Symptoms of Anxiety and Depression within the UNiversity community: the cross-sectional UN-SAD study.

The increasing complexity of academia, with its demanding working conditions and uncertain career opportunities, may affect the mental health of academics and potentially lead to mental health problems. The aim of this study is to determine the prevalence of depressive and anxiety symptoms in the academic population of the University of Udine and to compare symptoms in senior and younger academics and administrative staff.A cross-sectional survey was conducted between June and December 2020, involving academic and administrative staff in all departments. The prevalence of depressive and anxiety symptoms was assessed using the PHQ-9 and GAD-7 tools. The relationship between mental health outcomes and job role was analyzed using nonparametric tests and ordinal logistic regression.A total of 366 individuals participated: 109 junior academics, 146 senior and 111 administrative staff. The proportion of women was 55.7% and the mean age was 47.9 years. The prevalence of depressive and anxiety symptoms in the studied population was 25.7% (95% IC 21.5-30.4) and 22.7% (95% IC 18.7-27.2) respectively, with junior academics having the higher prevalence of both symptoms. Univariate models suggest a higher risk for anxiety symptoms OR 1.89 (1.13-3.17) for women.The prevalence of depressive symptoms is higher in our academic community than in the general population, especially among junior academics. These findings may reflect the impact of uncertain career and challenging environment on the mental health of young academics. Universities should provide more support to young academics so that they can contribute effectively and healthily to the advancement of research.

[Restructuring of inpatient emergency treatment : What will change?] / Neustrukturierung der stationären Notfallversorgung : Was ändert sich?

The resolution on the restructuring of inpatient emergency treatment was passed by the Federal Joint Committee (G-BA) on 19 April 2018 based on the Hospital Structure Act and became binding with the publication in the Bundesanzeiger on 18 May 2018. The resolution describes the future structural and qualitative prerequisites for participation of hospitals in the provision of emergency treatment in three levels: basic emergency treatment, extended emergency treatment and comprehensive emergency treatment. Furthermore, a level of nonparticipation is also planned. In addition, there are special modules, e.g. for the treatment of children and auxiliary modules for specifically equipped hospitals with highly specialized patient treatment (e.g. stroke unit). A transition regulation period of 3-5 years provides hospitals with the possibility to adjust to the new minimum requirements. The German Hospital Federation (DKG) and the National Association of Statutory Health Insurance Funds (GKV-SV) will negotiate the assessment of surcharges and deductions subsequent to the resolution.

Accuracy of visual analysis vs. apparent diffusion coefficient quantification in differentiating solid benign and malignant focal liver lesions with diffusion-weighted imaging.

PURPOSE: The authors compared the accuracy of diffusion-weighted imaging (DWI) visual analysis (VA) vs. apparent diffusion coefficient quantification (ADC-Q) in assessing malignancy of solid focal liver lesions (FLLs). MATERIALS AND METHODS: Using a 1.5-T system, two radiologists retrospectively assessed as benign or malignant 50 solid FLLs: (a) by VA of signal intensity on DWI images at b=800 s/mm(2) and ADC map; (b) by quantifying lesion ADC. Reference standard included histology or follow-up confirmation of diagnosis by a consensus panel. Receiver operating characteristic (ROC) curve analysis was performed. RESULTS: because of 20 false-negative hepatocellular carcinomas, VA showed lower accuracy than ADC-Q (52.0% VS. 68.0%). however, stratified accuracy for metastases was higher with VA (75.0 VS. 66%). ADC and signal features of malignant and benign FLLs were found to largely overlap. CONCLUSIONS: VA performed worse than ADC-Q for hepatocellular carcinoma and better for metastases. Overall, the accuracy of both methods was limited because of the overlap in visual appearance and ADC values between solid benign and malignant FLLs.

Degree of bile-duct dilatation in liver-transplanted patients with biliary stricture: a magnetic resonance cholangiography-based study.

