Landscape effects on pollination networks in Mediterranean gypsum islands.

Habitat fragmentation is a major driver of global change that has operated historically on Mediterranean ecosystems. However, more needs to be understood about how fragmentation influences ecological interactions, particularly pollination. Gypsum outcrops are historically fragmented Mediterranean habitats and settings for the evolution of many endangered soil-specialist plants with narrow ranges. In this study, we aimed to determine how fragmentation (area and connectivity) affects: (i) pollinator community composition and (ii) structural properties of pollination networks; and whether there are differences in the effects of fragmentation on: (iii) the number of interactions and visits among pollinator functional groups; and (iv) the number of interactions and specialisation degree between soil-specialist and soil-generalist plants. We characterised the degree of fragmentation and the pollination network structures in 12 gypsum habitat fragments embedded in a cropland matrix during two consecutive years. We found significant relationships between fragmentation and network structure. The effects of fragmentation differed among pollinator functional groups, but not between soil-specialist and soil-generalist plants, in terms of number of interactions. However, the relatively higher pollinator specialisation of soil-specialist plants suggested greater dependence on pollinators. Inter-annual variations in the network structures demonstrated the importance of temporal replication. The observed patterns related to the landscape structure and pollination at both the network and species levels provide insights into the key ecological processes in gypsum islands. These findings may help to identify the potential drivers of species persistence, especially for endangered soil-specialist plants with narrow ranges in a changing scenario with exacerbated habitat fragmentation.

Rol del laboratorio en el diagnóstico del hiperaldosteronismo primario / Laboratory Role in the Diagnosis of Primary Aldosteronism

El aldosteronismo primario se considera actualmente el causante de un 8 a 12 % de los casos de hipertensión arterial. El aumento de su prevalencia es consecuencia de cambios en los criterios diagnósticos. El tamizaje inicial se realiza en el laboratorio determinando la relación aldosterona/actividad de renina plasmática, para lo que se requieren estrictas condiciones preanalíticas; condiciones de reposo o deambulación, evitando interferencias de drogas terapéuticas que pueden afectar el resultado, de obtención y de conservación de la muestra, entre otras. Debido a la alta variabilidad en la medición de la actividad de renina plasmática, (radioinmunoensayo operador dependiente), se está proponiendo el uso de la relación aldosterona/concentración de renina, (donde la concentración de renina se determina por un método automatizado) aunque aún no hay consenso. El método de tamizaje es fundamental para el inicio del estudio de un paciente e influye en la prevalencia actual. Una vez establecidos los valores de corte para cada laboratorio, los pacientes con tamizajes positivos deben ser sometidos a pruebas confirmatorias, por ejemplo sobrecarga con sodio, o supresión con fludrocortisona, para evidenciar la secreción autónoma de aldosterona. Una vez confirmada se debe diferenciar la causa; las principales son adenoma productor de aldosterona e hiperplasia adrenal bilateral. El diagnóstico temprano permite el tratamiento correcto, evitando comorbilidades causadas por la hipertensión arterial (HTA) y remodelaciones vasculares y cardíacas por el exceso de aldosterona. Los tratamientos clásicos para la HTA no siempre son de utilidad en el aldosteronismo primario, por ello es importante el diagnóstico de la patología.

Primary aldosteronism is nowadays considered the cause of 8 to 12 % cases of hypertension. The increase in its prevalence is due to changes in diagnostic criteria. Initial screening is performed in the laboratory by obtaining the aldosterone to plasma renin activity ratio, for which strict preanalytical conditions are required, including; supine or upright posture; interaction of therapeutic drugs which may alter results; sample extraction and conservation, among others. Given the high variability in the measurement of plasma renin activity and its complexity (RIA), the use of the aldosterone to renin concentration ratio is proposed (where renin concentration is determined by an automated immunoassay), although no consensus has been reached in this matter. The screening method is essential to primarily identify those patients who should be further studied, and it influences the statistics on actual prevalence of primary aldosteronism. Once cutoff values have been determined for each laboratory, patients with positive screening results must be further submitted for confirmation tests, such as salt-loading test or fludrocortisone suppression test, in which the autonomous secretion of aldosterone is confirmed. Then, the cause of the excessive aldosterone production must be determined. The most common are aldosterone producing adenoma and bilateral adrenal hyperplasia. Early diagnosis allows for the correct treatment, minimizing comorbidities caused by hypertension and by vascular and cardiac remodelation due to the excess of aldosterone. Classic treatment for hypertension is not always useful in patients with primary aldosteronism; this is why it is important to know how to diagnose the underlying pathology.

