Anomalous Discharge of Endogenous Gas at Lavinio (Rome, Italy) and the Lethal Accident of 5 September 2011.

The Rome region contains several sites where endogenous gas is brought to the surface through deep reaching faults, creating locally hazardous conditions for people and animals. Lavinio is a touristic borough of Anzio (Rome Capital Metropolitan City) that hosts a country club with a swimming pool and an adjacent basement balance tank. In early September 2011, the pool and the tank had been emptied for cleaning. On 5 September, four men descended into the tank and immediately lost consciousness. On 12 August 2012, after a long coma the first person died, the second one reported permanent damage to his central nervous system, and the other two men recovered completely. Detailed geochemical investigations show that the site is affected by a huge release of endogenous gas (CO2 ≈ 96 vol.% and H2S ≈ 4 vol.%). High soil CO2 and H2S flux values were measured near the pool (up to 898 and 7.155 g·m-2·day-1, respectively), and a high CO2 concentration (23-25 vol.%) was found at 50-70 cm depth in the soil. We were able to demonstrate that gas had been transported into the balance tank from the swimming pool through two hubs connected to the lateral overflow channels of the pool. We show also that the time before the accident (60 hr), during which the balance tank had remained closed to external air, had been largely sufficient to reach indoor nearly lethal conditions (oxygen deficiency and high concentration of both CO2 and H2S).

Phoenixin-14: detection and novel physiological implications in cardiac modulation and cardioprotection.

Phoenixin-14 (PNX) is a newly identified peptide co-expressed in the hypothalamus with the anorexic and cardioactive Nesfatin-1. Like Nesfatin-1, PNX is able to cross the blood-brain barrier and this suggests a role in peripheral modulation. Preliminary mass spectrography data indicate that, in addition to the hypothalamus, PNX is present in the mammalian heart. This study aimed to quantify PNX expression in the rat heart, and to evaluate whether the peptide influences the myocardial function under basal condition and in the presence of ischemia/reperfusion (I/R). By ELISA the presence of PNX was detected in both hypothalamus and heart. In plasma of normal, but not of obese rats, the peptide concentrations increased after meal. Exposure of the isolated and Langendorff perfused rat heart to exogenous PNX induces a reduction of contractility and relaxation, without effects on coronary pressure and heart rate. As revealed by immunoblotting, these effects were accompanied by an increase of Erk1/2, Akt and eNOS phosphorylation. PNX (EC50 dose), administered after ischemia, induced post-conditioning-like cardioprotection. This was revealed by a smaller infarct size and a better systolic recovery with respect to those detected on hearts exposed to I/R alone. The peptide also activates the cardioprotective RISK and SAFE cascades and inhibits apoptosis. These effects were also observed in the heart of obese rats. Our data provide a first evidence on the peripheral activity of PNX and on its direct cardiomodulatory and cardioprotective role under both normal conditions and in the presence of metabolic disorders.

Nesfatin-1 as a new positive inotrope in the goldfish (Carassius auratus) heart.

The hypothalamic neuropeptide Nesfatin-1 is present in both mammals and teleosts in which it elicits anorexigenic effects. In mammals, Nesfatin-1 acts on the heart by inducing negative inotropism and lusitropism, and cardioprotection against ischemic damages. We evaluated whether in teleosts, Nesfatin-1 also influences cardiac performance. In the goldfish (Carassius auratus), mature, fully processed Nesfatin-1 was detected in brain, gills, intestine and skeletal muscle, but not in the cardiac ventricle. However, on the isolated and perfused working goldfish heart, exogenous Nesfatin-1 induced a positive inotropic effect, revealed by a dose-dependent increase of stroke volume (SV) and stroke work (SW). Positive inotropism was abolished by inhibition of adenylate cyclase (AC; MDL123330A) and cAMP-dependent kinase (PKA; KT5720), suggesting a cAMP/PKA-mediated pathway. This was confirmed by the increased cAMP concentrations revealed by ELISA on Nesfatin-1-treated hearts. Perfusion with Diltiazem, Thapsigargin and PD98059 showed the involvement of L-type calcium channels, SERCA2a pumps and ERK1/2, respectively. The role of ERK1/2 and phospholamban in Nesfatin-1-induced cardiostimulation was supported by Western blotting analysis. In conclusion, this is the first report showing that in teleosts, Nesfatin-1 potentiates mechanical cardiac performance, strongly supporting the evolutionary importance of the peptide in the control of the cardiac function of vertebrates.

Regulating effects of vascular endothelial growth factor and ANG II on frog's pericardial stomata, mesothelium and angiogenesis.

