[Reliability of ultrasound examination confirmed at autopsy in foetuses suffering from Dandy-Walker Syndrome]. / Attendibilità dell'esame ecografico confermata all'esame autoptico in feti affetti da Sindrome di Dandy-Walker.

BACKGROUND: The Dandy-Walker Syndrome (DWS) is a congenital malformation of the structures of the posterior cranial fossa with failure of the Luschka and Magendie foramina, which connect the ventricular system to the subarachnoid space, to open. In this syndrome, the cerebellar vermis may be absent or hypoplastic, the hemispheres small, the encephalic trunk and cervical spinal bone marrow flattened, complete or partial absence of cerebellar vermis, cystic dilatation of IV ventricle and frequently hydrocephalus. METHODS: We evaluated 56 cases of fetal malformations of the central nervous system from January 1998 to May 2001. Of these 56, 11 regarded the Dandy-Walker Syndrome. Ultrasound examinations were carried out at the 9(th) and 10(th) weeks, at the 21(st)-23(rd) weeks and at the 31(st) to 34(th) weeks of gestation so as to assess foetal anatomy and morphology. RESULTS: The results of the 11 pregnancies with Dandy-Walker Syndrome were as follows: 3 spontaneous miscarriages (at the 15(th), 18(th) and 20(th) weeks of gestation), 5 therapeutic abortions, 3 term pregnancies. Of the 3 newborns we were only able to follow the clinical course of two of them; both newborns underwent an intervention for ventriculo-peritoneal fluid derivation. At the moment both babies, aged respectively 30 and 25 months, are in good physical, intellectual and behavioural condition. CONCLUSIONS: Bearing in mind the notable clinical and socioeconomic importance of this malformation, we consider foetal morphological ultrasound to be a valid instrument for the correct management of pregnancy. Identification of lesions makes use of the comparison of ultrasound data with the results of histopathological examinations.

CuZn-superoxide dismutase in human thymus: immunocytochemical localisation and secretion in thymus-derived epithelial and fibroblast cell lines.

CuZn-superoxide dismutase (SOD) plays a key role in mediating the cellular response to oxidative stress. Its expression in normal thymus was investigated by immunohistochemical techniques and CD3-, CD68- and cytokeratin-specific staining, in order to identify thymocytes, macrophages and epithelial components. Immunocytochemical studies showed an overall CuZn-SOD thymic distribution with a prevailing concentration within thymic medulla. The analysis of CuZn-SOD release by thymus-derived epithelial and fibroblast cell lines showed the ability of both cell lines to release the anti-oxidant enzyme, especially in the presence of stress conditions as represented by serum and nutrient deprivation. These data suggest that CuZn-SOD could be a relevant antioxidant paracrine molecule in human thymus.

[Atelectasis following cesarean section. Personal experience]. / Atelettasia secondari a taglio cesareo. Nostra esperienza.

Purpose of this paper is to evaluate the risk of ateletasis in patients that underwent surgery of the abdomen (cesarean section), since the reflex of cough in these patients is notably altered for the limitation of the diaphragmatic excursions, due to analgesic contracture. The inhibition of cough's reflex causes retention of secretions with consequent bronchial obstruction and atelectasis. Personal experience in 6 cases of atelectasis following cesarean section is reported.

Early events of experimental exposure to amorphous and crystalline silica in the rat: time course of surfactant protein D.

Pneumoconioses determined by chronic inhalation of different kinds of silica present with peculiar clinical and histopathological features. Silicosis, caused by crystalline silica, is characterized by typical fibrous parenchymal nodules. Less defined are pneumoconioses due to amorphous silica. Aim of current experimental research on silicosis is to investigate the early events that lead to nodular fibrosis of the lung. A secretory component of the pulmonary environment, surfactant, seems to be involved in silica toxicity; surfactant protein D is a protein constituent, apparently involved in the homeostasis of the phospholipid component. We studied the behaviour of SP-D 2, 12 and 24 hours after treatment with 200 mg/kg crystalline silica or pumice powder suspended in 400 microl/kg saline solution and instiled intratracheally to rats. Both immunohistochemical localization and immunoblotting quantification demonstrated a sensible increase in intracellular SP-D, localized in alveolar type II cells and some bronchiolar epithelial cells, 2 hours after treatment. Increment appears less marked 12 hours after administration, reaching again levels comparable to control at 24 hours. The behaviour of SP-D after pumice instilation is similar, but with a significantly minor increment at 2 hours. These results indicate crystalline silica as responsible for a stronger acute injury of pulmonary tissue.

