Some tools for the identification of high caries risk individuals. A review

As a consequence of the polarisation of dental caries, which occurred over the last 3 decades in industrialised countries, the usefulness of risk assessment, both for individuals and for groups of subjects, became evident. At individual level, the early identification of high and medium caries-risk subjects allows to plan specific preventive measures for each subject's needs, based on the risk grade and the causally-directed diagnosis. At population level, risk assessment helps to increase the efficiency and to reduce the costs of caries preventive programmes. In this study, a review of caries-risk indicators is proposed: these indicators, collected through the analysis of relevant background data, clinical examination and salivary tests are indispensable to achieve a correct caries-risk assessment. A review of the studies on the attempts to produce prediction models for caries-risk assessment is presented: in view of the multifactorial nature of caries etiology and the complexity of the prediction of individual caries-risk, a multivariate approach is necessary. Finally, some suggestions on the clinical usefulness and on indications of caries-risk determination are given.

Assessment of genetic variability of haploids extracted from tetraploid (2n = 4x = 48) Solanum tuberosum

The objectives of this study were to assess the genetic variability of haploids (2n = 2x = 24) extracted from tetraploid Solanum tuberosum through 4x x 2x crosses with Solanum phureja. Molecular and phenotypic analyses were performed to fingerprint the genotypes used and to evaluate their potential use in breeding programs. AFLP analysis revealed the presence of specific bands derived from the tetraploid seed parent S. phureja, as well as ex novo originated bands. On average, 210 bands were visualized per genotype, 149 (70%) of which were common to both parental genotypes. The percentage of S. tuberosum specific bands ranged from 25.1% to 18.6%, with an average of 22%. The fraction of genome coming from S. phureja ranged from 1.9% to 6.5%, with an average value of 4%. The percentage of ex novo bands varied from 1.9% to 9.0%. The presence of S. phureja DNA is very interesting because it indicated that S. phureja pollinator is involved in the mechanism of haploid formation. The characterization for resistance to Erwinia carotovora subsp. carotovora and potato virus X (PVX) provided evidence that haploids may express traits that are lacking in the tetraploids they come from, which can be useful for both genetic studies and breeding purposes. It is noteworthy that genotypes combining resistance to both diseases and good pollen stainability were identified. Other possible breeding implications owing to the presence of S. phureja genome in the haploids analyzed are discussed.

New fluxon resonant mechanism in annular Josephson tunnel structures

A novel dynamical state has been observed in the dynamics of a perturbed sine-Gordon system. This resonant state has been experimentally observed as a singularity in the dc current-voltage characteristic of an annular Josephson tunnel junction, excited in the presence of a magnetic field. In this respect it can be assimilated to self-resonances known as Fiske steps. Differently from these, however, we demonstrate, on the basis of numerical simulations, that its detailed dynamics involves rotating fluxon pairs, a mechanism associated, so far, to self-resonances known as zero-field steps. This occurs because the size of nonlinear excitations is comparable with that of the system.

Selection for aneuploid potato hybrids combining a low wild genome content and resistance traits from Solanum commersonii

A breeding scheme based on the production of progenies with odd ploidy was followed to introduce useful genes from the wild Solanum commersonii (cmm) into S. tuberosum (tbr) genome. Hybrids from 5 x x 4 x crosses were characterized for traits of interest, and selection was assisted by amplified fragment length polymorphism (AFLP) analysis. As expected, most of the hybrids were aneuploids, with a trend towards a low degree of aneuploidy. Despite the fact that aneuploidy has often been associated with a reduction in male and female fertility, most of the hybrids were fertile following crosses with tbr, making it possible to produce viable offspring. A screening for resistance traits deriving from cmm was also carried out. With respect to freezing resistance, the killing temperatures of cold-acclimated genotypes were distributed between the wild and cultivated parental values, with some hybrids displaying an acclimation capacity higher than 3 degrees C. A wide variability was also found for tuber soft rot resistance, and hybrids with high levels of resistance were identified. Selection of hybrids was based on a two-stage scheme that consisted of conventional phenotypic selection followed by an estimation of the wild genome content still present in order to identify hybrids combining noteworthy traits with a low wild genome content. Previously selected cmm-specific AFLPs were used to monitor the degree of wild genome content still present in each hybrid. The percentage of cmm-specific markers ranged from 59% to 91%, with an average value of 75%. AFLP analysis was employed to assist in the selection of valuable hybrids for further breeding efforts.

