Somatotype and bioelectrical impedance vector analysis of Italian CrossFit® practitioners

Objectives

CrossFit® is a high-intensity sport characterized by various workouts that require strength, speed, endurance, or agility, impacting participants' body composition. This observational study aimed to determine the morphological (anthropometrical and bioelectrical) profile of CrossFit® athletes and to compare them with other athletic populations.

Methods

Anthropometrical measurements and bioelectrical vector analysis (classic and specific approaches) were performed on 145 CrossFit® practitioners (107 men aged 30.7 ± 8.4 years and 38 women aged 28.1 ± 6.7 years). Each participant's relative somatotype was calculated and compared between sexes and with a Spanish CrossFit® athletes' group. Resistance-reactance graphs and Hotelling's T2 test were applied to characterize the sample, compare them with an athletes' reference population, and identify differences between somatotype groups.

Results

The most represented somatotype in both groups was the balanced mesomorph (male 3.5-5.2 - 1.7 and female 4.4-4.5 - 1.8). Compared with Spanish CrossFit® athletes, significant differences were denoted for men but not women (SAD = 2.3). The bioelectrical graphs indicated that the distribution of CrossFit® athletes is quite heterogeneous and within average values for the athlete's reference. The mesomorphic and endomorphic components were associated with a higher phase angle.

Conclusions

CrossFit® practitioners predominantly present a mesomorphic component and show a body type like other power athletes, although with less pronounced characteristics. The somatotype may influence the vector's position in the RXc graphs. This study provided the bioelectrical tolerance ellipses for CrossFit® practitioners in classic and specific approaches for the first time.

Morphological Characteristics of Elite International Soccer Referees: Somatotype and Bioelectrical Impedance Vector Analysis

This study aimed to assess the physical characteristics of elite international soccer referees, compare them with other referee populations in the literature, and establish reference tolerance ellipses for the bioelectrical impedance vector analysis (BIVA) point graph. Forty-one elite international soccer referees (age 38.8 ± 3.6 years) participated in the study. The participants underwent body composition assessments, including dual-energy X-ray absorptiometry, BIVA, and somatotype. The Somatotype Attitudinal Distance (SAD), the two-sample Hotelling's T² test and the Mahalanobis test were used to determine somatotype and bioelectrical vector differences with the literature. The average somatotype of the referees was a balanced mesomorph (2.8, 6.5, 2.8). Elite international referees significantly differed from other samples in the literature (SAD = 2.1, 2.6, 2.9 with respect to Zimbabwean, Brazilian, and South African referees, respectively). The bioelectrical vector was significantly different from the general population (T² ≤ 76.6; F = 38.8; D = 1.44; p < 0.001) and athletes (T² ≤ 25.3; F = 12.6; D = 0.8; p < 0.001). Somatotype values and tolerance ellipses from this study may be useful as a reference for developing training programs and improving the selection process of referees in soccer.

A holistic picture of spatial distribution of river polluting loads in a highly anthropized area

For many years, there has been a debate on the polluting loads affecting the Gulf of Naples, one of Italy's most spectacular and iconic landscape. The wide territory bordering the Gulf includes the Sarno river basin (SRB) managed by the Southern Apennines River Basin District Authority in the framework of Unit of Management Sarno (UoM-Sarno). The paper investigated the anthropogenic pressures and their spatial distribution in the UoM-Sarno, revealing as SRB represents a hotspot of pollution mainly due to the high population density and widespread hydro-demanding activities which are responsible of high organic and eutrophication loads. The pollution sources, variably distributed on the area, and potentially conveyed to the wastewater treatment plants (WWTPs) located into SRB, were estimated considering the WWTPs treatment capacity as well. Results revealed a holistic picture of UoM-Sarno area allowing to establish the priorities of the interventions aimed at safeguarding the coastal marine resources. In particular, 2590 tons BOD/year were directly discharged into the Gulf of Naples due to the missing of sewers, and other 10,600 tons BOD/year are potentially discharged in the Sarno river reaching the sea, considering the contribution of population, industrial activity, and livestock.

Bioelectrical Impedance Vector Analysis of Young Elite Team Handball Players

Team handball is a highly dynamic sport where physical demands differ between categories and roles. Thus, physical characteristics are fundamental for the final performance. This study aims to (a) characterize a sample of young male and female elite team handball players with a non-athletic reference population; (b) to generate their 50%, 75%, and 95% percentiles of the bioelectrical variables. The study included 55 young elite team handball players (Males, n = 37, age = 17.0 ± 1.2 yrs, height = 185.8 ± 7.3 cm, weight = 82.0 ± 11.0 kg, body mass index (BMI) = 23.7 ± 2.5; Females, n = 18, age = 17.8 ± 0.9 yrs, height = 171.2 ± 6.4 cm, weight = 67.4 ± 7.2 kg, BMI = 23.0 ± 2.0). Height and bioelectrical variables were assessed in a state of euhydration and standard conditions. Bioelectrical impedance vector analysis (BIVA) was used to characterize the bioelectrical vector (BIA vector) distribution pattern for each group. Compared to the reference values, BIA vector showed statistically significant differences in males U17 (n = 19, T2 = 51.0, p < 0.0001), males U19 (n = 18, T2 = 82.0, p < 0.0001) and females U19 (n = 18, T2 = 85.8, p < 0.0001). Male groups were also bioelectrically different (T2 = 13.7, p = 0.0036). BIVA showed specific bioelectrical characteristics in young male and female elite handball players. This study provides an original data set of bioelectrical impedance reference values of young male and female elite team handball players. Our result might help to interpret individual bioimpedance vectors and define target regions for young handball players.

