The impact of COVID-19 pandemic control on vaccine-preventable invasive bacterial diseases in Piedmont (Italy).

PURPOSE: The impact of SARS-CoV-2 pandemic on other pathogens is largely unknown. We aimed to compare the prevalence of vaccine-preventable invasive bacterial infections before and during the pandemic in Piedmont (Italy). METHODS: We defined the monthly incidence of S. pneumoniae, H. influenzae and N. meningitides-invasive diseases from January 2010 to June 2021. Then, we compared the mean monthly cases during the previous 5 years (2015-2019) and the monthly cases in 2020 or 2021. RESULTS: We found significant reductions for invasive pneumococcal diseases (IPDs) in adults and H. influenzae-invasive diseases in 2020 and 2021 in comparison to the previous years, but not for invasive meningococcal diseases and IPDs in children. CONCLUSIONS: Further data are needed to confirm these findings and define possible post-pandemic evolutions in the epidemiology of vaccine-preventable invasive bacterial diseases.

Cloning and characterization of a novel member of protein kinase family from soybean.

The cDNA coding for a novel protein kinase from soybean (Glycine max L.), named GmPK6, was sequenced. The primary sequence of GmPK6 consists of 462 amino acids with an N-terminal sequence similar to the central region of Xenopus U1 snRNP 70K protein, and a C-terminal kinase domain representing structural mosaicism with features diagnostic of both protein serine/threonine and tyrosine kinases in eukaryotic organisms. The GmPK6 gene is expressed as 2.5 kb transcript in a variety of tissues.

First experience with the Lithoring in the management of urinary stones.

The Lithoring Multi-One is a lithotripter recently developed in Italy. Its main features are (1) spark gap generator with large ellipsoid, with tunable power for treatments with or without analgesia; (2) localization by fluoroscopy and ultrasounds without moving the patient; (3) isocentric variation of shock wave window, and (4) multifunctional table. It can treat both urinary and biliary stones. The first 50 patients were treated without anesthesia with an average of 1,700 shock waves at 19.2 kV. 37 patients had stones larger than 1 cm. 13 patients had ureteral stones. Two patients had complete staghorn stones. The disintegration rate was 97.9%, the overall stone-free rate at 3 months' follow-up was 83.3%, and the retreatment rate was 1.29 treatments for patients. No complication occurred.

Molecular identification of a soybean protein kinase gene family by using PCR.

In this study we report identification of six members of a protein kinase gene family from soybean (Glycine max L.). Two fully degenerate oligonucleotide primers corresponding to two conserved motifs (DLK-PENV and GTHEYLAPE) in the catalytic domains of eukaryotic protein serine/threonine kinases were used in a polymerase chain reaction (PCR) to amplify soybean cDNA. Sequence analysis showed that 28 of the PCR sequences represented six different putative protein serine/threonine kinases. These results not only demonstrate that catalytic domains of protein kinases are highly conserved between plants and other eukaryotes but also suggest that there are multiple genes encoding protein kinases in plants.

[Exploration of the intra-renal collecting system using flexible fibroscopy]. / Exploración del sistema colector intrarrenal a través de fibroscopia flexible.

23 cases of flexible retrograde nephroscopy system for undiagnosed hematuria or filling defect are reviewed. The introduction was carried out by combining hydraulic dilation, rigid ureterorenoscopy and a working sheath. The indications were merely diagnostic (filling defects and/or haematuria). The success rate was very high (22 of 23). 9 cases of papillary tumors, 4 cases of small radiolucent stones and 1 case of papillary necrosis were diagnosed. In 8 cases no pathology was found. The complication rate was extremely low and the postoperative course was uneventful. Flexible instruments offer a very good chance to explore the intrarenal collecting system and transureteral nephroscopy through a 10.8 F flexible scope is a feasible and effective procedure.

Molecular cloning and biochemical characterization of a receptor-like serine/threonine kinase from rice.

