Prevalence and causes of hypergastrinemia in primary hyperparathyroidism: a prospective study.

Gastrin levels have been reported to be often increased in patients with primary hyperparathyroidism (PHPT) considered to be caused by hypercalcemia. To determine the prevalence of increased basal gastrin and to investigate its causes, 52 consecutive patients with PHPT were studied prospectively, undergoing a clinical, biochemical, and gastric morphofunctional assessment before any parathyroid surgical procedure. This included evaluation of basal and secretin-stimulated gastrin, basal and pentagastrin-stimulated gastric acid secretion, upper gastrointestinal endoscopy, with histological evaluation for gastritis and Helicobacter pylori infection. Twenty of the 52 PHPT patients (38.5%) had increased fasting gastrin. Further investigation allowed us to clearly demonstrate the causes of hypergastrinemia in 16 of these 20 patients. In 7 of 20 (35%), hypergastrinemia was caused by gastric fundus atrophy; in 3 patients (15%), Zollinger-Ellison syndrome with Multiple Endocrine Neoplasia type I was diagnosed; whereas in another 20% of patients, mild hypergastrinemia was ascribed to Helicobacter pylori gastritis. Finally, in 2 patients, additional clinical history revealed an occasional use of the gastric antisecretory drug omeprazole a few days before the serum gastrin determination. This study shows that the hypercalcemic status per se is not sufficient to produce an increase in fasting gastrin levels. Furthermore, gastric fundus atrophy, and not gastrinoma, is the major cause of relevant (>160 pg/mL) hypergastrinemia.

Serum albumin level at admission: mortality and clinical outcome in geriatric patients.

We evaluated serum albumin at time of admission, within 72 hours, in 135 geriatric patients who were older than 70 years to establish its role as a predictor of death and clinical outcome at time of discharge. Serum albumin values were reduced significantly in patients who died compared with those who were discharged in unchanged/impaired and improved conditions (3.01 +/- 0.68 g/dL, 3.18 +/- 0.55 g/dL, and 3.65 +/- 0.52 g/dL respectively, P < 0.0001). A correlation between serum albumin concentration at admission and number of days elapsed from admission and death was found (r = 0.43, P < 0.05). Mortality rate was 38.6% in patients with serum albumin values < 3.3 g/dL compared with 14.1% in those with albumin values > or = 3.3 g/dL (P < 0.005). Similar results were obtained even when the main diagnostic conditions, such as cardiocerebrovascular disease and cancer, were considered. The results demonstrate that in geriatric patients the serum albumin level at admission may be a predictor of mortality and clinical outcome at discharge.

Fining treatments of white wines by means of polymeric adjuvants for their stabilization against browning.

Browning and maderization represent important problems for white wine stability. Essentially, this is due to polyphenol oxidation in the wine. The problem has been remedied by adsorption of polyphenol compounds with polymeric adjuvants (chitosans, scleroprotein, and polylactic acid) not used traditionally in wine-making. In particular, some chitosans reduced the polyphenol content and stabilized two Italian white wines (Trebbiano and Albana) to the same extent as did potassium caseinate, an adjuvant normally used in enology. Moreover, chitosans could be reused after a simple regeneration process.

A hospital survey of hypocalcemia and hypophosphatemia in malignancy.

We evaluated the incidence of hypo- versus hypercalcemia and hypo- versus hyperphosphatemia in a survey of 158 patients with malignancy; 55/158 had bone metastases. When serum calcium levels were corrected for albuminemia, the incidence of hypo- and hypercalcemia was respectively 10.8% and 10.1%. Hypophosphatemia was found in 29.7% patients, hyperphosphatemia in 2.5%. The incidence was slightly different in presence of bone metastases. Hypocalcemia and hypophosphatemia prevailed in osteoblastic metastases and hypercalcemia in osteolytic metastases. The incidence of hypocalcemia and hypophosphatemia in malignancy was therefore surprisingly high, even apart from the presence of bone metastases. Both hypo- and hypercalcemia were associated with elevated serum alkaline phosphatase levels. Moreover, a calcium-phosphorus product reduction was observed in osteoblastic metastases, suggesting a condition of secondary hyperparathyroidism.

[Fractures of the pelvis and associated abdominal lesions]. / Fratture del bacino e lesioni addominali associate.

106 cases of pelvic fracture and blunt abdominal trauma are reported and relationships between type of fracture, associated lesions and prognosis assessed. The presence of associated lesions, with the exception of urologic types, would appear to be correlated to the extent and prevalent application site of the trauma rather than to fracture morphology. The prognosis for patients with pelvic fractures is related to the frequency of associated lesions of intra-abdominal viscera and urological or retroperitoneal vascular structures.

Preliminary characterization of wild lactic acid bacteria and their abilities to produce flavour compounds in ripened model cheese system.