[A young patient with full visual acuity, small visual field defects, and normal fluorescence angiogram]

A 28-year-old female patient came to our clinic complaining of small central visual field defects in both eyes, without any impairments of visual acuity. She reported recent flu-like symptoms and work-related stress associated with high caffeine intake. Dark reddish cloverleaf-shaped lesions were noted in the macular region with red-free fundoscopy, and alterations of the external retinal layers were observed in spectral domain optical coherence tomography (SD-OCT). The visual field test (Octopus, program 32) revealed small central scotoma on both eyes. The fluorescein angiograms were normal. A suspected diagnosis of acute macular neuroretinopathy (AMNR) was made and the patient was scheduled for follow-up 4 weeks later. The follow-up examination showed persisting central scotoma as well as persistence of the lesions in the external retinal layers in OCT. The best-corrected visual acuity was still 20/20. In OCT angiography (OCT-A), a reduced correlation signal and therefore perfusion was detected in the outer retinal capillary plexus within the area of the fundoscopic macular lesions. Multimodal imaging, including SD-OCT and A‑OCT, plays a pivotal role in the diagnosis of acute macular neuroretinopathy. Even though no serious impairments of visual acuity are reported, patients should be informed about the possibility of permanent central scotoma.

Dynamics and Interaction of Vortex Lines in an Elongated Bose-Einstein Condensate

We study the real-time dynamics of vortices in a large elongated Bose-Einstein condensate (BEC) of sodium atoms using a stroboscopic technique. Vortices are produced via the Kibble-Zurek mechanism in a quench across the BEC transition and they slowly precess keeping their orientation perpendicular to the long axis of the trap as expected for solitonic vortices in a highly anisotropic condensate. Good agreement with theoretical predictions is found for the precession period as a function of the orbit amplitude and the number of condensed atoms. In configurations with two or more vortices, we see signatures of vortex-vortex interaction in the shape and visibility of the orbits. In addition, when more than two vortices are present, their decay is faster than the thermal decay observed for one or two vortices. The possible role of vortex reconnection processes is discussed.

Agent-based station for on-line diagnostics by self-adaptive laser Doppler vibrometry

A self-adaptive diagnostic system based on laser vibrometry is proposed for quality control of mechanical defects by vibration testing; it is developed for appliances at the end of an assembly line, but its characteristics are generally suited for testing most types of electromechanical products. It consists of a laser Doppler vibrometer, equipped with scanning mirrors and a camera, which implements self-adaptive bahaviour for optimizing the measurement. The system is conceived as a Quality Control Agent (QCA) and it is part of a Multi Agent System that supervises all the production line. The QCA behaviour is defined so to minimize measurement uncertainty during the on-line tests and to compensate target mis-positioning under guidance of a vision system. Best measurement conditions are reached by maximizing the amplitude of the optical Doppler beat signal (signal quality) and consequently minimize uncertainty. In this paper, the optimization strategy for measurement enhancement achieved by the down-hill algorithm (Nelder-Mead algorithm) and its effect on signal quality improvement is discussed. Tests on a washing machine in controlled operating conditions allow to evaluate the efficacy of the method; significant reduction of noise on vibration velocity spectra is observed. Results from on-line tests are presented, which demonstrate the potential of the system for industrial quality control.

Compact high-flux source of cold sodium atoms

We present a compact source of cold sodium atoms suitable for the production of quantum degenerate gases and versatile for a multi-species experiment. The magnetic field produced by permanent magnets allows to simultaneously realize a Zeeman slower and a two-dimensional magneto-optical trap (MOT) within an order of magnitude smaller length than standard sodium sources. We achieve an atomic flux exceeding 4 × 10(9) atoms/s loaded in a MOT, with a most probable longitudinal velocity of 20 m/s, and a brightness larger than 2.5 × 10(12) atoms/s/sr. This atomic source allows us to produce pure Bose-Einstein condensates with more than 10(7) atoms and a background pressure limited lifetime of 5 min.

[Presumptive clinical diagnosis of malaria in children in a hospital in the North Region (Cameroon)]

The authors studied the correlation between the prescription of antimalarial drugs and the results of a rapid diagnostic test (RDT) and thick smear during dry and rainy seasons in a regional hospital outpatient clinic in North Cameroon. Clinical diagnosis, essentially based on the presence of fever, has a positive predictive value of 2% when compared with laboratory results during the dry season, against 44% during the rainy season. This study confirms the epidemic nature of malaria in the Sahelian zone of the North Region and challenges the currently available hospital statistics. In this epidemiological context, the authors recommend routine laboratory diagnosis of malaria before any treatment, especially during the dry season. This is justified both therapeutically and economically.

Improved cellular uptake of functionalized single-walled carbon nanotubes

Single-walled carbon nanotubes (SWNTs) due to their unique structural and physicochemical properties, have been proposed as delivery systems for a variety of diagnostic and therapeutic agents. However, SWNTs have proven difficult to solubilize in aqueous solution, limiting their use in biological applications. In an attempt to improve SWNTs' solubility, biocompatibility, and to increase cell penetration we have thoroughly investigated the construction of carbon scaffolds coated with aliphatic carbon chains and phospholipids to obtain micelle-like structures. At first, oxidized SWNTs (2370 ± 30 nmol mg(-1) of SWNTs) were covalently coupled with an alcoholic chain (stearyl alcohol, C(18)H(37)OH; 816 nmol mg(-1) of SWNTs). Subsequently, SWNTs-COOC(18)H(37) derivatives were coated with phosphatidylethanolamine (PE) or -serine (PS) phospholipids obtaining micelle-like structures. We found that cellular uptake of these constructs by phagocytic cells occurs via an endocytotic mechanism for constructs larger than 400 nm while occurs via diffusion through the cell membrane for constructs up to 400 nm. The material that enters the cell by phagocytosis is actively internalized by macrophages and localizes inside endocytotic vesicles. In contrast the material that enters the cells by diffusion is found in the cell cytosol. In conclusion, we have realized new biomimetic constructs based on alkylated SWNTs coated with phospholipids that are efficiently internalized by different cell types only if their size is lower than 400 nm. These constructs are not toxic to the cells and could now be explored as delivery systems for non-permeant cargoes.

