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In the hybrid Positron Emission Tomography/Computed Tomography (PET/CT) method, the functional evaluation is integrated with the morphological information provided by co-registered CT, still performed for attenuation correction and lesion localization. However, co-registered CT images could provide additional diagnostic information that PET alone could underestimate. To optimize the diagnostic potential of this hybrid examination, we evaluated the prevalence and the clinical significance of incidental findings detected on co-registered CT images in a cohort of multiple myeloma (MM) patients.We evaluated 112 MM patients (mean age 65.8 y), who underwent [18F]FDG-PET/CT during their regular workup. All co-registered CT images were retrospectively reviewed by two expert radiologists and each non-myelomatous incidental finding (nM-IF) was collected and clinically graded according to a nM-IF Reporting and Data System (nM-RADS). In addition, nM-IFs were classified according to anatomic localization (skull, lung, mediastinum, abdomen, breast, gastrointestinal, genitourinary and cardiovascular system and muscle/soft tissue).163 nM-IFs were detected in 94/112 patients (83.9%) (mean value: 1.5 IFs per patient). The most interested anatomic districts were the lung (n=33; 20.2%), genitourinary (n=33; 20.2%) and gastrointestinal (n=30; 18.4%) systems. Focusing on the clinically significant findings (nM3+nM4), 92/163 (56.4%) IFs could have been required further investigations, of which 38/163 (23.3%) were potentially important and detected in 33/112 (29.5%) patients.The high percentage of potentially clinically significant IFs detected in MM patients emphasizes that co-registered CT images hold precious information often missed. Giving more relevance to co-registered CT with tailored acquisition and reconstruction protocols and dedicated reporting could optimize the potentiality of this multimodality imaging method with impact on clinical management.

The growing quantity of debris in Earth orbit poses a danger to users of the orbital environment, such as spacecraft. It also increases the risk that humans or manmade structures could be impacted when objects reenter Earth's atmosphere. During the design of a spacecraft, a requirement may be specified for the surviv-ability of the spacecraft against Meteoroid / Orbital Debris (M/OD) impacts throughout the mission; further-more, the structure of a spacecraft is designed to insure its integrity during the launch and, if it is reusable, during descent, re-entry and landing. In addition, the structure has to provide required stiffness in order to allow for exact positioning of experiments and antennas, and it has to protect the payload against the space environment. In order to decrease the probability of spacecraft failure caused by M/OD, space maneuver is needed to avoid M/OD if the M/OD has dimensions larger than 10cm, but for M/OD with dimensions less than 1cm M/OD shields are needed for spacecrafts. It is therefore necessary to determine the impact-related failure mechanisms and associated ballistic limit equations (BLEs) for typical spacecraft components and subsys-tems. The methods that are used to obtain the ballistic limit equations are numerical simulations and la-borato-ry experiments. In order to perform an high energy ballistic characterization of layered structures, a new ad-vanced electromagnetic accelerator, called railgun, has been assembled and tuned. A railgun is an electrically powered electromagnetic projectile launcher. Such device is made up of a pair of parallel conducting rails, which a sliding metallic armature is accelerated along by the electromagnetic effect (Lorentz force) of a cur-rent that flows down one rail, into the armature and then back along the other rail, thanks to a high power pulse given by a bank of capacitors. A tunable power supplier is used to set the capacitors charging voltage at the desired level: in this way the Rail Gun energy can be tuned as a function of the desired bullet velocity. This facility is able to analyze both low and high velocity impacts. A numerical simulation is also performed by using the Ansys Autodyn code in order to analyze the damage. The experimental results and numerical simulations show that the railgun-device is a good candidate to perform impact testing of materials in the space debris energy range.

To evaluate the prognostic value of 18F-FDG PET/CT in terms of survival in patients with locally advanced rectal cancer (LARC) who had undergone surgery preceded by neoadjuvant chemoradiotherapy (nCRT). Moreover, the existence of correlation between Overall Survival (OS) and Disease Free Survival (DFS) with pathological staging ((y)pTNM and TRG) was evaluated.A total of 58 patients with biopsy-proven of LARC were included. All patients underwent conventional diagnostic/staging procedures to characterize the rectal lesion. The first whole-body 18F-FDG PET/CT was performed 1 week before the beginning of nCRT (baseline scan). The second 18F-FDG PET/CT was scheduled at 5-6 weeks from nCRT completion (post-nCRT scan). Survival was evaluated in 3 different restaging classification systems, based on focusing only on primary lesion (TRG), loco-regional evaluation (ypTNM) and whole-body 18F-FDG PET/CT evaluation (VRA).Among the 58 patients at the end of the observation, 46/58 patients (79.3%) were alive and 12/58 (20.7%) were dead. This work demonstrated a higher percentage of patients with TRG complete response (39.7%) compared to literature (24.6%), with longer Overall Survival (OS) and Disease Free Survival (DFS) in responders even if without statistically significant differences.The present study highlights the predictive and prognostic potential role of 18F-FDG PET/CT in assisting physicians on personalized decision in the selective risk-adapted treatment strategy, and to schedule the correct follow-up approach.

