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Estrogens are recognized as neuroprotective and neurotrophic agents in the central nervous system. They are involved in neuronal differentiation and survival and promote neural development. Estrogen receptors alpha (ER-alpha) and beta (ER-beta) are predominantly expressed in neurons, whereas their presence in glial cells in vivo is more controversial. Changes in their expression during development have been described in different brain areas, but little is known about their presence in the spinal cord. We have carried out an immunohistochemical study in an attempt to analyze the expression of both ERs in astrocytes and oligodendrocytes of the rat spinal cord and their modifications during postnatal development. RT-PCR analysis of whole spinal cord extracts from 4-, 12-, and 25-day-old and adult rats indicated changes in the expression of both receptors during maturation. Immunohistochemistry of slices of the lumbar tract revealed that in an area of the ventral spinal cord that does not contain neuronal cell bodies, but mainly fibers and glial cells, both ER-alpha and ER-beta can be detected. Immunostaining is clearly nuclear, and, in the case of ER-alpha, both markedly positive and weakly labeled cells can be identified. ER-alpha is expressed during early development to progressively decline in the adult stage. In contrast, the ER-beta signal is low and peaks at postnatal day 25, whereas it is almost undetectable at other ages. Colocalization studies revealed that, at postnatal day 25, ER-alpha and ER-beta are expressed in astrocytes (identified by the specific marker glial fibrillar acidic protein) and oligodendrocytes (labeled by antimyelin 2',3'-cyclic nucleotide 3'-phosphodiesterase). The present results confirm the expression of ER-alpha and ER-beta in glial cells in vivo and suggest that, also in the spinal cord, glial cells may contribute to the effects of estrogen during development., (Copyright 2003 S. Karger AG, Basel)

Background: In the last years the real innovation in the treatment of groin hernia is represented by tension-free hernioplasty under local anaesthesia, based on the techniques of Lichtenstein and Trabucco, which use synthetic prosthesis (polypropylene) to restore the floor of inguinal tract and enable an early deambulation and return to work., Methods: In 21 months the authors have treated, only under local anaesthesia, 100 patients, 95 men and 5 women; the age ranged from 18 to 82 years; some of them suffer from systemic pathology (7 patients with cardiovascular diseases, 1 with epilepsy, 3 with pulmonary diseases, 1 with liver cirrhosis). All patients underwent short-term antibiotic prophylaxis. No mortality was recorded. The mean follow-up was 12.5 months with only one little and low recurrence detected., Results: Good results were obtained also in terms of intraoperative complication (nausea, vomiting, bradycardia, pain) and post-operative complications, (ecchymosis of scrotum and penis, edema of the scrotum, swelling of the skin suture, subcutaneous hematoma, inguinal pain, fever), not life-threatening, well tolerated and resolved spontaneously., Conclusions: The authors stress the advantages of local anaesthesia, the economic spare due, to one day hospital stay, the safety of the technique also in patients with severe general diseases (0.9-1% in USA). The authors survey the international literature confirming the great effectiveness of tension-free inguinal hernioplasty, in particular in terms of recurrences (Trabucco 0-0.025%, Amid 0.1%).

Using a diagnostic technique allowing thermal variations of the body surface to be translated into pictures by remote recordings (telethermography), the Authors studied a group of patients suffering from peripheral arteriopathies. The patients were also subjected to other tests (oscillography, pletysmography, electrothermometry, arteriography). The diagnostic reliability of the telethermographic procedure in the cases studied was 80% (8 cases out of 10), with 20% of false negatives. Even in the two falsely negative cases, however, the investigation proved useful, since it allowed the improvement obtained with medical and surgical therapy to be evaluated. The Authors therefore conclude by asserting that telethermography is an effective diagnostic means because of the reliability of the results and its simplicity in use, as well as being non-traumatic and hence easily repeatable.

16 patients suffering from acute pancreatitis were treated by intramuscular or intravenous administration of glucagon, with control of the amylasemia and amylasuria values at the start of treatment, the 12th hour and the 36th hour. By the 12th hour from the start of therapy they already observed a reduction in amylasemia and amylasuria to normal values, with disappearance of the symptomatology (pains, vomiting, shock) and complete cure of the patients in 94% of cases. On the basis of their own and others' experience, the Authors therefore believe that glucagon can advantageously be used in this disease, which is characterised by much higher mortality if treated with the traditional therapeutic means.

The authors review several existing classifications of traumatic events affecting the peripheral blood vessels; after discussing the symptoms of such events and diagnostic guidelines, they outline therapeutic approaches and emphasize above all the need for prompt surgery with the least possible delay after the injury. They review of cases of their own observation, and conclude by highlighting the basic concepts of modern surgery in this field of pathology.