The second life of terrestrial and plastic carbon as nutritionally valuable food for aquatic consumers.

Primary production is the basis for energy and biomolecule flow in food webs. Nutritional importance of terrestrial and plastic carbon via mixotrophic algae to upper trophic level is poorly studied. We explored this question by analysing the contribution of osmo- and phagomixotrophic species in boreal lakes and used 13 C-labelled materials and compound-specific isotopes to determine biochemical fate of carbon backbone of leaves, lignin-hemicellulose and polystyrene at four-trophic level experiment. Microbes prepared similar amounts of amino acids from leaves and lignin, but four times more membrane lipids from lignin than leaves, and much less from polystyrene. Mixotrophic algae (Cryptomonas sp.) upgraded simple fatty acids to essential omega-3 and omega-6 polyunsaturated fatty acids. Labelled amino and fatty acids became integral parts of cell membranes of zooplankton (Daphnia magna) and fish (Danio rerio). These results show that terrestrial and plastic carbon can provide backbones for essential biomolecules of mixotrophic algae and consumers at higher trophic levels.

A case of Solitary fibrous pleura tumor associated with severe hypoglycemia: the Doege-Potter 's Syndrome.

Solitary fibrous pleura tumor is a rare primary intrathoracic tumor of the pleura. It usually has an indolent clinical course, but sometimes it can have an aggressive behaviour. In 1930 Doege and Potter independently described this neoplasm, presenting with symptoms of hypoglycemia, hence the eponim of Doege-Potter's Syndrome. In this report, we illustrate a case of Doege Potter's Syndrome, treated with complete surgical resection.

Potential applications of biphosphonates in dental surgical implants.

Biphosphonates are largely used for their unquestionable properties of inhibiting bone resorption by osteoclasts in the treatment of various osteometabolic illnesses such as osteoporosis, multiple myeloma, tumors which metastasize to the bone and malignant hypercalcemia. In this literature review the physico-chemical properties, biologic activities and the mechanisms of action of biphosphonates are described. The use of these drugs is discussed, analyzing the quantity of results which have emerged through in vitro and in vivo experiments on animal models. In this study the efficiency of these drugs is demonstrated in contrasting the osteolitic processes of the alveolar bone, in promoting the neoformation and in bettering the quality of bone implants. However, it is important to draw attention to a worrying correlation which has emerged during the last 3-4 years, between osteonecrosis of the jaw (ONJ) and the systemic administration of aminobiphosphonates. This collateral effect did not emerge following the use of non-aminobiphosphonates. The aim of this review is to identify the guidelines for the use of biphosphonates in oral implant surgery.

Changes in the histochemical properties and meat quality traits of porcine muscles during the growing-finishing period as affected by feed restriction, slaughter age, or slaughter weight.

In this study, the degree of contractile and metabolic development of myofibers in porcine LM, rectus femoris (RF), and dark and light portions of the semitendinosus (STD and STL, respectively) was determined, and their impact on meat quality was compared at the same age but different BW (trial 1) or at a given BW but different age (trial 2) in 48 Swiss Large White barrows from 12 litters after the growing and finishing period. The barrows had ad libitum (A) or restricted (R, 80% of A) feed access. In trial 1, at 113 and 154 d of age, 6 barrows in treatment A (62.1 and 99.5 kg of BW, respectively) and 6 siblings in treatment R (51.0 and 86.6 kg of BW, respectively) were slaughtered. In trial 2, a similar protocol was used except that the barrows were slaughtered at 61.3 (104 or 119 d of age, respectively) or 101.3 kg of BW (145 or 167 d of age, respectively). Muscle fibers were stained and classified as slow oxidative (SO), fast oxidative-glycolytic (FOG), or fast glycolytic (FG), and fiber area and distribution were determined. At 113 and 154 d of age, R barrows had smaller (P < or = 0.04) SO fibers in the LM, STD, and STL, smaller (P < 0.01) FOG fibers in the STL, smaller (P = 0.03) FG fibers in the LM, and smaller (P < or = 0.04) overall mean area in the LM, STD, and STL. In the STL and RF, R barrows had fewer (P < or = 0.06) FG and more (P < or = 0.08) FOG fibers than A barrows at 113 and 154 d of age. Except for smaller FOG fibers in the STD of R compared with A barrows slaughtered at the same BW, the myofiber size did not differ (P > or = 0.11). However, the LM tended to have fewer (P = 0.06) SO and more (P < 0.01) FG fibers, and the STD had more (P < 0.01) FOG fibers in R barrows. Regardless of whether R barrows were slaughtered at the same age or the same BW as the A barrows, shear force values and cooking losses were greater (P < or = 0.08) in the STD and STL of R barrows. These findings revealed that myofiber hypertrophy was impaired by feed restriction in barrows compared at the same age, but differences in myofiber size vanished at the same BW. By contrast, restricted nutrient supply affected myofiber maturation depending on the age and BW, but the impact differed between muscles. The absence of changes in myofiber type distribution among the younger-lighter and older-heavier barrows indicated that myofiber maturation was already completed in the younger-lighter barrows. Although changes in meat quality traits were affected by the feeding regimen, they were not related to myofiber characteristics.