A receptor-like protein kinase, OsPK10, has been cloned from rice (Oryza sativa). The 2.8 kb cDNA contains an open reading frame capable of encoding a peptide sequence of 824 amino acids. The topological features of the predicted OsPK10 protein include an N-terminal signal peptide, a cysteine-rich extracellular ligand-binding domain, a membrane-spanning segment, and a cytoplasmic domain possessing all the hallmarks of catalytic domains of eukaryotic protein kinases. The cytoplasmic domain was selectively expressed in Escherichia coli and assayed for kinase activity. The results show the protein is capable of autophosphorylation using either ATP or GTP as the phosphate donor. Phosphoamino acid analysis reveals phosphorylation of threonines, consistent with the substrate specificity indicated by sequence motifs in the catalytic core. A single amino acid substitution of Glu for Lys-528 completely abolishes autophosphorylation activity. DNA gel blot analyses suggest that the haploid rice genome contains a single copy of the OsPK10 gene. OsPK10 transcripts appear to be more abundant in shoots than in roots of rice seedlings.

Age-related transcranial Doppler findings in the evaluation of cerebral circulation during postprandial and postural tests.

We used transcranial Doppler (TCD) to investigate whether there are cerebral circulation differences between young and elderly subjects in response to postprandial postural changes. Preprandial and postprandial systolic and diastolic blood pressure, heart rate, mean middle cerebral artery (MCA) velocity (Vmean MCA), systolic/diastolic MCA velocity ratio (Vs/Vd MCA) and pulsatility index (PI) were determined in 15 healthy elderly subjects (mean age 74.3 +/- 6.5 years) and in 10 younger subjects (mean age 31.6 +/- 7. 2 years) in the supine position and after a postural change. As compared with young subjects, elderly ones showed a greater postprandial systolic pressure decline (p < 0.05) associated with a significant decrease of Vmean MCA (p < 0.05), and a greater increase of Vs/Vd and PI (p < 0.05 both). We conclude that, as compared with young subjects, elderly ones have reduced cerebrovascular adaptive response to pressure modifications induced by postprandial postural changes.

Role of the variable domain in modulating potato spindle tuber viroid replication.

Potato spindle tuber viroid (PSTVd) is believed to undergo a series of specific structural transitions during replication. The variable domain of PSTVd is known to contain sequences that are important for replication/accumulation as well as one of three "premelting regions" which control breakdown of the native structure in vitro. We have examined the structural and biological effects of five single and two double nucleotide substitutions within premelting region 3 in an effort to isolate temperature-sensitive mutations affecting PSTVd replication or pathogenesis. None of these mutants replicated as rapidly as the wild type, and a variety of spontaneous sequence changes were detected in their progeny. Higher temperatures were able to partially overcome the inhibition of replication associated with a more stable secondary structure, but no well-defined temperature-sensitive PSTVd mutants were identified. Selective pressures arising from the interaction of assay temperature and structural stability in vivo appear capable of moving PSTVd populations between peaks of relatively high fitness. Depending on the exact nature and location of the mutation, selection may occur at the level of either the plus or the minus strand.

Flexible antegrade and retrograde nephroscopy: review of 50 cases.

50 cases of flexible instrumentation of the intrarenal collecting system are reviewed. 28 were performed by retrograde flexible ureterorenoscopy. The introduction was carried out by combining hydraulic dilation, rigid ureterorenoscopy and a working sheath. 22 cases were performed through a percutaneous route. The indications were both diagnostic (filling defects and/or hematuria) and therapeutic (caliceal stone and/or fragments). The success rate was high in the diagnostic cases (20 of 24), but lower in the therapeutic cases (13 of 26). The complication rate was extremely low and the postoperative course was always uneventful. Flexible instruments offer a very good chance to explore the intrarenal collecting system. Both transureteral and percutaneous flexible nephroscopies are feasible and effective procedures. A laser can be used well in this area.

Obstetric and gynaecological ureteric injuries: treatment and results.

OBJECTIVE: To compare endourological techniques and open surgery in the treatment of ureteric injuries following obstetric and gynaecological surgery. PATIENTS AND METHODS: From January 1982 to February 1994, 63 women (mean age 51 years, range 22-70) were treated for 72 ureteric lesions consequent upon obstetric or gynaecological surgery. In nine patients, 10 ureteric lesions were detected intra-operatively and repaired immediately. In the remaining 54 patients, the 62 ureteric injuries were diagnosed and treated after a delay; 29 patients with 37 ureteric injuries underwent repair by open surgery while 25 patients with a unilateral ureteric lesion underwent elective primary endourological treatment. RESULTS: The results of repair were not related to the type of treatment; the cure rate was 87, 88 and 90% for delayed open surgical, endourological and immediate intra-operative repair, respectively. The site (vesico-ureteric junction, uterine artery or infundibulopelvic ligament) and the type (fistula or stenosis) of ureteric lesion had no influence on the results, regardless of the type of treatment. The results of ureteric repair were related to the surgery that caused the lesion; 88% of the poor results occurred in the patients who underwent radical hysterectomy alone or combined with radiotherapy and approximately half of the irradiated patients required major surgery. CONCLUSION: When the patients are correctly selected, endourological treatment plays an equally important role in the treatment of gynaecologically-related ureteric injuries when compared to open surgery. Special attention should be paid to the treatment of lesions caused by radical hysterectomy alone or associated with radiotherapy, as these may lead to poor results.

