Molecular physiognomies and applications of adipose-derived stem cells.

Adipose-derived stromal/stem cells (ASC) are multipotent with abilities to differentiate into multiple lineages including connective tissue and neural cells. Despite unlimited opportunity and needs for human and veterinary regenerative medicine, applications of adipose-derived stromal/stem cells are at present very limited. Furthermore, the fundamental biological factors regulating stemness in ASC and their stable differentiation into other tissue cells are not fully understood. The objective of this review was to provide an update on the current knowledge of the nature and isolation, molecular and epigenetic determinants of the potency, and applications of adipose-derived stromal/stem cells, as well as challenges and future directions. The first quarter of the review focuses on the nature of ASC, namely their definition, origin, isolation and sorting methods and multilineage differentiation potential, often with a comparison to mesenchymal stem cells of bone marrow. Due to the indisputable role of epigenetic regulation on cell identities, epigenetic modifications (DNA methylation, chromatin remodeling and microRNAs) are described broadly in stem cells but with a focus on ASC. The final sections provide insights into the current and potential applications of ASC in human and veterinary regenerative medicine.

Rapid growth of myxoid leiomyosarcoma of the vulva during pregnancy: a case report.

Smooth muscle tumors arising in the vulva are rare. Leiomyosarcoma is the most common variant of vulvar sarcoma, and very few cases have been reported during pregnancy. A 36-year-old woman presented with a progressively enlarging vulvar mass during pregnancy, diagnosed as a Bartholin's gland cyst. The lesion was resected at 38 weeks of gestation during cesarean section and diagnosis of myxoid leiomyosarcoma of the vulva was made. Six weeks later the patients were referred to our center and submitted to wide vulvar excision with groin lymph node dissection that revealed the presence of a small residual focus of leiomyosarcoma. At 30 months of follow-up the patient was well without any sign of recurrent disease. Leiomyosarcoma should be included in the differential diagnosis of vulvar masses; progressively enlarging vulvar lesion should be biopsied even during pregnancy. Leiomyosarcoma should be considered in the differential diagnosis of vulvar mass.

Indications and outcome for intensive care unit admission during puerperium.

BACKGROUND: A significant decrease of maternal mortality related to improvement in diagnosis and prevention of disorders in pregnancy has been observed without a similar reduction of puerperal morbidity. Objective of this study was to identify risk factors and outcome of patients, which required intensive care during puerperium. METHODS: During the period 1987-1998 all pregnant patients, which were transferred from Department of Obstetrics and Gynecology to Intensive Care Unit (ICU) of University of Bari, were retrospectively included into the study. Several risk factors (age, preexisting diseases, gestational age, medical complication of pregnancy, mode of delivery, surgical additional procedure, fetal outcome, intrapartum transfusions, and puerperal complications) and the indications for transfer were evaluated. RESULTS: The overall incidence of admission into Intensive Care Unit was 0.17% (41/23.694) of deliveries. Indications for admission into ICU were worsening of preeclampsia in 75.6% of cases, severe bleeding in 14.7% of cases, maternal cardiac disease stage III AHA in 4.9% of cases, pulmonary embolism and acute pulmonary oedema respectively in 2.4% of cases. CONCLUSIONS: Transfer of patients to ICU due to hypovolemic postraumatic shock seems progressively declining thanks to modern criteria of obstetric management; on the contrary we assist to a prevalence of serious intrinsic maternal diseases often preexisting pregnancy or late consequence of preeclampsia, pulmonary embolism and sequelae of abnormal insertion of placenta.

[Combination of cisplatin and vinorelbin in the neoadjuvant treatment of locally advanced cervical carcinoma. Phase II study]. / Associazione di cisplatino e vinorelbina nel trattamento neoadiuvante del cancro cervicale localmente avanzato. Studio di fase II.

BACKGROUND: Aim of this phase II study is to evaluate the cytoreductive efficacy and the toxicity of a regimen consisting of cisplatin and vinorelbine as neoadjuvant chemotherapy for three cycles every 21 days in patients with locally-advanced cervical carcinoma. METHODS: Between April 1996 and December 1998, 33 untreated patients with locally-advanced cervical carcinoma received neoadjuvant chemotherapy with cisplantino 80 mg/m2 (day 1) plus vinorelbine 25 mg/m2 (day 1 and 8). Within 28 days from completion of chemotherapy patients in complete or partial response were submitted to radical hysterectomy plus pelvic lymphadenectomy. RESULTS: Twenty-six patients (79%) were submitted to radical surgery; four patients were not submitted to surgery because of poor response to treatment, two for anesthesiological contraindications and one refused surgery. The combination of cisplatin plus vinorelbine in this phase II study induced a clinical overall response rate of 90%, with 8 pathologic complete response (24%). CONCLUSIONS: The association of cisplatin and vinorelbine as neoadjuvant chemotherapy in locally-advanced cervical carcinoma showed to be safe and effective with a low cost and poor toxicity.

[Chronic hepatitis and liver cirrhosis]. / Epatite cronica e cirrosi epatica.

The Authors consider 349 liver biopsies; 32 of these showed cirrhosis. Patients with chronic hepatitis are at high risk for evolution to cirrhosis. Our aim is to establish the markers HBsAg and HBcAg comparing this with the risk groups and with the possible causes of cirrhosis.

Advanced breast cancer: response to somatostatin.

It has previously been reported that a somatostatin analogue has a direct antiproliferative effect on human breast cancer cells in vitro. Here we report preliminary data on the effects of the in vivo administration of SMS in patients with advanced breast cancer. The regimen consisted of iv infusion of 750 micrograms SMS t.i.d. for 10 days followed by 5 days at 500 micrograms im b.i.d. A partial response was observed in 3 out of 10 patients treated. Moreover, a marked reduction of oedema, cyanosis and bleeding from ulcerated tumor lesions was noted in most of the treated patients. Administration of SMS was devoid of toxic side effects. It is suggested that SMS may be of potential value in the therapeutic approach to advanced breast cancer.