EXERCISE AND MICRORNA

Physical activity stimulates numerous structural, metabolic, and morphological adaptations. These adaptations are vital for maintaining human health throughout life. Developments in molecular biology, biochemistry, and bioinformatics, along with exercise physiology have identified many signaling pathways, and transcriptional and translational processes responsible for exercise-related adaptations. The molecular mechanisms underlying the beneficial effects of exercise are not fully understood. Recently, the focus has been on microRNAs (miRNAs). They are small noncoding RNA molecules that negatively modulate gene expression and are involved in fundamental biological processes. This review describes miRNAs whose activities change in the heart, skeletal muscle, and circulation due to exercise. In addition, miRNAs with altered activity may be parameters adaptation to exercise, preventing injuries, and monitoring health status.

Molecular and IHC analysis of head and neck carcinomas associated with HPV infection

Head and neck squamous cell carcinomas (HNSCC) are a highly heterogenous disease which can be induced by two main carcinogens - tobacco and/or alcohol, or by HR HPV infection. This work examined 60 paraffin-embedded biopsies of head and neck carcinomas after histological verification. HPV infection, including its specific types in various HNSCC areas, was studied using multiplex qPCR. Expression levels of p16INK4A and p53 were detected by subsequent IHC analysis as being potential diagnostic markers. Based on the assumption that patients with HNSCC could benefit from anti-EGFR therapy (cetuximab), but the predictors are not yet defined, analyses of point mutations of ras genes (Kras, Nras) were carried out using multiplex qPCR and sequence analysis of the Braf gene. All statistical data were processed by Chí-x2 test.HPV infection was detected in 23.34 % of cases with HNSCC, of which 100 % were HPV 16, which is the most frequently infection found in the oropharyngeal region. Using IHC analysis, a positive expression of P16INK4A was detected in 100 % of HPV-positive HNSCC while this expression was discovered to be highly correlated with HPV infection. Furthermore, a correlation between p53 and HPV-negative HNSCC was proved. The mutation incidence was the highest in the Kras gene (codon 12 and codon 146), Nras (codon 12) and Braf. A correlation between tumor location in the oropharyngeal region and Kras mutations was proved. The HPV infection correlated with Kras mutations in case of codon 146 but on the grounds of low amount of output data, these figures could be irrelevant. In one case, c.1808 G>A, protein 603 Arg>Gln mutation was found in the Braf gene but its correlation with head and neck carcinomas has not been described yet (Tab. 2, Fig. 2, Ref. 24). Keywords: head and neck carcinomas, biopsy, HPV types, PCR, p16INK4A, p53, molecular predictors, Kras, Nras, Braf.

Metal sorption by biochars: A trade-off between phosphate and carbonate concentration as governed by pyrolysis conditions

Three feedstocks, pine wood, grass and cow manure, were pyrolyzed under various conditions and tested on their ability to sorb metals in aquatic systems. The feedstocks were pyrolyzed at 2 different temperatures (350 °C and 550 °C) and 2 different residence times (10 and 60 min) and resulting biochars were assessed on their capability to immobilize Pb, Cu, Cd and Zn. Manure-based chars, and to a lesser extent grass-based chars, featured high concentrations of phosphates and carbonates. These anions play an important role in metal sorption because they form insoluble complexes with the metals. Washing reduced the concentration of these anions, leading to a reduced sorption of metals by the biochar. The carbonate concentration on the biochars' surface increased at higher reactor temperature and longer residence times. The opposite trend was observed for the phosphate concentration and the cation exchange capacity. Accordingly, the optimal temperature-residence time combination for sorption was a trade-off between these properties. Biochar produced from cow manure and pyrolyzed at 550 °C for 10 min showed the best sorption for all metals considered.

Untangling Neolithic and Bronze Age mitochondrial lineages in South Asia

Two key moments shaped the extant South Asian gene pool within the last 10 thousand years (ka): the Neolithic period, with the advent of agriculture and the rise of the Harappan/Indus Valley Civilisation; and Late Bronze Age events that witnessed the abrupt fall of the Harappan Civilisation and the arrival of Indo-European speakers. This study focuses on the phylogeographic patterns of mitochondrial haplogroups H2 and H13 in the Indian Subcontinent and incorporates evidence from recently released ancient genomes from Central and South Asia. It found signals of Neolithic arrivals from Iran and later movements in the Bronze Age from Central Asia that derived ultimately from the Steppe. This study shows how a detailed mtDNA phylogeographic approach, combining both modern and ancient variation, can provide evidence of population movements, even in a scenario of strong male bias such as in the case of the Bronze Age Steppe dispersals.

Alkaline DNA Fragmentation in Vivo: Borderline or Negative Results Obtained Respectively with 7,12-Dimethylbenz[A]Anthracene and Benzo[A]Pyrene

Using the in vivo DNA damage alkaline elution assay, a satisfactory correlation with carcinogenicity in the same target organ has been previously shown for a variety of chemical agents. This work was intended to enlarge the exploration of the predictivity of this test. Benzo[a]pyrene (BP) was found negative for damage to liver DNA of mice and rats, and 7,12-dimethylbenz[a]anthracene (DMBA) negative for damage to liver and bone marrow DNA of mice and slightly positive for damage to mammary gland DNA of young female rats. The results were found to be correlated with the extension of DNA arylation in target organs in similar experimental conditions. From carcinogenicity data reported in the Survey of Compounds Which Have Been Tested for Carcinogenic Activity (vols. 1961-1973) BP and DMBA were both found to be essentially negative as liver carcinogens; however, DMBA was a potent carcinogen in inducing mammary tumors.

Effects of thymoquinone on liver miRNAs and oxidative stress in Ehrlich acid mouse solid tumor model

We investigated the effects of thymoquinone (TQ) on the expression of liver microRNAs (miRNAs), liver histopathology and oxidative stress in Ehrlich acid solid tumor model induced mice. We used 24 male BALB/c mice divided randomly into three groups. Control (C) group mice were injected intraperitoneally (i.p.) with 0.5 ml saline for four weeks. Tumor (T) group mice were injected i.p. with 0.5 ml saline for four weeks, then Ehrlich acid tumor cells were injected subcutaneously into the neck to induce solid tumor formation. TQ (T + Tq) group mice injected i.p. with 10 mg/kg TQ for four weeks, then Ehrlich acid tumor cells were injected subcutaneously into the neck of the mice in this group to induce solid tumor formation. At the end of the study, liver from all groups were removed for histopathological and miRNAs analysis, and oxidative stress measurement. We found that the expression of miR-206b-3p was up-regulated and the oxidative stress and necrosis increased in the liver tissue of mice with Ehrlich acid solid tumor. TQ application decreased the oxidative stress, prevented necrosis, increased regeneration and down-regulated the expression of miR-206b-3p in the liver tissue.