Fine distribution of CLOCK protein in hepatocytes of hibernating dormice

CLOCK protein is a member of the bHLH-PAS family of transcription factors, it is expressed in several tissues including the liver and is essential for normal circadian rhythms. In this study we investigate the distribution of CLOCK protein in hepatocytes of euthermic and hibernating edible dormice Glis glis as well as in hepatocytes taken from the hibernating animals submitted in vitro to experimental conditions mimicking the arousal process. Our results demonstrate that CLOCK protein is expressed in all animals and is mostly located in the nucleus, in particular, on perichromatin fibrils and nucleoli. During deep hibernation CLOCK protein becomes more abundant but an intracellular redistribution occurs: the protein significantly decreases in all cellular compartments, but it accumulates in the amorphous bodies. These nuclear bodies, typical of the hibernating state, probably represent storage sites for CLOCK protein to be quickly used upon arousal. Accordingly, in hepatocytes submitted to in vitro conditions mimicking arousal CLOCK protein levels rapidly reach the euthermic values, while amorphous bodies disappear.

Effect of macrophage depletion on viral DNA rebound following antiretroviral therapy in a murine model of AIDS (MAIDS)

In the attempt to eradicate HIV-1 infection, a strategy to eliminate macrophages, one of the most important cellular reservoirs in sustaining virus replication during HAART, could be of great benefit in the suppression of viral rebound. Aware of the ability of clodronate to cause macrophage depletion, the effect of the administration of clodronate encapsulated in erythrocytes on disease progression and on viral rebound was evaluated in a murine model of AIDS (MAIDS). One group of LP-BM5 retroviral complex-infected C57BL/6 mice received oral administrations of azidothymidine and dideoxyinosine daily for 12 weeks; two other groups received in addition, either clodronate-loaded erythrocytes or free clodronate at 7-10 day intervals. At the end of the treatment, the three groups maintained parameters characterizing disease progression similar to those of uninfected mice and showed a significantly lower level of BM5d DNA than infected mice in all organs and cells tested. To assess the viral rebound, some animals were left for an additional 4 month period without any treatment. After this time, the BM5d DNA content in blood leukocytes increased in all groups, but the group having received clodronate-loaded erythrocytes, in addition to transcriptase inhibitors, showed a significant delay in viral rebound.

Inhibition of HIV-1 replication in macrophages by red blood cell-mediated delivery of a heterodinucleotide of lamivudine and tenofovir

Homo- and heterodimers of nucleoside/nucleotide analogues as reverse transcriptase inhibitors are effective on HIV-1-infected human monocyte-derived macrophages (M/M) compared to the single drugs or their combination. Since the combined treatment of lamivudine (3TC) and tenofovir ((R)PMPA) has an antiretroviral efficacy and a synergic effect respect to separate drugs, the heterodinucleotide 3TCpPMPA was synthesized. A single administration of the dimer as free drug or 3TCpPMPA-loaded RBC selectively targeted to M/M was able to almost completely protect macrophages from "de novo" infection.

Cell-based drug delivery

Drug delivery has been greatly improved over the years by means of chemical and physical agents that increase bioavailability, improve pharmacokinetic and reduce toxicities. At the same time, cell based delivery systems have also been developed. These possesses a number of advantages including prolonged delivery times, targeting of drugs to specialized cell compartments and biocompatibility. Here we'll focus on erythrocyte-based drug delivery. These systems are especially efficient in releasing drugs in circulations for weeks, have a large capacity, can be easily processed and could accommodate traditional and biologic drugs. These carriers have also been used for delivering antigens and/or contrasting agents. Carrier erythrocytes have been evaluated in thousands of drug administration in humans proving safety and efficacy of the treatments. Erythrocyte-based delivery of new and conventional drugs is thus experiencing increasing interests in drug delivery and in managing complex pathologies especially when side effects could become serious issues.

Long-term treatment with autologous red blood cells loaded with dexamethasone 21-phosphate in pediatric patients affected by steroid-dependent Crohn disease

BACKGROUND

Inflammatory bowel disease (IBD) present in childhood in 15% to 25% of cases. The aim of therapy in children is not only to guarantee normal growth but also to prevent relapse and to maintain remission. Steroids are effective to induce remission; however, resistance, dependency, and irreversible side effects can develop. The aim of this study was to determine whether treatment with repeated infusions of autologous red blood cells (RBCs) loaded with dexamethasone 21-phosphate (Dex 21-P) is safe and allows maintenance of long-term remission in children with steroid-dependent Crohn disease (CD).

PATIENTS AND METHODS

Eighteen consecutive pediatric patients who met the inclusion criteria were admitted to the study. Infusions of autologous RBCs loaded with Dex 21-P were performed every 4 weeks; the mean duration of treatment was 24 months. At the beginning of treatment and after 6, 12, and 24 months, we performed clinical evaluation according to the Pediatric Crohn Disease Activity Index (pCDAI). Assessment of body mass in dexamethasone and bone mineral density by means of computerized bone mineralometry-dual energy x-ray absorptiometry, endoscopic evaluation, and hematic morning cortisol determination were also performed.

RESULTS

During treatment, the mean pCDAI significantly decreased (P < 0.05); 78% of patients discontinued steroids. Determination of morning cortisol showed suppression only on the first day after infusion, followed by normalization of values. Endoscopic findings showed remission in 44% of patients. None of the patients experienced serious side effects.

CONCLUSIONS

These data suggest that repeated infusions of RBCs loaded with Dex 21-P can be safe and useful to maintain long-term remission in pediatric patients with moderately active CD.