Evaluation of non-specific tissue alkaline phosphatase on bone samples from traditional and piezoelectric osteotomy.

The aim of this study is to test the response of bone during cutting actions in dental procedures by sampling alkaline phosphatase (ALP) as a biological reference marker. ALP is found abundantly in bone tissue. In the first series of experiments a temporal-minimum quantity of ALP enzyme response was recorded, the observed period was 40 minutes. The ALP samples treated with piezoelectric surgery showed a rapid increase, with peak at 30 min, and then declined rapidly within the next 10 minutes. A second experiment was performed to evaluate 4 cutting instruments: drill bits high speed turbine (T1); drill bits contra-angle (T2) Piezoelectric insertions (T3), and manual instruments (controls). This second experiment was to evaluate the ALP activity at 30 min. The T1 samples produced the highest results (3,66499 +- 0,51394); control groups had a lower response (0,72793 +- 0,22353), while the T2 group produced statistically significant higher results (2,77793 +- 0,40553) than T3 (1,16608 +- 0,32676). The different values obtained for ALP in these two experiments for a short period of time (30 min) cannot be interpreted as a response of bone tissue regeneration subjected to surgical trauma. The MINIMUM trauma caused by the surgical piezoelectric instruments, in respect to conventional surgical instruments is clearly evident from the phosphatase inflammatory activity.

Preprandial combination of lispro and NPH insulin improves overall blood glucose control in type 1 diabetic patients: a multicenter randomized crossover trial.

BACKGROUND AND AIM: While lispro insulin has been reported to lower postprandial blood glucose concentrations, less consistent effects have been shown for glycosylated hemoglobin (HbA1c) levels. Aim of this study was to determine whether pre-meal association of NPH, an intermediate-acting insulin, with lispro improves overall glycemic control in type 1 diabetic patients. METHODS AND RESULTS: Eighty-five type 1 diabetic patients were studied in a multicenter randomized comparative (human regular vs lispro insulin) crossover (3-month) study in which NPH insulin was given as a dinner or bedtime injection and at breakfast and lunch if necessary. The number of injections was kept constant: 42% and 58% of patients injected insulin 3 and 4 times per day, respectively. Fasting and preprandial blood glucose levels were similar, while postprandial levels improved after lispro compared to human regular insulin (breakfast: 8.28 +/- 2.39 vs 9.28 +/- 2.72 mmol/l; lunch: 8.33 +/- 2.67 vs 9.06 +/- 2.67 mmol/l, dinner: 8.06 +/- 2.72 vs 9.28 +/- 2.44 mmol/l, ANOVA: p = 0.003). HbA1c also improved after lispro: 8.1 +/- 0.9 vs 8.3 +/- 0.8%, p < 0.05. The rate of hypoglycemia was similar. Patients showed better acceptance of lispro treatment (p < 0.001). CONCLUSIONS: Lispro improves overall blood glucose control in type 1 diabetic patients without increasing the incidence of hypoglycemia. This can be achieved by an optimal combination of lispro insulin with NPH whenever the time intervals between meals are too long.

Daily dialysis Kt/V and flexible schedules: is it possible to control efficiency, when and how?

