[Effectiveness of measures to promote and control on the appropriateness of preventive measures taken on farms--health surveillance, surveys on damages associated with risk]. / Efficacia delle azioni di promozione e controllo sull'appropriatezza delle misure di prevenzione adottate nelle aziende agricole--la sorveglianza sanitaria, le indagini sui danni associati al rischio.

The agricultural activities have several issues in the management of safety and health of workers. The study of two ASL of Central Italy (VT and RMH) intended to check the risk conditions in order to highlight most critical points and define a prevention and surveillance plan. We moved in these directions: verification of workplaces and work practices; examination of machineries and equipment; active search of occupational diseases. We analyzed some peculiar aspects of the health surveillance of 75 workers such as risk from sun exposure, significantly underestimated by employers and competent doctors, despite sun exposure diseases are included in the list for which reporting is mandatory. Our study shows that a targeted campaign of prevention and control can lead to an improvement in safety management, on the other hand shows the necessity to bring occupational health physician to assess and manage also less valuated risks as the sun exposure.

Acylphosphatase is involved in differentiation of K562 cells.

The level of both isoforms of acylphosphatase was evaluated in the human erythroleukemia K562 cell line during differentiation. K562 cells were treated with PMA, which induces megakaryocytic differentiation, and with aphidicolin or hemin, which stimulate erythrocytic differentiation. While the MT isoform showed an average 10-fold increase independently of the differentiating agent used, only hemin treatment caused a similar increase of the CT isoform, suggesting a different role of the two isoforms in the cell. Treatment with either hemin or aphidicolin of K562 cells overexpressing the two acylphosphatase isoforms suggested the possibility that acylphosphatases play a role in the onset of differentiation.

Intracoronary air-filled albumin microspheres for myocardial blood flow measurement.

OBJECTIVES: The aim of this study was to explore the possibility of quantifying coronary blood flow by myocardial contrast echocardiography with air-filled serum albumin microspheres (Albunex). BACKGROUND: Air-filled albumin microspheres have been proposed as an intravascular tracer for the study of myocardial perfusion by contrast echocardiography. METHODS: In six anesthetized open chest dogs, the left circumflex coronary artery was cannulated and perfused by a roller pump with blood from the femoral artery. Both air-filled albumin microspheres (0.4 ml, 2 x 10(8) spheres/ml) and technetium-99m-labeled albumin were injected as a bolus into the coronary cannula at baseline and after treatment with dipyridamole (0.56 mg/kg body weight intravenously for 4 min). Two-dimensional echographic images of the left ventricular short axis were digitized to generate myocardial time-intensity curves; myocardial radioactivity was measured by an external detector to generate radionuclide time-activity curves. RESULTS: After dipyridamole, left circumflex coronary artery blood flow (as measured by both the pump and an electromagnetic flow meter) significantly increased (from 1.06 +/- 0.28 to 3.61 +/- 1.43 ml/min per g of myocardium). Peak intensity and rise time of contrast echo curves were able to differentiate baseline myocardial perfusion from coronary hyperemia but did not show any significant correlation with coronary blood flow. A weak inverse correlation with coronary blood flow was provided by myocardial mean transit time of air-filled albumin microspheres (r = 0.33). Conversely, a close inverse correlation with coronary blood flow was obtained by myocardial mean transit time of technetium-99m-labeled albumin (r = 0.95). Myocardial transit time of air-filled albumin microspheres (1.95 +/- 0.60 s) was also markedly shorter than that of labeled albumin (5.35 +/- 3.43 s, p < 0.001) and the measurements were less reproducible. CONCLUSIONS: In this experimental study, coronary blood flow was not adequately quantified by myocardial contrast echocardiography with intracoronary injection of air-filled albumin microspheres.

Myocardial washout of sonicated iopamidol reflects coronary blood flow in the absence of autoregulation.