Uric acid: friend or foe? Uric acid and cognitive function "Gout kills more wise men than simple"

OBJECTIVE

The association between hyperuricemia and cardiovascular risk is widely known, and hyperuricemia is associated with many pathological conditions due to its effect on the endothelial function and metabolic homeostasis. The aim of this study was to verify whether the available literature may support the hypothesis that uric acid has a protective and stimulating effect on the cerebral cortex.

MATERIALS AND METHODS

We reviewed the actual knowledge of the positive effects of uric acid in terms of antioxidant action, neuroprotection, cognitive function, and intellectual performance.

CONCLUSIONS

Uric acid has a stimulating effect on the cerebral cortex, and this could have allowed humans, compared with other animals, to develop higher brain mass volume, better intellectual performances, and maybe evolutionary supremacy. On the other, a growing body of evidence is accumulating on the independent association between uric acid and cardiovascular risk. A careful interpretation of uric acid levels is appropriate and necessary in different kinds of patients, both at risk of cardiovascular or neurodegenerative diseases, due to its contrasting significance.

Mitochondrial DNA lineages of Italian Giara and Sarcidano horses

Giara and Sarcidano are 2 of the 15 extant native Italian horse breeds with limited dispersal capability that originated from a larger number of individuals. The 2 breeds live in two distinct isolated locations on the island of Sardinia. To determine the genetic structure and evolutionary history of these 2 Sardinian breeds, the first hypervariable segment of the mitochondrial DNA (mtDNA) was sequenced and analyzed in 40 Giara and Sarcidano horses and compared with publicly available mtDNA data from 43 Old World breeds. Four different analyses, including genetic distance, analysis of molecular variance, haplotype sharing, and clustering methods, were used to study the genetic relationships between the Sardinian and other horse breeds. The analyses yielded similar results, and the FST values indicated that a high percentage of the total genetic variation was explained by between-breed differences. Consistent with their distinct phenotypes and geographic isolation, the two Sardinian breeds were shown to consist of 2 distinct gene pools that had no gene flow between them. Giara horses were clearly separated from the other breeds examined and showed traces of ancient separation from horses of other breeds that share the same mitochondrial lineage. On the other hand, the data from the Sarcidano horses fit well with variation among breeds from the Iberian Peninsula and North-West Europe: genetic relationships among Sarcidano and the other breeds are consistent with the documented history of this breed.

Prescription of oral antidiabetic drugs in K/DIGO chronic kidney disease stage 3 and 4: a single centre report

AIM

Evaluation of chronic kidney disease (CKD) is essential in order to prescribe properly oral antidiabetic drugs (OADs). The aim of our study was to report hypoglycemic drugs prescription to CKD in a cohort of type 2 diabetes mellitus (DM) outpatients.

METHODS

This survey included 1686 outpatients with type 2 DM treated with OADs who were not taking insulin evaluated by a team of diabetologists. Glomerular filtration rate (GFR) was calculated by the CKD-EPI formula and subjects were classified in the K/DIGO stages. Main clinical parameters were also evaluated.

RESULTS

Patients were aged 68±10 years, 57.1% were males, Body Mass Index was 30±5 kg/m2, glycated hemoglobin 8±1%, systolic and diastolic blood pressure values were 138±15/80±9 mmHg. Serum creatinine was 1.03±0.35 mg/dL and GFR 71±21 mL/min/1.73 m2. In 504 patients (30%) GFR was lower than 60 mL/min/1.73 m2. The different treatment groups had different GFR and hypoglycaemic drugs were prescribed differently in the different K/DIGO stages. The majority of subjects in stage 3A and 3B were treated with repaglinide, however a significant percentage of them were treated with metformin and sulfonylureas. Nearly half of subjects with CKD stage 4 were treated with metformin and sulfonylureas.

CONCLUSION

In this report we found that nearly one third of patients with type DM 2 had CKD and in a significant percentage of them OADs were prescribed even if they were in K/DIGO CKD stage 3 and 4.

The estimation of glomerular filtration rate in type 2 diabetic patients may depend on the equation used

BACKGROUND

The aim of this study was to compare the estimation of glomerular filtration rate (GFR) in type 2 diabetes mellitus (DM) outpatients.

PATIENTS AND METHODS

The study included 1686 subjects, aged 68±10 years. GFR was evaluated with five different equations: GFRMDRD186, GFRMDRD175, GFRCKD-EPI, GFRMAYO, GFRC-G.

RESULTS

GFR was lower than 60 ml min-1 kg-1 in 456 patients (27%) by GFRMDRD186, in 531 (31.5%) by GFRMDRD175, in 504 (30%) by GFRCKD-EPI, in 433 (26%) by GFRC-G, and in 255 (15%) by GFRMAYO. The mean differences in measuring GFR with the different formulae ranged from 1.03±6.20 to -14.5±11.9 ml min-1 1.73 m2-1.

CONCLUSIONS

The evaluation of GFR with different formulae in type 2 DM patients may identify different chronic kidney disease (CKD) stages. Physicians could take advantage by the knowledge of the formula used for evaluation of renal function, for a better interpretation of values and a more appropriate use in the everyday clinical practice.

Invasive procedure for intractable epistaxis in an old comorbid woman: a case report

Epistaxis is a condition mainly self-limiting or easily treated conservatively, although in rare cases it could become life-threatening. We discuss the case of a 73 year comorbid old woman with severe and recurrent epistaxis treated with superselective catheterism and embolization of the internal maxillary artery. The possible underlying causes, including drug related issues, are discussed.

