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In the last centuries, the anatomy of the liver has been the object of increasing interest. The International Anatomical Terminology tries to unify the terminology of liver anatomy, making it a living language. A single, worldwide-accepted classification of the liver still does not exist. In fact, definition of segments according to Couinaud's nomenclature is different from that of Goldsmith and Woodburne. The aim of this paper was to revise the liver topography by 64-Multislice Computed Tomography, in patients who had undergone repair of cholelithiasis, starting from classifications based on the efferent venous system or on the Glissonian system. This technique allows to remove virtually the liver parenchyma, and, together with the subsequent three-dimensional reconstruction of images, represents the best tool to visualise the hepatic ducts and segments. Through this approach, we propose a new terminology, which considers the liver divided into five lobes and seven segments plus one caudate lobe. In conclusion, this paper can represent a working hypothesis for a possible and future revision of the nomenclature of the hepatic functional territories and can be useful for clinical and didactic aims.

The temporomandibular joint (TMJ) connects the mandible to the skull. TMJ disorders induce degenerative tissue changes in TMJ disc that are largely the result of maladaption to abnormal joint loading. Histopathological studies have documented an association between TMJ arthropathy and loss of tissue cellularity, via apoptosis-related processes, that result in diminished extracellular matrix generation, organization, and repair. However, the exact molecular mechanisms underpinning the development and progression of such degenerative changes are still unclear. We review the most recent findings regarding the involvement of apoptotic mechanisms in TMJ disc degeneration. Although a number of aspects of TMJ disc degeneration have been thoroughly investigated, data on the involvement of apoptotic mechanisms and their mediators are few and quite recent; indeed most of the research conducted on fibrous cartilage apoptosis has focused on the intervertebral disc.

A literature review of tile treatment of cartilage defects was conducted, examining the current literature on the well-known treatments. In particular, advantages and drawbacks of each of the discussed treatments were evaluated considering outcomes available in literature. The literature search was conducted on PubMed and Scopus using appropriate keywords in relation to cartilage defects. Main research articles were selected for review. Cartilage damage affects thousands of persons each year; they are treated with implants and surgery. A major problem in the treatment of cartilage defects is the inability of cartilage to repair, which reduces the effectiveness of the treatment. In addition, cyclic loading of joints further degrades cartilage even after treatment. In relation to the conditions of cartilage lesions and the features of patients, a specific treatment is required in each case. Current treatments are often unpredictable in results but result in long term improvements for many patients, especially young patients. The well established treatments such as osteochondral implants, bone marrow stimulation techniques, chondrogenic cell implantations have advantages and drawbacks, so that the search has not been interrupted for new strategies, such as scaffold materials. In this review we describe benefits and disadvantages of the established methods of cartilage regeneration that seem to have a better long-term effectiveness.

This review was conducted as a complementary study to our review "Current concepts in the treatment of cartilage damage. A review", in this same Journal, on promising new strategies in the treatment of cartilage defects. The established treatments such as osteochondral implants, bone marrow stimulation techniques and chondrogeneic cell implantations, besides advantages, have drawbacks that have led to seek new strategies such as scaffold materials. Matrix-associated chondrocyte implantation, hyaluronan-based scaffolds, tissue-engineered collagen matrices seeded with autologous chondrocytes and encapsulation of autologous chondrocytes in poly(ethylene glycol) diacrylate (PEGDA) seem to be less invasive and have a good performance. In this review we describe benefits and disadvantages of the new procedures of cartilage regeneration by scaffolding materials such as PEGDA.

Two forms of genetic instability have been described in colorectal cancer: chromosomal instability, characterized by structural and numerical chromosomal abnormalities and associated to aneuploidy; and microsatellite instability, characterized by a deficiency in the mismatch repair system that leads to slippage in microsatellites and is associated to euploidy. Thirteen colorectal cancer sample DNAs were analyzed after colectomy. High-resolution genome-wide DNA copy number and Single Nucleotide Polimorphism genotyping analysis was performed by Affymetrix SNP 6.0 arrays that interrogates 906,600 single nucleotide polymorphisms and 945,826 copy number probes. We implemented this analysis as part of a routine procedure that includes the sampling of fresh tissue from the tumor mass without affecting the subsequent standard histopathological procedure. The novel molecular technology allows the determination of a genome-wide molecular karyotype using only 500 ng of high-quality tumor DNA; it distinguishes the two main types of genomic instability, discriminating between chromosomal instability positive and negative tumors. It also detects loss of heterozygosity (LOH) regions, called copy neutral-LOH. Tumor-associated copy neutral-LOH regions may play a pivotal role in oncogenesis when they determine duplications of either activating or loss of function gene mutation. We observed recurrent gains of chromosomes 2, 7, 8q, 9, 12, 13, 20 and losses of chromosomes 4, 5, 8p, 15, 17p, 18, 22, and Y, in agreement with previous cytogenetic studies. The use of such sampling procedure could stimulate the routine detection of point mutations in specific genes, thus avoiding subsequent sectioning of formalin-fixed and paraffin-embedded samples.

We report some variants, anomalies and aneurysms of the coronary artery tree observed in patients referred to our radiology department for suspected or known coronary artery diseases. 265 patients, with heart rate < 70 beats per minute and stable clinical conditions, underwent 64-MSCT. They were intravenously given contrast medium followed by saline as a chaser. Images and data were reconstructed and evaluated by two radiologists. Seven out of these patients (5 males and two females) were found to have abnormalities (variants or anomalies) of coronary arteries or coronary aneurysms, with an incidence respectively of 1.88% and 0.75%. Two patients had an anomalous origin of the left coronary artery from the pulmonary artery, as previously described (Castorina S et al., 2008). As regards the other patients, one had separate origins of the anterior descendant and circumflex arteries from the left lateral sinus with two ostia, one had quadrifurcation of the left coronary trunk, one had agenesis of the left coronary ostium and trifurcation of the right coronary artery and two had coronary aneurysms. Images acquired by 64-MSCT, because of their spatial dislocation, permit anatomical study from different perspectives. Our data confirm the ability of MSCT to evaluate, in a few seconds, anomalies of coronary arteries offering additional information for a more complete diagnosis.

