Influence of polarisation and differentiation on interaction of 43-kDa outer-membrane protein of Aeromonas caviae with human enterocyte-like Caco-2 cell line

It has been recognised that adherence and invasion to host cells are important steps in the pathogenesis of entero-pathogenic bacteria, including Aeromonas caviae. However, the virulence factors of A. caviae remain, for the most part, poorly known. This study examined the interaction of A. caviae isolates to Caco-2 cells in different polarisation and differentiation conditions. The adherence of A. caviae may be related to accessibility of host cell basolateral receptors. Aggregative A. caviae isolates, grown at 22 degrees C, were more adherent in both non-polarised and undifferentiated Caco-2 cells and EGTA-treated polarised and differentiated Caco-2 cells. Furthermore, monolayers pre-incubated with 43-kDa outer-membrane protein (OMP) or A. caviae strains pre-incubated with rabbit IgG anti-43-kDa OMP decreased adherence of some A. caviae strains to EGTA-treated polarised and differentiated Caco-2 cells, suggesting an interaction of 43-kDa OMP with basolateral cell receptors. Bacterial cells were observed adhering to microvilli and to plasma membrane on both the apical and basal surfaces of the monolayer. Pedestal-like formation with cytoskeletal rearrangement was also observed. The bacteria entered the Caco-2 cells and were observed enclosed in single and multiple membrane-bound vacuoles within the host cell cytoplasm. Furthermore, A. caviae were observed free in the cytosol of Caco-2 cells, suggesting escape form cytoplasmatic vacuoles.     

Oral contrast-enhanced three-dimensional helical-CT cholangiography: clinical applications

Our objective was to define the possibility of using oral-contrast-enhanced helical CT for the assessment of patients with cholecystolithiasis and of cholecystectomized symptomatic patients. Twenty-seven patients with cholecystolithiasis and 20 with a painful abdominal symptomatology after cholecystectomy (12 laparoscopic and 8 laparotomic) were recruited for this study. Cholangio-CT was performed 12–14 h after oral administration of 6 g of hyopanoic acid. The acquired data were then transferred to a second workstation and 3D reconstruction of the biliary tract was obtained. In all the cases the extrahepatic bile ducts were recognizable. Seven patients had no gallbladder opacification: CT images showed in 3 cases an infundibular stone and in 4 cases sclero-atrophic gallbladder. The intrahepatic bile ducts were visible in 21 of 27 patients with lithiasis and in 14 of 20 cholecystectomized patients. In 5 cholecystectomized patients cholangio-CT demonstrated the presence of residual choledochal or intrahepatic stones. In 3 cholecystectomized patients 3D reconstruction allowed identification of a long and winding stump of the cystic duct. Cholangio-CT is a non-invasive method to evaluate the biliary tract in patients who cannot be subjected to cholangio-MR, or as a preliminary to endoscopic retrograde cholangiopancreatography in cases of doubtful diagnosis after US and cholangio-MR. Electronic Publication     

Primary malignant melanoma of the gallbladder in dysplastic naevus syndrome

A case of gallbladder involvement by malignant melanoma in a 57-year-old woman is reported. The gallbladder, resected for cholelithiasis, harboured a pedunculated polypoid dark mass, which histologically revealed sheets and nests of epithelioid cells with hyperchromatic nuclei in the lamina propria and at the junctional level. These cells were pigmented (with positive reaction with Schmorl's stain and bleaching with peroxide) and showed immunohistochemical positivity for S-100, gp 100 antigen (HMB-45 antibody) and vimentin. The patient, affected by dysplastic naevus syndrome, had a melanoma in situ excised from the scalp 8 years earlier. The features of the investigated lesion address towards a diagnosis of primary gallbladder melanoma. Furthermore, this is the first time that the existence of such a controversial entity is sustained by the ultrastructural investigation of melanosomes, demonstrating the presence of two melanocitary populations, a typical one exclusively junctional and an atypical one both at the junctional level and in the lamina propria.     

Plasma rich in growth factors (PRGF) for the promotion of bone cell proliferation and tissue regeneration

Objectives

Over the past few years, studies about growth factors have been increasingly developed and the knowledge of their role in stimulating cell proliferation and differentiation used for therapeutic purposes. This study aims to compare a platelets concentrate, the plasma rich in growth factors (PRGF) to a control, consisting of cellulose membranes, to evaluate in vitro the cellular adhesion and migration of human osteoblasts (hOb) and understand if the use of platelets concentrates could be an advantage in view of bone tissue regeneration.

Study design

Twenty-seven human donors provided 27 blood samples used to make 54 samples: 27 for PRGF and 27 for the control group. PRGFs and controls were incubated for 48 h in sterility in 1 ml of culture with 10⁵ hOb and hOb in the scaffolds were then quantified.

Results

In PRGF samples, hObs were more numerous than in controls. (T?=?6.6964, p?<?0.0001).

Conclusions

Human osteoblasts are driven to colonize PRGFs with a greater efficacy than negative controls, probably due to the presence of chemokines and growth factors in PRGFs.

