Sensory-directed characterisation of distinctive aromas of Sauternes and Viognier wines through semi-preparative liquid chromatography and gas chromatography approaches.

Gas chromatography-olfactometry-mass spectrometry (GC-O-MS) has been very useful in identifying aroma compounds from within the complex matrix of wine. Supplementary separation can be required to overcome co-elution of volatiles or other sensory-directed chromatographic strategies are needed, including multidimensional chromatography and preparative fraction collection coupled to GC. Studies investigating 'overripe orange' aroma in sweet Sauternes wine and the similar 'apricot' aroma in Viognier wine were conducted. Wines with the targeted aroma attributes were selected and concentrated wine extracts prepared. GC-O found no individual aroma compounds with the targeted aroma attribute. Semi-preparative HPLC was used to obtain less complex fractions of the wine extracts. The fractions were eluted in water/ethanol and, therefore, could be smelled directly. Fractions with the targeted aroma character were further resolved by GC-preparative fraction collection (GC-PFC). Recombinational GC-PFC demonstrated the importance of the components within a 4 min preparative GC fraction to the 'overripe orange' aroma of typical Bordeaux dessert wine. In Viognier wine, monoterpenes linalool, α-terpineol and geraniol as well as benzaldehyde were found to be associated with the 'apricot' character. Thus, several wine aroma compounds interact for these specific aromas to be perceived. This sensory-led combination of separation techniques is a powerful tool for the identification of key compounds responsible for specific aromas across the wine and beverage industries.

Subtotal Occlusion of Left Anterior Coronary Artery in a Professional Athlete.

Screening for cardiovascular disease in athletes is crucial to avoid life-threatening complications. Here, we present the case of a fairly asymptomatic young professional soccer player with several cardiovascular risk factors, who proved to have significant coronary artery disease on coronary computed tomography which was ordered based on clinical suspicion and his family history. Informed consent for publication was obtained from the patient.

Influence of Chirality of Lactones on the Perception of Some Typical Fruity Notes through Perceptual Interaction Phenomena in Bordeaux Dessert Wines.

Recent studies concerning the aroma of noble rot dessert wines revealed the importance of a well-known phenomenon in perfumery, the perceptual blending, to create the perception of "overripe orange" nuances. Thus, compounds associated with both oak wood aging (3-methyl-4-octanolide and eugenol) and Botrytis cinerea development under the form of noble rot (2-nonen-4-olide and γ-nonalactone) contribute to a specific aroma of great noble rot dessert wines through perceptual interaction phenomena. This synthetic perception phenomenon was established from reconstitution, addition, and omission sensory experiments, using wine extract fractions supplemented with the volatile compounds previously mentioned. To better understand the sensory impact of these compounds, the goal of this research was to study the contributions of enantiomeric forms of 2-nonen-4-olide and γ-nonalactone and the diastereoisomers of 3-methyl-4-octanolide. After multidimensional chiral chromatography analysis, the relative proportions of enantiomers or diastereomeric forms were first established and then sensory experiments were carried out using the reference compounds with isolated fractions from dessert wines. A dominance of the R form was established for 2-nonen-4-olide, which was correlated with wine aging, while the S form is more dominant in young dessert wines. Furthermore, the reconstitution experiments confirmed perceptual interaction phenomena and revealed the sensory contribution of (R)-2-nonen-4-olide and cis-3-methyl-4-octanolide concerning the "overripe orange" nuances, whereas no sensory impact for the γ-nonalactone isomers was observed.

Dietary supplementation with tomato-juice in patients with metabolic syndrome: a suggestion to alleviate detrimental clinical factors.

Lycopene, a carotenoid, is known for its antioxidant properties. Little is known, though, about the relationship of dietary tomato-juice intake and risks factors, like inflammation, insulin resistance and hyperlipidemia, implicated in metabolic syndrome. In the present study, we examined whether supplementation with tomato-juice has any implication on the risk status of patients with metabolic syndrome. A comparative study was conducted in 27 individuals diagnosed with metabolic syndrome. Fifteen of them were instructed to use commercially available tomato-juice as refreshment 4 times a week over a period of two months and twelve individuals served as the control group. Several parameters reflective of the metabolic syndrome were monitored both in the group supplemented with tomato juice and in the control group (ADMA for entdothelial function, TNF-α and IL-6 for inflammation, FIRI for insulin resistance). There was a significant improvement in the inflammation status and the endothelial dysfunction of the tomato-juice supplemented patients. At the same time, insulin resistance improved and a pronounced decrease in LDL was recorded, along with a slight increase in HDL. The results of the present study suggest an alleviating effect of tomato-juice with regard to risk factors associated with metabolic syndrome.