MMP-2 selectivity in hydroxamate-type inhibitors.

Extracellular matrix metalloproteinases (MMPs) are a family of zinc-dependent neutral endopeptidases involved in physiological and pathological processes, through the cleavage of extracellular matrix. MMPs are capable of degrading essentially all matrix components, which is crucial for malignant tumor growth, invasion, metastasis and angiogenesis. The vertebrates MMP family includes at least 26 enzymes (23 have been known in humans) with only MMP-1, 2, and 7 experimentally validated as targets for antitumoral drug design. However, inhibition of MMP-1 has been hypothesized to be the cause of the clinically observed musculoskeletal syndrome when broad spectrum inhibitors are used. On the other hand, MMP-9 is a tricky enzyme, since its inhibition might be useful in treating patients with early-stage cancers, but MMP-9 is an anti-target in patients with advanced disease. So, MMP-9 inhibition should also be prevented. Therefore, selective MMP-2 inhibition arises as a pursued profile for MMP binders. Among them, hydroxamates have been extensively studied as small molecule drug candidates characterized by an effective zinc-binding group plus additional side chains responsible for the selectivity. This article pays particular attention to MMP-2 selectivity on hydroxamate-type inhibitors, especially against MMP-9, and their chemical structure, SAR, general synthetic methods, and molecular modelling studies are here reviewed in order to inspire further design of new effective anticancer agents.

Role of surgery in treatment of advanced differentiated thyroid carcinomas.

Well-differentiated thyroid carcinomas are characterized by a long natural history. The evolution of the reconstructive techniques and the improvement of the peri-operative anaestesiologist management of the patient have contributed, over the last few years, to a progressive widening of demolitive surgery. The aims of enlarged surgical treatment in differentiated advanced thyroid carcinomas are to guarantee respiratory and alimentary functions as well as symptomatic benefits, to obtain local control of the disease and the recovery of adjuvant therapeutic options, such as metabolic and conventional radiation. In the present study, 27 patients who underwent enlarged surgery for differentiated thyroid carcinoma involving the superior digestive-aerial ways (SDAW) were treated between January 1992 and December 2002. The following results were achieved: Group 1 (7 patients): partial resection of the trachea and larynx: 57% of patients are Not Evidence Disease (NED) at a mean follow-up of 7 years; the other 43% are Alive With Disease (AWD). Group 2 (4 patients): total laryngectomy associated with emi-pharyngectomy or oesophagectomy of whom 50% are NED at a mean follow-up of 6 years. Group 3 (4 patients): mediastinum dissection in sternotomy of whom 3 patients NED at 7, 8 and 12 years of follow-up, respectively (75%). Group 4 (12 patients): latero-cervical, retro-clavear and subclavear dissection, of whom 75% of cases are NED at a mean follow-up of 5.1 years. Enlarged surgery is justified by the long natural history of the differentiated histotypes and the advantages it offers to adjuvant therapies. An essential principle, in the case of enlarged thyroid resections, is the modularity. With respect to the loco-regional spread of the disease, the surgeon has to study a treatment plan with a surgical procedure that involves the various elective districts of spreading, planning each surgical step with the entity of demolition and reconstruction being modulated according to the demand.

Viagra, surgery and anesthesia: a dangerous cocktail with a risk of blindness.

Since the launch in 1998 of the anti-impotence drug sildenafil (viagra), the American food and drug administration has identified 50 cases of drug-related blindness, the so-called nonarteritic anterior ischemic optic neuropathy. This, very serious, side effect frequently leads to sudden, mostly irreversible loss of vision, and there is no proven effective treatment to cure patients or to prevent recurrence. The mechanism of ischemic optic neuropathy is not clear, but it could be related to the fact that the ophthalmic and central retinal arteries have an autoregulation of their own blood flow without any autonomic nerve supply; vasoreactivity could be lower albeit efficient, and therefore more vulnerable to systemic modifications of the circulation. But decreased visual acuity and loss of visual ability also are, although uncommon, anesthesiological and surgical complications. These data are consistent with the hypothesis that sildenafil, surgery and anesthesia, taken together, could be a potentially dangerous cocktail of risk factors for sudden irreversible loss of vision. To reduce the risk, sildenafil use should be avoided at least one week before surgical operations, since the reported cases of blindness developed 36h after drug ingestion.