Cleft of the lip, palate and alveolus are congenital oro-maxillofacial malformation with an established treatment protocol. At present, there is great interest in the alveolar bone grafting procedures that involve the use of platelet-rich-plasma (PRP), to enhance bone formation and specifically to promote bone graft healing in head and neck tissues regeneration. The aim of this retrospective case report study was to assess the condition and viability of the standard bone grafting in association with PRP (platelet rich plasma) to enhance osteogenesis and maintain osteointegration in alveolar cleft with a follow up of eight years from the surgical procedure. The viability of bone grafts was documented by means of head bone scintigraphy (99mTc-MDP). The scintigrams revealed the decreased uptake at the cleft region and the increased uptake at the adjacent alveolus of the cleft. From these findings we suggest that platelet concentrates decrease the need of further surgical intervention in cleft palate patients. In addition, scintigraphy may be useful to evaluate postoperative bone formation in the alveolar cleft.

In this review, some results of the experimental activity carried out by the authors on advanced composite materials for space applications are reported. Composites are widely employed in the aerospace industry thanks to their lightweight and advanced thermo-mechanical and electrical properties. A critical issue to tackle using engineered materials for space activities is providing two or more specific functionalities by means of single items/components. In this scenario, carbon-based composites are believed to be ideal candidates for the forthcoming development of aerospace research and space missions, since a widespread variety of multi-functional structures are allowed by employing these materials. The research results described here suggest that hybrid ceramic/polymeric structures could be employed as spacecraft-specific subsystems in order to ensure extreme temperature withstanding and electromagnetic shielding behavior simultaneously. The morphological and thermo-mechanical analysis of carbon/carbon (C/C) three-dimensional (3D) shell prototypes is reported; then, the microwave characterization of multilayered carbon-filled micro-/nano-composite panels is described. Finally, the possibility of combining the C/C bulk with a carbon-reinforced skin in a synergic arrangement is discussed, with the aid of numerical and experimental analyses.

Resumo Os resultados do Exame Nacional do Ensino Médio constituem uma ferramenta importante para diagnóstico das deficiências do ensino no final de um ciclo formativo, uma fonte relevante de dados para a avaliação do que foi aprendido pelos estudantes ao final do ensino médio. Neste trabalho, apresentam-se doze questões selecionadas das provas de Ciências da Natureza do Enem no período entre 2009 e 2014, classificadas disciplinarmente como "questões de física", nas quais algumas das alternativas de respostas revelam concepções não científicas bem delimitadas e descritas na literatura. A partir do desempenho nessas questões dos estudantes concluintes do ensino médio no ano do exame, fazem-se observações a respeito do processo de aprendizagem em física na educação básica. Esse estudo revela que há algumas dificuldades permanentes na compreensão de conceitos básicos de mecânica, fenômenos térmicos e ótica geométrica. Muitas dessas questões evidenciam a presença e eventual predominância de concepções não científicas. Mesmo com as dificuldades para modificar estas concepções, os resultados revelam que, apesar de todo o esforço desenvolvido de pesquisa desde os anos 1980, houve pouco impacto dos resultados no processo de ensino e aprendizagem, e pequena incorporação deste conhecimento acumulado nos materiais didáticos e nos cursos de formação de professores. Abstract The results of the National High School Examination (ENEM) are an important tool for a diagnosis of educational deficiencies at the end of a training cycle. This exam is a relevant source of data for the evaluation of what is learned by high school students. In this paper, twelve selected questions are presented, from the Natural Sciences exam in the period between 2009 and 2014, questions that were classified as "physics questions", in which the alternatives reveal well-delimited non-scientific conceptions described in the literature. From the students' performance on these items, observations about the learning process in physics in basic education are made. This study reveals that there are some permanent difficulties in understanding basic concepts of mechanics, thermal phenomena and geometric optics. Many of these questions point to the presence and even predominant role of non-scientific conceptions described in the research literature in physics teaching. Even knowing how difficult it is to modify these conceptions, the results reveal that, despite all the research effort in physics teaching since the 1980s, there was little impact of the results in the learning process, and only a few changes incorporating this knowlege in the didactic materials and in the teacher training courses.

