Changing conceptions of mathematics and infinity in Giordano Bruno's vernacular and Latin works

The purpose of this paper is to provide an analysis of Giordano Bruno's conception of mathematics. Specifically, it intends to highlight two aspects of this conception that have been neglected in previous studies. First, Bruno's conception of mathematics changed over time and in parallel with another concept that was central to his thought: the concept of infinity. Specifically, Bruno undertook a reform of mathematics in order to accommodate the concept of the infinitely small or "minimum," which was introduced at a later stage. Second, contrary to what Héléne Védrine claimed, Bruno believed that mathematical objects were mind-dependent. To chart the parallel development of the conceptions of mathematics and infinity, a seven-year time span is considered, from the publication of Bruno's first Italian dialogue (La cena de le ceneri, 1584) to the publication of one of his last Latin works (De minimo, 1591).

Biotoxicity and life cycle assessment of two commercial antifouling coatings in marine systems

Two commercial coating systems, each one consisting of both a primer and an antifouling ("System 1" based on Copper Oxide and "System 2" based on Zinc Oxide), have been analyzed in order to investigate their environmental impacts through Life Cycle Assessment (LCA) and laboratory tests. A cradle-to-grave analysis has been performed in order to quantify the environmental footprint of each coating solution and to define which element, material, or process mainly affect the environmental impact of such products. Moreover, it was performed a comparison between the different products to determine the most environmentally sustainable choice. In addition to LCA, several incubations of coated metal samples, by means of an innovative incubation system developed by the authors, have also been performed in marine water (Gulf of Naples, Mediterranean Sea, Italy), as critical environment favoring metal corrosion and biofouling generation. The life cycle analysis has showed that the production phase presents the highest environmental impact in almost all categories, mainly due to the use of chemical compounds. Moreover, after the laboratory tests, strong biotoxicity and contaminant diffusion, contributing to the marine toxicity potential, have been observed for both the commercial paints. As a final remark, there are straightforward indications of a strong need for anti-Microbial-Induced-Corrosion commercial coatings to substitute the toxic compounds with others in order to develop a greener solution.

New theories for new instruments: Fabrizio Mordente's proportional compass and the genesis of Giordano Bruno's atomist geometry

The aim of this article is to shed light on an understudied aspect of Giordano Bruno's intellectual biography, namely, his career as a mathematical practitioner. Early interpreters, especially, have criticized Bruno's mathematics for being "outdated" or too "concrete". However, thanks to developments in the study of early modern mathematics and the rediscovery of Bruno's first mathematical writings (four dialogues on Fabrizio's Mordente proportional compass), we are in a position to better understand Bruno's mathematics. In particular, this article aims to reopen the question of whether Bruno anticipated the concept of infinitesimal quantity. It does so by providing an analysis of the dialogues on Mordente's compass and of the historical circumstances under which those dialogues were written.

MODIFICATION OF ADJUSTABLE MACULAR BUCKLING WITH 29-G CHANDELIER LIGHT FOR OPTIMAL POSITIONING IN HIGHLY MYOPIC EYES WITH MACULAR HOLE

PURPOSE

To evaluate the efficacy of the modification of Adjustable Macular Buckling device in the treatment of myopic macular hole retinal detachment with posterior staphyloma.

METHODS

Four consecutive patients suffering from myopic macular detachment with macular hole were treated using the macular buckling procedure. An Adjustable Macular Buckling device was used in all four cases and was modified using a 29-gauge optical fiber to illuminate its macular plate.

RESULTS

Optical coherence tomography showed successful retinal reattachment and closure of the macular hole after the buckling procedure. The macular plate of the buckling device was properly positioned in all four patients. No complications were observed.

CONCLUSION

The modification of the macular buckling device improves the accuracy of its positioning by illuminating its macular plate.

Long-term follow-up of retropupillary iris-claw intraocular lens implantation: a retrospective analysis

BACKGROUND

The ideal intraocular lens in cases of aphakia without capsular support is debated. Choices include anterior chamber lenses, iris- or scleral-sutured lenses, and iris-claw lenses. Our aim was to report our long-term evaluation of the use of retropupillary implantation of the Artisan iris-claw intraocular lens (RPICIOL) in several aphakic conditions without capsular support.

METHODS

A retrospective analysis of consecutive 320 eyes of 320 patients (222 males and 98 females) without capsular support in which we performed RPICIOL implantation in post-traumatic aphakia (141 eyes, group 1), post-cataract surgery aphakia (122 eyes, group 2), and in cases in which penetrating keratoplasty was associated with vitrectomy (57 eyes, group 3). Either anterior or posterior vitrectomy procedures were performed with 20-, 23-, or 25-gauge techniques for different associated anterior or posterior segment indications. We reviewed the refractive outcome, anatomical outcome, long-term stability of the implants, and possible long-term complications.

RESULTS

The mean patient age was 59.7 years (range, 16-84 years) in group 1; 60.1 years (range, 14-76 years) in group 2; and 65.8 years (range, 25-71.5 years) in group 3. The mean follow-up time was 5.3 years (range, 1 month to 8 years). At the end of the follow-up period, the mean post-operative best-corrected LogMAR visual acuity was 0.6 (range, perception of light to 0.3) in group 1; 0.3 (range, 0.5-0.1) in group 2; and 0.6 (range, hand movement to 0.2) in group 3. Disenclavation of RPICIOLs occurred in three cases because of slippage of one of the iris-claw haptics and spontaneous complete posterior dislocation occurred in one case. One case presented with retinal detachment, and no cases of uveitis were observed. Eight cases complained of chronic dull pain, and severe iridodonesis was seen in five cases. One case of post-operative macular edema was observed without post-operative increase in the mean intraocular pressure. There was no statistically different change in the endothelial cell density (cells/mm(2)) at the end of the follow-up period.