Administration of fludarabine-loaded autologous red blood cells in simian immunodeficiency virus-infected sooty mangabeys depletes pSTAT-1-expressing macrophages and delays the rebound of viremia after suspension of antiretroviral therapy

A major limitation of highly active antiretroviral therapy is that it fails to eradicate human immunodeficiency virus (HIV) infection due to its limited effects on viral reservoirs carrying replication-competent HIV, including monocytes/macrophages (M/M). Therefore, therapeutic approaches aimed at targeting HIV-infected M/M may prove useful in the clinical management of HIV-infected patients. In previous studies, we have shown that administration of fludarabine-loaded red blood cells (RBC) in vitro selectively induces cell death in HIV-infected M/M via a pSTAT1-dependent pathway. To determine the in vivo efficacy of this novel therapeutic strategy, we treated six naturally simian immunodeficiency virus (SIV)-infected sooty mangabeys (SMs) with either 9-[2-(R)-(phosphonomethoxy)propyl]adenine (PMPA) only, fludarabine-loaded RBC only, or PMPA in association with fludarabine-loaded RBC. The rationale of this treatment was to target infected M/M with fludarabine-loaded RBC at a time when PMPA is suppressing viral replication taking place in activated CD4+ T cells. In vivo administration of fludarabine-loaded RBC was well tolerated and did not induce any discernible side effect. Importantly, addition of fludarabine-loaded RBC to PMPA delayed the rebound of viral replication after suspension of therapy, thus suggesting a reduction in the size of SIV reservoirs. While administrations of fludarabine-loaded RBC did not induce any change in the CD4+ or CD8+ T-cell compartments, we observed, in chronically SIV-infected SMs, a selective depletion of M/M expressing pSTAT1. This study suggests that therapeutic strategies based on the administration of fludarabine-loaded RBC may be further explored as interventions aimed at reducing the size of the M/M reservoirs during chronic HIV infection.

The polymorphism of multi-drug resistance 1 gene (MDR1) does not influence the pharmacokinetics of dexamethasone loaded into autologous erythrocytes of patients with inflammatory bowel disease

BACKGROUND

We have recently demonstrated that low doses of Dexamethasone 21-P (Dex 21-P), loaded in autologous erythrocytes and administered at monthly intervals, have been able to maintain steroid-dependent patients with Crohn's disease (CD) and ulcerative colitis (UC) in clinical remission with a progressive and complete tapering of systemic steroids.

AIM

Since multi-drug resistance 1 gene (MDR1) has a potential influence on Dexamethasone (Dex) bioavailability, we designed this study to investigate the correlation between MDR1 genotype and Dex pharmacokinetic after its delivery in patients with inflammatory bowel disease (IBD).

MATERIALS AND METHODS

Seventeen steroid-dependent consecutive patients with IBD (10 UC mean age 36 +/- 12, and 7 Crohn's disease mean age 31 +/- 5) were consecutively recruited. The C3435T polymorphism of MDR1 gene was studied by Denaturing High Performance Liquid Chromatography (DHPLC). Serum level of Dex were determined at the end of the infusion and after 15 days by high performance liquid chromatography electrospray mass spectrometry.

RESULTS

The mean dose of Dex 21-P administered was 9.9 mg +/- 4 (range 2.7-20.3), while the mean levels of Dex at the end of the infusion and after 15 days were 0.66 +/- 0.23 mM and 0.06 +/- 0.06 mM, respectively. Concerning the C3435T genotype, two patients were wild-type, eleven heterozygotes, and four homozygotes. No correlation between basal or 15-days plasma level of Dex and MDR1 genotype was found (r = 0.19 and r = 0.21, respectively).

CONCLUSION

Our findings demonstrated that Dex plasma level, after infusion of autologous erythrocytes loaded with Dex 21-P are completely independent by the MDR 1 gene polymorphism. This could be another potential advantage of this modality of drug delivering.

Advanced diagnostic tools: virtual colonoscopy and magnifying chromoendoscopy

Early endoscopic diagnosis of colorectal cancers (CRCs) represents the best tool for the reduction of CRC mortality, but the conventional colonoscopic view seems unable to clarify faint changes of colorectal mucosa. For these reasons, during the last few decades, two new techniques have been developed in order to better define, diagnose and treat colorectal lesions: chromoendoscopy (CE) and magnifying chromoendoscopy (MC). The authors herein highlight the benefits of both and compare the results of conventional endoscopy and CE with 0.2% indigo carmine solution, evaluating 995 consecutive selected patients referred for colonoscopy between January 1999 and March 2003 at the International Health Union of Rome. CE showed new neoplastic patterns not detectable with conventional endoscopy in 102 patients (10.2%). The incidence of high-grade dysplasia and early carcinomas was 9.9% for protruded, 13.1% for flat and 60% for depressed lesions. Our comparative study on 995 consecutive selected patients confirmed the existence of flat and depressed neoplasms in Italy and shows the high accuracy rate of CE over conventional endoscopy for the detection of non-polypoid lesions. CE should be used routinely in order to enhance the early diagnosis of CRCs, while MC in experienced hands represents a significant advance in colonoscopic practice improving the diagnosis of every single lesion, enhancing therapeutic efficacy of colorectal tumours.

Effect of listeriolysin O-loaded erythrocytes on Mycobacterium avium replication within macrophages

OBJECTIVE

To evaluate the efficacy of erythrocytes loaded with the haemolytic toxin listeriolysin O against Mycobacterium avium replication within human macrophages.

METHODS

Recombinant listeriolysin O was loaded in human erythrocytes by a procedure of hypotonic dialysis and isotonic resealing. Loaded erythrocytes were modified to allow them to be recognized and taken up by human macrophages infected with M. avium. The antimycobacterial activity of the erythrocytes loaded with listeriolysin O was evaluated by supernatant and intracellular cfu counts on days 4 and 7 post-erythrocyte administration.

RESULTS

Recombinant listeriolysin O was encapsulated in human erythrocytes to reach final concentrations ranging from 1 to 4 ng/mL of erythrocytes. Erythrocytes loaded with increasing quantities of recombinant protein were able to reduce (at most by 50%) M. avium replication in a dose-dependent fashion when administered to infected macrophages.