Angiographic treatment of high-flow priapism.

Priapism can be successfully treated by unilateral or bilateral percutaneous transcatheter occlusion of the internal pudendal arteries. Occlusion should be reversible in order to avoid impotence. Embolization with an autologous clot satisfies this requirement because of clot lysis and consequent vessel recanalization. This treatment is the most specific therapy in 'high-flow' priapism. The authors describe extensively 5 cases which demonstrate the feasibility of the method by which sexual potency is preserved.

Anther culture of wheat (Triticum aestivum L.) F1's and their reciprocal crosses.

Anthers from three sets of wheat (Triticum aestivum L. em. Thell) F1's and their reciprocal crosses, made between parental lines differing greatly in their ability to produce microspore derived callus, were cultured on the Chinese potato medium so that we could 1) more clearly define the role of nuclear or cytoplasmic factors within T. aestivum in transferring the ability to undergo in vitro androgenesis, and 2) to briefly review the gametic representation and disease screening potential of the resulting polyhaploid wheat plants. The microspore derived calli values from F1's were slightly less than the midparental value. Statistical analysis indicated that the ability of each F1 to produce callus either did not significantly differ from that of the respective parental line having the highest androgenic yield or it exceeded its respective parental line having the lowest yield. No differences were noted between the members of each pair of reciprocal crosses. The results indicate that the transfer of in vitro androgenic ability to F1 hybrids is not dependent upon the maternal cytoplasm source. Polyhaploid plants, carrying the Pm 3 a powdery mildew resistance gene, expressed resistance to culture 4 a of powdery mildew.

Extracorporeal shock wave lithotripsy in the prone position for stones situated anteriorly.

Stones situated anteriorly cannot be satisfactorily reached with extracorporeal shock wave lithotripsy (ESWL) in the supine position. By assuming the prone position, patients with stones in horseshoe or ectopic kidneys or in the iliac ureter can be treated by ESWL with the same success rate as patients with posterior stones. This new technique has been used in 30 patients with iliac ureteral stones, 5 patients with caliceal stones in horseshoe kidneys and 1 patient with a pyelic stone in a sacral kidney.

Percutaneous debulking of staghorn stones combined with extracorporeal shockwave lithotripsy: results and complications.

The results and complications of 122 percutaneous debulking of staghorn stones are carefully reviewed, discriminating between dilated and not dilated kidneys. Percutaneous debulking can be defined as satisfactory in about 70% of the cases. In the remaining 30% of the cases (mostly not dilated kidneys) it has got little or no results. The overall complication rate is quite low and most of the common complications can be prevented. Percutaneous procedures in nondilated kidneys have an overall complication rate highly superior to that in dilated kidneys. It should be preferable to treat as many staghorn stones as possible in nondilated kidneys with staged extracorporeal shockwave lithotripsy (ESWL) monotherapy, stenting the ureter and monitoring the urinary infection. Struvite stones are best suitable for stented ESWL because of their fragility. In case of cystine or oxalate monohydrate staghorn stone open surgery might be preferable in virgin patients, but it is often refused by the patients.

Percutaneous transcatheter renal angioplasty: an endourological experience.

A series of 56 percutaneous transcatheter renal angioplasties, carried out in an endourological unit, is reviewed and compared with radiological series. The results were inferior for fibrosclerotic lesions (77 vs. 90%) and nonostial atherosclerosis (67.8 vs. 75%), but slightly superior for ostial lesions (33 vs. 20-30%) in the endourological series as compared with the radiological series. Conversely, morbidity was significantly inferior (8.9 vs. 18.6%). The endourological series compares well with the radiological series in the literature. Percutaneous transcatheter renal angioplasty should be considered a procedure belonging both to interventional radiology and to endourology. Owing to the technical difficulties and the complication rate, it should not be performed in outpatients and a surgical support team should be available in the event of a threatening renal complication.

