Detection of human herpesviruses 6 and 7 in heart transplant recipients by a multiplex polymerase chain reaction method

In order to evaluate the possible reactivation of human herpesviruses 6 (HHV-6) and 7 (HHV-7) after heart transplantation, buffy-coat and plasma specimens from 21 transplant patients and 56 healthy blood donors were examined for HHV-6 and HHV-7 DNA by polymerase chain reaction. Human herpesvirus 6 and HHV-7 infection or reactivation has been suggested to play a role in cytomegalovirus disease progression in renal transplant recipients. In the present study, however, no significant difference in the prevalence of HHV-6 and HHV-7 was found between the immunosuppressed and the healthy population; moreover, no viral reactivation was found in the heart transplant recipients.

[Benign ulcers of the cecum]

Benign ulceration of the cecum is an uncommon lesion that was originally described by Cruveilhier in 1832. Etiology is unknown and symptomatology not pathognomonic. Pre-operative and intraoperative diagnosis is rare and difficult. Definitive diagnosis is usually obtained by histologic evaluation of the surgical specimen after a right hemicolectomy performed for a suspect of a neoplasm of the cecum. The authors present 7 cases of cecal ulcers and suggest that preoperative diagnosis may be due after a colonoscopy with biopsy. This examination may be performed only in that cases that appear without symptoms of acute abdomen. The authors suggest also to perform right hemicolectomy.

1,25-dihydroxyvitamin D3, transforming growth factor beta1, calcium, and ultraviolet B radiation induce apoptosis in cultured human keratinocytes

Apoptosis is a cellular process of self-directed suicide that plays a key role during morphogenesis and in the maintenance of homeostasis in continuously renewing tissues. Currently, apoptosis is detected mainly by gel electrophoresis of fragmented DNA and by typical ultrastructural features such as cell shrinkage and chromatin condensation. Recently, an in situ technique was developed that allows the detection of the apoptotic process in cells and the quantitation of apoptosis in cell populations. We applied this technique to evaluate the apoptotic process in cultured normal human keratinocytes under basic conditions and after stimulation with factors and agents that are presumed but have never been proved to induce apoptosis in these cells. Apoptosis was analyzed after stimulation with 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], transforming growth factor beta1 (TGFbeta1), calcium, UVB, or tumor necrosis factor alpha (TNFalpha). All these factors except TNFalpha induced apoptosis in human keratinocytes. Whereas UVB and calcium were good apoptogenic stimuli at 6 and 24 h, respectively, the vitamin D derivative and TGFbeta1 induced apoptosis after 5 and 6 d in culture. Apoptosis was also established by DNA fragmentation and electron microscopy. Finally, TUNEL technique showed that the number of apoptotic cells increases slightly (5-10%) from 24 to 144 h even in untreated keratinocytes. Our studies indicate that factors normally involved in the regulation of cell growth and differentiation can also control apoptosis.

The sequence of a 8 kb segment on the right arm of yeast chromosome VII identifies four new open reading frames and the genes for yTAFII145

We report the sequence of a 8,061 bp fragment of Saccharomyces cerevisiae chromosome VII. Five open reading frames (ORFs) of at least 100 amino acids were identified. Three show similarities to the amino-acid sequence of known gene products. ORF G9374 corresponds to the gene coding for the yTAFII145 protein: a TBP-associated factor whose amino-acid sequence was previously reported (Reese et al., 1994). The remaining ORF does not display similarities to known sequences.

Peak velocity of the outflow tract of the aorta: correlations with acid base status and oxygenation of the growth-retarded fetus

OBJECTIVE

To correlate the peak velocities of the aortic outflow tract of growth-retarded fetuses with fetal acid base status and oxygenation measured in utero.

METHODS

Thirty-one growth-retarded fetuses with abnormal umbilical pulsatility index (PI) measurements underwent fetal blood sampling. Blood pH, carbon dioxide pressure (PCO2), oxygen pressure (PO2), oxygen saturation, lactate concentration, and hemoglobin concentration were measured. Using color Doppler equipment, we measured the peak velocities of the outflow tract of the aorta, pulmonary artery, and ductus arteriosus before fetal blood sampling.