Granulocyte macrophage colony stimulating factor (GM-CSF) biological actions on human dermal fibroblasts.

Fibroblasts are involved in all pathologies characterized by increased ExtraCellularMatrix synthesis, from wound healing to fibrosis. Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) is a cytokine isolated as an hemopoietic growth factor but recently indicated as a differentiative agent on endothelial cells. In this work we demonstrated the expression of the receptor for GM-CSF (GM-CSFR) on human normal skin fibroblasts from healthy subjects (NFPC) and on a human normal fibroblast cell line (NHDF) and we try to investigate the biological effects of this cytokine. Human normal fibroblasts were cultured with different doses of GM-CSF to study the effects of this factor on GM-CSFR expression, on cell proliferation and adhesion structures. In addition we studied the production of some Extra-Cellular Matrix (ECM) components such as Fibronectin, Tenascin and Collagen I. The growth rate of fibroblasts from healthy donors (NFPC) is not augmented by GM-CSF stimulation in spite of increased expression of the GM-CSFR. On the contrary, the proliferation of normal human dermal fibroblasts (NHDF) cell line seems more influenced by high concentration of GM-CSF in the culture medium. The adhesion structures and the ECM components appear variously influenced by GM-CSF treatment as compared to fibroblasts cultured in basal condition, but newly only NHDF cells are really induced to increase their synthesis activity. We suggest that the in vitro treatment with GM-CSF can shift human normal fibroblasts towards a more differentiated state, due or accompanied by an increased expression of GM-CSFR and that such "differentiation" is an important event induced by such cytokine.

Extra cellular matrix features in human meninges.

We collected human fetal and adult normal meninges to relate the age of the tissue with the presence of collagenous and non-collagenous components of Extra Cellular Matrix (ECM). Immunohistochemistry led us to observe some differences in the amount and in the distribution of these proteins between the two sets of specimens. In particular, laminin and tenascin seem to be expressed more intensely in fetal meninges when compared to adult ones. In order to investigate whether the morphofunctional characteristics of fetal meninges may be represented in pathological conditions we also studied meningeal specimens from human meningiomas. Our attention was particularly focused on the expression of those non-collagenous proteins involved in nervous cell migration and neuronal morphogenesis as laminin and tenascin, which were present in lesser amount in normal adult specimens. Microscopical evidences led us to hipothesize that these proteins which are synthesized in a good amount during the fetal development of meninges can be newly produced in tumors. On the contrary, the role of tenascin and laminin in adult meninges is probably only interesting for their biophysical characteristics.

[Gastrointestinal angiodysplasia. Clinical, endoscopic, angiographic and histologic study]. / Angiodisplasia gastrointestinale. Studio clinico, endoscopico, angiografico ed istologico.

The authors report 10 cases of gastrointestinal bleeding angiodysplasia (4 male and 6 female). The surgical treatment was normally provided and the main clinical features, were observed by radiological, endoscopic and pathological findings. Angiodysplasia was observed in the colon (4 cases), in the small intestine (3 cases) and in the stomach (3 cases). Common symptoms (bleeding and sideropenic anaemia), where possible associated with endoscopic and angiographic study, permitted to determine diagnosis and lesion's extension. Pathological findings showed that vascular dilatation wasn't present only in the mucosa and in the submucosa, as in the amartomatous congenital forms, but was present in all intestinal wall, as in the secondary forms, more frequent.