Restoration of shooty morphology of a nontumorous mutant of Nicotiana glauca x N. langsdorffii by cytokinin and the isopentenyltransferase gene.

The shooty morphology of a nontumorous amphidiploid mutant of Nicotiana glauca Grah. x N. langsdorffii Weinm. was restored by cytokinins, whether exogenously applied or endogenously produced by transformation of the mutant with a transfer DNA (T-DNA) cytokinin-biosynthesis gene (isopentenyltransferase; ipt). Auxins alone did not confer this effect. Similar transformation was not achieved for the parental species. In the case of transformation with the ipt gene, selection of the transformed tissues was based on its hormone-independent growth in the presence of the antibiotic kanamycin. Transformed tissues exhibited a shooty morphology, indistinguishable from that of wildtype genetic tumors N. glauca x N. langsdorffii. This altered phenotype was caused by the presence and constitutive expression of the ipt gene. The insertion and expression of this gene in transformed tissues was confirmed by using the polymerase chain reaction (PCR) technique as well as conventional molecular hybridization analysis. Expression of the ipt gene led to an elevated level of cytokinin in the transformed mutant tissues. This evidence supports the notion that genetic tumors are caused, at least in part, by elevated levels of cytokinin in interspecific hybrids.

[Extracorporeal lithotripsy using the Lithoring multi-one, a third generation lithotripter]. / Litotrissia extracorporea con il lithoring multi-one, litotritore di terza generazione.

The Lithoring multi-one is a lithotripter recently developed in Italy. Its main features are: (1) spark gap generator with large ellipsoid with tunable power for treatments with or without analgesia (2) localization by fluoroscopy and ultrasounds without moving the patient (3) isocentric variation of shock wave window (4) multi-functional table. It can treat both urinary and biliary stones. Herein we described (1) the experimental in vitro studies, including those carried out by intentionally changing the direction of the blast path during the treatment (2) the experimental in vivo studies on pigs which demonstrated a rate of side effects favourably comparable with that of other spark gap lithotripters (3) the clinical experience on urinary stones which started in May, 1989. The first 50 patients were treated without anaesthesia with an average of 1700 shock waves at 19.2 Kv. 37 patients had stones larger than 1 cm. 13 patients had ureteral stones. Two patients had complete staghorn stones. The disintegration rate was 97.9 percent, the overall stone-free rate at 3 months follow-up was 83.3 percent and the retreatment rate was 1.29 treatments for patients. No complication occurred.

Painless extracorporeal shock wave lithotripsy for outpatients: a new option.

Extracorporeal shock wave lithotripsy is becoming the most common procedure for the treatment of renal and ureteral stones. The introduction of a new generator and a new hemi-ellipsoid for the Dornier HM-III lithotripter improves patient comfort and requires no general or peridural anesthesia, thus making it easier to perform this procedure on an outpatient basis.

In situ or retrograde manipulation of ureteral stones: still a controversy?

A series of 365 patients with ureteral stones is reviewed. ESWL, ureterorenoscopy, basket extraction and open surgery were alternatively used according to the stone and to the increasing experience in minimally invasive techniques. The overall success rate of in situ ESWL varied between 79 and 90% according to the localization of the stone and no difference was noted between patients treated with the original HM III Dornier lithotriptor and patients treated with the upgraded HM III with low pressure and large ellipsoid for painfree ESWL. Also the retreatment rate did not differ significantly (38 vs 42%). Ureterorenoscopy, carried out as first approach or after ESWL failure, was successful in 80.4% of the cases. Basket extraction was successful only in 32.3% of the cases. In situ ESWL, in one or two sessions, without anaesthesia and without hospital stay, is a good solution for roughly 80% of ureteral stones. Retrograde manipulation with or without ureterorenoscopy, requiring anaesthesia and hospitalization, should be reserved to failures of in situ ESWL.

Percutaneous temporary embolization of the internal pudendal arteries in idiopathic priapism: 2 additional cases.

We report 2 cases of successful treatment of priapism by transcatheter embolization of the internal pudendal arteries. Recovery of penile blood flow was confirmed by Doppler flowmetry and potency was preserved. Embolization with autologous clot is at least partially reversible and interventional angiography warrants consideration in the treatment of priapism.