CONCLUSIONS

RPICIOL for secondary implantations is a valid alternative strategy to scleral-fixated or angle-supported IOL implantation.

Endoscopic cyclophotocoagulation in refractory glaucoma after osteo-odonto-keratoprosthesis in Stevens-Johnson syndrome: a case report

PURPOSE

To report successful treatment of refractive glaucoma in a patient submitted to osteo-odonto-keratoprosthesis surgery for Stevens-Johnson syndrome.

METHODS

An interventional case report.

RESULTS

The patient is a 62-year-old Indian man with known Stevens-Johnson syndrome since 1972 secondary to tetracycline therapy, with bilateral dry eye and corneal blindness. He underwent symblepharon release surgery with mucous membrane graft in both eyes. Osteo-odonto-keratoprosthesis surgery was later performed on the left eye. He was submitted to 2 Ahmed valve implants to control secondary glaucoma but visual fields continued to worsen; hence, he underwent endoscopic 140° cyclophotocoagulation with a good control of IOP.

CONCLUSION

Endoscopic cyclophotocoagulation as alternative treatment provides good results in refractory glaucoma after osteo-odonto-keratoprosthesis surgery.

Akreos Adapt AO Intraocular Lens Opacification: A Case Report

A 79-year-old hyperglycemic patient was referred to the 'Santa Maria delle Croci' Hospital, Ravenna, Italy. He presented with visual impairment in the right eye. Four years ago, he had had an uneventful cataract surgery in the right eye. We observed an opacification of the intraocular lens (IOL) causing significant visual disturbance. The IOL was exchanged. Unfortunately, pathologic analysis was not performed. Patient-related factors such as hyperglycemia and hypertension might have been responsible for the opacification. To our knowledge, there is only one previous report of opacification of the Akreos Adapt AO IOL.

Combination of ion beam stabilisation, plasma etching and plasma deposition for the development of tissue engineering micropatterned supports

The performance of biomedical assays at both molecular and cellular level depends greatly on the ability to design new polymer surfaces. Patterns can be created by using materials with contrasted surface properties. In this work we describe in detail the preparation of micropatterned surfaces to be used as tissue engineering supports. Poly(ethylene glycol) (PEG) was used as the 'anti-fouling' polymer in opposition to functional regions covered by acrylic acid (AAc). Since spin-casted PEG films are unstable, ion beam stabilization (IBS) treatment was applied in order to render it insoluble. On the other hand, AAc films were deposited by low-power plasma chemical vapour deposition. Chemical properties of both polymers were monitored by Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy while topographic features were followed by atomic force microscopy. Finally, a micropattern was produced by using a mask, which isolated the IBS-PEG from the AAc-deposited regions. Endothelial cells cultured on the surface were observed to follow the micropatterns. In fact, for a certain surface density it was observed that the cells present tensile or compressive stresses when forced to remain in the anti-fouling or the functionalised regions, respectively.

Diagnosis and treatment of lymph node metastases of a rectal carcinoid tumor using In111-octreotide-scintigraphy and intraoperative gamma probe detection

Carcinoids represent 1-2% of the rectal cancer. We report the case of a woman with a rectal carcinoid and a hypogastric node metastasis. We propose a less invasive treatment of the metastase using In11-octreotide-scintigraphy and intraoperative gamma-probe detector.

¹³¹I treatment of toxic nodular goiter under combined thyrostatic-thyromimetic medication is at low risk of late hypothyroidism

AIM

Treatment of toxic nodular goiter with ¹³¹I is a first-line therapy for hyperthyroidism. To avoid a thyrotoxic storm, ¹³¹I is usually administered after pretreatment with antithyroid drugs, with thyroid-stimulating hormone (TSH) increase and functional recruitment of inhibited normal tissue. Therefore, both autonomous nodule(s) and normal tissue are irradiated. This may be a reason for late hypothyroidism occurring in 15-25% of patients. This study aimed at assessing different pretreatment modalities with combined methymazole and triiodothyronine, achieving euthyroidism with suppressed TSH.

METHODS

After diagnosis of autonomously functioning toxic nodule, patients were subjected to thyrostatic medication. Two months later, TSH was checked; if >0.5 mU/L triiodothyronine treatment was associated. After 2 more months, if the TSH level was suppressed, patients received ¹³¹I-therapy. A total of 149 patients were consecutively enrolled, 41 of whom with uninodular and 108 with multinodular goiter. They were evaluated at diagnosis, pretreatment, 3 and 6 months after therapy and at late follow-up (6.8+/-4.2 years; range: 1-22 years).

RESULTS

Administered activity was calculated according to ¹³¹I uptake and gland weight. Methymazole was discontinued 6 days before treatment and T3 was maintained until administration of ¹³¹I-therapy. Euthyroidism was achieved in 88% of patients. At late follow-up, subclinical hypothyroidism was observed in 10 patients (6.7%) and overt hypothyroidism in 5 patients (3.3%). No pathological consequences or side effects of ¹³¹I-therapy were found during the 6.8+/-4.2 year follow-up period.

