Stability of resveratrol over time and in the various stages of grape transformation

Research has been carried out with the purpose of verifying whether the resveratrol content in the skins or pomace of grapes stored for a long period of time without any particular protection with regard to temperature and humidity, could lead to a reduction of the content of this product detected at the beginning of the processing of grapes in vinification procedures. The dosages carried out both on the grape skin and on the pomace taken after fermentation and stored for a certain period of time, as well as on the products derived from alcoholic distillation, did not show the expected alterations in resveratrol content, considering their storage in bad environmental conditions for a long period of time. The results obtained confirm that resveratrol, unlike anthocyanins and other polyphenols, is stable and stores well over time.

Nephrotic syndrome as a clinical manifestation of graft-versus-host disease (GVHD) in a marrow transplant recipient after cyclosporine withdrawal

GVHD is one of the most frequent complications of BMT and recently nephrotic syndrome (NS) has been described as a manifestation of chronic GVHD. Here, we present an AA patient who developed NS 1 year after BMT when cyclosporine was stopped. Renal biopsy showed focal sclerosis associated with membranous deposits. He also had other clinical manifestations of chronic GVHD: sicca-like syndrome and colestasis. After 15 days of CsA therapy, he experienced a remarkable improvement in the NS and GVHD as a whole. We comment on immunological mechanisms that could be involved in the pathogenesis of this manifestation.

Microalbuminuria in IDDM is associated with increased expression of monocyte procoagulant activity

Microalbuminuria, the early phase of diabetic nephropathy, is associated with an increased risk of atherothrombosis. Monocytes play an important part in the pathogenesis of atherosclerosis and in the activation of haemostasis. However, procoagulant activity is poorly understood in Type I (insulin-dependent) diabetes mellitus, particularly in the presence of microalbuminuria. This study aimed to evaluate spontaneous and endotoxin-induced monocyte procoagulant activity in insulin-dependent diabetic patients with normoalbuminuria or microalbuminuria. Seventeen patients with microalbuminuria, 28 with normoalbuminuria and 26 healthy control subjects matched for age, sex, body mass index and smoking habit were studied. Mononuclear cells from peripheral venous blood were incubated with or without bacterial lypopolysaccharide. Spontaneous procoagulant activity and procoagulant activity after 3 h and 6 h of incubation were calculated. Spontaneous procoagulant activity values were similar in the three groups. After 3 h and 6 h incubation with bacterial lypopolysaccharide, procoagulant activity values were slightly, but not statistically significantly, higher in the normoalbuminuric diabetic group than in control group, and significantly higher in microalbuminuric diabetic group than in control group (p < 0.01). The increased endotoxin-induced monocyte procoagulant activity helps to explain the link between microalbuminuria and the increased risk of atherothrombosis in patients with Type I diabetes.

[Endoscopic fragmentation of gastric phytobezoars as a valid alternative, in selected cases, to traditional surgery]

Three cases of gastrointestinal bezoar are described. Two were submitted to conventional surgery and one to endoscopic fragmentation. The natural and postoperative pathophysiologic mechanisms responsible for the formation of bezoars were studied. The condition is generally asymptomatic, the clinical presentation being similar to that of gastritis and/or duodenitis. Endoscopy is the non-invasive technique of choice in the diagnosis of gastric bezoars. Treatment of these lesions in day-endoscopy consists in removal of the bezoar if less than 3 cm in diameter and fragmentation if larger in diameter followed by extraction of any fragments over 1 cm to prevent the risk of intestinal obstruction. Long term maintenance therapy with cisapride or metoclopramide is then immediately administered for preventive purposes, and it is also used in patients submitted to traditional gastric and/or duodenal surgery.

[Perineal surgical approach in the treatment of some disorders of the rectoanal function (fecal incontinence and obstructive constipation)]

A global experience in the surgical perineal approach to the treatment of alterations of recto-anal function (fecal incontinence and obstructed defection) is reported. Surgical techniques and results in four cases of fecal incontinence operated and surgical treatment of 14 patients suffering from obstructed defecation, due to organic obstacles (4 cases) or functional abnormalities (rectocele 10 cases) are discussed. Indications, surgical techniques as well as the obtained results are described.

