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Context Technological advances in fetal and neonatal medicine, recent changes in the French legal framework, and encouraging results of the long-term outcomes in children with neonatal renal failure provide elements for an ethical reflection. Methods We led a nationwide enquiry among French pediatric nephrologists, intensivists, and neonatologists, exploring the decision-making process when contemplating starting renal replacement therapy (RRT) or delivering palliative care to neonates or infants with pre-end-stage or end-stage renal disease; and the ethical quandaries at hand in such scenarios. Results A total of 134 responses with complete national coverage were obtained. Care to be delivered to an infant in pre-end-stage or end-stage renal disease did not achieve consensus. Pediatric nephrologists were more prone to initiate a dialysis/graft program than pediatric intensivists. When chronic kidney disease was associated with comorbidities, especially neurological impairment, physicians, regardless of their subspecialty, were more reluctant to initiate conservative treatment. Many of the doctors surveyed did not give their opinion in these prenatal and/or postnatal situations, considered to be unique and warranting a multidisciplinary reflection. Conclusion Such ethical dilemmas are challenging for parents and physicians. They can only be overcome by taking into account both concrete on the ground realities and general principles and values acknowledged to be a basis for respecting the individual. In this way, it ensures humaneness and humanization of a practice that must meet a variety of challenges, one by one. The answer is not simple; it is always unique to each child and can only be approached by a multidisciplinary, time-consuming, open discussion, which will never totally erase uncertainty.

El quiste ha representado durante mucho tiempo la descripcion fenotipica de las enfermedades renales de rinon con una denominacion similar: quiste solitario, displasia multiquistica, poliquistosis. Sin embargo, las enfermedades quisticas renales corresponden a entidades muy diferentes, algunas congenitas, otras transmisibles geneticamente, de evolucion a veces banal, pero que pueden dar lugar a enfermedad renal cronica en algunos casos. El diagnostico de certeza es, por lo tanto, indispensable para proporcionar una informacion clara y precisa a las familias. Se basa en el conocimiento de la descripcion y la evolucion de las lesiones constatadas, de la historia familiar y del aspecto fenotipico renal y extrarrenal de estas enfermedades. Sin embargo, desde hace algunos anos y, de un modo mas preciso, desde la aparicion de la secuenciacion genetica de alto rendimiento, el descubrimiento de los genes implicados ha comportado la llegada de un «actor central», el cilio primario, lo que permite agrupar actualmente estas enfermedades bajo el termino de ciliopatias. Este organulo celular esta vinculado al fenotipo quistico por su estructura y funcionamiento, asi como tambien por las numerosas vias de senalizacion en las que interviene o que lo modifican directamente. Desde luego, los mecanismos que sustentan esta relacion aun no se encuentran completamente dilucidados y el papel del cilio tal vez no sea tan central como se creia en un principio, pero este enfoque permite comprender mejor los mecanismos de la quistogenesis y los fenotipos extraquisticos de estas enfermedades, asi como considerar un enfoque diagnostico mas preciso, con una vision mas clara de la evolucion de las ciliopatias. Pero ello permite, sobre todo, aplicar posibilidades terapeuticas dirigidas especificamente a los mecanismos responsables de la quistogenesis.

Purpose The treatment of Bartholin's gland cysts by traditional surgery is characterized by some disadvantages and complications such as hemorrhage, postoperative dyspareunia, infections, necessity for a general anesthesia. Contrarily, CO2 laser surgery might be less invasive and more effective as it solves many problems of traditional surgery. The aim of our study is to describe CO2 laser technique evaluating its feasibility, complication rate and results vs traditional surgery. Methods Among patients treated for Bartholin's gland cyst, we enrolled 62 patients comparing traditional surgical excision vs CO2 laser surgery of whom 27 patients underwent traditional surgery, whereas 35 patients underwent CO2 laser surgery. Mean operative time, complication rate, recurrence rate and short- and long-term outcomes were assessed. Results The procedures required a mean operative time of 9 ± 5.3 min for CO2 laser surgery and 42.2 ± 13.8 for traditional surgery. Two patients (5.7 %) needed an hemostatic suture for intraoperative bleeding in the laser CO2 laser technique against 14.8 % for traditional surgery. Carbon dioxide allows a complete healing in a mean time of 22 days without scarring, hematomas or wound infections and a return to daily living in a mean time of 2 days. Instead, patients undergone traditional surgery required a mean time of 14 days to return to daily life with a healing mean time completed in 28 days. Conclusions The minimum rate of intra- and post-operative complications, the ability to perform it under local anesthesia in an outpatient setting make CO2 laser surgery more cost-effective than traditional surgery.

