Spatiotemporal dynamics of the electrical network activity in the root apex.

The study of electrical network systems, integrated with chemical signaling networks, is becoming a common trend in contemporary biology. Classical techniques are limited to the assessment of signals from doublets or triplets of cells at a fixed temporal bin width. At present, full characteristics of the electrical network distribution and dynamics in plant cells and tissues has not been established. Here, a 60-channels multielectrode array (MEA) is applied to study spatiotemporal characteristics of the electrical network activity of the root apex. Both intense spontaneous electrical activities and stimulation-elicited bursts of locally propagating electrical signals have been observed. Propagation of the spikes indicates the existence of excitable traveling waves in plants, similar to those observed in non-nerve electrogenic tissues of animals. Obtained data reveal synchronous electric activities of root cells emerging in a specific root apex region. The dynamic electrochemical activity of root apex cells is proposed to continuously integrate internal and external signaling for developmental adaptations in a changing environment.

In-patient rehabilitation in haemophilic subjects with total knee arthroplasty.

Total knee arthroplasty (TKA) is a major orthopaedic surgery intervention, indicated for severe haemophilic arthropathy. The aim of our study was to analyse rehabilitation outcome in haemophilic patients after TKA. A consecutive series of 21 patients (23 knees) was retrospectively evaluated. The mean age was 37 ± 8 years (range 22-55). Physiotherapy treatment was performed twice a day for 5 days week⁻¹, for 3 h day⁻¹. Assessment included knee range of motion (ROM), Visual Analogue Scale (VAS) for pain evaluation, Western Ontario and McMaster University (WOMAC) Score for functional outcome, Medical Research Council Scale (MRC) for quadriceps muscle strength evaluation, incidence of adverse events and a self-reported questionnaire. The patients'data were recorded before surgery (t0), at Rehabilitation Unit admission (t1), before discharge (t2) and at follow-up (t3), 11-48 months after rehabilitation. Western Ontario and McMaster University Score (ref. score: 0-96) was 56.7 ± 12 at t0 and 6.2 ± 6 at t3 (t3 vs. t0: P < 0.001). Visual Analogue Scale (ref. score: 0-10) decreased from 5.0 ± 2 at t1 to 2.1 ± 2 at t2 (t2 vs. t1: P < 0.05) and to 0.1 ± 0 at t3 (t3 vs. t2: P < 0.05). Flexion degrees increased from 43.4 ± 21° at t1 to 80.2 ± 15° at t2 (t2 vs. t1: P < 0.001) and to 95.0 ± 15° at t3 (t3 vs t2: P < 0.05). According to MRC (ref. score: 0-5), quadriceps muscle strength increased from 2.3 ± 0.6 at t1 to 3.6 ± 0.5 at t2 (t2 vs. t1: P < 0.05). Adverse events were found in four patients. Patients' satisfaction on their outcome at follow-up was referred as good by 72% of patients or excellent by 28% of patients. Postsurgical intensive rehabilitation in haemophilic patients resulted effective, safe and feasible.

Extrafloral-nectar-based partner manipulation in plant-ant relationships.

Plant-ant interactions are generally considered as mutualisms, with both parties gaining benefits from the association. It has recently emerged that some of these mutualistic associations have, however, evolved towards other forms of relationships and, in particular, that plants may manipulate their partner ants to make reciprocation more beneficial, thereby stabilizing the mutualism. Focusing on plants bearing extrafloral nectaries, we review recent studies and address three key questions: (i) how can plants attract potential partners and maintain their services; (ii) are there compounds in extrafloral nectar that could mediate partner manipulation; and (iii) are ants susceptible to such compounds? After reviewing the current knowledge on plant-ant associations, we propose a possible scenario where plant-derived chemicals, such as secondary metabolites, known to have an impact on animal brain, could have evolved in plants to attract and manipulate ant behaviour. This new viewpoint would place plant-animal interaction in a different ecological context, opening new ecological and neurobiological perspectives of drug seeking and use.

Lack of growth hormone response to acute administration of dexamethasone in anorexia nervosa.