Activated protein C resistance in type I diabetes

OBJECTIVE

To compare activated protein C (aPC) sensitivity in 37 type I diabetic patients and 33 healthy control subjects.

RESEARCH DESIGN AND METHODS

In this study, 37 type I diabetic patients and 33 healthy control subjects without personal or familial history of venous thrombosis and coagulation disorders, infections, intercurrent conditions, serum lupus anticoagulant, clinical cardiovascular complications, or drugs were examined.

RESULTS

The aPC ratio (aPTT [activated partial thromboplastin time] with and without aPC) was significantly lower in the type I diabetic patients than in the control subjects (P = 0.005).

CONCLUSIONS

These results suggest that the final steps of the protein C/S inhibiting system could be abnormal in type I diabetes.

Targeted screening for elongation factor Tu binding antibiotics

The development of a screen targeted to antibiotics which bind elongation factor Tu (EF-Tu) is described. The method was based on selection of antimicrobial activities which were antagonized by exogenous EF-Tu. Kirromycin, a known inhibitor of EF-Tu, was positive in this screen. Among 47,000 microorganisms screened, several producers of kirromycin-type antibiotics were detected and the novel antibiotics GE2270 and GE37468 were discovered. These thiopeptide molecules constitute, along with amithiamycin, a novel class of antibiotics acting on EF-Tu.

Rapid analysis of antibiotic-containing mixtures from fermentation broths by using liquid chromatography-electrospray ionization-mass spectrometry and matrix-assisted laser desorption ionization-time-of-flight-mass spectrometry

A crucial step in the isolation of antibiotic substances is establishing whether or not the isolated material represents a new chemical entity. Because of the importance of molecular weight to this process-known as dereplication-mass spectrometry has traditionally played an active role. In this communication a strategy for utilizing liquid chromatography-mass spectrometry (LC/MS) for novelty assessment is described. Crude extracts (20-50 µg) are chromatographed by conventional bore high-performance liquid chromatography (1 mL/min) after which a postcolumn split to divert roughly one-tenth of the sample to the mass spectrometer for molecular weight determination by electrospray ionization (ESI) mass spectrometry. The majority of the effluent is sent to a UV detector and ultimately collected as 1-min fractions for biological testing. As a secondary confirmation of molecular weight, an aliquot of each fraction (< 5%) is taken for analysis by matrix-assisted laser desorption ionization (MALDI). The improved efficiency of this approach over more traditional schemes utilizing off-line fraction collection and conventional ionization methods can be explained by several factors. First, the superior sensitivity of ESI and MALDI means that less material is required for successful analysis. Second, on-line LC/MS optimizes the efficiency of sample transfer and saves both time and labor. Furthermore, the concentration dependence of ESI allows a majority of the material injected for LC/MS to be recovered for biological testing without compromising the signal available for molecular weight determination. As a validation of the above method, crude extracts containing two well-characterized antibiotics-teicoplanin and phenelfamycin-were examined. Results from these analyses are presented along with data from the analysis of a potent unknown antifungal sample.

Procoagulant activity of mononuclear cells is increased in myeloproliferative and myelodysplastic diseases

Procoagulant activity (PCA) of peripheral mononuclear cells (PMC) was evaluated in patients with primary thrombocythemia (PT, group A), polycythemia vera (PV), idiopathic myelofibrosis (IM) and myelodysplastic syndromes (group B), and in 15 healthy subjects as control group. PCA of PMC was assayed under basal conditions and after agonist-induced stimulation: bacterial lipopolysaccharide, glycosylated granulocyte-macrophage colony-stimulating factor, recombinant alpha-interferon. PCA was similar in the control group and group A when no stimulation was used, while PCA was found significantly higher in group B patients in the same conditions. In group A patients and in the control group, but not in group B patients, a lower PCA expression was found when PMC were simultaneously coincubated with LPS and alpha-interferon with respect to LPS incubation alone.

