Altered resting-state functional connectivity in emotion-processing brain regions in adults who were born very preterm.

BACKGROUND: Very preterm birth (VPT; <32 weeks of gestation) has been associated with impairments in emotion regulation, social competence and communicative skills. However, the neuroanatomical mechanisms underlying such impairments have not been systematically studied. Here we investigated the functional integrity of the amygdala connectivity network in relation to the ability to recognize emotions from facial expressions in VPT adults. METHOD: Thirty-six VPT-born adults and 38 age-matched controls were scanned at rest in a 3-T MRI scanner. Resting-state functional connectivity (rs-fc) was assessed with SPM8. A seed-based analysis focusing on three amygdalar subregions (centro-medial/latero-basal/superficial) was performed. Participants' ability to recognize emotions was assessed using dynamic stimuli of human faces expressing six emotions at different intensities with the Emotion Recognition Task (ERT). RESULTS: VPT individuals compared to controls showed reduced rs-fc between the superficial subregion of the left amygdala, and the right posterior cingulate cortex (p = 0.017) and the left precuneus (p = 0.002). The VPT group further showed elevated rs-fc between the left superficial amygdala and the superior temporal sulcus (p = 0.008). Performance on the ERT showed that the VPT group was less able than controls to recognize anger at low levels of intensity. Anger scores were significantly associated with rs-fc between the superficial amygdala and the posterior cingulate cortex in controls but not in VPT individuals. CONCLUSIONS: These findings suggest that alterations in rs-fc between the amygdala, parietal and temporal cortices could represent the mechanism linking VPT birth and deficits in emotion processing.

Somatostatin up-regulates topoisomerase II alpha expression and affects LNCaP cell cycle.

mRNA differential display-PCR analysis was used to perform a systematic screening of Somatostatin (SS)-regulated genes in the human prostatic carcinoma cell line LNCaP (Lymph Node Carcinoma of the Prostate). A 170 bp fragment was shown to be up-regulated by SS. Sequence analysis of this fragment revealed its homology with the human Topoisomerase II Alpha gene. Up-regulation of Topoisomerase II Alpha was confirmed by Northern blot hybridisation and was induced by the same dose of SS (1 nM) earlier demonstrated to inhibit LNCaP cell growth. Furthermore, SS possible effects on timing, as well as concentration of Topoisomerase II Alpha along the different phases of the cell cycle were investigated. To this purpose changes in the enzyme protein concentration in response to SS were assessed in synchronised LNCaP cells. The hormone was shown to exert a perturbing effect on both parameters considered, possibly related to its inhibitory action on LNCaP cell replication.

Palliative radiotherapy for brain metastases.

Several studies have confirmed that results of different hypofractionated radiotherapy schedules for palliative purpose are similar to those of conventional higher doses. From 1992 to 1993, 56 consecutive patients with brain metastases were irradiated at our Institution. Three different schedules were used ranging between 18 and 40 Gy. Overall survival, clinical and radiological responses were evaluated with regard to schedules and prognostic characteristics of patient population. There were no significant differences between the treatments, even though patients with shorter estimated life expectancy were more likely to be irradiated with more hypofractionated radiotherapy. Short, cost effective treatments appear to be the best therapeutic option both for institution and patients in most palliative cases.

Radiotherapy in the symptomatic treatment of the oncological patients.

This paper presents an overview on the palliative use of radiotherapy in the treatment of cancer patients. The aim of symptomatic treatment is to improve the patient's quality of life through the control of local symptoms, without serious disturbance of the life style. Radiotherapy can control many symptoms like metastasis bone pain hematological disorders and other.

Radiation therapy of spinal metastases: results with different fractionations.