OBJECTIVES: The aim of the study was to evaluate the relation between measurements derived from myocardial contrast echocardiography and coronary blood flow. BACKGROUND: Contrast echocardiography has the potential for measuring blood flow. METHODS: In six open chest anesthetized dogs, the left circumflex coronary artery was cannulated and perfused with blood drawn from the left femoral artery. While adenosine was infused into the circuit, circumflex flow was generated by a calibrated roller pump to the point of abolishing coronary autoregulation. At each of 25 levels of coronary blood flow, paired bolus injections of sonicated iopamidol were performed proximal to a mixing chamber. The perfused area of the left circumflex coronary artery was labeled by radioactive microspheres injected into the perfusion line. Two-dimensional echocardiographic images of the left ventricular short axis were digitized off-line, and myocardial videodensity was measured in the area perfused by the left circumflex coronary artery to generate time-intensity curves. RESULTS: The washout slope of curves showed a good correlation with coronary blood flow, ranging from 0.5 to 12.5 ml/min per g of tissue. This correlation was good both in individual dogs (correlation coefficient [r] ranging from 0.78 to 0.96) and in the group of animals as a whole (r = 0.85). Washout slope also showed a good correlation with coronary diastolic pressure (r = 0.80), which ranged from 23 to 114 mm Hg, suggesting a possible primary effect of pressure on contrast washout. However, coronary blood flow appeared to be a stronger predictor of washout slope (partial F = 26.5, p < 0.001) than did perfusion pressure (partial F = 5.9, p < 0.05 by multiple regression). The injection to injection variability in myocardial washout slope appeared to be high (24%). The gamma variate fitting of curves did not improve the correlation with coronary flow (r = 0.78). CONCLUSIONS: Myocardial washout of sonicated iopamidol reflects coronary blood flow in a model in which coronary autoregulation is abolished.

Persistence of subendocardial perfusion after subtotal coronary embolisation.

The effects of acute subtotal embolisation of small coronary arteries on regional coronary flow and vasodilator reserve were investigated in seven open chest dogs. Unlabelled plastic microspheres (26(2) micron in diameter) were injected as boluses of 200,000-400,000 microspheres into the circumflex artery. Embolisation was repeated until reactive hyperaemia was totally abolished, which occurred after the injection of 62,000(4000) microspheres per gram. Intracoronary adenosine was then infused for 20 min at 1.2 mg.min-1. Regional myocardial blood flow was measured by radioactive microspheres under control conditions, after coronary embolisation, and during adenosine infusion. Coronary blood flow (0.98(0.07) ml.min-1.g-1) was reduced to 0.66(0.08) ml.min-1.g-1 after embolisation (p less than 0.005) when reactive hyperaemia was practically abolished. Embolisation reduced epicardial flow from 0.93(0.08) to 0.40(0.09) ml.min-1.g-1 (p less than 0.001), whereas endocardial flow was unchanged (1.03(0.11) vs 0.92(0.14) ml.min-1.g-1; NS); as a consequence, the endocardial to epicardial flow ratio increased from the control value of 1.11(0.06) to 2.31(0.35) (p less than 0.005). Adenosine infusion increased coronary blood flow from 0.66(0.08) to 1.66(0.41) ml.min-1.g-1 (p less than 0.05). Endocardial blood flow increased more than epicardial blood flow, leading to a further increase in the endocardial to epicardial flow ratio (3.79(0.13); p less than 0.05). Thus it is concluded that (a) embolisation of small arteries abolishes the reactive hyperaemic response to transient coronary occlusion; (b) microembolisation predominantly reduces subepicardial perfusion; and (c) adenosine administration may increase total and regional flow after subtotal occlusion of coronary small arteries.

Regional myocardial deoxyglucose uptake following electrical stimulation of canine efferent sympathetic cardiopulmonary nerves.

OBJECTIVE: The aim was to study the effect of stimulating individual acutely decentralised cardiopulmonary nerves on myocardial uptake of deoxyglucose. METHODS: In 17 open chest anaesthetised dogs the efferent axons of individual decentralised cardiopulmonary nerves were stimulated intermittently throughout 1 h while haemodynamic variables were measured. Tritiated 2-deoxyglucose was injected intravenously at the beginning of stimulation. Atropine was given when a cardiopulmonary nerve with efferent parasympathetic axons was studied. Distribution of label was detected using a multiwire proportional chamber. It was compared to blood concentration of deoxyglucose to permit quantitative mapping of regional myocardial uptake during the stimulation of each nerve. RESULTS: Neural stimulation of most of sympathetic efferent cardiopulmonary nerves increased deoxyglucose uptake in all myocardial tissue. Uptake was greatest in the left ventricle, less in the right ventricle, and least in the left and right atria. Regional myocardial uptake was also observed following individual cardiopulmonary nerve stimulation. Some nerves caused greater uptake than others. Cardiopulmonary nerves which are known to enhance inotropism when stimulated induced little increase of deoxyglucose uptake, whereas other nerves known to exert little positive inotropic effect induced considerable uptake. There was no correlation between haemodynamic changes and deoxyglucose uptake. CONCLUSIONS: It appears that (1) efferent sympathetic axons in one cardiopulmonary nerve can preferentially increase deoxyglucose uptake in specific regions of the myocardium and (2) the mechanisms responsible for enhancement of glucose uptake may differ from those responsible for inotropic responses.

