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In recent decades, perennial rhizomatous grasses have been introduced in the Po Valley (Northern Italy), not only to produce bioenergy, but also to face the loss of soil organic carbon due to intensive crop management. Given the dual purpose of perennial energy crops, this work was intended to evaluate changes induced by the introduction of these crops on soil microbial community structure and on soil functionality. We compared a 9 year-old land conversion to two perennial energy crops, giant Miscanthus (Miscanthus sinensis . × . giganteus) and giant reed (Arundo donax L.), with two 40-year old annual arable systems, continuous wheat and maize/wheat rotation. The structure of the bacterial community was studied by the fingerprinting method of denaturing gradient gel electrophoresis (PCR-DGGE) amplifying 16S rRNA fragments, while the functional aspects of soil were investigated through the determination of three soil enzyme activities involved in soil carbon, nitrogen, and phosphorous cycles (β-glucosidase, urease, and alkaline phosphatase, respectively). Introduction of perennial energy crops positively stimulated the three soil enzymes, especially in the shallow soil layer (0-0.15. m), where accumulation of carbon and nitrogen was stronger. Enzyme activities were also positively correlated with organic carbon, apart from β-glucosidase. A significant but weaker correlation was also observed between enzyme activities and total nitrogen. The DGGE profiles revealed the relationship between crop types and soil microbial communities. Community richness was higher in perennial than in annual crops, but no effect of soil depth was observed. In opposition, Shannon index of diversity was not influenced by crop type, but only by soil depth with a 32% increase in the shallow layer. We conclude that the introduction of perennial energy crops in a South European soil increases both soil biochemical activity and microbial diversity, related to the ability of these crops to stabilize organic matter in soil. It is thereby evidenced that perennial rhizomatous grasses for energy uses could represent a sustainable choice for the recovery of soils depleted by intensive agricultural management. © 2014 Elsevier B.V.

Phosphorus removal from soil solution is mainly due to adsorption and precipitation. For calcareous soils, with a large reservoir of exchangeable calcium, precipitation of insoluble Ca-P phases is the predominant process that reduces P availability to plants. Soil water content positively affects P-precipitation, while the addition of organic matter (OM) has an opposite effect. Little information on the effect of soil organic matter on P-insolubilisation as a function of soil water contents has prompted this study of the variation of extractable P, after addition of mineral P fertiliser. Columns packed with a calcareous soil were enriched with different levels of OM, extracted from Irish peat, and subjected to different rainfall simulations. After 102 days of experimentation and 171 mm of accumulated rainfall, the Olsen-P was 53% of the initially applied amount in 6.2% OM-enriched soil, 37% in 4.1% OM-enriched soil, and 20% in untreated soil (1.9% of OM). While the curve describing Olsen-P decrease as a function of accumulated rainfall was clearly exponential for untreated soil, the curves for OM-enriched samples were flatter, evidence that OM addition modified P-insolubilisation. The P-insolubilisation, after P-fertilisation, at several constant values of soil moisture for (i) calcareous soil, (ii) calcareous soil after removing carbonates and saturating the exchange complex with Ca, and (iii) calcareous soil after addition of different levels of OM followed first-order kinetics. The Kobss followed the order: Ca-saturated soil > untreated soil > OM-enriched samples. Results from rainfall simulation experiments and kinetics of Olsen-P decrease at several constant soil moisture contents indicated that the soil water amount was the main factor in reducing extractable P after P fertilisation and that the soil OM content was the main factor in keeping P in extractable forms. On the other hand, the addition of OM to calcareous soil increased the extractable P at each soil moisture regime, decreasing P-insolubilisation more effectively at lower soil water contents. P-sorption isotherms of calcareous soil after addition of different levels of OM showed that the presence of OM mainly influences P-insolubilisation, but not the adsorption process.

The aim of this study was to evaluate how the N losses through volatilization and leaching from soils fertilized with urea can be affected by the application of a urease inhibitor or a urease plus a nitrification inhibitor. The experiment was carried out using lysimeters with 15N-labelled urea and N-(n-butyl) thiophosphoric triamide (NBPT) as urease inhibitor and dicyandiamide (DCD) as nitrification inhibitor, comparing three different treatments: urea alone (U), urea + NBPT (UN) and urea + NBPT + DCD (UND). Both volatilization and leaching were significantly different in the soils used, according to their physico-chemical characteristics. However, the pattern of the loss was similar: the volatilization was significantly reduced by NBPT (UN), but the presence of DCD (UND) significantly increased the loss, with respect to UN. Considering leaching, the highest amount of NO3 – was lost with UND, the lowest with U. The greatest amount of N lost by leaching was soil-derived N produced by the N mineralization-immobilization turnover. We suggest that, by maintaining the NH4 + in the soils, the inhibitors, in particular DCD, caused a priming effect with a subsequent increase in the rate of soil organic matter mineralization and an extra release of soil organic N. The priming effect was real in the sandy loam (SL) soil where a net N release was observed, whereas in the clay loam (CL) soil the effect of the inhibitors was less pronounced and an apparent priming effect was observed; however, a real priming effect also cannot be excluded in this soil.