BACKGROUND: Daily hemodialysis is a promising treatment schedule but uniform criteria for defining efficiency are lacking. METHODS: On our daily dialysis (DD) schedule, duration is flexible (2-3 hours, patients are free to add up to 30 min/session), Qb 250-350 mL/min; dialyser 1.6-1.8 m2. Study was performed on 12 pts on DD for > or = 2 months, with > or = 4 Kt/V on subsequent days, tested in the same laboratory. GOAL: To evaluate variability and identify a simple method for weekly calculation, Kt/V was assessed for 133 sessions. RESULTS: On flexible DD, variability of Kt/V-session is high (relative error 4.9%-22%). On flexible schedules, within the time range chosen (2-3 hours) variability of average hourly Kt/V is lower (standard deviation: min (0.014; max (0.052 hour, relative error 4.9%-10%) allowing calculation of weekly Kt/V (averaging 3 sessions: relative error < 6%) suitable for clinical practice. CONCLUSIONS: Flexible schedules, allowing patients to increase treatment time, are an interesting clinical option, but a challenge for Kt/V assessment.

Modelling the "ideal" self care--limited care dialysis center.

Limited care dialysis is an interesting option, which has gained attention in several settings because of the aging of the uremic cohort. The aim of this study was to assess its potential in the Piedmont region in northern Italy, evaluating patients' and care-givers' preferences and testing them in a mathematical model of organisation. The study was conducted in the satellite unit of a university hospital (200-210 dialysis patients), following 35 patients (15 at home, 20 in the center, 10 on daily dialysis). Opinions were collected with a questionnaire and features identified were empirically tested through a simulation model. Most patients (34/35) preferred a small unit, with a stable caring team. Further options were flexibility of dialysis schedule, multiple treatment options, integrated center/home care. These needs could be met by a flexible organization including conventional dialysis (3/week) and daily dialysis (6/week). We employed a simulation model (ARENA software) to calculate the nurses required for each shift and the opening hours and best schedule for the unit. Addition of daily dialysis (2-3 hours) to two conventional 4-5 hour sessions to increased the number of patients followed or "spared" beds, ensuring flexibility. According to patients' best choice (7 dialysis stations), and to the recorded calls, the needs are for two nurses per shift, two shifts per day and six nurses for up to 30 patients in limited care. In conclusion, small centers with flexible schedules can tailor dialysis to patients' needs. A managerial approach is valuable for testing cost/benefit ratios in specific contexts.

Multiple inappropriate shocks precipitated by interrogation of an implantable cardioverter defibrillator.

A 57-year-old man suffered multiple inappropriate shocks from an implantable cardioverter defibrillator that could not be inactivated because the magnet switch feature was deactivated. Attempts to interrogate the defibrillator caused shocks to be delivered. Emergent explantation was performed and a loose sensing lead was discovered. Sensing and defibrillation leads functioned normally, and testing of the explanted generator demonstrated no abnormalities. A new generator was put in place and the patient has been without shocks for 6 months. This case illustrates the need for robust methods of attenuating electromagnetic interference and the importance of multiple methods of device inactivation.

Case studies on the effect of exercise and hot water submersion on intracardiac temperature and the performance of a pacemaker which varies pacing rate based on temperature.

The effectiveness of using blood temperature change as an indicator to automatically vary heart rate physiologically was evaluated in 3 patients implanted with Model Sensor Kelvin 500 (Cook Pacemaker Corporation, Leechburg, PA, USA) pacemakers. Each patient performed two block-randomized treadmill exercise tests: one while programmed for temperature-based, rate-modulated pacing and the other while programmed without rate modulation. In 1 pacemaker patient and 4 volunteers, heart rates were recorded during exposure to a hot water bath. Blood temperature measured at 10 sec intervals and pacing rate measured at 1 min intervals were telemetered to a diagnostic programmer and data collector for storage and transfer to a computer. Observation comments and ECG-derived heart rates were manually recorded. The temperature-based pacemaker was shown to respond promptly not only to physical exertion but also to emotionally caused stress and submersion in a hot bath. These events cause increased heart rate in the normal heart. Using a suitable algorithm to process the measurement of blood temperature, it was possible to produce appropriate pacing rates in paced patients.