Dynamical control of macroscopic quantum tunneling

We show that the quantum Zeno and anti-Zeno effects are realizable for macroscopic quantum tunneling by current-bias modulation in Josephson junctions (and their analogs in atomic condensates).

Glycoalkaloids and acclimation capacity of hybrids between Solanum tuberosum and the incongruent hardy species Solanum commersonii

F(1) and backcross hybrids between sexually incompatible species Solanum commersonii and Solanum tuberosum were characterized for glycoalkaloid content and capacity to cold acclimate. Glycoalkaloid (GA) analysis revealed that F(1) triploids and BC(1) pentaploids contained the glycoalkaloids of both parents. In BC(2) (near) tetraploids the situation was different, in that some hybrids produced the GAs of both parents, whereas others contained only the GAs of S. tuberosum. This suggested that the GAs from S. commersonii may be lost rapidly, and that they may have a simple genetic control. The total tuber GA content of BC(1) and BC(2) groups averaged quite acceptable levels (165.9 mg/kg in BC(1) and 192.8 mg/kg in BC(2)), with six genotypes having a GA content <200 mg/kg fresh weight. The F(1) triploid hybrids expressed a capacity to cold acclimate similar to S. commersonii, whereas BC(1) and BC(2) genotypes generally displayed an acclimation capacity higher than the sensitive parent but lower than S. commersonii. However, one BC(1) and two BC(2) genotypes with an acclimation capacity as high as S. commersonii were identified. The polar lipid fatty acid composition in S. commersonii and its hybrid derivatives showed that, following acclimation, there was a significant increase in 18:3. Correlation analysis between the capacity to cold acclimate and the increase in 18:3 was significant, suggesting that the increase in 18:3 can be used as a biochemical marker for the assisted selection of cold-acclimating genotypes in segregating populations.

Intrinsic d-wave effects in YBa(2)Cu(3)O(7-delta) grain boundary Josephson junctions

We have measured the angular dependence of the Josephson critical current density (J(C)) in c-axis tilt biepitaxial grain boundary YBa(2)Cu(3)O(7-delta) junctions. We observe for the first time intrinsic d-wave pairing symmetry effects manifested as an oscillatory dependence of J(C) on angle. This intrinsic effect is evident even though spontaneous currents, possibly induced by faceting or barrier impurities, are observed in the grain boundaries.

Effects of CO2 laser treatment on fibroblast attachment to root surfaces. A scanning electron microscopy analysis

BACKGROUND

The aim of this study was to analyze the CO2 laser effects on root surfaces affected by periodontal disease in comparison to scaling and root planing for fibroblast attachment.

METHODS

Thirty single-rooted human teeth extracted because of advanced periodontal disease were included in this study. A total of 60 specimens, obtained from all selected teeth, were randomly assigned to 3 groups: 1) control (untreated); 2) hand scaling and root planing (SRP); or 3) laser (CO2 defocused pulsed) and ultrasonic scaling. All the specimens were incubated in Petri dishes with fibroblast suspension, and then observed by scanning electron microscopy (SEM).

RESULTS

The control group showed the lowest number of attached cells, with no tightly attached fibroblasts. The laser plus scaling group showed the highest number of attached fibroblasts, with the tightly attached fibroblast prevailing. The laser-treated and scaled root specimens did not show any damage or morphologic alteration of the root surfaces.

