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Background & Aims: The aim of this study was to compare liver resection and radiofrequency ablation in patients with single hepatocellular carcinoma

According to the original Petersen criteria, we investigated the association between endothelial dysfunction and mild cognitive impairment (MCI) by flow-mediated dilation (FMD). We aimed to verify if endothelial dysfunction occurs in MCI and whether vascular factors are implicated in the MCI pathogenesis. This is a cross-sectional study performed on 34 subjects with clinical diagnosis of MCI and 37 controls, older than 60 years. Patients were enrolled from a geriatric outpatient clinic. All the recognized cardiovascular risk factors and an objective state of cognitive impairment were used as exclusion criteria. Cognitive function was evaluated using a scientific-validated neuropsychological battery, whereas MCI was recognized according to the Petersen criteria. Endothelial function was evaluated according to FMD from the brachial artery. The association between FMD and MCI was evaluated both by using a multivariate analysis and a correlation test. Finally, using the ANOVA analysis of variance, we tested the differences in flow-mediated dilation among MCI subgroups. Brachial FMD was significantly associated with MCI (p

BACKGROUND & AIMS: The aim of this study was to compare liver resection and radiofrequency ablation in patients with single hepatocellular carcinoma ≤3 cm and compensated cirrhosis. METHODS: The study involved 544 Child-Pugh A cirrhotic patients (246 in the resection group and 298 in the radiofrequency group) observed in 15 Italian centers. Overall survival and tumor recurrence rates were analyzed using the Kaplan Meier method before and after propensity score matching. Cox regression models were used to identify factors associated with overall survival and tumor recurrence. RESULTS: Two cases of perioperative mortality were observed in the resection group and the rate of major complications was 4.5% in the resection group and 2.0% in the radiofrequency group (p=0.101). Four-year overall survival rates were 74.4% in the resection group and 66.2% in the radiofrequency group (p=0.353). Four-year cumulative HCC recurrence rates were 56% in the resection group and 57.1% in the radiofrequency group (p=0.765). Local tumor progression was detected in 20.5% of ablated patients and in one resected patient (p

This case series evaluates the clinical and ultrasound response to tocilizumab treatment in patients with rheumatoid arthritis (RA). Six patients with active RA (DAS28 ≥ 3.2) for ≥6 months, refractory to conventional DMARDs or anti-TNF agents, received tocilizumab 8 mg/kg every 4 weeks, as monotherapy or in combination with DMARDs, for 6 months. The following clinical parameters were assessed monthly: number of tender joints (28 and 44 joints), number of swollen joints (28 and 44 joints), DAS28-ESR, DAS28-CRP, VAS score, global health status, health assessment questionnaire, patient global assessment of disease activity, physician global assessment of disease activity, functional assessment of chronic illness therapy (FACIT), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). All patients also underwent a gray-scale ultrasonography (US) assessment with power Doppler evaluation at each visit. All clinical parameters improved during the study, versus baseline. This improvement was statistically significant for most parameters 2 months following tocilizumab initiation and was sustained to the end of the observation period. The number of tender joints (44-joint evaluation), the FACIT score, and ESR and CRP concentrations were significantly improved versus baseline values after the first month of tocilizumab treatment. The course of US evaluations mirrored that of clinical parameters; a faster and more evident response was observed for foot joints, with respect to hand joints. This case series suggested the rapid clinical benefit of tocilizumab. Ultrasound assessment showed that the onset of this effect was faster in the foot joints than in the hand joints.