Time-dependent response of coronary flow to prolonged adenosine infusion: doubling of peak reactive hyperaemic flow.

UNLABELLED: In 11 anaesthetised, Open chest dogs the time course and degree of the coronary vasodilating response to intracoronary adenosine infusion was assessed. Continuous adenosine infusion, at a rate of 2.5 to 13.5 mumol . min-1, produced rapid (15 to 30s) vasodilation of the same degree as that evoked by a 30 s period of ischaemia (reactive peak hyperaemia), a finding reported previously by others. However, continuing the infusion led to further coronary vasodilation, reaching a maximum 20 to 45 min from the beginning of the infusion and remaining constant for up to 2 h, independently of further increases in the dose. This late response produced, on average, vasodilatation twice as great as that observed during reactive hyperaemia and was not associated with any haemodynamic change or with the opening of arterio-venous shunts. THE RESULTS: 1) suggest the existence of a double, time-dependent response of coronary receptor(s) to adenosine; 2) demonstrate, in the presence of a prolonged vasodilating stimulus, a possible increase in coronary blood flow to a degree far beyond that of post-ischaemic reactive peak flow, which is generally considered to be the maximal value of coronary blood flow that can be achieved.

The low Mr phosphotyrosine protein phosphatase behaves differently when phosphorylated at Tyr131 or Tyr132 by Src kinase.

The low molecular weight phosphotyrosine protein phosphatase (LMW-PTP) is phosphorylated by Src and Src-related kinases both in vitro and in vivo; in Jurkat cells, and in NIH-3T3 cells, it becomes tyrosine-phosphorylated upon stimulation by PDGF. In this study we show that pp60Src phosphorylates in vitro the enzyme at two tyrosine residues, Tyr131 and Tyr132, previously indicated as the main phosphorylation sites of the enzyme, whereas phosphorylation by the PDGF-R kinase is much less effective and not specific. The effects of LMW-PTP phosphorylation at each tyrosine residue were investigated by using Tyr131 and Tyr132 mutants. We found that the phosphorylation at either residue has differing effects on the enzyme behaviour: Tyr131 phosphorylation is followed by a strong (about 25-fold) increase of the enzyme specific activity, whereas phosphorylation at Tyr132 leads to Grb2 recruitment. These differing effects are discussed on the light of the enzyme structure.

Paraparesis in hereditary multiple exostoses: case report.

The authors report a case of hereditary multiple exostoses (HME) with neurologic complications, and review the literature. A 23-year-old man exhibited a worsening spastic paraparesis with sphincter dysfunction. The cranial nerves and the exteroceptive and deep sensations were apparently undamaged. The family history, the physical examination, and the systemic radiologic examination revealed all the characteristics of HME. The neurologic complication was caused by an exostosis, arising from the C2 right hemilamina, compressing the spinal cord. The patient quickly improved after a laminectomy.

Simultaneous in vitro and in vivo validation of nitrogen-13-ammonia for the assessment of regional myocardial blood flow.

Measurement of myocardial blood flow by 13NH3 relies heavily on the assessment of both the input function and the variable tissue extraction fraction. In six open-chest dogs, myocardial and arterial 13NH3 activity was measured both by in vitro sampling and by in vivo positron emission tomography (PET). Regional myocardial blood flow was forced to vary in the range 0.2-5 ml/min/g and actual values were assessed by in vitro counting of 153Gd microspheres. The ammonia input function was processed by: (a) total curve integration; (b) curve integration for 2 min; (c) integral of a fitted curve (gamma variate in vivo and exponential of the downslope in vitro). Method C brought to regional flow values which best approximated microspheres data. The in vitro correlation allows for correcting in vivo values for the flow-dependent extraction fraction. The method can be easily applied for regional myocardial blood flow measurements with PET in human studies.

Detection of perfusion defects during coronary occlusion and myocardial reperfusion after thrombolysis by intravenous administration of the echo-enhancing agent BR1.

