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Urinary excretion of type I collagen cross-linked aminoterminal telopeptide (NTx) is a specific index of bone resorption. The Authors have studied urinary NTx concentrations in 60 urine samples of preterm infants, from 32 to 36 weeks of gestation, to evaluate the trend of the bone marker in the first week of life. Urine samples were collected at 1, 3 and 7 days of life. NTx was measured by ELISA (OSTEOMARK) and the values expressed in nmol Bone Collagen Equivalent (BCE)/mmol u-creatinine and the mean values (+/- 1 SD) were compared by ANOVA. NTx levels showed a progressive increase from 1 to 7 days of life in every group (P = 0.002 at 32, 0.040 at 33, 0.019 at 34, 0.010 at 35 and 0.000 at 36 weeks of gestation). Moreover, by comparing the mean values in every day (1st, 3rd and 7th) in the whole period under investigation, significant variations were noticed at 1 and 7 days (P = 0.045 and P = 0.021) and highly significant variation on the 3r day (P =0.000). We found a inverse relationship between gestational age and NTx concentrations, with significantly higher values in preterm infants of 32-34 weeks compared to those found in the following weeks of life and to those of full term infants. Preterm infants have a higher bone turnover rate that seems to be responsible of the major risk of osteopenia. In conclusion, the trend of NTx at different gestational ages reflects the peculiar balance of mineral metabolism. The unexpected interruption of nutritional supply and of mineral triggers the turbulent combination of processes of bone formation and especially of bone resorption, that becomes more evident as more premature is the delivery.

Background and Objectives: Twenty five percent of patients who undergo radical surgical treatment for colorectal cancer have occult hepatic metastases that become evident during the follow-up period. We evaluated whether biliary carcinoembryonic antigen (CEA) measurements could be used in these patients to diagnose occult hepatic metastases., Methods: Three groups of patients were enrolled in the study. The first group consisted of patients treated for lithiasis of the common bile duct, the second group was affected by colorectal cancer and evident hepatic metastases, and the third group of patients underwent radical surgical treatment for colorectal cancer but had no evident hepatic metastases., Results: In the first study group, mean biliary CEA level was 0.52 ng/mL (normal value: 0-5 ng/mL) (diagnostic accuracy: 100%), 83.3 ng/mL in the second group (diagnostic accuracy: 91%) and 3.9 ng/mL in the third group. We registered only one false-positive result in the third group, whereas biliary CEA level was above normal values in the three patients in whom hepatic metastases developed (diagnostic accuracy: 89.5%)., Conclusions: This study suggests that biliary CEA determination could represent an important method to select patients affected by occult hepatic metastases for inclusion in appropriate treatment protocols., (Copyright 2002 Wiley-Liss, Inc.)

The Authors have studied urinary aminoterminal telopeptide of type I collagen (NTx), a bone catabolism marker of recent determination, by an enzyme-linked immunoassorbent assay (OSTEOMARK) in 80 urine samples of term healthy infants in the first 3 months of life. Highly significant variations have been compared in the whole period studied (P = 0.000). Levels of NTx increase significantly from 1 to 7 days of life, reaching a plateau that is kept until 45th day and then significantly decrease until 90th day, when, however, they result higher than the values reported in literature concerning older ages. The Authors conclude that even this bone catabolism marker is influenced, in the first week of life, by the particular phenomenology linked to the neonatal adaptation, and that, subsequently, shows a trend strictly linked to the bone turnover modifications throughout the faster stage of the growth.

The results of a study conducted to determine the usefulness of carcinoembryonic antigen (CEA) monitoring in the follow-up of patients with resected colorectal cancer are reported herein. The subjects of this study were 125 patients in whom CEA had been determined preoperatively and 239 patients in whom CEA had been monitored postoperatively. The results revealed increased preoperative CEA in only 24% of the subjects, and that this increment was correlated with subsequent more advanced tumor stage and a higher recurrence rate (P < 0.01). The postoperative CEA level exceeded the threshold in 71% of the patients affected by recurrence, 94.4% of whom developed liver metastases and 50%, nonhepatic recurrence. This marker showed elevated sensitivity for liver metastases (99%), whereas the sensitivity was lower for nonhepatic recurrence of the disease (94%). Thus, we concluded that CEA monitoring can be useful for preoperative colorectal tumor grading, even if its validity in the early diagnosis of recurrence is problematic, especially in terms of radical repeated surgery and survival.

The Authors have studied the role of various preventing diet for a primary prophylaxis of allergy in 125 newborns at risk of atopy: 30 exclusively breast-fed, 50 hypoallergenic milk fed, 30 soy milk fed, and 15 with conventional milk formula. IgE values were determined at 5 days, 6 months, and 12 months of age, IgE values at 5 days were compared to newborns not at atopic risk. The clinical follow-up lasted 4 years. Total IgE values at 5 days were significantly higher in new-born at atopic risk. Only breast-feeding subjects had IgE normal values at six months. Allergic symptoms were observed in 14% of infants with a guided diet and in 53% of infants with a conventional diet. Breast fed subjects had atopic disorders in only 8% of cases, subjects with hypoallergenic formula in 12% while soja milk fed in 25%. The Authors stress the role of breast feeding in preventing allergic disorders in subjects at atopic risk or, when human milk misses, of a hypoallergenic formula, more than soy milk and conventional formula and confirm the possibility of diet and ambiental prophylaxis of allergy.

The authors describe a two months aged patient affected by cow's milk protein intolerance (CMPI) with serious haemorrhagic manifestations. As blood coagulative laboratory findings demonstrated a prolongation of P.T. and P.T.T. with a marked reduction of vitamin K-dependent factors only, the authors believe these bleeding manifestations secondary to a case of late haemorrhagic disease of the newborn. Vitamin K treatment determined a rapid normalization of haemorrhagic symptoms and laboratory clotting tests, without any alteration of these ones during the patient's follow-up too. The authors suggest that blood coagulative pattern must be investigated in all CMPI cases, especially in the ones with a precocious onset of clinical symptoms. In the cases with vitamin K-dependent factors deficiency the treatment is immediately necessary, while in other cases a daily dietary supplementation or a vitamin K weekly or monthly injection could be enough in order to prevent any further vitamin K-dependent factors deficiency.

During a screening examination for orthodontic evaluation and for possible partial anodontia, a large radiopaque mass was found in the right maxillary sinus of a 12-year-old boy. Further radiographic views were used to locate and establish a working diagnosis. The mass was removed with use of a standard Caldwell-Luc approach. It was diagnosed histologically as a complex odontoma.

Stimulation of inositol phospholipid hydrolysis by norepinephrine or 5-hydroxytryptamine was reduced in hippocampal or cortical slices from rats repeatedly injected with (Asu1.7)eel-calcitonin (2.5 IU/kg i.p.). This effect was specific, as the basal or carbamylcholine-stimulated inositol phospholipid hydrolysis was unchanged in slices from calcitonin-injected animals. The reduced responsiveness to norepinephrine did not reflect a decreased number or affinity of alpha 1-adrenergic recognition sites, suggesting that calcitonin treatment leads to a reduced coupling between alpha 1-adrenoceptors and phospholipase C.