Recently, the focus of Space Research has been set both on scientific and commercial fields. When planning a mission in space, it is necessary take into account the environment in which the instrumentations and the satellite that carries them will go to work. About 25% of operating anomalies are in fact due to the space environment that affects the control and management systems of the spacecraft and of the instrument. So it is mandatory to guarantee the compliance with the low earth orbit (LEO) space environment that degrades the performances and functionality of materials with phenomena such as atomic oxygen (AO), ultraviolet (UV) radiation, plasma, micrometeoroids and orbital debris (MMOD), as well as extreme thermal states given by orbital temperature cycles. In this frame the study of Outgassing properties and the hypervelocity impact resistance of space materials and in particular of Carbon based materials is of primary importance. A material with poor outgassing properties will degas volatile particles of itself and humidity with critical effects on electronic and optical devices. The resistance to high vacuum will assure the durability and the reliability of materials and structures. Very important is also the ability of a material or a structure to withstand impacts of MMOD. In this paper Outgassing and impact tests have been carried out on samples obtained from C/C prototypes for employment in re-entry systems and on samples of Carbon Fiber Reinforced Polymer (CFRP). The outgassing tests have been performed both on “naked” and coated samples per C/C kind and on CFRP. An Advanced Linear Electromagnetic Accelerator (ALEA), named railgun, has been developed in order to perform high energy impact test. The experimental results of impact test showed a damage limited to the Carbon based materials shell and could be adopted as solution to guarantee a safe mission and furthermore also that the railgun is suitable to perform impact testing of materials in the space debris energy range; at last, outgassing tests results show a complete compatibility of the materials under investigation with the standard.

A numerical and experimental characterization of multilayered composite plates reinforced with micro- and nano-fillers to withstand high velocity impacts (HIV) is reported. Main objective of the work is to identify a feasible time/cost saving approach for the production of lightweight structures with significant ballistic capabilities for anti-debris aerospace application. Such procedure is based on the molding system process which is typically adopted for the composite laminates manufacturing, thus avoiding any autoclave processing. The materials employed and the production route are described, then the preliminary results of the ballistic characterization are reported and compared to the numerical simulations.

In this study some general guidelines to be used for the installation of microcellular base stations in order to guarantee exposure levels have been identified. A detailed analysis of field strength levels around realistic urban microcellular antennae has been performed by means of experimental and theoretical evaluations as a function of antenna type and the characteristics of the surrounding environment.

This Conference is the fifth of a series of Workshops on High Energy Gamma- ray Experiments, following the Conferences held in Perugia 2003, Bari 2004, Cividale del Friuli 2005, Elba Island 2006. This year the focus was on the use of gamma-ray to study the Dark Matter component of the Universe, the origin and propagation of Cosmic Rays, Extra Large Spatial Dimensions and Tests of Lorentz Invariance., Comment: 328 pages, 7.8Mb, Proceedings of the 5th SCINEGHE Workshop, June 18-20, 2007 http://www.roma2.infn.it/SciNeGHE07/

BackgroundPsychiatric patients often do not receive the same health treatment reserved for patients with no mental disorders. Stigma in mental-health nurses can worsen the patients’ healing time and quality of care.ObjectiveTo explore the different attitudes towards mental illness and psychiatry in nursing students (NS) of the first and the final year of university, and the importance of having visited a psychiatric ward and having known a psychiatric patient.MethodsFifty NS completed the following tests:– Community attitudes towards mental ill (CAMI);– Attitudes towards psychiatry (ATP-30);– Empathy quotient (EQ).ResultsNS of the final year differ significantly from those of the first year in 4 CAMI items, in Authoritarianism subscale (P = 0.041), Social Restrictiveness (P = 0.029) and Community Mental Health Ideology (P = 0.045), indicating a more mature and responsible approach to psychiatric patients, without considering them a threat to be secluded. EQ does not show a significant difference in empathy, not even considering the individual items. Final year NS also have more positive attitudes toward Psychiatry in 3 ATP-30 items and total score (P = 0.01). Those who visited a psychiatric ward have more positive attitudes towards mental illness and Psychiatry, in 6 CAMI items and 3 ATP-30 items. Having personally known a psychiatric patient leads to positive attitudes in only a few CAMI items.ConclusionsLast-year NS, who have had more direct relationships with patients through practical training, have more empathetic and less stigmatizing attitudes. It is also very useful to attend a psychiatric ward during the nursing training.Normal 0 14 false false false IT X-NONE X-NONE.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Our aim is to investigate, through a broad review of medical literature, the role of depressive syndrome on the adherence to lifestyle modifications (TLC) in patients with risk factors for cardiovascular disease (CVD). We conducted a systematic computerized literature search of MEDLINE using the following key words: depressive syndrome, cardiovascular risk factors, lifestyle, physical activity, diet, smoking, blood pressure, metabolic syndrome and diabetes. We have considered metanalyses studies, reviews, original articles, case-control studies published between 1992 and 2010. Furthermore, we have considered the impact of depressive syndrome on the different cardiovascular risk factors. From our search we have selected 42 English articles published between 1992 and 2010 of whose 16 were longitudinal cohort studies, 5 research reports, 10 longitudinal case-control studies, 2 metanalyses, 5 reviews and 4 prevalence studies. All our selected studies agree to give to depressive syndrome a negative role on the adherence to lifestyle modifications. For this reason, depression represents an indirect and independent cardiovascular risk factor that needs to be detected and treated for a successful cardiovascular prevention.