CONCLUSION

Treatment of toxic nodular goiter with ¹³¹I-therapy, under combined thyrostatic-thyromimetic treatment is a simple, safe, well-tolerated, and effective procedure.

The I.F.A.S.T. model allows the prediction of conversion to Alzheimer disease in patients with mild cognitive impairment with high degree of accuracy

This paper presents the results obtained with the innovative use of special types of artificial neural networks (ANNs) assembled in a novel methodology named IFAST (implicit function as squashing time) capable of compressing the temporal sequence of electroencephalographic (EEG) data into spatial invariants. The aim of this study is to test the potential of this parallel and nonlinear EEG analysis technique in providing an automatic classification of mild cognitive impairment (MCI) subjects who will convert to Alzheimer's disease (AD) with a high degree of accuracy. Eyes-closed resting EEG data (10-20 electrode montage) were recorded in 143 amnesic MCI subjects. Based on 1-year follow up, the subjects were retrospectively classified to MCI converted to AD and MCI stable. The EEG tracks were successively filtered according to four different frequency ranges, in order to evaluate the hypotheses that a specific range, corresponding to specific brain wave type, could provide a better classification (0.12 Hz, 12.2 - 29.8 Hz; 30.2 - 40 Hz, and finally Notch Filter 48 - 50 Hz). The spatial content of the EEG voltage was extracted by IFAST step-wise procedure using ANNs. The data input for the classification operated by ANNs were not the EEG data, but the connections weights of a nonlinear auto-associative ANN trained to reproduce the recorded EEG tracks. These weights represented a good model of the peculiar spatial features of the EEG patterns at scalp surface. The classification based on these parameters was binary and performed by a supervised ANN. The best results distinguishing between MCI stable and MCI/AD reached to 85.98%.(012 Hz band). And confirmed the working hypothesis that a correct automatic classification can be obtained extracting spatial information content of the resting EEG voltage by ANNs and represent the basis for research aimed at integrating spatial and temporal information content of the EEG. These results suggest that this low-cost procedure can reliably distinguish eyes-closed resting EEG data in individual MCI subjects who will have different prognosis at 1-year follow up, and is promising for a large-scale periodic screening of large populations at amnesic MCI subjects at risk of AD.

Atmospheric fall-out of metals around the Murano glass-making district (Venice, Italy)

BACKGROUND, AIM AND SCOPE

Murano's glass-makers have held a monopoly on quality glass-making for centuries known all over the world. Artistic glass manufacture entails exposure to complex mixtures of pollutants, including metals. A few studies have reported high levels of trace elements in marine waters, sediments and mussels around Murano and shown that emissions from Murano glass-making workshops significantly influence air quality in the Venice area. Nevertheless, to date, there is very little information on atmospheric concentrations and virtually none on atmospheric deposition fluxes of trace elements around the island. This study presents data on the distribution of trace elements in the air and atmospheric depositions around Murano, based on a 2-year sampling period.

MATERIALS AND METHODS

Airborne PM10 particulate matter was collected daily in the period December 2001-June 2003 (254 air samples), and atmospheric depositions were collected every 19 +/- 6 days, in the period August 2001-July 2003 (38 samples) on the roof of the Experimental Glass Laboratory on the island of Murano. All samples were analysed by ICP-MS for As, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Sb, Se and Zn contents.

RESULTS

Atmospheric concentrations of As, Cd, Cr, Ni, Pb, Se and Zn were 1-2 orders of magnitude greater on the island of Murano than in the nearest urban areas (Venice and Mestre), with values higher than those reported for European industrial sites. The atmospheric deposition fluxes of all elements were also higher in Murano than those detected by other studies in Venice and Mestre and in the Porto Marghera industrial zone, with As, Cd, Sb and Se 1-2 orders of magnitude higher.

DISCUSSION

In order to study the spatial variability of the atmospheric fall-out, data from other sampling stations belonging to Venice atmospheric deposition monitoring networks were used. A decreasing gradient from Murano to the closer leeward stations was observed for As, Cd and Se. Pb and Zn deposition fluxes in Venice were also comparable to those observed in the Porto Marghera industrial zone, thus, indicating a similar or even higher level of contamination. Principal component analysis confirmed significant contamination from the glassworks.

CONCLUSIONS

As shown by our study, atmospheric loadings of metals around Murano are significant. These observations confirm that emissions from Murano also significantly influence atmospheric deposition in the Venice area. Specifically, the mean daily Cd flux in the most affected area, which includes the whole of the historic city centre of Venice, is approximately 18 microg m(-2) day(-1), i.e. more than 65 times higher than the Dutch limit and more than three times higher than that of Germany.

RECOMMENDATIONS AND PERSPECTIVES

On the basis of our data, there is a clear-cut need for remedial action in the Lagoon of Venice. Monitoring is indispensable, so that the efficacy of remedial measures can be evaluated and appropriate information about risks for human health and well-being can be made available. The atmospheric compartment must also be considered by Italian and European law which, until now, has not yet established any standard for atmospheric deposition.

