Laparoscopy in staging, follow-up, and restaging of ovarian carcinoma

Laparoscopy was systematically employed for the study of 143 cases of primary ovarian tumor in the various phases of staging, treatment, follow-up, and restaging. We found that laparoscopy allowed a more precise staging if used before laparotomy. Verification of response at any time in the course of therapy was readily achieved by laparoscopy.

[Moya-moya syndrome. Progression of the angiographic picture and therapeutic prospectives]

Moya moya is an obstructive cerebrovascular disease characterised by peculiar cerebral angiographic features consisting of intracranial stenosis or occlusion of the internal carotid artery or its terminal branches associated with telangiectatic vessels at the base of the brain. Opinion is still divided between a congenital versus an acquired aetiology. Recurrent episodes of sudden hemiplegia, headache and convulsive manifestations occur more frequently in paediatric patients, while subarachnoid bleeding is usually the presenting finding in adults. After a progressive course for many years, the disease frequently stabilizes sometimes with residual disability. Surgical approach to improve cerebral blood flow has been developed but there is a high incidence of complications in pediatric patients. To minimize the defects during ischemic phase, a pharmacological therapy might be useful. We report a new case of childhood moya moya disease which developed a typical angiographic progressive pattern during three years between the first and the latest bilateral study. Clinical course of patient suggest that antiaggregating drugs and calcium antagonists might be useful in this disease although controlled studies are of course needed.

Laparoscopy in abdominal staging of esophageal carcinoma. Report of 369 cases

Three hundred sixty-nine patients with cancer of the esophagus (280) and of the cardia (89) underwent laparoscopy, which revealed single or multiple metastases to the liver, peritoneum, omentum, stomach, and lymph nodes in 52 patients (14%) and a metastasis to the gastric wall or to the regional lymph nodes in 36 patients (9.7%). Laparoscopic false negative findings in our series of 250 cases submitted to laparotomy was only 4.4% (2.8% for the liver, 1.2% for the peritoneum, and 0.4% for the omentum). Cirrhosis was diagnosed in 14.3% and severe portal hypertension in 6.7% of our series. Laparoscopy is a very effective procedure in pretherapy staging of esophageal cancer.

Some specific features of exercise stress in athletes

Stress factors which can elicit several psychoemotional, neuromotor and cardiovascular reactions in athletes before or during training and competition are discussed. The authors' data concern firstly the significance of ACTH depletion. Exploration of the neuromotor system, the flicker test, evaluation of the urinary excretion of amine metabolites and several types of questionnaires (related to stress, anxiety and coronary risk factors) in a group of 35 athletes have outlined their psychophysiological reactions and behaviour. The necessity to prevent and manage distress phenomena found in 20 subjects is considered.

The role of p53 in growth of mouse fibroblast lines

To examine the hypothesis that p53 protein may play a central role in regulating reproduction of mammalian cells, we compared the absolute amounts and relative rates of synthesis of p53 protein in two pseudonormal cell lines, 3T3 and C3H 10T1/2, during quiescence, during log proliferation, and in quiescent cells stimulated with serum. The absolute amount of p53 protein per cell was found to be severalfold lower in quiescent cells than in log-phase cells. The ratio of the rate of synthesis of p53 protein to the rate of synthesis of total protein was slightly higher in quiescent cells than the same ratio in log-phase cells. Thus, entry into quiescence is not accompanied by a differential switch-off of synthesis of p53 protein. In quiescent cells stimulated with serum the amount of p53 protein per cell and its rate of synthesis increase, but only in proportion to the increase in total protein per cell and the increase in rate of total protein synthesis. Similarly, 12-14 h after serum stimulation, the time of the G1 to S transition, the accumulated increase in p53 protein per cell is about what would be expected for a short-lived protein whose rate of synthesis has increased in proportion to the increase in rate of synthesis of total protein. The results are not those expected for a protein that functions specifically in release from quiescence or in transition from G1 to S.

Location of the isoleucine arrest point in CHO and 3T3 cells

An isoleucine arrest point in G1 was determined by two methods for CHO and 3T3 cells. In the first method the fraction of cells entering S after isoleucine deprivation was assessed by [3H]thymidine labelling and autoradiography. In the second method cells entering S after isoleucine deprivation were identified by double-label autoradiography using [3H] and [14C]thymidine. From the fraction of cells entering S, determined by the two methods, the arrest point in G1 (and entry into G0) is located within the last 40 min of G1.

