Stable isotopes and C/N ratios in marine sediments as a tool for discriminating anthropogenic impact.

Sources of anthropogenic pollution were categorised by combining elemental and isotopic techniques (C/N ratios and δ(13)C, δ(15)N) on samples of surficial sediments in the harbour of Naples (Southern Tyrrhenian Sea, Italy). The study area, due to the intense and diversified industrial and commercial activities, is an appropriate natural laboratory to verify reliability and relevance of geochemical methodologies applied to exploration of sources, pathways and fate of contaminants in highly polluted coastal marine systems. Application of cluster analysis to the whole dataset and resolution of a δ(13)C and δ(15)N Moore-Penrose system equation provided information to reliably discriminate and identify anthropogenic point sources in the studied sediments. In particular, effects of oil spilling and wastewater discharge within the area of the harbour of Naples were clearly discriminated thus suggesting high-potential of the two numerical techniques, applied to the C and N elemental and isotopic values, to explore effects of anthropogenic impact in marginal and confined coastal basins. The δ(15)N values showed high sensitivity to discriminate sewage discharges (treated or untreated organic matter), clearly indicating the point of emissions. The δ(13)C shows indirect capability of discriminating crude oil and petroleum products.

Transcriptional upregulation of histone deacetylase 2 promotes Myc-induced oncogenic effects.

Myc oncoproteins and histone deacetylases (HDACs) modulate gene transcription and enhance cancer cell proliferation, and HDAC inhibitors are among the most promising new classes of anticancer drugs. Here, we show that N-Myc and c-Myc upregulated HDAC2 gene expression in neuroblastoma and pancreatic cancer cells, respectively, which contributed to N-Myc- and c-Myc-induced cell proliferation. Cyclin G2 (CCNG2) was commonly repressed by N-Myc and HDAC2 in neuroblastoma cells and by c-Myc and HDAC2 in pancreatic cancer cells, and could be reactivated by HDAC inhibitors. 5-bromo-2'-deoxyuridine incorporation assays showed that transcriptional repression of CCNG2 was, in part, responsible for N-Myc-, c-Myc- and HDAC2-induced cell proliferation. Dual crosslinking chromatin immunoprecipitation assay demonstrated that N-Myc acted as a transrepressor by recruiting the HDAC2 protein to Sp1-binding sites at the CCNG2 gene core promoter. Moreover, HDAC2 was upregulated, and CCNG2 downregulated, in pre-cancerous and neuroblastoma tissues from N-Myc transgenic mice, and c-Myc overexpression correlated with upregulation of HDAC2 and repression of CCNG2 in tumour tissues from pancreatic cancer patients. Taken together, our data indicate the critical roles of upregulation of HDAC2 and suppression of CCNG2 in Myc-induced oncogenesis, and have significant implications for the application of HDAC inhibitors in the prevention and treatment of Myc-driven cancers.

Prognostic correlates of combined coronary flow reserve assessment on left anterior descending and right coronary artery in patients with negative stress echocardiography by wall motion criteria.

AIMS: To assess the prognostic correlates of Doppler echocardiographically derived coronary flow reserve (CFR) on two coronaries in patients with negative stress echo. Vasodilator stress echocardiography allows dual imaging of regional wall motion and CFR both on left anterior descending (LAD) and right coronary artery (RCA). METHODS: The study group comprised 460 patients with known or suspected coronary artery disease and negative stress echo by wall motion criteria. All underwent dipyridamole (up to 0.84 mg/kg over 6 minutes) stress echo with CFR evaluation of either LAD or RCA by Doppler, and were followed up for a median of 32 months. A CFR value of < or =2.0 was taken as abnormal. RESULTS: CFR was abnormal in 174 patients (38%) (57 in LAD only, 48 in RCA only, and 69 in both LAD and RCA) and normal in 286 patients (62%). During follow-up, there were 77 cardiac events: 5 deaths, 44 acute coronary syndromes (6 STEMI, and 38 NSTEMI) and 28 late (>6 months from stress echo) revascularisations. CFR of < or =2.0 on LAD was the strongest multivariable predictor of either definite (death, acute coronary syndrome) and major (death, acute coronary syndrome, late revascularisation) events, followed by diabetes mellitus. Anti-ischaemic therapy at the time of testing and resting wall motion abnormality were also independently associated with major events. Preserved CFR in both LAD and RCA was associated with better (p<0.0001) definite and major event-free survival compared to abnormal CFR in one or both coronary vessels. CONCLUSION: CFR evaluation of either LAD or RCA allows the identification of distinct prognostic patterns. In particular, preserved CFR in both coronary vessels is highly predictive of a very favourable outcome, while reduced CFR in either coronary vessel, and especially on LAD, is a strong predictor of future cardiac events.

