The Predisposition for Type 2 Diabetes Mellitus and Metabolic Syndrome.

Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are diseases caused by the interaction of genetic and non-genetic factors. Therefore, the aim of our study was to investigate the association between six common genetic polymorphisms and T2DM and MetS in males. A total of 120 T2DM, 75 MetS, and 120 healthy controls (HC) were included in the study. ACE ID, eNOS 4a/b, ATR1 A1166C, OXTR (A>G), SOD1 +35A/C, CAT-21A/T gene polymorphisms were genotyped by PCR or PCR-RFLP techniques. T2DM was diagnosed at an earlier age compared to MetS (54 vs 55 years old, p=0.0003) and the difference was greater in carriers of the OXTR G allele (54 vs 56 years old, p=0.0002) or both OXTR G and eNOS b alleles (54 vs 56, p=0.00016). The SOD1 AA genotype (O.R.=0.11, p=0.0006) and the presence of both ACE I and OXTR1 A (O.R.=0.39, p=0.0005) alleles revealed to be protective for T2DM. SOD1 AA and AC genotypes were protective factors for triglyceride (p=0.0002 and p=0.0005, respectively) and HDL cholesterol (p=0.0002 and p=0.0004, respectively) levels in T2DM patients. ACE DD was identified more frequently in hypertensive T2DM patients (O.R.=3.77, p=0.0005) and in those who reported drinking alcohol (p=0.0001) comparing to HC and T2DM patients who did not drink alcohol, respectively. We observed that T2DM patients who reported drinking alcohol had an increased frequency of ACE DD and eNOS bb (p<0.0001), or ACE DD and OXTR G (p<0.0001) compared to non-drinkers. No gene polymorphisms were associated with MetS.

SURGICAL APPROACH OF LUNG CARCINOID TUMORS.

Bronchial carcinoid tumours (typical and atypical carcinoid) are endobronchial tumours that can benefit from both local endobronchial treatment and surgical treatment. Given their relatively good prognosis compared to the other two forms of pulmonary neuroendocrine tumours, there is a current concern about the implications of lymph node involvement as well as the identification of new prognostic factors to shape the treatment of these patients in the future.

Unconventional Spin Relaxation Involving Localized Vibrational Modes in Ho Single-Atom Magnets.

We investigate the spin relaxation of Ho single atom magnets on MgO/Ag(100) as a function of temperature and magnetic field. We find that the spin relaxation is thermally activated at low field, while it remains larger than 1000 s up to 30 K and 8 T. This behavior contrasts with that of single molecule magnets and bulk paramagnetic impurities, which relax faster at high field. Combining our results with density functional theory, we rationalize this unconventional behavior by showing that local vibrations activate a two-phonon Raman process with a relaxation rate that peaks near zero field and is suppressed at high field. Our work shows the importance of these excitations in the relaxation of axially coordinated magnetic atoms.

EMERGENCY SURGICAL TRACHEAL DECOMPRESSION IN A HUGE RETROSTERNAL GOITER.

INTRODUCTION: Over the past decades, several definitions and classifications of cervico-mediastinal goiters have been proposed. We analyzed and discussed the clinical presentation, the diagnostic procedures and the surgical technique in relation to post-operative complications and long-term results in a case of a sixty-six years old obese, hypertensive female admitted in the Thoracic Surgery Department with respiratory distress (inspiratory dyspnea, stridor) progressively aggravating during the latest month. METHODS: Cervico-thoracic CT scan revealed the existence of a cervico-mediastinal huge goiter which developed mostly intrathoracic (2/ 3 of the goiter). It determined a tracheal compression, reducing its caliber by two thirds, and its displacement to the right side. The proposed surgical procedure was total thyroidectomy and it involved a bipolar approach (transcervical and transsternal) through a partial upper cervico-sternotomy. RESULTS: The complete removal of the goiter and the decompression of the trachea have been achieved. Postoperative results were very satisfactory, with the absence of the respiratory distress. The histological examination revealed a multinodular goiter with epithelium hyperplasia. CONCLUSION: The presence of a complicated cervico-mediastinal goiter with severe respiratory distress required a surgical excision as the main and immediate treatment option. The surgical procedure represented a milestone for both the anesthesiologist (difficult intubation, with a thin tracheal tube in the absence of the jet ventilation technology) and for the surgeon. The goiter's excision from the visceral mediastinum was very difficult because of its huge dimensions and close relations with trachea and great vessels (anterior) and esophagus, erector spinal muscles and the spine (posterior).

