Search

Introduction: Couples who have not achieved a pregnancy within one year of unprotected intercourse qualify for a fertility work-up. A semen analysis is part of this work-up and includes the assessment of sperm concentration, motility and morphology. The predictive value of sperm morphology has been

Studies on the immune defence system of Antarctic fishes are of interest to investigate the presence of evolutionary adaptations to low temperature seawater. In the present paper, primers designed to conserved regions of TR , the antigen receptor expressed by T lymphocytes and mediator of main adaptive immune responses, were used for the homology cloning of the icefish Chionodraco hamatus TR  chain cDNA. The full length cDNA consists of 1219 nucleotides that translates in a single reading frame to give a predicted 304-amino acid molecule. The sequence shows highest nucleotide and amino acid identity with the sea bream (Sparus aurata) TR  . A multiple alignment with other known TR  molecules evidenced the presence of conserved amino acid residues involved in structural and functional domains within most teleost species. Real-time PCR analysis was used to investigate TR  basal expression, that resulted maximal in the thymus, followed by gills and spleen. Finally, the 3D structure of the icefish TR  was predicted by homology modelling and compared to the closest homologous Sparus aurata, a fish Teleost living in more temperate environmental conditions. The comparison of these two models suggests that the icefish TR  may be more flexible, as a consequence of a less compact structure and a lower number of H-bonds. L'articolo è disponibile sul sito dell'editore http://www.tandfonline.com/

Our aim was to evaluate the efficacy of abdominal US and fine-needle aspiration biopsy (FNAB) in the diagnosis of disseminated mycobacteriosis (DM) in patients with Acquired Immunodeficiency Syndrome (AIDS). We reviewed the US and clinical records of 18 AIDS patients (12 males; 22-43 years) with DM studied with abdominal US. 18 patients underwent fine-needle aspiration biopsy of enlarged abdominal lymphnodes and 11 underwent FNAB of the spleen. All aspirates were studied with acid-fast stain for fast examination and cultures for isolation of mycobacteria. Abdominal US showed: enlarged abdominal lymphnodes (diameter range: 5-35 mm; mean 17 mm) splenomegaly (spleen diameter range: 14-22 cm; mean: 16.2 cm) and hepatomegaly (right hepatic lobe thickness range: 14.5-18.5 cm) in all patients; multiple splenic abscesses (diameter range: 3-20 mm) in 11 patients; small intestine wall thickening in 5 patients (maximum bowel wall thickness range: 7-15 mm); mild to moderate ascites in 8 patients; pleural effusion in 4 patients; hyperechogenicity of the kidney cortex in 5 patients; peritoneal abscesses in one and a retroperitoneal abscess in one patient. fast-acid-stain of spleen and/or lymphnode FNAB specimens allowed early diagnosis of mycobateriosis in 18/18 cases (100%). Cultures of lymphnode aspirates grew mycobacteria in 10/18 patients (56%). Spleen aspirates grew mycobacteria in 11/11 patients (100%) Blood cultures were positive in 6/18 patients (33%). Diagnosis of species was M. tuberculosis in 9 and M. avium in 6 patients. In 3/18 patients (17%) all cultures were negative. In conclusion, abdominal US features suggest DM in AIDS patients. Spleen and/or lymphnode FNAB allows a specific diagnosis in 100% of the patients.

