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In this report we describe the case of a young woman with familial adenomatous polyposis who developed metastatic rectal cancer during pregnancy. At diagnosis, we decided to perform a transabdominal laparoscopic adrenalectomy, because of the high risk of bowel obstruction, and to define the origin of the adrenal gland lesion, suspected to be primary on the basis of imaging results. The histological specimen showed a collision tumor between an adrenal metastasis of a rectal tumor and a primary adrenal gland carcinosarcoma. The peculiarity of the case is due not only to its clinical presentation during pregnancy, but also to the presence of this uncommon adrenal collision tumor. A particular challenge for the clinician is to define the priority between these two tumors: the presence of two distinct and colliding aggressive neoplasms poses a problem in the choice of the best therapeutic approach, also given the impossibility to biopsy all metastatic sites. However, we decided to treat the patient as having a metastatic rectal cancer, because we had a solid histological confirmation of metastases.

A multicentric study has been carried out to compare the efficacy and the safety of monocomponent human insulins of different concentration (Novo Actrapid HM U-40 and U-100) in CSII-treated Type 1 diabetics. 15 males, all of whom had been diabetic for at least 2 yr, had been treated by CSII and were skillful in the self-monitoring of diabetes were selected for observation at 3 different clinical centres (Bologna, Chieti and Torino). After a 1-week period of insulin dose optimization, the patients were asked not to modify either basal or pre-prandial insulin infusion during the following 2 weeks in which they were treated alternately by U-40 or by U-100 insulin (7 days for each treatment in random sequence). Each day or at least every other day, patients recorded at home a 9-point blood glucose profile by means of glucose-sensitive strips and photometric reading (Reflocheck System-BOEHRINGER MANNHEIM, FRG). The patients used the microinfuser Miles Microjet Bolus 2 for the U-40 infusion and the same model with appropriate modifications for the U-100 infusion. On the last day of each study period, blood samples were drawn after the pre-breakfast insulin bolus. Paired Student's t-test analyses between blood glucose values obtained with different regimens did not show a significant difference in metabolic control. Similarly no difference could be observed in insulin absorption after an identical bolus of U-40 or U-100 insulin. In conclusion human U-100 insulin seems to be as effective and safe as U-40 and is recommended in order to reduce the size of microinfusers.

The 64 m diameter Sardinia Radio Telescope (SRT) has recently started an early science program using three cryogenic front-ends covering four bands: P-band (305-410 MHz), L-band (1.3-1.8 GHz), high C-band (5.7-7.7 GHz), K-band (18-26.5 GHz). The L- and the P-bands can be observed simultaneously with a single coaxial receiver installed at the primary focus, while a seven beam K-band receiver and a mono-feed high C-band receiver are installed, respectively at the secondary and beam waveguide focus. Additional front-ends are under construction to further expand the telescope observing capabilities. We report on the design and performance of the front-ends already installed on SRT and give an overview of the new ones to be completed in the near future.

CD13/aminopeptidase N is a multifunctional cell surface metalloprotease expressed in myeloid and activated endothelial cells; in epithelial cells of the intestine, liver, and kidney; and in other cells. A growing body of evidence suggests that CD13 has an important role in inflammation and angiogenesis. Furthermore, a CD13 form selectively expressed by the angiogenic endothelium, but not in normal vessels, is recognized by peptides containing the Asn-Gly-Arg (NGR) motif. Because of this property, NGR peptides have been exploited as ligands for the selective delivery of a variety of therapeutic and imaging agents to angiogenic vessels. In this chapter, we discuss the structural and functional properties of NGR peptides and their potential applications as drug delivery systems in diseases with angiogenesis and inflammatory components. In addition, we discuss the experimental evidence suggesting that the asparagine residue of NGR can rapidly undergo deamidation, a spontaneous reaction that changes NGR to isoDGR (an integrin-binding motif), and the potential biological, pharmacological, and toxicological implications of this sequence transition in peptide-drug conjugates.

A multidisciplinary approach to congenital heart diseases in adults is a primary element for modern medicine. The diagnosis of a sinus venosus atrial septal defect is a typical example of disease that requires the different skills of the cardiologist, cardiac surgeon and radiologist. © 2010 Italian Federation of Cardiology.