Influence of the farming system on the epiphytic yeasts and yeast-like fungi colonizing grape berries during the ripening process.

Grape berries are colonized by a wide array of epiphytic microorganisms such as yeast and filamentous fungi. This microbiota plays a major role in crop health and also interferes with the winemaking process. In this study, culture-dependent and -independent methods were used to investigate the dynamics and diversity of the yeast and yeast-like microorganisms on the grape berry surface during maturation and the influence of cropping systems in this microflora. The results showed a significant impact of both the farming system and the maturity stage on the epiphytic yeast and yeast-like community. A quantitative approach based on counting cultivable populations indicated an increase in the yeast and yeast-like population during the grape ripening process, reaching a maximum when the berries became overripe. The cultivable yeast and yeast-like population also varied significantly depending on the farming system. Microorganism counts were significantly higher for organically- than conventionally-farmed grapes. The yeast and yeast-like community structures were analysed by culture independent methods, using CE-SSCP. The results revealed changes in the genetic structure of the yeast and yeast-like community throughout the ripening process, as well as the impact of the farming system. Copper-based fungicide treatments were revealed as the main factor responsible for the differences in microbial population densities between samples of different farming systems. The results showed a negative correlation between copper levels and yeast and yeast-like populations, providing evidence that copper inhibited this epiphytic community. Taken together, our results showed that shifts in the microbial community were related to changes in the composition of the grape-berry surface, particularly sugar exudation and the occurrence of copper residues from pesticide treatments.

Identification of a new lactone contributing to overripe orange aroma in Bordeaux dessert wines via perceptual interaction phenomena.

Recent studies have demonstrated the existence of a typical sensory concept for Bordeaux dessert wines, including the world famous wines of Sauternes. Volatile compounds from several chemical families (thiols, aldehydes, and lactones) were identified and correlated with aromatic typicality in these wines. However, these studies were unable to indicate "key" aromas of overripe fruits, especially overripe orange. The alternative strategy developed in this research combined both analytical and sensory studies of fractions of dessert wine extracts obtained by semipreparative high-performance liquid chromatography (HPLC). Multidimensional gas chromatography coupled to olfactometry and mass spectrometry (MDGC-O/MS) was applied to some of the HPLC fractions recalling "overripe fruit", and a new lactone, 2-nonen-4-olide, was identified. Reconstitution and omission tests using the HPLC fractions highlighted the importance of specific compounds, particularly 2-nonen-4-olide, in the expression of overripe orange notes. Although this lactone presents minty and fruity odors, its key contribution to the typical aroma of orange in Bordeaux dessert wines was revealed through perceptual blending.

Administration of tomato juice ameliorates lactate dehydrogenase and creatinine kinase responses to anaerobic training.

Creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH) are important biological markers of various myocardial disorders and exercise-induced muscle damage. Lycopene, on the other side, is a natural anti-oxidant with protective action against cardiovascular risk. Fifteen anaerobically trained athletes with elevated LDH and CPK baseline levels were enrolled in this study after undergoing thorough biochemical and cardiovascular evaluation with echocardiocraphy. In nine athletes tomato juice, a lycopene plain juice, was administered during and after exercise, replacing the carbohydrate supplementation beverages commonly used during training for over a 2-month period. Tomato juice administration significantly reduced LDH and CPK levels, which returned back to almost normal levels. At the same time homocysteine and C-reactive protein were also attenuated. No changes were observed in the control group, where the usual carbohydrate supplementation had been followed.

Value of magnetic resonance imaging in diagnosis of adenomyosis and myomas of the uterus.

