Controlling tumor-derived and vascular endothelial cell growth: role of the 4Ff2 cell surface antigen.

We have isolated a monoclonal antibody, clone betaE11, which recognizes an antigen that is highly abundant on the surface of mitotic vascular endothelial cells and tumor cells. By sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting, expression of this 190-kd antigen is approximately threefold higher in mitotic versus interphase endothelial cells. Treatment of tumor cells with an antibody to the betaE11 antigen inhibits their growth in a dose-dependent manner in vitro with maximal inhibition at an antibody concentration of 1 microg/ml. Different tumor cell lines demonstrate varying sensitivities to anti-betaE11 with the following order of growth inhibition: colon > prostate = glioma > melanoma = fibroblast > breast > liver. Furthermore, the betaE11 antigen localizes to regions of prostatic intraductal neoplasia in paraffin-embedded sections. Mass spectrometry of the cell-derived betaE11 protein and V8-protease fingerprint analysis indicate that the betaE11 antigen is nearly identical to the 4F2 heavy chain antigen, a cell surface protein that has been implicated in cell activation and proliferation. Expression of the betaE11 antigen during mitosis functionally links it to a fundamental aspect of cell proliferation, and its spatial localization on the surface of both proliferating endothelium and tumor cells demonstrates its potential for tumor immunotherapy.

[Hereditary nonpolyposis colorectal cancer (Lynch syndrome): a review of the literature and case reports]. / Cancro colorettale ereditario non poliposico (sindrome di Lynch): revisione della letteratura e contributo casistico.

The recent observation of a new HNPCC patient case induced the Authors to review their experience with the syndrome as well as to make an up to date of the problems related to diagnosis, surgical management, surveillance and genetic counselling for such patients with a lifelong high cancer risk. Patients with HNPCC and their first-degree relatives, whose risk of early colorectal carcinoma (especially in the proximal colon) as well as a variety of extracolonic cancers (particularly endometrium, ovary, stomach, small bowel, ureter and renal pelvis) is significantly higher then that of patients with sporadic carcinoma, should be properly managed with surgery and then with endoscopic examination (ideally all life long) starting--in unaffected individuals--at early age (25 years old). Problems related to genetic counselling are considered as well.

[The megacolon in myotonic dystrophy: case report and review of the literature]. / Il megacolon nella distrofia miotonica: case report e review della letteratura.

Myotonic dystrophy (MD) is an autosomal dominant inherit disease, slowly progressive, involving multiple organ systems. Disorders at any level of the gastrointestinal tract are relatively common and manifest as disturbances in motility, such as impaired esophageal transport, delayed gastric emptying, and megacolon. A 51 years-old man was admitted to our surgical department with obstructive symptoms. Diagnostic evaluation showed megacolon and the typical clinical features of the MD, such as weakness, myotonia, frontal baldness and testicular atrophy. Risk of perforation and dehydration led to emergency total colectomy with ileorectal stapled anastomosis. The patient didn't suffer for compliance related to surgical treatment but, after 1 month in intensive care, died of pneumonia and myocardial infarct. The overall frequency of perioperative complications in patients with MD ranges from 8.2 to 42.9%. The risk of perioperative pulmonary complications is particularly high. Thus, we believe that the conservative treatment of motility disorders of the bowel in patients with MD is to be justified and that surgical treatment should be reserved, as last resort, performing a early diagnosis and careful monitoring during perioperative period.

[Traditional cholecystectomy in a patient with situs viscerum inversus partialis]. / Colecistectomia per via tradizionale in paziente con situs viscerum inversus partialis.

The authors discuss the etiology of situs viscerum inversus partialis (SVIP), the associated anomalies and the malformations and the relative clinical problems, reviewing the international literature. The present a case of a 51 years old female with a diagnosis of umbilical hernia and cystocele. During hospitalization the patient complained a typical acute cholecystitis pain. The patient underwent ultrasonography, CT scan, and MNR that allowed us to diagnosis a calculous cholecystitis with SVIP and was elected for an open cholecystectomy. The Authors describe the surgical technique in relation to the anatomic anomalies, in particular vascular ones, that were discovered with the imaging studies and confirmed at laparotomy.

[Synchronous and metachronous colorectal cancers: a case series contribution]. / I cancri sincroni e metacroni del colon-retto: contributo casistico.

The Authors, on the basis of their experience with neoplastic colorectal pathology and after a review of the Literature, report a reappraisal of the problems related to colorectal multiple carcinomas. They emphasize the importance of routine preoperative pancolonoscopy for the identification of possible synchronous tumors (both benign and malignant) and periodic endoscopic follow-up (ideally a life-long one) for the detection and removal of all adenomatous polyps as well as early stage metachronous carcinomas, especially for patients with HNPCC. Besides, they stress the importance of sensibilization of the population about the heritability of colorectal carcinomas.

[Our experience in the recurrence of rectal cancer operated with radical intention in light of a case load treated in a homogeneous manner]. / La nostra esperienza delle recidive di cancri rettali operati con intento radicale alla luce dei risultati di una casistica trattata in maniera omogenea.

A reappraisal of the results obtained after potentially curative resection for rectal cancer compared with "historical" results is reported. An increase of the overall survival rates was registered as well as a corresponding lowering of the pelvic recurrences: 4.54% in the group of patients with a-two-year follow up. As for relapse surgery, however, reviewing the series from January 1991 to December 1994, the results are still poor because relapses were not resectable in 85.7% of the cases.