[Biliary lithiasis in childhood. A spectrum of diseases with different clinical significance during fetal life, childhood and adolescence]. / La litiasi biliare in età pediatrica. Uno spettro di patologie con diverso significato clinico nella vita fetale nel lattante, nell'infanzia e nell'adolescenza.

On the basis of a research on fetal cholelithiasis, a review on the various form of cholelithiasis in pediatric age has been carried out. These include, in addition to fetal cholelithiasis, lithiasis in the first year of life and lithiasis in infancy and adolescence. These various expressions of the same pathology differ for incidence, predisposing factors, clinical situation, therapy and follow-up. The research conducted on fetal cholelithiasis showed an incidence of 0.39%, higher than expected. There isn't any maternal, obstetrical or fetal predisposing factor. The diagnosis is purely instrumental and is not correlated with known clinical or humoral data. The most frequent evolution is spontaneous resolution of the biliary echogenic images in absence of clinical manifestations; the complications are rare and not well documented. Cholelithiasis in the first years of life is correlated with malformative, pharmacologic or iatrogenic predisposing factors. The clinical situations include symptomless cases with spontaneous resolution and cases with serious complications. Therapy is to be chosen in each case in accordance with clinical features. Pediatric cholelithiasis beyond the first year of life, especially in the later childhood and adolescence, can be similar to cholelithiasis of adults for epidemiology, pathogenesis, symptomatology and therapy.

[Madelung's disease. Clinical case and review of the literature]. / Malattia di Madelung. Caso clinico e revisione della letteratura.

Symmetrical benign lipomatosis (Madelung's disease) is extremely rare. Approximately 200 cases have been reported in the literature. SLB is a syndrome characterized by the occurrence of symmetric lipomas of the neck. No clear etiology has been recognized while a frequent association with systemic metabolic abnormalities has been described. The only effective therapy is the palliative surgical removal of the fatty tissue by lipectomy or liposuction. Experience with surgically treated patients shows the tendency of this disease to recur.

[Prospective research on fetal cholelithiasis: incidence, predisposing conditions, echographic diagnosis, and clinical features]. / Una ricerca prospettica sulla colelitiasi fetale: incidenza, condizioni predisponenti, diagnosi ecografica e quadro clinico.

The Authors report a prospective study on fetal cholelithiasis, analyzing its differences with the more widely known cholelithiasis of paediatric age. The study shows that the number of cases diagnosed by ultrasonography is higher than expected (0.39%, 3 cases on 764 pregnancies). The Authors could find no correlation between fetal cholelithiasis and any maternal, obstetrical and fetal factor. They have focused attention on sonographic imaging showing clinical-instrumental correlation between echogenic material, clinical features and their evolution. The study confirms that the most common evolution results in spontaneous resolution of fetal endocholecystic pathological images. Finally, wide review of the international literature is reported on the rare, but possible clinical manifestations and their complications.

[Hydatid cysts of the right lobe of the liver treated with total pericystectomy using a transparenchymal approach]. / Cisti idatidee del lobo destro del fegato trattate con pericistectomie totali per via transparenchimale.

The Authors report on 2 cases of hydatid cyst of the right hepatic lobe. A transparenchymal approach with total pericystectomy was the treatment of choice.

[Splenic localization of an echinococcal cyst]. / Localizzazione splenica della cisti da echinococco.

The finding of echinococcal cyst in the spleen is an extremely uncommon event occurring in Literature in 4% of the cases, setting, for frequency, after the liver and the lungs. The symptomatology is not very evident, being characterized by fever, left upper quadrant fullness or discomfort due to splenomegaly, which is demonstrable with physical examination and US. Splenectomy is the best surgical choice in the treatment of echinococcal cyst while conservative surgery should be reserved as an alternative in very selected cases.

[Fetal biliary lithiasis: ultrasonographic diagnosis and clinical interpretation. Report of 3 cases]. / La litiasi biliare fetale: diagnosi ecografica e interpretazione clinica. Descrizione di tre casi.