STUDY OBJECTIVE: To estimate the diagnostic performance of magnetic resonance imaging (MRI) in detection of myomas and adenomyosis of the uterus. DESIGN: Prospective cohort observational study (Canadian Task Force classification II-2). SETTING: Department of obstetrics and gynecology, tertiary academic hospital. PATIENTS: One hundred fifty-three consecutive women with an enlarged uterus accompanied by gynecologic symptoms and/or with an asymptomatic pelvic mass. INTERVENTION: Total abdominal hysterectomy. All patients underwent MRI before the operation. MEASUREMENTS AND MAIN RESULTS: The sensitivity, specificity, positive, and negative predictive value of MRI for the diagnosis of uterine pathology was calculated using histologic findings as the standard criterion for final diagnosis. Receiver operating characteristics curves were constructed to describe the diagnostic performance of MRI. In the diagnosis of myomas, MRI demonstrated sensitivity of 94.1%, specificity of 68.7%, PPV of 95.7%, and NPV of 61.1%. In the diagnosis of adenomyosis, MRI demonstrated sensitivity of 46.1%, specificity of 99.1%, PPV of 92.3%, and NPV of 88.5%. The area under the curve (AUC) for the diagnostic performance of MRI in the detection of myomas and adenomyosis was 0.81 and 0.73, respectively. Uterine sarcoma was diagnosed in 5 patients; in these cases, MRI demonstrated sensitivity of 60.0%, specificity of 99.2%, PPV of 75.0%, and NPV of 98.4%. The AUC for MRI in the diagnosis of uterine sarcomas was 0.80. CONCLUSIONS: MRI exhibits a high AUC for the diagnosis of both adenomyosis and myomas. The PPV of MRI in the diagnosis of adenomyosis and myomas of the uterus is high as well. MRI seems to be a useful technique in everyday clinical practice in the diagnostic approach of these common conditions, enabling clinicians to select the most appropriate management.

A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology.

OBJECTIVE: To compare the diagnostic performance of saline infusion sonohysterography (SIS), transvaginal ultrasound (TVS), and diagnostic hysteroscopy (DH) in the detection of endometrial lesions in symptomatic women. DESIGN: Prospective, comparative study. SETTING: Obstetrics and Gynecology Department of a tertiary academic hospital. PATIENT(S): A total of 105 consecutive women presenting in an outpatient clinic with symptoms of menorrhagia, postmenopausal bleeding, and infertility. INTERVENTION(S): Each patient had TVS, SIS, and DH. MAIN OUTCOME MEASURE(S): The sensitivity, specificity, and positive and negative likelihood ratios (LR+ and LR-) for TVS, SIS, and DH were determined for the diagnosis of endometrial pathology. More specifically, the diagnostic performance of each of these three methods was compared after receiver operating characteristic analysis. RESULT(S): By comparative analysis of the area under the curve, DH was found to have a significantly better diagnostic performance compared to SIS and TVS. In addition, after comparing the receiver operating characteristic curves, DH was found to be significantly more precise in the diagnosis of intracavitary masses than TVS and SIS. However, SIS was more accurate compared to TVS. CONCLUSION(S): Saline infusion sonohysterography appears to be more valuable than TVS in the diagnosis of intracavitary masses (both polyps and myomas).

Pregnancy rates after hysteroscopic polypectomy depending on the size or number of the polyps.

OBJECTIVE: To assess the reproductive benefits of hysteroscopic polypectomy in previous infertile women depending on the size or number of the polyps. DESIGN AND METHODS: In this retrospective study, from February 2000 to September 2005, totally 83 selected women were included with: a) diagnoses of primary or secondary infertility, endometrial polyp/polyps and abnormal uterine bleeding. Endometrial polyps were diagnosed by transvaginal ultrasound followed by diagnostic hysteroscopy, to confirm diagnosis, and hysteroscopic polypectomy. All 83 subjects who consisted the study group, met inclusion criteria: age under 35 years, at least 12 months of infertility, from 3 to 8 months menstrual disorders (intermenstrual bleeding or spotting, menometrorrhagia or menorrhagia) and from 3 to 18 months of follow-up with attempts to conceive after hysteroscopic polypectomy. The endometrial polyp/polyps appeared to be the only reason to explain their infertility after infertility workup of the couples. There was a comparison of fertility rates after hysteroscopic polypectomy between patients having endometrial polyp < or = 1 cm and patients with bigger or multiple polyps. RESULTS: Of the 83 subjects, all were found to have endometrial polyps in diagnostic hysteroscopy, confirmed at histologic examination after hysteroscopic polypectomy. Among patients of the study group, there were no significant differences in age, type or length of infertility, or follow-up period after the procedure. The mean size of the endometrial polyps was 1.9 +/- 1.4.cm. Thirty-one patients had endometrial polyp < or = 1 cm and 52 patients had bigger or multiple endometrial polyps. Following polypectomy, menstrual pattern was normalized in 91.6% of patients. Spontaneous pregnancy and delivery at term rates, in the total population of the study, increased after the procedure and were 61.4% and 54.2% respectively. There was no statistical difference in fertility rates between patients having polyps < or = 1 cm and patients having >1 cm polyps or multiple polyps. Spontaneous abortion rate in the first trimester of pregnancy was 6% of the total number of patients and there was no statistical difference between patients with small or bigger/multiple polyps. Type of infertility did not affect fertility rates after hysteroscopic polypectomy. Complication rate after hysteroscopic polypectomy was as low as 2.4%, while recurrence rate of the procedure reached 4.9% of patients. CONCLUSION: Hysteroscopic polypectomy of endometrial polyps appeared to improve fertility and increase pregnancy rates in previous infertile women with no other reason to explain their infertility, irrespective of the size or number of the polyps. Type of infertility of patients seems not to affect fertility rates after hysteroscopic polypectomy. Menstrual pattern was normalized in the majority of patients after hysteroscopic polypectomy. In addition, hysteroscopic polypectomy is a safe procedure with low complication rate.

