Recurrent plexiform schwannoma in vestibular mucosa.

Schwannoma, also called neurilemmoma, is a benign neoplasm of peripheral nerve sheath. An infrequent location of a multiple intraoral plexiform schwannoma arising on the branches of the facial nerve in the vestibular mucosa of a young male patient is here discussed. Surgical treatment has been discussed on the base of histological findings and diagnosis.

[Endoluminal radiofrequency ablation of the great saphenous vein versus stripping. A preliminary study]. / Termoablazione con radiofrequenza della vena grande safena versus stripping. Studio preliminare.

AIM: To compare the postoperative courses of patients subjected to closure procedure or stripping of the great saphenous vein (GSV). METHODS: We examined 2 groups of 15 patients with ostial and truncular saphenous insufficiency matched for CEAP clinical and anatomic classes. Group A patients underwent saphenous closure; short stripping was performed on those of Group B. In the Group A surgery was performed under spinal (12) or local (3) anesthesia; the procedure was preceded by crossotomy (5), crossectomy (1) or saphenous ligation (8); in 11 cases micro-phlebotomies were associated. In the Group B surgery was performed under general (5), spinal (7) or local (3) anesthesia; the procedure always was preceded by crossectomy (1); in 11 cases micro-phlebotomies were associated. RESULTS: Group A patients were discharged 6-18 hours after surgery. None presented ecchymosis, hyperemia or skin lesions. Five complained of mild aching thigh pain, which did not require pain medication. All resumed normal daily activities the day after surgery and returned to work after 4.9 days. Six months after surgery, none of the patients had evidence of saphenous vein re-channeling. Group B patients were discharged 12-18 hours after surgery. Nine had ecchymosis on the thigh. Five reported mild thigh pain requiring analgesics. Normal daily activities and work were resumed 2.7 and 9.3 days after surgery. CONCLUSIONS: This retrospective study seems to confirm that endoluminal radiofrequency ablation of the GSV provides good immediate results with no significant complications and can reduce postoperative pain and the length of convalescence with respect to those of stripping.

Isolated splenic metastasis from colon cancer.

Solid-tumor metastases of the spleen are rare and usually associated with disseminated disease. There are only seven reports in literature of isolated splenic metastases from colorectal carcinoma, which generally metastasize to regional lymphonodes, liver and abdominal peritoneum. We report a case of isolated splenic metastasis in a 55-year-old woman who had undergone left hemicolectomy, lymphadenectomy and chemotherapy 18 months earlier for adenocarcinoma of the sigmoid colon with positive pericolic and inter-aortocaval lymphonodes. This is the eighth documented case of isolated splenic metastasis from colon cancer. Previously reported cases of this type are reviewed along with the mechanism underlying neoplastic spread to the spleen.

[Osteopathy in neonatology]. / Osteopatia in neonatologia.

Osteopathy offers a variety of non invasive healing treatments for birth trauma and pediatric problems and it is a choice in Neonatology. It is the osteopaths' highly developed sense of touch that allows the physician to palpate (feel) the patient living anatomy. The osteopathic's job is to set the body up to heal itself, to restore this normal function. The osteopath gently applies a precise amount of force to promote movement of body fluids, eliminate dysfunction in the motion of the tissues and release compressed bones and joints. We report a study to determine the safety and efficacy of osteopathic treatments. The gentle nature of this treatment makes it particularly effective for babies. It can be used to reduce distress and trauma in babies delivered by forceps or after a protracted and difficult delivery (whose prolonged crying may be misdiagnosed as colic), and can be used to treat infants who become hyperactive. Among 4558 babies observed between 1999 and 2001 in our Neonatology Unit, 488 cases were observed by an osteopath and 155 cases have been selected for osteopathic treatment. The outcome measure was symptom relief. There were no adverse effects.

Glucocorticoid receptors in human peripheral blood mononuclear cells in relation to explosive performance in elite handball players.

Ten handball players, members of the Italian National Team (aged 20-25 years), were studied in two sessions corresponding to different performance levels. The first session occurred one week after the end of the regular season of the Italian Handball Federation: it corresponded to the beginning of the training cycle for the European Handball Championship. The second session occurred ten weeks after the first session. During this period, training consisted of 3 weeks of active recovery and 7 weeks of increasing workload. For each session, jumping performances (maximal height in a single jump, average mechanical power for a 15-s set of consecutive jumps) were evaluated. Venous blood samples were collected in resting conditions immediately before jumping performances to assess cortisol and testosterone plasma concentrations and glucocorticoid receptors (GcR) binding capacity and affinity in peripheral blood mononuclear cells (PBMCs). All the parameters, except GcR binding affinity, increased in the second session. The trends of variation in jumping performances, steroid hormone levels and GcR binding capacity were similar. For testosterone, this agrees with the hypothesis that an adequate level of this hormone is a prerequisite for improvement in explosive performances. For cortisol, higher GcR binding capacity after 10 weeks of training (with respect to initial values) indicated an up-regulation of GcR concomitant with the increase in hormone levels and performances. These findings suggest that the adaptation to training, confirmed by the improvement in performance, is characterized by a high value of GcR binding capacity and that it is mediated, among other factors, by the hormone levels and up-regulation of the receptors.

