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Left ventricular non-compaction (LVNC) is a myocardial disease characterized by a two-layered structure typically seen at the apical and lateral left portions of the ventricular myocardium, distal to the papillary muscles. While considered a rare disease, its prevalence in children is increasing due to the increased awareness of this condition and improved resolution of imaging techniques. The etiology is heterogeneous, ranging from inherited conditions to acquired diseases. Although many patients are asymptomatic, some patients may experience adverse events, including heart failure, arrhythmias, or thromboembolic events. Several echocardiographic or cardiac magnetic resonance imaging diagnostic criteria have been proposed for diagnosing LVNC. However, their application in children is significantly limited. This review aims to describe the clinical and genetic characteristics of children with LVNC and discuss the role of the proposed diagnostic criteria.

Retroperitoneal schwannoma is a very rare benign tumour that accounts for only a small percentage of retroperitoneal tumours. The preoperative diagnosis is difficult and the only treatment is complete surgical excision. The authors report their experience with a case of a voluminous retroperitoneal mass in a 42-year- old male patient, incidentally discovered during a diagnostic search for a blunt abdominal trauma. Because of the unclear origin of this mass, the patient underwent periodic radiological and ultrasonographic examinations. Three years later, owing to a slight increase in this mass and vague abdominal discomfort reported by the patient, surgical excision was performed. Histological examination of the surgical specimen revealed an "ancient schwannoma". The patient is alive and well and has had no recurrence in the twenty months since surgery. The authors, after a short discussion of the subject, go on to examine the diagnostic and therapeutic treatments of this rare benign neoplasm, which always arouses lively clinical and scientific interest.

Aim of the Study: The Authors report on a patient personally observed owing to a tumefaction, mimicking a pomelo, located on the posterior chest wall, in the same site of another past surgical operation dating back to four years ago. This tumefaction was clear at the inspection, not aching and hard-elastic at the palpation, mobile synchronously with respiratory movements, but unable to alter respiratory mechanics., Case Report: The patient was subjected to laboratory tests, which showed nothing pathological, and to instrumental tests (RX and TAC of the chest, bony scintigraphy) which showed a roundish solid tumefaction, with no "secondary" interest of bony tissue. In this case, it was executed a posterior-lateral thoracothomy, at the VI intercostal space, in the area circumscribing the past surgical scar. The careful removal of the adhesions between the mass and the costal plane, not without the sacrifice of the periosteum, permitted us the total exeresis. The anatomo-pathological test showed a desmoid fibromatosis (desmoid tumor) extra-abdominal (12.5 x 9 x 5 cm). About this kind of neoplastic masses, the risk of post-surgical relapse is very high; so many Authors consider opportune a radio-chemical adjuvant therapy. In this case, the radical excision allowed the Authors to avoid the post surgery pharmacological treatment and to get no relapses after two years from the operation.

The clinical case reported here concerns a giant lipoma (22 x 12 x 10 cm; 2740 g) located in the distal region of the right thigh, in a subfascial zone. The patient was referred to our department for a relapse of thrombophlebitis of the right lower limb (occurring about two years earlier) and presented a large tumefaction of the mid third of thigh at objective examination, the presumed onset of which dated back about ten years after a traumatic accident. Ultrasonography confirmed the presence of the tumefaction but did not allow us to identify its origin with certainty. Musculoskeletal magnetic resonance imaging, however, revealed a gross expansive lesion closely connected to the distal part of the femur, suggesting its probable benign nature. The mass was totally resected without either muscle section or the sacrifice of periosteum. The histological findings indicated an atypical lipomatous tumour. The therapy of giant lipomas is invariably surgical excision. Nevertheless, the high risk of relapse (which is typical of this kind of neoplastic proliferation) despite radical resection, makes a systematic postoperative follow-up necessary.