High plasma growth hormone (GH) levels, associated with abnormal hormone responses to provocative stimuli, point to an altered GH secretion in anorexia nervosa. The GH-releasing effect of acutely administered glucocorticoids, firmly established in normal subjects, has not been reported in these patients. In this study, acute iv administration of 4 mg of dexamethasone, compared with saline, increased plasma GH in nine normal-weight women (AUC 848.2 +/- 127.95 vs 242.8 +/- 55.35 micrograms.l-1.min-1, p < 0.05, respectively) but was ineffective in 11 anorectic patients (AUC 3271.8 +/- 1407.11 vs 2780.0 +/- 1162.04 micrograms.l-1.min-1, NS). After dexamethasone, a significant lowering of plasma cortisol was observed in normal women (AUC 25367.0 +/- 3128.43 vs 47347.1 +/- 4456.61 nmol.l-1.min-1, after dexamethasone and saline, respectively, p < 0.05), but not in anorectic patients (AUC 77809.3 +/- 8499.92 vs 78454.9 +/- 7603.62 nmol.l-1.min-1, NS). In both groups, plasma adrenocorticotrophin (ACTH) displayed a significant decrease after dexamethasone (AUC 523.6 +/- 92.08 vs 874.2 +/- 115.03 pmol.l-1.min-1, p < 0.05, after dexamethasone and saline, respectively, in anorectic patients and 377.5 +/- 38.41 vs 1004.9 +/- 200.51 pmol.l-1.min-1, p < 0.05, in controls). However, when considering the hormonal decremental areas, a significant dexamethasone-induced ACTH inhibition, compared to saline, was evidenced in normal (delta AUC -414.4 +/- 65.75 vs 222.9 +/- 42.40 pmol.l-1.min-1, p < 0.05) but not in anorectic women (delta AUC -254.2 +/- 96.92 vs 2.9 +/- 132.32 pmol.l-1.min-1, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly associated with a granular cell tumor of the neurohypophysis: a clinical and histological study. Case report.

Acromegaly is usually caused by a growth hormone (GH)-secreting pituitary adenoma, and hypersecretion of GH-releasing hormone (GHRH) from a hypothalamic or neuroendocrine tumor accounts for other cases. The authors report on the unusual association of acromegaly with a granular cell tumor of the neurohypophysis. A 42-year-old woman with a 10-year history of acral enlargement, headache, and menstrual abnormalities was referred to our department for a suspected GH-secreting pituitary adenoma. The patient's basal GH levels were mildly elevated at 4.8 microg/L, were not suppressed in response to an oral glucose tolerance test, and increased paradoxically after administration of thyrotropin-releasing hormone. The patient's insulin-like growth factor-1 (IGF-1) level was elevated at 462 microg/L, whereas a magnetic resonance image of the sella turcica revealed an intra- and suprasellar lesion that was compatible with a diagnosis of pituitary adenoma. A transsphenoidal approach to remove the lesion, which was mainly suprasellar, was successful during a second operative attempt, resulting in the clinical and biochemical regression of the patient's acromegaly. Four months postoperatively, the patient's basal GH level was 0.9 microg/L and her IGF-1 level was 140 microg/L. Histological analysis of the operative specimen demonstrated a granular cell tumor of the neurohypophysis, which when stained proved negative for pituitary hormones and GHRH. This case represents the first reported association between a granular cell tumor of the neurohypophysis and acromegaly. Granular cell tumor of the neurohypophysis could be added to the restricted list of neoplastic causes of acromegaly secondary to hypersecretion of a GH-releasing substance.

[Association of hyperthyroidism and diabetes mellitus. Description of a case with partial recovery of pancreatic beta-islet function]. / Associazione di ipertiroidismo e diabete mellito. Descrizione di un caso con parziale ripristino della funzione pancreatica beta-insulare.