PURPOSE: This study assessed whether the degree of bile-duct dilatation in liver-transplanted patients is correlated with the time from intervention and the type of underlying biliary stricture. METHODS AND MATERIALS: Fifty-seven 3D magnetic resonance cholangiograms (MRCs) performed on 42 liver-transplanted patients were retrospectively evaluated. Diameter was measured at the level of the extrahepatic bile duct (EBD), right hepatic duct (RHD), left hepatic duct (LHD), anterior and posterior right hepatic ducts (aRHD, pRHD) and left lateral and medial ducts (LLD, LMD). Data were stratified according to the type of biliary stricture (all types, anastomotic, ischaemic-like, mixed) and compared, on a per-examination basis: (a) between two groups based on time from transplantation using a 1-year threshold (nonlongitudinal analysis); (b) among 26 repeated examinations on 11 patients (longitudinal analysis); (c) among different stricture groups. RESULTS: The biliary tree was slightly dilated within 1 year from transplantation (2.9±1.3 to 6.1±3.2 mm). In general, nonlongitudinal analysis showed minimally larger duct size after 1 year (mean +1.4±0.5 mm) despite significant differences at most sites of measurement considering all types of strictures (p<0.01; Mann-Whitney U test). Longitudinal analysis showed diameter increase over time, although without statistically significant differences (p>0.01; Kruskal-Wallis test). No significant difference in bile-duct size was observed when comparing types of stricture (p>0.01; Kruskal-Wallis test). CONCLUSIONS: Biliary dilatation after liver transplantation is mild and develops slowly regardless of the underlying type of stricture, possibly in relation to graft properties. MRC has a potential role as first-line imaging modality for a reliable assessment of biliary dilatation and the presence of a stricture.

[Isolation precautions, diagnostics and organization in German emergency departments during the 2020 COVID-19 pandemic]. / Isolationsmaßnahmen, Diagnostik und Organisation in deutschen Notaufnahmen während der COVID-19-Pandemie 2020.

BACKGROUND: Since the beginning of the coronavirus disease 19 (COVID-19) pandemic, German emergency departments (ED) have been working in the area of conflict between high case load and demanding hygienic and organizational challenges. The aim of this study was to gain an overview of the current status of isolation measures, diagnostics and patient allocation of suspected COVID-19 cases. METHODS: Supported by the German Society for Interdisciplinary Emergency and Acute Medicine (DGINA) we invited leading ED physicians to answer an anonymous online survey regarding isolation measures, diagnostics and organization in emergency rooms during the COVID-19 pandemic. RESULTS: A total of 139 responders from all federal states and all levels of care took part in the survey. Standard operating procedures on COVID-19 exist in almost all participating EDs, although concrete measures to end isolation are often missing. Most EDs screen patients for the "classic" COVID-19 symptoms such as fever, respiratory symptoms or contact to positive subjects in a standardized fashion, although the threshold for prophylactic isolation varies greatly. The individual swab-testing and allocation strategies vary relatively strongly. Less than half of all EDs have a separate procedure for uninterrogatable patients (e.g. major trauma). In about 8% of suspected cases, COVID-19-specific thoracic computed tomography is performed in the ED. CONCLUSION: The current survey shows that the German EDs are well positioned for the moment, even though the isolation threshold is too high at some locations. In view of a possible increase in the number of cases during the winter season, a more precise differentiation of the previous recommendations of the Robert Koch Institute, especially for emergency admission patients, would be desirable. In this context, we propose a universal algorithm for the (de-)isolation of suspect cases in the ED.

High incidence of pulmonary thromboembolism in hospitalized SARS-CoV-2 infected patients despite thrombo-prophylaxis.

BACKGROUND: SARS-CoV-2 infected patients present thrombotic complications caused by direct endothelial cells injury of the microvessels. Pulmonary thromboembolism (PE) has been reported by Computed Tomography pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia with high D-dimer levels. OBJECTIVES: We present the characteristics of SARS-CoV-2 infected patients diagnosed of PE by CTPA in our hospital. We also present the comparison of these findings with non-infected patients with PE data. METHODS: Retrospective observational cohort study that included patients over 18 years of age hospitalised consecutively between 26th February and 20th May 2020 in an European Hospital with SARS-CoV2 virus infection, and with suspected infection at beginning of admission but with negative PCR, who were studied with CTPA for suspicion of VTE, during their hospitalization. RESULTS: During the study period, 52 CTPA were performed in our hospital, sixteen in SARS-CoV-2 infected patients, with 4 cases (33%) of PE in the infected group, and 11 (44%) in the non-infected group. No significant differences in age (p = 0.43) and sex (p = 0.31) were found between the two groups, infected and non-infected patients. In the infected group, the patients who had PE had a much lower median age (47.8 years) than those without PE (73.3 years). No differences between infected and non-infected patients were detected in the diagnosis of PE with CTPA, 28.6% versus 27.8% (p = 1.00). Overall patient mortality was 1.9%; one patient died (6.3%) in the infected group, and none in the non-infected group (p = 0.31). CONCLUSION: A considerable incidence of PE diagnosed by CTPA in SARS-CoV-2 infected patients has been observed, despite thrombo-prophylaxis.

