Application of spectrometric analysis to the identification of pollution sources causing cultural heritage damage.

Black crusts are recognized to have been, up to now, one of the major deterioration forms affecting the built heritage in urban areas. Their formation is demonstrated to occur mainly on carbonate building materials, whose interaction with an SO2-loaded atmosphere leads to the transformation of calcium carbonate (calcite) into calcium sulfate dihydrate (gypsum) which, together with embedded carbonaceous particles, consequently forms the black crusts on the stone surface. An analytical study was carried out on black crust samples collected from limestone monumental buildings and churches belonging to the European built Heritage, i.e., the Corner Palace in Venice (Italy), the Cathedral of St. Rombouts in Mechelen (Belgium), and the Church of St. Eustache in Paris (France). For a complete characterization of the black crusts, an approach integrating different and complementary techniques was used, including laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS), Fourier transform infrared spectroscopy, optical and scanning electron microscopy. In particular, the application of LA-ICP-MS permitted to obtain a complete geochemical characterization in terms of trace elements of the black crusts from the inner parts to the external layers contributing to the identification of the major combustion sources responsible for the deterioration over time of the monuments under study. In addition, the obtained results revealed a relation between the height of sampling and the concentration of heavy metals and proved that the crust composition can be a marker to evaluate the variation of the fuels used over time.

An integrated approach to assess air pollution threats to cultural heritage in a semi-confined environment: the case study of Michelozzo's Courtyard in Florence (Italy).

An example of an integrated approach to assess air pollution threats to cultural heritage in a semi-confined environment is presented in this work, where the monitoring campaign carried out at the Michelozzo's Courtyard (in Palazzo Vecchio, Florence, Italy) is used as a case study. A wide research project was carried out, with the main aim of obtaining the first quantitative data on air quality and microclimate conditions inside the Courtyard, and, if possible, identifying the main causes of degradation and suggesting appropriate conservation strategies. The investigation adopted a holistic approach involving thermographic measurements on the wall paintings, microclimatic analysis, gaseous pollutant monitoring, atmospheric particles characterisation and dry deposition compositional analysis. Attention was focused on the wall painting depicting the city of Hall because of its anomalous and critical conservation conditions, which are visible at a glance, due to the contrast between a wide darker zone around the central subject of the painting and external lighter areas.

Sentinel node biopsy in breast cancer.

Axillary lymph node dissection (ALND) is an important tool in staging patients with breast cancer. However, this procedure has several sequelae and complications and improvement in early diagnosis has led to an increasing number of cases of ALND in which axillary nodes are found to be negative. Sentinel node (SN) biopsy appears to be a less invasive alternative to ALND. The aim of the present study was to assess whether SN is a reliable indicator for axillary staging. We studied 126 consecutive patients with T1-T2 breast cancer and clinically negative axilla. In each case, 30-70 MBq of 99mTC-labelled colloidal albumin was injected subdermally close to the tumour and SN was visualised by lymphoscintigraphy. Surgery was performed 24 h after injection and the SN was removed under the guidance of a gamma ray-detecting probe. ALND was then undertaken in all cases. A histopathologic examination of the SNs was then made and the findings compared with the status of the other axillary nodes. SNs were identified and biopsied in 115/126 patients (91.3%) and correctly predicted the axillary status in 110/115 cases (95.6%). In five cases (4.4%), SNs were found to be negative, but other axillary nodes were positive. Our data confirm that SN biopsy is a good method for staging the axilla in patients with breast cancer. However, before SN biopsy can replace ALND in daily clinical practice, some technical aspects must be standardized, and clinical trials are required in order to clarify the prognostic impact of false-negative cases.

Cryptogenic temporal lobe epilepsy. semi-quantitative interictal 99mTc HMPAO SPECT: statistical correlation with clinical data and EEG.

The aim of our work was to identify clinical and electroencephalographic factors that are statistically correlated to 99mTc HMPAO hypofixation in cryptogenic temporal lobe epilepsy. We selected a homogeneous group of patients (28 males and 17 females) affected by temporal lobe epilepsy and having normal results on computed tomography and magnetic resonance imaging. Patients were classified according to semeiological characteristics of the seizures, presence or absence of spikes on electroencephalography (EEG), age at onset, illness duration, and drug resistance. The presence of focal interictal spikes on EEG was statistically correlated to 99mTc HMPAO temporal hypofixation (p = 0.04). The other electroclinical factors considered in this series did not play an important role in modifying radiopharmaceutical fixation in focal epilepsy in interictal phase. We speculate that a possible explanation for focal radiopharmaceutical hypofixation, in addition to hypoperfusion, is an increased permeability of the blood-brain barrier (due to perivascular inflammation or other causes) which can be responsible for 99mTc HMPAO escape with a resultant hypofixation.

Utility of Tc 99m HMPAO SPECT in the early diagnosis of Rasmussen's syndrome.

Neuroradiological examinations are important in the diagnosis of Rasmussen's syndrome (RS), but they frequently result normal in the early phase of the disease. We performed Tc 99m HMPAO SPECT (single photon emission computed tomography) on an 11-year, 5-month-old, right-handed girl, two months since the first seizure. SPECT showed a reduced uptake of HMPAO in the left temporal region despite normal results with magnetic resonance imaging (MRI). After six months, she developed epilepsia partialis continua, neurological signs appeared, and MRI showed cortical atrophy on the left side. SPECT seems to be a useful, inexpensive and diffuse technology able to give information in the early phases of RS useful in the prevention of serious consequences of the disease within a medical therapeutic program (ganciclovir or intravenous immunoglobulins).