[Type 1 Arnold Chiari malformation in a subject with Noonan syndrome]. / Malformazione di Arnold Chiari tipo 1 in soggetto con sindrome di Noonan.

We report a case of Noonan syndrome with characteristic facies, short stature, defect cardiac, epilepsy in a 15 months old girl with Arnold Chiari malformation type 1. We discuss our observations in relation to Noonan syndrome and ACM I.

Monitoring strength training: neuromuscular and hormonal profile.

PURPOSE: This study investigated changes induced by a single heavy resistance training session on neuromuscular and endocrine systems in trained athletes, using the same exercises for training and testing. METHODS: Five different groups volunteered: track and field male sprinters (MS, N = 6), track and field female sprinters (FS, N = 6), body builders (BB, N = 6), and weight lifters performing low-repetition exercise (WLL, N = 4) and high-repetition exercise (WLH, N = 4). In training, the work performed during half and full squat exercise was monitored for mechanical power output as well as EMG analysis on leg extensor muscles of the subjects belonging to the MS, FS, and BB groups. Just before and immediately after the training session, venous blood samples were obtained for RIA determination of testosterone (T), cortisol (C), lutropin (LH), human prolactin (PRL), and follitropin (FSH) in FS and MS. In the other three groups (BB, WLH, and WLL), the hormonal profile was limited to T and human growth hormone (hGH) only. RESULTS: After training the power developed in full squat demonstrated a statistically significant decrease (P < 0.01) in MS and no changes in FS. The EMG activity remained constant during the training session. Consequently, the EMG/Power ratio increased in both MS and FS, although only in MS a statistical significance was noted (P < 0.05). In MS immediately after the session the levels of C, T, and LH were significantly lower (P < 0.05). No changes were found in FS. In both groups and in BB significant negative correlation was found between changes in T level and EMG/Power ratio in half squat performance. CONCLUSIONS: It is likely that adequate T level may compensate the effect of fatigue in FT fibers by ensuring a better neuromuscular efficiency.

Adaptive responses of human skeletal muscle to vibration exposure.

The aim of this study was to investigate the effects of whole-body vibrations (WBV) on the mechanical behaviour of human skeletal muscle. For this purpose, six female volleyball players at national level were recruited voluntarily. They were tested with maximal dynamic leg press exercise on a slide machine with extra loads of 70, 90, 110 and 130 kg. After the testing, one leg was randomly assigned to the control treatment (C) and the other to the experimental treatment (E) consisting of vibrations. The subjects were then retested at the end of the treatment using the leg press. Results showed remarkable and statistically significant enhancement of the experimental treatment in average velocity (AV), average force (AF) and average power (AP) (P < 0.05-0.005). Consequently, the velocity-force and power-force relationship shifted to the right after the treatment. In conclusion, it was affirmed that the enhancement could be caused by neural factors, as athletes were well accustomed to the leg press exercise and the learning effect was minimized.

Effect of oral creatine supplementation on jumping and running performance.

The study was designed to investigate the effect of creatine monohydrate ingestion (20 g daily for 5 days) on performance in 45 s maximal continuous jumping and in all-out treadmill running at 20 km x h(-1), (inclination 5 degrees, duration approximately 60s). The participants were qualified sprinters and jumpers. The effect of creatine was compared with placebo in a double-blind design. Creatine (Cr) supplementation led to a significant enhancement of performance capacity in the jumping test by 7% during the first 15 s and by 12% during the second 15 s of the exercise. The positive effect of Cr supplementation was not observed in the last third of the continuous jumping exercise, when the contribution of anaerobic metabolism was decreasing. The time of intensive running up to exhaustion improved by 13%. The results show that Cr supplementation helps to prolong the time during which the maximal rate of power output could be maintained.

[Neurofibromatosis I: a clinical series and genetic correlations]. / Neurofibromatosi tipo 1. Casistica e correlazioni genetiche.