[Nontraumatic resuscitation room management of critically ill patients]. / Nichttraumatologisches Schockraummanagement.

Critically ill patients are often initially treated by out-of-hospital emergency medicine services. A major challenge-especially at the interface between out-of-hospital and in-hospital care-is to continue patient care without wasting time, while maintaining a high level. These include the stabilization of vital functions (e.g., airway management, noninvasive/invasive ventilation, circulatory stabilization) and implementation of a suitable diagnostic and therapeutic strategy (e.g., laboratory examinations, sonography, radiological imaging). In recent years, therefore, interest and research has focused on the topic of "nontraumatic resuscitation room care". The first monocentric data recently became available and work is ongoing to develop nontraumatic resuscitation room management for optimal care of critically ill patients in the emergency department. Based on initial studies, experiences and expert opinions, this paper describes a structured approach to nontraumatic resuscitation room management.

[Long-term evaluation of immune response to hepatitis B vaccine in 136 patients undergoing hemodialysis]. / Evaluación a largo plazo de la respuesta inmunológica a la vacuna de la hepatitis B en 136 pacientes en hemodiálisis.

UNLABELLED: Hemodialysis (HD) patients have an impaired response to hepatitis B(HB) vaccines, and the persistence of immunity, the efficacy of revaccination and the periodicity of post-vaccination testing are not well defined. We present the experience during 13 years in an outpatient dialysis center of 136 HD patients who completed a HB vaccination program consisting in 3 doses of 40 microg intramuscular recombinant B vaccine (Engerix-B). In all patients anti-HBs titers were determined annually and in 31 patients every 6 months. Nonresponders patients and responders patients that lost their antibodies(< 10 UI/ml) received annually a booster double dose of vaccine. Seventy-four patients(54.4%) developed immunity and the remaining 62 patients were considered nonresponders. When compared both groups, gender and the etiology of chronic kidney disease did not differ between the two groups; nevertheless, nonresponders patients were significantly older than responders. After 1 year of follow-up, 32% of responders had no detectable anti-HBs levels, and only 18% of patients remained immunoreactive 6 years afer vaccination. The peak anti-HBs titer immediately after completion of the vaccination schedule was found to be a major predictor of maintaining immunity: 75% of patients with anti-HBs titers greater than 1000 IU/ml remained immunoreactive 3 years after vaccination compared to 47% of patients with titers between 100-999 IU/ml(p=0.08) and 34% of patients with titers between 11-99 IU/ml(p=0.02). The administration of additional doses of vaccine were effective in 24% of the nonresponders patients, and 69% of them remained seropositive at the end of the 1-year follow up. Repeated booster doses of vaccine in nonresponders patients to the first booster dose afforded seroconversion in 19.6% of the patients. Performing post-vaccination testing every six months it would have allowed to give booster doses of vaccine in 16% of responder patients before the annual period. CONCLUSION: This current study demonstrates that a HB vaccination schedule with a regular serological follow-up and repeated booster doses , affords an acceptable seroprotection in HD patients.

[Kinetic of calcium, phosphate, magnesium and PTH variations during hemodiafiltration]. / Cinéica del calcio, fósforo, magnesio y variaciones de la parathormona (PTH) en pacientes en hemodiafiltracion.