CONCLUSIONS

Erythrocytes loaded with listeriolysin O are effective against M. avium replication within macrophages. We are confident that the strategy presented could be useful against mycobacteria other than M. avium (such as Mycobacterium tuberculosis and Mycobacterium leprae) by itself or as part of an antimycobacterial treatment.

Low-molecular-weight heparin versus warfarin for secondary prophylaxis of venous thromboembolism: a cost-effectiveness analysis

PURPOSE

To compare the cost effectiveness of low-molecular-weight heparin with that of oral anticoagulants in preventing recurrences after an episode of venous thromboembolism.

METHODS

A decision tree was used to assess the cost and the expected quality-adjusted years of life (QALY) after treatment with either low-molecular-weight heparin or warfarin, based on pooled data from six published trials. Preferences were elicited with a modified time trade-off method in a sample of patients attending an anticoagulation clinic.

RESULTS

Compared with warfarin, low-molecular-weight heparin significantly decreased the rate of minor bleeding (odds ratio [OR] = 0.24; 95% confidence interval [CI]: 0.14 to 0.43) but not recurrent deep vein thromboses (OR = 0.77; 95% CI: 0.43 to 1.35). Patients' preference for warfarin (0.988, on a 0 to 1 scale) was lower than that for low-molecular-weight heparin (0.992), but the difference was not statistically significant. A Monte Carlo analysis estimated that low-molecular-weight heparin saved an average of 13 quality-adjusted days compared with warfarin, at a cost of $6,583 per QALY (95% CI: $5,525 to $7,625) based on costs in Italy and $28,231 per QALY (95% CI: $20,872 to $36,773) based on costs in the United States. When we included rebound recurrences after interruption of therapy, which were more common with low-molecular-weight heparin, treatment with low-molecular-weight heparin cost $53,166 per QALY in Italy and $177,166 per QALY in the United States.

CONCLUSIONS

Low-molecular-weight heparin might be a cost-effective drug for secondary prophylaxis of venous thromboembolism, especially in patients at high risk of recurrence and where the drug's cost is lower. The apparent increase in recurrence after interruption of therapy needs to be investigated more thoroughly before low-molecular-weight heparin can be recommended routinely.

Erythrocyte-mediated delivery of a new homodinucleotide active against human immunodeficiency virus and herpes simplex virus

Monocyte-derived macrophages (MDMs) play a central role in the pathogenesis of infection by human immunodeficiency virus (HIV-1) and represent one of the main reservoirs of the virus in the body. In addition, MDMs can easily be infected by various herpes viruses, including herpes simplex virus type 1 (HSV-1). We have synthesized a new antiviral agent (Bis-PMEA) that consists of two 9-(2-phosphonylmethoxyethyl)adenine (PMEA) molecules bound by a phosphate bridge. This nucleotide analogue, like the parent compound PMEA, has strong and selective activity against HIV-1 and HSV-1. A drug-targeting system previously developed in our laboratory was used for the selective delivery of these drugs to macrophages. Bis-PMEA and PMEA were encapsulated into autologous erythrocytes by a procedure of hypotonic dialysis and isotonic resealing. Loaded erythrocytes were modified to increase their recognition and phagocytosis by human macrophages. By administering Bis-PMEA-loaded erythrocytes to macrophages, 47% of Bis-PMEA and 28% of PMEA was still present 10 days after phagocytosis; in contrast, only 12% of PMEA was found in macrophages receiving PMEA-loaded erythrocytes. Bis-PMEA-loaded erythrocytes were then added to macrophages infected with HIV-1 and HSV-1 and their antiviral activity evaluated. Remarkable protection was obtained against HIV-1 and HSV-1 infection (95 and 85%, respectively). Therefore, Bis-PMEA acts as an efficient antiviral prodrug that, following selective targeting to macrophages by means of loaded erythrocytes, can protect a refractory cell compartment.

fMRI auditory language differences between dyslexic and able reading children

During fMRI, dyslexic and control boys completed auditory language tasks (judging whether pairs of real and/or pseudo words rhymed or were real words) in 30 s 'on' conditions alternating with a 30 s 'off' condition (judging whether tone pairs were same). During phonological judgment, dyslexics had more activity than controls in right than left inferior temporal gyrus and in left precentral gyrus. During lexical judgment, dyslexics were less active than controls in bilateral middle frontal gyrus and more active than controls in left orbital frontal cortex. Individual dyslexics were reliably less active than controls in left insula and left inferior temporal gyrus. Dyslexic and control children differ in brain activation during auditory language processing skills that do not require reading.

Inhibition of HIV-1 replication in macrophages by red blood cell-mediated delivery of a heterodinucleotide of azidothymidine and 9-(R)-2-(phosphono methoxypropyl)adenine

Monocyte-derived macrophages (M/M) are considered important in vivo reservoirs for different kinds of viruses, including HIV. Hence, therapeutic strategies are urgently needed to protect these cells from virus infection or to control viral replication. In this paper, we report the synthesis, target delivery and in vitro efficacy of a new heterodinucleotide (AZTpPMPA), able to inhibit HIV-1 production in human macrophages. AZTpPMPA consists of two established anti-HIV drugs [zidovudine (AZT) and tenofovir (PMPA)] chemically coupled together by a phosphate bridge. This drug is not able to prevent p24 production when administered for 18 h to M/M experimentally infected with HIV-1 Bal (inhibition 27%), but can almost completely suppress virus production when given encapsulated into autologous erythrocytes (inhibition of p24 production 97%). AZTpPMPA is slowly converted to PMPA, AZT monophosphate and AZT (36 h half-life at 37 degrees C) by cell-resident enzymes. Thus AZTpPMPA should be considered a new prodrug of AZT and PMPA that is able to provide stechiometric amounts of both nucleoside analogues to macrophage cells and to overcome the low phosphorylating activity of M/M for AZT and the modest permeability of PMPA.

