Multimodal study of pelvic splenosis: a rare cause of abdominal pain

We present a rare case of pelvic splenosis, in a 46-year-old man, with a previous history of partial splenectomy, complaining of nonspecific pain in the lower abdominal quadrants. Splenosis is a benign acquired condition, defined as a heterotopic autotransplantation of splenic tissue in other compartments of the body, caused by rupture of the splenic capsule following trauma or splenectomy. Splenosis is often asymptomatic and incidentally found and does not require treatment. Surgery is indicated only in patients presenting with symptoms or complications. In our case, the multimodal imaging study (ultrasound, MRI, CT, and scintigraphy) allowed a correct differential diagnosis without resorting to invasive procedures, susceptible to complications     

TAS1R3 and TAS2R38 Polymorphisms Affect Sweet Taste Perception: An Observational Study on Healthy and Obese Subjects

Background: The inter-individual differences in taste perception find a possible rationale in genetic variations. We verified whether the presence of four different single nucleotide polymorphisms (SNPs) in genes encoding for bitter (TAS2R38; 145G > C; 785T > C) and sweet (TAS1R3; −1572C > T; −1266C > T) taste receptors influenced the recognition of the basic tastes. Furthermore, we tested if the allelic distribution of such SNPs varied according to BMI and whether the associations between SNPs and taste recognition were influenced by the presence of overweight/obesity. Methods: DNA of 85 overweight/obese patients and 57 normal weight volunteers was used to investigate the SNPs. For the taste test, filter paper strips were applied. Each of the basic tastes (sweet, sour, salty, bitter) plus pure rapeseed oil, and water were tested. Results: Individuals carrying the AV/AV diplotype of the TAS2R38 gene (A49P G/G and V262 T/T) were less sensitive to sweet taste recognition. These alterations remained significant after adjustment for gender and BMI. Moreover, a significant decrease in overall taste recognition associated with BMI and age was found. There was no significant difference in allelic distribution for the investigated polymorphisms between normal and overweight/obese patients. Conclusions: Our findings suggest that overall taste recognition depends on age and BMI. In the total population, the inter-individual ability to identify the sweet taste at different concentrations was related to the presence of at least one genetic variant for the bitter receptor gene but not to the BMI.     

Systematic review of existing guidelines for NAFLD assessment

Aim: In this systematic review, guidelines on non-alcoholic fatty liver disease (NAFLD) were evaluated, aiming at a guideline synthesis focusing on diagnosis an...     

Donor islet endothelial cells in pancreatic islet revascularization

OBJECTIVE

Freshly isolated pancreatic islets contain, in contrast to cultured islets, intraislet endothelial cells (ECs), which can contribute to the formation of functional blood vessels after transplantation. We have characterized how donor islet endothelial cells (DIECs) may contribute to the revascularization rate, vascular density, and endocrine graft function after transplantation of freshly isolated and cultured islets.

RESEARCH DESIGN AND METHODS

Freshly isolated and cultured islets were transplanted under the kidney capsule and into the anterior chamber of the eye. Intravital laser scanning microscopy was used to monitor the revascularization process and DIECs in intact grafts. The grafts’ metabolic function was examined by reversal of diabetes, and the ultrastructural morphology by transmission electron microscopy.

RESULTS

DIECs significantly contributed to the vasculature of fresh islet grafts, assessed up to 5 months after transplantation, but were hardly detected in cultured islet grafts. Early participation of DIECs in the revascularization process correlated with a higher revascularization rate of freshly isolated islets compared with cultured islets. However, after complete revascularization, the vascular density was similar in the two groups, and host ECs gained morphological features resembling the endogenous islet vasculature. Surprisingly, grafts originating from cultured islets reversed diabetes more rapidly than those originating from fresh islets.