The coexistence of Graves' disease and insulin-dependent diabetes mellitus is well known among autoimmune polyglandular syndromes and sustained by common underlying immune pathogenic factors. Hyperthyroidism itself may lead to impaired glucose tolerance in subjects with intact beta-cell function through various not well clarified mechanisms and treatment of thyroid hyperfunction, on the other side, generally ameliorates the degree of metabolic control when diabetes is pre- and/or coexisting. We report a case of Graves' disease associated with diabetes mellitus, in which a partial recovery of insulin secretion is documented after euthyroidism was restored.

[Blood glucose and insulin responses to oral glucose in hyperthyroidism]. / Risposta glicemica ed insulinemica al glucosio orale nell'ipertiroidismo.

Because thyroid hyperfunction "per sè" can induce impaired glucose tolerance in 2-57% of patients, we have studied glycaemic and insulinaemic response to oral glucose load (OGTT) in this condition. Glycaemic and insulinaemic curves after oral glucose (100 g), the respective secretory areas (AUC-G and AUC-IRI) have been determined in 13 hyperthyroid patients (8 Graves disease, 4 multinodular toxic goiters and 1 Plummer's adenoma) and in 16 healthy control subjects. AUC-G, AUC-IRI and median values of G and IRI in most of considered times have resulted significantly greater in hyperthyroid patients. This study has confirmed the impact of thyroid hyperfunction on carbohydrate metabolism, but has not proved an impaired insulin secretion as previously reported in Literature. In conclusion, we believe that: a) hyperthyroidism is associated with greater circulating levels of G and IRI, b) hyperinsulinaemia in addition to hyperglycaemia suggests that insulin-resistance is underlying in this condition.

[Hyperfunctioning thyroid carcinoma. Description of a case]. / Carcinoma tiroideo iperfunzionante. Descrizione di un caso.

Differentiated thyroid cancers account for 1% of all neoplasias but only for 2.3% of thyroid nodules. A particular condition is represented by the association with hyperthyroidism, which is found in about 7% of cases. Even more rarely may be themselves cause of thyrotoxicosis. In the present paper, the case of a 66-year old male patient, bearing a recently appeared goiter, referred to us for suspicion of lung cancer and hyperthyroid symptoms, is reported. Among appropriate investigations, the finding of high titer of thyroglobulin in the aspiration needle and cytology examination suggested that thyroid lesion was primary and not metastatic, while scintiscan with J-131 isotope showed that excess of thyroid hormones was just due to it; histological diagnosis was of papillary carcinoma. As to the pathogenesis of the neoplasma during hyperthyroidism, a causal role of thyroid stimulating auto-antibodies has been suggested in the cases associated with Graves' disease, absent in our patient, which could elicitate cancer progression in the mean time. Interestingly, activating mutation of thyroid hormone receptor (TSH-r) gene has been demonstrated in a hyperfunctioning differentiated cancer. Notwithstanding the unexpected clinical behaviour may appear very rare, molecular biology studies on aspiration biopsies (FNAB) will allow, in the future, to better define the neoplastic nature of some hot nodules. In personal opinion, this particular pathology must be attently searched both for its implications in the prognosis and therapeutic strategy and because it could be less rare than generally considered up to now.

[Circulating levels of CoQ10 in hypo- and hyperthyroidism]. / Livelli circolanti di CoQ10 nell'ipo- e nell'ipertiroidismo.

Coenzyme Q10 (CoQ10) plays an essential physiologic role in oxidative phosphorylation and its plasma and tissue concentration has been evaluated in various pathologic conditions, both endocrine and non endocrine; among the latter particularly in cardiac failure. Plasma CoQ10 determination has been reported in the literature an a useful diagnostic tool in differential diagnosis of thyroid diseases. In the present study we have evaluated CoQ10 circulating levels both in hypo- and hyperthyroidism. For this purpose plasma CoQ10, fT3-fT4 and TSH concentrations have been determined (HPLC, RIA and IRMA respectively) in a group of hypothyroid patients, hyperthyroid and control subjects. No patient was harbouring cardiovascular, metabolic or systemic disease. CoQ10 has resulted 0.97 +/- 0.46 mcg/ml in the hypothyroid group, 0.51 +/- 0.35 in hyperthyroid and 0.73 +/- 0.16 in control group, with a significative difference between first and second group only; more, the prevalence of high levels has appeared greater in hypo- towards hyperthyroid patients and that of low levels in the latter greater than in the former. Finally an inverse relation of CoQ10 with fT3 and tT3, but not with fT4 and tT4, has been shown. In conclusion, plasma CoQ10 levels have not given in this study a sharp distinction between euthyroidism on a side and hypo- and hyperthyroidism on the other, but necessity of longitudinal studies after therapy is outlined, both to know time of normalization of plasma concentrations and to verify the opportunity of exogenous administration of CoQ10 in hyperthyroid patients with risk factors for heart failure.