BackgroundStigma towards mental illness has a major impact on the quality of life and the health care of psychiatric patients. Several studies have reported that health professionals have more negative attitudes than general population.AimsTo explore empathy and attitudes towards mental illness in nursing students (NS) and non-health university students. Our purpose is to see how NS have more empathic and less stigmatizing attitudes towards psychiatric patients, compared to other university students.MethodsWe tested 96 university students (50 NS and 46 non-health university students), with the following questionnaires anonymously filled out:– Community attitudes towards mental ill (CAMI), to evaluate the different students’ attitudes towards mental illness;– Empathy quotient (EQ), to assess empathy.ResultsNS differs from the other group in 5 items of CAMI (P < 0.05 in 3 items and P < 0.01 in 2 items), and Authoritarianism subscale (P = 0.023). This shows that NS have a greater general awareness and less stigmatizing attitudes about the need to hospitalize the mentally ill, the difference between psychiatric patients and general population, the wrong need of segregation and the real causes of mental illness. There is also a significant difference in EQ (items 6, 21, 25, 44, 59): future nurses seem to have a slightly higher empathy, even though the EQ total score does not differ in the two groups.ConclusionsThese results suggest that there is a difference with respect to the attitudes towards psychiatric patients in NS and students who do not follow health-care courses: NS have more empathetic and less stigmatizing attitudes.Disclosure of interestThe authors have not supplied their declaration of competing interest.

In this study we performed subdermal injection of 99mTc-labeled albumin combined with subareolar (SA) injection of blue dye to axillary lymphatic mapping and sentinel lymph node biopsy (SNLB) in patients with multifocal and multicentric breast cancer (MC) to evaluate the feasibility and accuracy of this technique. We compared the results with a group of patients with unifocal breast cancer. From January 1999 to March 2006 axillary lymph node mapping and SLNB was performed on 250 patients followed by a complete axillary lymph node dissection. Retrospective analysis showed that 32 (12.8%) of these patients have MC on final histopathologic examination and 218 (87.2%) have unifocal cancer. In statistical analysis tumor size shows a significant difference (p=.01) with largest lesions in MC. In MC often histological type is invasive lobular with or without in situ cancer (p= .001). Metastatic lymph node involvement was significantly higher in the MC group compared to unifocal cancer group (p=.001). False negative (FN) rate was 5.8% in MC and 9.6% in unifocal cancers. The overall accuracy of lymphatic mapping was 96.8% in MC and 97.6% in unifocal cancers. Sensitivity was 94.4% in MC and 91.2% in unifocal cancers. In this study we provide further evidence that lymphatic mapping may be reliable even in patients with MC. SA injection technique demonstrates a high sentinel lymph node identification rate and low FN rate; therefore this technique should been recommended to SLNB in patients with MC of the breast.

Estudamos as forças aerodinâmicas que atuam sobre uma bola de futebol. Analisando o vídeo de uma jogada famosa de Pelé, nós mostramos que um fenômeno curioso, a crise do arrasto, influenciou significativamente o movimento da bola. O efeito Magnus, associado à rotação da bola, também revelou-se importante para o desfecho da jogada. Usando um programa de computador que simula o movimento de bolas chutadas em diferentes condições, discutimos vários aspectos do lance de Pelé e da Física do futebol, em particular as bolas de efeito e a folha seca de Didi. We study the aerodynamic forces acting on a soccer ball. Analyzing the video of a famous shot by Pelé, we show that a curious phenomenon, the drag crisis, greatly influenced the motion of the ball. The Magnus effect, caused by the rotation of the ball, was also important to the outcome of the kick. Using a computer code that simulates the flight of balls we discuss several aspects of Pelé's shot and of soccer physics, in particular bending kicks and Didi's dry leaf.

Seveso is a town (40,000 inhabitants) 16 km north of Milan, which from 10 July 1976 became synonymous with the chemically induced ecological catastrophe because of the large number of people affected by dioxin exposure and of the large area involved. The most polluted area (about 43 ha) was artificially reconstructed and transformed into a wood composed mainly of oaks with some scattered green fields and some bushy areas, the Bosco delle Querce urban park. A four-year survey monitoring the present ecological and biological risk parameters of the artificially reconstructed ecosystem shows its full ecological recovery as an urban park. Plant and animal coenoses are well composed and the park has been colonized by annelids, insects, amphibians, reptiles, birds and mammals. All these animals are useful biological reagents for risk-assessment because of their potential long-term exposure to TCDD. When some of the endpoints of the xenoestrogen-like molecules' action were studied (i.e., gametogenesis and the gross morphology of genital organs in rabbits and house mice), no signs of TCDD effects were detected. Mutagenicity tests and the house mouse sperm DNA COMET assay do not reveal the presence of any biological risk. The study of the carabidocoenosis and the housefly cytogenetics corroborates this last indication, thus guaranteeing the successful ecological recovery of the formerly most polluted Seveso area.