CONCLUSIONS

In summary, DIECs contributed to the revascularization of fresh, but not cultured, islets by participating in early processes of vessel formation and persisting in the vasculature over long periods of time. However, the DIECs did not increase the vascular density or improve the endocrine function of the grafts.Clinical islet transplantation can restore endogenous insulin production and glycemic control in patients with type 1 diabetes, yet increased knowledge, and hence refinement, would allow for a wider application of this therapy (1). Pancreatic islets are interspersed by a dense and tortuous capillary network that facilitates an efficient exchange of oxygen, nutrients, and hormones between the endocrine cells and the bloodstream. Transplanted islets are revascularized by blood vessels that grow into the islets from the host organ via angiogenesis (2), although the acquired vasculature has a significantly lower vessel density compared with the endogenous islets (3). Furthermore, during the initial avascular engraftment period, a dramatic reduction in insulin content and high rate of cell death occur within the islets (4). Therapies that enhance the angiogenic capacity of islets by overexpression of vascular endothelial growth factor-A (VEGF-A) can increase the vascular density of islet grafts and improve metabolic function (5,6).Recently, we and others showed that donor islet endothelial cells (DIECs) can form functional vessels within transplanted islets (7,8). Immediately after isolation (i.e., in freshly isolated islets), a large number of intraislet endothelial cells (ECs) are present (7–9). However, if the islets are cultured, the intraislet ECs rapidly disappear, and by 4 days, only ∼5% of the initial content is detected (7). Therefore, freshly isolated islets, in contrast to cultured islets, contain an extra pool of ECs that potentially could promote islet revascularization and function after transplantation. Here, we have performed a detailed characterization of the role of DIECs in the revascularization of transplanted islets.     

Hepatocyte growth factor-modulated rat Leydig cell functions

Hepatocyte growth factor (HGF) regulates many cellular functions acting through c-Met, its specific tyrosine kinase receptor. We previously reported that in prepuberal rats HGF is secreted by the peritubular myoid cells during the entire postnatal testicular development and by the Sertoli cells only at puberty. We have also demonstrated that germ cells at different stages of development express c-Met and that HGF modulates germ cell proliferation and apoptosis. In the present article, we extend our study to the interstitial compartment of the testis and demonstrate that the c-Met protein is present on Leydig cells. The receptor is functionally active as demonstrated by the detected effects of HGF. We report in this article that HGF significantly increases the amount of testosterone secreted by the Leydig cells and decreases the number of Leydig cells undergoing apoptosis. The antiapoptotic effect of HGF is mediated by caspase-3 activity because the amount of the active fragment of the enzyme is decreased in Leydig cells cultured in the presence of HGF. However, treatment with the growth factor does not modify the expression levels of caspase-3 mRNA. These data indicate that HGF regulates the functional activities of Leydig cells. Interestingly, the steroidogenetic activity of the cells is increased by HGF in cultured explants of testicular tissues as well as the antiapoptotic effect of HGF. Therefore, our data indicate that HGF has a crucial role in the regulation of male fertility.     

Efficacy of PTQ agent in the treatment of faecal incontinence

Faecal incontinence caused by a weak or disrupted internal anal sphincter is common and the efficacy of current treatments for this condition is poor. This study evaluated the short- and long-term effects of injections of silicone biomaterials (PTQ) commonly used to increase anal internal sphincter resistance. A total of 16 patients with a mean age of 66 years affected by faecal incontinence with a low anal resistance to the pressure due to previous surgery of the pelvic region were submitted to intra-sphincteric PTQ injections. The effects of the treatment on the symptoms associated with faecal incontinence and on quality of life were evaluated with the American Medical System Score and with anal ultrasound at 3 months and one year after the procedures in comparison with the scores calculated at entry. At 3 months from the procedure, anal ultrasound confirmed that PTQ injections had been correctly performed without material migration to other regions. Faecal continence was significantly improved but more efficacy was found one year after the injections. The American Medical System Score calculated one year after the procedures was significantly improved in comparison with the scores calculated at entry. During the follow-up the Authors did not observe any significant complications. PTQ injections significantly improved faecal continence and consequently the quality of life of patients with sphincter dysfunctions.