A laboratory experiment evaluated the rate of urea hydrolysis and ammonia volatilization from urea (U) mixed in organo‐mineral (O‐M) fertilizers. These fertilizers were incubated in soil in the presence or absence of N‐(n‐butyl)thiophosphoric triamide (NBPT) as a urease inhibitor. Two organic matrices, leather (L) and peat (P), were used to prepare the O‐M fertilizers. In the absence of NBPT, the highest ammonia losses and the fastest rate of urea hydrolysis were in the soil treated with the fertilizer containing leather (UL50). Significantly lower ammonia losses occurred with peat‐based fertilizers. Although the fertilizer containing peat (UP50) stimulated the rate of urea hydrolysis with respect to the urea alone, no increase in ammonia volatilization was detected. NBPT‐containing fertilizers were stored for different times (0,7, 30, and 60 days) and temperatures (25°C and 40°C), and the NBPT recovery was monitored by extraction and analysis by HPLC. The NBPT recovery decreased by increasing ei...

The present paper explores the relationships between anxiety, depression, hunger sensation and body composition in obese patients (OP). The aim is to detect whether or not there are abnormalities in these relationships in OP as compared to clinically healthy subjects (CHS). The study was performed on 22 CHS (2 M, 20 W; mean age = 24 +/- 2 years; mean body mass index = 21 +/- 2 kg/m2) and 48 OP (4 M, 44 W; mean age = 40 +/- 17 years; mean body mass index = 32 +/- 7 kg/m2). Anxiety and depression were found to be correlated, negatively, with the relative lean body mass, and, positively, with the fat body mass in OP but not in CHS. These findings corroborate the idea that anxiety and depression can reach an abnormal expression when obesity shows its worst loss in lean body mass and its highest expansion in adipocyte mass. As hunger sensation was found not to correlate with either anxiety or depression in OP, the opinion is expressed that the impairment of anxio-depressive integrity is a corollary of obesity rather than a primary affective disorder leading to obesity via an enhanced food intake.

Suoli bruni acidi delle formazioni arenacee silicoclastiche alloctone di età cretacea dell’Appennino bolognese mostrano evidenti situazioni di degrado, dal momento che nell’arco di venti anni si sono assottigliati gli orizzonti organo minerali, fenomeno non sempre dovuto ad effetti di erosione laminare e quindi da ascrivere a possibili cambiamenti delle condizioni climatiche. Quanto questo fenomeno abbia influito sui processi evolutivi all’interno del suolo è stato valutato su tre profili di inceptisuoli dystrici localizzati a quote differenti di cui nel passato erano già state eseguite letture di carattere pedologico e determinazioni chimico fisiche. In tali profili, gli orizzonti A1 ed A2, che nell’insieme presentano spessori variabili dai 10 ai 5 cm in funzione della quota, pur mostrando un indice di umificazione totale (HU) compreso tra il 74 ed il 90%, si differenziano nettamente per il contenuto in carbonio organico (dal 6 all’11% in A1; dal 2,2 all’1,5% in A2) e per il grado di saturazione basica (dal 50% a valori superiori in A1 e al di sotto del 30% in A2). Ciò trova spiegazione nella differente modalità di saturazione del complesso di scambio, prevalentemente da ioni Ca2+ in A1 ed idrogenionica in A2 con conseguente iperacidificazione del mezzo e significative presenze di Al3+ scambiabile. La presenza dello ione Ca2+ rappresenta il risultato dell’azione idrolitica sui nesosilicati del tipo grossularia Ca3Al2[SiO4]3 che costituisce una delle componenti mineralogiche più significative della roccia madre. Viene evidenziato un grado di pedogenesi non spinta e la mancanza di orizzonti con caratteri spodici attraverso la correlazione di alcune forme di Fe ed Al ottenute mediante estrazione selettiva; tuttavia le forme di Fe ed Al estratte in pirofosfato, e quindi per lo più legate alla componente organica, mostrano lievi incrementi al di sotto degli orizzonti A1 nei profili dei suoli collocati a quote più elevate. Le osservazioni così condotte pongono in evidenza come l’esiguo spessore dell’orizzonte A1 e la diminuita protezione da parte degli orizzonti organici siano sintomatici del possibile avvio di fenomeni di lisciviazione tali da provocare nei suoli indagati effetti degradativi in tempi relativamente brevi.