[Apudomas: nosographic and physiopathological aspects]

The authors intend to contribute to the knowledge of this complex and in part not fully defined subject of apudomas, in particular with regard to classification criteria and physiopathological aspects. After having examined the characteristics of these neoplasias (probably common embryonal origin, similar radioimmunological, immunohistochemical and ultrastructural characteristics, the capacity to convert amine precursors into amines), the authors focus on the most significant aspect of these carcinoids which, in the light of current knowledge, possess varying but undisputed degrees of biological aggressiveness. They also highlight the importance of the gastroenteric tract as an organ with an endocrine function and lastly affirm the value of the classification which, using the pancreas as the reference organ, distinguishes endocrine neoplasias in this tract into entopic and ectotopic examples.

Antibiotic GE37468 A: a novel inhibitor of bacterial protein synthesis. II. Structure elucidation

GE37468 A is a novel antibiotic produced by Streptomyces sp. ATCC 55365. It has molecular mass 1309.48 and formula C59H52O12N14S5 and belongs to the thiazolyl peptide group of antibiotics. The structure was elucidated by 1H and 13C NMR and MS studies on intact molecule and its hydrolysis products. The antibiotic is a highly modified peptide containing a macrocycle and a side chain composed of a thiazole ring and two dehydroalanine units.

Antibiotic GE37468 A: a new inhibitor of bacterial protein synthesis. I. Isolation and characterization

GE37468 A is a new thiazolyl peptide antibiotic obtained by fermentation of Streptomyces sp. strain ATCC 55365. It inhibits bacterial protein synthesis by acting on elongation factor Tu and is structurally and functionally related to the GE2270 class of EF-Tu inhibitors. It is active in vitro against Gram-positive bacteria and Bacteroides fragilis, and protects mice against Staphylococcus aureus infection.

[Phyllodes breast tumors: apropos 2 cases]

The observation of two cases of phyllode tumors of the breast, one benign and the other malignant, brought the Authors to focus the fundamental aspects of these neoplasias. The histologic coexistence of both epithelial and connectival components, a relative unpredictable clinical evolution, the high frequency of recurrences, the stromal hyperproduction and modifications as expression of malignancy, and the need for large excisions are the fundamental characteristics of these tumors, which are considered transitional forms between benignity and malignancy.

Bioconversion capacity of Streptomyces sp GE44282, a producer of the antibiotics heneicomycin and aurodox

Streptomyces sp GE44282 was isolated in the course of a screening program for novel antibiotics. It co-produces heneicomycin and aurodox, two kirromycin-type antibiotics, which differ by the presence of an hydroxyl group at the C30 position of aurodox. Heneicomycin is converted into aurodox both by growing and resting cells of Streptomyces sp GE44282 and by the producer of aurodox, Streptomyces goldiniensis ATCC 21386. This bioconversion of heneicomycin is substrate-specific and is not observed using the producer of heneicomycin, Streptomyces filippiniensis NRRL 11044. The three strains show very similar taxonomic characteristics. These results suggest that heneicomycin is a precursor of aurodox, the production of which depends on the bioconversion capability expressed by the strain.

[Indications and surgical treatment of Crohn disease]

On the basis of their experience (a series of 21 surgical approaches), the authors subdivide the indications for surgical treatment into absolutes and relatives. They recommend to operate also for relative indications in order to improve the patient's way of life, avoiding the establishment of extensive adhesions, under-nourishment and invalid subocclusive symptomatology. As the surgical treatment is not curative and is burdened from repeated operations, the authors suggest using a conservative surgery. They confirm the uninfluence, to prevent fistula and/or local recurrence, to carry out an anastomosis on healthy or slightly macroscopic disease tissues.