Post-treatment periapical periodontitis X-ray versus CBCT - a case report.

Post treatment periapical periodontitis is usually caused by residual microbes, due to poorly treated root canals and microleakage. Our clinical case proved that orthograde, single-visit endodontic re-treatment is the first choice for the clinician. Cone Beam Computed Tomography (CBCT) images detect the presence and the real extension of the periapical periodontitis and the outcome of the endodontic treatment, in terms of healing the bone defect. Compared with the limited 2-D data obtained by using the radiograph, the CBCT shows a 3-D image of the tooth, the root canal, and the surrounding tissue.

Magnetic remanence in single atoms.

A permanent magnet retains a substantial fraction of its saturation magnetization in the absence of an external magnetic field. Realizing magnetic remanence in a single atom allows for storing and processing information in the smallest unit of matter. We show that individual holmium (Ho) atoms adsorbed on ultrathin MgO(100) layers on Ag(100) exhibit magnetic remanence up to a temperature of 30 kelvin and a relaxation time of 1500 seconds at 10 kelvin. This extraordinary stability is achieved by the realization of a symmetry-protected magnetic ground state and by decoupling the Ho spin from the underlying metal by a tunnel barrier.

Porous clay heterostructures: A new inorganic host for 5-fluorouracil encapsulation.

This study proposed a new inorganic host for drug encapsulation. Porous clay heterostructure (PCH), synthesized using modified montmorillonite with hexadecyltrimethylammonium bromide, was used as host material and 5-fluorouracil (5-FU) as guest drug. Drug encapsulation within PCH in different conditions (soaking time, temperature and pH value) was investigated. Possible interactions of 5-FU with PCH were pointed out using different characterization methods like spectroscopic techniques (FT-IR, UV-vis, XPS), thermogravimetrical and BET analysis. The obtained results suggested that PCH host exhibits a high drug encapsulation efficiency which was influenced by factors like soaking time and pH value. PCH zeta potential value was strongly influenced by pH value. The PCH zeta potential significantly varies at acid pH, while a pH value higher than 7 provides a less variation. UV-vis analysis showed that after 30 min PCH host registered a maximum encapsulation efficiency value (44%) at room temperature using an incubation solution with a pH of 11. The soaking temperature does not substantially affect the loading of drug in PCH host. Thermogravimetrical analysis highlighted that drug encapsulation efficiency of PCH was mainly influenced by pH values. BET results confirmed the PCH synthesis and drug loading capacity.

Cervico-mediastinal thyroid masses - our experience.

INTRODUCTION: Over the last decades, several definitions and classifications of cervico-mediastinal goiters and thyroid masses have been proposed. We analyze and discuss the clinical presentation, the diagnostic procedures and the surgical technique in relation to post-operative complications and results in cervico-mediastinal thyroid masses admitted in our Clinic of Thoracic Surgery over a period of 22 years (1991-2012). METHODS: We reviewed 130 patients who underwent surgery for retrosternal thyroid masses, 77 (59.23%) women and 53(40.77%) men. Mean age was of 53 years. Shortness of breath was observed in 71 (54.61%) patients as the most frequent preoperative symptom. Cervico-thoracic CT scan reveales the existence of a cervico-mediastinal mass and can appreciate the degree of intrathoracic progression, tracheal compression and dislocation, as well as the relations with other anatomical structures of the visceral mediastinum. All 130 patients were prepared for a thoracic approach, majority of the cases were operated by Prof. T. Horvat. The surgical procedure was performed by cervical approach only in most of the cases (106 cases) (Kocher type cervicotomy in 63 cases and Horvat type "en-Y" cervicotomy in 43 cases). We used a bipolar approach for large cervico-thoracic masses: cervicotomy and partial upper sternotomy in 20 cases, cervicotomy and full sternotomy in 3 cases, cervicotomy and right axillary thoracotomy in one case. RESULTS: The removal of the thyroid mass and decompression of the trachea have been achieved in all cases. Post operative results were very satisfactory, with absence of respiratory distress and with normal function of the vocal cords. No post operative mortality was encountered. CONCLUSION: The presence of a cervico-mediastinal thyroid mass with or without respiratory distress requires a surgical excision as the only treatment option. The surgical procedure represented a milestone for both anesthesiologist (difficult intubation in some cases of large goiters) and thoracic surgeon.Thyroid masses extending to the mediastinum can be excised successfully by cervical incision. Bipolar approach has an excellent outcome, achieving a safe resection, especially in large thyroid masses extending to the mediastinum with close relations to mediastinal structures.