Here, we tested that healthy elderly (Nold) and Alzheimer’s disease (AD) individuals can be discriminated with a moderate accuracy using resting state eyes-closed electroencephalographic (rsEEG) markers. Eyes-closed rsEEG data were collected in 100 Nold and 120 AD subjects. eLORETA freeware estimated the source current density (SCD) and functional connectivity (lagged linear connectivity, LLC) in frontal, central, parietal, occipital, temporal, and limbic regions. Delta (2–4 Hz), theta (4–8 Hz), alpha 1 (8–10.5 Hz), and alpha 2 (10.5–13 Hz) were the frequency bands of interest. Univariate (i.e., single rsEEG marker with receiver operating characteristic, ROC, curve) and multivariate (i.e., multiple rsEEG markers with artificial neural networks, ANNs) classifiers were used. The best accuracy was of 76% with univariate classifiers and 77% with multiple classifiers. The present results suggest that both univariate and multivariate rsEEG classifiers allowed a moderate classification rate between Nold and AD individuals. Interestingly, the accuracy based on multiple rsEEG markers as inputs to ANNs was similar to that obtained with a single rsEEG marker, unveiling their information redundancy for classification purposes. In future AD studies, multiple rsEEG markers should also include other classes of independent linear (i.e. directed transfer function) and nonlinear (i.e. entropy) variables to improve the classification.

During the second and the third trimesters of pregnancy and in the first 3 months following childbirth, about one-third of women experience urinary incontinence (UI). During pregnancy and after delivery, the strength of the pelvic floor muscles may decrease following hormonal and anatomical changes, facilitating musculoskeletal alterations that could lead to UI. Pelvic floor muscle training (PFMT) consists in the repetition of one or more sets of voluntary contractions of the pelvic muscles. By building muscles volume, PFMT elevates the pelvic floor and the pelvic organs, closes the levator hiatus, reduces pubovisceral length and elevates the resting position of the bladder. Objective of this review is to evaluate the efficacy of PFMT for prevention and treatment of UI during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. The largest medical information databases (Medline–Pubmed, EMBASE, Lilacs, Cochrane Library and Physiotherapy Evidence Database) were searched using the medical subject heading terms “pelvic floor muscle training”, “prevention”, “urinary incontinence”, “urinary stress incontinence”, “objective measurement techniques”, “pregnancy, “exercise”, “postpartum” and “childbirth” in different combinations. Overall, the quality of the studies was low. At the present time, there is insufficient evidence to state that PFMT is effective in preventing and treating UI during pregnancy and in the postpartum. However, based on the evidence provided by studies with large sample size, well-defined training protocols, high adherence rates and close follow-up, a PFMT program following general strength-training principles can be recommended both during pregnancy and in the postnatal period.

Recommendations for using fluorodeoxyglucose positron emission tomography (FDG-PET) to support the diagnosis of dementing neurodegenerative disorders are sparse and poorly structured.Twenty-one questions on diagnostic issues and on semi-automated analysis to assist visual reading were defined. Literature was reviewed to assess study design, risk of bias, inconsistency, imprecision, indirectness and effect size. Critical outcomes were sensitivity, specificity, accuracy, positive/negative predictive value, area under the receiver operating characteristic curve, and positive/negative likelihood ratio of FDG-PET in detecting the target conditions. Using the Delphi method, an expert panel voted for/against the use of FDG-PET based on published evidence and expert opinion.Of the 1435 papers, 58 papers provided proper quantitative assessment of test performance. The panel agreed on recommending FDG-PET for 14 questions: diagnosing mild cognitive impairment due to Alzheimer's disease (AD), frontotemporal lobar degeneration (FTLD) or dementia with Lewy bodies (DLB); diagnosing atypical AD and pseudo-dementia; differentiating between AD and DLB, FTLD or vascular dementia, between DLB and FTLD, and between Parkinson's disease and progressive supranuclear palsy; suggesting underlying pathophysiology in corticobasal degeneration and progressive primary aphasia, and cortical dysfunction in Parkinson's disease; using semi-automated assessment to assist visual reading. Panellists did not support FDG-PET use for pre-clinical stages of neurodegenerative disorders, for amyotrophic lateral sclerosis and Huntington disease diagnoses, and for amyotrophic lateral sclerosis or Huntington-disease-related cognitive decline.Despite limited formal evidence, panellists deemed FDG-PET useful in the early and differential diagnosis of the main neurodegenerative disorders, and semi-automated assessment helpful to assist visual reading. These decisions are proposed as interim recommendations.