Erythrocyte-mediated delivery of dexamethasone in patients with chronic obstructive pulmonary disease

Human erythrocytes from ten patients with chronic obstructive pulmonary disease (COPD) were loaded with increasing amounts of dexamethasone 21-phosphate and were re-infused into the original donors. Drug-loaded erythrocytes acted as circulating bioreactors, converting the non-diffusible dexamethasone 21-phosphate into the diffusible dexamethasone. Pharmacokinetic analyses on these patients showed that a single administration of drug-loaded erythrocytes was able to maintain detectable dexamethasone concentrations in blood for up to seven days. This continuous release of dexamethasone was paralleled by the suspension of beta2-agonist and oral corticosteroid treatments by all of the patients. Thus dexamethasone 21-phosphate-loaded erythrocytes are safe carriers for corticosteroid analogues and are a useful alternative to frequent oral or inhaled drugs in elderly patients with COPD.

Comparison of fMRI and PEPSI during language processing in children

The present study explored the correlation between lactate as detected by MR spectroscopy (MRS) and blood oxygenation level dependent (BOLD) responses in male children during auditory-based language tasks. All subjects (N = 8) participated in one proton echo planar spectroscopic imaging (PEPSI) and one functional magnetic resonance imaging (fMRI) session that required phonological and lexical judgments to aurally presented stimuli. Valid PEPSI data was limited in the frontal areas of the brain due to the magnetic susceptibility of the eye orbits and frontal sinuses. Findings from the remainder of the brain indicate that subjects show a significant consistency across imaging techniques in the left temporal area during the lexical task, but not in any other measurable area or during the phonological task. Magn Reson Med 45:217-225, 2001.

Effects of a phonologically driven treatment for dyslexia on lactate levels measured by proton MR spectroscopic imaging

BACKGROUND AND PURPOSE

Dyslexia is a language disorder in which reading ability is compromised because of poor phonologic skills. The purpose of this study was to measure the effect of a phonologically driven treatment for dyslexia on brain lactate response to language stimulation as measured by proton MR spectroscopic imaging.

METHODS

Brain lactate metabolism was measured at two different time points (1 year apart) during four different cognitive tasks (three language tasks and one nonlanguage task) in dyslexic participants (n = 8) and in control participants (n = 7) by using a fast MR spectroscopic imaging technique called proton echo-planar spectroscopic imaging (1 cm3 voxel resolution). The age range for both dyslexic and control participants was 10 to 13 years. Between the first and second imaging sessions, the dyslexic boys participated in an instructional intervention, which was a reading/science workshop.

RESULTS

Before treatment, the dyslexic boys showed significantly greater lactate elevation compared with a control group in the left anterior quadrant (analysis of variance, P = .05) of the brain during a phonologic task. After treatment, however, brain lactate elevation was not significantly different from that of the control group in the left anterior quadrant during the same phonologic task. Behaviorally, the dyslexic participants improved in the phonologic aspects of reading.

CONCLUSION

Instructional intervention that improved phonologic performance in dyslexic boys was associated with changes in brain lactate levels as measured by proton echo-planar spectroscopic imaging.

Biochemical characterization of a hepatitis C virus RNA-dependent RNA polymerase mutant lacking the C-terminal hydrophobic sequence

The RNA-dependent RNA polymerase activity of hepatitis C virus is carried out by the NS5B protein. The full-length protein was previously purified as a non-fusion protein from insect cells infected with a recombinant baculovirus. The characterization is now described of a C-terminal hydrophobic domain deletion mutant of NS5B purified from E. coli. In addition to increased solubility, deletion of this sequence also positively affected the polymerase enzymatic activity. The efficiency of nucleotide polymerization of both the full-length and the C-terminal truncated enzymes were compared on homopolymeric template-primer couples as well as on RNA templates with heteropolymeric sequences. The largest difference in the polymerase activity was observed on the latter. On all the templates, the increased activity could be ascribed, at least in part, to enhanced template turnover of the deletion mutant with respect to the full-length enzyme. The elongation rates of the two enzyme forms were compared under single processive cycle conditions. Under these conditions, both the full-length and the deletion mutant were able to incorporate about 700 nt/min.

Metabolism, mitochondrial uptake and toxicity of 2', 3'-dideoxycytidine

2',3'-Dideoxycytidine (ddCyd) is a prescription anti-retroviral drug that causes mitochondrial toxicity and peripheral neuropathy. ddCyd is actively phosphorylated by cytosolic deoxycytidine kinase and nucleoside (di)phosphate kinase to the 5'-triphosphate derivative. However, 2',3'-dideoxycytidine 5'-diphosphocholine (ddCDP-choline) was also found in human cells incubated with ddCyd. In this paper we show that ddCDP-choline is produced from dideoxyCTP (ddCTP) and phosphocholine by phosphocholine cytidylyltransferase. dCTP and CTP appear to activate this synthesis in a concentration-dependent manner. Although ddCTP and ddCDP-choline can both enter the mitochondria, ddCDP-choline uptake is more efficient than ddCTP uptake. These data suggest that ddCDP- choline is the ddCyd metabolite that is probably responsible for mitochondrial toxicity. The uptake of ddCTP and ddCDP-choline by mitochondria is inhibited by 3.0 mM l-carnitine in the cell-free system investigated; when added to U937 cells grown in the presence of 0.25 microM ddCyd, 3.0 mM l-carnitine partially abrogated the mitochondrial toxicity of ddCyd.

Dyslexic children have abnormal brain lactate response to reading-related language tasks

BACKGROUND AND PURPOSE

Children with dyslexia have difficulty learning to recognize written words owing to subtle deficits in oral language related to processing sounds and accessing words automatically. The purpose of this study was to compare regional changes in brain lactate between dyslexic children and control subjects during oral language activation.