Cocaine and acute vascular diseases

Cocaine is one of the most widely used drugs of abuse. Chest pain is the most common side effect requiring emergency visits after cocaine use. Vasoconstriction and platelet activation are the main effects of cocaine in the vasculature. In this brief review, we consider the most important clinical effects of cocaine abuse on the heart, brain and kidney. Symptoms related to cocaine toxicity such as myocardial infarction, congestive heart failure, arrhythmias, aortic dissection, stroke, renal failure, are similar to the clinical picture of atherosclerotic vascular damage, even if the age of cocaine abusers is usually in the second and third decades. Clinicians (especially emergency department physicians) should consider substance abuse among the differential diagnosis of chest pain in young people.

Definitive radiochemotherapy with weekly cisplatin in patients with head and neck cancer; single institution outcome analysis

PURPOSE

The objective of this study was to evaluate the feasibility, toxicity and efficacy of definitive radiochemotherapy with weekly cisplatin in head and neck cancer in a single institutional setting.

METHODS

Previously untreated patients with stage II-IV head and neck cancer were included. Radiotherapy consisted of 70 Gy/7 weeks/35 fractions. All patients received concurrent cisplatin 40 mg/m(2) weekly.

RESULTS

Between 2/2002 and 8/2009, 148 consecutive patients (WHO ≤ 2, male to female ratio 6/1, median age 56 years) were treated. The mean follow-up was 40 months. Tumors of the oropharynx were the most frequent (46%) and stage IV predominated (80%). Eighty-nine percent of the patients had received the full radiation treatment as planned. Omission of weekly cisplatin occurred frequently, mainly because of hematological toxicity. Only 64% of the patients completed at least 5 cycles of chemotherapy. Grade 3/4 mucosal toxicity developed in 32% of the patients. The late toxicities were acceptable: 74% of the patients were able to eat solid food during the 1st post-treatment year, 4 patients were not able to swallow at all during the 1st post-treatment year, requiring thus permanent feeding tube. Five cases of osteoradionecrosis of the mandible were reported. Three-year overall survival, locoregional control, time to progression and disease free survival were 34, 60, 52 and 29%, respectively.

CONCLUSION

Definitive radiochemotherapy with weekly cisplatin was toxic, with high rate of morbidity and mortality in this patient population. Five weekly cycles of 40 mg/m(2) cisplatin seem to be the dose limit for most patients. Three-year survival was significantly reduced despite the promising high initial response and locoregional control.

Left kidney: an unusual site of cocaine-related renal infarction. A case report

Acute renal infarction is a well known, although relatively unfrequent, cause of flank pain resistant to administration of spasmolytic and nonsteroidal anti-inflammatory drugs. We present an original case of a 41-year-old man, complaining of acute severe left flank pain, resistant to common analgesic therapy, who was diagnosed of segmental renal infarction of a branch of left renal artery. Pathophysiology of renal damage in cocaine users is multifactorial, and it has been postulated that the right kidney was more prone to ischaemia. Left kidney represents an extremely unusual site of cocaine-related renal infarction.

Clinical features of cardio-renal syndrome in a cohort of consecutive patients admitted to an internal medicine ward

Introduction:

Cardiorenal syndrome (CRS) is a disorder of the heart and kidney whereby interactions between the 2 organs can occur. We recorded the clinical features of CRS in patients consecutively admitted to an Internal Medicine ward.

Patients and Methods:

We retrospectively analyzed the anthropometric, history, clinical, biochemical and treatment characteristics in 438 out of 2,998 subjects (14.6%) admitted to our unit (from June 2007 to December 2009), diagnosed with CRS, according to Acute Dialysis Quality Initiative (ADQI) recommendations. Estimated glomerular filtration (eGFR) was calculated using several equations: MDRD (Modification of Diet in Renal Disease; 2 variations GFR_MDRD186, GFR_MDRD175), Mayo, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockroft-Gault.

Results:

Mean age was 80±8 years, 222 (50.6%) were males, 321 (73.2%) were smokers, 229 (52.2%) were diabetic, 207 (47.2%) had a history of acute myocardial infarction, 167 (38.1%) had angina, 135 (30.8%) were affected by cerebrovascular disease, 339 (77.3%) had peripheral arterial disease. CRS was type 1 in 211 cases (48.2%), type 2 in 96 (21.9%), type 3 in 88 (20.1%), type 4 in 29 (6.6%) and type 5 in 14 (3.2%). eGFR, calculated by different formulae, ranged between 31 and 36 ml/min/1.73 m². GFR was lower in CRS type 3 than in the other types, and the values ranged between 24 and 27 ml/min/1.73 m². Mean hospital length-of-stay (LOS) was 9.8±6.3 days. Diuretics were the most prescribed medication (78.7%); only 5 patients underwent haemodialysis.

Conclusions:

CRS is common, especially in the elderly. CRS Type 1 was the prevalent subset and patients had stage 3-4 renal insufficiency. Results obtained from the GFR equations were similar although the Mayo equation tended to overestimate the eGFR.

The dilemma of diagnosing fever of unknown origin: large arteries vasculitis revealed by 18F-FDG PET/CT imaging. A case report

Fever of unknown origin (FUO) is an uncommon disease, and its underlying etiology may include a number causes, i.e., infections, malignancies, autoimmune conditions. Diagnosis is often a difficult task, and usually physician spend time and money in order to define the etiology of FUO. We report a case of patient who presented with FUO and headache, and positron emission tomography (PET) with 2-deoxy-2-[fluorine-18] fluoro-D-glucose (18F-FDG) allowed to reveal the presence of a large vessel vasculitis. 18F-FDG PET may represent an useful tool in patients with FUO, since it can early depict an hypermetabolic activity due to inflammation and so help to achieve a final diagnosis in some cases of FUO.

Pleural effusion in an immunocompetent woman caused by Mycobacterium fortuitum

Mycobacterium fortuitum is a non-tuberculous mycobacterium that can cause pneumonia, abscess and empyema in subjects with predisposing lung diseases. However, pleurisy with effusion is rare. Herein, we report the case of a 74-year-old immunocompetent female patient without apparent risk factors, who suffered haemorrhagic pleural effusion as the main clinical manifestation. Pleural nodules were detected by computed tomography scan, and microbiological analysis revealed M. fortuitum in the absence of other pathogens. The patient was treated with ceftriaxone and ciprofloxacin, and full recovery ensued in 4 weeks. To our knowledge, this is the first reported case of haemorrhagic pleural effusion in an immunocompetent patient without underlying diseases. Although non-tuberculous mycobacterial infections are rarely accompanied by pleural involvement, M. fortuitum should be considered in such cases, especially when microbiology fails to detect the usual pathogens, and when the clinical picture is unclear.