The humic substances (HS) are macromolecules involved in many chemical and biochemical processes of great importance for soil fertility and environmental equilibrium. The HS ensure a slow release of nutrients, a high soil quality and a less extent of green house gas emissions. The addition of organic matter to contaminated soils, especially those with organic pollutants (PAH, PCBs, LAS) has been recently employed successfully. For these reasons, the addition of biomasses more or less rich in humic-like compounds had become important to improve the quality of organic matter in exploited or contaminated soils. The aim of this study' was to characterize the organic matter of three contaminated soils located in North Italy, before and after the remediation with two different kind of compost. The soils analyzed came from a stone quarry, a landfill and from an industrial area in disuse. The samples extracted and separated in the two classical conventional fractions (humic and fulvic acids) have been investigated using some humification parameters and different analytical techniques: potentiometric titrations, spectroscopic (FT-IR) and thermal analysis (TG and DTA) were applied to obtain structural information. The results have shown a general increase in the organic matter in the soil samples amended with biomasses respect to untreated soils. In particular, thermal analysis reveals an increase of the second exotermic peak after the soil treatment due to the presence of organic matter more resistant to the degradation. DRIFT spectra confirm a structural change of the soil organic matter well correlated with the amendment type. Note: 'Research supported with funds provided by PRIN-Cofin 2002 (National Coord. P. Genevini).

To evaluate whether a structural defect in the human glucose transporter gene GLUT1 could be involved in the aetiology of insulin resistance, a key factor of non-insulin-dependent diabetes mellitus (NIDDM) and obesity, we performed single-strand conformation polymorphism (SSCP) analysis in 40 subjects (20 NIDDM patients and 20 subjects with familial obesity). The GLUT1 gene, which is involved in basal glucose transport in most tissues, consists of ten exons and encodes a 492 amino acid protein. Population studies have shown a strong association between the X1 allele of an XbaI restriction fragment length polymorphism of the GLUT1 gene and NIDDM. We therefore performed SSCP analysis in NIDDM subjects known to carry at least one X1 allele. Variant SSCP patterns were detected in exons 2, 4, 5 and 9. Sequence analysis of the SSCP variants revealed the presence, in all exons examined, of silent mutations consisting of single-nucleotide substitutions with no amino acid changes. Both NIDDM and obese patients showed a high frequency of polymorphism in the sequence (50% and 35%, respectively). We conclude that the GLUT1 gene is unlikely to play a role in the aetiology of NIDDM and obesity. However, the strong association between the GLUT1 gene and NIDDM, together with the recent family studies showing linkage between chromosome 1p and NIDDM warrant further studies on this chromosomal region.

Susceptibility to autoimmune insulin-dependent (type 1) diabetes mellitus is determined by a combination of environmental and genetic factors, which include variation in MHC genes on chromosome 6p21 (IDDM1) and the insulin gene on chromosome 11p15 (IDDM2). However, linkage to IDDM1 and IDDM2 cannot explain the clustering of type 1 diabetes in families, and a role for other genes is inferred. In the present report we describe linkage and association of type 1 diabetes to the CTLA-4 gene (cytotoxic T lymphocyte associated-4) on chromosome 2q33 (designated IDDM12). CTLA-4 is a strong candidate gene for T cell-mediated autoimmune disease because it encodes a T cell receptor that mediates T cell apoptosis and is a vital negative regulator of T cell activation. In addition, we provide supporting evidence that CTLA-4 is associated with susceptibility to Graves' disease, another organ-specific autoimmune disease.