AIMS AND BACKGROUND: Local radiotherapy plays an important role in the palliative treatment of all skeletal metastases, particularly those of the spine, with the purpose to obtain pain relief and prevent pathologic fractures or vertebral collapse. METHODS: From June 1991 to October 1993, 95 patients with a total of 103 sites of spinal metastases were treated at the Institute of Radiology of the University of Rome "La Sapienza". Fractionations and total doses were divided as single fractions of 800 cGy, hypofractionated multiple fractions for a total dose of 20 Gy administered in 4-5 days, and conventional multiple fractions for a total dose of 30-40 Gy in 2-4 weeks. An evaluation of the efficacy of the different radiation treatments was performed with the use of a simplified descriptive pain scale. RESULTS: Seventy-three (70.9%) of 103 treatments were evaluables. An overall response rate of 82.2% was obtained: complete in 38.3% and partial in 43.8%, irrespective of total dose, fractionation and location of irradiated spinal metameres. The analysis of results did not show significant differences between the treatment courses. CONCLUSIONS: We confirm that radiation therapy has a major role in the management of pain control and prevention of fractures in patients with spinal metastases. Hypofractionated and single fraction treatments showed equal efficacy compared to more prolonged therapy, with an advantage for the patient and the radiation therapy institution.

[Exclusive radiotherapy in stage III esophageal cancer]. / Radioterapia esclusiva nel cancro dell'esofago stadio III.

BACKGROUND: The purpose of the report is to evaluate the role of radiotherapy in the treatment of stage III esophageal carcinoma and to analyze the influence of site, extension, grade of dysphagia and histology on local control and survival. METHODS: Twenty males and 6 females were submitted to external beam therapy with 4-6 MV X-rays and received 60-70 Gy in fractions of 180 cGY to 200 cGy per day, 5 days a week. Radiation therapy technique was two posterior oblique portals and a single anterior field at 100 cm SAD. After 4500 cGy portals were coned down, holding the spinal cord dose below 4500 cGy. RESULTS: Global response to therapy was 73.1%. Median survival was 11 months. The 2-year survival rate was 12.5% in patients with lesions smaller than 5 cm and 5.5% for those with lesions greater than 5 cm. Patients with grade 2 dysphagia had a median survival of 16 months, those with grade 1, 11 months and 2 patients with grade 0, 4 and 9 months. In all patients mild to moderate esophagitis was observed. Two patients developed esophagotracheal fistula. CONCLUSIONS: Exclusively radiotherapy cannot be considered the treatment of choice in III stage patients. Primary chemoradiotherapy may emerge as the treatment of choice for cancer of the esophagus.

Pain therapy in elderly cancer patients.

In most (65-80%) cancer patients at an advanced stage of illness we find significant, invalidating symptoms of pain. Cancer pain is a complex pain (with a nociceptive, neuropathic and deafferentation component), which requires a multidisciplinary approach (surgery, radiochemotherapy, and pain therapy). Pain therapy has various pharmacological strategies at its disposal (opiates, anti-inflammatory and adjuvant drugs) together with modulation and neurodestructive techniques, which must be applied taking account of both the stage of the disease and the pain intensity. In elderly patients, a careful, tailored management of pharmacological therapy is required. In older age, personality disorders are also to be found (anxiety, depression, hypocondria and feeling of abandonment), which make therapy more complex and varied. Knowledge of these problems will, however, make it possible to control cancer pain in elderly patients to the best possible effect and improve the quality of life in the advanced and terminal stages.

Screening for glaucoma with a non-mydriatic fundus camera.

183 first-degree relatives of glaucoma patients were photographed by a technician with non-mydriatic fundus camera in order to study the suitability of wide angle black-and-white fundus photographs in screening for glaucoma. The success rate of photography was 92%. The optic disc and retinal nerve fiber layer abnormalities were evaluated from the photographs by an ophthalmologist. 31 subjects (17%) were referred to further ophthalmological examinations. We found 6 (3%) new glaucomas. In addition, in 6 patients (3%) retinal nerve fiber layer defect was the only abnormality, 5 subjects (3%) showed a hemorrhage and 2 eyes had collateral vessels as a sign of asymptomatic venous stasis change at the optic disc. Only 1 of the 6 (17%) patients with glaucoma would have been found with tonometry alone. The results of this study indicate that non-mydriatic retinal camera is a useful tool in screening for glaucoma.

[The esthetic results in patients undergoing postoperative radiotherapy in breast carcinoma]. / Risultati estetici nelle pazienti sottoposte a radioterapia postoperatoria nel carcinoma mammario.