CONCLUSION

CO2 laser treatment in defocused, pulsed mode with a low power of 2W combined with mechanical instrumentation constitutes a useful tool to condition the root surface and increase fibroblast attachment to root surfaces.

Root surface morphological changes after focused versus defocused CO2 laser irradiation: a scanning electron microscopy analysis

BACKGROUND

Many studies have observed damages to root surfaces treated by CO2 laser in continuous mode with a focused beam. The morphologic changes observed were always associated with temperature increase induced by high energy release.

METHODS

The purpose of this study was to analyze by scanning electron microscopy (SEM) the effects of CO2 laser in 2 different modes on root surfaces. Study samples consisted of 30 extracted single-rooted periodontally compromised human teeth. Root specimens were randomly assigned to 3 groups: group A (12) treated with CO2 laser in continuous mode with a focused beam of 0.8 mm; group B (12) treated with CO2 laser in pulsed mode with defocused beam of 4 mm; and group C (6), untreated controls.

RESULTS

Group A (continuous mode) showed severe damages to dentin surfaces such as craters and fissures. Group B (defocused mode) did not result in any damages to the root surfaces, showing flat and smooth surfaces with apparent fusion of the smear layer and dentinal tubules almost completely sealed. The untreated control group was characterized by irregular and amorphous surfaces with several shallow depressions.

CONCLUSIONS

Although both laser modes resulted in changes to the treated root surface specimens, the changes resulting in a smooth surface from use of defocused pulsed beam may present an advantage in periodontal treatment.

Evidence for tetrasomic inheritance in a tetraploid Solanum commersonii (+) S. tuberosum somatic hybrid through the use of molecular markers

In order to assess the potential for interspecific recombination between the cultivated Solanum tuberosum (tbr) and the sexually isolated wild species Solanum commersonii(cmm), genetic analysis of a F(2) progeny obtained by selfing one tetraploid cmm (+) tbr somatic hybrid was performed through molecular markers. For this purpose, the extent of disomic and/or tetrasomic inheritance of species-specific RAPD and AFLP markers was determined by following their segregation in a 90-genotype progeny, and testing all the possible segregation ratios in a selfed tetraploid progeny. The RAPD analysis performed using 16 primers revealed that the cmm-specific RAPDs were mainly (93.7%) duplex markers and were equally distributed between loci with a disomic (46.7%) and tetrasomic (53.3%) inheritance. The AFLP analysis led to the identification of 272 (58%) informative AFLPs, which were either cmm- or tbr-specific markers. About 63% of cmm-specific AFLPs were duplex loci, most of which (92.6%) were inherited as tetrasomic loci. As regards the tbr-specific AFLPs, the percentage of simplex loci (52.9%) was higher than that of duplex loci (32.6%), and among the latter most (88.5%) were inherited as tetrasomic loci. Overall, 130 duplex markers were found, of which 53.1% were cmm-specific and 46.9% were tbr-specific. Out of 130 markers, 18 (13.8%) were inherited as disomic, and 112 (86.2%) as tetrasomic, loci. This implies that the majority of duplex markers were located on chromosomes which at meiosis tend to randomly pair as bivalents or to form tetravalents. The total number of simplex loci was 119, and most of them (82.3%) were tbr-specific loci. In some cases the observed segregation ratios even allowed us to clearly determine whether a random chromosome or chromatid segregation was detected. This was the case of three cmm-specific RAPDs, 19 cmm- and 25 tbr-specific AFLPs, which fit a 20.8:1 or 2.5:1 ratio, both cases for which a clear random chromatid segregation can be assumed, since they represent the limit of segregation expected when the distance between the locus and the centromere always leads to a cross-over event. The percentage of ascertained crossing-over events was around 37% out of the tetrasomically inherited loci clearly identified (128 loci), a value indicating that the flow of genes from the sexually isolated S. commersonii to the cultivated potato is possible, for at least a large proportion of genes.