This study was conducted from September 2000 to September 2004 on 8 cases of inguinal canal endometriosis. All the patients presented an inguinocrural tumefaction of variable size. In 3 cases (symptomatic endometriosis), the patient's medical history yielded a preoperative diagnosis. In the other 5 cases (asymptomatic endometriosis) we obtained an incidental intraoperative diagnosis. In 2 of these, concomitant frank inguinocrural disease further hampered the preoperative diagnosis, while in the other 3 cases we were oriented towards an inguinal adeno-lymphatic disease. We found no signs of neoplastic transformation in our case series. The histological examination confirmed the diagnosis of endometriosis in all 8 cases, without any atypical cellular signs. From an analysis of the literature we deduced that the worldwide incidence of endometriosis is about 10% of the female population, though it is known that in the vast majority of cases there are few or no symptoms. Even today, despite the routine use of advanced diagnostic and surgical procedures, endometriosis foci are very often identified only incidentally owing to the greater incidence of asymptomatic or paucisymptomatic forms. The aim of our study is to stress the difficulty in diagnosing asymptomatic endometriosis and, above all, to suggest that, in the presence of a concomitant hernial pathology in a woman of child-bearing age, the diagnostic hypothesis of endometriosis should never be disregarded.

The Hartmann procedure has, in emergency colo-rectal surgery, many implications. The decision is based on clinical, radiological, instrumental and pathological findings. The authors report the results of 76 Hartmann's procedures performed between 1986 and 1995 and compare their results with those found in the current medical literature on the topic. In particular, they draw attention to an increased use of this procedures in colo-rectal emergencies; the morbility and mortality rates confirm the severity of the clinical cases that can be treated with this operation. To improve results the authors propose a therapeutic plan that uses a score for stratification of the risk (MPI, APA-CHE II, SSI, Hinchey); so the surgeon can choose the best surgical operation. Finally, the authors underline the importance of the principles of oncology surgery in colo-rectal cancer.

The supernatant of CD8+ cells, isolated from a permanent lymphoblastoid cell clone established from a long term culture of a T cell acute lymphoblastic leukemia, contained two distinct molecules with suppressive activity on PHA1-induced PBMC proliferation. This clone does not produce TNF-alpha, TNF-beta, alpha-IFN, gamma-IFN, IL-1, IL-2 and has not natural killer activity. In the attempt to purify and biochemically characterize the lymphoblastic cell line-derived T-cell SFs, a multi-step chromatographic separation has been used. Two different peaks of biologic activity have been separated by HPLC gel permeation in the range of 100-120 Kd and 75-85 Kd referred to as high molecular weight suppressor factor HMWSF, and low molecular weight suppressor factor LMWSF, respectively. These fractions were then concentrated, dialyzed and further purified by anion exchange HPLC. This chromatographic step allowed us to considerably purify the two SFs. The biologically active fractions derived from the previous chromatographic step were eventually subjected to hydrophobic interaction HPLC (HIC) for final purification. The highly purified material was characterized by polyacrylamide gel electrophoresis in sodium-dodecylsulfate (SDS-PAGE): a single band corresponding to 115 Kd was observed for HMWSF, while LMWSF yielded a single band at 80 Kd. The isoelectric points (pI) of the different SFs was determined by flat-bed isoelectric-focusing: the HMWSF yielded a single band at pI 7.4, while a much lower pI was observed for LMWSF, 3.5-3.6. Studies on temperature lability indicated that both proteins are stable for 3-4 hours at room temperature (RT), 24-36 hours at +4 degrees C and 7-10 days at -80 degrees C.

The aim of the present work is to assess whether reactivation of viral replication occurred in children affected by chronic hepatitis undergoing long term immunosuppressive therapy. 123 serum samples belonging to 25 children were retrospectively evaluated for HBV-DNA and HBeAg. Sera were collected prior to and during the protocol treatment (steroids alone or with azathioprine). Presence of HBV-DNA was evaluated by means of molecular hybridization technique, using a radiolabelled probe of cloned HBV-DNA. Sera (100 1) were denatured and transferred into nylon membrane (spot) then prehybridized and hybridized. After washing in stringent conditions, the filter was exposed in autoradiographic cassette with Kodak film XOmat5. Positivity was semiquantitatively evaluated by blackening of the spot. Increase or appearance of HBV-DNA was observed in the sera from 24/25 pts. HBeAg became positive in 4/5 pts previously negative. Obtained data shows reactivation of viral replication during immunosuppressive therapy. Data are especially significant in those cases in which such activity has apparently ceased or not been detected; HBV may be considered as a latent virus.