Organic complexed super-phosphates (CSPs) are formed by the complexation of humic acid (HA) with calcium monophosphate. The aim of this study was to determine whether two CSPs, characterized by different HA concentrations, added to a calcareous soil at an agronomic dose, were able to maintain the phosphorus (P) in a soluble form longer than the superphosphate fertilizer. Another important goal was to verify if CSP could positively influence soil microbial biomass and soil microbiological activities. Organic complexed super-phosphates were capable of keeping a large portion of P in a soluble form under different soil water conditions. In particular, the CSP with the highest organic C content was the most effective product, capable of maintaining, in an available form, the 73 % of the initially added P at the end of the experiment. In addition, it was the most effective in increasing C–CO2 soil emission, microbial biomass carbon (C) and nitrogen (N), fluoresceine diacetate hydrolysis and activities of alkaline phosphomonoesterase, β-glucosidase and urease. The addition of CSPs to soil probably produced a priming effect, increasing several times C–CO2 release by the treated soil. The significant correlation (p < 0.05) between C–CO2 emission and the amount of C added to soil by CSP suggests that the added HA acted as trigger molecules.

The use of N-(n-butyl)thiophosphoric triamide (NBPT), as a urease inhibitor, is one of the most successful strategies utilized to increase the efficiency of urea-based fertilization. To date, NBPT has been added to the soil incorporated in fertilizers containing either urea or the inhibitor at a fixed percentage on the urea weight. The possibility of using NBPT physically separated from urea-based fertilizers could make its use more flexible. In particular, a granulated product containing NBPT could be utilized in soils treated with different urea-based fertilizers including livestock urine, the amount depending on soil characteristics and/or the urea source (e.g., mineral fertilizer, organo-mineral fertilizer, or animal slurry). In this study, a multilayer soil column device was used to investigate the influence of an experimental granular product (RV) containing NBPT and a garlic extract, combining the ability to protect NBPT by oxidation and nitrification inhibition activity, on (a) spatial variability of soil urease and nitrification activities and (b) timing of urea hydrolysis and mineral-N form accumulation (NO(2)(-), NO(3)(-), NH(4)(+)) in soil treated with urea. The results clearly demonstrated that RV can, effectively, inhibit the soil urease activity along the soil column profile up to 8-10 cm soil layer depth and that the inhibition power of RV was dependent on time and soil depth. However, nitrification activity is not significantly influenced by RV addition. In addition, the soil N transformations were clearly affected by RV; in fact, RV retarded urea hydrolysis and reduced the accumulation of NH(4)(+)-N and NO(2)(-)-N ions along the soil profile. The RV product was demonstrated to be an innovative additive able to modify some key ureic N trasformation processes correlated with the efficiency of the urea-based fertilization, in a soil column higher than 10 cm.

To clarify the effect of the heat wave that accompanies the passage of a fire on some chemical parameters related to soil fertility and plant growth, we subjected two soils, classified as a sandy loam and a silty clay, respectively, to artificial heating under controlled conditions. We arranged the

The aim of this study was to examine the expressions of the bcl-2, bax, fas and c-myc apoptosis-related genes in benign prostatic hyperplasia (BPH) and prostate carcinoma (CaP) to determine whether significant differences exist within each disease and between the two groups of patients. The correlation between gene expression and tumour diameter, stage, Gleason score and serum PSA was also investigated.Tissue specimens from 51 cases of BPH and 27 cases of CaP were examined for bcl-2, bax, fas and c-myc expression by reverse transcriptase-PCR (RT-PCR).In BPH, bcl-2 and bax gave the weakest signals (p0.001). In CaP, bcl-2 was the least expressed gene (p0.001). In both patient groups, fas and c-myc were the most highly expressed genes (p0.05). Both bcl-2 and bax were expressed at higher levels in CaP than in BPH (p0.02). The bcl-2/bax ratio was lower in CaP than in BPH (p0.001). Bcl-2 was more highly expressed in high Gleason grade (7) tumours (p0.05). In the BPH group, bax showed a positive relationship with fas (p0.01), while the bcl-2 level inversely correlated with that of c-myc (p0.05).Our data showed that all the apoptosis-related genes were expressed in both BPH and CaP. The stronger expression of bax and the lower bcl-2/bax ratio observed in CaP may suggest a pro-apoptotic stimulus, while the higher bcl-2 levels appear to counterbalance the tendency to cell death.