Presence or absence of a G1 period in the cell cycle and growth control in a Chinese hamster cell line

Cells of the V79-8 line grow with little or no G1 period. Serum or isoleucine deprivation results in cell death rather than entry into quiescence. Introduction of a G1 period of 4-5 h by treatment with a mutagen is not sufficient to re-establish the ability to enter quiescence. The experiments described here show that introducing a G1 period by mutation that lowers the rate of protein synthesis does not restore to the cell any competence to arrest in G1 and enter a state of quiescence.

Familial membranous subaortic stenosis

Familial occurrence of membranous subaortic stenosis (MSS) is described in three families. The defect was found in 2 siblings in two of these families, and in 3 siblings of the third family. The importance of early diagnosis and treatment of MSS is emphasized. We suggest early evaluation of first-degree relatives of patients with MSS for the possibility of this defect.

Effects of GM1 ganglioside in cerebrovascular diseases: a double-blind trial in 40 cases

A randomized, double-blind trial on the effects of GM1 ganglioside in cerebrovascular diseases was done on 40 patients; the treatment (40 mg/day i.m. injection) began after the acute phase and lasted 6 weeks. 18 cases took the drug and 16 the placebo. The evaluation of the cases was made by graduating the severity of the clinical signs, and some neurophysiological and morphological parameters, i.e., EEGs, flash-evoked potentials and computer tomography scans. We found that the drug, in comparison with the placebo treatment, improved the clinical signs and also the neurophysiological parameters, whereas it was ineffective for the morphological damage. These data seem of some interest in relation to the action of GM1 ganglioside in the processes of neurotransmission and neuronal plasticity as described in the experimental animal.

Risk factors in long-term sequelae of central nervous system prophylaxis in successfully treated children with acute lymphocytic leukemia

Seventy-two successfully treated patients with acute lymphocytic leukemia, all in first complete remission and all off therapy, who had received CNS prophylaxis (radiotherapy, 2,400 rad, plus intrathecal methotrexate), were studied by computed tomography (CT) of the brain, EEGs, and neurologic evaluations 3 to 9 years after the end of prophylaxis. Thirty-five patients showed CT brain scan abnormalities: intracranial calcifications (twelve); widening of the subarachnoid spaces (eight); isolated dilatation of ventricular spaces (three) and with frontal periventricular hypodensity (two); dilatation of ventricular and subarachnoid spaces (nine); and a hypodense area (one). Only 17 patients showed aspecific EEG abnormalities which were never linked to CT scan findings. None of our patients presented major motor deficits at the neurologic examination. A stepwise logistic regression technique showed that age less than 5 years at the time of prophylaxis was the most important risk factor (p = 0.008) of CT brain scan abnormalities followed by neurets (p = 0.037) and sex (p = 0.10). Furthermore, the multivariate analysis pointed out that the interactions between these variables were not significant and the effects were only of the first order.

Density-dependent regulation of growth in somatic hybrids between normal Chinese hamster fibroblasts and V79-8 (G1-) cells

The purpose of this work was to determine the relationship between the presence of a G1 period in the mitotic cycle and a cell's ability to respond to density-dependent regulation of growth (DDR). Somatic hybrids were obtained between normal fibroblasts from newborn Chinese hamsters, which show a strong response to DDR, and V79-8 Chinese hamster cells, which are insensitive to DDR. Two variant V79-8 sublines were used, one reported to lack a G1 period (G1-) and the other with a G1 period (G1+). Fourteen hybrid clones were isolated in selective medium and analysed for growth properties and cell cycle parameters; their hybrid nature was supported by chromosome counts. All hybrid clones, irrespective of whether a V79-8 G1- or G1+ cell was one of the parents, showed pronounced DDR and had G1 periods of various lengths. Previous experiments had shown the absence of G1 to be dominant in somatic hybrids between V79-8 G1- and G1+ cell lines. Our results may mean that the G1- property provided by V79-8 is unable to overcome the very long G1 of normal fibroblasts, or in cells that can be arrested in G1 in response to DDR, some function prevents the dominant effect of the G1- cell on at least part of the G1 period.