We evaluated the prevalence of cervicovaginal Bacteria, group B Streptococcus (GBS), Gardnerella vaginalis (GV), Candida spp., Chlamydia trachomatis (CT), Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) in pregnant women with and without diabetes mellitus (DM).Cervicovaginal swabs were gathered from 473 pregnant patients divided into 127 diabetic and 346 non-diabetic. The results were correlated to gestational age, parity and glycemic control.A higher prevalence of MH/UU (p=0.012) was found in the diabetic patients. After the 28th week of pregnancy, the prevalence for all investigated microorganisms appeared similar except for MH/UU (p=0.014). In multigravida, there were statistical differences between two groups in testing for Bacteria (p=0.015) and for MH/UU (p=0.037). The diabetic condition correlated to the state of multigravida in cases positive for Candida spp. (p=0.049) and in those testing positive for at least one microorganism (p=0.043). Pregnant with a blood glucose92 have twice the risk of being positive to a single microbiological test than those with better glycemic control.The higher prevalence of MH/UU after the 28th weeks can be explained with the physiologically reduced insulin tolerance characteristic of this gestational period. Among the diabetic testing positive to Candida spp. the statistically significant association was observed only in multigravida condition. These data suggest that diabetic multigravida women are at increased risk for Candida spp. infection in relation to the improper glycemic control.

Die Schwere der komplexen Herzfehlbildung, die unbehandelt zum Versterben des Neugeborenen bereits nach wenigen Stunden oder Tagen fuhren kann, erfordert meist einen chirurgischen Eingriff schon in der fruhen Neugeborenenperiode. Alle innerhalb der Neugeborenenperiode (≤28 Lebenstage) am Deutschen Kinderherzzentrum Sankt Augustin in den Jahren 2007 und 2008 durchgefuhrten herzchirurgischen Eingriffe wurden analysiert. Die postoperativen Komplikationen sowie Ursachen und Umstande der postoperativen Sterblichkeit wurden untersucht. Von 984 Herzoperationen entfielen 191 auf Neugeborene. Dazu gehorten die Norwood-Operation bei hypoplastischem Linksherzsyndrom (n=44), der Verschluss des persistierenden Ductus arteriosus bei Fruhgeborenen (n=27), die arterielle Switch-Operation fur die Transposition der grosen Gefase (n=25), in 6 Fallen mit einem Verschluss des Ventrikelseptumdefekts assoziiert, die Korrektur der Aortenisthmusstenose (n=16), die Anlage eines modifizierten Blalock-Taussig-Shunts (n=14), die Korrektur der Fallot-Tetralogie (n=11) und des Truncus arteriosus communis (n=11). Der durchschnittliche praoperative Risikoscore (Aristoteles-Score) lag bei 12,20±4,54 Punkten; 13 Prozeduren hatten einen Score von mindestens 20 Punkten. Die Herz-Lungen-Maschine wurde in 124 Operationen eingesetzt. Fruh nach der Operation verstarben 13 Patienten, was einer Sterblichkeit von 6,8% entspricht. Das chirurgische Risiko stieg mit der Komplexitat der Prozeduren und erreichte 23,1% (3/13) fur Interventionen mit einem Aristoteles-Score von mindestens 20 Punkten. Der postoperative Verlauf war bei 107 der 178 Uberlebenden (60,1%) komplikationslos, bei 71 traten Komplikationen auf. Fur mindestens 7 Tage beatmet werden mussten 30 Neugeborene. Die mediane Liegedauer auf der Intensivstation betrug 8 Tage und der gesamte mediane Krankenhausaufenthalt 18 Tage. Die Ergebnisse der chirurgischen Therapie komplexer Herzfehler sind heute, anders als noch vor wenigen Jahren, auch im Neugeborenenalter exzellent. Das operative Risiko bleibt jedoch hoch, wenn der Aristoteles-Score die Grenze von 20 Punkten erreicht.