Hemodiafiltration (HDF) is a technique resulting from coupling of diffusive and convective transport and thereby increase the elimination of small and middle molecules. However, may induce a convective loss from others substances such as calcium and magnesium. The aim of this study was to evaluate the effects of Ultrafiltration on the kinetics of calcium, phosphate, magnesium and parathyroid hormone. A total of thirteen patients (7 males and 6 females) on hemodialysis, were studied. Each patient was randomly dialyzed with the same dialysate calcium concentration and three different ultrafiltration rate. Schedule A: High flux hemodialysis, schedule B: HDF with 10% of weight body and schedule C: HDF with 20% of weight body. The others parameters were kept identical. Total Ultrafiltration was 2,6+/-0,9 L (9,78+/-3,78 ml/min) in A, 9,3+/-1,7 L (34,54+/-6,22 ml/min) in B and 16,3+/-3,3 L (60,94+/-12,63 ml/min) in C. Replacement fluid during dialysis was 6,85+/-1,42 and 13,65+/-2,9 L. in C and C respectively. Postdialysis total,ionized calcium and magnesium were significantly lower in schedules B and C versus A. PTH levels did not differ significantly. However, PTH changes during dialysis was -36.6+/-38.6%, 6.3+/-69.8% and 32.2+/-63.2% in A, B and C, respectively (p<0.05 A vs. C). A significant inverse correlation was found between total Ultrafiltration and postdialysis levels of total calcium (r:-0.56, p<0.001), ionized calcium (r:-0.65, p<0.001) and magnesium (r:-0.47, p<0.01). No differences were observed in pre and postdialysis phosphate levels, neither mass transfer and clearance of phosphate. We concluded that high ultrafiltration flow rates and substitution fluid without divalent cations induces a negative calcium and magnesium balance. These changes may stimulate PTH secretion during HDF. This technique did not resulted in a higher clearance or phosphate removal.

[Oxidative stress analysis in patients on hemodiafiltration on-line]. / Análisis del estrés oxidativo en pacientes en hemodiafiltración en línea.

Patients with chronic renal disease have a very high mortality due to cardiovascular disease. However, the traditional risk factors are not the only one explanation. Nowadays, there are new risk factors becoming, and one of these is the oxidative stress. Besides today we know that when these patients receive haemodialysis are being exposed to an additional oxidative stress. The aim of this study was to measure and to compare the degree of oxidative stress in two groups of patients on different dialysis techniques: a) On-Line Haemodiafiltration three times / week (OL-HDF). b) Daily Om-Line haemodiafiltration ( six times / week ) ( dOL-HDF) We studied 9 patients with chronic renal disease stage 5 on hemodialysis. They all were men, with a medium age of 72,5 +/- 6 years. Five patients were on dOL-HDFand four on tOL-HDF. Glutathione (GSH) concentration of patients on dOL-HDF before dialysis was 742+/- 153 nmol/ml and post-dialysis de 878+/- 223. Blood GSSG concentration before and after dialysis was 34+/- 14 nmol/ml y 137+/- 74 nmol/ml (p< 0,03). GSSG/GSH ratio pre-dialysis was 58+/-10 and post-dialysis 169+/-65 ( p < 0,03). In OL-HDF group GSSG concentration and the ratio GSSG/GSH also increased in a significative way from 99+/-45 nmol/ml to 179+/-66 nmol/ml, and from 161+/- 99 to 337+/-143 ( p<0,05). We also found differences in pCR concentrations between both groups; 3+/-1,4 g/l in dOL-HDF and 8,75+/-5,8 g/l in HDF OL. (p< 0,05). We did not find differences between xatine-oxidase activity before and after hemodialysis and between groups. In conclusion, patient with terminal chronic renal disease on OL-HDF receive an additional load of oxidative stress, as the increase in GSSG/GSH ratio in both groups shows. However patients on dHDF-OL shows low ratios GSSG/GSH post-hemodialysis and low pCR concentrations, and maybe this could be explained because daily on line haemodiafiltration improves purification of inflammatory mediators. Clue words: Hemodialysis, oxidative stress, glutathione, gssg/gsh ratio, xantine oxidasa.

Multimodal Approach of Pulmonary Artery Intimal Sarcoma: A Single-Institution Experience.