Vitrectomy and translocation of the anterior chamber intraocular lens to the sulcus: a closed microsurgical technique for the UGH syndrome

This interventional case report presents an anterior chamber intraocular lens (AC-IOL) translocation technique to manage a case of uveitis-glaucoma-hyphema (UGH) syndrome associated with posterior dislocation of nuclear fragments and vitreitis as a consequence of capsule rupture during cataract surgery. Pars plana vitrectomy followed by an AC-IOL translocation from the anterior chamber to the sulcus without additional surgical corneal incision was performed. At 12 months' follow-up, the original AC-IOL was in stable position in the posterior chamber, with binocular refractive balance and no further astigmatism and resolution of the UGH syndrome.

Dementia, delusions and seizures: storage disease or genetic AD?

We describe a case of a young patient suffering from a rapidly progressive cognitive decline, associated with delusions, myoclonus and seizures and with no family history for dementia. Clinical features, along with skin biopsy findings were overlapping storage disease; the genetic analysis, however, demonstrated a de novo presenilin 1 mutation. The present report suggests the usefulness of genetic determinations in early-onset cases of dementia, even without an autosomal dominant trait of inheritance; for these cases and their relatives an extensive genetic counselling should be recommended.

The IFAST model, a novel parallel nonlinear EEG analysis technique, distinguishes mild cognitive impairment and Alzheimer's disease patients with high degree of accuracy

OBJECTIVE

This paper presents the results obtained with the innovative use of special types of artificial neural networks (ANNs) assembled in a novel methodology named IFAST (implicit function as squashing time) capable of compressing the temporal sequence of electroencephalographic (EEG) data into spatial invariants. The aim of this study is to assess the potential of this parallel and nonlinear EEG analysis technique in distinguishing between subjects with mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients with a high degree of accuracy in comparison with standard and advanced nonlinear techniques. The principal aim of the study was testing the hypothesis that automatic classification of MCI and AD subjects can be reasonably correct when the spatial content of the EEG voltage is properly extracted by ANNs.

METHODS AND MATERIAL

Resting eyes-closed EEG data were recorded in 180 AD patients and in 115 MCI subjects. The spatial content of the EEG voltage was extracted by IFAST step-wise procedure using ANNs. The data input for the classification operated by ANNs were not the EEG data, but the connections weights of a nonlinear auto-associative ANN trained to reproduce the recorded EEG tracks. These weights represented a good model of the peculiar spatial features of the EEG patterns at scalp surface. The classification based on these parameters was binary (MCI versus AD) and was performed by a supervised ANN. Half of the EEG database was used for the ANN training and the remaining half was utilised for the automatic classification phase (testing).

RESULTS

The best results distinguishing between AD and MCI reached to 92.33%. The comparative results obtained with the best method so far described in the literature, based on blind source separation and Wavelet pre-processing, were 80.43% (p<0.001).

CONCLUSION

The results confirmed the working hypothesis that a correct automatic classification of MCI and AD subjects can be obtained extracting spatial information content of the resting EEG voltage by ANNs and represent the basis for research aimed at integrating spatial and temporal information content of the EEG.

POPs in the Lagoon of Venice: budgets and pathways

Dioxins and furans (PCDD/Fs), polychlorobiphenyls (PCBs) and hexachlorobenzene (HCB) in the ecosystem of the Lagoon of Venice were studied, in order to provide a general picture of conditions in the lagoon in terms of contamination by persistent organic pollutants (POPs). We present here novel data on atmospheric deposition, water, sediment and clam samples collected in the lagoon during the period January 2001-December 2004. Atmospheric deposition was sampled monthly at six sites located both close and far from large industrial and urban sources. Water samples were collected monthly from fifteen stations, and twenty-five samples of sediments and clams (Tapes philippinarum) were collected in four areas where clams are farmed and harvested inside the lagoon. All samples were analysed for PCDD/Fs, PCBs and HCB by HRGC/HRMS in the same laboratory. All samples examined (atmospheric deposition and water) substantially confirmed the spatial pattern reported in previously published data on sediments and atmospheric deposition: the zone surrounding the Porto Marghera petrochemical plant always had the highest levels of POPs (i.e., PCDD/Fs: atmosphere approximately 6 pg of 2,3,7,8-TCDD equivalents (I-TE) m(-2)d(-1); water 0.37 pg I-TEl(-1); sediment: 300 ng kg(-1); clam 2.8 pg I-TE g(-1)), and the minima were found at points on the margins of the lagoon (PCDD/Fs: atmosphere approximately 1 pg I-TEm(-2)d(-1); water 0.05 pg I-TEl(-1); sediment: approximately 5 ng kg(-1); clam approximately 0.2 pg I-TE g(-1)). Intermediate values were often encountered in the historical city centre of Venice and in the central part of the lagoon. To confirm this, new data on correlation between levels of PCDD/F in sediments and clams are reported, both for absolute values and for the PCDD/F "fingerprint". There is always a clear fingerprinting signature (PCDF/PCDD>1) for samples collected near Porto Marghera, and the opposite (PCDF/PCDD<1) in the rest of the lagoon.