Le rein assure en permanence plusieurs fonctions. L’epuration de certains toxiques comme l’uree ou la creatinine, le maintien de l’equilibre hydroelectrolytique du milieu sanguin, on parle d’homeostasie, et enfin il joue un role exocrine essentiel par l’intermediaire d’hormones pour la regulation de la pression arterielle (systeme renine angiotensine), la production de globules rouges (erythropoietine) et le metabolisme phosphocalcique (vitamine D). Ces deux premieres fonctions (epuration et homeostasie) peuvent se schematiser en deux etapes principales : des phenomenes de filtration au niveau du glomerule et des phenomenes de secretion/ reabsorption au niveau des tubules. La filtration se deroule a travers la barriere de filtration glomerulaire (paroi capillaire + cellule epitheliale +membrane basale) (Fig. 1). Pour cela il faut que la pression sanguine soit superieure a la pression dans la chambre urinaire. Le filtre laisse alors passer l’eau et les elements dissous dans le plasma en fonction de leur taille (il bloque les grosses molecules dont la taille est superieure a celle de l’albumine). Ce sont les urines primitives. La clairance d’une substance est la quantite de plasma totalement epuree de cette substance par unite de temps. La clairance permet de mesurer cette fonction de filtration du rein. Ce n’est que secondairement au niveau du tubule, qui fait suite au glomerule, que les mecanismes de secretion et de reabsorption (actifs ou passifs) vont venir ajuster le contenu de l’urine primitive afin de maintenir l’homeostasie plasmatique. Cela aboutit a la formation de l’urine definitive. Ces mecanismes comprennent des mouvements d’eau et des differents ions presents en suspension : sodium, potassium, chlore, bicarbonate, calcium, phosphore, protons... Dans l’insuffisance renale, c’est le maintien de cet equilibre hydroelectrolytique qu’il va falloir entretenir malgre l’atteinte renale grâce entre autres a la mise en place de la dialyse peritoneale. La dialyse va donc etre entouree de mesures visant a controler le bon equilibre hydroelectrolytique de l’enfant.

Objectives: Optical coherence tomography (OCT) is a noninvasive technique that allows imaging of the retinal nerve fi ber layer (RNFL). A reduction of the RNFL thickness has been found in several neurological disorders, including Parkinson Disease (PD). Aim of this study was to investigate RNFL thickness in patients with idiopathic REM sleep behavior (iRBD), a key symptom of the premotor stage of PD. Methods: Fifteen videopolysomnography-con fi rmed iRBD patients (14 males, 69.4 7 years) underwent OCT, 123I-FP-CIT-SPECT to assess Dopamine Transported (DAT) levels, and color testing. We measured RNFL thickness of temporal and nasal regions in both eyes and computed an asymmetry index in nasal and temporal regions (mean of the upper and lower quadrants), respectively. Thirteen healthy volunteers (seven males, 65.6 4 years) served as control group for OCT data. Correlation was searched for between RNFL asymmetry index and i) DAT striatal binding ratios (SBR) and asymmetries; ii) quantitative parameters of REM sleep without atonia (RWA). Results: Compared to controls, iRBD patients showed a signi fi cantly (P = 0.02) higher asymmetric RNFL index in the nasal regions only. No signi fi cant correlation was found between OCT data and either DAT SBR or RWA parameters. Conclusions: This very preliminary data shows that OCT RNFL asymmetry might be an early sign of neurodegeneration in iRBD patients, possibly unrelated to striatal DAT levels or RWA severity. Neurodegenerative disorders often manifest with an asymmetric pattern at the very beginning; the present data needs to be explored in a larger series.