Pharmacological and dietary prophylaxis and treatment of acute actinic esophagitis during mediastinal radiotherapy

Our purpose was to evaluate a pharmacological and dietary protocol of prophylaxis and treatment of acute actinic esophagitis during mediastinal radiotherapy. This phase II study was conducted on 29 patients affected by cancer not directly involving the esophagus. The irradiated volume included at least 10 cm of esophagus with a median dose of 46 Gy and the incidence of clinical acute esophagitis was scored with RTOG-EORTC tables. During the entire course of radiation therapy all patients were subjected to prophylaxis pharmacological therapy in addition to dietetic rules commonly used. All patients were evaluable, 9 (31%) had no acute esophageal toxicity, 20 (69%) had toxicity of degree 1, and no patient showed a toxicity of degree 2, 3, or 4, there were no toxicity-related related interruptions of the radiotherapy course. In conclusion, this low cost protocol seems to reduce the incidence and degree of acute radiation esophagitis (without added morbidity), compared with literature reports.

Evaluation and use of plant biodiversity for food and pharmaceuticals

Many epidemiological studies have shown the importance of fruit and vegetables in the human diet so as to prevent the onset of cardiovascular disease and several forms of cancer. The use for food and pharmaceuticals of two of the most widely grown and genetically well-known species in the world, the tomato and the potato, is reviewed. Tomatoes are important sources of vitamin C, potassium, folic acid and carotenoids such as lycopene and beta-carotene. It has been demonstrated that lycopene has anti-oxidant properties and interferes with the growth of cancerous cells. At the Department of Agronomy and Plant Genetics in Portici, interesting results have been obtained with the constitution of stable tomato hybrids having a high content of lycopene and vitamin C. Many of the parental lines used in constituting the hybrids come from interspecific crosses. Potato is also very important in the human diet for its content of high quality proteins, mineral salts and vitamins and it has many medicinal properties. The use of diploid wild species to transfer traits such as high content of vitamin C, mineral salts and high quality proteins into the cultivated potato through ploidy manipulation is discussed.

[Implants in partially edentulous patients with history of periodontal disease]

BACKGROUND

Microbiota associated with periodontal diseases were also associated with periimplant diseases. The purpose of this study was to determine the clinical status and composition of subgingival microbiota of implants and natural teeth in a group of partially edentulous patients with history of periodontal disease.

METHODS

38 partially edentulous patients with history of periodontal disease, treated with dental implants, were selected for this study. Patients selected for the study were in good health condition and did not take any antibiotics in the last six months. One year after second stage surgery a total of 72 implants and 38 teeth underwent clinical and microbiological examination. Clinical parameters were PD, PAL, PI and GI. Subgingival plaque samples were analyzed by dark-field microscopy and cultural analysis.

RESULTS

Clinical parameters didn't show any significant differences between periodontal and periimplant tissues. Dark-field microscopic examination showed higher prevalence of rods and spirochetes around implants than around teeth. There were no differences detected by cultural examination in the subgingival microbiota at peri-implant and periodontal sites.

CONCLUSIONS

Findings from this study showed no differences between implants and teeth in partially edentulous patients with history of periodontal disease one year after second stage surgery. Implants were colonized by microbiota similar to that observed around teeth and were well-maintained in patients with a history of periodontitis.

[New methods of percutaneous closure of patent ductus arteriosus]

Various devices have been developed for the percutaneous closure of persistent patent ductus arteriosus (PDA). In recent years Gianturco coils have become increasingly widespread for this purpose. Poor control during positioning is a major disadvantage of Gianturco coils, with resultant embolization of coils and residual shunts. Very recently a new screwing detachable coil is available (Cook Cardiology, Europe). Between January 1996 and January 2000, 34 consecutive patients with PDA underwent cardiac catheterization. Thirty cases were judged suitable for this procedure, on the base of diameter and morphology of the ductus. Three cases were excluded because of the ductal diameter was too large (> 4.2 mm) and one because of its morphology (type B). In 28 patients a single coil was positioned, while in one case 2 coils were simultaneously used. In 29 cases (97%) complete closure was obtained (in 18 cases immediately, in 6 after 24 hours, in 5 after 1 month). One case showed a residual shunt and a second coil was applied eighteen months later with complete closure. So, considering also this last case, the closure was achieved in 100%. There were neither embolization or other complications. In conclusion, screwing detachable coil for PDA closure is a safe, very effective and at low cost technique. Therefore nowadays this procedure represents the method of choice for occlusion of small PDA (minimal diameter < or = 4 mm).