Detection of urinary abnormalities in a community from northern Italy based on the World Kidney Day screening program

BACKGROUND

Chronic kidney disease (CKD) is a worldwide health problem, and promotion of the World Kidney Day has improved general population education and awareness of renal illnesses aimed at ameliorating disease prevention. The Kidney Day was also an opportunity for us to investigate risk factors for CKD in an Italian population.

PATIENTS AND METHODS

A total of 1,341 subjects from the general population living in the area of Ferrara, a town in the northeast of Italy, aged 50-70 years, were investigated. From each participant age, sex, smoking status, current antihypertensive medications, hypercholesterolemic and diabetic status, body mass index (BMI), waist circumference and blood pressure (BP) were obtained. All subjects underwent dipstick urinalysis for the evaluation of proteinuria, hematuria and leukocyturia.

RESULTS

Fifteen percent of patients were diabetics, and 20% were smokers. Mean BMI was 26.9 ± 4.3 kg/m(2), mean systolic BP was 133.7 ± 18.7 mmHg and mean diastolic BP 78.1 ± 9.9 mmHg. A total of 828 participants were not taking any antihypertensive drugs. In 24% of subjects, we found proteinuria, in 18% hematuria and in 16% leukocyturia. Proteinuria was significantly associated with age and diabetes, hematuria was associated with age, female sex and smoking status, and leukocyturia was associated with age and female sex.

CONCLUSIONS

Urinary abnormalities are common in general population, and in many cases, various abnormalities overlap. These abnormalities could be associated with cardiovascular risk factors. We believe that our initiative, based on the experience of the World Kidney Day, could increase the awareness of general practitioners and general population of the risks of renal conditions.

The complex and diversified mitochondrial gene pool of Berber populations

The mitochondrial DNA variation of 295 Berber-speakers from Morocco (Asni, Bouhria and Figuig) and the Egyptian oasis of Siwa was evaluated by sequencing a portion of the control region (including HVS-I and part of HVS-II) and surveying haplogroup-specific coding region markers. Our findings show that the Berber mitochondrial pool is characterized by an overall high frequency of Western Eurasian haplogroups, a somehow lower frequency of sub-Saharan L lineages, and a significant (but differential) presence of North African haplogroups U6 and M1, thus occupying an intermediate position between European and sub-Saharan populations in PCA analysis. A clear and significant genetic differentiation between the Berbers from Maghreb and Egyptian Berbers was also observed. The first are related to European populations as shown by haplogroup H1 and V frequencies, whereas the latter share more affinities with East African and Nile Valley populations as indicated by the high frequency of M1 and the presence of L0a1, L3i, L4*, and L4b2 lineages. Moreover, haplogroup U6 was not observed in Siwa. We conclude that the origins and maternal diversity of Berber populations are old and complex, and these communities bear genetic characteristics resulting from various events of gene flow with surrounding and migrating populations.

Rare mtDNA variants in Leber hereditary optic neuropathy families with recurrence of myoclonus

OBJECTIVE

To investigate the mechanisms underlying myoclonus in Leber hereditary optic neuropathy (LHON).

METHODS

Five patients and one unaffected carrier from two Italian families bearing the homoplasmic 11778/ND4 and 3460/ND1 mutations underwent a uniform investigation including neurophysiologic studies, muscle biopsy, serum lactic acid after exercise, and muscle ((31)P) and cerebral ((1)H) magnetic resonance spectroscopy (MRS). Biochemical investigations on fibroblasts and complete mitochondrial DNA (mtDNA) sequences of both families were also performed.

RESULTS

All six individuals had myoclonus. In spite of a normal EEG background and the absence of giant SEPs and C reflex, EEG-EMG back-averaging showed a preceding jerk-locked EEG potential, consistent with a cortical generator of the myoclonus. Specific comorbidities in the 11778/ND4 family included muscular cramps and psychiatric disorders, whereas features common to both families were migraine and cardiologic abnormalities. Signs of mitochondrial proliferation were seen in muscle biopsies and lactic acid elevation was observed in four of six patients. (31)P-MRS was abnormal in five of six patients and (1)H-MRS showed ventricular accumulation of lactic acid in three of six patients. Fibroblast ATP depletion was evident at 48 hours incubation with galactose in LHON/myoclonus patients. Sequence analysis revealed haplogroup T2 (11778/ND4 family) and U4a (3460/ND1 family) mtDNAs. A functional role for the non-synonymous 4136A>G/ND1, 9139G>A/ATPase6, and 15773G>A/cyt b variants was supported by amino acid conservation analysis.

CONCLUSIONS

Myoclonus and other comorbidities characterized our Leber hereditary optic neuropathy (LHON) families. Functional investigations disclosed a bioenergetic impairment in all individuals. Our sequence analysis suggests that the LHON plus phenotype in our cases may relate to the synergic role of mtDNA variants.

[GIST: surgical treatment of 34 cases]

In our Department of General Surgery 34 patients underwent surgery for GIST from 1983 to 2002. In stomach (21 cases) we performed: 7 local resections, 7 partial gastric resections, 5 total gastrectomies, 1 total gastrectomy + splenopancreatectomy, 1 diagnostic laparoscopy with biopsy. In small bowel (5 cases) we performed a typical intestinal resection, while in colon localization (4 cases) 2 anterior colorectal resections and 2 right partial colectomies. In duodenal and omental localization (2 cases each) we performed local resection. There was no operative mortality or morbidity. Actual survival is 67.6%. Prognostic prediction on the basis of histological findings is difficult, thus after surgery we suggest a long last follow-up.