According to the new research criteria for the diagnosis of Alzheimer's disease, episodic memory impairment, not significantly improved by cueing, is the core neuropsychological marker, even at a pre-dementia stage. The FCSRT assesses verbal learning and memory using semantic cues and is widely used in Europe. Standardization values for the Italian population are available for the colored picture version, but not for the 16-item printed word version. In this study, we present age- and education-adjusted normative data for FCSRT-16 obtained using linear regression techniques and generalized linear model, and critical values for classifying sub-test performance into equivalent scores. Six scores were derived from the performance of 194 normal subjects (MMSE score, range 27-30, mean 29.5 ± 0.5) divided per decade (from 20 to 90), per gender and per level of education (4 levels: 3-5, 6-8, 9-13, >13 years): immediate free recall (IFR), immediate total recall (ITR), recognition phase (RP), delayed free recall (DFR), delayed total recall (DTR), Index of Sensitivity of Cueing (ISC), number of intrusions. This study confirms the effect of age and education, but not of gender on immediate and delayed free and cued recall. The Italian version of the FCSRT-16 can be useful for both clinical and research purposes.

The present work aims at showing how dyspareunia linked to endometriosis can affect the life of fertile age women and how surgical treatment of endometriosis can relieve painful symptoms and consequently improve sex and social life. From a cohort of 320 women with a clinical and instrumental diagnosis of pelvic endometriosis, 67 patients were selected. These patients had deep dyspareunia that underwent laparoscopic surgical treatment. All the patients had filled out a pre- and post-surgery questionnaire. Six months after laparoscopic treatment, a significant reduction of dyspareunia was recorded, per VAS scores. A statistically significant improvement in sex life was observed between the pre- and post-surgical condition: in particular, an increased number of coituses and of non-difficult coituses, a higher number of patients who declared that pain did not negatively affect sexual pleasure and of patients achieving orgasm. The quality of the sex life in patients with endometriosis and dyspareunia showed significant improvement 6 months after laparoscopic treatment. In view of the diagnostic delay characterizing this disease and confirmed by our results, it is essential to involve a multidisciplinary team to assess all the signs and symptoms of endometriosis that may appear in a women of fertile age. This clinical approach is able to ensure a treatment that is as personalized as possible and an appropriate follow-up also with the objective of preserving reproductive performance.

Resume Nous presentons un cas d’embolie pulmonaire gazeuse fatale, confirmee par l’autopsie, survenue au 25e jour de vie chez un enfant premature hypotrophe. La presence de bulles d’air dans la tubulure de perfusion nous avait oriente vers ce diagnostic. Dans certaines conditions, l’utilisation d’un raccord mâle–mâle peut favoriser l’entree de bulles d’air dans les tubulures de perfusion. Nous proposons une alternative a ce type de montage. Cette complication est sans doute sous-estimee et nous preconisons une grande vigilance dans l’utilisation de montages de perfusion complexes.

Background: Resilience is a complex personality characteristic of people facing a significant change, adversity, distress, acute or chronic disease. The Wagnild and Young Resilience Scale is an appropriate instrument to study resilience and has been already validated in the Italian young-adult population. Objective: To verify psychometric properties of the Italian version of the RS scale in adults and elderly healthy subjects. Design: The participants filled out RS questionnaire; statistical analysis was performed to evaluate psychometric properties of the scale. Setting: University of Genoa: courses reserved for elderly people and Clinical Neurology outpatients' department. Participants: 178 adults and elderly healthy subjects. Measurement: The Italian version of RS scale and three associate questionnaire (General Health Questionnaire, Ego-Resilience Scale, Beck Depression Inventory) were used to assess concurrent validity of RS, its reliability, stability, internal consistency and concurrent validity. Results: Time stability was assessed in a sub-sample of 48 subjects (Mean age = 68.89 yr, SD 7.54) by test-retest correlation (r=0.80). RS reliability was evaluated in the whole sample of 178 subjects (Mean age = 63.92 yr, SD 14.6) with an RS mean score of 138.43 (SD 14.6). Internal consistency was evaluated by Cronbach alpha (?=0.86). Concurrent validity was assessed by correlation with General Health Questionnaire (r=-0.45), Ego-Resilience Scale (r=0.59) and Beck Depression Inventory (r=-0.31). Principal component analysis resulted into six components, labelled according to the best association with the five components hypothesized by Wagnild and Young (i.e.: meaningfulness, self-reliance, perseverance, existential aloneness, equanimity a and b). Conclusion: Our data indicate that the Italian version of the RS scale is a reliable tool in the adults and elderly subjects in order to promote interventions and stress-management to improve resilience and facilitate successful aging.