RESULTS

The peak velocities measured in the outflow tract of the aorta, pulmonary artery, and ductus were significantly lower in growth-retarded fetuses than in 140 normal fetuses of comparable weight. The correlation observed between pulmonic and aortic peak velocities was significant (r = 0.84), as was that between pulmonic and ductal peak velocities (r = 0.74). Growth-retarded fetuses with abnormal aortic peak velocities had significantly lower values of PO2, oxygen content and pH, and had higher lactate concentration and PCO2 than did growth-retarded fetuses with normal peak velocities. Estimated fetal weight and umbilical PI (mean +/- standard deviation) were not significantly different in these two groups. Moreover, significant direct correlations were found between proximal aortic peak velocities and lactate concentrations (correlation coefficient 0.71, P < .0001) and O2 content (P < .02, r = 0.42).

CONCLUSION

For growth-retarded fetuses, Doppler peak velocity in these vessels is significantly lower than in normal fetuses of comparable weight. Aortic, pulmonic, and ductal peak velocity correlated significantly. Growth-retarded fetuses with abnormally low peak velocity in the outflow tract of the aorta have a higher risk of acidemia and hypoxia than those with normal velocities.

Transforming growth factor-beta 1 modulates beta 1 and beta 5 integrin receptors and induces the de novo expression of the alpha v beta 6 heterodimer in normal human keratinocytes: implications for wound healing

The molecular mechanism underlying the promotion of wound healing by TGF-beta 1 is incompletely understood. We report that TGF-beta 1 regulates the regenerative/migratory phenotype of normal human keratinocytes by modulating their integrin receptor repertoire. In growing keratinocyte colonies but not in fully stratified cultured epidermis, TGF-beta 1: (a) strongly upregulates the expression of the fibronectin receptor alpha 5 beta 1, the vitronectin receptor alpha v beta 5, and the collagen receptor alpha 2 beta 1 by differentially modulating the synthesis of their alpha and beta subunits; (b) downregulates the multifunctional alpha 3 beta 1 heterodimer; (c) induces the de novo expression and surface exposure of the alpha v beta 6 fibronectin receptor; (d) stimulates keratinocyte migration toward fibronectin and vitronectin; (e) induces a marked perturbation of the general mechanism of polarized domain sorting of both beta 1 and beta 4 dimers; and (f) causes a pericellular redistribution of alpha v beta 5. These data suggest that alpha 5 beta 1, alpha v beta 6, and alpha v beta 5, not routinely used by keratinocytes resting on an intact basement membrane, act as "emergency" receptors, and uncover at least one of the molecular mechanisms responsible for the peculiar integrin expression in healing human wounds. Indeed, TGF-beta 1 reproduces the integrin expression pattern of keratinocytes located at the injury site, particularly of cells in the migrating epithelial tongue at the leading edge of the wound. Since these keratinocytes are inhibited in their proliferative capacity, these data might account for the apparent paradox of a TGF-beta 1-dependent stimulation of epidermal wound healing associated with a growth inhibitory effect on epithelial cells.

In vitro infection of human epidermal Langerhans' cells with HIV-1

Epidermal Langerhans' cells (LC) from human immunodeficiency virus type-1 (HIV-1)-infected patients harbour HIV-1 proviral DNA and RNA. In the present study, we investigated whether LC from epidermis of normal, HIV-seronegative subjects could be infected in vitro with HIV-1. Epidermal cells (EC) spontaneously detached from epidermal sheet cultures were enriched for LC (10-25% of CD1a+/CD4+ cells), deprived of contaminating T cells and then incubated with HIV-1IIIB. After 24 hr, purified LC and LC-depleted EC fractions were obtained by immunomagnetic separation. Polymerase chain reaction (PCR) analysis showed the presence of HIV-1 proviral DNA (gag) only in purified LC. In addition, LC-enriched EC, purified LC, LC-depleted EC or the non-permissive cell line, TF-1, the latter having being previously challenged with HIV-1IIIB for the same length of time as the EC, were co-cultivated with C8166 cells, and the co-cultures assessed for the presence of HIV DNA by PCR. Co-cultures of C8166 cells with purified LC or LC-enriched EC previously exposed to HIV-1IIIB exhibited a time-dependent increase in HIV proviral DNA. In contrast, PCR analysis of C8166 cells co-cultured with either LC-depleted EC or TF-1 cells gave negative results. Finally, C8166 cells co-cultured with HIV-infected LC formed syncytia, showed membrane budding and released numerous retroviral particles. The results indicate that LC from normal subjects can be infected in vitro with HIV and can transmit infection to myeloid cells. This in vitro model may help in understanding the regulation of HIV infection of LC.

