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BACKGROUND: To evaluate in vitro the adherence capability of two bacteria to vaginal epithelial cells (VEC) by comparing product A containing L. plantarum P 17630, in soft-gel capsule formulation* and product B containing Döderlein's bacillus, now classified as L. gasseri, in vaginal tablet formulation, marketed for many years in Italy. METHODS: The comparative study of two commercially available preparations followed an open, controlled trial. Collection of VEC samples was done in an ambulatory setting; the adherence tests were carried out at the Institute of Microbiology of the Università Cattolica del Sacro Cuore, Piacenza. The study was made on intact VEC, washed and drawn from 20 patients affected by bacterial vaginitis and/or vaginosis. One capsule or tablet, suspended in physiological solution, was mixed with a suspension of VEC. Adherence of lactobacilli to the VEC was counted by light microscopy and by CFU cultured on the plates. The type of adhesion was evaluated as well. RESULTS: The mean number of lactobacilli adhering to individual VEC was higher for product A containing L. plantarum P 17630. On the plate cultures, 10(6)-10(8) CFU/sample were found for product A, compared with 10(2)-10(4) CFU/sample for product B. L. plantarum P-17630 adhere prevalently to single cells, whereas L. gasseri adhere by forming small chains. CONCLUSIONS: Product A has a better capability of adherence to VEC than does product B. Even the type of adhesion of L. plantarum P 17630 enabled it to remain better attached to the VEC. The results suggest that in vivo product A may be more likely to provide better colonization, thus affording better protection of the vaginal milieu.

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This paper shows for the first time the higher oxidizability of low-density lipoprotein (LDL) in plasma from adrenoleukodystrophy (ALD) patients compared to that of control subjects. LDL oxidation susceptibility was assessed by conjugate diene formation, hydroperoxide and lipoperoxide formation, and electrophoretic mobility. Simvastatin therapy, an HMG-CoA reductase inhibitor, seems to be a protective pharmacological agent against the higher oxidizability of LDL in plasma from ALD patients.

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The authors describe a case of antral Watermelon Stomach (WS) in a seventy-eight year old woman with severe iron-deficient chronic anemia, liver cirrhosis and diabetes mellitus. Endoscopy was diagnostic on the 3rd-4th examination because of the disease's rarity and the concomitance of systemic pathologies, such as portal hypertension, in which often a congestive gastropathy with similar aspects is associated. Whether out of clinical evolution, or capillary thrombosis, or vertical fibromuscular hyperplasia of the lamina propria were considered distinctive elements. By means of literature review it wasn't possible to establish the portal hypertension's prevalence out of the WS cases, but it could be a chance factor. In this way some polycentric prospective trials could be useful. The endoscopic practice is important not only for diagnosis but also for therapeutical means, even if in our case surgery was the chosen treatment.

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The authors report a case of associated injuries (thoracoabdominal trauma with multiple rib and sternum fractures, perforation of the small intestine, abdominal cutaneous ecchymosis) caused by a seat belt, and describe the possible seat-belt mechanisms of lesion in road accidents. Some clinical aspects are discussed; in particular the diagnostic problems concerning a seat-belt syndrome as well as the limits of effectiveness in the use of belts.

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To assess the effect of obstructive sleep apnea treatment on plasma renin activity (PRA) and plasma aldosterone seven male patients were studied under two conditions: untreated and treated with nasal continuous positive airways pressure (CPAP). PRA and plasma aldosterone were measured at 10-min intervals for both nights. CPAP treatment diminished the urinary and Na+ excretion, whereas plasma volume increased. The mean levels of PRA and aldosterone were significantly enhanced by the treatment, increasing respectively from 1.5 +/- 0.3 to 3.0 +/- 0.7 ngAI ml-1.hr-1 (p less than 0.05) and from 8.0 +/- 1.0 to 12.0 +/- 1.7 ng.100 ml-1 (p less than 0.05). PRA curves reflected the overall sleep structure as similarly described in normal subjects. The apnea-induced sleep disturbance led to flat PRA profiles and the restoration of a normal sleep pattern by treatment restored the PRA oscillations related to the sleep cycles and consequently restored aldosterone oscillations. The mean amplitude of these oscillations increased respectively from 1.0 +/- 0.1 to 1.8 +/- 0.4 ngAI ml-1.hr-1 and from 5.4 +/- 1.2 to 10.9 +/- 1.9 ng.100 ml-1. These results suggest that CPAP treatment modifies the nocturnal patterns of PRA and aldosterone by increasing their mean levels and their oscillation amplitude. This indicates increased secretion, which contributes to the normalization of urine and Na output.

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The authors describe a case of retroperitoneal rupture of the duodenum following blunt abdominal trauma. The aetiology, symptomatology of these lesions are discussed and treatment is stressed. Duodenal fistula continues to be a serious postoperative complication. Primary repair with drainage is the preferred treatment. Gastrostomy, internal decompression and feeding jejunostomy are usefully added in the most severe duodenal injuries.

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The authors investigated the variations in breakage under comparable compression loads induced by concentric erosion of diaphyseal bone in experimental animals. The results varied according to whether the internal or external cortex had been eroded, and whether the proximal or distal segments of the diaphysis were involved. Our findings appear to have some practical relevance regarding the etiopathogenesis of pathological fractures.

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