METHODS

Brain lactate metabolism was measured during four different cognitive tasks (three language tasks and one nonlanguage task) in six dyslexic boys and in seven control subjects (age- and IQ-matched right-handed boys who are good readers) using a fast MR spectroscopic imaging technique called proton echo-planar spectroscopic imaging (1-cm3 voxel resolution). The area under the N-acetylaspartate (NAA) and lactate peaks was measured to calculate the lactate/NAA ratio in each voxel.

RESULTS

Dyslexic boys showed a greater area of brain lactate elevation (2.33+/-SE 0.843 voxels) as compared with the control group (0.57+/-SE 0.30 voxels) during a phonological task in the left anterior quadrant. No significant differences were observed in the nonlanguage tasks.

CONCLUSION

Dyslexic and control children differ in brain lactate metabolism when performing language tasks, but do not differ in nonlanguage auditory tasks.

A high-throughput radiometric assay for hepatitis C virus NS3 protease

A novel radiometric in vitro assay for discovery of inhibitors of hepatitis C viral protease activity, suitable for high-throughput screening, was developed. The NS3 protein of hepatitis C virus (HCV) contains a serine protease, whose function is to process the majority of the nonstructural proteins of the viral polyprotein. The viral NS4A protein is a cofactor of NS3 protease activity in the cleavage of NS3-NS4A, NS4A-NS4B, NS4B-NS5A, and NS5A-NS5B junctions. To establish an in vitro assay system we used NS3 proteases from different HCV strains, purified from Escherichia coli and a synthetic radiolabeled peptide substrate that mimics the NS4A-NS4B junction. Upon incubation with the enzyme the substrate was separated from the radiolabeled cleavage product by addition of an ion exchange resin. The assay was performed in a microtiter plate format and offered the potential for assaying numerous samples using a laboratory robot. Taking advantage of these features, we used the assay to optimize reaction conditions by simultaneously varying different buffer components. We showed that physicochemical conditions affect NS3 protease activity in a strain-specific way. Furthermore, the sensitivity of the assay makes it suitable for detection and detailed mechanistic characterization of inhibitors with low-nanomolar affinities for the HCV serine protease.

Cerebral N-acetylaspartate is low in patients with multiple sclerosis and abnormal visual evoked potentials

PURPOSE

Our purpose was to compare cerebral proton MR metabolite changes in patients with multiple sclerosis (MS) and abnormal visual evoked potentials (VEPs) with those in MS patients with normal VEPs.

METHODS

Seventeen subjects with clinically definite MS were studied with VEPs and MR spectroscopic imaging. Proton MR metabolites were measured using a fast spectroscopic imaging technique called proton echo-planar spectroscopic imaging (PEPSI). Kurtzke's Expanded Disability Status Scale (EDSS) score was also ascertained for each subject to obtain a clinical rating. Twelve regions of interest within the visual pathway of the cerebrum were evaluated for levels of N-acetylaspartate (NAA), choline, creatine, and the presence or absence of MR-detectable lesions.

RESULTS

PEPSI NAA values (water-normalized, CSF-corrected) were significantly lower in MS subjects with abnormal VEPs than in subjects with normal VEPs. MR-detectable lesion fractions and EDSS scores were also significantly different between the two VEP groups, but NAA comparison had a P value 100 times less than either of these measures.

CONCLUSION

In patients with MS, NAA measurements in the optic pathways of the brain were sensitive to VEP abnormalities. NAA was more sensitive to VEP changes than were choline, creatine, MR-detectable lesions, and EDSS score.

Functional MR spectroscopy of the auditory cortex in healthy subjects and patients with sudden hearing loss

PURPOSE

To use MR spectroscopy to study the biochemical changes produced by auditory stimuli in patients with sudden sensorineural hearing loss and to compare these findings with the biochemical changes seen in healthy volunteers.

METHODS

Single-voxel MR spectroscopy was used to study biochemical changes in the auditory cortex in 11 control subjects and 19 patients with sudden sensorineural hearing loss. MR spectroscopic signals were measured during three different sound conditions (scanner noise, music, and sirens).

RESULTS

A lower MR spectroscopic lactate signal was observed in control subjects during the music stimulus than during the other sound conditions. This music-induced lactate change was not observed in patients with hearing loss. The other proton metabolites (choline, creatine, N-acetylaspartate [NAA]) remained stable during the different auditory stimuli. However, the NAA/creatine ratio was higher in the auditory cortex of patients than in the control subjects, and was not dependent on the sound condition.

CONCLUSION

The detection of stimulus-induced and stable biochemical MR spectroscopic changes in patients with hearing loss may be useful in assessing disease activity.

Engineering human interleukin-6 to obtain variants with strongly enhanced bioactivity

Interleukin-6 (IL-6) triggers the formation of a high affinity receptor complex with the ligand binding subunit IL-6Ralpha and the signal transducing chain gp130. Since the intracytoplasmic region of the IL-6Ralpha does not contribute to signaling, soluble forms of the extracytoplasmic domain (sIL-6Ralpha), potentiate IL-6 bioactivity and induce a cytokine-responsive status in cells expressing gp130 only. This observation, together with the detection of high levels of circulating soluble human IL-6Ralpha (shIL-6Ralpha) in sera, suggests that the hIL-6-shIL-6Ralpha complex is an alternative form of the cytokine. Here we describe the generation of human IL-6 (hIL-6) variants with strongly enhanced shIL-6Ralpha binding activity and bioactivity. Homology modeling and site-directed mutagenesis of hIL-6 suggested that the binding interface for hIL-6Ralpha is constituted by the C-terminal portion of the D-helix and residues contained in the AB loop. Four libraries of hIL-6 mutants were generated by each time fully randomizing four different amino acids in the predicted AB loop. These libraries were displayed monovalently on filamentous phage surface and sorted separately for binding to immobilized shIL-6Ralpha. Mutants were selected which, when expressed as soluble proteins, showed a 10- to 40-fold improvement in shIL-6Ralpha binding; a further increase (up to 70-fold) was achieved by combining variants isolated from different libraries. Interestingly, high affinity hIL-6 variants show strongly enhanced bioactivity on cells expressing gp13O in the presence of shIL-6Ralpha at concentrations similar to those normally found in human sera.