Spatial discontinuities in human immunodeficiency virus type 1 quasispecies derived from epidermal Langerhans cells of a patient with AIDS and evidence for double infection

A nonhomogeneous spatial distribution of human immunodeficiency virus type 1 quasispecies was observed for epidermal Langerhans cells purified from skin patches taken from a patient with AIDS soon after death. Each patch presented a unique collection of sequences, distinct from those of juxtaposed patches or those derived from the other leg. Infection of Langerhans cells by virus from underlying T cells in the dermis might explain this partition. The analysis revealed the presence of two distinct cocirculating viral strains, indicating double infection.

Quantitation by competitive PCR of HIV-1 proviral DNA in epidermal Langerhans cells of HIV-infected patients

Langerhans cells (LC) belong to the dendritic cell family and represent the principal antigen presenting cells populating squamous epithelia. We have reported the presence of human immunodeficiency virus Type 1 (HIV-1) proviral DNA and RNA in purified LC from the epidermis of seropositive patients. The aim of this study was to quantify HIV-1 proviral DNA in LC of infected patients using a competitive polymerase chain reaction (PCR) assay. Bulk epidermal cell (EC) suspensions were obtained from the skin of nine AIDS patients and six seronegative subjects. Purified LC and LC-depleted EC were prepared by immunomagnetic separation using an anti-CD1a monoclonal antibody. LC preparations did not contain T cells, as assessed by reverse transcription PCR analysis of the T cell receptor beta-chain gene (C region). In addition, no CD14+ cells could be detected in LC fractions by immunostaining of cytospin preparations. To quantify HIV-1 DNA, a new competitive PCR system was devised using SK145/150 as primers (gag) and a competitor plasmid DNA with a modified sequence (209 instead of 142 bp). The number of HIV-1 DNA copies found in the LC of AIDS patients ranged from 107 to 3,645/10(5) LC. In contrast, LC-depleted EC from the same subjects were all negative. The results indicate that in AIDS patients the frequency of infected LC is comparable to that reported for peripheral blood CD4+ T cells.

Distinctive integrin expression in the newly forming epidermis during wound healing in humans

The integrin receptor family plays a fundamental role in mediating cell attachment to a variety of extracellular matrix molecules. In normal human epidermis, the alpha 2 beta 1, alpha 3 beta 1, alpha 6 beta 4, and alpha v beta 5 integrin heterodimers are expressed and appear largely confined to the basal cell layer. In the present study, beta 1, beta 4, and alpha v integrin expression in the epidermis during wound healing in humans was examined. Punch biopsies were performed on healthy volunteers. At daily intervals up to day 8, and at days 11, 14, 21, and 28, the wound site was surgically removed. Using immunofluorescence microscopy, several modifications of the integrin expression pattern were observed on migrating keratinocytes during the re-epithelialization phase of the wound-healing process: i) alpha v expression was strongly enhanced and polarized at the basal pole of basal keratinocytes; ii) among the beta 1 integrins, alpha 3 beta 1 was overexpressed and distributed over the entire basal keratinocyte membrane and a weak alpha 5 beta 1 reactivity became evident; and iii) alpha 6 beta 4 was detected as a linear staining along the newly forming dermal-epidermal junction. Moreover, both during the re-epithelialization phase and during the first 2 weeks after wound closure, alpha 3, alpha 6, alpha v, beta 1, and beta 4 were no longer confined to the basal layer, as in normal epidermis, but were also found on several suprabasal cell layers. These results suggest that alpha v beta 5, alpha 3 beta 1, and alpha 5 beta 1 may be the main integrin receptors mediating keratinocyte spreading and migration over the provisional matrix of the wound bed.