We report on the importance of the integration of data obtained from digital coronary angiography and stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography in evaluating the hemodynamic significance of coronary arteriovenous fistulae.Coronary fistulae were detected with coronary angiography in 9 patients. All patients underwent clinical examination, transthoracic echocardiography, stress electrocardiogram and stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography.Stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography and stress electrocardiogram showed stress-induced myocardial ischemia in 2 patients. The first patient with familial predisposition and risk factors for ischemic heart disease presented a mesocardic heart murmur on clinical examination. At stress ECG (125 Watt, 153 b/m' max frequency 93%, arterial pressure 230 mmHg, max frequency pressure product 35,200) ischemic alterations were recorded at the first minute of the second stage of the Bruce protocol. Coronary angiography detected a circumflex artery fistula in the coronary sinus. Stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography for the evaluation of stress/rest perfusion detected a reversible perfusion defect of the proximal portion of the posterolateral and lateral walls, thus confirming the hemodynamic importance of the flow through the fistula during stress cycloergometric testing. In the second patient familial predisposition to ischemic heart disease and previous inferior wall myocardial infarction and non-significant stress ECG, coronary angiography identified a subocclusive stenosis of the right coronary artery and an anomaly between the anterior interventricular artery and the left pulmonary artery. The presence of the contrast medium in the left pulmonary artery identified a flow from the left ventricle to the left pulmonary artery. Good angiographic results were obtained after percutaneous coronary angiography of the right coronary artery stenosis. Due to the onset of angina stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography was performed to evaluate stress/rest perfusion (75 Watt, 125 b/m', 88% max frequency, arterial pressure 200 mmHg, double max product 25,000 with ST depression of 1.5 mm in V1-V4) and identified an irreversible perfusion defect due to infarction and a reversible perfusion defect of the anterior wall and apex due to ischemia caused by the anomalous flow through the coronary fistula. The correspondence between the site of the coronary artery where the fistula originates, identified by coronary angiography, and the reversible perfusion defects, identified by stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography, indicates that the anomalous flow through the fistula may cause myocardial ischemia. The irreversible perfusion defects of the inferior wall are the result of right coronary artery subocclusive stenosis.Coronary fistulae cause myocardial ischemia only in a small number of patients. Data obtained from single photon emission tomography in evaluating stress/rest myocardial perfusion, correlated with data from coronary angiography, have shown that changes in patients with terminal coronary anomalies may be due to different coronary diseases: ischemia to anomalous flow through the fistula and myocardial infarction to subocclusive right coronary artery stenosis. Stress/rest 99mTc sestamibi single photon emission tomography for the evaluation of myocardial perfusion is a reliable means of assessing the functional importance of the terminal coronary anomalies detected by coronary angiography. Evaluation of the hemodynamic importance of the coronary fistulae is indispensable in programming corrective surgery.

The aim of this study was to evaluate the efficacy of 51Cr-EDTA clearance to tailor the carboplatin dose in two different therapeutic regimens of advanced epithelial ovarian cancer.14 patients entered the study, eight treated by carboplatin (C) alone and six by C and paclitaxel (P). The dose of C was calculated from the Calvert formula [DOSE(mg) = desired AUC x (GFR + 25)] based on the Glomerular filtration rate (GFR) figure; in our protocol desired Area under the curve (AUC) figure was 5 mg/ml x min. The method used to calculate the GFR requires only 4 blood samples taken in the late part of the disappearance plasmatic curve and conjugates accuracy to an acceptable clinical compliance.In only 5 courses a significant hematological toxicity (HT) was present (4 courses grade 2, 1 course grade 3); it was necessary to delay only 2 courses; no treatment was discontinued because of HT.We concluded that there is no summation toxicity of C and P if administered simultaneously and that the assessment of GFR by 51Cr-EDTA clearance is an optimal tool to predict an acceptable toxicity.