[Osteocalcin and hyperthyroidism]. / Osteocalcina e ipertiroidismo.

Osteoporosis may be induced by hyperthyroidism through an increase of bone turnover, because bone resorption exceeds formation in this condition. Also therapy with 1-thyroxine, especially by TSH-suppressive doses, may induce a reduction in bone mineral content. Circulating osteocalcin (sBGP) significantly increases both in endogenous and exogenous hyperthyroxinemia and is considered a reliable non invasive marker of bone turnover. In this study an extra-increase of sBGP in hyperthyroid post-menopausal women towards pre-menopausal is reported, the persistence of high sBGP levels in patients affected by any type of hyperthyroidism after four months of therapy and a positive relationship with thyroid hormones (fT4). Therefore monitoring of this serum marker may be suggested also in patient chronically treated with 1-thyroxine to avoid, if possible, overzealous therapy.

[Thyrotoxic periodic paralysis and Graves' disease. Description of an HLA-CW7-positive case]. / Paralisi periodica tireotossica e morbo di Graves. Descrizione di un caso HLA-CW7 positivo.

Thyrotoxic periodic paralysis is an uncommon complication of hyperthyroidism, more frequent in Oriental populations and in male than in female subjects. Electron microscopic investigations have shown characteristic degenerative changes of muscle fiber. In this study the sequence of pathophysiologic events proposed by the literature is illustrated and a case of thyrotoxic periodic paralysis in a HLA-CW7 positive patient affected by Graves' disease is reported.

[Adrenal incidentaloma in a patient operated upon for colon carcinoma]. / Incidentaloma surrenalico in paziente operato per carcinoma del colon.

The extensive use of visualization techniques has allowed the finding of adrenal masses without clinical symptoms in a growing number of patients affected by diseases of different nature. The challenge of these masses, so called incidentalomas, is particularly diagnostic but also prognostic and therapeutic. A flow-chart of proper investigations utilized in a tumoral patient harbouring a left adrenal mass, permitted the correct diagnosis and prognosis.

[Lipoprotein(a), parameters of lipid metabolism and hemostasis in obese patients]. / Lipoproteina(a), parametri del metabolismo lipidico e dell'emostasi in pazienti obesi.

BACKGROUND: The prevalence of obesity is increasing in the population of industrialized countries and this condition is today considered a risk factor for cardiovascular diseases because, at least partly, it represents a prothrombotic state. METHODS: For this reason we have studied plasma lipid concentrations (C, TG, HDL-C), Lp(a) and some parameters of haemostasis (PAI-1, t-PA, D-dimer) in 41 non diabetic obese patients (38 females and 3 males) and in 36 healthy normal weight subjects. RESULTS: Lipid pattern has resulted in overlapping both in the two studied populations and in the two subgroups of pre- and postmenopausal women, while greater concentrations of Lp(a), (p < 0.001) and t-PA (p < 0.05) have been found in obese populations vs controls, but not different between the two subgroups; in particular, Lp(a) has resulted > 30 mg/dl in 34.14% of obese patients and in no case in the control group. Finally, Lp(a) concentrations have been found for the first time to be positively related to C and negatively to HDL-C in the obese population. CONCLUSIONS: As Lp(a) is believed to be a pathogenetic linkage between atherogenesis and thrombosis and can be affected by weight loss, the efficacy of the reduction of high plasma levels of Lp(a) needs to be considered with longitudinal studies.

Hypopituitarism and antiphospholipid syndrome.