Free radical production during metabolism of organic hydroperoxides by normal human keratinocytes

Evidence of a relationship between tumor production induced by various organic (hydro)peroxides and free radical formation has been shown in cultured murine keratinocytes and human skin-tumor cell line. In the present study the bioactivation of cumene hydroperoxide, t-butyl-hydroperoxide, and benzoyl peroxide via one-electron oxidation or reduction was compared in freshly isolated and in cultured normal human keratinocytes. The formation of methyl free radicals during the metabolism of cumene and t-butyl-hydroperoxide was shown by the electron spin resonance-spin trapping technique. Radical formation increased under hypoxic conditions. An intracellular activation site was demonstrated by the use of two spin-trapping agents, the hydrophilic, membrane-impermeable, 3,5-dibromo-4-nitrosobenzenesulfonic acid and the lipophilic, membrane-permeable alpha-(4-pyridyl-1-oxide)-N-t-butylnitrone. At 30 min incubation and 25 mM concentration, hydroperoxides exhibited cytotoxicity, as indicated by trypan blue exclusion and lactate dehydrogenase release assay; free radicals were concurrently trapped. Hydroperoxides at a lower concentration (1 mM) did not significantly affect cell viability. However, free radical production was still detected using a membrane-permeable spin trap. The incubation of keratinocytes with benzoyl peroxide did not show any peroxide-dependent radical adduct. No significant differences in bioactivation capability were demonstrated between freshly isolated and cultured human keratinocytes. The results indicate that cultured human keratinocytes can be used as a model system for the study of the metabolic activation to free radical intermediates of toxic and carcinogenic compounds in the epidermis.

Phosphatidylserine enhances the ability of epidermal Langerhans cells to induce contact hypersensitivity

Phosphatidylserine (PS) modulates several immune functions in vitro, including T cell activation, antibody and cytokine production, and macrophage growth. In the present work we studied the effects of PS on the induction of contact hypersensitivity (CH) in mice. BALB/c mice painted with PS (9.4-75 mg/kg) and with a sensitizing dose of DNFB or oxazolone on the same skin site exhibited a dose-dependent augmentation of CH reactions to either DNFB (&gt; 60%) or oxazolone (&gt; 35%), respectively. Bovine brain PS-enriched phospholipid mixture, lyso-PS, and dipalmitoyl-PS also induced similar enhanced CH responses, whereas phosphatidylglycerols had no effect. Increased CH was observed only when PS was applied from 2 days before to 12 h after DNFB. Immunization of naive syngeneic mice with skin grafts that were treated with PS and DNFB also led to enhanced (&gt; 50%) CH responses. In addition, immunization by iv injection of epidermal cell suspensions enriched for Langerhans cells (LC) or of purified LC that were treated with PS (1-100 microM, 30 min, 37 degrees C), and then modified in vitro with DNBS (1 mg/ml, 30 min, 37 degrees C) led to increased (&gt; 30-75%) CH responses in recipient syngeneic animals. Finally, adoptive transfer of DNFB-immune lymph node cells obtained from mice that were treated with PS induced augmented CH responses in recipient animals. The results suggest that PS is capable of up-regulating the induction of CH in mice by stimulating the APC function of epidermal LC.

Phosphatidylserine enhances the ability of epidermal Langerhans cells to induce contact hypersensitivity