Myocardial perfusion assessed by a pharmacological scintigraphic test is a time-honored method to assess the functional significance of a coronary stenosis. There is no study that has compared coronary flow reserve assessed by adenosine/base contrast-enhanced transthoracic echo Doppler in harmonic mode with myocardial perfusion by adenosine/base 99mTc-sestamibi SPECT. The aim of this study was to compare the absolute coronary flow reserve measured in the left anterior descending coronary artery using a new noninvasive method (transthoracic harmonic Doppler) with adenosine/base 99mTc-sestamibi SPECT.Twenty-two patients scheduled for coronary angiography underwent evaluation of basal and hyperemic flow in the left anterior descending coronary artery using transthoracic harmonic Doppler. Simultaneously (during the same adenosine infusion) the patients were injected with 99mTc-sestamibi (10 mCi). Baseline scintigraphic study was obtained 4 hours later (99mTc-sestamibi, 30 mCi).Angiography showed in the left anterior descending coronary artery no or not significant stenosis (40% lumen narrowing) in 14 patients (Group I) and a severe stenosis (75%) in the remaining 8 patients (Group II). Coronary flow reserve dichotomized as normal (or = 2.0) or abnormal (2.0) gave concordant results with SPECT. Overall, in fact, 18 studies (81%) were in agreement (k = 0.48, p = 0.02). In addition, coronary flow reserve proved to be a useful complementary tool to SPECT in patients with severe multivessel disease (and global hypoperfusion; 2 cases) and left bundle branch block (1 case).Coronary flow reserve assessed by transthoracic harmonic Doppler gives concordant results with SPECT perfusion scintigraphy. The diagnostic potential of SPECT may be increased by the noninvasive assessment of coronary flow reserve in the left anterior descending coronary artery.

Scintigraphy with 111In-DTPA-octreotide (111In-octreotide) enables the localization of tumours with somatostatin receptors on their cell membranes, of which pituitary adenomas are an example. Trans-sphenoidal excision of such tumours is sometimes incomplete and the detection of post-surgical residues is a difficult diagnostic task. In this study, we used 111In-octreotide SPET to visualize pituitary adenomas and their minimal residues. In positive cases, the indirect demonstration of the presence of somatostatin receptors may be decisive for the planning of treatment. 111In-octreotide SPET was able to visualize adenomas in 21 of 27 patients (77.7%) (10 GH-secreting, 10 PRL-secreting and 1 non-secreting). Repeat SPET after the recurrence of clinical symptoms and hormone hypersecretion revealed intense 111In-octreotide uptake by residues in 8 of 10 patients (4 GH-secreting and 6 PRL-secreting). Magnetic resonance imaging was positive in only 3 of these 10 patients. Our results suggest that 111In-octreotide SPET, in combination with other imaging modalities, is useful in the diagnosis and follow-up pituitary adenomas. It ensures better selection of patients for treatment with somatostatin analogues, both pre- and post-operatively, and assists in the development of personalized treatment plans.

Sixty patients (31 male and 29 female) with thalassemia major, aged between 6 and 26 years, 18 of which were splenectomized, were observed in this study evaluating the oro-maxillo-facial alterations and correlating them to transfusion indexes, serum ferritin levels, splenectomy and age. For each patient a haematologic and odontostomatologic card was filed with a view to report the medical and clinical history regarding: the haematologic picture, the prevention of caries and parodontal disease, the facies characteristics, the odonto-stomatologic examination, the orthodontic diagnosis, the skull X-rays and the orthopantomography. Poor oral hygiene as well as misknowledge of prevention were generally observed. All the patients showed carious lesions but most of them had never seen a dentist for therapy. The disharmonious growth of splanchnocranium, with the enlargement of the jaw and of its alveolar process, induced by the bone marrow hyperplasia, produced various and serious malocclusion stages (Angle's II class, deep bite, open bite), gnathologic alterations, hypodiaphanous paranasal sinuses and orbital hypertelorism, with a typical oriental-like facies. Malocclusion and the poor oral hygienic conditions determined the occurrence of marginal gingivitis, mainly localized at the level of the lower frontal teeth. In only 3 patients the oral mucous membrane was pale and atrophic. During this investigation agenesia and dental retention were reported in 30% and in 26% of the examined cases respectively, while no patients had supernumerary teeth. Tooth volume, position and shape abnormalities rarely occurred. Only in two patients was enamel hypoplasia described. The caries frequency greatly varied in number and in degree. Only five patients did not show any carious lesions. The caries index (DMF) for the permanent teeth calculated in all the 60 subjects was 5, 12 +/- 4.76. By utilizing Spearman's rank test the number of teeth with caries in the permanent dentition (DFM) and in the mixed dentition (DFM + dmf) was correlated to the average value of ferritin, with the ferritin peak, with transfusion requirements and with the age of the patient at the date of the clinical examination. A significant inverse correlation was therefore demonstrated between transfusion requirements and caries in the mixed dentition. The chi 2 test was used to assess the different frequency of the caries index (above 5) between splenectomized and non-splenectomized patients. Splenectomy proved to be associated only apparently to the total number of patients with more than 5 caries. Conversely, in the non-splenectomized group the frequency of patients with more than 5 caries was definitely lower. Indeed the overall number of caries in both groups of splenectomized and non-splenectomized subjects, of the same average age, was almost identical. Consequently, splenectomy and the higher number of caries are statistically more probable in individuals affected by thalassemia, of increasing age, without however being mutually correlated.