The regenerative capacity of the liver after partial hepatectomy or chemical injury is well known. In human liver, the resident progenitor cells are called "hepatic progenitor cells" (HPCs) while the term "oval cells" should be discouraged in order to indicate the stem cell compartment. The aim of our study was first to analyse the cellular aspects of liver regeneration through differentiation in cholangiocytes and hepatocytes, and then to characterise resident progenitor cells, using "primary cultured hepatocytes" derived from healthy adult human livers. Human hepatocytes were isolated from fresh surgical specimens of patients who underwent hepatic resections in our Clinical Centre surgery operating room. Hepatic differentiation and function were analysed by immunocytochemistry techniques and the presence of liver epithelial cell populations within normal adult human liver, was demonstrated by immunohistochemistry analysis. These cells expanded in vitro and showed the capacity for self-renewal and multipotent differentiation. Human liver stem cells expressed several mesenchymal markers, such as CD44, but not haematopoietic stem cell markers. In addition, these cells expressed alpha-fetoprotein, albumin, CK7 and CK19, indicating a partial commitment to hepatic and biliary cells. Interestingly the expression of both hepatocytes and biliary markers in HPCs reflects the bipotential nature of the hepatic stem cells toward both the hepatic and biliary lineage. According to their immature and bipotential phenotype, hepatic epithelial cells might represent a pool of precursors in the healthy human adult liver.

A new generation of Multislice Computed Tomography (MSCT 64) was introduced by Siemens in Italy in the end of 2004. It acquires 64 slices per rotation and provides significantly improved image quality with drastically reduced scan times. This technique allows newer applications, particularly in vascular, cardiac, and colonic imaging. We investigated the accuracy of MSCT 64 in 120 patients for the detection of high-grade coronary-artery stenoses and occlusions. A detailed description of the most intriguing images (big vessels of mediastinum, supra aortic trunks, collateral circulation in an aortic pathology, aortic fissuration) is reported. MSCT 64 (multislice CT 64) represents an undisputed technological evolution of the imaging in the living being. Contrary to conventional coronary angiography (CCA), it enables to carry out noninvasive angiography in various settings, providing potential diagnostic and prognostic applications.

Colorectal cancer is a significant cause of morbidity and mortality in Western populations. Due to the fact that epithelial cells of colon have an important role in the pathophysiology of cancer, we set up a mechanical method combined with an enzymatic digestion of surgical resections derived from our Clinical Centre to obtain tumoral colon epithelium cell cultures. The cells proliferated under the chosen culture conditions and were maintained for several weeks, including subcultivation steps. We characterised the cell morphology by light and phase contrast microscopes and by immunoistochemistry analysis. Moreover, we also demonstrated the preservation of the secretory function of the cultured cells over the time. This validated model of primary epithelial cells from colon cancer will be used to understand the biological and pathological features of human tumoral colonic cells. This will be done by studying the expression of specific proteins in the tumor and analysing mutations of specific genes in each patient to relate each genetic signature to a precise pharmacological response.

The experience of numerous cases of surgical operations carried out over the ten years from 1990-2000, has meant we have been able to reflect on the fact that the median, ulnar, radial (upper extremity), tibial and external popliteal sciatic (lower extremity) nerves are more greatly exposed to compressive pathology. This is due to certain anatomical topographical relationships with canals, semi-canals, tunnels in well-defined and unchanging sites. From this point of view, a pathology with an etiopathogenic topographical tendency is emerging.

Here are analysed personal observation about high duplication of median nerve at the wrist. Here are reported 18 cases on 3300 operations for carpal tunnel. The results are compared with the literary casuistry.

The following are observations on 500 consecutive cases of coronary angiographical studies carried out on patients without any case history of myocardial ishcemia. There were 251 males and 249 females. The patients' average age was 45 years old.

Immunohistochemical techniques were used to examine testis biopsy specimens in subjects of different ages, in whom histological examination of the seminiferous tubules revealed a reduction in number, immaturity or absence of germinal elements. Our aim was to detect changes in the expression of the vimentin and cytokeratin (8-18-19) intermediate filaments in Sertoli cells. The use of anti-vimentin antibodies demonstrated intense Sertoli cell positivity in all the cases studied, confirming that germinal alterations do not interfere with the expression of these filaments. The Sertoli cells of the subjects affected by pathological conditions also reacted positively to anti-cytokeratin antibodies. This finding was constant in all the testes, showing evident signs of germinal immaturity. In contrast, anti-cytokeratin positivity was not observed in the control specimens after the pre-pubertal stage. Our findings show that persisting co-expression of vimentin and cytokeratin filaments in the Sertoli cells of productive subjects may be a marker of germinal cell degeneration.

An immunohistochemical method was used to study the structural characteristics of the epithelium of the bladder trigone in 20 premenopausal women. Fragments of mucosa were obtained by cystoscopy from the trigones of the 20 subjects. Monoclonal antibodies (34 beta E12 and 34 beta B4) were used to demonstrate the presence of stratified squamous epithelium-specific cytokeratins in these samples. Based on our results, we believe that the frequent finding of stratified squamous epithelium in the trigone of the female bladder is a consequence of the stimulation of estrogen, which is believed to act on the trigone, but not on the rest of the bladder. This may be due to the complex histogenesis of the bladder. Embryologically, the trigone derives from the mesoderm, while the rest of the bladder derives from the endoderm.