Phosphatidylserine (PS) modulates several immune functions in vitro, including T cell activation, antibody and cytokine production, and macrophage growth. In the present work we studied the effects of PS on the induction of contact hypersensitivity (CH) in mice. BALB/c mice painted with PS (9.4-75 mg/kg) and with a sensitizing dose of DNFB or oxazolone on the same skin site exhibited a dose-dependent augmentation of CH reactions to either DNFB (> 60%) or oxazolone (> 35%), respectively. Bovine brain PS-enriched phospholipid mixture, lyso-PS, and dipalmitoyl-PS also induced similar enhanced CH responses, whereas phosphatidylglycerols had no effect. Increased CH was observed only when PS was applied from 2 days before to 12 h after DNFB. Immunization of naive syngeneic mice with skin grafts that were treated with PS and DNFB also led to enhanced (> 50%) CH responses. In addition, immunization by iv injection of epidermal cell suspensions enriched for Langerhans cells (LC) or of purified LC that were treated with PS (1-100 microM, 30 min, 37 degrees C), and then modified in vitro with DNBS (1 mg/ml, 30 min, 37 degrees C) led to increased (> 30-75%) CH responses in recipient syngeneic animals. Finally, adoptive transfer of DNFB-immune lymph node cells obtained from mice that were treated with PS induced augmented CH responses in recipient animals. The results suggest that PS is capable of up-regulating the induction of CH in mice by stimulating the APC function of epidermal LC.

[A comparison between phase-contrast optical microscopy and scanning electron microscopy for the analysis of air-borne asbestos fibers in an office environment]

There is no general agreement on the relationship between results obtained by optical microscopy (PCOM) and electron scanning microscopy (SEM) or electron transmission microscopy (TEM) for airborne asbestos fibres. However, a considerable amount of data has been produced in latter years indicating that a general correlation factor, not differing greatly from unity, can be established between the two analytical techniques if counts are limited to fibres longer than 5 microns. A study was made of the relationship between SEM and PCOM when used simultaneously for determination of background concentrations of asbestos in office buildings. Twenty-four couples of samples were collected in parallel for PCOM and SEM in different locations distributed over the various floors of two buildings containing amosite sprayed on structural parts. Asbestos and total fibre counts by SEM were performed following the Verein Deutscher Ingenieure (VDI) method 3492. For total fibre counts the European PCOM method was mainly used. Discrimination of asbestos from non-asbestos fibres was performed using criteria based on birefringence and morphological characteristics of fibres. Counts included only those fibres longer than 5 microns, diameter less than 3 microns and aspect ratio greater than 3. Both total fibres and asbestos fibres were recorded separately by PCOM and SEM. the arithmetic and geometric means of the ratio between PCOM and SEM were 1.3 and 1.1 respectively for total fibres and 1.2 and 1.1 for asbestos fibres (excluding one outlying value). The regression study showed a significant linear correlation (P = 0.01) with correlation coefficients of 0.84 for asbestos fibres and 0.52 for total fibres.

Direct detection of HIV-1 RNA in epidermal Langerhans cells of HIV-infected patients

Human Langerhans cells (LC) are bone marrow-derived, HLA-DR+, CD1a+, and CD4+ dendritic antigen-presenting cells found in stratified squamous epithelia. As other members of the dendritic leukocyte family, to which they belong, LC have been reported as targets for HIV-1 infection. The aim of the present study was to investigate whether HIV-1 RNA is expressed in epidermal LC of HIV-1-infected patients. Bulk epidermal cell (EC) suspensions were prepared from skin of nine recently deceased AIDS patients and 11 seronegative controls. Purified LC (94 +/- 4% HLA-DR+ cells with no CD3+ cells, as assessed by flow microfluorimetry analysis) and LC-depleted EC were obtained by immunomagnetic separation using an anti-CD1a monoclonal antibody. Samples were analyzed for the presence of HIV-1 RNA by reverse transcription of a spliced mRNA region of the tat gene, followed by polymerase chain reaction amplification. HIV-1-spliced RNA was detected in LC from 6 of 9 patients examined, whereas LC-depleted EC fractions from the same patients were all negative. The results indicate that epidermal LC from HIV-seropositive patients actively transcribe HIV-1 proviral DNA, further supporting the hypothesis that HIV productively infected LC could serve as a reservoir of the virus in the epidermis and as a source for the infection of T lymphocytes.