The aim of this study was to use compartmental analysis as a theoretical tool to provide quantitative and unitary data for a more precise determination of 111In-OCT concentrations in a tumour site and various body organs. Five subjects (3 male and 2 female) with neoplasias were studied. Structural and parametric identification of the model was based on the plasma, urine, total body and ROI (soft tissue, spleen, kidney and tumour) activity values. The model was of the mammillary type with 5 compartments (blood, soft tissue, spleen, kidneys and urine) for the 4 patients with a negative scintiscan and 6 (blood, soft tissue, spleen, kidneys, urine and tumour) for the adenocarcinoma patient. Numerical constants were determined by running a best-fit procedure with the MINUIT minimisation program (CERN library) using a microVAX 3800 computer. The reliability of the models was also tested. 111In-OCT accumulates in the kidneys and spleen, from which it is slowly released into the blood. Elimination is via the urine at first rapidly, then more slowly. The maximum concentration in the tumour compartment is reached at 12-14 hours and remains almost constant.

An account is given of the results observed with I-131 MIBG scintigraphy in four patients (1 bladder pheochromocytoma, 3 neuroblastomas) chosen on account of their particular clinical and diagnostic interest from a series of 41 apudoma patients examined by means of this technique. In the first patient, the unusual site of the tumor in the posterior wall of the bladder meant that its detection by I-131 MIBG was only possible after catheterization of the bladder. In the second patient, uptake in the metastasis was only evident after removal of the primary tumor. In the third patient, the scintiscan revealed several metastases (some in bone) not detected by CT. In the fourth patient (congenital neuroblastoma), enhanced uptake accompanied the appearance of high plasma catecholamine and urinary vanillylhandelic acid values, suggesting a functional switch from a nonsecreting to a secreting form. a supplementary In-111 DTPA-Octreotide (OCT) scintiscan of this patient demonstrated the presence of somatostatin receptors on the neuroblasts. Thus, this examination would seem particularly useful for the differentiation of nonsecreting neuroblastomas. Its employment in assessment of the therapeutic capacity of OCT itself is also suggested.

In 27 patients on periodic haemodialysis, serum levels of alkaline phosphatase (ALP), osteocalcin (BGP), intact parathyroid hormone (PTHi) and its two fragments, terminal COOH (PTH-Cter) and middle molecule (PTH-MM), and procollagen type 1 carboxy-terminal extension peptide (P1CP) were measured. The same patients underwent radiography of the skull and of the hands, ultrasonography of the parathyroids and scintigraphy of the skeleton with 99mTc-MDP. The study was completed by the measurement of aluminium (Al) in the blood and the deferoxamine test (DFO). Two groups of patients emerged, one (group A, n = 14) with PTHi greatly increased (201.07 +/- 109.72 pg/mL) and the other (group B, n = 13) with values within the normal range (32.69 +/- 17.06 pg/mL) (p0.001). In group A, ALP, BGP and particularly P1CP were increased with a statistically significant difference compared to group B. Specific radiographic alterations were found in 12 patients of group A; 7 patients also had hypertrophy of the parathyroids. There was no difference in the scintigraphic alterations of the skeleton between the two groups. The authors conclude that it is the association of the high values of PTHi with those of the markers of bone metabolism, the normal level of Al, the negativity of the DFO test and the radiological alterations which together allow the diagnosis of renal osteodystrophy with hyperparathyroidism.

SummaryGenetic and cytological analyses of house-flies collected from 12 pig-breeding farms throughout the British Isles demonstrated that the non-standard sex determination mechanism prevailing in South-East England, involving a dominant female determinant (F) and virtual homozygosity for a male determinant on theXchromosome (Xm, both males and females morphologicallyXX), was not typical of the country as a whole. Instead there was a gradual decrease in the frequency of F,Xmand a rarer male determinantMIII, and a concomitant increase in the standard male determiningYchromosome, on moving north, east and west of this region. Only the Scottish and probably the Irish populations were fully standard (XXfemalesXYmales), although one from the East Anglian coast in which non-standard determinants were rare was predominantly of this type. Populations from intermediate areas possessed complex multifactorial mechanisms in whichY, FXmandMIII coexisted. It is hypothesized that this radial cline in sex determinants, like the latitudinal cline known from mainland Europe, represents a transient polymorphism caused by the recent and continuing invasion of non-standard determinants into originally standard populations. The cause(s) of this apparently rapid evolutionary change, however, remain unclear.