The implicit function as squashing time model: a novel parallel nonlinear EEG analysis technique distinguishing mild cognitive impairment and Alzheimer's disease subjects with high degree of accuracy

Objective. This paper presents the results obtained using a protocol based on special types of artificial neural networks (ANNs) assembled in a novel methodology able to compress the temporal sequence of electroencephalographic (EEG) data into spatial invariants for the automatic classification of mild cognitive impairment (MCI) and Alzheimer's disease (AD) subjects. With reference to the procedure reported in our previous study (2007), this protocol includes a new type of artificial organism, named TWIST. The working hypothesis was that compared to the results presented by the workgroup (2007); the new artificial organism TWIST could produce a better classification between AD and MCI. Material and methods. Resting eyes-closed EEG data were recorded in 180 AD patients and in 115 MCI subjects. The data inputs for the classification, instead of being the EEG data, were the weights of the connections within a nonlinear autoassociative ANN trained to generate the recorded data. The most relevant features were selected and coincidently the datasets were split in the two halves for the final binary classification (training and testing) performed by a supervised ANN. Results. The best results distinguishing between AD and MCI were equal to 94.10% and they are considerable better than the ones reported in our previous study ( approximately 92%) (2007). Conclusion. The results confirm the working hypothesis that a correct automatic classification of MCI and AD subjects can be obtained by extracting spatial information content of the resting EEG voltage by ANNs and represent the basis for research aimed at integrating spatial and temporal information content of the EEG.

Atmospheric fall-out of POPs (PCDD-Fs, PCBs, HCB, PAHs) around the industrial district of Porto Marghera, Italy

In order to estimate the importance of atmospheric fall-out of persistent organic pollutants (POPs) around the industrial district of Porto Marghera, Italy, atmospheric depositions of POPs were collected using bulk samplers inside the Lagoon of Venice. Seventy-seven atmospheric deposition samples were collected monthly over a 12-month period (March 2003-March 2004) at seven sites located close to the industrial area of Porto Marghera. Samples were analysed by HRGC/HRMS for PCDD-Fs, PCBs, HCB and PAHs. Differences in mean daily fluxes of all organic pollutants between industrial, urban and lagoonal stations were clear, atmospheric depositions at industrial sites being higher than target values for dioxin deposition recommended by the EU strategy on dioxins, furans and polychlorobiphenyls. In order to calculate atmospheric loadings of POPs around the industrial district, we considered an area defined by a distance of 10 km from the hypothetical centre-point of the main sources of atmospheric emissions from Porto Marghera. The calculated loadings, compared with the previous estimates, show that annual loadings of POPs are 12, 510, 90 and 130 kg of PCDD-Fs, PCBs, HCB and PAHs, respectively, corresponding to 350-500 mg TEQ, thus indicating a slight decrease in PCBs and a great decrease in HCB with respect to 1998-99. The input coming from the atmosphere is of the same order of magnitude of that due to the watershed runoff and approximately one-half of the direct industrial discharges.

Atmospheric bulk deposition to the lagoon of Venice Part I. Fluxes of metals, nutrients and organic contaminants

First available data on atmospheric fall-out were provided by sampling monthly bulk depositions in four sites inside the Lagoon of Venice (550 km2). Sampling was carried out monthly during the period July 1998-July 1999, in one site near an industrial area (Porto Marghera; site D), another site in the city of Venice (site A), and the remaining two in the southern- and northernmost ends of the Lagoon (Valle Figheri, site C; Valle Dogà site B). The following determinations were carried out for each samples: pH, conductivity, grain-size, particulate load, and dissolved nutrients (N, P). Samples were then subdivided into soluble and insoluble fractions, and Al, Ca, Na, K, Mg, Si, Mn, Fe, Zn, Ni, Cr, Cu, Pb, Cd, As, Hg, Ti, V, S, P, Se and Sb were analysed on both fractions. Total organic micropollutants (PAH, PCB, HCB, DDT, PCDD/F) were measured. As regards particle size distribution, there was great variability among sampling sites. The percentage of the < or =2 microm grain-size fraction was higher in the southern and northern ends of the Lagoon. Small differences were found among sites for major elements, whereas higher variability was observed for inorganic and organic micropollutants, with standard deviations between 20% and 60% of the fluxes measured. Major differences in annual fluxes between the most polluted sites (mostly D and A) and background (site B) were seen for Cd (0.26 vs. 0.06 mg m(-2) year(-1)), Hg (41 vs. 15 microg m(-2) year(-1)), PCB ( approximately 2500 vs. approximately 500 ng m(-2) year(-1)) and HCB ( approximately 8000 vs. approximately 1000 ng m(-2) year(-1)). Comparisons with previous data, collected in the periods 1993-1994 and 1995-1997, were only available for a few trace metals. A definite decline in the annual Pb flux in the city of Venice was detected, from 18 to 13 mg m(-2) in 1996/1997 and 1995/1996 respectively, to approximately 5 mg m(-2) in the present study. Total annual deposition was calculated by means of two different methods, which gave very similar results: (i) the mean value of deposition in the four sites was multiplied by lagoon area (550 km2); (ii) the monthly rain isopleths were combined to normalize deposition values. The figures are: 15-34 kg of Hg and Sb, approximately 200 kg of As, approximately 100 kg of Cd and PAH, 0.7-1.3 tons of Cr, Ni and V, more than 2 tons of Cu and Pb, 17 of Zn, 55 of total P, approximately 200 of Al, and 3900 of DIN. Total fluxes of organics inside the lagoon were: PAH approximately 100 kg; HCB approximately 1 kg; DDT approximately 0.4 kg. PCB and PCDD/F fluxes were approximately 500 g and approximately 10 g, corresponding respectively to 0.1 and 0.4 g I-TE. The correlations between fluxes of inorganic micropollutants and grain-size were significant. Multivariate statistical analysis was applied to investigate more accurately relationships between the insoluble and dissolved fractions of inorganic micropollutants and grain-size fractions. In particular, significant correlations were highlighted between the dissolved fraction of As and the < or =1 mum particle size fraction. Relations between levels of SigmaPCDDF, SigmaPCDD, PCB and PAH congeners and grain-size revealed significant correlation coefficients for the remote sites (B, C), and none in the urban and industrial sites (A, D). In particular, significant correlations were highlighted between SigmaPCDDF, SigmaPCDD and particle size fraction < or =2 mum, and between benzo(a)pyrene and PCB 167 and particle size fraction 4-8 mum.