Study of the count-to-mass conversion factor for asbestos fibres in samples collected at the emissions of three industrial plants

Count-to-mass conversion factors for asbestos fibres in the stack emissions of three industrial plants were calculated. Dust samples deriving from different working processes were collected downstream from the fabric-based filtration systems. Gravimetric measurements were carried out utilizing an X-ray diffraction procedure based on the use of a silver filter that permits the correction for X-ray absorption by the sample. The number of fibres covered by regulations ('Regulated fibres') (F) was counted by phase-contrast optical microscopy (PCOM) on a section of the same filter as had been used for gravimetric measurements. The values of the conversion factors vary widely, ranging from 0.4 x 10(3) to 4.9 x 10(3) fibers per microgram (F microgram -1) according to the working process involved. They are always less than 20 x 10(3) F microgram -1, the value specified in the EEC Directive 217/87 concerning the prevention of asbestos pollution in the environment.

Detection of HIV-1 in epidermal Langerhans cells of HIV-infected patients using the polymerase chain reaction

Langerhans cells (LC) are bone marrow-derived, HLA-DR+, CD1a+, dendritic antigen-presenting cells found in stratified squamous epithelia. Within resident epidermal cells (EC), LC are the only cells expressing the CD4 antigen and are, therefore, a possible target for human immunodeficiency virus (HIV) infection. To date, conflicting results have been reported on the in vivo infection of LC by HIV. The aim of the present study was to investigate the presence of HIV-1 proviral DNA in epidermal LC of HIV-1-infected patients. EC suspensions were prepared from clinically normal skin of nine seropositive patients. Purified LC and LC-depleted EC were obtained by immunomagnetic separation and analyzed for the presence of HIV-1 proviral DNA by the polymerase chain reaction using primer pairs from different conserved regions (env and gag) of the HIV-1 genome. HIV-1 proviral DNA was detected in LC from seven of nine patients. LC-depleted EC fractions from the same nine patients were all negative, with the exception of one case. Altogether these results demonstrate that epidermal LC are infected by HIV-1 and constitute the only resident cell type in the epidermis harboring the virus. Further studies are, however, needed to demonstrate HIV replication in LC and to elucidate the functional role of LC in this infection.

Reciprocal compression between the axillary artery and brachial plexus

Angiographic studies were performed on 60 of 394 patients diagnosed as having thoracic outlet syndrome. Ten of the patients studied angiographically presented with obstruction of contrast material in the axilla with refilling of the axillary artery through the external mammary and shoulder arteries. The obstruction was caused by lower trunk brachial plexus compression. This seldom known cause of hyperabduction syndrome occurred in 2.5 per cent of the patients examined for thoracic outlet syndrome. Surgical treatment consists of loosening the axillary artery by tying off the external mammary and circumflex arteries, followed by section and anastomosis of the axillary artery anteriorly to the brachial plexus. Angiography is considered a basic diagnostic procedure, mainly when concomitant compression occurs and gives good dynamic information on the location and importance of the compression.

The use of bovine pericardium as an arterial graft. A 5-year follow-up

From June 1980 to June 1985, 42 patients were subjected to patch graft angioplasties using glutaraldehyde tanned bovine pericardium. Life-table analysis showed a 100% patency in the grafted areas. Histological studies made on specimens recovered at 7 and 19 months showed no major deterioration of the original structure. Fibrous cell infiltration was not extensive enough to be harmful. Elastic fibers were relatively preserved, with some dissociation. No endothelialization, infection, thrombosis, or aneurysm dilatation was detected. Angiographic control up to 37 months showed patency and normal internal surface of the graft. It appears from this study that bovine pericardium is a good alternative as a vascular graft material.

Combined renal and pyelic fusion with crossed ectopia of single ureter

A case of a forty-five-year-old woman with fused kidneys and intercommunicating pelves drained by a single ureter crossing the midline is reported. A review of the literature is presented.

The intraventricular conduction time of fetal heart in pregnancies with suspected fetal growth retardation

Electrocardiographs from 68 fetuses with ultrasound evidence of growth retardation were recorded from the maternal abdomen; QRS duration was measured and compared to normal standards previously obtained in our Institute. Of these fetuses, 54 were small-for-gestational-age at birth and 44 exhibited QRS duration values below -2 SD for their gestational age. All but one of the 14 normal fetuses showed normal QRS values (positive predictive value = 98%; negative predictive value = 57%). Of 11 fetuses with QRS duration values below -4 SD, nine were particularly small, below the 2nd centile of weight for gestation. QRS duration measurements may represent a sensitive method for identifying fetal growth-retardation. The QRS duration also seems to provide a reliable prognosis of perinatal outcome. Normal values are a reassuring factor: abnormal cardiotocographic records were observed in only 2 out of 23 cases and no low Apgar scores or perinatal deaths occurred. QRS values below -4 SD proved to be associated with abnormal cardiotocographic records (7/13), low Apgar scores (5/15) and perinatal deaths (3/15).