Insulin receptor substrate 2 (IRS2) plays a crucial role in the regulation of insulin signaling. Several polymorphisms of the gene encoding IRS2 have been identified. The variant causing Gly1057Asp substitution is relatively frequent in humans and its impact on insulin sensitivity seems to be dependent on age and body weight. The aim of our study was to evaluate the relationships between Gly1057Asp variant and insulin sensitivity assessed by HOMA, and adiposity evaluated by measurement of epicardial fat (EpiF) thickness in the elderly. We studied 87 subjects, 42 men and 45 women, mean age±SD: 74.23±7.24years. In the subjects carrying the Gly1057Asp variant of the IRS2 gene we found higher HOMA index values (3.40±1.14 vs. 2.21±1.25, p0.001) and increased epicardial adipose tissue (11.77±1.65 vs. 10.43±1.93mm, p0.001) compared to wild type subjects. Univariate linear regression analyses evidenced that HOMA index was correlated with BMI (beta=0.152, p0.001), fasting plasma glucose (beta=0.018, p=0.002), LDL cholesterol (beta=0.008, p=0.024), total cholesterol (beta=0.007, p=0.039), weight (beta=0.054, p0.001), presence of Gly1057Asp variant (beta=1.185, p0.001) and EpiF thickness (beta=0.540, p0.001). In multivariate analysis HOMA index was still associated with the presence of the Gly1057Asp variant of the IRS-2 gene (beta=0.568, p=0.002) and with EpiF thickness (beta=0.414, p0.001). Furthermore, a statistically significant positive correlation between EpiF thickness and HOMA was found (r=0.773, p0.001) and this was not different between wild type control subjects and carriers of Gly1057Asp variant of the IRS2 gene (p=0.718). Similar results were obtained in comparing subjects with normal fasting glucose levels. In conclusion, in our elderly subjects the presence of the allelic variant Gly1057Asp of IRS2 gene was associated to the degree of insulin resistance assessed by HOMA index and with EpiF thickness, independently from the extent of obesity, suggesting its contribution to global cardiometabolic risk.

In recent years, three instruments have been launched into orbit with the aim of producing global maps of sea surface salinity and soil moisture using the 1400–1427 MHz band: SMOS, Aquarius and SMAP. Although this frequency band is allocated to passive measurements only, RFI (Radio-Frequency Interference) is present in the data of all three missions. On a global scale, the three sensors have observed approximately the same distribution of RFI. Japan is an important exception that has implications for the design of RFI detection algorithms. RFI in Japan is caused by a large number of emitters belonging to the same system (TV receivers) and for this reason some traditional RFI detection strategies detect little to no RFI over Japan. The study of this case has led to an improvement of the approach to detect RFI in Aquarius data.

Aquarius is an L-band active/passive sensor designed to globally map sea surface salinity from space [1, 2]. Two instruments, a radar scatterometer and a radiometer, observe the same surface footprint almost simultaneously. The radiometer is the primary instrument for sensing sea surface salinity (SSS), while the scatterometer is included to provide a correction for sea surface roughness, which is a primary source of error in the salinity retrieval. Although the primary objective is the measurement of SSS, the instrument combination operates continuously, acquiring data over land and sea ice as well. An important feature of the data processing includes detection and mitigation of Radio Frequency Interference (RFI), which is done separately for both active and passive instruments. Correcting for RFI is particularly critical over ocean because of the high accuracy required in the brightness temperature measurements for SSS retrieval. It is also necessary for applications of the Aquarius data over land, where man-made interference is widespread, even though less accuracy is required in this case. This paper will provide an overview of the current status of the Aquarius RFI processing and an update on the ongoing work on the improvement of the RFI detection and mitigation performance.

Aquarius and SMAP brightness temperature data are used to estimate sea ice thickness in the polar regions. The method is based on the inversion of a radiative transfer model for ice-covered sea. This model predicts the emission from ice-covered sea and is similar to the one used by the SMOS group. The sea ice thickness values retrieved from Aquarius and SMAP measurements using this technique are compared with the SMOS data. Since Aquarius ceased operation due to component failure on at the beginning of June 2015, while the SMAP radiometer began operating at the end of March 2015, data from April 2015 are used in the comparison. Results obtained using Aquarius and SMAP data are consistent with each other, but show a high uncertainty compared to the SMOS sea ice thickness product.

The present work deals with the application of genotoxicity biomarkers by means of the Comet assay in haemocytes and spermatozoa of the crustacean Gammarus elvirae exposed in vivo to heavy metals. Furthermore, a basal levels (BLs) study of DNA damage in the two cell types considered for two different gammarids species, G. elvirae and Echinogammarus veneris, was carried out. It is important to identify factors that influence the outcome of the assay in order to obtain reliable and reproducible results usable for risk assessment purposes. Our results highlight that the Italian legal limits for Hg and Pb, respectively, 0.5 and 50 µg/L, are inadequate for establishing safety thresholds in the aquatic environment. Furthermore, the freshwater invertebrate G. elvirae, used for the first time to measure the effect of genotoxicants, is a good candidate for evaluating the genotoxicity damage induced by heavy metals. Our results concerning spermatozoa show excessively variable responses and high BLs.