Tetracycline fibres used to control bacterial infection during guided tissue regeneration (GTR)

AIMS

The colonization of suspected periodontal pathogens during the healing of periodontal defects treated by guided tissue regeneration (GTR) with e-PTFE membranes and tetracycline fibers was investigated.

METHODS

Fifteen patients, each with one pair of angular periodontal bone defects of comparable size and morphology were recruited for the study. In a matched-pair study design, the test defects were treated with e-PTFE membranes in combination with tetracycline fibers, while control defects were treated with e-PTFE membranes alone. Microbiological specimens were taken from control as well as from test sites preoperatively (T0), intraoperatively (T1), two weeks after surgery (T2) and from membranes at time of removal (T3). Cultural methods were used to identify the following species: Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn) and Actinobacillus actinomicetemcomitans (Aa).

RESULTS

At baseline and T1, none of the suspected periodontal pathogens were detected at test or control sites. Levels of P. intermedia and F. nucleatum, as mean percentages of total culturable microflora, were detected at levels significantly higher in control sites than test sites at times T2 and T3.

CONCLUSIONS

Findings from this study suggest that e-PTFE membranes are frequently colonized by periodontal pathogens, and that bacterial colonization of healing sites after GTR procedures can be kept under control with a controlled delivery system releasing tetracycline.

Bacterial colonisation during GTR treatment. A longitudinal analysis

The purpose of the present study was to evaluate the long-term biological and clinical effects of a controlled delivery system releasing tetracyclines during the healing of interproximal periodontal defects treated by the technique of guided tissue regeneration (GTR) using e-PTFE membranes.

METHODS

Fifteen patients, each with two comparable interproximal periodontal defects, underwent surgical treatment with e-PTFE membranes in conjunction with tetracycline fibres at the test site and e-PTFE membranes alone at the control site. Microbiological specimens were taken from each site treated at baseline (T0) and one year after surgery (T4). Plaque index (PI), gingival index (GI), pocket depth at probing (PD) and attachment level at probing (PAL) were recorded at baseline (T0) and one year after surgery (T4). The presence of selected pathogenic microbial species, Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Fusobacterium Nucleatum (Fn) and Actinobaccillus Actinomicetemcomitans (Aa), was investigated and these species were identified by cultural methods.

RESULTS

No statistically significant difference in the level of periodontal pathogens was detected between the test and control sites at time T4. Likewise, no significant clinical difference between the test site and the control site was detected at time T4.

CONCLUSIONS

The results suggest that tetracycline fibres used in conjunction with e-PTFE membranes do not provide and further clinical and microbiological improvement or effect the healing of periodontal defects one year after GTR treatment.

Longitudinal study of dental implants in a periodontally compromised population

BACKGROUND

The purpose of this longitudinal study was to determine the clinical status and the composition of the subgingival microbiota of dental implants and natural teeth in patients with a history of periodontitis.

METHODS

Twenty-five partially edentulous patients treated for moderate to advanced adult periodontitis and having a total of 42 implants participated in this 3-year study. The assessment of clinical status was done 1, 2, and 3 years after prosthetic loading (T1, T2, and T3, respectively). Clinical parameters evaluated included probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI). The subgingival microbiota at peri-implant and periodontal sites were analyzed at T1 and T2.