Smoking habit in pregnancy and sociodemographic background in six Italian centres

Studies carried out in foreign countries (US and UK, mainly) indicate that maternal characteristics, such as age, parity, social class, and prenatal care, are related to child's growth, mortality, and morbidity, as well as to cigarette smoking. These characteristics may act as confounding variables in the analysis of the effects of maternal smoking on babies in fetal and neonatal periods. Until now there has been a lack of information on the subject, because even the most recent available data concern women over age 14 regardless of obstetric history. This paper deals with smoking habits, before and during pregnancy, of 37,664 women included in a multicenter survey of perinatal preventive medicine (MPPI), which was performed in 6 Italian centres (Trieste, Milan, Parma, Rome, Naples, Bari) between 1973 and 1979, with the financial support of the Italian National Research Council. The results of the MPPI and other surveys are compared and the association between maternal smoking habits and sociodemographic background is investigated by multiple correspondence analysis. As to Italy, unlike UK and US, in the 1970s women of high social status show the highest prevalence of the smoking habit. Moreover, in pregnancy, the large majority gives up smoking, or at least reduces it, mainly in high socioeconomic levels, so that the proportion of pregnant women who keep on smoking over 10 cigaretts per day is very low (0.5-3.8%) and poorly related to sociodemographic factors. Therefore, it seems unlikely that these may exert serious confounding effects on the relationships between smoking in pregnancy and perinatal outcome.

[The megaureter-megabladder syndrome. Apropos of a case]

The authors report the observation of a five year old boy who presents recurrent urinary tract infections with infrequent voiding and without residual urine. Uroradiologic investigations show a megaureter-megabladder syndrome. Pathogenesis and management of this syndrome are then discussed.

Cigarette smoking in pregnancy: relationship to perinatal outcomes in six Italian centres

In this study the relationship of maternal smoking in pregnancy to low birth weight, fetal growth retardation, preterm delivery, and perinatal deaths has been investigated in a sample of 36,544 women with their single newborns, from 6 Italian centers (Triese, Milan, Parma, Rome, Naples, Bari), where a multicenter survey of perinatal preventive medicine (MPPI) was carried out, between 1973 and 1979, with the financial support of the Consiglio Nazionale dell Ricerche. The proportions of babies weighing 2500 g or less, and of babies with birth weight, head circumference or crown-heel length below the 10th centile were similar among nonsmokers and "stopped" smoker mothers, while they increased with increasing smoking levels. As regards head circumference and crown-heel length below the 10th centile, odds ratios are essentially the same before and after adjustment for age, parity, and socioeconomic class (about 1.5 for "1-10CGT" and up to 2.5 for "11+CGT"). Only slight increases have been observed in the odds ratios concerning low birthweight below the 10th centile (about 1.5 for "1-10CGT" and up to 3.5 for "11+CGT") after adjusting for the socioeconomic demographic variables (i.e. mainly removing the favourable effect of high socioeconomic class or low parity, which more frequently characterize smoker mothers). Owing to the lower smokers' frequencies, cigarette smoking estimated attributable risks concerning low birth weight and "small for dates" babies in the MPPI centres (between 4% and 19%) are considerably lower than those estimated in studies carried out in the US or Canada. Data analyzed in the present study do not indicate any relationship between maternal smoking and preterm delivery or perinatal deaths.

Queyrat's erythroplasia of the prepuce: a case-report

A case of Queyrat's erythroplasia of the prepuce is reported. The Authors emphasize the precancerous role of the lesion because of its high frequency of malignant transformation. Local excision appears to be the only adequate form of treatment.