A numerical simulator has been developed to study remote sensing from space in the spectral window at 1.413 GHz (L-band), and it has been used to optimize the cold-sky calibration (CSC) for the Aquarius radiometers. The celestial sky is a common cold reference in microwave radiometry. It is currently being used by the Soil Moisture and Ocean Salinity satellite, and it is planned that, after launch, the Aquarius/SAC-D observatory will periodically rotate to view “cold sky” as part of the calibration plan. Although radiation from the celestial sky is stable and relatively well known, it varies with location. In addition, radiation from the Earth below contributes to the measured signal through the antenna back lobes and also varies along the orbit. Both effects must be taken into account for a careful calibration. The numerical simulator has been used with the Aquarius configuration (antennas and orbit) to investigate these issues and determine optimum conditions for performing a CSC. This paper provides an overview of the simulator and the analysis leading to the selection of the optimum locations for a CSC.

The third Stokes parameter will be observed from space for the first time at L-band by the Soil Moisture and Ocean Salinity and Aquarius/SAC-D satellites. The correlation between polarizations, which is the source of the third Stokes parameter, is of interest at L-band to measure Faraday rotation and also to indicate novel features of the surface. However, spurious signals (false indication of correlation) can occur in the third Stokes parameter. For example, this happens when the radiometer crosses boundaries associated with a large change in brightness temperature, such as land-water boundaries. In this paper, calculations with the Aquarius radiometer antennas will be used to show that these spurious signals are due to the cross-polarization coupling and large beamwidth associated with realistic L-band antennas in space.

BACKGROUND: Heavy and constant use of organophosphorus (OP) larvicides selected Culex pipiens L. resistant populations through two main mechanisms of genetic resistance, the increased activity of detoxifying esterase and the production of alterate acetylcholinesterase-1 (AChE1) by G119S mutation. The aim of this study was the assessment of the distribution of Cx. pipiens populations resistant to temephos and chlorpyrifos in the north-eastern regions of Italy and the occurrence of the insensitive AChE in these populations. Data describe the situation in the last years before European legislation prohibited the use of OP larvicides in mosquito control, up until 2007. RESULTS: For the first time a high level of OP resistance in the samples from Ravenna (182-fold, 80% A4/B4 or A5/B5 esterases and 38.3% Ester5), Emilia Romagna region, was detected; therefore, new data from the Veneto and Friuli Venezia Giulia regions were obtained and reinforced existing knowledge about resistance previously studied along the Adriatic coast. Nearby, in the Villa Verucchio locality, the highest (87.5%) AChE1R was found. CONCLUSION:Cx. pipiens resistance esterases A5/B5 and A4/B4 spread southward along the Adriatic coastal plain while OPs were being used in mosquito control, as confirmed by the first molecular screening of the AChE1 gene in these populations. Copyright © 2010 Society of Chemical Industry

This study was carried out to assess whether endothelial dysfunction, evaluated by flow-mediated dilation (FMD), is related to the occurrence of the Metabolic Syndrome (MetS) in old age. Eighty patients (25 men and 55 women), mean age 74.1±7.4 years (range 65-99 yrs) were studied. Information on all subjects, medical history and regular medications was obtained. Subjects underwent a clinical examination and laboratory tests. The presence of MetS was evaluated according to the revised NCEP-ATP III criteria. An ultrasound vascular examination (US) of the carotid and brachial arteries was performed in all patients. Intima-media thickness (IMT), presence of plaques (PL), endothelium-dependent (EDV) and -independent vasodilation (EIDV) were also evaluated. Patients were divided into two groups according to the presence/absence of MetS. Significant differences were found between MetS and non MetS patients in: EDV (p