The purpose of this study was to detect myocardial perfusion defects as a result of coronary occlusion and myocardial reperfusion after thrombolysis with intravenous (i.v.) administration of the echo contrast agent BR1 (Bracco Research, Switzerland), which consists of microbubbles (median diameter 2.5 microm) containing sulfur exafluoride in a phospholipidic shell. To generate a coronary thrombosis, a copper coil was advanced into the left circumflex coronary artery in eight anesthetized dogs with opened chest cavities. Coronary occlusion occurred 18 +/- 10 minutes after the insertion of the coil and was documented both by an electromagnetic flow meter (as zero blood flow) and by radiolabeled microspheres (as myocardial perfusion defect). After 2 hours of occlusion, streptokinase was infused i.v.; reperfusion was documented by both the flow-meter and microspheres. Left ventricular cavity enhancement was apparent after all contrast injections. Peak cavity intensity did not increase with dose and was not affected by signal processing (suggesting signal saturation), whereas the duration of contrast effect significantly increased with the dose (from 26 +/- 16 to 147 +/- 74 seconds). Myocardial contrast intensity also increased after contrast (from 15 +/- 12 to 21 +/- 18 gray level/pixel, p < 0.001). Contrast echo detected myocardial perfusion defects (corresponding to 17% +/- 11% of LV cross-sectional area) in all the injections performed during coronary occlusion and detected myocardial reperfusion with a sensitivity of 50% versus microspheres. The extent of perfusion defects by contrast echo showed a good correlation with microspheres (r = 0.73). Myocardial reperfusion was not detected by changes in heart rate, aortic pressure, pulmonary arterial pressure, cardiac output, left ventricular fractional area change, or wall-motion score index. Hemodynamic parameters were not affected by contrast injections. Thus, the i.v. administration of BR1 allows us to accurately detect myocardial perfusion defects during coronary occlusion and, to a lesser extent, myocardial reperfusion after thrombolysis.

Secretory polymorphism and serous cutaneous gland heterogeneity in Bufo granulosus (Amphibia, Anura).

Three types of secretory products (a, b and c) in the poison glands of the Argentine toad Bufo granulosus have been detected under light microscope. The type a secretory product consists of granules of homogeneous density, type b of vesicles with a translucent compartment and type c of granules of varying density. Subsequent transmission electron microscope analysis disclosed obvious similarities in the secretory pathways of type a and c granules; the differences detected under light microscope are due to the functional phases observed. On the contrary, production of type b secretory vesicles involves a distinctive pathway. Therefore, two classes of glands (I and II) have been identified. Glands of the first class are typical of bufonid toads and produce granules provided with repeating substructure; glands of the second class, which manufacture a lucent product, are unusual in the family Bufonidae. Ultrastructural differences, consistent with the two gland classes, have also been described in the myoepithelia. The myocytes ensheathing class I secretory units possess striking cytoskeletal specializations, whereas those of class II glands are rich in sarcoplasmic reticulum. The distinctive ultrastructural traits detected in these myoepithelial cells have been compared with the results of previous studies on the dimorphic serous glands of Bombina. Findings point to the use of pharmacological treatment on the skin of anurans with different classes of serous glands to elicit differential secretory discharge.

[Lymph node staging in prostatic carcinoma Lymphography, pedal and intraprostatic lymphoscintigraphy, transcutaneous fine-needle lymph node biopsy and pelvic "guided" lymphadenectomy. Considerations on a series of 20 cases (1 September 1978-31 January 1980)]. / Lo staging linfonodale del carcinoma della prostata. Linfografia, linfoscintigrafia pedidia ed intraprostatica, biopsia linfonodale transcutanea con ago sottile e linfadenectomia pelvica "orientata". Considerazioni su una serie di 20 casi (1-9-1978/31-1-1980).

Evaluation of lymph node involvement in carcinoma of the prostate is an essential step in staging when radical management is still possible. For this purpose, lymphography, lymphoscintigraphy, thin-needle transcutaneous lymph node biopsy, and pelvic lymphadenectomy have been variously combined since 1978 in 20 new cases (T1-T2-T3/Mo). Pedal lymphography displayed a good correlation with the histological data offered by adenectomy, and proved indispensable for the execution of transcutaneous biopsy under fluoroscopic control. Pedal lymphoscintigraphy is less invasive than lymphography. It provided suggestive morphological pictures of the lymph node chains, including those outside the pelvis; these, however, were difficult to interpret and must be regarded as of great, but complementary utility. Intraprostatic lymphoscintigraphy by injecting the radionuclide into the gland capsule permitted visualisation of the periprostatic nodes and confirmed previous experimental and clinical data. Lymph node metastases were seen in 50% of cases. Their frequency was inversely proportional to the degree of histological differentiation. In all cases, the external iliac and "obturator" (internal chain of external iliac group) notes were involved. Voluminous metastases were observed in two cases of "incidental" (To) carcinoma. The lymphography contrast medium was always found in the "obturators". It is suggested that these findings underscore the need for careful lymph node examination, even in the earliest stages of prostate cancer. They also raise further queries with regard to the treatment of incidental carcinoma.