Atmospheric bulk deposition to the Lagoon of Venice Part II. Source apportionment analysis near the industrial zone of Porto Marghera, Italy

Multivariate statistical analyses were applied to measurements of atmospheric deposition of total particulate (TSP), inorganic elements (Al, Ca, Na, K, Mg, Si, Mn, Fe, Zn, Ni, Cr, Cu, Pb, Cd, As, Hg, V and S) and organic compounds (PAH, PCB, HCB and PCDD/F) collected in four stations, all located in the Lagoon of Venice. Aerosols at the scale of the basin (i.e., within a distance of 20 km) were mainly characterised by two end-members, one natural (composed of mineral particulate and marine spray) and one anthropogenic (with at least two different source components), affecting the sites in various ways. Variability at the two distant (>20 km) sites (Valle Dogà, Valle Figheri) was mainly due to natural components, whereas the other two stations (city of Venice, Dogaletto, approximately 5 km) were mainly impacted by industrial (and urban) sources. Total annual inputs were compared with the limits recently set by law (maximum allowed discharge=MAD). In the year of study, MAD values were exceeded for total As, Cd, Hg, Pb, dissolved Zn, PAH and PCDD/F. These results indicate that industrial sources gave rise to a quasi-permanent compositional (background) effect near the industrial area. The risk associated with atmospheric deposition should be quantified within the DSPIR framework to avoid future negative consequences in populations living in the vicinity of Porto Marghera.

Measurement of atmospheric deposition of polychlorinated dibenzo-p-dioxins and dibenzofurans in the Lagoon of Venice, Italy

Data on atmospheric fall-out of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) were provided by collecting bulk deposition in four stations inside the Lagoon of Venice. A total of 44 monthly samples was collected during the period July 1998-July 1999 in one site near an industrial area (Porto Marghera), one site in the city of Venice, and two sites in the southern- and northernmost ends of the Lagoon. Fluxes of PCDD/Fs were between 0.1 and 470 pg m(-2) d(-1), corresponding to 0-9.2 pg of 2,3,7,8-TCDD equivalents (TEQ) m(-2) d(-1), with a gradient increasing from remote to urban/industrial stations. Thus, annual deposition of PCDD/Fs to the Lagoon (total area=550 km2), calculated with various methods, turned out to be approximately 12 g, corresponding to approximately 400 mg TEQ. Significant differences were found among the stations, with a clear fingerprinting signature (PCDF/PCDD>1) of the deposition collected near Porto Marghera, and a reversed pattern (PCDF/PCDD<1) in the rest of the Lagoon, which pattern was similar to the sediments collected in the same locations. Lastly, the amount of bulk sigmaTEQ of all stations was compared with the guide values for dioxins in depositions proposed by De Fré et al. [Organohalogen Compounds 45 (2000) 324].

Prevalence of the E1317Q variant of the APC gene in Italian patients with colorectal adenomas

Loss of APC is an initial, rate-limiting event in inherited and sporadic colorectal tumorigenesis. Rare germline APC mutations have been identified in patients with multiple colorectal adenomas. Recently, the E1317Q APC variant has been associated with a predisposition to the development of multiple colorectal adenomas. In this study, the prevalence of the E1317Q variant was examined in 182 patients with single or multiple colorectal adenomas, and in 235 controls. In all, E1317Q was identified in two of 182 patients with adenomatous polyps (1.1%) and in two of 235 controls (0.8%) (p = 0.59). The risk of harboring adenoma(s) among subjects bearing the E1317Q variant was 1.29 (95% CI 0.09-18.0). No difference in the prevalence of E1317Q between cases with single (2.0%) or multiple colorectal adenomas (0.7%) and controls (0.8%) was found. None of the subjects with a family history of colorectal cancer carried the E1317Q variant. In conclusion, our results confirm that only a very small fraction of colorectal adenomas may be associated with the presence of E1317Q.