OBJECTIVE. We sought to investigate the efficacy of contrast-enhanced sonography using a second-generation contrast agent for the evaluation of hepatocellular carcinoma in patients with cirrhosis by comparing the results to those obtained with contrast-enhanced helical CT. SUBJECTS AND METHODS. Between October 2002 and March 2003, 74 patients with cirrhosis (60 men and 14 women; age range, 47–80 years; mean age, 67 years) who had a single nodule of hepatocellular carcinoma were selected to be studied from a cohort of 437 patients with cirrhosis. The size range of the 74 nodules was 9–65 mm (mean, 28.2 mm). Twenty-eight (38%) were 20 mm smaller (range, 9–20 mm; mean, 16.6 mm), and 46 (62%) were larger than 20 mm (range, 21–65 mm; mean, 35.2 mm). Contrast-enhanced sonography was performed at a low mechanical index after IV administration of the contrast agent Sono- Vue. CT scans were obtained in all patients. The enhancement pattern related to tumor hypervascularity was analyzed. The chi-square test was used for statistical analysis. RESULTS. For the 28 hepatocellular carcinomas 20 mm or smaller, contrast-enhanced sonography showed 15 (53.6%) as hypervascular and 10 (35.7%) as avascular; three (10.7%) carcinomas were missed. On CT, 12 (42.9%) of the 28 hepatocellular carcinomas appeared hypervascular, 13 (46.4%) appeared hypovascular, and three (10.7%) were missed. For the 46 hepatocellular carcinomas larger than 20 mm, contrast-enhanced sonography showed 42 (91.3%) as hypervascular and four (8.7%) as avascular. On CT, 35 (76.1%) hepatocellular carcinomas appeared hypervascular, eight (17.4%) appeared hypovascular, and three (6.5%) were missed. Differences between CT appearance of hepatocellular carcinomas and contrastenhanced sonographic appearance of the carcinomas were not statistically significant. Concordance between contrast-enhanced sonographic and CT appearances was observed in 61 (82.4%) of 74 cases. CONCLUSION. Contrast-enhanced sonography is similar to CT for detecting hepatocellular carcinoma hypervascularity. It could be complementary to conventional unenhanced sonography for evaluation of liver nodules.

Objective. To verify the role of sonography in screening of acute appendicitis in patients admitted to an infectious disease unit for suspected acute infectious enteritis. Methods. One hundred eighty consecutive patients (102 male and 78 female; age range, 5-72 years; mean age, 31 years) admitted for suspected infectious enteritis or typhoid fever were prospectively studied with abdominal sonography within 48 hours after admission. None of the patients had peritoneal irritation. Forty-six patients (25%) had white blood cell counts of more than 10,000/mm 3 (range, 10,300-18,000/mm 3 ). The diagnosis of acute appendicitis was made when a detectable appendix with an anteroposterior diameter of greater than 7 mm could be seen on sonography. Results. Eleven (6%) of 180 patients had thickened appendixes (anteroposterior diameter range, 7-14 mm); 2 of them had periappendiceal abscesses. Four (36%) of 11 patients with acute appendicitis had high white blood cell counts. All sonographic diagnoses of acute appendicitis and periappendiceal abscesses were confirmed at surgery. Sonography ruled out acute appendicitis in 169 patients. In all of them, clinical and sonographic follow-up excluded the diagnosis of acute appendicitis. Normal appendixes were shown on sonography in 38 (22%) of 169 cases and were not detectable in 131 (78%) of 169. Conclusions. Sonography of the appendix is a useful method for early assessment of acute appendicitis in patients thought to have enteritis or typhoid fever.

The purpose of our study was to analyze the efficacy, side effects, and short-term complications of saline-enhanced percutaneous radiofrequency ablation performed under sonographic guidance in a series of cirrhotic patients with hepatocellular carcinoma. SUBJECTS AND METHODS. Between September 2000 and June 2002, 84 patients (55 men and 29 women) with cirrhosis who ranged in age from 48 to 74 years (mean age, 64 years) and who had 95 hepatocellular carcinomas (seven patients had two tumors and two patients had three tumors) were treated with high frequency-induced thermotherapy. The diameters of the tumors ranged from 1.5 to 8.5 cm (mean, 3.6 cm). The efficacy of radiofrequency ablation was evaluated with triphasic contrast-enhanced CT performed 4 weeks after the procedure.Posttreatment CT showed complete necrosis in 73 (77%) of 95 hepatocellular carcinomas in 62 patients. Complete necrosis based on tumor size was seen in 40 (95%) of 42 tumors with diameters equal to or smaller than 3 cm, 32 (71%) of 45 tumors with diameters between 3.1 and 5.0 cm, and one (12%) of eight tumors with diameters larger than 5.0 cm. Twenty-two hepatocellular carcinomas showed incomplete necrosis. None of the patients experienced major complications. Four patients were lost to follow-up. The length of the follow-up period ranged from 4 to 22 months (mean, 10 months). One patient died 8 months after the radiofrequency ablation treatment. All the remaining patients are still alive. During the follow-up period, eight (10%) of 80 patients showed a local recurrence on sonography and CT.Our experience suggests that percutaneous radiofrequency ablation of hepatocellular carcinoma with high frequency-induced thermotherapy is safe and effective in the treatment of hepatocellular carcinomas equal to or smaller than 3 cm, fairly effective for hepatocellular carcinomas between 3 and 5 cm, and ineffective for tumors larger than 5 cm.

