Trattamento della contrattura capsulare da impianto protesico mammario. Nostra esperienza

La più comune complicanza in pazienti sottoposte ad intervento chirurgico di impianto protesico mammario è la contrattura capsulare. Non esiste, attualmente, un trattamento standard efficace per questa complicanza. Lo scopo del presente articolo è illustrare la nostra esperienza sull’uso degli antagosisti dei recettori per i leucotrieni nel trattamento della contrattura capsulare. I risultati mostrano che l’utilizzo di questi farmaci è in grado di ridurre il dolore e la distorsione della mammella in pazienti con un lungo decorso di contrattura capsulare

Endothelin-1[1–31], acting as an ETA-receptor selective agonist, stimulates proliferation of cultured rat zona glomerulosa cells

AbstractEndothelin-1 (ET-1)[1–31] is a novel hypertensive peptide that mimics many of the vascular effects of the classic 21 amino acid peptide ET-1[1–21]. However, at variance with ET-1[1–21] that enhances aldosterone secretion from cultured rat zona glomerulosa (ZG) cells by acting via ETB receptors, ET-1[1–31] did not elicit such effect. Both ET-1[1–21] and ET-1[1–31] raised the proliferation rate of cultured ZG cells, the maximal effective concentration being 10−8 M. This effect was blocked by the ETA-receptor antagonist BQ-123 and unaffected by the ETB-receptor antagonist BQ-788. Quantitative autoradiography showed that ET-1[1–21] displaced both [125I]PD-151242 binding to ETA receptors and [125I]BQ-3020 binding to ETB receptors in both rat ZG and adrenal medulla, while ET-1[1–31] displaced only [125I]BQ-3020 binding. The tyrosine kinase (TK) inhibitor tyrphostin-23 and the p42/p44 mitogen-activated protein kinase (MAPK) inhibitor PD-98059 abolished the proliferogenic effect of ET-1[1–31], while the protein kinase-C (PKC) inhibitor calphostin-C significantly reduced it. ET-1[1–31] (10−8 M) stimulated TK and MAPK activity of dispersed ZG cells, an effect that was blocked by BQ-123. The stimulatory action of ET-1[1–31] on TK activity was annulled by tyrphostin-23, while that on MAPK activity was reduced by calphostin-C and abolished by either tyrphostin-23 and PD-98059. These data suggest that ET-1[1–31] is a selective agonist of the ETA-receptor subtype, and enhances proliferation of cultured rat ZG cells through the PKC- and TK-dependent activation of p42/p44 MAPK cascade

Adrenomedullin (ADM), acting through ADM(22-52)-sensitive receptors, is involved in the endotoxin-induced hypotension in rats

The possible involvement of adrenomedullin (ADM) in the endotoxin-induced hypotension has been investigated in the rat. Lipopolysaccharide (LPS, 500 &kg intraperitoneum) caused a severe decrease in the blood pressure (BP), reaching maximum 2-3 h after the injection and subsiding after 12 h. The putative ADM-receptor antagonist ADM(22-52) (3 nmoHkg) counteracted LPS-induced BP lowering at 1 and 2 h, and reversed it at 3 and 6 h CGRP(S-37), a selective antagonist of the CGRPl receptors, was ineffective. Both ADM(22-52) and CGRP(%37) did not evoke significant changes in the basal BP. Our findings provide strong support to the view ADM overproduction plays a major role in the LPS-induced decrease in BP, and suggest a potentially important therapeutic effect of the blockade of ADM(22-52)-sensitive receptors during endotoxic shock

Merkel cell carcinoma in the orbitopalpebral region

Trabecular carcinoma is a rare cutaneous neuroendocrine carcinoma that probably originates from the Merkel cells that are usually found in the basal layer of the epidermis. The treatment of Merkel cell carcinoma is controversial and there is no specific therapeutic protocol because of the small number of cases that have been published. The procedures used to treat Merkel cell carcinoma must be tailored to minimise morbidity while maximising survival. Because the condition is so rare and difficult to diagnose and treat, we report three cases of orbitopalpebral tumours that confirm the local and regional aggressiveness and the high metastatic potential of this tumour

Different types of embolization before surgical excision of haemangiomas of the face

The management of hemangiomas of the face depends on several clinical factors. Many treatments have been recommended for the management of patients with hemangiomas. However, most of them have not shown good results in terms of post-treatment morphology and function of the organs. Surgery of these benign lesions can at times be disfiguring, especially when the lips, muscles, or the maxilla are involved. In addition, by the very nature of these lesions, surgical treatment may be associated with excessive intra and perioperative blood loss. As an alternative to surgical excision, different types of embolization treatments have been developed for all types of hemangiomas. In many instances the procedure was performed preoperatively or intraoperatively. The various therapeutic embolizations, if performed correctly, lead to a significant reduction in the blood flow within the angiomatous mass. Different types of embolization of the lesions and subsequent surgical extirpation can be considered the method of choice in the treatment of voluminous hemangiomas of the face

Breast desmoid tumor after augmentation mammoplasty: Two case reports

Desmoid tumor of the breast is a rare fibroblastic disease, a slow-growing and histologically benign lesion that accounts for 0.2% of all breast tumors. It can arise either primarily from the breast parenchyma or, by secondary invasion, from the muscolo-aponeurotic layer of the pectoral muscles. These tumors do not metastatize, have no capsule but do have the propensity to aggressively invade local tissues and organs. It has been suggested that these tumours are associated with surgical and non-surgical tissue trauma, certain hormones and genetic susceptibility. We describe two cases of breast desmoid tumor after breast augmentation. A 52-year-old Caucasian woman and 38-year-old Caucasian woman presented for a breast implant change. During surgery an inelastic, soft, capsulated mass, arising from the periprosthetic capsula in the area of pectoralis major muscle was found. The mass was removed en bloc together with a portion of the periprosthetic capsula, the resection including a portion of the pectoralis major muscle fascia in both cases. The results of this histological examination suggested an extra-abdominal desmoid tumor. To date both the local and the general conditions of the two patients are good, with no signs of recurrence of the lesion

Preliminary report on the effect of cyanoacrylates on the maturation process of hypertrophic scars

[No abstract available

T-CELL LYMPHOMA PRESENTING AS A RAPIDLY ENLARGING TUMOR ON THE LOWER EYELID.

Lymphoma or leukemia skin lesions as a secondary site of disease are quite common; however, to discover a cutaneous Hodgkin or non-Hodgkin lymphoma is very unusual. To find a cutaneous T-cell lymphoma on the skin of the face is a rarity. Because the condition is so rare and difficult to diagnose and treat, we report the case of a young man with a T-cell lymphoma with atypical and anaplastic cells on the lower eyelid. The patient was treated with 4 cycles of chemotherapy, and radiotherapy, and the tumor was resolved after 6 weeks. Our case was clinically suggestive of a rapidly enlarging malignant lymphoma on the eyelid. If the lymphomas are detected at an early stage the prognosis for survival is favorable. A few forms of treatment are possible, either surgical treatment, or radiotherapy and chemotherapy, where response to the treatment is better