Contribution of mass spectrometry to the structural confirmation of components of the antibiotic GE2270 complex

The GE2270 complex consists mainly of GE2270 A (MW 1289), a thiazolyl peptide antibiotic whose structure originates from the modification of a chain of 14 amino acids in a process which creates six thiazole rings and one pyridine. Together with the main component, a number of structurally related molecules are co-produced in small quantities by fermentation. A preparative high-performance liquid chromatrography method was developed to isolate GE2270 factors B1, B2, C1, C2a, C2b, D1, D2, E and T. Their structures, preliminarily determined by 1H-nuclear magnetic resonance spectroscopy in comparison with GE2270 A, were confirmed by low and high resolution fast-atom bombardment mass spectrometry and studies on the intact molecules and on their main hydrolysis products. Their molecular weights range from 1246 to 1306 Da. The structural differences between the factors lie in the extent of methylation and/or oxidation of thiazole rings (D and E) and asparagine, and in the aromatization of the oxazoline ring.

PAI-1 and factor VII activity are higher in IDDM patients with microalbuminuria

Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD) in insulin-dependent diabetes mellitus (IDDM) patients, but the pathophysiological basis of this association is not clear. To see whether or not hemostatic dysfunctions might contribute to explain this association, we measured tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), factor VII activity, plasma fibrinogen, and plasma endothelin-1 (ET-1) in 13 microalbuminuric (albumin excretion rate [AER], 20-200 micrograms/min) and in 13 comparable normoalbuminuric (< 20 micrograms/min) IDDM patients. t-PA and ET-1 were similar in the two groups, whereas PAI-1 activity (5.65 +/- 1.92 vs. 0.85 +/- 0.58 IU/ml, P < 0.05), factor VII (87.85 +/- 4.94 vs. 76.54 +/- 2.31%, P < 0.05), and plasma fibrinogen (3.38 +/- 0.21 vs. 2.65 +/- 0.13 g/l, P < 0.05) were significantly higher in microalbuminuric than in normoalbuminuric patients. Plasma fibrinogen was related to AER (r2 = 0.23, P < 0.05), whereas triglycerides and factor VII were related to PAI-1 (r2 = 0.39, P < 0.001 and r2 = 0.10, P < 0.05). These results suggest that microalbuminuria is associated with a hypercoagulative and hypofibrinolytic state. Hemostatic dysfunctions might be a pathogenetic link between microalbuminuria and CVD.

[Anomalies of coagulation and fibrinolytic activity in patients with chronic pulmonary thromboembolism]

INTRODUCTION

Haemostatic and fibrinolytic parameters were evaluated in patients with chronic pulmonary hypertension following pulmonary embolism (CPE). The diagnosis of CPE was based on lobar or segmental defects on perfusion lung scans and by pulmonary angiograms which showed complete or partial obstruction of main or segmentary lobar arteries.

METHODS

Antithrombin III (AT III), protein C, protein S, and lupus anticoagulant (LA) were assayed in 8 patients with CPE; in 6 out of 8 patients plasma fibrinolytic activity was assessed both under basal conditions and after venous stasis. The control group consisted of 4 normal subjects. Protein C and protein S antigens were assayed by an electrophoretic method. Protein C and protein S biological activities were assayed by a manual clotting system. AT III was assayed by chromogenic method. Fibrinolytic total activity was studied on fibrin plates, tPA and PAI-1 activities by chromogenic method; tPA and PAI-1 antigens by ELISA technique.

RESULTS

One patient out of 8 showed a protein C deficiency and 3 patients out of 8 were positive for a LA. All patients had a statistically significant reduction of plasma fibrinolytic activity (p < 0.001) and of tPA activity (p < 0.0005) after venous stasis as compared to the control group.

CONCLUSIONS

Our data show that significant haemostatic abnormalities may underlie this disease. In particular, a) an impairment of fibrinolytic plasma activity and low levels of plasminogen activator may be found, and b) the undiagnosed presence of a LA may be the cause of these thrombotic events. The meaning of these results needs further assessment.