The Klippel-Trenaunay syndrome is a rare congenital pathology which includes varices, hemangiomas and hypertrophy of limbs. The Authors report two cases and pay particular attention to the diagnostic and therapeutical protocols. Although these aspects are still open questions, the Authors conclude that conservative therapy is often sufficient while surgery is requested only in the severe forms.

Forty-six patients with cirrhosis and 75 biopsy-proved hepatocellular carcinoma (HCC) nodules underwent percutaneous ethanol injection (PEI) regardless of number (up to five) and size (mean diameter, 3.6 cm) of tumoral lesions and clinical severity of cirrhosis (11 patients in Child's class C were included). Ethanol was injected under sonographic guidance through 20 to 22 gauge needles so as to obtain homogeneous hyperechogenicity of lesions. A total of 271 PEI sessions were carried out, delivering 2 to 14 ml per session. All nodules but one decreased in size, and seven were no longer appreciable on sonography. Recurrence was detected in two patients. The 3 year survival rate of all cases was 86%. Child's classes A and B patients fared better (3 yr survival 100%); 2 year survival of subjects with HCC < or = 3 cm was 92%. Multifocality did not affect survival. Most patients experienced mild pain at the site of injection, but only two major complications were encountered: partial chemical thrombosis of the left portal vein and cholangitis. Both cases were managed conservatively. In conclusion, PEI seems to offer a safe and valuable tool for therapy of HCC, especially in patients with good functional liver reserve and small (< or = 3 cm) tumors.

Fourteen patients (9 females, 5 males; age range: 22-80 years) with 16 univesiculated hydatid cysts of the liver (O ranging 4.2-14 cm) underwent two sessions of puncture-aspiration-alcohol injection (D-PAI) under real-time US guidance at 3-day intervals. Two patients had postoperative recurrences. One patient was pregnant (9 weeks' gestation): her cyst doubled its volume over 2 months. One patient had HBV chronic hepatitis treated by means of interferon: also in this case the cyst doubled its volume. The remaining were high-risk patients for surgery or had refused operation. At US follow-up (ranging 4-24 months) 6 cysts exhibited complete reconstitution of liver parenchyma. In the extant patients two different US patterns were observed: 1) liquid areas with detached inner membranes (4 cysts); 2) solid inhomogeneous areas (6 cysts). In these cases the volume was reduced by 50-80%. No allergic complication occurred either during or after the procedure. Two patients only were affected with vomiting and fever, which resolved in a few hours. Our results indicate D-PAI of univesiculated hydatid cysts of the liver to be an effective alternative to surgery.

To define the epidemiologic and clinical significance of delta infection in the Naples area, we sought anti-delta antibodies in all cases of HBV-associated liver diseases, hospitalized in our department during 1983 (234 acute hepatitis, 9 of which fulminant; 51 chronic hepatitis; 32 cirrhosis; 19 hepatocarcinomas) and in randomly selected acute hepatitis over the previous 6 years. Delta agent in acute forms and IgM anti-HBc in delta-positive acute forms were also tested. The acute cases were controlled for at least 9 months after dismissal. Delta infection showed a high prevalence in the Naples area (20% of all acute cases in 1983; similar prevalences in previous years; high rate of coinfections, 81%; no peculiar modalities of circulation) and a high pathogenicity, as proved by the greater prevalence in fulminant cases (66.7%) and severe chronic forms. Moreover superinfection appears a more dangerous event than coinfection as regards the diseases becoming chronic (77.8% vs 2.5%).

Seven hundred ninety-one consecutive patients with acute viral hepatitis, 17 of whom had liver failure, and 97 healthy volunteers were examined by ultrasound. No specific patterns were found in either the uncomplicated or the complicated forms. Only 19 subjects showed a typical "bright liver" pattern, which is correlated with significant vacuolar hepatocellular degeneration. The increased brightness and clear visualization of portal vein radicle walls, previously described in this disease, were detected in only 32.2% of the hepatitis patients but were also seen in 30.9% of the normal controls.