RESULTS

No significant difference in clinical parameters between implants and teeth and within the 2 groups between different time points was observed through the study. PD and CAL measurements of sampled periodontal and peri-implant sites did not show any statistically significant difference through the study and between the 2 groups. PI of sampled periodontal sites showed a statistically significant improvement during the study. From the morphological observation of the subgingival microbiota, a significant difference in the composition of motile rods between implants and teeth was found at T1. There were no differences detected in the subgingival microbiota, culturally identified at peri-implant and periodontal sites for the duration of the study.

CONCLUSIONS

In conclusion, implants were colonized by the indigenous periodontal microbiota and were well maintained in patients with a history of periodontitis. No significant association between progressing or non-progressing periodontal or peri-implant sampled sites in terms of loss of attachment and infection with at least one of the searched periodontal pathogens was found, suggesting that the presence of putative periodontopathogens at peri-implant and periodontal sites may not be associated with future attachment loss or implant failure.

A clinical comparison of the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients

This study compared the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients performing different oral hygiene regimens: the air powder polishing system (APP), and the rubber cup and pumice (RCP) technique. Sixty-two patients were divided into two groups: group I included 40 subjects who did not use any chlorhexidine mouthwash and group II comprised 22 subjects who regularly rinsed with a chlorhexidine mouthwash (at a 0.12 per cent concentration) and showed increased tooth staining. Using a split-mouth experimental design, the buccal and lingual tooth surfaces were cleaned in half of the mouth by the APP and in the opposite half by the RCP technique. Tooth surfaces were scored before (PRE) and after (POST) the experimental procedures for the plaque index (PI), and for the presence of tooth staining. In addition, the treatment time required by each procedure was recorded. In test group I, significant reductions in the PI after APP and RCP were observed. Likewise, in test group II, both procedures significantly reduced the baseline PI values. In both experimental groups, the percentage of stained sites significantly decreased after APP and RCP, but in test group II, APP seemed to be more effective than RCP. In addition, APP required significantly less time than RCP to remove dental plaque and staining. These data show that both professional prophylaxis procedures are effective in orthodontic patients, with APP being the most time-efficient technique and the most effective method for removal of tooth staining.

Exercise test in detecting anomalous behaviour of blood pressure in patients successfully operated on for coarctation of the aorta

Twenty-eight patients operated with success for isolated coarctation of the aorta (i.e. with normal blood pressure and upper/lower limb gradient < or = 20 mmHg at rest) underwent exercise testing to evaluate blood pressure and upper/lower limb pressure gradient during exercise. At maximum effort: 57% (16/28) of the patients were hypertensive and 43% (12/28) of patients increased upper/lower limb gradient over 35 mmHg. No significant correlation was found between the age at surgery (before or after 3 years of age) and maximal systolic blood pressure on exercise and maximal pressure gradient on exercise. The 12 patients with an exercise pressure gradient > 35 mmHg underwent digital angiography or magnetic resonance of the aorta. In 7 cases a mild residual narrowing was found (5 with mild transverse aortic arch hypoplasia, 2 with a mild residual coarctation). In 5 cases no residual narrowing was present. Many factors are thought to be involved in the anomalous behaviour of blood pressure during effort: in some cases anatomic factors, as residual narrowings of the aorta, in other cases functional factors, as increased forearm vascular reactivity, altered baroceptor function, different reactivity and structure of the pre- and post-stenotic aorta, etc., in other cases finally, both factors, anatomic and functional. We conclude that the exercise testing provides the best information on blood pressure modifications during activity and it allows to us to identify those patients which, because of exercise-induced hypertension, remain at risk of premature cardiovascular disease, also after a successful operation. However, when hypertension is found during effort, a strenous physical activity should be avoided and antihypertensive treatment may be required. So the cardiovascular risk due to hypertension can be reduced in the long term follow-up. Corrective surgery for coarctation of the aorta, introduced in 1944, has completely modified the natural history of the disease. Nowadays the operative risk is very low for isolated coarctation and the great majority of the patients is asymptomatic after surgical repair. Nevertheless, their life expectancy is substantially shortened, if compared with the survival curve of a normal population. The vascular and cardiovascular accidents, usually related to residual systemic hypertension, are the most common cause of this. Some studies in the literature have shown that many patients with normal blood pressure and no or little residual upper/lower limb pressure gradient at rest, may develop an anomalous blood pressure response e and/or a high upper/lower limb pressure gradient during exercise. We have studied by exercise test a group of patients successfully operated on for isolated coarctation of the aorta to evaluate the behaviour of the systolic blood pressure and the upper/lower limb pressure gradient during exercise. The aim was to recognize the patients who, inspite of very good operative result, remain at cardiovascular risk in the long-term follow-up.