The hepatic vasculature is highly complex. The hepatic artery (a branch of the celiac tripod) and the portal vein (formed by the confluence of the splenic and superior mesenteric veins) provide a dual blood supply while venous drainage is guaranteed by the hepatic veins. There are also numerous anatomic variants that can involve one or more of the system's three components.Hepatic artery variants are the least common. Ten types have been identified, including several that are fairly frequent and others that are quite rare, and the variation generally involves the extrahepatic portion of the vessel. Portal vein variants are found in around 20% of the population. They can involve the main portal trunk or segmental branches. Variants of the hepatic veins are the most common. They involve the number and course (supernumerary veins) or the number, course, and openings (accessory veins).Knowledge of portal vein and hepatic vein variants, which are extremely common, is of prime importance for precise localization of lesions. Hepatic artery variants are equally important for surgical treatment of hepatic disease, especially liver transplantation, where it is essential for preoperative workup and postoperative follow-up of the recipient as well as for assessment of potential donors.SommarioLa vascolarizzazione del fegato è complessa: arteria epatica, ramo del tripode celiaco, e vena porta, costituita dalla confluenza delle vene splenica e mesenterica superiore, forniscono una doppia vascolarizzazione; mentre il drenaggio è assicurato dalle vene sovrepatiche, inoltre vi è un numero significativo di varianti che possono interessare separatamente o contemporaneamente i tre i sistemi.Le varianti dell’arteria epatica, meno frequenti rispetto alle altre, sono state classificate in dieci tipi di cui alcuni più comuni, altri del tutto eccezionali, riguardano principalmente il tratto extra-epatico del vaso. Quelle della vena porta, che si riscontrano in circa il 20% della popolazione, possono interessare sia i rami principali che i segmentari. Quelle delle vene sovrapatiche, le più frequenti, possono riguardare il numero ed il decorso (vene soprannumerarie) o il numero ed il decorso, ma anche lo sbocco (vene accessorie).La conoscenza delle varianti portali e delle vene sovrepatiche, estremamente frequenti, è di primaria importanza per la possibilità di localizzare con precisione eventuali lesioni; non meno importante è la conoscenza delle varianti dell’arteria epatica, in relazione alle terapie chirurgiche, in particolare per quello che riguarda i trapianti, sia nella fase pre-operatoria, sia nella valutazione del potenziale donatore, sia nel follow-up.

In an attempt to unravel the possible relationships among coastal stability, genetic variability and orientation behaviour in the sandhopper Talitrus saltator, we have screened four subpopulations of this species. Sandhoppers along 3 km of a dynamic sand beach were studied for orientation performance (i.e. adherence to the seaward theoretical escape direction (TED)) and sequence variation for a fragment of the mitochondrial (mt) gene encoding for the cytochrome oxidase subunit I (COI). The sampling sites differed in the stability of the shoreline (from severely eroded to accreting). Analysis of molecular variance (AMOVA) revealed significant subdivisions among the four locations. The subpopulation sampled at the most eroded point showed no haplotype diversity and had the highest scatter in orientation. Genetic diversity increased with decreasing erosion. Orientation performances were best where the beach is in dynamic equilibrium, and were progressively more scattered at the accreting points. Multiple lin...

Metabolic syndrome (MetS) is an important risk factor for vascular diseases. Two simple and low cost measurements, the epicardial fat (EFT) obtained by echocardiography and abdominal fat (AFT) thickness evaluated by Dual-Energy X-Ray Absorptiometry (DEXA), have been validated as a markers of fat storage in young adults and elderly patients affected by MetS. At present no studies are available yet to compare the two techniques and to test their relationship with MetS. Moreover, no data exit concerning the association between hepatic steatosis, a well known indicator of intra hepatic fat storage and perivisceral fat storage. Aims of our study were: 1) to compare EFT and AFT in a group of patients with and without MetS; 2) to study whether and how these two different approaches predict MetS or risk of malnutrition in the obese elderly; 3) to evaluate the relationship between MetS occurrence, EFT, AFT and hepatic steatosis (HS).We studied 55 elderly outpatients ( 29 males and 26 females) referred to MetS service of the IRCCS "Casa Sollievo della Sofferenza" during the year 2007.Subjects underwent a complete clinical and anthropometric evaluation, laboratory tests for glycaemia and lipid profile for MetS definition. Liver ultrasound was executed to verify the occurrence of HS, a well known indicator of intraparenchymal fat storage. HS was defined as hyperechoic liver pattern in patients without liver disease or hepatic enzymes abnormalities. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Echocardiography for EFT evaluation and DEXA for AFT and fat free mass of the abdomen (FFM) measurement were also performed. Mini Nutritional Assessment (MNA) was used to test the risk of malnutrition in the elderly.Patients were divided in two groups according to the absence (24 patients Group 1) or the presence (31 patients Group 2) of the MetS. HS was present in 26 (57.7%) patients. MetS patients had significantly higher AFT and EFT, and lower FFM than patients without MetS. MNA scores were not different. EFT and AFT showed a good correlation ( R 0.8 p0.001) but only EFT was associated with the MetS. HS was also correlated to EFT and AFT. MNA showed a risk of malnutrition in 73% of MetS patients and 23% in patients without MetS but both EFT and AFT were not correlated with MNA scores.In the elderly patient with MetS, AFT and EFT are greater than in non MetS patients. Both AFT and EFT are strongly correlated to HS but only EFT was associated with MetS. In obese patients, the risk of malnutrition, as evaluated by MNA, is not associated with an increased fat tissue measured by echocardiography or DEXA.