In the context of researches for studying the possibilities of ultrasonic A-mode research for a diagnosis of thyroid, mamma and abdominal organs affections, in this first part the authors make known the results obtained studying nodulary lesions. After a short notice about ultra-sounds, echoscopic apparati and methods for echoscopic research, they outline the semeiologic characters for echoscopic A-mode diagnostic and they stop on echoscopic obtained pictures: liquid crops, nodulary images with homogeneus echostructure scarcely ecogena and nodulary images with not homogeneus echostructure highly ecogena. Then they ended with some considerations about the principles and the indications of this method, in the light of personal experience.

As part of their exploration of the possibilities afforded by A-mode ultrasonic investigation in several disorders of surgical interest, the authors report the results obtained in the study of solitary thyroid nodules. More precisely, after a brief explanation of ultrasonics, current apparatus for echography, and methods for echographic examination, they describe the semiological features exploited in A-mode echography: namely nodules with liquid content, mixed content, solid homogeneous content, and solid heterogeneous content. They conclude with considerations on the principles and indications of this diagnostic procedure in the light of their personal experience.

To define the epidemiologic and clinical significance of delta infection in the Naples area, we sought anti-delta antibodies in all cases of HBV-associated liver diseases, hospitalized in our department during 1983 (234 acute hepatitis, 9 of which fulminant; 51 chronic hepatitis; 32 cirrhosis; 19 hepatocarcinomas) and in randomly selected acute hepatitis over the previous 6 years. Delta agent in acute forms and IgM anti-HBc in delta-positive acute forms were also tested. The acute cases were controlled for at least 9 months after dismissal. Delta infection showed a high prevalence in the Naples area (20% of all acute cases in 1983; similar prevalences in previous years; high rate of coinfections, 81%; no peculiar modalities of circulation) and a high pathogenicity, as proved by the greater prevalence in fulminant cases (66.7%) and severe chronic forms. Moreover superinfection appears a more dangerous event than coinfection as regards the diseases becoming chronic (77.8% vs 2.5%).

To verify the value of ultrasound (US) in the diagnosis of cirrhosis, the ratio of transverse caudate lobe width to right lobe width (C/RL) was determined with US in 25 healthy subjects and 156 consecutive patients with either histologically proved acute viral, chronic persistent, or chronic active hepatitis or cirrhosis. The C/RL ratio had a sensitivity of 43%, a specificity of 100%, and an accuracy of 79% in cirrhosis. The sensitivity was very low in alcoholic cirrhosis, low in cryptogenic cirrhosis, and high in hepatitis B virus related cirrhosis. In spite of its fairly low overall sensitivity, the C/RL ratio is a useful measurement in assessing chronic liver disease because of its high specificity in cirrhosis.

The prevalences of delta co-infections and superinfections in 100 randomly selected subjects for each year from 1977 to 1982 and in all the subjects of subsequent years until April 1986, admitted to our Department with acute viral hepatitis B (AVHB), were evaluated and compared with the annual incidence of cases of AVHB reported in Naples during the same period. Moreover, anti-delta antibodies were determined in the sera of 25 consecutive cases of HBsAg-positive chronic active hepatitis and 25 consecutive cases of HBsAg-positive chronic active hepatitis and 25 consecutive cases of HBsAg-positive cirrhosis, respectively, for 1977, 1980, 1983 and 1986. Our data show a high, constant circulation of HDV and a decrease in its incidence in acute forms over the last 3 years, which coincides with the parallel lower incidence of AVHB, but which is not reflected in the delta prevalence in the chronic forms. They also indicate the possible existence of alternate cycles of increase and decrease in the infection, partly dissociated from HBV circulation, which present peculiar epidemiologic characteristics.