P-selectin and von Willebrand factor in bovine mesenteric lymphatics: an immunofluorescent study

P-selectin (PADGEM, GMP-140, CD62) is an integral membrane protein specific to alpha granules of platelets and Weibel-Palade bodies of blood vascular endothelial cells. The presence in lymphatic endothelial cells of numerous Weibel-Palade bodies and their positivity to immunocytochemical reaction for von Willebrand factor have previously been characterized and described. Because von Willebrand factor and P-selectin codistribute in Weibel-Palade bodies of blood vascular endothelial cells we investigated the presence of both P-selectin and von Willebrand factor in lymphatic endothelium. Lymphatic vessels expressed positive reaction to immunocytochemical assay thereby demonstrating the presence of P-selectin in the endothelium. Distribution and intensity of the reaction were similar to those observed in bovine blood vascular endothelium.

[Surgical treatment of diverticular disease of the colon. Our experience in the last decade]

The authors analyse their personal experience of diverticular disease of the colon and, comparing it with that of other authors, draw attention to some fundamental data relating to the type of management chosen. Having underlined the high incidence of disease in relation changed living conditions, the authors point out that this pathology is becoming more frequent as a result of the increased average age and that subacute and acute clinical manifestations of the disease are also more common-place. Attention has often been drawn to the presence of non-evolved phlogistic symptoms which it is possible to treat medically thus enabling the operation to be postponed in some cases to a time which is more convenient for the patient, whereas in other cases it has resulted in the remission of symptoms. Surgical therapy need not be used in "silent" cases, but is obligatory in recurring or complicated forms. The authors also affirm that surgery is not burdened by particular postoperative complications which, if present, are linked essentially to peritonitis due to perforation or to other associated pathologies. The use of mechanical staplers has also restricted the number of derivative operations and those performed in several stages.

Elevated urinary excretion of endothelins in streptozotocin diabetic rats

Endothelin-1,2 urinary excretion, has been determined in control and streptozotocin diabetic rats at different times after diabetes induction. Diabetic rats showed increased urinary excretion of endothelins as compared to control rats, already three days after diabetes induction and up to 20 weeks.

[Aberrant pancreas: description of a clinical case and review of the literature]

Aberrant pancreas is a rare finding pathology. Authors reviewed this problem after their personal observation of a specific case, pointing out the behaviour of the disease, particularly the difficult for a careful preoperative diagnosis. They also point out the necessity to make a diagnosis of "suspect" in presence of a symptomatology with the referred characters and when there aren't instrumental findings for evident pathologies.

Acetyl-L-carnitine effect on nerve conduction velocity in streptozotocin-diabetic rats

Measurement of nerve conduction velocity (NCV) is a useful and sensitive tool for evaluating diabetes related neurological dysfunctions. The method used allows to monitor the parameter at different times in the same group of rats, so that it is possible to observe simultaneously the development of the damage in time, and to evaluate the improvement related to the treatment. The repeated oral treatment with acetyl-L-carnitine (ALC, CAS 5080-50-2) 250 mg/kg caused an improvement in NCV of the diabetic rats; the effect was higher when the treatment started early with respect to the diabetes induction. The improvement in NCV was constant in time and comparable from 2 to 6 weeks of the treatment. In conclusion, oral treatment with ALC was able to normalize the impairment of NCV in streptozotocin rats, the effect being constant in time from 2 to 6 weeks of treatment and up to 8 weeks after induction when administration started in early stage of diabetes (2-3 weeks after induction); however, at this time the NCV is already significantly decreased.

Identification of the major degradation products of 4-methoxy-2-(3-phenyl-2-propynyl)phenol formed by exposure to air and light

Exposure of 4-methoxy-2-(3-phenyl-2-propynyl)phenol (CO/1828) to air and light (accelerated by temperature) yields 1-(2-hydroxy-5- methoxyphenyl)-3-phenylpropynone as the major degradation product. With extraction, this product rapidly degrades to 5-methoxyaurone and 6-methoxyflavone. In addition, a mixture of dimeric and heterodimeric compounds that are not fully identified was observed. These results indicate the formation of a reactive ortho-quinone methide as an unstable intermediate. This hypothesis is supported by evidence that the aurone slowly isomerizes into the flavone in control samples. Identification of compounds was accomplished with mass spectrometry, nuclear magnetic resonance spectrometry, UV-high-performance liquid chromatography, and comparison with authentic samples.

Metabolism of (-)-6(S)-hydroxy-4(R)-(1-hydroxy-1-methylethyl)-1- cyclohexene-1-ethanol in rat and dog

1. The metabolism of a new mucoactive drug, chemically (-)-6(S)-hydroxy-4(R)- (1-hydroxy-1-methylethyl)-1-cyclohexene-1-ethanol (CO/1408), has been studied in rat and dog after a single oral dose; eight metabolites were identified. 2. Oxidation of the primary and secondary alcohol groups, hydroxylation in allylic positions and conjugation with glucuronic acid occurred in both species. Products of oxidation on the double bond have not been identified. 3. Using reversed-phase h.p.l.c. and beta-cyclodextrin in the eluent it was found that the glucuronide metabolites varied with species and with the biological fluid examined.

[Stapler reconstruction after total gastrectomy contrasted with manual anastomosis]

A personal series (1985-1987) of 22 cases of total gastrectomy for cancer is analysed, a comparison being made between 11 cases treated with manual anastomosis and 11 reconstructed using a stapler. The advantages and disadvantages of the various techniques are examined and although no substantial difference is noted between the two reconstructive modalities, at least as regards morbidity and mortality, stress is laid on the unquestionable advantages of mechanical staplers. These are essentially speed of execution, suture perfection and excellent long-term results.