Over the last few years, incidental thyroid microcarcinoma (TMC) has become a frequent disease and its incidence in some reports is considerable. The discovery of new cases depends on the progress of the diagnostics (US scan, fine needle biopsy and cytology, CT, MRI), on the extended indications to thyroidectomy for benign disease and on the attention in pathologic examination of the specimen. The clinical evolution of this disease is not well known: in spite of a high incidence reported in some autoptic series, suggesting that this tumour could have a good prognosis, some authors report an overall incidence of up to 11% of local recurrence, metastasis and mortality. For these reasons the treatment of TMC is still controversial today. Aim of this study was to estimate the incidence and the clinico-pathological findings of TMC over a one year period of total thyroidectomies for diffuse benign thyroid diseases, and to evaluate, on the basis of the frequency of incidental microcarcinoma, if the surgical procedure of complete removal of the gland should be adopted in any case. In this series no patient had pre-operative diagnosis or tentative diagnosis of carcinoma and the incidence of TMC at the final histologic examination was 27.4%. Total thyroidectomy confirmed to be the treatment of choice for diffuse benign diseases and appeared necessary to obtain both, diagnosis and treatment of incidental TMC.

Hunger sensation (HS) is a signal whose levels change during the 24-h day. The daily mean level of HS was correlated with the human body compartments, as investigated by bioelectrical impedance analysis, to detect the relationship between the orectic perception and both the free fat mass (FFM) and the fat body mass (FBM) in 22 clinically healthy subjects (CHS) (2 M, 20 W, BMI: 18.5–24.0 kg/m2) and 48 obese patients (OP) (4 M, 44 W, BMI: 25.2–54.7 kg/m2). In CHS, the daily mean level of HS correlated positively with the FFM and negatively with the FBM. These correlations were not present in OP. This lack of relationships between HS and the body compartments where energy is maximally consumed (i.e., the FFM) and maximally stored (i.e., the FBM) indicates that the orectic response to energy expenditure and the orectic inhibition to fat accumulation are feedback mechanisms which are impaired in obesity.

The human hunger sensation (HS) is a perceptive signal characterized by day-night variability (DNV). This pattern was investigated with respect to its relations with the body compartments in 22 clinically healthy subjects (CHS, 11 males and 11 females, mean age: 24 +/- 2.5 years, mean BMI: 21 +/- 1.7). The DNV was investigated by means of conventional descriptive statistics and the single cosinor method (SCM). Both procedures were applied to the orexigram, i.e., the 24-h profile of the orectic stimulus (OS) provided by each subject, who self-rated his/her HS (from 1 to 10 hunger units) every half hour. Body composition was investigated by Bioelectrical Impedance Analysis (BIA) on the day when the orexigrams were compiled. It was found that the daily HS level correlates positively with the Free Fat Body Mass (FFBM) and negatively with the Fat Body Mass (FBM). These opposite relations indicate that HS is stimulated by the needs of the FFBM, and inhibited by expansion of the FBM, and provide further evidence of the existence of an "adipostat" anorectic mechanism.

Oxidized LDL (ox-LDL) have been involved in the pathogenesis of several human diseases including dermatological pathologies. Oxidative modification of low-density lipoproteins (LDL) is accompanied by both extensive degradation of its polyunsaturated fatty acids and production of lipoperoxides. These highly reactive products induce an intracellular oxidative stress with a variety of cytotoxic effects. In order to evaluate cellular damage induced by oxidative stress in epidermal cells, a human epidermoid carcinoma cell line in culture (A 431) was used as experimental model. Cell treatment with UV-oxidized LDL resulted in cytostatic and cytotoxic effects characterized by morphological and functional alterations: inhibition of cell proliferation, modifications of cytoskeleton network, microtubular derangement, loss of cell-cell and cell-substrate contacts, cell detachment and cell death by apoptosis. The ox-LDL-induced alterations were almost completely prevented by pre-incubating cells with alpha-tocopherol. The results presented here could be of relevance for a better comprehension of the pathogenic mechanisms of several human diseases, including dermatological pathologies, and could indicate that antioxidants such as alpha-tocopherol could represent an important therapeutic challenge in the maintenance of cell and tissue homeostasis in the long run.

Several factors have been involved in the pathogenesis of postoperative hypocalcemia after total thyroidectomy (TT). The real cause is yet unclear, but postoperative (p.o), hypoparathyroidism seem s to be the most important factor.337 patients underwent TT; a systematic and accurate identification and preservation of parathyroid glands was always performed. In all patients calcemia was evaluated before and after surgery (1St, 2nd, 4th, 15th, and 30th day), moreover in 90 patients was also evaluated phosphorus, magnesium, alkaline phosphatase, total proteins, PTH, calcitonin serum levels and urinary levels of calcium and phosphorus.No permanent hypocalcemia was observed and transient hypocalcemia was present in 13.6% of patients. Among 90 patients, 84 showed normal calcium serum levels like the others parameters; the other 6 showed a post-operative hypocalcemia associated with clinical symptoms, an increase of phosphoremia and a decrease of PTH and phosphaturia in early p.o days; in these patients calcemia and PTH levels reached normal values within 30 days after surgery.The surgical manipulation of parathyroid glands should be the cause of lowering of PTH serum concentration and transient hypocalcemia.