Bacteria organize their lipid membrane composition to survive under different environmental conditions. The lipid signals are messengers to modulate motility, biofilm formation and virulence in phytopathogenic bacteria as well as represent a class of signals exchanged during the perception, and regulation of defence mechanism in the host-pathogen interaction. LC-TOF and LC-MS/MS were adopted to assess the lipid composition of X. fastidiosa subsp. pauca strain De Donno and polar, non-polar lipids, free fatty acids and oxylipins were characterized and quantified in bacterial cells and cultural filtrate. The lipid profile of X. fastidiosa subsp. pauca strain De Donno during the interaction with the model plant Nicotiana tabacum Petit Havana SR1 was exploited. This study highlighted specific class of lipids (e.g. ornitholipids and oxylipins) accumulate differently in infected plant tissues compared to uninfected ones. The in vitro and in vivo studies spotlight the following scenario: the lipid profile of X. fastidiosa contributes to shape its lifestyle in vitro during change from twitching motility to biofilm formation and during its relation with the host. The results suggest the presence of other DSFs than the already described ones (i.e. XfDSF1 and 2), and lipid entities, such as OL1, TAG 52:2, oleic acid and 7,10-diHOME, may constitute an arsenal of molecules that actively contribute to plant-pathogen cross-talk. Moreover, naturally infected and healthy olive samples (cv. Ogliarola salentina) were collected in an affected olive orchard (Lecce and Taranto provinces, Apulia region) to investigate their lipidomic profile. It emerges a scenario in which the X. fastidiosa-infected olive samples presented at least bacterial specific lipid and, other host-pathogen shared lipid entities.

Several fungi belonging to the genus Trichoderma can act as mycoparasites and are used commercially as biological control agents against plant-pathogenic fungi, such as Rhizoctonia solani, Botrytis cinerea, Sclerotium rolfsii, Sclerotinia sclerotiorum, and Pythium spp. (5, 6, 18). Mycoparasitic strains can penetrate and kill the host fungi. Mycoparasitism is accompanied by the secretion of antifungal metabolites, such as peptaibol antibiotics (32, 47), and morphological changes, such as coiling around the host and development of hooks and/or appressorium-like structures (11). Hydrolytic enzymes, such as chitinases, glucanases, and proteases, also are important for biocontrol activity, since they enable Trichoderma to degrade the host's cell wall and to utilize its cellular contents (20). Chitinase gene expression is induced by colloidal chitin, fungal cell walls, or the chitin monomer N-acetylglucosamine (29). In Trichoderma atroviride the N-acetylglucosaminidase (NAGase)-encoding gene, nag1, has a major impact on the induction by chitin of other chitinases (4). In mycoparasitic interactions between T. atroviride and R. solani, expression of ech42, which encodes endochitinase 42, is triggered by a low-molecular-weight diffusible factor released from the host prior to physical contact between the two fungi (10, 50). Lectins in the host's cell wall can induce coiling of the mycoparasite around the host (1, 24, 41). Elucidation of the signaling pathways underlying mycoparasitism has only recently begun. Heterotrimeric G proteins are composed of α, β, and γ subunits. Gα subunits play pivotal roles in the recognition process, virulence, and virulence-dependent development in a number of plant-pathogenic fungi (3, 15, 26, 27, 31). Fungal Gα subunits are highly conserved and can be divided into three major subgroups (3). In T. atroviride, the subgroup I Gα protein Tga1 affects light-induced conidiation and mycoparasitism-related coiling (41). The corresponding protein in Trichoderma virens is involved in antagonism against S. rolfsii but not in antagonism against R. solani. ΔtgaA loss-of-function mutants sporulate and have coiling behavior similar to that of the wild type (37), suggesting that the subgroup I Gα subunits have different functions in these mycoparasites. The T. virens subgroup II G protein α subunit, TgaB, has no specific role in development or mycoparasitism (37). Fungal subgroup III Gα proteins also regulate morphological and developmental processes, such as germination, conidiation, and secondary metabolite production (28, 53), and they may increase intracellular cyclic AMP (cAMP) levels by stimulating adenylyl cyclase (28, 33, 39). The objectives of this study were to isolate a subgroup III Gα subunit deletion mutant of T. atroviride and to determine its role in development and mycoparasitism. This report is the first report of the role of the Tga3-mediated G protein pathway in mycoparasitism-related properties, such as host recognition, chitinase expression, and secretion.