INTRODUCTION: Pulmonary artery sarcoma (PAS) is a rare tumor, whose therapeutic approach is mainly based on surgery, either pneumonectomy or pulmonary endarterectomy (PEA). The prognosis reported in published series is very poor, with survival of 1.5 months without any kind of treatment. PATIENTS AND METHODS: From January 2010 to January 2016, 1027 patients were referred to our hospital for symptoms of acute or chronic pulmonary thromboembolic disease. Twelve patients having a confirmed diagnosis of PAS underwent PEA. Median age was 64.5 years. Most patients had a long history of symptoms, having a median time of 7.5 months from onset of symptoms to surgery. RESULTS: Following PEA and cardiopulmonary rehabilitation, 10 patients received conventional chemotherapy with doxorubicin and ifosfamide, starting at a median of 42 days from surgery. Four patients also received radiotherapy. Four patients have died due to disease progression, while 7 are still alive, with 5 being disease-free at 4-55+ months from diagnosis. CONCLUSIONS: In patients with PAS, a multimodal approach including PEA, CT, and RT is feasible but it should be evaluated individually, according to the tumor extension and the patient's clinical condition. Apart from improving quality of life mainly by reducing or delaying symptoms due to PH, it may improve life expectancy.

[Middle molecules removal. Beyond beta2-microglobulin]. / Depuración de grandes moléculas. Más allá de la beta2-microglobulina.

The uremic toxin removal capacity mainly depends on dialyzer and hemodialysis modes. The low-flux hemodialysis only removes solutes having molecular weights less than 5.000 Da. High-flux hemodyalisis represents a form of low-volume hemodiafiltration because of the internal filtration and back-filtration that can take place within a dialyzer. Hemodiafiltration with large volumes of replacement fluid seems to be the best technique for removing all small, medium-sized and large molecules. The objective of our study was to evaluate the large molecules removal bigger than beta2-microglobuline on high flux haemodialysis and on-line hemodiafiltration with postdilutional infusion, in patients with three times a week dialysis and on short daily dialysis. We studied 24 patients, 15 males and 9 females stable on haemodialysis programme, twelve on standard four to five hours three times a week dialysis and twelve on 2 to 2 1/2 hours six times a week dialysis. All patients were dialysed with Fresenius 4008 monitor, three sessions on high flux haemodialysis (HD) and three sessions on on-line hemodiafiltration (OL-HDF). Two sessions with each filter were performed (polisulfone HF80, polyethersulfone Arylane H9 and new polisulfone APS 900). Pre and postdialysis concentrations of urea, creatinine, (beta2-microglobulin (beta2-m), myoglobin, prolactin and alpha1 microglobulin (alpha1-m) were measured. There was no difference in urea and creatinine small molecules removal. beta2m removal was 68% on HD and 81% on OL-HDF. Myoglobin and prolactin present a similar removal pattern, a higher removal with new filters (60% with Arylane and 59% with APS) in comparison with clasical polisulfone (22% with HF80). The mean alpha1-m reduction rate on HD was 6% and on OL-HDF 22%. OL-HDF with APS 900 filter was the most remove technique (35.4%), significatively higher than the other modes and filters. We can conclude that the new filters generation reach a better uremic toxins removal, specially in large molecules higher than beta2-m and on HD modality.

[Estimation of the cost in the farmacologic treatment of chronic renal failure]. / El coste del tratamiento farmacológico en la enfermedad renal crónica.

The prevalence and incidence of end stage renal disease has increased considerably in the past years. We know that the cost of treatment of these patients is high. Limited information exists on care resource utilization for maintenance of patients before the initiation of replacement therapy. The purpose of this study is determine the cost of pharmaceutic treatment during the predialysis phase. Pharmacy cost was analyzed for 200 patients controlled on outpatient nephrology department. The mean age was 72.4 years, 59% were males, and the comorbidity distribution was: hypertension 87%, hyperlipidemia 56% and diabetes 35%. The per-patient-per-month charges were 215.45 Euro, with a continous increase from 84.64 Euro on stage 1 to 352.59 Euro on stage 5 of chronic kidney disease. Erythropoiesis stimulants were reponsible of 46.5% of these cost. The most frequent prescribed medications were antihypertensive drugs, statins and iron preparations. Patients with end stage renal disease generate significant cost during the predialysis period. The limited resources, and the growth of health care expeditures, particulary the spending for prescriptions drugs, are two of the major problems for Health Care Systems. A better knowledge of the associated costs to the treatment of these patients will help us to increase our efficiency.