OBJECTIVE: To observe the regulating effects of vascular endothelial growth factor (VEGF) and angiotensin II (ANG II) on the frog's pericardium, lymphatic stomata and angiogenesis so as to reveal their effects and mechanism on the mesothelial permeability, lymphatic stoma regulation and myocardial hypertrophy. METHODS: VEGF and ANG II were injected into the frog's peritoneal cavity so as to examine the changes of the pericardial stromata by using transmission electron microscopy, scanning electron microscopy and computerized imaging analysis. RESULTS: Scattered distributed pericardial stomata were found on the parietal pericardium of the frog with a few sinusoid mesothelial cells, whose blood supply was directly from the cardiac chambers flowing into the trabecular spaces of the myocardium (because there are no blood vessels in the myocardium of the frog). The average diameters of the pericardial stomata in VEGF and ANG II groups were 1. 50 microm and 1.79 microm respectively, which were much larger than those in the control group (0.72 microm, P < 0.01); the average distribution densities of the stomata were 8. 25/0.1 mm2 and 12.80/0.1 mm2 in VEGF and ANG II groups, which were also much higher than those in the control group (3.57/0.1 mm2, P < 0.01); the sinusoid areas in VEGF and ANG II groups were 2442.95 microm2/0.1 mm2 and 2121.79 microm2/0.1 mm2, which were larger than that in the control group (995.08 microm2/0.1 mm2 , P < 0.01); no angiogenesis was found in the frogs of the experimental groups. CONCLUSIONS: VEGF and ANG II could strongly regulate the pericardial stomata by increasing their numbers and openings with larger diameters and higher distribution density. They could also increase the sinusoid areas with the result of the higher permeability of the pericardium, which clearly indicated that VEGF and ANG II could speed up the material transfer of the pericardial cavity and play an important role in preventing myocardial interstitial edema. Yet there was no strong evidence to show the angiogenesis in the myocardium.

[Is total parenteral nutrition necessary in patients subjected to radical cystectomy?] . / E necessaria la nutrizione parenterale totale nei pazienti sottoposti a cistectomia radicale?

BACKGROUND: The aim of the study is to evaluate the nutritional stats in candidates to radical cystectomy in order to minimize post-operative complications. METHODS: The evaluation is carried out on the basis of anthropometric, bio-humoral and immunologic indexes in a retrospective analysis of patients who underwent major urologic surgery during the last two years. Twenty cases of invasive bladder cancer (mean age 71 years) who underwent radical cystectomy have been studied: in 13 cases urinary diversion by Camey II technique, in 7 cases by Bricker technique has been performed. In 5 cases of orthotopic neo-bladder, endovenous parenteral protein sparing nutrition was carried out for 4 days, in the remaining 15 cases glucidic and saline solutions have been administered. RESULTS: In all the 20 evaluated patients post-operative complications have not been observed. CONCLUSIONS: On the basis of the data obtained, the conclusion is drawn that patients with bladder cancer are generally not so malnourished to need an artificial feeding regimen. Considering the urinary tract substitution effects on renal function and metabolism, particularly for the role of glucose on proximal and distal tubule the usefulness of administering only glucidic solutions and maintaining a good diuresis is underlined.

[Regulating effects of VEGF and ANG II on the frog's pericardial mesothelium, stomata, and angiogenesis].

OBJECTIVE: To observe the regulating effects of vascular endothelial growth factor (VEGF) and angiotensin II (ANG II) on the frog's pericardium, lymphatic stomata, and angionesis so as to understand their influences on the mesothelial permeability, lymphatic stoma regulation, and myocardial hypertrophy. METHODS: VEGF and ANG II were injected into the frog's peritoneal cavity. The results were obtained by using LM, SEM, and computerized imaging analysis. RESULTS: Scattered distributed pericardial stomata were found on the parietal pericardium of the frog with a few sinusoid mesothelial cells. Since there were no blood vessels in the frog's myocardium, its blood supply was directly from the cardiac chambers flowing into the trabecular spaces of the myocardium. The average diameters of the pericardial stomata in VEGF and ANG II groups were 1.50 and 1.79 microns respectively, which were much larger than those in the control group (0.72 micron, P < 0.01). The average distribution density of the stomata was 8.25/0.1 mm2 and 12.80/0.1 mm2 in VEGF and ANG II groups, which was also much higher than that in the control group (3.57/0.1 mm2, P < 0.01). The sinusoid areas in VEGF and ANG II groups were 2443.95 microns 2/0.1 mm2 and 2121.79 microns 2/0.1 mm2, which was larger than that in the control group (995.08 microns 2/0.1 mm2, P < 0.01). No angionesis were found in the frogs of the experimental groups. CONCLUSIONS: VEGF and ANG II strongly regulate the pericardial stomata by increasing their numbers and openings with larger diameters and higher distribution density. They can also increase the sinusoid areas with the result of the higher permeability of the pericardium, which clealy indicated that VEGF and ANG II can speed up the material transfer of the pericardial cavity and play an important role in preventing myocardial interstitial edema. Yet there is no strong evidence showing angionesis in the myocardium.