Systemic acute-phase response after laparoscopic and open cholecystectomy.

BACKGROUND: Cytokines are the main mediators of inflammation and the response to trauma. The purpose of this study was to compare variations in cytokine levels following laparoscopic cholecystectomy (LC) and mini-laparotomy cholecystectomy (OC), since these two types of operations were considered to be a unique model for examining the role of local tissue injury in postoperative inflammatory reactions. METHODS: A total of 40 patients were studied. Eighteen of them underwent LC; the remaining 22 were operated on using the open technique. Systemic concentrations of interleukin-6 (IL-6), interleukin-1 (IL-1), tumor necrosis factor (TNF), and C-reactive protein (CRP) were measured before and after the operation. In addition, we compared pre- and postoperative white blood cell (WBC) counts, postoperative body temperature, and length of postoperative hospitalization. RESULTS: There was no difference between the two groups in IL-1 and TNF response. The rise in plasma IL-6 levels (18.86 +/- 9.61 vs 5.00 +/- 0.0 pg/ml, p < 0.0001) and CRP (8.40 +/- 5.81 vs 1.43 +/- 1.30 mg/dl, p < 0.001) were more marked after open cholecystectomy than after the laparoscopic procedure. There was no correlation between serum CRP concentrations and the other postoperative parameters. CONCLUSION: The magnitude of the acute-phase response was less pronounced following laparoscopic cholecystectomy, consistent with a reduction in tissue trauma.

[Tissue expression of carbohydrate antigen 19-9 (CA 19-9) in adenomatous lesions of the colorectum]. / Espressione tissutale dell'antigene carboidrato 19-9 (CA 19-9) nelle lesioni adenomatose del colon-retto.

Serum levels of tumor markers almost not detectable in precancerous states or early cancer, the behavior of the tumor associated antigen CA 19-9 in colorectal carcinogenesis was analysed. In order to investigate the adenoma-carcinoma sequence, tissue antigenic expression was measured in adenomas, characterized by different size and histology, and compared with that found in normal colonic mucosa. Tissue content of CA 19-9 was determined by an immunoperoxidase technique (ABC-POD) in 88 colonic polyps, and correlated to the degree of histological dysplasia, and dimension of adenoma. Tissue content of CA 19-9 was also evaluated in non-adenomatous mucosa obtained by endoscopic biopsy. Among the 88 polyps, 50 showed the tubular histological type, while 31 resulted tubulovillous and 7 villous. High degree of dysplasia was present in 7 adenomas (7.9%) and focal carcinoma was observed in 6 (6.8%). Positivity for CA 19-9 was registered in 60.2% of adenomas. No correlation was found between tissue-CA 19-9 and degree of dysplasia, size of adenoma and villous component. However, a statistically significant correlation was observed between expression and cellular distribution of the antigen (chi 2 = 98.07, p < 0.00001). Our data confirmed CA 19-9 expression in adenomas, but it is unlikely this tissue antigen proves to be a reliable marker of adenoma-carcinoma sequence.

Nucleoli, rRNA genes and ITS region in Posidonia oceanica (L.) Delile.

The maximum number of nucleoli was counted in interphase nuclei of Posidonia oceanica, and a restriction pattern of nuclear rDNA was obtained after digestion with four restriction endonucleases and Southern hybridization. P. oceanica has only one type of ribosomal gene whose size was estimated to be 18.5 kbp long. The nucleotide sequence of the entire ITS region was also determined by direct sequencing of PCR amplified DNA fragments. The sequence of the ITS region was aligned with those of homologous regions of other monocots available in literature, and phylogenetic trees were obtained.

[Surgical treatment of pancreatic pseudocysts]. / Trattamento chirurgico delle pseudocisti del pancreas.

The Authors report their experience of 62 consecutive patients with pancreatic pseudocysts observed within the period 1973-1993. Spontaneous resolution of the pseudocyst occurred in 16 cases. Forty-five patients were surgically treated (31 post-necrotic cysts, 5 post-traumatic cysts and 9 retention cysts); operations included internal drainage in 32 (cystojejunostomy in 13, cystogastrostomy in 18 and cystoduodenostomy in one), external drainage in 8 and pancreatic resection in 5 patients. One patient underwent percutaneous catheter drainage of a post-necrotic pseudocyst. Indications for surgery included complications, nonresolution or persistence of symptoms, and extension. The operative mortality and morbidity rates were higher in the patients submitted to external drainage (22.2% vs 6.2%; 55.5% vs 21.8% respectively). On the basis of the results the Authors conclude that the internal drainage, particularly cystojejunostomy, should be considered the operation of choice for pancreatic pseudocysts because of the lower mortality and morbidity. On the contrary, external drainage is indicated for infected or ruptured pseudocysts.