Reduction of plasma fibrinolytic activity following high-dose cyclophosphamide is neutralized in vivo by GM-CSF administration

BACKGROUND

GM-CSF has broad clinical applicability as a potent myelopoietic stimulator. However, its function is not restricted to the myelopoietic system and several observations suggest that GM-CSF may interfere with the hemostatic balance. In order to assess whether GM-CSF has any influence on hemostasis, we evaluated some coagulative and fibrinolytic parameters in patients treated with GM-CSF following chemotherapy.

METHODS

Fibrinolytic activity (FA), fibrinogen and D-dimer were evaluated before and after high-dose cyclophosphamide in 6 patients additionally treated with GM-CSF and in 5 control patients; moreover, tissue plasminogen activator (tPA) was assayed in those treated with GM-CSF. Comparative in vitro analysis was performed on cultured endothelial cells before and after exposure to GM-CSF.

RESULTS

Control patients showed a significant decrease in plasma FA after chemotherapy compared to basal values (FA/mm2: 15.6 +/- 2.1 at day + 2 and 20.8 +/- 19 at day + 4 vs. 103.8 +/- 64.2 at day 0; p < 0.005); conversely, no FA reduction was observed in GM-CSF-treated subjects. In this latter group a marked increase in tPA antigen was seen, consistent with enhanced FA. No significant changes in plasma D-dimer and fibrinogen values were detected in the two groups. tPA, urokinase-type plasminogen activator, PAI-1 and procoagulant activity were evaluated in vitro on cultured human endothelial cells and found to be unchanged following GM-CSF addition.

CONCLUSIONS

The results demonstrate that high-dose chemotherapy may negatively influence plasma FA. This adverse side effect is neutralized by GM-CSF administration. The discrepancy found between in vitro and in vivo GM-CSF activity on hemostatic may be explained by in vivo GM-CSF stimulation of cell types other than endothelial cells.

Fibrinolytic imbalance in essential thrombocythemia: role of platelets

Thrombotic and hemorrhagic complications are frequent in patients with essential thrombocythemia (ET), a myeloproliferative syndrome with an increased number of circulating platelets. Since platelets are a physiological reservoir for the plasminogen activator inhibitor (PAI-1) contained in plasma, we evaluated plasma and platelet tissue plasminogen activator (tPA) and PAI-1 in 20 ET patients with and without thrombotic complications and in 13 control subjects. In ET patients with thrombotic complications there was a significantly greater platelet PAI-1 functional activity than in ET patients without thrombotic complications and in the control group (p < 0.05 and p < 0.025, respectively). Moreover, platelet tPA activity was significantly low in all ET patients (p < 0.001). This fibrinolytic imbalance (increased plasminogen inhibitor and lowered activator) might be a critical cofactor in the thrombotic complications in ET patients.

[The role and problems of the surgical approach in adrenal incidentalomas]

The authors report a series of 5 incidentalomas: 4 nonfunctioning adrenocortical adenomas and 1 nonfunctioning pheochromocytoma. They emphasise the importance of US, CT, MRN, and scintigraphy in differential diagnosis compared to laboratory tests. In addition, they affirm that a correct oncological approach necessarily involves radical surgery and rule out the possibility of adopting a "wait and see" policy based on relative factors such as tumour size, function and the patient's age. The authors suggest using a posterior or anterior access route depending on the nature and size of the incidentaloma and recommend reserving the lateral incision for special cases.

[Primary non-Hodgkin's lymphomas of the stomach]

Histological and staging classifications of gastric non-Hodgkin lymphomas are reported. On the basis of their experience and taking into account the above mentioned principles, the authors dwell upon the advantages and limits of endoscopy for the diagnosis of such neoplasms. The primary role of surgery in the management of gastric lymphomas is also confirmed.

A high throughput assay for inhibitors of HIV-1 protease. Screening of microbial metabolites

A novel method for discovery of HIV-1 protease inhibitors in complex biological samples has been developed. The assay is based on two specific reagents: a recombinant protein constituted by a portion of the HIV-1 Gag polyprotein comprising the p17-p24 cleavage site, fused to E. coli beta-galactosidase, and a monoclonal antibody which binds the fusion protein in the Gag region. Binding occurs only if the fusion protein has not been cleaved by the HIV-1 protease. The assay has been adapted for the screening of large numbers of samples in standard 96-well microtiter plates. Using this method about 12000 microbial fermentation broths have been tested and several HIV-1 protease inhibitory activities have been detected. One of these has been studied in detail.