Exchange biasing single molecule magnets: coupling of TbPc2 to antiferromagnetic layers.

We investigate the possibility to induce exchange bias between single molecule magnets (SMM) and metallic or oxide antiferromagnetic substrates. Element-resolved X-ray magnetic circular dichroism measurements reveal, respectively, the presence and absence of unidirectional exchange anisotropy for TbPc(2) SMM deposited on antiferromagnetic Mn and CoO layers. TbPc(2) deposited on Mn thin films present magnetic hysteresis and a negative horizontal shift of the Tb magnetization loop after field cooling, consistent with the observation of pinned spins in the Mn layer coupled parallel to the Tb magnetic moment. Conversely, molecules deposited on CoO substrates present paramagnetic magnetization loops with no indication of exchange bias. These experiments demonstrate the ability of SMM to polarize the pinned uncompensated spins of an antiferromagnet during field-cooling and realize metal-organic exchange-biased heterostructures using antiferromagnetic pinning layers.

[Minimally invasive surgery in the treatment of malignant pleuro-pericardial effusions]. / Chirurgia miniinvaziva în tratamentul pleuro-pericarditelor maligne.

INTRODUCTION: Malignant pleuro-pericardial effusions (MPPEs) are a common problem in the treatment of patients with cancer and may occur with any malignancy. METHODS: Between 01.01.1998 -31.12.2008 we conducted a retrospective study. During this period of time 46 patients were diagnosed and treated for malignant pleuro-pericardial effusions in Clinic of Thoracic Surgery under Prof. Teodor Horvat coordination (from SUUMC). RESULTS: In this study a total of 42 MPPEs have been approached through minimally invasive procedures (36 patients underwent thoracoscopic procedures and 6 patients were subjected to VATS). In our study, the pulmonary cancers were the most frequent primary cancers who caused MPPEs (22 cases). The thoracoscopic pleuro-pericardial window was the most frequent and efficient procedure used for pericardial drainage (34 cases). Effective control of the recurent malignant pleural and pericardial effusions was made most frequent through postoperative pleural bleomycin instillation (22 cases) and through thoracoscopic insufflation of talc in 14 cases. CONCLUSIONS: The minimally invasive thoracic surgery is a safe and efficient method for diagnosis and treatment of pleuro-pericardial effusions.

[A giant thoracoabdominal tumor--hereditary multiple exostoses]. / Tumora giganta toracoabdominala. Maladia exostozanta ereditara.

Hereditary multiple exostoses (HME), also known as osteochondromatosis, is an inherited, autosomal dominant disorder in which multiple osteochondromas develop throughout the skeleton. We present the case of a 17 years old boy diagnosticated with HME with multiple prior orthopedic interventions for upper and lower limbs deformant osteochondromas. He was admitted in our service for a giant osteochondroma localized at the left thoraco-abdominal border arising from C11, C12 ribs, involving the thoracic postero-bazal wall, the abdominal posterior wall and practically the entire left retroperitoneal space. We performed the total resection of this giant tumor (2.6 kg) with postero-inferior thoracic parietectomy (10 to 12 ribs) and abdominal postero-lateral parietectomy followed by the thoraco-abdominal parietal reconstruction with a dual-mesh soft tissue patch, after the high reinsertion of the left diaphragm. The postoperative results were very good from both points of view: esthetical and functional, with preservation of the diaphragm activity and the anatomical reposition of the abdominal viscera. The paper refers to the etiopathogenesis, clinical symptoms, diagnostic, and therapeutic considerations of HME.

[Pleurotomy--an operation by the general surgeon]. / Pleurotomia -- operatie la îndemâna chirurgului generalist.

The authors present the newest data of a minimal thoracic technique: the pleurotomy. In our times this technique requires the modem chest tubes, the complete pleurotomy sets for different emergent situations. The authors presents the indications, the possible complications, their own technique of pleurotomy and the actual management of pleural drainage.

Giant laterocervical fibrosarcom.