The effect of peribulbar block with ropivacaine on bi-hemispheric cerebral oxygen saturation in aged patients.

We evaluated the effects of peribulbar block for eye surgery on bi-hemispheric regional cerebral oxygenation (rSO2)) of aged patients. In 66 adult patients, peribulbar block was performed using ropivacaine 10 mg.ml(-1) with hyaluronidase 100 IU.ml(-1). Cerebral oxygenation was monitored using continuous non-invasive, near-infrared spectroscopy. The rSO2 data on the side where the eye block was performed were evaluated as eye block side values, whereas the data recorded on the other side were taken as control values. Mean rSO2 values on the side where regional block was performed were not significantly different from control values (p > 0.05). Nevertheless, in several patients, a slight desaturation in the cerebral hemisphere on the block side was detected. Therefore, in aged patients, peribulbar block with ropivacaine does not significantly modify bi-hemispheric rSO2, but rSO2 monitoring during peribulbar block should be a field of future research in aged patients with brain injury or disease.

A case report of osteochondroma of the frontotemporosphenoidal suture.

Osteochondroma, also known as osteocartilaginous exostosis, is the most frequent benign bone tumour of the skeletal system. Despite its preference for long bones (tibia and femur), osteochondroma may occur in some short bones developing endochondral ossification. Seventy-five percent of the patients present only with a single lesion, whereas 25% have multiple lesions; this last clinical condition, defined as osteochondromatosis (disorder of autosomal dominant inheritance) shows a high risk of malignant transformation (about 11%). In the craniofacial area this tumour is very rare. The sites of predilection are the coronoid process and mandibular condyle, even though osteochondromas arising from the base of the skull, maxillary sinus and zygomatic arch have been previously described. However, an osteochondroma originating from the frontotemporosphenoidal suture has not been reported before in the literature. We present a unique case of osteochondroma of the frontotemporosphenoidal suture. Moreover, the relevant international literature has been reviewed and all diagnostic and surgical matters have been discussed.

Jumping characteristics of naïve foals: lead changes and description of temporal and linear parameters.

The selection of foals as future showjumpers remains a subjective process based on qualitative parameters; and hence, frequently suffers from disparity in the criteria used by experts in the field. A detailed biomechanical description of foals while jumping would be most helpful in providing a better basis for the accurate assessment of their future athletic ability. The Qualisys Pro Reflex system was used to capture 3-dimensional kinematics of 41 Dutch Warmblood foals age 6 months free jumping a vertical fence, preceded by a cross pole fence. The left lead was the most preferred lead for both the fore- and hindlimbs, from the landing following the cross poles to the first move-off stride after clearing the vertical fence. The foals displayed a high incidence of rotary gallop during both the jump stride (divided into take-off, jump suspension and landing) and the first move-off stride, while change of lead was frequently observed during jump suspension. At the take-off side of the fence, the trailing forelimb in the last approach stride was placed furthest from the fence, whereas the trailing hindlimb at take-off was placed closest (P<0.05). At the landing side, the trailing forelimb was the closest and the leading hindlimb of the move-off stride 1 was the furthest (P<0.05). The trailing forelimb in the approach stride 1 had a significantly longer stance phase duration than the leading forelimb. At landing, the leading forelimb stance phase lasted longer than that of the trailing forelimb (P<0.05). The hindlimbs did not differ in their stance phase duration at take-off. The height reached by the hooves above the fence top was significantly greater in the hind limbs (P<0.05). In addition, the hindlimbs (97.1 +/- 2.6%) shortened more than the forelimbs (92.6 +/- 5.7%) (P<0.05). It is concluded that the overall jumping technique of foals is similar to that reported in literature for mature horses. If the patterns are consistent throughout the rearing period, the quantitative analysis of the kinematics of free jumping foals may provide a valid quantitative basis for early selection.