To evaluate long-term results of hypocaloric dietetic treatment in patients with essential obesity.The study was carried out in 1,479 woman and 320 men. Body weight was evaluated at 3 months and at 1, 2 and 3 years.The best results in short term reduction of weight excess were found in obesity due to sedentariness or arisen after operation or emotional stress. It has been also observed that the percentage of subjects loosing weight decreased after the first year of treatment, while the percentage of subjects gaining body weight.Long term hypocaloric dietetic treatment in subjects with low or moderate essential obesity should primarily be aimed preventing further gain in body weight.

We have investigated 2672 obese subjects (2324 females and 348 males); of these, the following two groups were considered: obese subjects with or without thyroid disease. Subjects were stratified according to age, sex, and BMI. The prevalence of thyroid disease was correlated to age, sex and BMI increased body weight. Our data showed that 22% of patients affected by essential obesity and not resident in area of iodine deficiency is affected by thyroid diseases which are not diagnosed (18%). In the obese subjects, presence of goiter is more frequent than in the normal weight subjects and affects mainly adult males. Chronic thyroiditis is typical of females (9:1 female:male ratio) with no difference between normo and overweight subjects. Prevalence of single nodule in the obese is similar to the normal weight subjects, it is more frequent in adults and in subjects with medium size obesity. However, occurrence of carcinoma (8%) in single nodules appears higher in the overweight (5-6%) as compared to the normal weight subjects.

Cholesteryl ester transfer protein (CETP) is a plasma protein involved in the reverse cholesterol transport and expressed in several human tissues and cell lines. We studied CETP expression in Caco-2 cell line, a model of the human enterocyte epithelium. By reverse-transcriptase polymerase chain reaction, we could demonstrate that in basal condition Caco-2 cells have a low rate of expression of active CETP mRNA. Furthermore, we found that even in this cell line CETP mRNA alternative splicing occurs with deletion of exon 9 sequence. Densitometric analysis of the in vitro amplified fragments showed that under basal conditions about 60% of reverse transcribed CETP cDNA corresponds to exon 9-deleted transcripts. After challenge with 50 microM sodium oleate, there is a approximately 2 fold increase in the transcription rate of the full-length CETP cDNA, as measured by competitive PCR, which is accompanied to an increased activity measured in the cell-conditioned medium. On the contrary, no significant change is seen in the amount of exon 9-deleted cDNA. Consequently, an inversion in the ratio of full-length and exon 9-deleted CETP cDNA is evident, suggesting that sodium oleate selectively enhances the expression of full-length CETP mRNA.

The presence of nodules in the thyroid gland is the most frequent cause of endocrinopathy. The prevalence of thyroid nodules in the United States is estimated to be between 3-10%, whereas the prevalence of thyroid nodules in European adult population is estimated to be between 4-10%. At our Clinic of Obesity, the presence of nodules in the thyroid gland of obese patients is often found, incidentally, for this reason, we decide to investigate the prevalence of this pathology in obese patients and to quatify the number of times in which the presence of nodules had not been previously diagnosed.3248 obese patients were examined during in the last six years (1991-1996); of these patients 747 were affected by obesity and thyropathy; of these 747 we took into consideration only those with a cold single nodule and correlated the presence of the nodule with BMI, sex and age.The prevalence of a cold single nodule in the obese patients was 31%, of which 83% has not been previously diagnosed. Of cold nodules 8% was represented by carcinoma. The carcinoma appeared more often in females than in males (3:1). The incidence of cold nodules was more frequent in adults and in mild-medium obesity.