AIMS: The aim of this work was to preliminary characterize wild lactic acid bacteria (LAB), previously isolated during artisanal Pecorino Siciliano (PS) cheese-making for technological and flavour formation abilities in a model cheese system. METHODS AND RESULTS: Twelve LAB were studied for the ability to grow at 10 and 45 degrees C, to coagulate and acidify both reconstituted skim milk and ewe's milk. Moreover, the capacity of the strains to generate aroma compounds was evaluated in a model cheese system at 30- and 60-day ripening. Flavour compounds were screened by sensory analysis and throughout gas chromatography (GC)-mass spectrometry (MS). Most of the strains were able to grow both at 10 and 45 degrees C and exhibited high ability to acidify and coagulate ewes' milk. Sensory evaluation revealed that the wild strains produced more significant flavour attributes than commercial strains in the 60-day-old model cheese system. GC-MS data confirmed the results of sensory evaluations and showed the ability of wild lactobacilli to generate key volatile compounds. Particularly, three wild lactobacilli strains, belonging to Lactobacillus casei, Lb. rhamnosus and Lb. plantarum species, generated both in 60- and 30-day-old model cheeses system, the 3-methyl butan(al)(ol) compound, which is associated with fruity taste. CONCLUSIONS: The present work preliminarily demonstrated that the technological and flavour formation abilities of the wild strains are strain-specific and that wild lactobacilli, which produced key flavour compounds during ripening, could be used as tailor-made starters. SIGNIFICANCE AND IMPACT OF THE STUDY: This study reports the technological characterization and flavour formation ability of wild LAB strains isolated from artisanal Pecorino cheese and highlights that the catabolic activities were highly strain dependent. Hence, wild lactobacilli could be selected as tailor-made starter cultures for the PS cheese manufacture.

Primary solitary meningioma of the lung.

Light microscopic, ultrastructural and immunohistochemical features of a case of primary meningioma of the lung are described in this report. The lesion was incidentally discovered in the right lung of a 68-year-old man and treated by lobe resection. No evidence of recurrence or metastasis has been detected 2 years after surgery. The literature is reviewed and the differential diagnosis from other neoplasms presenting as coin lesions in the lung is stressed. Different histogenetical theories and the relation to so-called "minute pulmonary chemodectomas" are discussed.

A novel chitosan derivative to immobilize alpha-L-rhamnopyranosidase from Aspergillus niger for application in beverage technologies.

alpha-L-rhamnopyranosidase (Rha, EC 3.2.1.40) is an enzyme of considerable importance to food technology in increasing the aroma of wines, musts, fruit juices and other beverages. The aim of this research is the immobilization of the Rha contained in a commercial preparation already used in the winemaking industry and purified in the manner described in a previous study [1]. The immobilization supports tested were chitin, chitosan and derivatized chitosan, diethylaminoethyl chitosan (DE-chitosan) never previously used for this type of application. Particularly, on DE-chitosan, the Rha was adsorbed and cross-linked with various bifunctional agents (glutaraldehyde, diepoxyoctane, suberimidate and carbodiimide), whose best results (immobilization yields and activity) were obtained with carbodiimide (EDC) that allowed a reduction in the involvement of the enzyme amine groups that are probably important in catalytic mechanism. In addition, the use of rhamnose and a succinimide (NHS) during cross-linking enhanced the action of the EDC and so increased the immobilization yield and activity. The immobilized Rha retained the kinetic parameters (K(m) and V(max)) of the free enzyme and increased stability. Moreover, this biocatalyst allowed an increase in the aroma in a model wine solution containing glicosidic precursors with a marked reduction in specificity toward tertiary monoterpenols as compared to the free enzyme.

A simple method for purifying glycosidases: alpha-l-rhamnopyranosidase from Aspergillus niger to increase the aroma of Moscato wine.

alpha-L-rhamnopyranosidase (Rha, EC 3.2.1.40) is an enzyme of considerable importance in food technology for increasing the aroma of wines, musts, fruit juices and other alcoholic beverages. The aim of this research is to study the purification of Rha contained in a commercial preparation already used in the winemaking industry. With the procedure adopted, Rha recovery values were excellent (ca 85%), comparable with those we found in a previous paper on the purification of other glycosidases such beta-D-glucopyranosidase (betaG) and alpha-L-arabinofuranosidase (Ara) [1]. The Rha purification value (4.3) and drastic reduction in brown compounds (DeltaAbs 95%) represent other strengths of the proposed method that has proved inexpensive and simple to apply. In addition, purified Rha has shown itself to be more stable than other glycosidases. This had optimum effect at pH 4, while optimum temperature was 70 degrees C, greater than that found for other glycosidases. The purified enzyme was characterized in terms of the kinetic parameters K(m) (1.40 mM) and V(max) (1.30 U mg(-1) of protein) and subsequently used to increase aroma a model wine solution containing aromatic precursors extracted from the skins of Moscato grapes, with an increase in the content of total terpenols of ca 2.3 times.

Pulmonary lymphangioleiomyoma in a patient with multiple endocrine neoplasia type I.

The multiple endocrine neoplasia (M.E.N.) syndromes consist of a group of proliferative disorders that selectively target specific sets of endocrine and soft tissue cells. Here we report a case of lymphangioleiomyoma of the lung in a patient with multiple endocrine neoplasia Type I (M.E.N. I). This is the first time such an association has been reported. In our opinion it could possibly be ascribed to the genetic predisposition to proliferative disorders of patients with M.E.N. syndromes.