Proctocolectomy for ulcerative colitis after liver transplantation for primary sclerosing cholangitis.

BACKGROUND: Sclerosing cholangitis is a chronic cholestatic liver disease of unknown etiology. Immunologic and genetic factors may be involved in the pathogenesis of the disease, characterized by fibrosis involving bile ducts, which can progress to biliary cirrhosis and cholangiocarcinoma (8%-30%). Sclerosing cholangitis is frequently associated with inflammatory bowel diseases, especially ulcerative colitis (60%-80%), which may require a proctocolectomy with ileal pouch anal anastomosis if there is no response to therapy or the appearance of colonic carcinoma. PATIENTS AND METHODS: Among 1629 liver recipients from 1990 to 2008, 47 (2.9%) had sclerosing cholangitis as the cause of cirrhosis. Forty two percent of these also had associated inflammatory bowel disease with 34% displaying ulcerative colitis. Eight patients died after liver transplantation (OLT) in the absence of recurrence of sclerosing cholangitis. Among the remaining 39 patients, 17 (43.6%) developed recurrent of sclerosing cholangitis; three required re-OLT, and among these three patients, one developed another recurrence. After OLT, ulcerative colitis persisted in an active state in eight patients, requiring proctocolectomy with ileal pouch-anal anastomosis for three patients (median time after OLT was 78.6 months). RESULTS: One of the three patients who had proctocolectomy had an immediate complication, a pelvic hematoma, which required a surgical approach. One patient developed acute pouchitis 15 months after OLT, medically treated with antibiotics and corticoids. Histology of the colectomy specimen demonstrated colorectal cancer in two patients (pT3N0 and pT2N0) and high-grade dysplasia in the remaining subjects. All patients displayed a cure of their colonic disease (median follow-up 14 months) despite two patients developing recurrence of the liver disease. CONCLUSION: Proctocolectomy with ileal pouch anal anastomosis is safe in patients who underwent OLT for sclerosing cholangitis in association with ulcerative colitis. If not surgically treated, patients may receive immunosuppression to prevent rejection and disease recurrence, avoiding at the same time the occurrence of "de novo" neoplasms. Mammalian target or rapamycin inhibitors may have an important role but this must be established with randomized controlled trials.

Variations of the isotopic ratios of uranium in environmental samples containing traces of depleted uranium: theoretical and experimental aspects.

The possibility of using conventional analysis, such as gamma spectrometry and alpha spectrometry, for the detection of traces of depleted uranium (DU) in environmental samples has been investigated. The expected values have been compared with the experimental results obtained by using mollusc samples gathered in the Adriatic Sea. The analysis has shown that it is possible to detect DU. if the percentage composition is about 20% depleted uranium and 80% natural uranium, for a sample containing 10 Bq x kg(-1) of 238U. The possibility of extending this approach to samples with any given uranium concentration is investigated.

Transcriptional map of 170-kb region at chromosome 11p15.5: identification and mutational analysis of the BWR1A gene reveals the presence of mutations in tumor samples.

Chromosome region 11p15.5 harbors unidentified genes involved in neoplasms and in the genetic disease Beckwith-Wiedemann syndrome. The genetic analysis of a 170-kb region at 11p15.5 between loci D11S601 and D11S679 resulted in the identification of six transcriptional units. Three genes, hNAP2, CDKN1C, and KVLQT1, are well characterized, whereas three genes are novel. The three additional genes were designated BWR1A, BWR1B, and BWR1C. Full-length cDNAs for these three genes were cloned and nucleotide sequences were determined. While our work was in progress, BWR1C cDNA was described as IPL [Qian, N., Franck, D., O'Keefe, D., Dao, D. , Zhao, L., Yuan, L., Wang, Q., Keating, M., Walsh, C. & Tycko, B. (1997) Hum. Mol. Genet. 6, 2021-2029]. The cloning and mapping of these genes together with the fine mapping of the three known genes indicates that the transcriptional map of this region is likely to be complete. Because this region frequently is altered in neoplasms and in the genetic disease Beckwith-Wiedemann syndrome, we carried out a mutational analysis in tumor cell lines and Beckwith-Wiedemann syndrome samples that resulted in the identification of genetic alterations in the BWR1A gene: an insertion that introduced a stop codon in the breast cancer cell line BT549 and a point mutation in the rhabdomyosarcoma cell line TE125-T. These results indicate that BWR1A may play a role in tumorigenesis.

Molecular Probe Data Base (MPDB).