Baetimyces, a new genus of Harpellales, and first report of Legeriomyces ramosus from the northeastern Iberian Peninsula.

Baetimyces, belonging to the Legeriomycetaceae, is described here as a new genus. Its single species, B. ancorae, has been found growing in the hindgut of mayfly nymphs of the genus Baetis (Ephemeroptera, Baetidae) inhabiting a Pyrenean Mountains canal-stream from the northeastern region of the Iberian Peninsula. The new genus is characterized by having trichospores with two thick appendages of unequal length, and by zygospores perpendicularly and medially attached to the zygosporophore. The new genus may be related to Glotzia, Legeriomyes, and Zygopolaris, and similarities with these and other genera are compared and discussed. The new species often coexists in the same gut with Legeriomyces ramosus, which is reported for the first time in Spain.

[Malignant maxillary tumors involving the pterygo-maxillary and infratemporal fossae: a series of 200 cases]. / Resezione cranio-facciale anteriore per tumori maligni: esperienza di 200 casi.

At the Cranio-Maxillo-Facial Surgery Unit of the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan, Italy between 1987 and 1999 200 anterior cranio-facial resections were performed on malignant ethmoid tumors involving the anterior cranial base and extending to the nasal fossae and, at times to the orbit and maxillary and sphenoid sinuses. In the second portion of this case study the authors simplified their surgical technique. The frontal craniotomy was made rectangular and low, performed with an oscillating saw and scalpel, without drilling holes. The osteotomy of the cranial base was modulated according to tumor extension. Typically a paralateronasal facial incision was performed without opening the upper lip. Whenever the maxillary sinus and/or orbit were involved, the skin incision and osteotomy was consequently modified. Repair of the cranial base was performed with a pedicled pericranial flap. In this case study there were 6 post-operative deaths in the first 30 patients and only 2 in the remaining 170. The male/female ratio was 145/55, mean age 55 years (12-80) and average follow-up 38 months (2-117). There were 120 primary tumors while the remaining 80 patients presented recurrences from prior treatments. There were 96 adenocarcinomas, 42 spinocellular carcinomas, 21 esthesioneuroblastoma 15 adenoid-cystic carcinomas, 9 melanomas and 17 rare tumors. Our classification identified the following stages: 69 T2, 54 T3 and 77 T4 while the UICC-AJCC staging system indicated: 25 T1, 16 T2, 68 T3 and 91 T4. The NED survival according to tumor stage (INT classification) was: T262.3%, T3 44.4% and T4 29.9%. The NED survival for patients who had not previously undergone treatment was: T2 71.7%, T3 58.8% and T4 42.5%. On the other hand the NED survival for the cases of recurrence was: T2 43.5%, T3 20% and T4 16.2%. These results lead to the conclusion that the surgical technique currently used is valid and that the anterior cranio-facial resection should always be performed in patients with ethmoid tumors coming into contact with, or eroding, the cribriform plate. For all staging classes, the prognosis for those patients undergoing surgery for recurrence from prior, inadequate treatment was significantly worse than that for the primary tumors.

Cloning and characterization of TPE4A, a thiol-protease gene induced during ovary senescence and seed germination in pea.

A cDNA clone encoding a thiol-protease (TPE4A) was isolated from senescent ovaries of pea (Pisum sativum) by reverse transcriptase-polymerase chain reaction. The deduced amino acid sequence of TPE4A has the conserved catalytic amino acids of papain. It is very similar to VSCYSPROA, a thiol-protease induced during seed germination in common vetch. TPE4A mRNA levels increase during the senescence of unpollinated pea ovaries and are totally suppressed by treatment with gibberellic acid. In situ hybridization indicated that TPE4A mRNA distribution in senescent pea ovaries is different from that of previously reported thiol-proteases induced during senescence, suggesting the involvement of different proteases in the mobilization of proteins from senescent pea ovaries. TPE4A is also induced during the germination of pea seeds, indicating that a single protease gene can be induced during two different physiological processes, senescence and germination, both of which require protein mobilization.

Flexible intramedullary "classical" nailing in childhood: use in fractures of the femur and humerus.