The effect of simulated rain on folpet and mancozeb residues on grapes and on vine leaves

Artificial rainfalls were used to determine the effect of the amount of the rainfall and the time interval between pesticide application and rainfall event, on folpet and mancozeb residues on grapes and vine leaves. Forty-five mm of rain were administered to the vineyard in different amounts (45; 30+15; 15+15+15 mm). Folpet showed good rainfastness on the grapes and on the leaves. A modest decrease was observed only in the experiments that had received 45 mm of rain at one go. Mancozeb showed a lower rainfastness, since a portion of the deposit was easily washed off also by a modest rainfall. The percentage of this portion was higher in the grapes (38%) than in the leaves (20%). The data obtained in these experiments show that, in the case of folpet, it is not necessary to repeat the treatment when it rains the day after, while it is recommendable to repeat it in the case of mancozeb.

Fenhexamid residues in grapes and wine

The behaviour of the fungicide, fenhexamid, on grapes, and during wine-making, as well as its effect on the microflora of alcoholic and malolactic fermentation has been studied. After treatment, the residue on grapes decreased rapidly to one-third of the initial level after the first week, while it remained constant during the following two weeks. At harvest, in the wine obtained by vinification without skins, the fungicide residue decreased on average by 49%, while in the wine obtained by vinification with skins, the decrease was on average 62%. The presence of this fungicide on grapes and in the wine did not affect alcoholic and malolactic fermentation, nor did fermentation cause any degradation of the fungicide. A simple and rapid gas chromatograhic method (GC-NPD) for the determination of fenhexamid residues in grapes, must and wine is described.

Fate of quinoxyfen residues in grapes, wine, and their processing products

Quinoxyfen is a new fungicide that belongs to the family of the quinolines, recently introduced to control powdery mildew (Uncinula necator). In this paper the fate of quinoxyfen residues from vine to wine and in their processing products was studied. After the last of four applications at the recommended rate, 0.38 mg/kg of residue was found on the grapes, which is under the legal limit fixed in Italy (0.5 mg/kg). The degradation rate was according to a pseudo-first-order kinetics (r = 0.964) and the half-life was 7.24 days. Vinification was carried out with and without maceration. During the vinifications without maceration <50% of the residues passed from the grapes to the musts. Separation of the lees (8%) from the must by centrifugation caused no detectable residues in centrifuged must. At the end of fermentation with and without maceration no quinoxyfen residues were determinable in the wine. No effect on the alcoholic or malolactic fermentation was observed even in the presence of higher quinoxyfen concentrations than those found in the grapes at harvest time. During fermentation, the yeasts partially degraded the pesticides and completly adsorbed them. Bacteria, on the other hand, do not have any degradative effect on the pesticides. The raisins obtained by sun-drying did not contain any residues, whereas those obtained by oven-drying show the same amount of residues as in the fresh grapes. During the sun-drying process the fruit weight decreased by a factor of 4; the decrease in the oven-drying was equivalent. Samples of dregs and liquid lees, fortified with high levels of quinoxyfen. were double-distilled. The first dregs distillate, with an alcohol content of 32.1%, did not show any residues, whereas the first lees distillate, with an alcohol content of 34.5%, showed 7% of the initial residues. After the second lees distillation, the obtained product showed an alcoholic content of 81.2% and no residues of quinoxyfen (<0.01 mg/kg).

Ultraviolet C irradiation at 0.5 kJ.m(-)(2) reduces decay without causing damage or affecting postharvest quality of star ruby grapefruit (C. paradisi Macf.)

Star Ruby grapefruit [Citrus paradisi (Macf.)] were harvested in November, February, and May, treated with ultraviolet C (UV-C) light at 0.5, 1.5, or 3.0 kJ.m(-)(2), and then stored at 7 degrees C and 90-95% relative humidity (RH) for 4 weeks with 1 additional week at 20 degrees C and approximately 80% RH. Untreated fruits were used as control. UV-C irradiation at 0.5 kJ.m(-)(2) effectively reduced decay development as compared to nontreated fruit without causing damage. Irradiation at dosages >0.5 kJ.m(-)(2) did not further improve decay control and caused rind browning and necrotic peel, the extent of damage depending on treatment dosage and harvest date. The percentage of damaged fruit after irradiation at the higher UV-C dosages was significantly higher in fruit harvested in November; differences between fruits harvested in February and May were negligible. After UV-C irradiation, the phytoalexins scoparone and scopoletin accumulated in flavedo tissue, their amounts depending on harvest date and UV-C dosage. Both phytoalexins showed similar accumulation patterns, although the concentrations of scoparone were much lower than those of scopoletin. Phytoalexin levels increased in most samples as the treatment dosage increased. No detectable levels of scoparone and scopoletin could be found in nonirradiated fruit. The influence of UV-C treatments on soluble solids concentration and titratable acidity of juice was negligible.

Acephate and buprofezin residues in olives and olive oil

Field trials were carried out to study the persistence of acephate and buprofezin on olives. Two cultivars, pizz'e carroga and pendolino, with very large and small fruits respectively were used. After treatment, no difference was found between the two pesticide deposits on the olives. The disappearance rates, calculated as pseudo first order kinetics, were similar for both pesticides (on average 12 days). Methamidophos, the acephate metabolite, was always present on all olives, and in some pendolino samples it showed higher residues than the maximum residue limit (MRL). During washing, the first step of olive processing, the residue level of both pesticides on the olives did not decrease. After processing of the olives into oil, no residues of acephate or methamidophos were found in the olive oil, while the residues of buprofezin were on average four times higher than on olives.