p16INK4a as a diagnostic marker of a cervical intraepithelial neoplasia of grade 2+ (CIN2+) in atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) cytological samples has been analyzed, but has not yet been included in clinical routine practice. One hundred and ninety-one patients with an abnormal Pap test (84 ASC-US and 107 LSILs) who underwent colposcopy were selected for this study. At enrollment, 96 patients (Group 1) had a positive colposcopy and therefore underwent a cervical biopsy, while 95 (Group 2) had a negative colposcopy and were followed up for up to 1 year. Both groups were tested for p16INK4a using immunocytochemical methods, and the p16INK4a results were correlated with histology or follow-up outcome. In Group 1 ASC-US cases, 82% of lesions less than CIN2 were p16INK4a-negative and all CIN2 cases were p16INK4a-positive (p=0.00044). In Group 1 LSIL cases, 71% of lesions less than CIN2 were p16INK4a-negative and 87% of CIN2/3 were p16INK4a-positive (p=0.00033). Seventy-seven percent of Group 2 ASC-US patients with a negative 1-year follow-up (NF-U) were p16INK4a-negative at enrollment, while all patients with positive follow-up (PF-U) were p16INK4a-positive (p=0.00113). In Group 2 LSIL cases, 83% of patients with NF-U were p16INK4a-negative, while 65% of patients with PF-U were p16INK4a-positive at enrollment (p=0.0014). In fact, 39% of the positive p16INK4a LSIL patients had CIN2+ histological lesions. The positive predictive value of p16INK4a for CIN2+ was 50% in ASC-US and 52% in LSIL cases; the negative predictive value was 100 and 94%, respectively. In conclusion, in our patients, a negative p16INK4a appears to be a marker of the absence of CIN3, while a positive p16INK4a can be correlated with the presence of histological CIN2+ found at enrollment or during the subsequent follow-up. Thus, its clinical predictive value is independent from the colposcopic aspect at enrollment.

The principles and applications of scanning electron microscopy (SEM) to electrochemical power sources are explained. The general features of an SEM are briefly described with particular attention to (1) generation and focusing of the electron beam over the samples, (2) interactions between electrons and atoms in the sample producing the analytical signals, (3) detection and recording modes, and (4) image reconstruction from secondary or backscattered electrons. Electron probe microanalysis (EPMA), using wavelength-dispersive or energy-dispersive detectors for X-ray spectrometry (wavelength-dispersive spectrometry (WDS) or energy-dispersive spectrometry (EDS)), is introduced to illustrate the potential of this technique for qualitative and quantitative elemental chemical analysis. Finally, applications of SEM and EPMA in the field of electrochemical storage devices are introduced, with emphasis on morphology, granulometry, and composition of electrodes.

This article briefly describes transmission electron microscope (TEM) and related techniques, such as high-resolution transmission electron microscopy (HRTEM), scanning transmission electron microscopy (STEM), and principles and applications in the field of electrochemical power sources. Instrumentation and operation are discussed together on the basis of the electron scattering phenomena that generate contrast both in the real (imaging mode) and reciprocal space (diffraction mode). Applications of TEM on the study of materials in electrochemical devices are discussed, demonstrating the capability of this technique in the characterization of electrochemically active materials down to the atomic scale.

We report on the first results obtained from our development project of focusing gamma-rays ($>$60 keV) by using Laue lenses. The first lens prototype model has been assembled and tested. We describe the technique adopted and the lens focusing capabilities at about 100 keV., 8 pages 9 figures, to be published in SPIE Procs. 7011, 2008

A fatal pulmonary air embolism, confirmed by an oriented necropsy, is described in a 25-day-old premature and small-for-gestational-age neonate. The embolism was suspected after air bubbles were detected in the infusion line. The air bubbles originated from a male Luer-lock to male Luer-lock connector, which was part of a specific assembly of the perfusion line. A solution to this problem is thereby proposed. We recommend caution in using complex infusion line assemblies because such complications are probably underestimated.

