Temperature-dependent internode elongation in vegetative plants of Arabidopsis thaliana lacking phytochrome B and cryptochrome 1.

Vegetative plants of Arabidopsis thaliana (L.) Heynh. form a compact rosette of leaves in which internode growth is virtually arrested. Rapid extension of the internodes occurs after flower buds are present in the reproductive apex. Under natural radiation, continuous light from fluorescent lamps, or short photoperiods of light from fluorescent lamps, plants of the phyB cry1 double mutant (lacking both phytochrome B and cryptochrome 1) did not form normal rosettes because all the internodes showed some degree of elongation. Internode elongation was weak in thephyB single mutant and absent in the cry1 mutant, indicating redundancy between phytochrome B and cryptochrome 1. The absence of phytochrome A caused no effects. The failure to form normal rosettes was conditional because internode elongation was arrested at low temperatures in all the mutant combinations. In contrast, the temperature dependence of phytochrome B and cryptochrome 1 effects on hypocotyl growth was weak. The elongation of the internodes in phyB cry1 was not accompanied by early flowering as showed by the lack of effects on the final number of leaves. Apex dissection indicated that in phyB cry1 double mutants internode elongation anticipated the transition from the vegetative to the reproductive stage. Thus, stem growth in Arabidopsis thaliana is not fully dependent on the program of reproductive development.

[Quality of data or quality of care? Comparison of diverse standarization methods by clinical severity, based on the discharge form, in the analysis of hospital mortality]. / Qualità dei dati o qualità dell'assistenza? Confronto tra diversi metodi di standardizzazione per gravità clinica, basati sulla scheda di dimissione, nell'analisi della mortalità ospedaliera.

Using discharge abstract data, we analysed hospital mortality comparing four different methods of risk adjustment. All patients discharged from the S. Giovanni Battista (Molinette) hospital in Turin (Italy) between January 1996 and June 1999 (n = 169,746) were classified with All Patient Refined--Diagnosis Related Groups (APR-DRG). A first analysis evaluated the time trend of hospital mortality by semester. A second analysis compared hospital mortality during the last 12 months among eight units of internal medicine (n = 5592). All comparisons were made through logistic regression models. As the quality of discharge abstracts increased during time and showed variation among units with similar patients, all comparisons were repeated using four models, characterised by increasing predictivity and sensitivity to quality of data. In addition to crude comparisons (A), the other models included as risk factors: B) age and emergency admission; C) same as 'B' plus expected mortality by APR-DRG; D) same as 'B' plus expected mortality by APR-DRG and risk of death subclass. If no risk factors were considered (A), hospital mortality showed an increasing trend, with an odds ratio (OR) of 1.02 by semester, with a 95% confidence interval (CI) between 1.01 and 1.03. The association was weakened when age and mode of admission were taken into account (B) and disappeared when the APR-DRG expected mortality was also considered (C) (OR = 1.00; CI = 0.98-1.01). Finally, if the comparisons were adjusted also for the expected mortality by APR-DRG and risk of death subclass (D) a reversed trend appeared (OR = 0.95; CI = 0.94-0.97). The comparison among the units of internal medicine gave discordant results according to the method used to adjust for confounders. The most striking variations were detected for those units with the best and the worst clinical data. The unit with the poorer clinical data (average number of diagnoses per patient = 2.9) showed a crude OR of 1.38 (CI = 0.99-1.93) and an adjusted OR (D) of 1.71 (CI = 1.10-2.66); the unit with the best quality of data (average number of diagnoses per patient = 4.4) changed the OR from 1.55 (CI = 1.06-2.26) (A) to 0.66 (CI = 0.37-1.17) (D). In conclusion, these results confirm the high sensitivity of the APR-DRG classification to the quality of data and, more in general, suggest to be prudent when using powerful instruments like this to assess quality of care, especially if the quality of data among the units compared is less than optimal or not homogeneous.

[Fistulae in diverticular disease of the colon]. / Le fistole nella malattia diverticolare del colon.

Fistulas in colon diverticular disease are a not uncommon complication, that arise spontaneously in the evolution of a diverticulitis, and also as a complicated dehiscence of surgical anastomosis. The intermediate step of a fistula is a deep abscess that finds through the parietal layers of abdomen or towards other adjacent organs. So the surgeon can be confronted with external and internal and complex fistulas. As for diagnostic manoeuvres, the surgical choices are outside a rigid schedule, and is on the personal sensibility of the surgeon.

[Perineal sarcoma. Report of a clinical case]. / Sarcoma perineale. Presentazione di un caso clinico.

The authors report a case of perineal leiomyosarcoma treated using a combined surgical and radiotherapy protocol. Exeresis was performed through an incision in the left anterior perineum, beside the vagina. The patient then underwent TCT with excellent results.

[A case of ureteral stenosis and ureterorectal fistula secondary to sigmoid diverticulitis]. / Su di un caso di stenosi ureterale e fistola uretero-rettale secondarie a diverticolite del sigma.

The paper reports a case of ureteral [correction of urethral] stenosis with ureterorectal [correction of urethro-rectal] fistula due to diverticulitis of the sigmoid [correction of sigma] which resolved following reconstruction of the urinary tract by ureterocystostomy [correction of urethrocystotomy] using a modified version of Boari's technique, with satisfactory renal functional recovery. On the basis of an analysis of the literature, the authors comment on ureteral [correction of urethral] stenosis and its etiological diagnosis.