Inter-annual variability in atmospheric input and partitioning of heavy metals in the Lagoon of Venice

Atmospheric bulk deposition of major and trace elements was measured at Venice from November 1995 to October 1997. Collection was carried out using polyethylene bulk passive samplers, samples being collected bi-weekly. In order to highlight the contribution of the atmosphere to water chemistry and particle budgets in the Lagoon of Venice, the geochemical composition (Si, Al, Ca, Mg, K, Na, Mn, Cr, Zn, Pb, Cd, Cu, As) of dissolved and insoluble bulk fractions was determined by AAS + ICP mass spectrometry. Great sample variability was found, with almost two orders of magnitude between maximum and minimum values for several metals. All fluxes in 1995/96 were 30% lower than in 1996/97, ranging from -3% (Ca) to -57% (Li), except for Zn, Cd and As. On the contrary, the solubility of all elements decreased during 1996/97. Partitioning between soluble and insoluble phases shows that Al, Cr, Fe and Si are mainly in the insoluble form, whereas for As, Ca, Cu, Mg, Na, Ni, K, Pb and Zn the dissolved fraction represents 50-90% of total input. The amount of particle load affects partitioning between dissolved and particulate, especially for Al and Pb. Seasonal variability was evident. The lowest pH values (approximately 5.2) were recorded in winter, causing an increase of solubility for all metals except for As, which showed the highest solubility in summer.

[Topical anesthesia for cataract surgery with phacoemulsification: lidocaine 2% vs ropivacaine 1%. Preliminary results]

BACKGROUND

The safety, tolerability and efficacy of ropivacaine 1% vs lidocaine 2% for phacoemulsification using topical anesthesia during cataract surgery, are compared.

METHODS

A prospective, randomized, double-blind study comparing two agents for topical anesthesia is reported.

ENVIRONMENT

Operative Unit of Ophthalmology, general Hospital. 1893 consecutively patients were studied (ASA 1-3, 738 males, 1155 females, age 71.8+/-9.7 years, range 35-90 years) undergoing routine phacoemulsification under topical 2% lidocaine (group I) and 1% ropivacaine (group II). The mains outcome measures of the study were: - the total dose of local anesthetic for obtaining a reduction of corneal sensation measured with the Cochet-Bonnet esthesiometer (value>3); - the pain recorded with visual analogic scale and verbal scale at: T1 = the first injection of local anesthetic; T2 = corneal incision; T3 = the end of surgery; T4 = 1h after surgery; T5 = the first postoperative day; - any requirement for additional intraoperative injection anesthesia and systemic sedation when needed; - surgeon assessments of operative conditions and patient cooperation; - patients' subjective level of comfort; - complications.

RESULTS

Topical anesthesia using lidocaine 2% was significantly more painful than the ropivacaine 1%. The onset of anesthesia adequate for surgery was similar in all two groups. There were differences between the groups with respect to perioperative analgesia because the VAS was significantly higher in lidocaine group than in ropivacaine group. There were no statistically differences between the two groups at the follow-up. Inadequate anesthesia was seen in 8.05% (74/919 patients) cases of group I vs 0.9% (22/974 patients) of group II. Sedation was needed only in 10 patients and 6 patients of group I and II respectively. The surgeon assessment showed more patient cooperation in the ropivacaine group (83%). Satisfactory comfort (level 1) was reported by 60.4% in the lidocaine group and 86.8% in the ropivacaine group. In both groups there were cases of postoperative epithelial edema (29 patients in group I vs 36 patients in group II) although it decreased after the first postoperative day. No other significant side-effects were observed with the use of either formulations.

CONCLUSIONS

Lidocaine 2% and ropivacaine 1% were safe and effective agents in patients having phacoemulsification with IOL implantation. However, ropivacaine provides more good operative conditions than lidocaine for the surgeon and comfortable surgical circumstances for the patient.

Clarithromycin in rheumatoid arthritis patients not responsive to disease-modifying antirheumatic drugs: an open, uncontrolled pilot study

OBJECTIVE

In 1996 we found by serendipity that 2 patients with rheumatoid arthritis (RA) who were taking clarithromycin (CM) to eradicate Helicobacter pylori experienced a regression of their RA symptoms. Following this observation, we tested the hypothesis that this reduction in symptoms could have been caused by CM administration.

METHODS

We performed a 6-month, open, uncontrolled pilot study on 18 patients (14 females and 4 males, mean age 62 yrs.) with RA who had previously received DMARDs (mean 2.6) and discontinued the treatment at least one month earlier because lack of efficacy or severe side effects. Patients were treated with CM at the dose of 500 mg twice per day for the first 10 days, followed by a daily maintenance dose of 250 mg twice per day.

RESULTS

4/18 patients did not complete the treatment, 2/18 were not responsive to the treatment and 2/18 discontinued the treatment. Following ACR criteria the improvement was: 10 patients ACR 20; 6 patients ACR 50; and 2 patients ACR 70. The remaining 4 patients did not reach ACR 20 since either the number of tender or swollen joints was not to the level required. Reductions in PGE2 and soluble phospholipase A2 plasma levels were closely related to CM plasma levels.

CONCLUSIONS

Ourfindings suggest that CM treatment can be beneficial in those patients who are not responsive to or cannot tolerate DMARDs. No definitive conclusions can be drawn based on the present study, due to the small sample size involved.

Effect of estradiol valerate alone or in association with cyproterone acetate upon vascular function of postmenopausal women at increased risk for cardiovascular disease

OBJECTIVES

a large body of evidence has been accumulated suggesting that impairment of vascular endothelial function is an initial step in the development of atherosclerosis. Recent studies have shown that estrogen replacement therapy in postmenopausal women (PMW) improves endothelium-dependent, flow-mediated dilatation (FMD) while the cyclical adjunct of a progestin may reverse this effect.