Greek experience in the use of Thermachoice for treating heavy menstrual bleeding: prospective study.

Heavy menstrual bleeding (HMB) occurs in a considerable percentage of the general population and is one of the main causes due to which a patient is referred to health services. Despite the efforts for pharmaceutical interventions, the symptom usually persists, therefore operative techniques are needed to control the bleeding. Today, apart from the choice of hysterectomy, other less aggressive techniques have been invented. The first results of the Greek Study Group on Gynecological Endoscopy regarding the use of the Thermachoice device are hereby presented. One hundred patients suffering HMB were treated with the Thermachoice device following a standard protocol designed by the Study Group. The follow-up meetings with the patients were held at 3, 6, 12, 24, and 36 months. It seems that the overall effectiveness rate (96%) is satisfactory and it is similar to the overall effectiveness rate reported in other relevant studies upon the Thermachoice device.

Summarization from medical documents: a survey.

OBJECTIVE: The aim of this paper is to survey the recent work in medical documents summarization. BACKGROUND: During the last decade, documents summarization got increasing attention by the AI research community. More recently it also attracted the interest of the medical research community as well, due to the enormous growth of information that is available to the physicians and researchers in medicine, through the large and growing number of published journals, conference proceedings, medical sites and portals on the World Wide Web, electronic medical records, etc. METHODOLOGY: This survey gives first a general background on documents summarization, presenting the factors that summarization depends upon, discussing evaluation issues and describing briefly the various types of summarization techniques. It then examines the characteristics of the medical domain through the different types of medical documents. Finally, it presents and discusses the summarization techniques used so far in the medical domain, referring to the corresponding systems and their characteristics. DISCUSSION AND CONCLUSIONS: The paper discusses thoroughly the promising paths for future research in medical documents summarization. It mainly focuses on the issue of scaling to large collections of documents in various languages and from different media, on personalization issues, on portability to new sub-domains, and on the integration of summarization technology in practical applications.

The natural history of HPV infection of the uterine cervix. Long-term observational and histological data.

BACKGROUND: To investigate the natural history of HPV infection of the uterine cervix following a 10-year prospective observational study. PATIENTS AND METHODS: Three hundred and thirty women with cytological and colposcopic features of HPV infection +/- CIN 1 were recruited into the study. These women were followed up for a period of 10 years, during which time they had repeated colposcopic assessments and cytological monitoring Those women with evidence of high-grade disease at any stage of follow-up were treated by Large Loop excision of the transformation zone (LLETZ) and excluded from the study. At the end of the surveillance period, 179 women with evidence of persistent HPV infection alone or in conjunction with low-grade disease underwent a shallow diagnostic LLETZ. In total, 51 women defaulted from follow-up. RESULTS: Thirty-three per cent of the women with cytological and colposcopic features suggestive of persistent HPV infection alone during the 10-year follow-up period had histological evidence of CIN at the end of the study. Two thirds of this disease was graded as CIN 2 or 3. Nineteen per cent of the women with cytological and colposcopic features suggestive of persistent HPV infection and CIN 1 actually had high-grade CIN at histology (CIN 2 and 3). Only 6.1% of the study population had normal histological findings. CONCLUSION: The finding that a relatively large percentage of high-grade lesions might have been masked for anything up to a decade by a low-grade phenotype, coupled with the worrying percentage of defaulters from follow-up, indicate that an early decision for intervention (diagnostic and/or therapeutic) may be appropriate if a low-grade abnormality persists after a short surveillance period.