Detection and characterization of a glutenin subunit with unusual high Mr at the Glu-A1 locus in hexaploid wheat.

A hexaploid wheat landrace collected from the Baluchistan province of Pakistan was found to possess a novel high-molecular-weight glutenin subunit (HMW-GS). The subunit has a very slow electrophoretic mobility as revealed by SDS-PAGE, and its molecular weight is comparable to that of the highest molecular weight glutenin subunit ("2.2" encoded in the D-genome) reported so far in hexaploid wheat varieties and landraces of Japanese origin. Evidence obtained from (PCR) gene amplification studies using the primers specific for Glu-1 loci proved that the gene coding for this novel subunit belongs to the Glu-A1 locus located on the long arm of chromosome 1A. Digestion of the amplified gene (PCR product) with restriction enzymes indicated that the novel gene differs from prevailing Glu-A1 alleles (null, 1 and 2(*)) by an extra DNA fragment of approximately 600 base pairs. The results also indicated that the novel subunit is most probably a derivative of subunit 2(*) that has very likely incorporated the 600-bp fragment following a process of unequal crossing over. The present findings were further substantiated by reserved phase high performance liquid chromatography (RP-HPLC) analysis.

[Anatomicosurgical research on isolating the retrohepatic segment of the vena cava inferior]. / Ricerca anatomo-chirurgica sull'isolamento del segmento retroepatico della vena cava inferiore.

The retrohepatic segment of the inferior vena cava is considered of major importance in the surgical management of both thoracoabdominal trauma and neoplasms involving the venous wall. Twenty autopsies and 10 anatomical specimens were employed to examine the patterns of the avascular inter-hepato-caval median space. For the isolation and ligation of the hepatic veins a rubber snare was inserted into the avascular plane assuring a right tension of the vasculo-parenchymal lamina which attracts the liver to the vena cava. The number and the course of the hepatic veins were clearly identified. Authors' experience, coupled with a critical review of the literature, confirms that successful isolation of the believed surgically inaccessible retrohepatic vena cava and hepatic veins may represent a suitable approach for major injuries or neoplasias of these structures.

[Anatomicosurgical study of the superior mesenteric vein]. / Contributo allo studio anatomo-chirurgico della vena mesenterica superiore.

Results of an autoptic study of the superior mesenteric vein in thirty cadavers are reported. The anatomo-surgical patterns of the venous axis are emphasized. In fact, a better knowledge of this vessel allows an easier and safer surgical approach during pancreatic resections.

Structure and chromosomal localization of DNA sequences related to ribosomal subrepeats in Vicia faba.

Subrepeating sequences of 325 bp found in the ribosomal intergenic spacer (IGS) of Vicia faba and responsible for variations in the length of the polycistronic units for rRNA were isolated and used as probes for in situ hybridization. Hybridization occurs at many regions of the metaphase chromosomes besides those bearing rRNA genes, namely chromosome ends and all the heterochromatic regions revealed by enhanced fluorescence after quinacrine staining. The DNA homologous to the 325 bp repeats that does not reside in the IGS was isolated, cloned and sequenced. It is composed of tandemly arranged 336 bp elements, each comprising two highly related 168 bp sequences. This structure is very similar to that of the IGS repeats and ca. 75% nucleotide sequence identity can be observed between these and the 168 bp doublets. The most obvious difference lies in the deletion, in the former, of a 14 bp segment from one of the two related sequences. It is hypothesized that the IGS repeats are derived from the 336 bp elements and have been transposed to ribosomal cistrons from other genome fractions. The possible relations between these sequences and others with similar structural features found in other species are discussed.

[A case of malignant retroperitoneal fibrohistiocytoma]. / Un caso di fibroistiocitoma maligno retroperitoneale.

A case of retroperitoneal malignant fibrous histiocytoma, with particular reference to its clinico-pathologic characteristics, is reported. The primary large lesion, presenting with a cavitary lung metastasis, resulted to be unresectable at surgery because of major abdominal vessels infiltration.

Protein kinase in pine pollen.

Protein kinase (E.C. 2.7.1.37) activity towards both endogenous and exogenous substrates has been detected in pine pollen (Pinus canariensis P. Sm.) and partially purified by DEAE-cellulose chromatography. It seems to be not affected by cyclic AMP.