Vascular damage is a well known cause of hypopituitarism since Sheehan's report of postpartum pituitary necrosis; it has subsequently been reported that also sickle-cell anemia, eclampsia, pituitary apoplexy and other pathologies may induce failure of the anterior hypophysis through this mechanism. The antiphospholipid syndrome (APS) is characterized by widespread arterial and venous thrombosis with resulting different clinical features; Addison's disease due to adrenal thrombosis is the only endocrine involvement reported so far in this syndrome. We report here a case of global anterior pituitary insufficiency which developed soon after cerebral ischaemic stroke in a 62 year aged woman with Lupus aicoagulant activity (LAC) and large atrial thrombosis; underlying pathologies were excluded by appropriate investigations. Therefore in our opinion this is the first case in which anterior hypopituitarism is reported in the clinical constellation of APS and the second type of endocline involvement.

[Systemic adjuvant chemotherapy of bladder carcinoma with 5 fluorouracil and cyclophosphamide]. / Chemioterapia adiuvante sistemica del carcinoma vescicale con 5 fluorouracile e ciclofosfamide.

Patients with bladder cancer in pT2 and pT3 infiltrating stages have a 5 year survival rate less than 50% after primary surgical and/or radiant therapy. Aim of the present study was to evaluate if adjuvant chemotherapy could improve survival in these subjects. For this purpose, 16 patients underwent treatment with 5-Fluorouracil and cyclophosphamide (min. three, max six courses). The obtained results have shown a 5 year actuarial survival rate of about 48%. Our experience has not shown therefore any improvement compared with primary treatment alone.

[Differentiated carcinoma of the thyroid gland. Anatomo-clinical characteristics]. / I carcinomi differenziati della tiroide. Caratteristiche anatomo-cliniche.

Differentiated carcinomas of the thyroid constitute a broad group of tumours with different biological and epidemiological aspects. They are still a challenge to the pathologist: a correct definition of the histological type can give in fact important indications for prognosis, therapy and follow-up. The nosological settlement of these tumours has been questioned by recent studies which have described traits of medullary and anaplastic carcinomas. Their prognosis is good on the whole, but notwithstanding their rarity, they show various biological and histological aspects which still have to be better clarified.

[Postoperative follow-up in differentiated carcinoma of the thyroid gland]. / Follow-up post-operatorio dei carcinomi differenziati della tiroide.

Serial serum thyroglobulin determinations and 131I whole body scans are the main diagnostic tools in the follow-up study of patients with treated differentiated thyroid cancer. A thyroglobulin level below 1 ng/ml during suppressive therapy is unsuspicious . In two thirds of patients there is discordance of iodide trapping and thyroglobulin secretion: thyroglobulin assay can't therefore be used as a predictive index of radioiodine uptake.

[Surgical and postsurgical therapy of differentiated carcinomas of the thyroid]. / La terapia chirurgica e post-chirurgica dei carcinomi differenziati della tiroide.

Surgical removal of the gland has been for a long time an essential tool in the therapy of differentiated thyroid carcinomas. Radical or conservative operation is discussed in the surgical management of thyroid carcinoma. In all cases main risk factors must be considered: age, sex and tumour extension. I131 therapy is prescribed in the treatment of functioning metastasis of patients after total thyroidectomy. Substitutive hormonotherapy must also suppress TSH secretion.

[Guillain-Barré syndrome associated with hypothyroidism. Report of a case]. / Sindrome di Guillain-Barrè associata a ipotiroidismo. Descrizione di un caso.

Polyradiculoneuritis is considered an autoimmune disease which can occur concurrently with other immune disorders both endocrine and extraendocrine. A case associated with hypothyroidism is described.

[Chronic lymphatic leukemia with cerebral localization. A case report]. / Leucemia linfatica cronica con localizzazione cerebrale. Descrizione de un caso.

Central nervous system (C.N.S.) involvement is present in 20% of leukemic patients, while it accounts for only 2% of primary extranodal localizations of malignant lymphoma (M.L.). A clinical case in which a neurological syndrome is the opening symptom of chronic lymphatic leukemia (C.L.L.) is described.