Soft tissue sarcomas are rare tumors representing 1% of all malignancies and less than 10% concerning head and neck tumors. We are presenting the case of a 42-year-old patient that was admitted in our service for a giant laterocervical tumor (15/12/10 cm). We performed total excision of this tumor en bloc with the involved tegument; the resulting defect was covered with a split thick skin graft. The weight of the tumor was 500 g. Histopathological examination revealed an intermediate-grade fibrosarcoma. The postoperative evolution was good; radiotherapy was indicated.

Nonlinear domain-wall velocity enhancement by spin-polarized electric current.

The interaction between a dc spin-polarized electric current and a magnetic domain wall in a Permalloy nanowire was studied by high-bandwidth scanning Kerr polarimetry. The full functional dependence of wall velocity on electric current and magnetic field is presented. With the pinning potential nulled by a field, current-induced velocity enhancements exceeded 35 m/s at a current density of approximately 6 x 10(11) A/m(2). This large enhancement, more than 10 times that found in pinning-dominated experiments, results in part from an interaction that is nonlinear in current and independent of current direction.

GDH biosensor based off-line capillary immunoassay for alkylphenols and their ethoxylates.

The application of a quinoprotein glucose dehydrogenase modified thick-film sensor as label detector in a capillary immunoassay (CIA) for xenoestrogens is presented. The detection of the alkylphenols and their ethoxylates is based on the competition between the analyte and tracer molecules for the binding sites of anti-alkylphenol ethoxylate antibodies. This assay is performed off-line in small disposable PVC capillaries coated with immobilized antibodies. This format allows the combination of the assay with a small portable device potentially useful for on-site environmental monitoring. Beside high amplification the utilization of beta-galactosidase as enzyme label allows the direct combination with a GDH biosensor at optimal pH conditions. The bioelectrocatalytic properties of this biosensor offer an additional amplification and thus allow a very sensitive quantification of 4-aminophenol, generated by the beta-galactosidase. Detection limits of the analytes in the microg/l range were obtained, while other phenolics and surfactants showed no or very little cross reactivity.

Detection of Escherichia coli in water by culture-based amperometric and luminometric methods.

The application of amperometric biosensor- and chemiluminiscence based methods for rapid detection of viable E. coli in water has been investigated. An amplification of the amperometric signal by a factor of 4 was obtained when the cellobiose dehydrogenase (CDH) biosensor was used instead of a plain graphite electrode for detection of b-galactosidase (b-GAL) activity at 22.5 degrees C. A linear correlation was demonstrated for detection time (DT) vs. initial concentrations (logarithmic units) of E. coli IT1 and E. coli in environmental samples, respectively, by use of the CDH biosensor or a chemiluminometric technique. The study has shown that an E. coli concentration > or = 10(4) cfu/100 mL in environmental samples was determined by the CDH biosensor within one working day. However, further reduction of the DT can be obtained, e.g. by increasing the signal amplification factor using other biosensors.

Antibody-based methods for surfactant screening.

This brief overview summarises the immunoassay-based results obtained in the course of two years of the European INCO-Copernicus project BIOTOOLS. The project is aimed at simplifying the procedures for detection of surface active compounds (SAC) using, among others, antibody-based methods, i.e., microtiter plate-based enzyme-linked immunosorbent assays (ELISA), polarisation fluoro immunoassays (PFIA), and enzyme flow injection immunoassays (FIIA). Thirty-three rabbits were immunised with five different sulphophenyl moieties and three p-hydroxyphenyl moieties conjugated to protein immunogens to produce analytical antibodies against linear alkylbenzene sulphonates (LAS) and nonylphenol (NP). Although most of the antibodies exhibited binding reaction in indirect ELISA, only a few showed the required assay sensitivity. The best antibodies for LAS exhibited a 50% binding inhibition at IC50 19.8 microg L(-1) in indirect ELISA. Similar inhibition was observed for direct ELISA using peroxidase tracers. Antibodies against NP allowed the establishment of an indirect assay operating in the mg L(-1) range. A rapid and simple protocol for the screening of NP and LAS using homogeneous PFIA is described. The assay time for 10 samples was 7 minutes, thus allowing fast detection of the selected SAC at the mg L(-1) level. A generic competitive FIIA system, using a protein G column for separation of free and antibody-bound beta-galactosidase (beta-Gal) tracer, was developed for the screening of LAS, NP, and nonylphenol decaethoxylate (NPEO10). The FIIA had a sample throughput (STP) of 5-10 samples per hour, with limits of detection (LOD) for LAS, NP, and NPEO10 of 19.5, 52, and 2.4 microg L(-1), respectively. The developed FIIAs were applied to spiked rain and surface water.