Investigations of impact biomechanics for penetrating ballistic cases.

This study aims to investigate the penetration of a projectile into a surrogate human tissue numerically, using Finite Element (FE) simulation. 20% Balistic Gelatin material (BG) is simulated with an elasto-plastic hydrodynamic constitutive law, and then impacted by steel spheres at different velocities. The results from the FE simulations are compared with existing experimental data and other analytical equations from the literature. To our knowledge, this is the first study to investigate a projectile penetration by numerical simulation, and then compare the results with analytical and experimental data from previous studies. This developed model gives encouraging results for further investigations of penetrating impact of projectile in the human body.

[Extramedullary erythropoiesis in the posterior mediastinum: clinical and radiological aspects of the authors' own case (Cooley's disease)]. / Eritropoiesi extramidollare nel mediastino posteriore: considerazioni clinico-radiologiche su di una osservazione personale (morbo di Cooley).

A case of intrathoracic extramedullary hematopoiesis, during Cooley's disease in a 38 year old male, is analysed, especially from the point of view of its radiological signs. The combination of radiological, clinical and laboratory findings makes the interpretation of the radiographs more precise. The radiologic diagnosis is essential because it makes it possible to avoid biopsy or surgery which can be harmful because of the extreme vascularity of this erythropoietic tissue. This avoids excision of these masses and thus avoids exacerbation the anemia.

[Evaluation of the chest roentgenograms of 90 workers employed in the production of silicon-alloys (author's transl)]. / Valutazione dell'esame radiologico del torace di 90 operai addetti alla produzione di leghe al silico.

The chest X-rays (double exposed; focus 0.6 X 0.6 mm2; grid 10:1 ratio; FFD 2.0 m) of 90 workers employed in the production of silicon-alloys were classified according to ILO U/C 1971: 14 have been considered "border line" and 14 showed definite pathologic findings. Among the last, 10 concerned subjects who had never previously been exposed to ther dusts.

[A case of pseudophlebitis of the great saphenous vein: focal nodular myositis of the gracilis muscle]. / A propos d'un cas de pseudophlébite de la grande veine saphène: une myosite nodulaire focale du muscle gracilis.

A case of focal myositis in a healthy 68-year-old woman is described. The patient was admitted for evaluation of a painful soft-tissue mass localised on the medial side of the left thigh, initially misdiagnosed as thrombophlebitis of the v. saphena magna. Laboratory data were normal, in particular sedimentation rate and muscle enzyme levels. After exclusion of venous thrombosis, the mass localised in the left m. gracilis was surgically removed. Histologic examination of the biopsy specimen showed muscle cell necrosis and severe inflammation, with lymphocytic infiltration leading to the diagnosis of focal myositis. This is a rare benign inflammatory pseudotumour of skeletal muscle. The aetiology and pathogenesis of the disease remain unclear. It is most commonly seen in the lower extremities and may mimic thrombophlebitis or soft-tissue neoplasm. Ultrasound and magnetic-resonance scans are helpful, but definitive diagnosis is obtained only by histology. Because recurrent lesions in other skeletal muscles are possible, and a third of patients develop polymyositis, a follow-up of several years is recommended.

[Lymphography in staging prostatic cancer: correlations between the histo-pathological, anatomic and radiologic results in 30 patients. The role of transcutaneous lymph node biopsy]. / La linfografia nella stadiazione del carcinoma della prostata: correlazioni fra i risultati istopatologici, anatomici e radiologici in 30 pazienti. Il ruolo della biopsia linfonodale transcutanea.

Between September 1, 1978 and March 1, 1981, 35 patients with prostatic carcinoma, apparently localized (T0-3) and histologically proved, underwent pedal lymphography. 30 out of 35 underwent cytologic and/or histopathologic examination of pelvic lymph nodes, either by transcutaneous thin needle biopsy and/or pelvic lymphadenectomy. Prospective analysis demonstrated an overall lymphographic sensitivity of 84.2%, specificity of 73.7%, positive accuracy of 68.7% and negative accuracy of 78.5%. The authors herein underline the usefulness of lymphography and lymph node biopsy which, if cytologic positiveness occurs, allows to avoid pelvic lymphadenectomy.