[Effects of oral cannabis and dronabinol on driving capacity]. / Effets du cannabis oral et du dronabinol sur la capacité à conduire.

Two retrospective epidemiologic studies have shown that cannabis is the main psychoactive substance detected in the blood of drivers suspected of driving under the influence of psychotropic drugs. An oral administration double-blind crossover study was carried out with eight healthy male subjects, aged 22 to 30 years, all occasional cannabis smokers. Three treatments and one placebo were administered to all participants at a two week interval: 20 mg dronabinol, 16.5 mg D9-tétrahydrocannabinol (THC) and 45.7 mg THC as a cannabis milk decoction. Participants were asked to report the subjective drug effects and their willingness to drive under various circumstances on a visual analog scale. Clinical observations, a psychomotor test and a tracking test on a driving simulator were also carried out. Compared to cannabis smoking, THC, 11-OH-THC and THC-COOH blood concentrations remained low through the whole study (<13.1 ng THC/mL,<24.7 ng 11-OH-THC/mL and<99.9 ng THC-COOH/mL). Two subjects experienced deep anxiety symptoms suggesting that this unwanted side-effect may occur when driving under the influence of cannabis or when driving and smoking a joint. No clear association could be found between these adverse reactions and a susceptibility gene to propensity to anxiety and psychotic symptoms (genetic polymorphism of the catechol-O-methyltransferase). The questionnaires have shown that the willingness to drive was lower when the drivers were assigned an insignificant task and was higher when the mission was of crucial importance. The subjects were aware of the effects of cannabis and their performances on the road sign and tracking test were greatly impaired, especially after ingestion of the strongest dose. The Cannabis Influence Factor (CIF) which relies on the molar ratio of active and inactive cannabinoids in blood provided a good estimate of the fitness to drive.

Efecto adverso psiquiátrico con lorlatinib; medicamento con poca experiencia de uso / Adverse psychiatric effects with lorlatinib, a medicine that has not been widely used

El cáncer de pulmón no microcítico (CPNM) es la causa más frecuente de neoplasia maligna mortal en todo el mundo. Los tratamientos selectivos moleculares han supuesto un avance importante en el tratamiento del CPNM en pacientes determinados cuyos tumores albergan diversas mutaciones tales como EGFR, BRAF, reordenamiento ALK o ROS. El lorlatinib es un TKI selectivo de ALK con capacidad para penetrar en el cerebro y con gran actividad contra las fusiones de ALK y ROS1, incluidas las mutaciones de resistencia. Se describe el caso de una mujer con cáncer de pulmón no microcítico que presenta efecto adverso psiquiátrico en relación a lorlatinib

Non-small cell lung cancer (NSCLC) is the most common cause of death worldwide. Selective molecular treatments have been an important advance in the treatment of NSCLC in certain patients whose tumors have diverse mutations such as EGFR, BRAF, ALK rearrangement or ROS. Lorlatinib is an ALK-selective TKI that it is able to penetrate the brain and it has highly activity against ALK and ROS1 fusions, including resistance mutations. We describe the case of a woman with non-small cell lung cancer who has an adverse psychiatric effect in relation to lorlatinib

Membranotropic properties of the water soluble amino acid and peptide derivatives of fullerene C60.

The modifying effects of the products of the equimolar addition Of DL-alanine and DL-alanyl-DL-alanine to fullerene C60 on the structure and permeability of the lipid bilayer of phosphatidylcholine liposomes has been studied using the luminescence probe technique. It is shown that these water soluble amino acid and dipeptide derivatives of fullerene (C60-AD) are quenchers of pyrene fluorescence and erythrosine phosphorescence of in both a water solution and liposomes. To study the permeability of the lipid bilayer a procedure based on the triplet probe technique has been developed. It has been found that the C60-AD derivatives under study are able to localize inside the artificial membrane, to penetrate into the liposomes through the lipid bilayer and to perform activated transmembrane transport of bivalent metal ions.