This a case report of a solid papillary tumor of the pancreas in a young woman of 18 years, who was referred to after having suffered for a period of 8 months with a rather vague symptomatology, characterized by dyspepsia, fatigue and, towards the end of the 8 month period, weight loss (approximately 2 kg). In the last week, as a consequence of a modest abdominal trauma, the patient was submitted to abdominal CT that showed a burden at the head of the pancreas, demonstrating a round neoformation about 6 cm in diameter with solid echogenicity slightly hypodense. Subsequently, she underwent an operation with the diagnosis of pseudocystis of the pancreas. During surgery, a big cystic formation of the head of the pancreas, into which a drain was introduced, was revealed. The histological postoperative examination was compatible with pancreatic tumor with a low grade of malignancy, cystic papillary or solid papillary type. Therefore, the patient came under our observation and underwent an operation of pancreatoduodenectomy. Two years after the operation, the patient had completely recovered. In this case, we discussed the problem of performing certain preoperative diagnoses despite the aid of modern diagnostic imaging, this being a very rare illness that almost exclusively plagues young women (median age 19 years). This diagnosis has an uncertain histological origin and is generally accompanied by a modest and vague symptomatology. The surgical procedure, given the low grade of malignancy of the neoplasm and the excellent long-term prognosis, must be, with respect to the oncological radicality, as conservative as possible.

The case of a 58 years-old woman with incidental adrenal tumor without endocrinological features of Cushing's syndrome, dexamethasone nonsuppressible uptake of 131I-19 iodocholesterol on right adrenal gland, and no uptake of the left, is described. Right adrenalectomy was performed with the diagnosis of adrenal tumor. The histopathological study revealed that the mass was an adrenal adenoma composed of mixtures of clear and compact cells. Postoperative course was uneventful without replacement therapy with cortisol. This case report suggest that in patients with incidental adrenal tumor, the adrenocortical scintigraphy is very useful for the identification for autonomously functioning adrenal mass.

OBJECTIVE: Protection of residual beta cell function at the time of diagnosis of insulin-dependent diabetes mellitus (IDDM) by intensive insulin therapy and the addition of nicotinamide (NA) has been established. The objective of this study was to evaluate the effect of a free oxygen radical scavenger such as vitamin E (Vit E) on residual beta cell function and parameters of metabolic control in patients with recent onset IDDM undergoing intensive insulin therapy. DESIGN: The effect of Vit E was compared with that of NA (control group) in a randomized multicentre trial. METHODS: Eighty-four IDDM patients between 5 and 35 years of age (mean age 15.8 +/- 8.4 (s.d.) years) entered a one year prospective study. One group of patients (n = 42) was treated with Vit E (15 mg/kg body weight/day) for one year; the other group (n = 42) received NA for one year (25 mg/kg body weight/day). All patients were under intensive insulin therapy with three to four injections a day. Basal and stimulated (1 mg i.v. glucagon) C-peptide secretion, glycosylated haemoglobin and insulin dose were evaluated at diagnosis and at three-monthly intervals up to one year. RESULTS: Preservation and slight increase of C-peptide levels at one year compared with diagnosis were obtained in the two treated patient groups. No statistically significant differences were observed in basal or stimulated C-peptide levels between the two groups of patients for up to one year after diagnosis. Glycosylated haemoglobin and insulin dose were also similar between the two groups; however patients receiving Vit E under the age of 15 years required significantly more insulin than NA-treated patients one year after diagnosis (P < 0.04). CONCLUSIONS: Our data indicate that Vit E and NA possess similar effects in protecting residual beta cell function in patients with recent onset IDDM. Since their putative mechanism of protection on beta cell cytotoxicity is different, combination of these two vitamins may be envisaged for future trials of intervention at IDDM onset.

The present study, aimed at the prevention of infantile obesity was carried out in two schools of Roma and regarded also the alimentary education. 295 students 101 males and 194 females was considered; the result pointed out that 114 (38.6%) were found obese, 57 (19.3%) overweight and 124 (42.0%) normal weight. The alimentary behaviour was the same of other students: usually three meals and often snacks use during the day, a lot of the student use to eat watching the television and the physical activity is done not so much. The results of these paper are related to the literature data.

OBJECTIVE To provide data on the incidence of IDDM in Rome and the Lazio region evaluated prospectively from 1989 to 1993 for a total of > 5 million subjects younger than 15 years. RESEARCH DESIGN AND METHODS All patients with newly discovered IDDM diagnosed between 1 January 1989 and 31 December 1993 among residents in Rome and its region were recorded. Primary ascertainment was based in diabetes clinics and specialized hospitals in the region, whereas the secondary independent source was taken from the archives of the region where patients are registered to obtain exemption from paying for medications. RESULTS We identified 330 new patients with a degree of ascertainment of 85%. Overall the incidence rate of the disease was 7.9 per 100,000 per year (95% CI 7.1–8.8). The incidence was higher in the 5- to 9-year-old age-group (10.4 per 100,000) and in winter (36.2%). The cumulative risk for the disease is on the order of 1.18 per 1,000 subjects < 15 years of age. No significant differences in incidence were observed between boys and girls. There were 14 instances of coma at diagnosis (4.3%), but hyperglycemia without ketonuria was diagnosed in 35% of patients, suggesting an early diagnosis. DISCUSSION Compared with the other continental Italian regions for which data are available for a single year, the IDDM incidence rate in Rome is similar. We conclude that the IDDM incidence rate in Rome and its region is comparable to that in other Southern European countries and remained stable over the 5-year observation period.