[Pseudocyst of the adrenal gland: diagnosis and treatment. Description of a clinical case]. / Pseudocisti del surrene: diagnosi e trattamento. Descrizione di un caso clinico.

A case of pseudocyst of the suprarenal gland in a 32-years-old woman is reported. Stress is laid on the description of the clinical case and the diagnostic and therapeutic problems involved are reviewed.

[A case report of Castleman's disease in a patient with endometrioid adenocarcinoma of the ovary]. / Su un caso di malattia di Castleman in paziente portatrice di adenocarcinoma endometrioide dell'ovaio.

The Authors report a case of Castleman's disease in a 45-year-old woman. She was admitted to hospital because of a thrombophlebitis of the left lower limb. An abdominal echotomography showed evidence of a mass with a diameter of about 6 cm at the pancreatic isthmus, and a cyst (diameter 25 mm) in the right ovary. An explorative laparotomy was performed and the masses were removed. Histological examination identified them respectively as a Castleman's disease of hyaline-vascular type and an endometrioid carcinoma of the ovary.

[Biliary cystadenoma. Discussion of a clinical case]. / Il cistoadenoma biliare. Discussione su un caso clinico.

A case of biliary cystadenoma is reported. The neoplasm was located at the left lobe of the liver and its diameter was 18 cm. It presented with abdominal swelling and palpable mass in epigastric region. A left hepatectomy was performed, to achieve a complete resection of the tumor.

[Constipation: drug or surgical treatment?]. / La stipsi: terapia medica o chirurgica?

Constipation is a very frequent symptom. It affects 7-10% of people. Otherwise a severe constipation exists which is rare, but extremely serious with evacuations every 15 days to 2 months. We expose the classification of constipation in its types: colonic, rectal and anal. We analyse the diagnostic trial which has to be started with a careful anamnesis and well directed physical examination. Laboratory tests and instrumental investigations will be essential means to define exactly the type of constipation and its pathogenetic mechanism. We go deep into physical involvement of constipation and into the problem of constipation in the elderly: except for particular groups (women suffering from colonic hypokinetic constipation) the age of patient is usually old. Medical treatment is described especially regarding the type of constipation. At last we review the surgical techniques proposed for every form of constipation, with exposure and interpretation of their results.

[Economic amputations of the lower limbs due to ischemia. I]. / Le demolizioni economiche degli arti inferiori per ischemia. Parte I.

The problem relating to leg amputation following ischemia are analysed in the first part of this study, bearing in mind that amputation must be as conservative as possible in order to ensure the best quality of life. Following a short review of the topic and the introduction of recent trends, the case for amputation, which must be early in order to be conservative, is studied. The first part of this article concludes with a discussion of Doppler and clinical evaluations as techniques used to determine the level of amputation.

[Economic amputations of the lower limbs due to ischemia. II]. / Le demolizioni economiche degli arti inferiori per ischemia. Parte II.

In this second note, some technical details used during amputation are described, leaving out the systematic description of interventions. The analysis of the postoperative period shows that the more distal the amputation, the higher the incidence of local complication, while about postoperative mortality our data show an opposite trend. The Authors conclude by pointing out that an early indication and an accurate evaluation often allow a more distal amputation, that must be as conservative as possible anyway.

Gastric angiography: data for oesophagogastroplasty.

A report is presented on an angiographic study of the gastric arterial system conducted on 20 human stomachs taken from cadavers during routine autopsies. The aim of the study was to define the anatomical bases for the supply of blood to the isoperistaltic gastric tubule in oesophagogastroplasty operations. The study reveals that on its own the right gastroepiploic artery cannot ensure adequate vascularisation of the gastric fundus. The importance of pressuring the right hand section of the vascular arch along the small curve was also noted and is due to the constant presence of major anastomoses at antral level with the right gastroepiploic artery. The study also revealed the constant presence of a direct intramural anastomotic circulation between the right and left gastroepiploic arteries.

[Endogastric migration of an Angelchik prosthesis. A case report and review of the literature]. / Migrazione endogastrica di una protesi di Angelchik. Descrizione di un caso clinico e revisione della letteratura.

At first, the authors mention indications and way of placement of the Angelchik prosthesis. Then after a wide review of the literature, they describe the complications and results. Finally a case of penetration into the stomach of an Angelchik prosthesis is reported. It was favourably resolved by an operation.

Endoscopic insertion of 248 prostheses in inoperable carcinoma of the esophagus and cardia: short-term and long-term results.

We present our findings after 248 endoscopic intubations with the Nottingham introducer and more recently with the Dumon-Gilliard system for inoperable carcinoma of the esophagus and cardia. Mortality within the first week was 7.6% decreasing to 4.3% with the Dumon-Gilliard method. Survival after 3 months was 61.5%, after 6 months 32.3%, after 1 year 4.8%. The quality of swallowing was very good in 51.5% of the cases, while 36.7% of the patients suffered from dysphagia for semisolids and 10.1% for semiliquids. Obstruction occurred in 36 cases; proximal and distal dislocations were found in four cases each. In 20 patients with esophagorespiratory fistula we had an operative mortality of 15%, but 6-month survival was 35.7% and 1 year survival was 7.1%.