patient 36 years with acute abdominal pain and progressive anaemia. The history of the patient shows no past signs and symptoms of either renal pathology or traumatic event. Radiological examinations demonstrates dislocation of the kidney through presence of large retroperitoneal formation interpretable as haematoma. Progressing bloodless, they proceeded to embolization of renal artery and successive nephrectomy. Only histological examination of the removed kidney demonstrates the presence of a renal clear cells adenocarcinoma.

Minor oral injuries in children.

Traumatic injuries involving the oral cavity in children often result from falls or collisions with stationary objects. Repair of lacerations involving the soft tissue structures within the oral cavity is described. These injuries often can be managed by emergency department personnel, with referral to an oral and maxillofacial surgeon for follow-up care. Initial management of more extensive injuries such as dentoalveolar fractures, penetrating injuries and burns is also described. Immediate consultation with the appropriate specialist is suggested, because significant deformity and/or morbidity may result from minor oral injuries.

[Effect of hormone replacement therapy on postmenopausal ocular function]. / Effetti della terapia ormonale sostitutiva sulla funzionalità oculare in postmenopausa.

OBJECTIVE: Determination of the effects of hormonal replacement therapy (HRT) on various ocular parameters and symptoms in postmenopausal women. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology, University "Federico II" of Naples. PATIENTS: 14 healthy women treated orally with equine conjugated estrogen in continuous (0,625 mg/daily) and acetate-medroxyprogesteron (10 mg/daily) from 17th to 28th day for three months. MEASURES: Ocular symptomatology, intraocular pressure (IOP), lacrimal secretion, reflected and basal and corneal thickness. RESULTS: After 3 months of HRT the IOP was reduced of 10.8% (p < 0.005), the lacrimal secretion, reflected and basal, increased of 19% and 48%, respectively and the corneal thickness increased of 16.6%. CONCLUSION: The HRT has a positive effect on ocular physiology.

[Effects of ipriflavone on bone loss induced by GnRH analog]. / Effetti dell'ipriflavone sulla perdita ossea indotta da un analogo del GnRH.

The aim of this study is to evaluate the association between GnRH analogues and ipriflavone, drug modulating the bone turnover limiting the negative bone effects of analogue. Thirty patients (33 +/- 5.4 years, mean +/- SD) affect by benign gynecological conditions in which there was an indication to use GnRH analogs have been treated with leuprolide acetate at the monthly intramuscular dose of 3.75 mg, for six months. Fifteen of these patients also received 600 mg/day per os of ipriflavone (group A), while the other 15 patients have been treated exclusively with leuprolide acetate (group B). Before and after treatment, radial bone mineral density (BMD) and main markers of bone turnover were measured in all patients. Before treatment no difference in the considered parameters could be detected between the two groups. In group A, after 6 months of treatment no significant decrease in BMD and no variations in the bone turnover parameters. On the contrary, in group B, after six months of treatment, a significant decrease (p < 0.05) in BMD was observed in comparison to basal and group A values. In the same group alkaline phosphatase, osteocalcin and urinary calcium/creatinine and hydroxyproline/creatinine ratio proved significantly increased in comparison to basal and group A values (both with p < 0.05). Ipriflavone, therefore, seems to be effective in counteracting the negative effects of GnRH-a induced on bone.

Laparoscopic sonography during abdominal laparoscopic surgery: technique and imaging findings.

Laparoscopy is becoming the preferred approach for managing several abdominal disorders. The main limitations of laparoscopic surgery and diagnostic laparoscopy are the loss of the surgeon's tactile feedback and the inability to undertake a complete internal evaluation of solid parenchyma. Probes for laparoscopic sonography have been introduced to compensate for the limitations of laparoscopic surgery and to increase the diagnostic efficacy of laparoscopy [1]. In this article we describe our experience with laparoscopic sonography and illustrate the normal anatomic findings and some applications in biliary surgery and other abdominal laparoscopic procedures.