The authors report their experience with flexible intramedullary nailing in the treatment of some fractures of the femur and humerus during childhood. The series goes back 2 years, with 16 patients treated, and 2 years follow-up for 10 of them. The method used took two variations into consideration: that of multiple bundle nailing, and that of two secant arc nails. Flexible intramedullary nailing presents a consistent series of advantages, that are divided into advantages of a biological (physiological consolidation), mechanical (flexible stability), and practical (comfort for the patient) nature. The authors believe that the advantages divided into relative and absolute have a very relevant weight.

[The interdisciplinary approach and early surgery in the trigonocephaly]. / Approccio interdisciplinare e chirurgia intercettiva nella trigonocefalia.

Craniofacial surgery aims to stop the pathological process due to the presence of one or more malformations affecting this part of the body, in order to prevent and reduce the secondary damage caused by wrong development of the stricken structures. However, in order to achieve this goal, it is necessary to abide by some criteria, like the interdisciplinary nature of therapeutic procedures and early surgery. Since craniofacial malformations affect some anatomical areas that need combined approaches for diagnosing, preventing and correcting the existing anomalies or the possible complications, it is extremely necessary to set a collaboration between different medical and surgical disciplines. Surgical "timing", lasting from 4 to 6 months, is the basis of early surgery, which aims to prevent the morphostructural alterations of the part, assuring again the physiological growth of the stricken tissues. For this reason, craniostenosis are the malformation syndromes that mainly fit this kind of therapeutic protocol. In this document the authors describe the application of the above cited principles for the resolution of the stenosis of the metopic suture in 9 patients (3 males and 6 females), admitted to the Department of Maxillofacial Surgery of the University of Rome "La Sapienza".

Lachman ativo radiográfico: qual a necessidade de sua utilizaçäo? / Active radiographic Lachman test: do we need to use it?

Os autores apresentam os resultados de um estudo prospectivo englobando 38 pacientes, de um grupo de 75, com suspeita clínica de lesäo do ligamento cruzado anterior (LCA). Os testes clínicos incluíram: gaveta anterior, teste de Lachman e teste de pivot shift. Todos os pacientes foram submetidos também ao teste de Lachman ativo radiográfico. Os 38 pacientes foram submetidos a tratamento cirúrgico e durante o procedimento foi constatada visualmente a lesäo completa do LCA; a este grupo adicionou-se uma amostra de dez indivíduos sabidamente normais. Os resultados dos testes clínicos foram correlacionados com o teste de Lachman ativo radiográfico. Os autores encontraram pela observaçäo clínico-cirúrgica e pela análise estatísticas, que o melhor índice para o diagnóstico de uma lesäo do LCA é o teste de Lachman. O teste de Lachman ativo radiográfico deve ser utilizado quando há dúvida diagnóstica no resultado dos testes clínicos ou quando seja necessário medir e documentar a instabilidade anterior do joelho.

Case report: pulmonary blastoma in children--response to chemotherapy.

Pulmonary blastoma (PB) is a rare primary malignancy of the lung, with about 54 cases reported in children. The tumor consists of mesenchymal and epithelial components resembling the fetal lung. It has been treated primarily with surgery and the effect of combination chemotherapy has not been systematically investigated. A 15-year-old girl with PB with metastases to bone and regional lymph node, and high levels of alphafetoprotein, is reported. A preoperative combination chemotherapy consisting of cisplatinum, etoposide alternating with iphosphamide with mesna, vincristine and epirubicine resulted in an objective response that permitted subsequent safe surgical excision of the primary tumor. This intensive combination chemotherapy should be tested in the management of advanced PB in children, as initial therapy as well as an adjuvant to surgery.

Effects of calcium antagonists in the treatment of ophthalmic postherpetic neuralgia.

Postherpetic neuralgia is one of the most common, but also one of the most difficult conditions to treat. This condition mainly involves trigeminal, intercostal and sciatic nerves and the brachial plexus area. It mostly appears in patients older than 60 years. Although pain is a transient condition, the pain of postherpeutic neuralgia may become intractable, disabling an may decrease the quality of the patient's life. We studied 30 patients affected by ophthalmic postherpetic neuralgia, appearing, some months after fronto-orbital cutaneous eruption. All patients received nicardipine retard, decreasing gradually, 40 mg/day for 2 weeks. The monitoring of pain was performed using the visual analogue score of Scott-Huskissonn. The results show an improvement in 'pain relief'.