Laparoscopy in the diagnosis of primary carcinoma of the gallbladder. A study of 98 cases

Ninety-eight cases of carcinoma of the gallbladder were studied by laparoscopy from 1968 to 1982. The gallbladder was completely explored in 48 patients. Hard white plaques of the gallbladder wall were noted in 30 patients. Local metastases were found in 89 patients. A diagnosis of malignancy by biopsy was made in 90% of cases although only three biopsies were taken from the gallbladder itself. Laparoscopy is useful in identifying those rare cases where radical surgical intervention may improve survival.

[Ischemic cerebrovascular accidents in childhood. Problems of neuroradiological diagnosis]

The authors present 19 cases of stroke with subsequent hemiplegia in children from 5 months to 15 years of age. These cases are not strictly correlated with haematologic alterations. The aetiopathogenesis remains uncertain in the most of patients, in which predisposing causes are absent and angiographic pictures do not demonstrate anatomical lesions or occlusions of cerebral vessels. In our series, cerebral angiography was performed in 16 children and showed vascular alterations only in 6 cases. CT scan some time after the acute hemiplegia, demonstrated low-density areas in 12 cases over 17 examined, with the characteristic evolution of ischemic lesions.

Laparoscopic splenic biopsy

The authors report their experiences with 1243 laparoscopic splenic biopsies performed between 1968 and 1982 at the Laparoscopy Center of the Regional Hospital in Padua. We may conclude that: The risk of laparoscopic splenic biopsy in minimal and fears regarding its performance are unjustified. The diagnostic value of splenic biopsy is evident if a comparison is made, in the different groups, between the percentage and the accuracy of the diagnoses made with the single macroscopic and the histological examinations, respectively. As well as the staging and follow-up of malignant lymphomas, examination of the spleen in clinically suspected splenopathy is a new and interesting indication for laparoscopy, for it is now possible to take one or more biopsies.

[Cerebral changes shown by computed tomography in children with acute lymphatic leukemia after therapy]

The authors discuss the CT findings of the late brain damage by the radiochemotherapic treatment for the prophylaxis of meningeal leukemia in 50 patients, 1 divided by 15 years old. The more frequent CT findings are: enlargement of the subaracnoid spaces; ventricular dilatation; hypodensity of cerebral parenchima; calcifications. These findings correspond to two clinical and anatomo-pathological conditions: subacute leucoencephalopathy and mineralizing microangiopathy. A greater damage on central nervous system was demonstrated in younger children (5 years old) at the time of prophylaxis of meningeal leukemia, that were irradiated with NSD = 950 ret.

Risk factors for post-operative wound infection in cardiac surgery patients

In a prospective study of 372 patients undergoing cardiac surgery, we evaluated the relative contribution of host factors and patient care variables to the risk of post-operative wound infection. Host factors studied were age, sex, country of origin, the diagnosis for which the operation was performed and, for coronary artery by-pass operations, the functional cardiac status according to modified New York Heart Association criteria. The performance of more than one operation during a single admission carried the highest risk for infection, followed by a coronary artery by-pass operation lasting for more than six hours or performed on patients 65 years or older. In patients undergoing coronary artery by-pass surgery, host factors (age and cardiac function) were associated with infections in the chest wound, while the length of the operation was found to affect the occurrence of infections at the "donor" site.

Genetic effects of chromium compounds

Seven different test systems were utilized to investigate the genetic activity of chromium compounds: infidelity of DNA replication in vitro by DNA pol alpha from calf thymus, damage of DNA detected by alkaline elution in treated mammalian cells or in DNA purified and treated in vitro, DNA repair synthesis in mammalian cells in vitro detected by autoradiography or scintillation counting after labelling with [3H]dThd, gene mutations in the Salmonella typhimurium Ames test, gene mutations (6TG resistance) in cultured hamster cells, sister-chromatid exchanges in different rodent cell cultures, and transformation to anchorage-independent growth of hamster cells in vitro (soft-agar assay). Potassium dichromate and chromium chloride were used as water-soluble Cr(VI) and Cr(III) salts. Several reference mutagens (EMS, MMS, MMC, 4NQO) were included in the single tests as positive controls. Cr(VI) was active in all the tested systems, except in the induction of DNA damage and DNA repair synthesis in cultured cells. Cr(III), on the other hand, was absolutely inactive unless a direct interaction with purified DNA was permitted by the test conditions. The relevance of data from the various tests to the understanding of the mechanisms of the genotoxic activity of chromium is discussed. Effects other than the direct interaction of Cr(III) with DNA are inferred, which can cause infidelity of the DNA polymerase functions.