[Guidelines on medically assisted reproduction: legal issues and professional liability]. / Linee Guida in materia di P.M.A.: risvolti giuridici e profili di responsabilità professionale.

The authors analyze the legal and medico-legal issues deriving from the recent Law No. 40 of February 19, 2004 concerning the Medically Assisted Reproduction. In particular, they analyze the contrasting points between the dispositions of Law No. 40/2004 and those of Law No. 194/1978 on the voluntary interruption of pregnancy, and they analyze the guidelines about the procedures and the techniques of the Medically Assisted Reproduction, issued by the Ministry of Health with D.M. of July 21, 2004. The Guidelines, as well as some sentences of several courts, lead to some reflections also about the consent and the professional liability, in particular considering the various moments of the medical action, from the first interview to the carrying out of the assisted reproduction techniques.

Lightwand intubation using the Trachlight: a brief review of current knowledge.

PURPOSE: About 1% to 3% of laryngoscopic intubations can be difficult or impossible. Light-guided intubation has been proven to be an effective, safe, and simple technique. This article reviews current knowledge about the newer version lightwand: the Trachlight (TL). SOURCE: To determine its clinical utility and limitations, we reviewed the current literature (book and journal articles) on the TL since its introduction in 1995. PRINCIPAL FINDINGS: TL has been shown to be useful both in oral and nasal intubation for patients with difficult airways. It may also be useful in "emergency" situations or when direct laryngoscopy or fiberoptic endoscopy is not effective, such as with patients who have copious secretions or blood in the oropharynx. TL can also be used for tracheal intubation in conjunction with other devices (laryngeal mask airway -LMA-, intubating LMA, direct laryngoscopy). However, TL should be avoided in patients with tumours, infections, trauma or foreign bodies in the upper airway. CONCLUSIONS: Based on the clinical reports available, the TL has proven to be a useful option for tracheal intubation. In addition, the device can also be used together with other intubating devices, such as the intubating LMA and the laryngoscope, to improve intubating success rates. A clear understanding of the principle of transillumination of the TL, and an appreciation of its indications, contraindications, and limitations, will improve the effectiveness of the device as well as reducing the likelihood of complications. Finally, regular practice with the TL with routine surgical patients requiring tracheal intubation will further improve intubation success rates.

[Portal hypertension and enterostomy: a dangerous combination. Colostomy-induced varices as a rare cause of gastrointestinal hemorrhage. Report of a case and review of the literature]. / Ipertensione portale ed enterostomia: un binomio a rischio. Le varici colostomiche come causa rara di enterorragia. Descrizione di un caso e revisione della letteratura.

Variceal bleeding from enterostomy in an unusual complication of portal hypertension. The hemorrhage can be managed in most patients with local measures, but if these manouvres fail, surgical procedures may be required. Treatment options include pressure dressings, stomal revision or disconnection, suture or ligation of stomal varices, bowel resection, and porto-systemic shunting. Recently sclerotherapy and percutaneous transhepatic embolization have been reported. A case of ectopic varices in the site of colostomy complicated by recurrent hemorrhage is described and the therapeutic option utilized is discussed with review of Literature to assess the efficacy of the various treatment options.

Pulse oximetry with the laryngeal mask airway.

This study evaluated the accuracy of pulse oximetry measured by a modified laryngeal mask airway (LMA). Ten anaesthetized patients (ASA I-II, aged 18-45) undergoing elective knee arthroscopies (mean-duration 40 min) were studied. A transmission pulse oximeter probe/sound OHMEDA was attached on the back of LMA (sizes 4 and 5) in an area in contact with the floor of the laryngeal part of the pharynx. Pharyngeal pulse oximetry as well as LMA cuff pressure were monitored and recorded every 5 min from the time of insertion (T0) to removal (T8) and were compared to simultaneous finger pulse oximeter readings. At T2 the cuff was over-inflated to obtain a 100 cm H2O intracuff pressure. At T3 the cuff pressure was decreased at 60 cm H2O. Pharyngeal pulse oximetry correlated with finger pulse oximetry throughout the study and was not effected by over-inflation of the LMA. This modification of the LMA provides an accurate method of measuring pulse oximetry which may be of use in a variety of circumstances.