Water use and water-use efficiency of chickpea and lentil in a Mediterranean environment

Water supply is a major constraint to crop production for both chickpea and lentil in West Asia and North Africa, both of which have a Mediterranean climate. This study examined water use and water-use efficiency of chickpea and lentil from 3 experiments over 12 seasons, 1986–87 to 1997–98, in northern Syria. The strongest determinant of grain yield of chickpea and lentil and their water use under rainfed conditions is rainfall and its distribution. Large inter-seasonal fluctuations in weather resulted in larger inter-seasonal fluctuations in water use, and therefore in production of legumes. Seasonal evapotranspiration (ET) was significantly correlated with seasonal rainfall for both chickpea and lentil. Mean ET over 12 seasons was 268 mm for chickpea and 259 mm for lentil. The depth of extraction was, on average, 120 cm for chickpea and 80 cm for lentil. The average extractable soil water was 125 mm for chickpea and 90 mm for lentil over 12 seasons. For lentil, water-use efficiency for dry matter (WUEdm) and for seed yield (WUEgr) was 13.7 and 3.8 kg/ha.mm, respectively; for chickpea, WUEdm and WUEgr, 8.7 and 3.2 kg/ha.mm, respectively. Supplemental irrigation can significantly increase grain yield of both chickpea and lentil. However, there was less increase in grain yield in the wet seasons than in the dry seasons. Estimated soil evaporation was 80 mm for lentil and 105 mm for chickpea. The average transpiration efficiency was 7.1 kg/ha.mm for lentil and 6.4 kg/ha.mm for chickpea. Estimated potential transpiration efficiency for seed yield was 11.8 kg/ha.mm for lentil and 12.2 kg/ha.mm for chickpea. Both the average water-use efficiency and potential transpiration efficiency for lentil and chickpea were lower than those for cereals. Despite this, the rotation benefits and higher economic return provide the potential for these legumes to replace fallow or to break continuous cereal cropping in the region's farming system.

[Hypertrophic cardiomyopathy during adrenocorticotrophic hormone administration in infants: a case report]

We report a 2-month-old child with infantile myoclonic seizures, who developed congestive heart failure secondary to hypertrophic cardiomyopathy while receiving adrenocorticotropic hormone (ACTH) therapy. Treatment with propranolol and withdrawal of ACTH led to the resolution of cardiac hypertrophy as determined by two-dimensional echocardiography. Possible links between ACTH therapy and the development of hypertrophic cardiomyopathy are examined. Our report confirms that a careful monitoring is required to detect cardiac abnormalities during ACTH administration.

[Pseudoaneurysm and aneurysm of the left ventricle. Discription of a case and long-term follow-up]

Left ventricle pseudoaneurysm is an uncommon complication of myocardial infarction; urgent operation is usually recommended, because of the high rate of severe complications. We report a single case with coexistence of a true aneurysm and a pseudoaneurysm, asymptomatic after three years of follow up in the absence of surgery.

CASE REPORT

The patient, female, aged 69, was observed after an event of prolonged chest pain; ECG showed inferolateral necrosis. Echocardiographic examination showed: left ventricle enlargement with postero-lateral akinesis and septo-apical aneurysm, thin apical thrombosis and mild mitral regurgitation; a non-contractile concameration, aside of lateral wall, containing some thrombotic material and communicating with the left ventricle through a little hole (gap of echoes), crossed by a very little inflow jet. The diagnosis of coexisting septo-apical "true" aneurysm and postero-lateral pseudoaneurysm was confirmed with CT scan, NMR and left ventriculography. Coronary angiography showed total occlusion of LAD and a critical stenosis of mid LAD. The patient refused the operation. In 36 months follow-up no symptoms nor significant echocardiographic changes were observed.

DISCUSSION

The pseudoaneurysm is caused by slow fissuration of the myocardium (after a myocardial infarction) with adhesion of pericardium and fibrosis, resulting in a saccular cavity, communicating with the left ventricle by a little hole; on the contrary the more frequent "true" aneurysm is a progressive dilatation and thinning of the ventricular wall, with parietal fibrotic degeneration. Echocardiography may be useful in differential diagnosis, but an excellent quality of the images is required and false negatives and positives are frequent. In this case the echocardiographic features include the thickness of the pseudoaneurysmal wall, the very low flow through the communication hole and the minimal mitralic involvement.

CONCLUSION

This particular pattern, when accurately assessed, could probably be predictive of low risk and favorable prognosis in patients with pseudoaneurysm.

[Pulmonary thromboembolism. A clinical case with unusual presentation]

The authors describe a rare case of pulmonary thromboembolism with unusual clinical findings and emphasized the large difficulty encountered in formuling a correct diagnosis in a reasonable time. A man, 60 years old, was admitted to a Medical Division of our hospital for the appearance of chest pain and epigastric pain during effort in the last year. He smoked 20 cigarettes a day and drank wine (1 or 2 litres a day). He was affected by hypercholesterolemia and in the past reported relapsed thrombophlebitis in the left leg. Four years before admission to our hospital he underwent large and small left saphenectomy. He had no cardiac events in the past. After a non significant exercise stress test the patient was treated with nitrates and asa and was discharged from the hospital. At home the symptoms increased and after 8 months the patient was admitted again to the Cardiologic Division of the hospital. At admission he reported dyspnea and chest pain at rest, not only during effort and the ECG showed negative T waves in anterior and inferior leads. Intravenous heparine, nitrates and calcium antagonists stabilized the clinical picture. The following examinations revealed: reduction of the T wave negativity at the ECG registered during chest pain; mild enlargement of the heart at the chest roentgenogram; normal value of the left ventricle and apical and midseptal by ipokinesia at the transthoracic echocardiogram; normal coronary artery at the coronary arteriography. "Vasospastic angina" was diagnosed and the patient was discharged after 20 days, asymptomatic. After 15 days he returned to the hospital again for chest pain, dyspnea, hypotension and syncope despite therapy. At physical examination he showed a painful left tibio-tarsal tumefaction, an increased and splitting second heart sound in the pulmonary area and a systolic murmur in the third and fourth left interspace. The ECG showed a severe anterior ischemia, while a new transthoracic echocardiogram revealed a considerable dilatation of the right atrium, right ventricle and the main pulmonary artery with severe tricuspid regurgitation and pulmonary hypertension (mean PAP about 50 mmHg). The following pulmonary perfusion scintigraphy confirmed the diagnosis of pulmonary embolism and the selective right and left pulmonary arteriography exhibited multiple thrombi and large intravascular filling defects. The right heart catheterization confirmed a chronic precapillary pulmonary hypertension (mean PAP = 55 mmHg). About 24 hours after these examinations the patient died because of a cardiac arrest with electromechanical dissociation. Pulmonary thromboembolism is a potentially fatal disease characterized by a largely variable clinical presentation. Frequently pulmonary embolism diagnosis is difficult especially when clinical findings are unusual. In the case observed the "typical" chest and epigastric pains associated with the electrocardiographic findings directed diagnosis towards myocardial ischemia. Also after the coronary arteriography that showed normal coronary artery, the erroneous diagnosis persisted. Pulmonary embolism was correctly diagnosed too late to begin an effective therapy. These unusual clinical findings and diagnostic mistakes are stressed and critically reviewed in the article.