Statistical parametric mapping (SPM) is used worldwide to compare brain perfusion single photon emission computed tomography (SPECT) data. The default template within the SPM package used for SPECT image normalization includes images of a group of healthy subjects studied with [(99m)Tc]HMPAO. Since [(99m)Tc]HMPAO and [(99m)Tc]ECD have shown to distribute differently in SPECT studies, we formulated the hypothesis that comparing set of [(99m)Tc]ECD data normalized by means of a [(99m)Tc]HMPAO template may lead to incorrect results.A customized [(99m)Tc]ECD template was built with SPECT and magnetic resonance imaging (MRI) images of 22 neurologically healthy women. Then, two sets of subjects, i.e. a group of patients with very early Alzheimer's disease (eAD) and a matched control group, studied by means of [(99m)Tc]ECD SPECT, were chosen for comparisons. The same statistical approach (t-test between eAD patients and controls and correlation analysis between brain SPECT and a cognitive score) was applied twice, i.e. after normalization with either the default [(99m)Tc]HMPAO template or the customized [(99m)Tc]ECD template.In the comparison between eAD and controls, a cluster of difference in the posterior cingulate gyrus of both hemispheres was only highlighted when using the customized [(99m)Tc]ECD template, but was missed when using the default [(99m)Tc]HMPAO template. In the correlation between brain perfusion and a cognitive score, the significant cluster was more significant and far more extended, also including the right superior temporal gyrus, using the customized [(99m)Tc]ECD template than using the default [(99m)Tc]HMPAO template.These data suggest the need of customized, radiopharmaceutical-matched SPECT templates to be used within the SPM package. The present customized [(99m)Tc]ECD template is now freely available on the web.

We report the status of the HAXTEL project, devoted to perform a design study and the development of a Laue lens prototype. After a summary of the major results of the design study, the approach adopted to develop a Demonstration Model of a Laue lens is discussed, the set up described, and some results presented., 11 pages, 11 figures, 2007 SPIE Conference on Optics for EUV, X-Ray, and Gamma-Ray Astronomy III

Retinol transport and metabolism have been well characterized in mammals; however, very little is known in fish. To study the mechanism by which fish retinol-binding protein (RBP) is able to remain in plasma besides its small molecular size, we isolated RBP cDNA from a carp liver cDNA library. Comparison of the deduced amino acid sequence with that of known vertebrate RBPs showed that carp RBP has high homology to the other cloned vertebrate RBPs, but it lacks the COOH-terminal tetrapeptide, RNL(S)L, which is most likely involved in the interaction with transthyretin in mammalian RBPs. In addition, the primary structure of carp RBP contains two consensus N-linked glycosylation sites that represent a unique feature. We have obtained experimental evidence, by in vitro and in vivo expression experiments, that both sites are indeed glycosylated. We have also characterized the protein as a complex type N-linked glycoprotein by lectin binding assay, neuraminidase and endoglycosidase H and F digestion. Inhibition of glycosylation by tunicamycin treatment of transfected cells caused a great reduction of RBP secretion. Since kidney filtration of anionic proteins is less than half that of neutral protein of the same size, this finding strongly suggests that the amount of carp RBP filtration through kidney glomeruli may be reduced by a glycosylation-dependent increase in the molecular size and negative charge of the protein. A second unique feature of carp RBP as secretory protein is the presence of a nonconserved NH(2)-terminal hydrophobic domain, which functions as an insertion signal but is not cleaved cotranslationally and remains in the secreted RBP.

Zinc has a wide spectrum of biological activities and its deficiency has been related to various tissue dysfunctions and alterations of normal cell metabolism. Zinc also plays an important role in the antioxidant cellular defenses being a structural element of the non-mitochondrial form of the enzyme superoxide dismutase (CuZnSOD). We have already reported that Zn deficiency induces severe alterations in the rat intestine, that are reverted by treatment with dexamethasone (Dex) or thyroxine (T4). Here we report a paradoxical increase of CuZnSOD activity in rat intestine after 20 and 40 days of zinc deficiency. The increase of CuZnSOD activity is not due to an upregulation of gene expression because both Northern and Western blot analysis indicate that CuZnSOD mRNA and protein levels are not affected by zinc deficiency. A significant increase of lipid peroxidation was also observed in duodenum and jejunum associated with zinc deficiency. Treatment with either Dex or T4 to zinc-deficient rats protects against intestinal oxidative damage and results in SOD activity similar to control rats. Because glutathione peroxidase and catalase activities decreased in zinc deficiency, we speculate that the increase in SOD activity may be associated with an accumulation of hydrogen peroxide that may activate inflammatory molecules, further worsening tissue damage.