Microbiotica associated with refractory periodontis. Prevalence and antibiotic susceptibility

BACKGROUND

The aim of the present study was to analyze the composition of subgingival microflora in patients with refractory periodontitis and to evaluate the antimicrobial sensitivity of isolated periodontopathic microorganisms to different antibiotics.

METHODS

Eleven subjects with a mean age of 46.4 years were selected for the present study. All had been treated for periodontal disease in the past. After further disease progression patients were included in this study. Eight subgingival plaque samples per patients were collected for cultural analysis.

RESULTS

"Black pigmenting anaerobic bacilli" were the pathogenic microorganisms more frequently isolated. The findings from antibiotic susceptibility test showed that high number of bacteria associated with refractory periodontitis resulted resistant to erythromycin, metronidazole and tetracycline. The most effective antibiotics were ciprofloxacin, amoxicillin-metronidazole and amoxicillin-clavulanic acid.

CONCLUSIONS

Microbiological analysis and antibiotic susceptibility test should be considered important tools in the management of patients with poor clinical response to conventional periodontal treatment.

[Transcatheter closing of patent ductus arteriosus using detachable coils]

Various devices have been developed for the percutaneous closure of persistent patent ductus arteriosus (PDA). In recent years Gianturco coils have become increasingly widespread for this purpose. Poor control during positioning is a major disadvantage of Gianturco coils, with resultant embolization of coils and residual shunts. Modifications to improve the positioning of coils have been developed. Very recently a new screwing detachable coil is available (Cook Cardiology, Europe). Between January 1996 and March 1999, 24 consecutive patients with PDA underwent cardiac catheterization. Twenty cases were judged suitable for this procedure, on the base of diameter and morphology of the ductus. Three cases were excluded because of the ductal diameter was too large (> 4.2 mm) and one because of its morphology (type B). In 19 patients a single coil was positioned, while in 1 case 2 coils were simultaneously used. In 19 cases (95%) complete closure was obtained (in 15 cases immediately, in 2 after 24 hours, in 2 after 1 month). One case showed a residual shunt and a second coil was applied eighteen months later with complete closure. So, considering also this last case, the closure was achieved in 100%. There were neither embolization or other complications. In conclusion, screwing detachable coil for PDA closure is a safe, very effective and at low cost technique. Therefore nowadays this procedure represents the method of choice for occlusion of small PDA (minimal diameter < or = 4 mm).

Combined effect of high-fat diet and copper deficiency during gestation on fetal copper status in the rat