Type 1 neurofibromatosis represents 90% of all forms of neurofibromatosis. It is a disease with an incidence of 1:3000 neonates with a dominant autosomic form of transmission, but 50% of all cases are sporadic owing to new mutations. Diagnosis is mainly clinical and requires at least of the following signs: CAL, neurofibromas, glioma of the optic nerve, axillary lentigo, Lisch's nodules, bone lesions and the presence of the disease in at least one first-degree relation. These criteria may also be applied in children under 6 years old as is confirmed by the clinical series of 5 cases referred to our attention. The deletion of the long arm of chromosome 17 in the zone proximal to the centromere containing the gene of type 1 neurofibromatosis was observed in one case. The phenotype of this subject was correlated to another 5 cases reported in the literature.

[Seckel syndrome. Report of a case]. / La sindrome di Seckel. Presentazione di un caso.

The paper report a case of Seckel's syndrome in a girl aged 7 years and 2 months who was referred to the authors attention due to abdominal colic. Low birth weight together with a significant delay in weight and stature increase, microcephalia with the typical bird head and considerable mental retardation were sufficient to diagnose the syndrome. Interesting analogies were observed with another case of a patient with Seckel's syndrome born to an epileptic mother receiving antiepileptic treatment which was suspended during the second month of gestation. In the case presented here, no drugs were taken during pregnancy although the mother had received antiepilepsy treatment for years.

[Acute accidental intoxication. Comments and cases in Brianza]. / Le intossicazioni acute accidentali. Considerazioni e casistica in Brianza.

A 10-year series of cases of acute intoxication in children observed at USSL 61 is analysed paying special attention to epidemiological, clinical and therapeutical aspects. Only a precise knowledge of the problem through an appropriate evaluation of epidemiological data will allow the prevention of acute intoxication to be tackled through legislative measures or the use of information and health education campaigns.

[Emergencies in childhood. Experience at a Pediatric First Aid Unit in a regional hospital]. / Le urgenze nell'età evolutiva. Esperienza di un Pronto Soccorso Pediatrico di un Ospedale zonale.

During 1989 4445 children, divided into four different age groups, were treated in the First Aid Unit of Carate Brianza Hospital. The paper analyses the types of pathology and reasons for using the First Aid Unit. The statistical incidence of accidents involving children, above all cranial and other injuries and the accidental swallowing of toxic substances or drugs, was assessed in an attempt to prevent the causes. The type of accident was also correlated to age group. The paper confirms the affirmation made by other researchers that the inappropriate use of emergency services is linked to the lack of relationship between the family and local pediatrician rather than the lack of primary care.

[Minor burns in childhood. Clinical cases]. / Le ustioni minori in età pediatrica. Casistica.

The paper reports a retrospective study of 106 cases of first and second degree burns which were treated in an outpatient setting in order to identify the overall conditions which expose a child to these risks and the risk factors leading to complications. The aim of the study was to establish a correct prevention programme.

[Transient hyperphosphatasemia in infants]. / Iperfosfatasemia transitoria dell'infanzia.

Striking transient increases in serum alkaline phosphatase in 2 infants are reported. Isoenzymes were studied in 2 infants and increased activity was found in bone as well as in liver fractions. Repeated serum determinations demonstrated a duration of about 4-6 weeks. The etiology is unknown but an infectious cause is discussed. The condition may be rather frequent but gives no obvious symptoms. It is important to know this condition to avoid unnecessary diagnostic procedures.

The effect of pre-stretch on mechanical efficiency of human skeletal muscle.

The mechanical efficiency of positive work was studied in six subjects performing three different types of exercises. On the first occasion the subjects ran on a motor-driven treadmill at 3.33 m s-1; the second and the third exercises consisted of performing rhythmical vertical jumps for 1 min both in rebound (RJ) and no-rebound (NRJ) conditions. The mechanical efficiency calculated in NRJ, which reflects only the conversion of biochemical energy into mechanical work, was found to be lower than the corresponding observation in RJ, 17.2 vs. 27.8% (P less than 0.001), respectively. These differences could not be explained by only the storage and recoil of elastic energy occurring in RJ compared with NRJ. The calculated extra work delivered 'free' was greater than the potential elastic energy which could be stored within the leg extensor muscles (187 vs. 124 J for each jump, P less than 0.05). It is likely that other factors might be responsible for the extra work found in NRJ. It was suggested that the difference in the length of time to perform positive work between a simple shortening contraction and a stretch-shortening muscular activity could be also responsible for the enhanced efficiency observed in RJ. This suggestion was supported by the high relationship (P less than 0.001) found between the time to perform positive work and the mechanical efficiency measured in jumping and estimated during running.