METHODS

the purpose of this study was to evaluate endothelium-dependent, FMD in the brachial artery and the plasma levels of Endothelin-1 in menopausal females treated with estradiol valerate with and without cyclical cyproterone acetate in 20 PMW (mean age 64+/-6 years) with more than one risk factor for coronary artery disease. After a baseline evaluation, PMW entered a double-blinded, placebo controlled single cross-over study and were randomized to receive either estradiol valerate (2 mg) for 21 days or estradiol valerate (2 mg) for 11 days and estradiol valerate (2 mg) and cyproterone acetate (1 mg) for 10 days. Patients were crossed-over the complementary treatment 7 days after completing the first treatment phase. The study of forearm blood flow was repeated at the end of each treatment period.

RESULTS

estradiol valerate significantly increased FMD as compared with baseline (12+/-3 vs. 7+/-4%, P<0.01) the adjunct of cyproterone acetate did not affect the effect of estradiol valerate upon FMD (12+/-3 vs. 11+/-4%, P=NS). Similarly reactive hyperemic flow increased after estradiol valerate alone (24%) or in association with cyproterone acetate (24%) compared with baseline. Plasma levels of Endothelin-1 were significantly reduced by estradiol valerate alone or in association with cyproterone acetate.

CONCLUSIONS

in conclusion hormone replacement therapy with estradiol valerate and cyproterone acetate improves endothelial function and reduces plasma levels of Endothelin-1 in PMW at risk of coronary artery disease. These effects may be relevant for cardioprotection.

How progestins influence the cardiovascular effect of hormone replacement therapy

Hormone replacement therapy aims to protect against osteoporosis and alleviate fastidious menopausal symptoms such as hot flushes, depression, sleep disturbances and vaginal dryness. In view of the acknowledgement of estrogen deficiency as a major trigger for the acceleration of cardiovascular risk after menopause, hormone replacement therapy may also be proposed as a substantial beneficial cardioprotective agent. The effects of progestins on lipoprotein profile and vasomotor tone are dependent on the chemical structure and the scheme of administration of progestins, with androgenic progestins and cyclical therapy having a potential detrimental effect. Prospective primary and secondary prevention studies, however, suggest that the adjunct of non-androgenic progestins to estrogen therapy is at least as effective as estrogen replacement therapy in reducing cardiovascular mortality and morbidity. Data from recent randomized secondary prevention studies have to be viewed with caution.

Usefulness of histological examination for the diagnosis of onychomycosis

BACKGROUND

[corrected] Direct microscopy and culture tests currently used in the diagnosis of nail mycosis can yield false-negative results, and confirmation of the pathogenic agent, especially in non-dermatophyte infections, is often a lengthy process.

OBJECTIVE

The aim of this study was to investigate the usefulness of the histological examination of nail clipping samples in supplementing the standard microscopic and culture techniques for the diagnosis of onychomycosis.

PATIENTS AND METHODS

One hundred and seventy-two subjects affected by nail alterations suggestive of onychomycosis were evaluated. Nail specimens were studied with 3 different techniques: direct microscopic examination of a 40% KOH clarified preparation, fungal culture and histological examination. Patients positive for fungal infection were re-evaluated with the same techniques after treatment with oral terbinafine, fluconazole or itraconazole and topical application of bifonazole or ciclopirox for 2 months.

RESULTS

Direct microscopy was positive in 102 (59.3%) nail specimens. The culture test was positive in 90 cases (52.9%), showing a dermatophyte in 45, a yeast in 23 and a mould in 22 samples. The histological examination was positive in 94 (54.6%) samples. In 4 cases, it was the only investigation confirming the clinical diagnosis of nail mycosis. In most of the cases, the morphological aspect of the hyphae and/or spores suggested also to which group of pathogens (dermatophytes, yeasts or moulds) the mycetes observed in the histological sections could be ascribed. The concurrent presence of a dermatophyte and a mould was evidenced in a few specimens. The control histological examination at the end of the treatment showed negative results or residual non-vital hyphae and/or spores.

CONCLUSIONS

Results of the present study indicate that the histological examination of nail clipping specimens is a relatively inexpensive, rapid and easily performed procedure. It is useful to confirm or refute the results of routine microscopy and culture tests. Moreover, nail histopathological observation may help in ascribing a pathogenic role of non-dermatophyte isolates and evaluating the effectiveness of antifungal treatment.

Organic pollution in a Ramsar site (Piallassa Baiona, northern Adriatic Sea)

A core collected in the Piallassa Baiona lagoon, a salt-marsh area already studied for Hg contamination related to nearby industrial sites, was analysed for organic micropollutants. Surface sediments show high concentrations of total PCBs (1148 ng g-1), PCDD/Fs (64 ng g-1) and PAHs (4801 ng g-1). According to a sedimentation rate of 0.4 cm y-1, the high increases in total PAH, PCB and PCDD/F concentrations began in the 1960s and peaked in the 1970s, in parallel with the highest Hg concentrations. Instead, the recent contamination, which primarily involves PCBs and PCDD/Fs, has been observed to be unrelated to Hg concentrations. Organic micropollutant concentrations in the sample core were compared with the sediment quality criteria provided by international guidelines, and revealed high toxic potential. This heavy contamination was also confirmed by comparison with similar environments, particularly the Lagoon of Venice. Further investigations are needed to understand better the sources of the recent contamination and to explain the different transfer pathways involved during sedimentation of the "old" material, dumped 20-30 years ago.