Inter-laboratory comparison of liquid chromatographic techniques and enzyme-linked immunosorbent assay for the determination of surfactants in wastewaters.

Seven laboratories participated in an inter-laboratory comparison exercise within the framework of the PRISTINE, SANDRINE and INEXsPORT European Union Projects. Solid-phase extraction (SPE) methodologies were used for the extraction of target analytes from wastewaters. The analytical strategies were based on liquid chromatography (LC) coupled to mass spectrometric (MS) or to fluorescent (FL) detection in all cases with the exception of one laboratory using a test-tube enzyme-linked immunosorbent assay kit. Samples were spiked with the surfactants nonylphenolpolyglycol ether, coconut diethanolamide, linear alkylbenzene sulfonate, nonylphenolpolyglycol ether sulfate, alkylpolyglycol ether and secondary alkane sulfonate. After enrichment on previously conditioned SPE cartridges, the SPE cartridges were distributed among the participating laboratories without the information about the amount of spiked surfactants. In addition, SPE cartridges loaded with a real-world environmental sample containing a tannery wastewater were also analyzed. The results of the programme showed that SPE followed by LC-MS techniques are reliable for the surfactants determination at submicrogram to microgram per liter levels in wastewaters. Inter-laboratory precision values were calculated as the reproducibility relative standard deviation (RSD(R)) which was determined from the reproducibility standard deviation (sR) and the average concentration at a particular concentration level. When data from all laboratories were pooled, the RSD(R) values ranged from 5.1 to 28.3% for the determination of target analytes. The most accurate result corresponded to that given for linear alkylbenzene sulfonates. Taking into account that different methodologies were used (including non-chromatographic techniques) and the complexity of the samples analyzed, it can be considered that acceptable reproducibility values were obtained in this inter-laboratory study.

An enzyme flow immunoassay that uses beta-galactosidase as the label and a cellobiose dehydrogenase biosensor as the label detector.

The aim was to develop a fast generic enzyme flow immunoassay (EFIA) using a beta-galactosidase (beta-GAL) label in combination with colorimetric detection as well as with a new amperometric biosensor as the label detector. The amperometric biosensor was previously developed within the group for the determination of diphenols in surface water samples. Antigen (Ag, analyte), tracer (Ag*, antigen labeled with beta-GAL), and antibody (Ab) were incubated off-line. After the equilibrium was reached, the sample was introduced into the flow system. The antibody complexes, AgAb and Ag*Ab, were trapped in a protein G column while the free unbound tracer was eluted and detected by an amperometric biosensor downstream after substrate reaction. The enzyme label beta-GAL converted the substrate 4-aminophenyl-beta-D-galactopyranoside (4-APG) into 4-aminophenol (4-AP), which subsequently was detected by a cellobiose dehydrogenase (CDH) modified solid graphite electrode. 4-AP was first oxidized at the electrode surface at +300 mV vs Ag/AgCl, and the formed 4-imino quinone (4-IQ) was reduced back to 4-AP by the CDH in the presence of cellobiose. By combining the EFIA with the CDH biosensor, the overall signal of one tracer molecule is amplified at two occasions, i.e., one enzyme label converts the substrate into many 4-AP molecules, and second these are further amplified by the CDH biosensor. The optimum conditions for the EFIA in terms of the molar ratio between tracer and beta-GAL, temperature, flow rate, etc., was investigated with colorimetric detection, using 2-nitrophenyl-beta-D-galactopyranoside (2-NPG) as the beta-GAL substrate. The performance of both the colorimetric and CDH biosensor detection was investigated and both methods were applied for determination of the model compound atrazine in spiked surface water samples. Detection limits of 0.056 +/- 0.008 and 0.038 +/- 0.007 microg L(-1) and IC50 values of 2.04 +/- 0.294 and 0.42 +/- 0.08 microg L(-1) were obtained for colorimetric and CDH detection, respectively. Matrix effects were less pronounced with the CDH biosensor than with colorimetric detection.