Redox and fungicidal properties of phthalocyanine metal complexes as related to active oxygen.

Some chemical and fungicidal effects of 20 phthalocyanines of Co, Fe, Cu, and Al were studied. Under dark conditions, these complexes reduced nitroblue tetrazolium in the presence of KCN, accelerated the autoxidation of ascorbate or hydroquinone and decomposed hydrogen peroxide. In the later reaction, hydroxyl radical was generated as evidenced with the deoxyribose assay. The inhibition by superoxide dismutase and catalase of catalyzed autoxidation of ascorbate suggests the participation of superoxide anion-radical and hydrogen peroxide in the reaction. Most complexes were toxic to the fungus Magnaporthe grisea which causes blast disease of rice. The toxicity was enhanced by light being diminished by antioxidant reagents sequestering active oxygen species. Some complexes (including nontoxic ones), after 1-day contact with a leaf surface of the disease-susceptible rice cultivar, induced the fungitoxicity of leaf diffusate. This toxicity was also light-activated and sensitive to antioxidant reagents. Several complexes, when added to inocula, decreased 2-3 times the frequency of the compatible symptoms of the blast. It is suggested that in planta, the dark redox activity of phthalocyanines along with their photosensitization promote the generation of active oxygen, which damages the parasite and, therefore, favors disease resistance.

Blood transfusion and other prognostic variables in the survival of patients with cancer of the head and neck.

The clinical records of 207 patients with squamous cell carcinoma of the head and neck, diagnosed and surgically treated at the Otolaryngology Division of Pordenone General Hospital and Aviano Cancer Centre, northeast of Italy, from January 1982 to December 1987, were retrospectively reviewed to gather information on blood transfusions and other characteristics potentially related to survival. The group of patients (mean age = 59 years) included 85 cases (41%) of laryngeal cancer, 80 cases (39%) of oropharyngeal and hypopharyngeal cancer, and 34 cases (16%) of cancer of the oral cavity. Fifty-five patients (27%) did not receive any blood transfusion while 152 patients were transfused with different amounts of blood. At the univariate analysis, nodal involvement, clinical stage, type of therapy, status of surgical margins, and metastatic spread beyond the nodal capsule appeared to be significantly linked to prognosis. After adjustment for other prognostic variables, transfused patients showed a twofold higher hazard ratio as compared to nontransfused patients, but such an unfavorable predictive value should be evaluated in the context of the other prognostic correlates of cancer of the head and neck.

Squamous cell carcinoma of the posterior pharyngeal wall: characteristics compared with the lateral wall.

Squamous cell carcinoma of the posterior oro- and hypopharyngeal wall (SCCPPW) is a relatively rare tumour. A retrospective investigation of 63 patients with SCCPPW and 449 patients with carcinoma of the lateral oro- and hypopharyngeal wall, treated between 1964 and 1992, has been carried out. Most SCCPPW were asymptomatic, macroscopically superficial and at early stages. They were usually detected by chance during an examination for a different type of malignancy. Fifty-seven percent of SCCPPW patients had multiple tumours; however this occurrence did not alter the survival rate. The crude five-year survival rate for SCCPPW was 22 percent and was not significantly different from that of patients with lateral wall tumours. Moreover, both local control and recurrences also were not statistically different.

[Cobalt-corrin oligonucleotide derivatives as reagents for selective cleavage of nucleic acids]. / Kobal't-korrinovye proizvodnye oligonukleotidov kak reagenty dlia izbiratel'nogo rasshepleniia nukleinovykh kislot.

Techniques for preparing catalytically active corrin complexes of cobalt with monofunctional e-carboxyl- and e-amino groups in a macroligand are suggested. Two methods of the covalent attachment of such Co-corrin complexes to the terminal 3'- and 5'-phosphate groups of oligodeoxyribonucleotides were studied: the introduction of the complex to the oligonucleotide after oligonucleotide synthesis in aqueous solution and in the course of automated solid-phase oligonucleotide synthesis. Introducing of the Co-corrin complex during solid-phase synthesis was more efficient. It was demonstrated that the oligonucleotide probe thus obtained was able to act as a nuclease in the presence of ascorbic acid, the location of the clearage sites being determined by the addressing oligonucleotide.