The accuracy of modeling plane wave scattering by dielectric cylinders of finite length and circular cross section for microwave remote sensing applications is investigated. Exact expressions for their scattering cross section do not exist, leading to the use of approximate analytical methods. Two widely used models, based on the approximation of the induced currents, are considered here, and the validity of their results is evaluated by comparison with a corresponding numerical solution.

Summary Electrophoretic variation at the Phosphoglucomutase locus has been studied in 17 populations of the cave cricket Dolichopoda geniculata from caves in Central Italy ranging from the sea level up to 1080 m. 11 populations show a diallelic polymorphism; the distribution of genotypes agrees rather closely with Hardy-Weinberg expectations. Allelic frequencies were found to be linearly associated with the elevation of the caves where polymorphic Dolichopoda populations were found. The implications of this finding which suggest a role by natural selection at the molecular level are discussed. Zusammenfassung Phosphoglucomotase-Polymorphismus und naturliche Auslese in Populationen der Hohlengrille Dolichopoda geniculata Mit Hilfe der Starkegelelektrophorese wurden die Variationen des Phosphoglucomutase-Locus an 17 Populationen der Hohlengrille Dolichopoda geniculata untersucht, die aus Hohlen unterschiedlicher Hohe (0–1080 m) in Zentralitalien stammen, 11 Populationen zeigen einen diallelen Polymorphismus; die Verteilung der Genotypen folgt weitgehend der Hardy-Weinberg Erwartung. Die Allelfrequenzen der polymorphen Dolichopoda-Populationen sind linear korreliert mit der Hohe ihres Fundortes. Die Folgerungen dieser Befunde, die auf eine Selektion auf molekularer Ebene hindeuten, werden diskutiert.

This letter describes the effect of thermal emission from the Moon on remote sensing of sea surface salinity from space. In most cases, radiation from the Moon is negligible; however, at several times during the lunar cycle, it is possible for radiation to be reflected from the Earth's surface into the main beam of the radiometer antennas. The signal in such cases can be important because of the high radiometric accuracy required to monitor salinity. Examples are presented using the Aquarius orbit and antennas for both smooth and rough ocean surfaces.

In this study we analyzed patterns of sequence divergence in about 1kb of mitochondrial DNA coding for two genes (16S rRNA and Cytochrome Oxidase I, COI) in 15 populations and 61 individuals of the halophilic fairy shrimp Phallocryptus spinosa (Milne-Edwards, 1840). Populations were sampled in saline and hypersaline water bodies from Spain, France, Italy, Greece, Turkey, Ukraine, Iran, Uzbekistan, Cyprus, Algeria, Morocco and Botswana. Our genetic findings suggest complex phylogeographic relationships and pronounced genetic differentiation among populations. Multiple phylogenetic methods and nested clade analysis revealed the existence of four highly divergent maternal lineages with strong phylogeographic patterns and signatures of either allopatric fragmentation or restricted gene flow with isolation by distance. These results are further supported by the hierarchical analysis of molecular variance (AMOVA) and pairwise F ST values, which indicate that most of detected genetic heterogeneity is apportioned among populations. Genetic relationships among haplotypes fit geographical hypotheses in most cases but one. Indeed, one haplotype is shared among French, Iranian and Uzbekistan populations. We hypothesize that this peculiar occurrence might be due to an avian-mediated long distance passive dispersal event.