In this paper, the current status of the Molecular Probe Data Base (http://www.biotech.ist.unige.it/interlab/ mpdb.html ) is briefly presented together with a short analysis of its activity during 1997. This has been performed by statistically evaluating the 'logs' of the Internet servers that are used for its distribution with reference to the geographical origin of the requests, the words that were utilized to carry out of the searches and the oligonucleotides that were retrieved. Planned enhancements of this database are also described. They include a revision of its data structure and, even more relevant, of its data management procedures.

[Parotid gland sialolithiasis: a new therapeutic option]. / Scialolitiasi della ghiandola parotide: nuova opzione terapeutica.

In chronic lithiasis of the salivary glands surgery is the only approach available whenever the stone cannot be removed by dilating or dissecting the salivary duct. The introduction of lithotripsy in the treatment of kidney and gall stones has made it possible to apply this method to salivary gland stones as well. The present study was aimed at evaluating the safety, reliability and effectiveness of lithotripsy in 36 patients with symptomatic parotid gland stones which could not be removed by conservative surgery. Ultrasound revealed the stones which were on the average 4.8 mm. In 147 cases they were located in the intraparenchymal area while the remaining 19 cases were located within the duct. No patient required anesthesia, sedative or analgesic. The average number of sessions per patient was 3.8 and each treatment lasted an average of 30 minutes. After lithotripsy, in all 10 of the patients who had completed the treatment, the stone was either totally eliminated or reduced enough to allow for spontaneous elimination. The side effects found in 9 of the patients were minor pain (2 patients), a transitory duct hemorrhage (6 patients) and skin petechia (4 patients). No damage to the salivary glands or adjacent anatomical structures was revealed upon treatment or later during the 10 month average follow up (range 1-22 months). Extracorporeal lithotripsy is a safe, effective, non-invasive alternative therapeutic option for the treatment of parotid sialolithiasis.

Molecular Probe Data Base (MPDB).

Molecular Probe Data Base contains detailed information on synthetic oligonucleotides with a sequence of up to 100 nucleotides. This database prevalently contains information related to human oligonucleotides used in diagnostics. Molecular Probe Data Base has been made available on-line through the Internet by means of Network Information Retrieval (NIR) tools since 1993. Two years ago, a collaboration with EMBL Data Library was also set up, so that the Molecular Probe Data Base has been integrated with other molecular biology data banks in the sphere of the SRS WWW network browser. In this paper, the most recent enhancements and the current status of the Molecular Probe Data Base are briefly presented.

Extracorporeal electromagnetic shock-wave lithotripsy for salivary gland stones.

Sialoadenectomy for sialolithiasis is necessary when the stone cannot be removed through the salivary duct. In addition, extracorporeal. shock-wave lithotripsy has recently become available for this purpose. The safety and efficacy of this method was assessed in 52 outpatients bearing stones with an average diameter of 6.76 mm in the submandibular or parotid gland. Anesthetics, sedatives, and analgesics were not required. Twenty-four of the 36 patients with submandibular gland calculi and all 16 with parotid sialolithiasis had complete stone disintegration or fragmentation of the calculi, with possible spontaneous clearance. Untoward effects were observed in 15 patients, namely localized skin petecchiae, transitory swelling of the gland, and self-limiting bleeding from the duct. No persistent damage of the salivary glands or adjacent structures was noted during a mean follow-up period of 10 months.

Molecular probe data base (MPDB).

The molecular probe data base (MPDB) contains detailed information on synthetic oligonucleotides, including their identification, target genes, applications and bibliographic references. It is available on-line through Internet and can be searched by using Network Information Retrieval tools. In this article the most recent enhancements of MPDB, both in terms of data contents and new ways of access, are described. These include a recently established collaboration with EMBL Data Library, in the sphere of SRSWWW network browser, in view of a better integration of MPDB with other molecular biology databases.

Molecular Probe Data Base (MPDB).

This paper provides an update on the contents and structure, forms and mode of data distribution of the Molecular Probe Data Base (MPDB), a database that collects and provides on-line information on the sequence, target gene, applications and bibliographic references of synthetic oligonucleotides. The recent data extension and the new means of accessing the database are discussed.

[Epidemiologic longitudinal study of a population of workers of the state railroads exposed to noise]. / Studio epidemiologico longitudinale di una popolazione di lavoratori delle Ferrovie dello Stato esposta al rumore.

Loss of hearing due to chronic noise exposition is a well-known pathology and many nations have regulations for the protection of workers with periodical audiometry and ONT check-ups. For the last 15 years, the authors have followed state railway workers of the Milan area who were professionally exposed to noise. All were periodically examined by ONT specialists and submitted to audiometry. The findings underscore the importance of these periodical examinations and their efficacy for the prevention of hearing loss due to noise.

[Hepatocystic ducts: anatomic curiosity or surgical challenge?]. / I dotti epatocistici: curiosità anatomica o sfida chirurgica?