[An unusual case of "catecholamine necrosis" caused by accidental digitalis poisoning]

Toxic manifestations of digitalis are one of the most prevalent adverse drug reactions encountered in clinical practice. The estimated incidence is about 20% in hospitalized patients in the USA. The authors describe a rare case of myocardial "catecholamine necrosis" (anteroseptal myocardial infarction) during accidental digitalis intoxication. A male patient, 75 years old, suffering from cirrhosis and ascites, take on by mistake a tablet of digoxin 0.25 mg. four times at day for eleven days. He hadn't heart disease in the past. At the eleventh day the patient showed a deep tiredness and so he was submitted to a clinical examination and electrocardiogram. The ECG demonstrated an anteroseptal myocardial infarction in the second-third electrical stage. The patient was hospitalized. The successive examination revealed: very high plasma digitalis concentrations; an increase of the serum levels of CPK and LDH; a significant increase of plasmatic and urinary catecholamine levels which return to normal values after fifteen days; apical akinesia at the echocardiographic examination; no signs of residual myocardial ischemia to the echo-dypiridamole stress test; normal coronary artery to the coronary arteriography and absence of coronary artery spasm to the ergonovine test. Furthermore the abdominal echography and the abdominal computerized tomography didn't reveal surrenal disease but showed an important liver disease. The patient was free from other cardiac events in the follow-up. Generally, during the digitalis intoxication we observe various rhythm and conduction disturbances. Instead in this case no serious arrhythmias were registered and the main expression of the drug toxicity was an anteroseptal myocardial infarction with undamaged coronary artery. Also the usual extracardiac symptoms and signs of the digitalis intoxication were absent in this case. All these observations can be explained with the pathological increase of the cathecholamine levels, indirectly induced by digitalis; with the direct toxic effect of the drug at the myocardic level; with the contemporary absence of ionic disturbances; with the concomitant liver disease. The direct toxic effect of the digitalis produced an increase in calcium ions availability for the electromechanical coupling and an increase of the intramyocardial pressure; the increase of the adrenergic activity determined contemporary an increase in the oxygen consumption of the myocardial cells, a rise of vascular tone and coronary artery tone and a reduction of the duration of the diastole. All these factors provoked a "primary and secondary" ischemia which evolved toward a real "cathecholamine necrosis" and produced a myocardial infarction. This hypothesis explains the myocardial infarction in absence of injury at the coronary arteriography and without coronary spasm at the ergonovine test; moreover it explains the transient increase in cathecholamine plasma levels observed in the acute phases an normalized after fifteen days. The "cathecholamine necrosis" is an anatomical definition, nevertheless in our opinion it gives account of the rare clinical situation observed.

Influence of harvesting and drying techniques on microflora and mycotoxin contamination of figs

Mould growth and mycotoxin (aflatoxins and ochratoxin A) formation were examined in the 1993 dried figs crop. The relationships between mould/mycotoxin contamination and orchard conditions, different harvesting techniques, harvesting time and intactness of fruits were investigated. The fruits were examined during drying and effects of different pretreatments, sun drying and solar drying on the mould and mycotoxin contamination in figs were also studied. Aflatoxins (B1, B2, G1 and G2) were not present in the firm or shrivelled ripe figs. Among the samples examined during drying, only one of the 32 samples was found to be aflatoxin positive. Ochratoxin A was not detected in any of the samples analysed. The moisture content, aw and pH values of full ripe and shrivelled fruits were suitable for mould growth and mycotoxin formation while these parameters in pretreated and dried fruits were found to be too low to allow such outcome. It was observed that harvesting the fruit by hand-treating with different solutions and application of solar drying were effective in reducing contamination level.

Chemical and mutagenic patterns of airborne particulate matter collected in 17 Italian towns

The mutagenicity of airborne particulate matter collected in 17 towns of Italy in 1990 was assessed using the Ames test. The mutagenicity of crude extract correlated with amount of lead, suggesting the direct contribution of gasoline car exhausts. Moreover, the mutagenicity correlated with particulate matter amounts. An inverse correlation with temperature was observed. The crude extracts were fractionated in acid, basic, and neutral fractions. The latter was further separated into polycyclic aromatic hydrocarbon (PAH), polar, and nonpolar fractions. Acid and polar fractions showed the higher mutagenicity. Average recovery of mutagenicity was about 60%.

[Calcitonin-induced anaphylactic shock. Case report and review of the literature]

A case of anaphylactic shock determined by intramuscular administration of a dose of synthetic calcitonin in a 64-years-old man is described. The patient had not suffered significant cardiovascular events in the past; he smoked twenty cigarettes a day and he was treated with calcitonin for osteoporosis and polyarthrosis. Allergy to diclofenac was demonstrated in the past while preceding administrations of spray calcification didn't provoke side-effects in the patient. Nevertheless after the second i.m. administration of the drug he suddenly fainted. Dyspnea, severe hypotension and maculo-papular erythema were present at the moment of admission to our hospital. The continuous electrocardiogram monitoring showed a characteristic "migrant" ST elevation at first in the anterior leads, then in inferior and septal leads, and premature ventricular and atrial beats. The echocardiographic transtoracic examination proved an apical and septal akinesia which completely disappeared after one hour at a second echocardiographic examination. In spite of intensive medical treatment (lignocaine and hydrocortisone e.v.) the patient had a sustained ventricular tachycardia that quickly degenerated into ventricular fibrillation. After one DC shock at 300 joules we observed spontaneous spontaneous restoration of the normal sinus rhythm. The following clinical evolution was good and no other arrhythmias or cardiovascular symptoms were observed. In order to estimate the reasons of the clinical picture the patient was submitted to serial blood examinations, serial electrocardiograms, exercise stress test, echodypiridamole stress test and serial echocardiograms. The blood examinations showed a relative eosynophilia (3%), the increase of IgE serum level (316 UI) and transient ipokalemia (2.3 mEq/l). None pathological findings were observed in the other examinations.(ABSTRACT TRUNCATED AT 250 WORDS)

[The role of the echo-dipyridamole test in the differential diagnosis of chest pain]