Fetal cholelithiasis was first diagnosed in 1983 and since then there have been only few reports about the presence of gallstones in the fetus. Maternal conditions, fetal or obstetrical predisposing risk factors have been proposed to have a causative role, but the pathogenesis of fetal gallstones remains unknown. Clinical sequelae of fetal gallstones are poorly understood as well as the role of fetal cholelithiasis in predisposing the adult to gallstones. We report on 3 patients whose cholelithiasis was diagnosed by obstetrical ultrasonography. Repeated ultrasound scans were performed in each patient until resolution of the US images. The goal of US was to correctly identify the number, size, and US features of the material within the gallbladder. The presence of distal shadowing or comet-tail artifact was assessed. Multiple, small echogenic foci without distal shadowing were recognized in the fetal gallbladder in our patients. Echogenic material was present at the US exams after birth in two patients and disappeared in the second month of life. In the third case echogenic foci disappeared during pregnancy. In all the cases, US showed no biliary tract abnormality, and neither the mothers nor the patients had clinical or laboratory findings consistent with liver or biliary diseases. The Authors discuss a diagnostic protocol to detect and follow-up gallstones in the perinatal period by ultrasonography. In our experience, fetal cholelithiasis confirmed to be a self-limiting disease without complications and did not require any form of therapy. However, a close follow-up is indicated in these patients until spontaneous resolution is demonstrated by US.

[Primary cysts of the spleen: a case report]. / Cisti primarie della milza: descrizione di un caso clinico.

The cystic pathology of the spleen is comparatively infrequent and the origin is parasitic, hydatid. The parasitic cysts are the 65% of the total and the cysts secondary at trauma are the 28%. The real or primary cysts of the spleen are only the 75 of the case record. Analyze, in this work, the etiology and the clinic of these formations and show the personal experience about a clinical case arrived at our observation with negative anamnesis for trauma and with aspecific symptomatology like dyspepsia. We think that this notification is useful because the cystic primary formations of the spleen are very rare.

[In vitro growth of skin fibroblasts of patients with atypical ductal hyperplasia of the breast: effects of 17 beta-estradiol]. / Crescita in vitro di fibroblasti cutanei di pazienti affette da iperplasia duttale atipica della mammella: effetti del 17-beta-estradiolo.

In this work we investigated the growth of skin fibroblasts, in vitro cultured, drawn from women suffering Atypical Ductal Hyperplasia (I.D.A.) and from healthy women (controls). Whether in basic conditions or after administration of 17, beta-estradiol, in single of repeated dose, cellular growth was valued. The results obtained show that skin fibroblasts drawn from women suffering I.D.A. treated with 100 microliters/ml of estradiol (effective dose), have an increase of the growth. Moreover the increase of the growth seems to be bequest to "effective dose" but not to the number of administrations.

[Different proliferative capacity of human fibroblasts after 17 beta-estradiol administration]. / Differenti capacità proliferative di fibroblasti umani in seguito a somministrazione di 17, beta-estradiolo.

In this study the authors examined the influence of 71, beta-estradiol on cutaneous fibroblasts taken off either from healthy patients with no family history for cancer, or from patients with breast cancer. Fibroblasts were taken from the subcutaneous tissue of the mammary gland by a biopsy carried out in each patients on the same quadrant of the granular surface. Soon after biopsy, the tissue fragments have been washed, dished ed incubated in RPMI at 37 degrees C in a humidified atmosphere of 5% CO2 and 95% air. The action of the hormone was evaluated by the means of cells count for field, in 20 fields in each dish with an inverted microscope (20 x magnification). The results demonstrated that cutaneous fibroblasts from patients with breast cancer show higher values of cell density than those from healthy one. This phenomenon is present both in basal conditions and after hormonal treatment. Two different dosages were used, but only the highest (100 microliters/ml of 17, beta-estradiol) was responsible for an increase of the cell density in all of the treated patients as compared the control groups. These data suggests the presence of a threshold dosage for the estrogens. Below such a dosage there are no effects on cellular growth.