Use of ion chromatography for monitoring microbial spoilage in the fruit juice industry.

Fruit juices and purees are defined as fermentable, but unfermented, products obtained by mechanical processing of fresh fruits. The presence of undesired metabolites derived from microbial growth can arise from the use of unsuitable fruit or from defects in the production line or subsequent contamination. This involves a loss in the overall quality that cannot be resolved by thermal treatment following the start of fermentation. With these considerations, together with microbiological control, the analysis of different metabolites, which can be considered as microbial growth markers, such as alcohols (i.e. ethanol, etc.), acids (i.e. acetic, fumaric, lactic, etc.) is fundamental in order to achieve a better evaluation of product quality. Enzymatic determination and other single-component analytical techniques are often used for the determination of these metabolites. When the microbial spoilage is not well known, this results in a long and cumbersome procedure. A versatile technique that is capable of determining many metabolites in one analysis could be helpful in improving routine quality control. For this purpose, an ion chromatographic technique, such as ion exclusion, for separation, and diode array spectrophotometry and conductivity, for detection, were evaluated. Both different industrial samples and inoculated samples were analyzed.

DSM-III mental disorders in general medical sector: predictors of outcome.

In 1987, a multicentric research was carried out in Emilia-Romagna, an administrative area in northern Italy. Nine hundred and forty one people in the general medical sector were contacted to enter a two-stage procedure to identify DSM-III cases. Cases were recontacted for 3-month, 1-year and 2-year follow-ups. Eighty cases completing at least the one-year follow-up were analysed. The sample was split into "still-cases" and "no longer-cases" depending on the persistence of a DSM-III diagnosis at the last follow-up. Both clinical and social features proved to be predictors of the outcome. A disorder lasting one year or longer, past recurrences, Axis I comorbidity, older age, being married and having children were the features which at the first assessment predicted an unfavourable outcome. Having children and past episodes proved to be the best predictors of remaining a case in a stratified logistic regression model. The persistence of major difficulties during the follow-up period was also correlated to a "still-case" status.

Steady-state pharmacokinetics of idebenone in healthy volunteers.

An open study was conducted with 12 healthy male Caucasian volunteers to determine the single dose and steady-state pharmacokinetics in plasma after a total daily dose of 90 mg of idebenone administered as 45 mg twice daily for 10 consecutive days. In the dose regimen investigated, multiple daily doses of 90 mg of idebenone were well tolerated by healthy male volunteers and were not associated with any clinically relevant changes in ECG or clinical laboratory parameters. The results of the physical examinations after study termination revealed normal findings in all volunteers. To evaluate the single dose and steady-state pharmacokinetic profile, blood samples were collected at predetermined time points during the study. In those subjects examined, generally good systemic exposure with rapid absorption of idebenone was obtained throughout the entire dosing period. Exposures to idebenone and its metabolites after both single and repeated oral doses of idebenone were comparable in magnitude. Further, the exposures attained were generally consistent with those observed in a previous study after 30 mg three times daily. All pharmacokinetic assessments were associated with a low to moderate degree of inter-subject variability.

DSM-III mental disorders in general medical sector: a follow-up and incidence study over a two-year period.

In three general medical settings (general practice, hospital medical wards and emergency rooms) about 20% of the adult attenders had a DSM-III mental disorder, mainly in the area of affective and anxious disorders. Some of these disorders were quite severe. Of those cases reassessed 1 year and 2 years after the first interview, less than a quarter reached a "no-diagnosis status". The chronicity of most cases dependent on the interplay not only of either relapse or duration of the main disorder but also of comorbidity and incidence of new disorders. A high incidence of more transient disorders in subjects who were well at first assessment was also found.

Influence of post-rumen supply of nutrients on rumen digesta load and voluntary intake of a roughage by sheep.