We have verified the utility of echo-dipyridamole test in the diagnosis of chest pain of unsure origin, especially in patients who cannot be quickly submitted to exercise stress test because of permanent abnormalities at basal ECG or because of clinical reasons. 17 patients with chest pain, abnormalities at basal ECG not evolutive and insignificant for myocardial ischemia, absence of enzymatic curve, were admitted to our hospital from September 1988 to January 1990. All these patients were submitted before the ninth and fifteenth day of hospitalization to the echo-dipyridamole test. Drugs were discontinued 3 days before the test. Dipyridamole was administered intravenously in 4 minutes at dosage of 0.56 mg/kg during ECG and echocardiographic monitoring. If no ECG or echocardiographic changes were observed, a second intravenous bolus of dipyridamole at a dosage of 0.28 mg/kg in 2 minutes was made. After the end of infusion continuous ECG and echocardiographic monitoring was performed for 20 minutes at least. Blood pressure was controlled every 3 minutes. Only the major changes in segmental wall motion were considered for analysis to minimize possible errors. Moreover a second physician not present during the test, revised in following the wall motion changes of all the tests. The test was positive in 5 patients (29%) (positive group) and negative in 12 (71%) (negative group). The changes in the heart rate and blood pressure observed during the test were not significantly different in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Correlations between 15 polycyclic aromatic hydrocarbons (PAH) and the mutagenicity of the total PAH fraction in ambient air particles in La Spezia (Italy)

Airborne particulate matter has been monitored 4 times a month for 1 year (1988) in the city of La Spezia (Italy). The polycyclic aromatic hydrocarbon (PAH) fractions were extracted, purified and characterized for the content of 15 individual PAH. In general when concentrations of individual PAH were compared statistical correlation was obtained. Mutagenicity studies were performed by the use of the Ames plate test with the Salmonella strains TA98, TA100, TA98NR and TA98DNP6 with and without metabolic activation (S9 mix). The TA98 strain was by far the most responsive and the S9 mix was absolutely required as expected when PAH are assayed. Besides mutagenicity, toxicity was also considered and it proved to be correlated with mutagenicity in TA98, +S9. The TA98NR and TA98DNP6 strains showed no appreciable differences from the parental strain TA98 indicating the absence of significant amounts of direct-acting nitro derivatives in our PAH samples. Of the 15 PAH considered in this study the amounts of cyclopental[c,d]pyrene (CPP) correlated best with mutagenicity. The role of CPP in contributing to the indirect mutagenicity of urban air PAH samples is discussed.

[Ventricular afterload and transmitral Doppler flow profile: effects of the diving test]

The influence of loading conditions on mitral flow velocity profile was studies by pulsed wave Doppler echocardiography in 10 normal subjects during diving test (5 min face exposure to iced water). The cold stimulus increased blood pressure (p less than 0.001), peripheral resistances (p less than 0.001), peak-systolic and end-systolic left ventricular (LV) meridional wall stresses (p less than 0.005). No significant change was found in heart rate. LV end-diastolic volume was unchanged, while LV end-systolic volume increased (p less than 0.005). Consequently, LV fractional shortening decreased (p less than 0.001). Thus, in spite of enhanced LV contractility (assessed by a significant increase in LV end-systolic stress to volume ratio, p less than 0.02) LV pump performance fell, because of prevailing afterload as well as lack of acute recruitment of LV preload reserve (afterload-contractility mismatch). Such an increase in LV afterload was associated with remarkable changes in LV diastolic dynamics: isovolumic relaxation time (IRT) was prolonged (p less than 0.001) and ventricular filling was relatively displaced towards late diastole (peak early to peak atrial velocities ratio, pE/pA: 1.5 +/- 0.3 vs 1.9 +/- 0.3 p less than 0.001; peak atrial filling rate: 326 +/- 47 vs 242 +/- 38 ml/s; p less than 0.001; normalized late diastolic velocity: 0.87 +/- 0.10 vs 0.73 +/- 0.06; p less than 0.01). Also, IRT values significantly correlated with pE/pA values (r = -0.75; p less than 0.001). In conclusion, diving test produced important changes in LV hemodynamics which, in turn, influenced LV relaxation and filling pattern. Our results indicate that operative LV loading conditions should be considered when assessing diastolic function by the analysis of transmitral Doppler flow profile.

DNA damage in mouse and rat liver by caprolactam and benzoin, evaluated with three different methods

Benzoin and caprolactam were examined for their capability of inducing alkaline DNA fragmentation in mouse and rat liver DNA after treatment in vivo. Three different methods were used. With the alkaline elution technique we measured an effect presumably related to the conformation of the DNA coil. With a viscometric and a fluorometric unwinding method we measured an effect presumably related to the number of unwinding points in DNA. For both compounds only the alkaline elution technique was clearly positive. The results suggest that both caprolactam and benzoin can induce an important change in the conformation of the DNA coil without inducing true breaks in DNA.

Mutagenicity of polycyclic aromatic hydrocarbon fractions extracted from urban air particulates

Polycyclic aromatic hydrocarbon (PAH) fractions, purified from extracts of airborne particles collected in the area of Genoa municipality, were assayed for mutagenicity in the Salmonella/microsome test. PAH fractions accounted for only a portion of the total mutagenic activity and also displayed a different specificity of genetic activity, as compared to unfractionated material. The analysis of 224 samples collected from January 1986 to November 1987 in 10 different localities led to a large number of positive results in strain TA100 with S9 mix and, less frequently, also in TA98 without metabolic activation. Mutagenicity was related to the intensity of anthropogenic atmospheric pollution, and showed some seasonal variations, although it was not possible to discriminate particular sources of pollution on the basis of mutagenicity patterns. The mutagenic potency in TA100 (S9+) of airborne PAH fractions was significantly correlated with the concentration of individual PAHs in most of the monitored localities. The spectrum of mutagenicity of monthly samples pooled from several localities in S. typhimurium strains, with and without S9 mix, provided evidence for some contribution of nitro derivatives of PAHs or possibly also of other compounds present in the same fractions. The results obtained are discussed in view of their predictive value as indicators of potential health hazards, and of the reliability of this biological tool as a complement to chemical analyses in the evaluation of ambient air pollution.