[Bronchopulmonary carcinoids: neoplasms with attenuated malignancy or true and proper malignant tumors?]

The authors, in reporting their series of 6 bronchopulmonary carcinoids, dwell upon the criteria used to classify such neoplasms pointing out the related diagnostic problems. The presence of metastases and/or local recurrences as well as the impossibility to define the aggressiveness of the tumor brought the authors to consider such tumors as malignant. They conclude for a surgical approach which should be conservative: segmentectomy and lobectomy in elective procedures, whereas pneumonectomy and endoscopic resection should be reserved to particular cases.

[Early gastric cancer: staging and diagnostic-therapeutic trends]

The Authors in reviewing the main epidemiological and histological features of Early Gastric Cancer, dwell upon the atypical symptomatology pointing out the importance of an early diagnosis for a successful surgical treatment. Furthermore, they affirm the primary role of subtotal gastrectomy, associated with regional lymphadenectomy and omentectomy. At last, the need to extend postoperative follow-up to the main abdominal and thoracic organs for the frequency of synchronous or metachronous neoplasms is stressed.

[The theatrical dimension of suicide]

"Theatrical" is a term that in psychiatry mostly has a discredited connotation and that is often disparaged. This work means to assign to suicide's and attempted suicide's "theatrical dimension", a different side, showing theatricality as a very important communicative, creative and vital force.

[The citizen's opinion on genetic counseling. Acceptability of the service in the province of Ferrara (Cento)]

At Cento (Ferrara), a town characterized by a moderate incidence of thalassemia, only 8.62% of men and 16.53% of women have a fair knowledge of genetic diseases and of their prevention. This lack of information was common to all categories covered by the poll. In spite of this, public was generally in favour of a genetic consultancy service. Table 1 reveals that 74.14% of men and 83.47% of women would use the informations provided by genetic consultancy for preventive purposes.

[The client's viewpoint on genetic counseling. Acceptability of the service in a Bolognese community (Castel San Pietro Terme)]

It has been found that the public's knowledge of genetic diseases and their prevention was extremely limited in the Commune of Castel San Pietro Terme (Bologna). This lack of information was common to all categories covered by the poll. In spite of this, the public was generally in favour of a genetic consultancy service. Overall figures reveal that 84.06% of men and 79.58% of women interviewed would use the information provided by genetic consultancy for preventive purposes.

[The client's viewpoint on genetic counseling. Acceptability of the service in an Oristanese community (Cabras)]

At Cabras (Oristano), a town characterized by a high incidence of thalassaemia and G6PD deficiency less than half the people between 18 and 35 have a fair knowledge of genetic diseases and of their prevention. The lack of information is higher among people working in the primary sector, housewives and generally, among those who are uneducated. The majority of the people we have interviewed are favourable to undergo analysis to single out carriers. Of these many have said to be unwilling to give birth to children if they belong to a couple at risk. Other have said they do not exclude of having children all the same but to be willing to amniocentesys, and to miscarriage if necessary. From a total calculation results that 88,03% of the men and 82,18% of the women we have interviewed would use, as a prevention, the information obtained from a genetic centre.

[Arteriovenous fistulas]

Three cases of arteriovenous fistulae observed in recent years at the University of Rome's 3rd Surgical Clinic, and of different site, entity are aetiology, are presented. The recent international literature is reviewed and the more outstanding clinical and therapeutical features of this form are discussed.

[Endothoracic goiter with retro-tracheo-esophageal migration]

A case of endothoracic goitre with crossed, left-right, retrovascular, retro-tracheo-oesophageal migration is used as the basis for pathogenetic and diagnostic discussion and for stressing the surgical importance of correct topographic and migratory classification of each form.