The effects of post-rumen supply of nutrients on the rumen digesta load and voluntary consumption of roughage by Border Leicester X Merino ram lambs was investigated. A chopped wheaten hay was offered to the ram lambs (n 24), whose nutrient intake was altered by infusing into the abomasum a liquid supplement, containing reconstituted cow's milk, sodium caseinate, minerals and vitamins, for a period of at least 30 d. Either two or three lambs were allocated by live weight to each of ten rates of nutrient supplementation. The lambs were slaughtered at a target live weight of 31 kg. Voluntary intake of hay was estimated over the last 7 d of feeding. The amounts of digesta and organic matter (OM) in the rumen were measured by emptying after slaughter. The particle size distribution of the digesta was measured by wet sieving and the fractional outflow rate of particulate matter by reference to the marker lignin. Growth rate of the lambs increased linearly as total energy infused increased. The linear increase in growth rate indicated that roughage was not substituted for infused nutrients on a direct energy basis. OM intake from hay declined linearly as the amount of nutrients infused increased. The decline in intake was associated with a decline in both total digesta and the amount of rumen OM. Both the fractional digestion rate of OM and the fractional outflow rate of particulate matter from the rumen were unaffected by the amount of nutrients infused. The results indicated that the rumen digesta load of young sheep fed on a single roughage is directly related to their energy deficit, that is the difference between the capacity of the animals to use energy and the energy available to them for metabolism.

A pharmacological study of the cardiovascular effects of TRH-T in haemorrhagic shock in rats.

An extremely severe hypovolemic shock was produced in urethane-anesthetized rats by massive bleeding. In such preterminal conditions (mean arterial pressure = 19-25 mmHg; pulse pressure = 10-18 mmHg; death of all saline-treated animals in 26.16 +/- 3.18 min) the i.v. injection of protirelin tartrate (TRH-T) within 5 min after shock induction promptly and dose-dependently improved arterial pressure, pulse pressure and respiration, the dose of 4 mg/kg ensuring survival for 402.01 +/- 39.45 min without the need for the restoration of blood volume. The injection of TRH-T 20 min after shock induction, on the other hand, was ineffective. The concurrent administration of morphine (2.5 mg/kg i.v.) partially antagonized the effect of TRH-T; however, if the dose of the peptide was increased, its effect was restored. The effect of TRH-T in haemorrhagic shock was associated with a significant increase in the volume of residual circulating blood. The present data (i) confirm that TRH-T improves cardiovascular function and greatly prolongs survival in an otherwise irreversible model of haemorrhagic shock; (ii) show that this effect is associated with mobilization of residual blood and that respiratory function is greatly improved as well; (iii) indicate that the anti-shock effect of TRH-T is partially antagonized by morphine in a surmountable way. Finally, on the basis of our results, it appears that TRH-T has to be given rapidly after shock induction to be effective.

Trauma and seronegative spondyloarthropathy: rapid joint destruction in peripheral arthritis triggered by physical injury.

Two B27 positive patients developed peripheral arthritis immediately after a significant musculoskeletal injury. Unlike previously reported peripheral arthritis precipitated by trauma in B27 positive subjects the arthritis was rapidly destructive.

Coexistence of ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis: another report.

A middle-aged man presented with a 10-year history of intermittent low back pain. Radiological examination of the spine disclosed findings of both ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH). Radiography of the hands showed the typical enthesopathy of DISH. To our knowledge this is the 2nd published case on the coexistence of the two diseases.

Isolated HLA-B27 associated Achilles tendinitis.

The case of a 37 year old man with a longstanding HLA-B27 associated bilateral Achilles tendinitis without seronegative spondyloarthropathy is reported. This case suggests that heel enthesopathy may for a long time be the only clinical manifestation of the HLA-B27 associated disease process.

A double-blind controlled study to compare the efficacy of an antacid plus oxethazaine with that of an antacid alone in the treatment of pain due to gastric or duodenal ulceration.

A double-blind study was carried out in 40 patients with typical ulcer pain and suffering from gastric or duodenal ulcer to compare the pain-relieving efficacy of oxethazaine/magnesium and aluminium hydroxide mixture with that of the antacid combination alone. Patients took 8 ml doses of either treatment when necessary over a period of 4 weeks. Both treatment regimens were equally effective in reducing the painful symptoms of peptic ulceration, but the total volume of medication required to achieve adequate symptomatic relief was less in patients taking antacid plus oxethazaine than in patients taking antacid alone. It is suggested that the combination of oxethazaine plus antacids, therefore, is to be preferred, because, by allowing a reduction in the intake of antacid, the risk of side-effects due to antacid therapy is thereby reduced.