Summary Five hundred and forty-four immigrant women, admitted from 1983 to 1993 to the 2nd Institute of Obstetrics and Gynaecology of Rome University, were enrolled in the study. Africa and East Europe were the most common places of birth. Seventy-five per cent of women gave birth spontaneously, and a caesarean section was performed in 22.2%. The frequency of spontaneous delivery and caesarean section was about the same among Italian and immigrant women.

In this study the immunohistochemical expressions of epidermal growth factor receptor (EGF-R) and erbB-2 in endometrial carcinomas at different stages of disease progression were evaluated and correlated with clinicopathological prognostic variables. Our results indicate that EGF-R and erbB-2 molecules are expressed in normal endometrium as well as in the majority of the carcinomas evaluated (83% and 92% respectively). The intensity of the immunostaining varied greatly (1+ to 3+) in the different tumors. Within these tumors we focused on those characterized by high levels of expression (i.e. overexpression). Expression and overexpression of EGF-R has been associated with poorly differentiated tumors and with a 3.3 times higher risk of a more rapid disease relapse. Overexpression of the erbB-2 oncoprotein was significatively correlated with depth of myometrial invasion (M0-M1 vs M2-M3 p=0.05), pathological stage (stage I vs II-IV p=0.02) and grade of tumor differentiation (G1 vs G2-G3 p=0.001). In particular, c-erbB-2 overexpression was able to discriminate between the different subsets of stage I carcinomas. None of the IA tumors overexpressed the oncoprotein, as compared to IB and IC (41% and 100% respectively, p=0.04). This finding highlights a role for erbB-2 protein as a prognostic parameter in stage I endometrial carcinoma patients.

The purpose of this work was to set up an in vitro model for the study of normal and pathological functions of the colonic epithelium. We have isolated colonic crypts by mild proteolytic digestion and mechanical dissociation of human biopsy material obtained during colonoscopy. The crypts, free of connective tissue, when placed in culture rapidly attached to the substrate and formed colonies containing over 95% of epithelial cells. Histochemical and ultrastructural characterization of the colonies showed the presence of both absorptive and secretory cells, exhibiting a high degree of differentiation. Proliferative activity occurred mostly during the first 24 h and progressively declined thereafter. The cells survived and maintained differentiated characteristics for at least three days in culture. This method can be used to study normal functions of the colonic epithelium. It may also be employed to investigate both noxious and protective factors in pathological conditions such as inflammatory bowel disease and colorectal neoplasia.

We evaluated in parallel the action of antigliadin (AGA-IgA) and anti-endomysium (EmA) antibodies in a group of 144 coeliac patients during the various diagnostic procedures, and in 277 controls (206 affected by other gastroenterological diseases and 71 healthy or affected by non-gastroenterological diseases, not causing any immune changes). Little difference was observed between the two tests both during the initial phase of the disease and during gluten-free diet. No EmA positivity was observed in controls; AGA-IgA resulted positive in 6.3% of gastroenterological controls and in 5.6% of non-gastroenterological controls. Finally, the sensitivity, specificity and predictability of the two tests were evaluated in a sample of 92 subjects undergoing intestinal biopsy. The results show that the tests have the same sensitivity, but only for EmA 100% specificity was found.

The authors both detected hemarthrosis and calculated intraarticular pressure and blood supply to the femoral head using diagnostic tests (ultrasound, arthrography, manometric measurements, and bone scan tomography) in 18 patients with femoral neck fracture. The data obtained, in agreement with other reports in the literature, show a relationship between the condition of the joint capsule, the level of intraarticular pressure, and the arterial blood supply to the femoral head in cases of undisplaced or slightly displaced femoral neck fracture. The potential clinical implications are discussed.