The aims of this prospective multicenter study were to identify variables associated with in-hospital mortality among patients undergoing surgical procedures, to develop a prediction rule, and to statistically validate its reliability.Data from 24,654 consecutive informed patients over 15 years of age were collected from 22 surgical centers between January 1989 and December 1990. Using logistic regression analysis separate models were fit for seven surgical disciplines to predict the risk of 30-day in hospital mortality. Variables used to construct the regression models included age, sex, systolic blood pressure, renal dysfunction, hepatic dysfunction, concomitant diseases, severity of surgery, priority of surgery and duration of anesthesia. The performance of the prediction rule was evaluated by computing sensitivity, specificity and predictive values, analyzing the ROC curve and comparing observed with expected deaths.The significance of the independent variables varied within each model. All models significantly predicted the occurrence of in-hospital mortality. At a 0.5 cuptoint of predicted risk sensitivity of prediction rule was 99.89%, positive predictive value 98.51%, and overall predictive value 98.41%, whereas specificity was 7.92% and negative value slightly higher than 50%. The area under the ROC curve was 0.80 (perfect, 1.0). The correlation between observed and expected deaths was 0.99.This prediction rule, developed using multicenter data, is characterized by the following advantages: includes only nine variables; can be utilized by seven different surgical disciplines; is highly accurate, and is easily available to clinicals with access to a microcomputer or programmable calculator. This validated multivariate prediction rule would be useful both to calculate the risk of mortality for an individual surgical patient and to contrast observed and expected mortality rates for an institution or a particular clinician.

Our knowledge of the genetics of insulin-dependent diabetes mellitus (IDDM), and in particular the HLA system, has gained considerable expansion due to the application of molecular biology. The genetic susceptibility to this disease is linked to the HLA region, particularly the DQ alpha and DQ beta chain genes. The presence of an amino acid other than aspartic acid in position 57 of the DQ beta chain and arginine in position 52 of the DQ alpha chain represent, to date, the best markers to identify subjects at-risk for developing IDDM. The identification of such subjects may be useful for strategies aimed at preventing the disease and may also offer new insight into population screening.

To verify the efficacy and absence of risk attributable to therapy with alkaline solutions for correction of lactic acidosis and to demonstrate the usefulness of L-carnitine in converting lactate into pyruvate in conditions of good blood oxygenation.Prospective study on a consecutive series of patients subdivided into three groups following the use of: alkalinizing therapy (group I), L-carnitine (group II), or saline solution (group III). Groups 1 and 2 were further subdivided into subgroups "a" and "b" according to the type of alkalinizing agent and of L-carnitine somministration.Teaching Hospital-Torrette di Ancona.65 patients submitted to major vascular surgery with aortic clamping in the time period between January 1992 and August 1993.During aortic clamping patients of: group I received 2 mEq:kg of bicarbonate or tromentamolo according to the specific subgroup. Group II received a bolus of 2 g of L-carnitine, patients of group IIb received further 2 g of carnitine in continuous perfusion until the end of surgery. Group III received no pharmacological intervention.HR BP, arterial blood gases and lactic acid levels were measured at 12 pre-determined times.Only a neutralizing effect of alkalinizing therapy was observed, whereas the lactic acid measurements demonstrated no significant differences between the different groups.These results confirm the data of other Authors concerning the good compliance of alkalinizing therapy, however, there was demonstrated no clear evidence of its effective usefulness. No metabolic stimulation due to L-canitina could be demonstrated in our experimental conditions.

The Authors have controlled the validity of VQI to quantify pulmonary shunt (Qs/Qt). The survey involved (group A) patients who had undergone major surgery and (group B) patients hospitalized in ICU for cardiorespiratory failure. Four subgroups were identified in both the groups according to different values of SaO2. A good correlation, already described by Räsänen, was comproved in the groups and subgroups. However a progressive reduction of the coefficient of correlation from the lower to the higher values of SaO2 was noted. Finally the differences observed between group A and group B, are supposed to be dependent on a greater variability of haemoglobin, in the surgical group, in relation to the time of evaluation.