The Authors report two cases of cysto-hepatic ducts. Clinical and therapeutic patterns of this rare biliary disease are stressed, underlining the surgical hazard related to iatrogenic damage of bile ducts during operative manoeuvres.

[Diagnostic approach to extra-renal pheochromocytoma]. / Approccio diagnostico ai feocromocitomi extra-surrenalici.

Stress is laid on certain principles of diagnostic research in the event of extra-suprarenal pheochromocytomas. The importance of CT is recalled, specifying the usefulness of complementary examinations such as selective venous catheterism and above all of scintigraphy with 131I MIBG.

[Solitary ulcer of the rectum. Description of a case]. / L'ulcera solitaria del retto. Descrizione di un caso.

A case of solitary rectal ulcer is presented. Different views on the pathogenesis are discussed. Symptoms were nonspecific: anal pain, rectal tenesmus and bleeding. On sigmoidoscopy, the lesion has a characteristic appearance, but the definitive diagnosis of benignity must depend upon the recognition of specific histopathologic features in rectal biopsy specimens from ulcer margins. In this case, the surgical treatment was satisfactory, but frequently neither medical nor surgical treatment achieve relief of symptoms or healing of the lesion.

Digital interface for bioelectrical data acquisition system.

The action potential digitalized and stored by means of a fast solid state electronic waveform recording system (Digitalizer) can be directly read out on a printer or in a computer for further processing. It has been designed a digital interface allowing the automatization of these bioelectrical data acquisition and printing process.

Temperature effects on the properties of the Hodgkin-Huxley propagated action potential model determined by computed solutions and phase-plane analysis.

The equation for membrane potential (V) of the squid giant axon or some muscle cells, which is the heart of the Hodgkin-Huxley model for the action potential, can be written in three ways: first, as a partial differential equation in time and space; second, as an ordinary differential equation in time, assuming uniform wave propagation for the action potential, and third, as an even simpler ordinary differential equation for the potential at a point, so-called "space clamp" conditions. Solutions were computed for the first two of these equations, at three different temperatures, and the results compared. Temperature dependence of the appropriate parameters was calculated from a simple exponential relationship. Significant changes in the quantitative predictions of the model were found as the temperature was changed from 6.3 C to 18.5 C. Phase-plane (V v V, I v V) analysis has been used to examine the nature of these differences.

Digital interface for bioelectrical data acquisition system

The action potential digitalized and stored by means of a fast solid state electronic waveform recording system (Digitalizer) can be directly read out on a printer or in a computer for further processing. It has been designed a digital interface allowing the automatization of these bioelectrical data acquisition and printing process.

Temperature effects on the properties of the Hodgkin-Huxley propagated action potential model determined by computed solutions and phase-plane analysis

The equation for membrane potential (V) of the squid giant axon or some muscle cells, which is the heart of the Hodgkin-Huxley model for the action potential, can be written in three ways: first, as a partial differential equation in time and space; second, as an ordinary differential equation in time, assuming uniform wave propagation for the action potential, and third, as an even simpler ordinary differential equation for the potential at a point, so-called [quot ]space clamp[quot ] conditions. Solutions were computed for the first two of these equations, at three different temperatures, and the results compared. Temperature dependence of the appropriate parameters was calculated from a simple exponential relationship. Significant changes in the quantitative predictions of the model were found as the temperature was changed from 6.3 C to 18.5 C. Phase-plane (V v V, I v V) analysis has been used to examine the nature of these differences.

Digital interface for bioelectrical data acquisition system.

The action potential digitalized and stored by means of a fast solid state electronic waveform recording system (Digitalizer) can be directly read out on a printer or in a computer for further processing. It has been designed a digital interface allowing the automatization of these bioelectrical data acquisition and printing process.

Temperature effects on the properties of the Hodgkin-Huxley propagated action potential model determined by computed solutions and phase-plane analysis.

The equation for membrane potential (V) of the squid giant axon or some muscle cells, which is the heart of the Hodgkin-Huxley model for the action potential, can be written in three ways: first, as a partial differential equation in time and space; second, as an ordinary differential equation in time, assuming uniform wave propagation for the action potential, and third, as an even simpler ordinary differential equation for the potential at a point, so-called [quot ]space clamp[quot ] conditions. Solutions were computed for the first two of these equations, at three different temperatures, and the results compared. Temperature dependence of the appropriate parameters was calculated from a simple exponential relationship. Significant changes in the quantitative predictions of the model were found as the temperature was changed from 6.3 C to 18.5 C. Phase-plane (V v V, I v V) analysis has been used to examine the nature of these differences.