We have previously shown that a low-copper (Cu) diet produced alterations in placental Cu transport and fetal Cu stores. Because Cu deficiency has been associated with lipid deposition in rat dam liver, we hypothesized that a high fat intake, a prevalent dietary habit in many populations, may worsen fetal Cu status and its closely linked iron (Fe) deposits. Pregnant rats were fed one of four diets during the second half of gestation: NFNCu: normal fat (7%), normal Cu (6 mg/kg); HFNCu: high fat (21%), normal Cu; NFLCu: normal fat, low Cu (0.6 mg/kg), and HFLCu: high fat, low Cu. One day before delivery, dams were anesthetized, and maternal as well as fetal plasma and tissues were obtained. Maternal, fetal, and placental weights were indistinguishable regardless of the group. Dam plasma Cu and placental Cu were lower in both LCu groups than in the NFNCu or the HFNCu groups. However, fetal plasma Cu was similar in all treatment groups. Dam and fetal liver Cu stores were reduced in the LCu groups compared to the NCu groups. This resulted in lower fetal/maternal liver Cu ratios in the NFLCu (1.79+/-0.14, p < 0.05) and HFLCu (1.59+/-0.21, p < 0.05) as compared to the NFNCu (4.12+/-0.44) and the HFNCu (4.15+/-0.27). Dam liver Fe was higher in the NFNCu than in HFNCu group (1.10+/-0.8 vs. 0.89+/-0.06 micromol/g, p < 0.05); fetal liver Fe from HFNCu and NFLCu dams was lower than that from NFNCu fetuses (NFNCu: 2.42+/-0.14; HFNCu: 1.92+/-0.15, p < 0.05; NFLCu: 1.81+/-0.10, p < 0.01). Fetuses of the HFLCu group had a lower heart Fe than the NFNCu group (0.56+/-0.03 vs. 44.0+/-3.0 microg/g, p < 0.01). These data indicate that a maternal high-fat diet can potentially aggravate the effects of Cu deficiency by further altering fetal Cu and Fe tissue stores.

Carotid rupture and intraplaque hemorrhage: immunophenotype and role of cells involved

BACKGROUND

A complete immunohistochemical characterization in complicated carotid plaques is still lacking. The cellular components of 165 carotid endarterectomy specimens were analyzed to assess their role in the pathogenesis of plaque rupture and intraplaque hemorrhage without rupture.

METHODS AND RESULTS

The fibrous caps at the sites of plaque rupture showed CD68+ macrophages, T-lymphocytes, and scarce B-lymphocytes. Ruptured plaques showed mononuclear infiltrates in the caps, shoulders, and bases of the plaques in 85% of the cases. Only 46% of nonruptured plaques showed such infiltrates (P <.0001). Two types of lipid cores were recognized: avascular or mildly vascularized and highly vascularized. The vessels of the latter type reacted with CD31 and CD34. In 57.5% of the cases, the base and the shoulders of the plaques showed neoformed, CD34+ vessels, often surrounded by mononuclear infiltrates. Intraplaque hemorrhage without rupture had highly vascularized lipid cores in all cases. T-lymphocytes and macrophages were in close contact with neoformed vessels.

CONCLUSIONS

Plaque rupture is characterized by mononuclear cell infiltration of the caps, whereas intraplaque hemorrhage without rupture is characterized by extensive vascularization of the plaque.

Effect of cyclosporin on apoptosis in human cultured monocytic THP-1 cells and synovial macrophages

OBJECTIVE

Cyclosporin A (CyA) is an immunosuppressant drug used for the treatment of rheumatoid arthritis (RA), that might affect programmed cell death (apoptosis) of the cells involved in the synovial inflammatory reaction. The effects of CyA on apoptosis were evaluated on cultured human monocytic myeloid cells (THP-1 cell line) and on RA synovial macrophages.

METHODS

In order to induce THP-1 cell differentiation into adherent cells, an amount of these was treated with human recombinant IFN-gamma before incubation with CyA. Primary cultures of synovial macrophages were obtained from RA patients and treated in vitro with CyA.

RESULTS

CyA, at the pharmacological range (100-300 ng/ml) employed in the treatment of RA, seems to induce, after 48-96 hrs, programmed cell death in differentiating THP-1 cells, whereas cultured synovial macrophages (fully differentiated monocytic cells) do not show any apoptosis at the same time.

CONCLUSION

Short-term CyA treatment may induce increased apoptosis in immature and differentiating cultured monocytes. Cultured synovial macrophages (resident monocytic-derived and differentiated cells) seem to be resistant to the treatment as far as apoptosis is concerned.