[Early and late anthracycline-induced cardiotoxicity in childhood: non-invasive evaluation of contractility in 116 patients]. / Cardiotossicità precoce e tardiva da antracicline in età pediatrica: valutazione non invasiva dello stato contrattile in 116 pazienti.

In order to evaluate the incidence and the characteristics of anthracycline-induced cardiotoxicity we studied 116 children treated with anthracyclines with echocardiography, by using load dependent and independent indexes of contractility (respectively: 1-shortening fraction of the left ventricle (D%), velocity of circumpherential shortening (VCF), telesystolic wall stress (Ses) and 2-the regression curves between D% and Ses VCF and Ses). Eighty-six were off therapy, and 30 were evaluated during induction and reinduction. Off therapy patients had a D% lower than that of controls (37.5 +/- 5.7 vs 41.3 +/- 5.0, p<0.001), but it was clearly depressed only in 8% of them. VCF was also lower than in controls (1.7% +/- 0.5 vs 2.0 +/- 0.6, p<0.001), but in no patient it was clearly depressed. Ses was higher than in controls (63.8 +/- 20.6 vs 44.5 +/- 10.5, p<0.001) and elevated in 47% of them; it was positively related to the dose of anthracyclines administered (r = 0.25, p<0.05). The regression curves between D% and Ses and VCF and Ses showed a depressed contractility in off therapy patients. Dilated cardiomyopathy was present only in 1 of them (1.16%) and regional hypokinesia in 3 (3.5%). Children studied during the acute phase had normal D%, VCF, Ses and regional wall motion during the all period of study. These results indicate that 1) anthracycline-induced cardiotoxicity in childhood is mostly a late event, 2) a long term follow-up of these patients is necessary, 3) the use of Ses and of load independent indexes, more than that of D% and VCF, is mandatory to detect the cardiac damage.

Prostate-specific antigen as a unique routine test in monitoring therapy for inoperable prostate cancer: comparison with radionuclide bone scan and prostatic acid phosphatase.

The aim of the present investigation was the evaluation of cost-effectiveness of variables used in monitoring patients with inoperable prostate cancer. Prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and radionuclide bone scan were considered. The tumor marker positivity was assessed according to dynamic criteria (> 50% increase between consecutive samples). 108 patients entered the study; 72 patients treated with a luteinizing hormone-releasing hormone analogue were followed up for periods ranging from 12 to 64 months. PSA and PAP levels were measured using immunometric assays. Both cutoff-based and dynamic, serial sample-based decision criteria were employed. With respect to a positive bone scan, PSA showed negative predictive values of 82 and 77%, respectively, using 4 and 10 ng/ml as cutoff points. Progression of the disease to the bone occurred in 20 patients: in 17 PSA was the first indicator of progression, in the other 3 PAP anticipated PSA for a very short time (3-4 months), which was not of relevance to clinical decisions. PAP is less specific and sensitive than PSA; PAP may eventually provide information on disease status in a limited percentage of patients with advanced prostate cancer treated with androgen ablation, being differently regulated with respect to PSA. No increasing PSA profile was detected in patients who responded to the therapy. From the results of the present investigation, we draw the following conclusions: (1) PSA can be used reliably as a unique tool in the follow-up of patients for the early detection of progressive disease, and (2) dynamic criteria of evaluation of serial PSA determinations probably provide more effective and earlier clinical information.

Dynamic liver radionuclide scanning in the evaluation of liver failure and portal hypertension in cirrhotic patients.

Dynamic liver radionuclide scanning was performed in cirrhotic patients to correlate three parameters derived by this technique to the severity of liver function impairment and clinical-endoscopic signs of portal hypertension. We found a close association between the severity of liver failure (Child-Pugh criteria) and both the relative blood flow (p < 0.05) and the shape (shifting to the left) of the early flow curve (p < 0.01). A significant association between the presence of portal hypertension and shifting to the left of the flow curve was demonstrated in all cases in which tense ascites was associated with varices (p < 0.05). Finally, a statistically significant association (p < 0.05) was found between the degree of esophageal varices (Beppu's criteria) and the liver-to-spleen uptake ratio. These data suggest that dynamic isotope liver scanning could be an important tool in the diagnostic evaluation of liver function impairment and portal hypertension.

Scintigraphic oesophageal clearance in diabetics: clinical usefulness.

The whole digestive tract is one of the sites most involved in diabetic autonomic neuropathy. The aim of this work was to validate the clinical usefulness of oesophageal scintigraphy in the early detection of this complication of diabetes. Eighty-one diabetic patients without oesophageal symptoms were studied by solid meal scintigraphic test (SMST) and 35 out of them also by liquid meal scintigraphic test (LMST). As controls, 20 normal volunteers were studied by LMST and 14 by SMST. Forty-seven diabetics studied by SMST were also evaluated by cardiovascular tests (CT) and for the presence of retinopathy and peripheral neuropathy. The most statistically significant difference between diabetics and controls was found at 75s with SMST. SMST results showed a statistically significant correlation with CT. No correlation was found with the presence of retinopathy or peripheral neuropathy. We conclude that SMST is a useful, safe, low-cost diagnostic tool in the detection of diabetic autonomic neuropathy.