INTRODUCTION: Early stage breast cancer (pT-T2, N0, N+, M0) is generally treated with conservative surgery followed by radiation therapy, which procedures yield similar results to radical surgery. We studied the effects of irradiation on residual breast parenchyma in patients submitted to quadrantectomy and complementary irradiation. MATERIAL AND METHODS: 331 patients (Stage T1, T2, N0, M0) submitted to quadrantectomy and axillary dissection 1980-1993, were examined. The tumor was localized in external quadrants in 257 cases and in internal ones in 74 cases. Radiotherapy was given with 4-6 MV photon beams produced by a linear accelerator; the total dose to the breast was 50 Gy with a 10 Gy boost to tumor bed. All the patients were submitted to follow-up mammography at 6 months, one and two years after the end of radiotherapy. Parenchymal density was evaluated on an arbitrary scale from 0 to 3. We also considered the following other parameters: skin thickness, calcifications, cysts and possible signs of recurrence. RESULTS: Trabecular patterns were unchanged in 41 patients (grade 0) and slightly changed in 67 (grade 1); 135 patients had grade 2 and 90 grade 3 changes. 254 patients had skin thickening. All the changes disappeared at 2-3 years' follow-up. The patients with bigger breasts had poorer cosmetic results. CONCLUSIONS: It is very important to assess irradiation-induced tissue changes to detect any early recurrence of breast carcinoma. All radiation-induced changes decrease over time, which confirms the good tolerance and the good cosmetic results of complementary irradiation for breast cancer

A community-based outbreak of Salmonella enterica serotype Typhimurium associated with salami consumption in Northern Italy.

An outbreak of Salmonella enterica serotype Typhimurium belonging to phage type (PT) 193 occurred in autumn 1995 and involved 83 individuals in a large area of Northern Italy (Lombardy Region). Epidemiological and microbiological investigations of strains isolated from clinical and food specimens revealed that the vehicle was a batch of salami, produced on 4 September 1995 by a local firm. The outbreak was contained when the batch was withdrawn from sale. Insufficient ripening of the salami had allowed the salmonella to survive, emphasizing the need to define criteria for the ripening process of foods such as salami.

The nitric oxide transduction pathway in Trypanosoma cruzi.

A nitric oxide synthase was partially purified from soluble extracts of Trypanosoma cruzi epimastigote forms. The conversion of L-arginine to citrulline by this enzyme activity required NADPH and was blocked by EGTA. The reaction was activated by Ca2+, calmodulin, tetrahydrobiopterin, and FAD, and inhibited by N omega-methyl-L-arginine. L-Glutamate and N-methyl-D-aspartate stimulated in vivo conversion of L-arginine to citrulline by epimastigote cells. These stimulations could be blocked by EGTA, MK-801, and ketamine and enhanced by glycine. A sodium nitroprusside-activated guanylyl cyclase activity was detected in cell-free, soluble preparations of T. cruzi epimastigotes. L-Glutamate, N-methyl-D-aspartate, and sodium nitroprusside increased epimastigote cyclic GMP levels. MK-801 bound specifically to T. cruzi epimastigote cells. This binding was competed by ketamine and enhanced by glycine or L-serine. Evidence thus indicates that in T. cruzi epimastigotes, L-glutamate controls cyclic GMP levels through a pathway mediated by nitric oxide.

Adenylyl cyclase and G-proteins in Phytomonas.

Phytomonas sp. membranes have an adenylyl cyclase activity which is greater in the presence of Mn2+ than with Mg2+. The Mg2+ and Mn2+ activity ratio varies from one membrane preparation to another, suggesting that the adenylyl cyclase has a variable activation state. A[35S]GTP-gamma-S-binding activity with a Kd of 171 nM was detected in Phytomonas membranes. Incubation of these membranes with activated cholera or pertussis toxin and [adenylate 23P]NAD+ led to incorporation of radioactivity into bands of about 40-44 kDa. Crude membranes were electrophoresed on SDS-polyacrylamide gels and analyzed, by Western blotting, with the 9188 anti-alpha[s] antibody and the AS/7 antibody (anti-alpha[i], anti-alpha[i1], and anti-alpha[i2]. These procedures resulted in the identification of polypeptides of approximately 40-44 kDa. Phytomonas adenylyl cyclase could be activated by treatment of membrane preparations with cholera toxin, in the presence of NAD+, while similar treatment with pertussis toxin did not affect this enzyme activity. These studies indicate that in Phytomonas, adenylyl cyclase activity is coupled to an unknown receptor entity through G alpha[s] proteins.