     

Role of CT in the diagnosis of jejunal–ileal perforations

Purpose

The purpose of this study was to evaluate the computed tomography (CT) signs of free and covered small-bowel perforations and the potential of CT in recognising the aetiology.

Materials and methods

Thirty-five patients with surgically proven small-bowel perforation were retrospectively evaluated. Fundamental signs (extraluminal air, solution of continuity) and secondary signs (thickening of the mesentery, free or perilesional fluid, wall thickening) were considered.

Results

CT alterations were found in 31/35 (88.6 %) patients: extraluminal air (30/35, 85.7 %), solution of continuity (11/35, 31.4 %), intra-abdominal fluid (27/35, 77.1 %), thickening of the mesentery (20/35, 57.1 %), and wall thickening (14/35, 40 %). In 25/35 cases (71.4 %) pneumoperitoneum was detected, associated with secondary signs (23/25, 82 %), confirmed as free perforations at surgery. In 5/35 patients (14.2 %), peri-intestinal air bubbles and secondary signs were evident, while in 1/35 cases (2.8 %) only secondary signs were seen, namely covered perforations. In 4/35 patients (11.4 %) with a covered perforation, the CT scan was negative. The nature of the perforations was completely recognisable in 26/31 cases (83.9 %), partially identifiable in 4/31 (12.9 %), not evident in 1/31 (3.2 %).

Conclusion

CT investigation is essential in the recognition of a small-bowel perforation and in the definition of its nature.     

Selektive, lumbale, mediolaterale und laterale (lateroforaminale) Wurzeldekompression bei lateraler Wirbelkanalstenose

Zusammenfassung Operationsziel Dekompression einer lumbalen Nervenwurzel (meist L5) vom Hiatus duralis bis lateral des Foramen intervertebrale und bis zum lateralen Kompartiment ohne Zerstörung des Gelenks. Indikationen Knöcherne Kompression einer lumbalen Nervenwurzel im Recessus lateralis, Foramen intervertebrale und intervertebralen Kompartiment. Kontraindikationen Bei korrekter Diagnose gibt es keine Kontraindikationen. Erschwerend kann die extraforaminale Dekompression der fünften Lendenwurzel sein, besonders im Fall der degenerativen ventralen Verschiebung des fünften Lendenwirbels. Operationstechnik Medianer Zugang zum Spinalkanal und zum intervertebralen Kompartiment. Freilegung und Dekompression der Wurzel im Spinalkanal und im Recessus lateralis bis zur Umbiegungsstelle in das Foramen intervertebrale. Mikrotechnische Exploration des intervertebralen Kompartiments, Dekompression der Wurzel, Erweiterung des Foramen intervertebrale. Ergebnisse 88 von 94 Patienten, die von 1991 bis Ende 1994 operiert worden waren, wurden 1995, acht bis 54 Monate (durchschnittlich 28 Monate) nach der Operation, erneut untersucht. 96 Wurzeln waren dekomprimiert worden, am häufigsten die Wurzel L5. Eine doppelseitige Operation war nie notwendig gewesen. 73 Patienten werteten die Operation in Bezug auf ihre radikulären Beschwerden als Erfolg, zehn als nützlich; bei vier Patienten ergab sich keine signifikante Erleichterung. In einem Fall lag eine irreversible Fußheberparese mit Deafferenzierungsbeschwerden im Dermatom L4 vor. Bei sechs Patienten, wovon vier mit dem Gesamtergebnis der Behandlung zufrieden waren, zeigte sich eine leichte Verschlechterung der Kreuzschmerzen. Summary Objectives To eliminate radicular symptoms by decompression of a lumbar nerve root (usually L5) from its dural exit to the intervertebral foramen up to the lateral compartment without damaging the facet joint. Indications Bony decompression of a lumbar nerve root at the lateral recess, in the intervertebral foramen, and in the intervertebral compartment. The mediolateral and lateral decompression is indicated in deformation of the spinal canal caused by wear. It is usually found at the concave side of a degenerative scoliosis. Contraindications There exists no contraindication on the condition that the diagnosis is correct. An extraforaminal decompression on the fifth lumbar nerve root can be more difficult, particularly in instances of an anterior degenerative displacement of the fifth lumbar vertebra. An alternative to this selective decompression could be a rather disadvantageous removal of the facet joint. Surgical Technique Medical approach to the spinal canal and the intervertebral compartment. Exposure and decompression of the root in the spinal canal and at the lateral recess up to the point where the nerve root curves laterally into the intervertebral foramen. Microscopic exploration of the intervertebral compartment, decompression of the root and enlargement of the intervertebral foramen. Results Follow-up (average of 28 months) of 88 patients out of 94 operated between 1991 and end of 1994. Six patients of advanced age had died in the meantime. Decompression of 96 roots, most often at the level of L5. Bilateral surgery was never required for any of the patients. Successful relief of radicular symptoms was reported by 73 patients, 10 patients judged the operation as beneficial, and 4 did not experience any improvement. One patient suffered from an irreversible drop foot accompanied by symptoms of deafferentation at the L4 dermatome. A slight deterioration of the low back pain was reported by 6 patients - 4 of whom were satisfied with the overall result.