SUMMARYHouseflies collected from eight pig-breeding farms were used to investigate the nature of sex determinants in fly populations of South-East England. Earlier observations had shown that their sex determination mechanism was not of the standard (XX females, XY males) type.Most flies of both sexes were XX; the male determining Y chromosome of standard populations was rare. Test-crosses to females of standard multimarked strains and crosses using aneuploid (OX) flies identified two dominant male determinants, one on autosome 3 (M III) and another on the X chromosome (Xm), and provided the first demonstration in this species of an active involvement of the X chromosome in sex determination. A small secondary constriction on X appeared to indicate reliably the presence of Xm. Most individuals in field populations were Xm homozygotes, implying the presence of an unlocated female determinant F,† epistatic to Xm and M III.M III was less common and differed in frequency between samples. Its increased frequency in a strain selected in the laboratory with the pyrethroid insecticide permethrin might be due either to genetic drift, or to linkage between M III and a gene on autosome 3 that confers resistance to pyrethroids in houseflies.

SUMMARYThe distribution of sex-determinants in field populations ofMusca domestica domesticaL. was studied in 62 samples of flies collected at 53 sites (animal farms) between 1975 and 1981 in an area stretching North–South from Denmark (+ Iceland) to Sicily.Karyological observations and genetic analyses demonstrated the existence of three types of population along a latitudinal cline. Populations of Northern Europe were of the standard type (XXfemales andXYmales) with theYchromosome determining sex. Those of Central and Southern Italy from sites below 100 m.a.s.l. (metres above sea level) were autosomal (XXfemales and males), sex in them being determined by autosomal sex-determinants for both femaleness and maleness. In the large intermediate zone the populations were mixed and had several karyotypes in both sexes. In this zone an altitudinal gradient was also observed, with autosomal determinants less common at higher altitudes. Genetic tests showed, in the autosomal and in the mixed populations, the presence of two autosomal male factors:MIII, the most common, on autosome III andMII, on autosome II.The gradient in sex determinants found in flies of Western Europe appears to be a dynamic phenomenon of relatively recent origin. Both climatic influence and selective pressure with insecticides have probably contributed towards the micro-evolution of populations with different sex-determinants in the houseflies of the area studied.

SUMMARYIn the housefly, mosaics appear spontaneously but rarely. Sexual mosaics or gynandromorphs also appear in strains in which sex determination is based on autosomal sex factors. Rare cases of recombination in the male have been reported by some authors. In field and laboratory populations, mitotic plates with figures indicating exchange of chromatid segments are regularly observed in tissues of individuals of both sexes and at all stages of development. All these anomalies are interpreted as outward manifestation of the same phenomenon: mitotic recombination. The cytological basis of mitotic recombination, its relative frequency, its influence on linkage and genetic variability are discussed.

The case is described of a 56 year old patient admitted to hospital with rhabdomyolysis without myoglobinuria and caused by hypokalaemia following the ingestion of liquorice. The patient was treated with L. Carnitine chloride and KCl.

The kinetics of 99mTc(Sn) methylene diphosphonate [99mTc(Sn)MDP] were evaluated by means of compartmental analysis in 5 normal children and 17 thalassemic subjects. Blood and urine activity were analyzed with a computer program which generates intercompartmental rate constants by an iterative least-square method providing a best-fit to the input data. The amount of tracer in each compartment (corrected for decay) was determined as a function of time. The transfer rate of 99mTc(Sn)MDP from blood to extracellular fluid and lamellar bone (K1-3) was about 20% higher in thalassemic subjects than in normal children. The transfer rate of 99mTc(Sn)MDP from blood to woven bone (K1-4) was about 57% higher in thalassemic subjects. A faster rate of spread into woven bone appears to be the major cause of higher bone uptake of 99mTc(Sn)MDP in thalassemic subjects, which suggests that in these patients bone tissue reoccupies the space previously replaced by hyperplastic marrow. Moreover, the increased bone extraction rate revealed a correlation between anemia and bone metabolic activity.

In rotating machinery, actions of the moving parts take place at specific angular positions rather than at specific times. For this reason, having a geometrical refer- ence, such as the one provided by an encoder, and studying the Instantaneous An- gular Speed (IAS) variations can provide a large amount of information about the health status of the machine. In fact, from the variation of the IAS during the ma- chine loads’ cycle it is possible to identify defects and faults. The current work fo- cuses on the estimation of the IAS through the Elapsed Time (ET) method, using a counter in order to measure the time elapsed between the pulses of an encoder. Both IAS and vibration measurement are conducted on an asynchronous four poles electrical motor driven by 50Hz line current, without load. The study com- pares the order analysis of both signals. The bearing’s Fundamental Train Fre- quency is detected using IAS estimation.