Replacing maize silage with hydroponic barley forage in lactating water buffalo diet: impact on milk yield and composition, water and energy footprint, and economics.

This study investigated the feasibility of integrating hydroponic barley forage (HBF) production into dairy ruminant production, focusing on its effect on milk yield and components, energy and water footprints, and economic implications. Maize silage (MS) was used as a benchmark for comparison. The research was conducted on a water buffalo dairy farm equipped with a fully automated hydroponic system producing approximately 6,000 kg/d of HBF as fed (up 1,000 kg/d on DM basis). Thirty-three lactating water buffaloes were assigned to 3 dietary treatments based on the level of MS or HBF in the diet: D0 (100% MS), D50 (50% MS and 50% HBF), and D100 (100% HBF). The feeding trial lasted 5 weeks plus a 2-week adaptation period during which each cow underwent a weighing, BCS scoring, recording of milk yield and components, including somatic cell count and coagulation characteristics. Based on the data obtained from the in vivo study, the water and energy footprints for the production of MS and HBF and buffalo milk, as well as income over feed cost, were evaluated. Complete replacement of MS with HBF resulted in a slight increase in milk yield without significant impact on milk component. The resource footprint analysis showed potential benefits associated with HBF in terms of water consumption. However, the energy footprint assessment showed that the energy ratio of HBF was less than 1 (0.88) compared with 11.89 for MS. This affected the energy efficiency of milk yield in the 3 diets, with the D50 diet showing poorer performance due to similar milk yield compared with D0, but higher energy costs due to the inclusion of HBF. The production cost of HBF was about 4 times higher than that of farm-produced MS, making feed costs for milk yield more expensive. Nevertheless, HBF can potentially improve income over feed costs if it increases milk yield enough to offset its higher production costs. Overall, the results suggest that the current practice of using HBF to replace high quality feedstuffs as concentrates is likely to result in energy and economic losses.

Processing methods for human amniotic membrane as scaffold for tissue engineering with mesenchymal stromal human cells.

Tissue engineering is an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function. The aims of this work were to compare chemically and physically processed human Amniotic Membranes (hAM) and analyze the cytocompatibility and proliferation rate (PR) of two primary human mesenchymal stromal cell lines, from different sources and donor conditions seeded over these scaffolds. The evaluated hAM processes were: cold shock to obtain a frozen amniotic membrane (FEAM) with remaining dead epithelial cells, denudation of hAM with trypsin for 20/10 min (DEAM20/10) or treatment with sodium dodecyl sulfate to decellularized hAM (DAM). All samples were sterilized with gamma radiation. The selection of the treated hAM to then generate composites was performed by scanning and transmission electron microscopy and characterization by X-ray diffraction, selecting DEAM10 and FEAM as scaffolds for cell seeding. Two sources of primary human stromal cells were used, both developed by our researchers, human Dental Pulp Stem Cells (hDPSC) from living donors and human Mesenchymal Stromal Cells (hMSC) from bone marrow isolated from brain dead donors. This last line of cells conveys a novel source of human cells that, to our knowledge, have not been tested as part of this type of construct. We developed four in vitro constructs without cytotoxicity signs and with different PR depending on the scaffolds and cells. hDPSC and hMSC grew over both FEAM and DEAM10, but DEAM10 allowed higher PR.

Synthesis and characterization of a bovine collagen: GAG scaffold with Uruguayan raw material for tissue engineering.

Tissue engineering (TE) and regenerative medicine offer strategies to improve damaged tissues by using scaffolds and cells. The use of collagen-based biomaterials in the field of TE has been intensively growing over the past decades. Mesenchymal stromal cells (MSCs) and dental pulp stem cells (DPSCs) are promising cell candidates for development of clinical composites. In this study, we proposed the development of a bovine collagen type I: chondroitin-6-sulphate (CG) scaffold, obtained from Uruguayan raw material (certified as free bovine spongiform encephalopathy), with CG crosslinking enhancement using different gamma radiation doses. Structural, biomechanical and chemical characteristics of the scaffolds were assessed by Scanning Electron Microscopy, axial tensile tests, FT-IR and Raman Spectroscopy, respectively. Once we selected the most appropriate scaffold for future use as a TE product, we studied the behavior of MSCs and DPSCs cultured on the scaffold by cytotoxicity, proliferation and differentiation assays. Among the diverse porous scaffolds obtained, the one with the most adequate properties was the one exposed to 15 kGy of gamma radiation. This radiation dose contributed to the crosslinking of molecules, to the formation of new bonds and/or to the reorganization of the collagen fibers. The selected scaffold was non-cytotoxic for the tested cells and a suitable substrate for cell proliferation. Furthermore, the scaffold allowed MSCs differentiation to osteogenic, chondrogenic, and adipogenic lineages. Thus, this work shows a promising approach to the synthesis of a collagen-scaffold suitable for TE.

Hay or silage? How the forage preservation method changes the volatile compounds and sensory properties of Caciocavallo cheese.

The aim of this study was to determine the effect of the forage preservation method (silage vs. hay) on volatile compounds and sensory properties of a traditional Caciocavallo cheese during ripening. A brown-midrib sudangrass hybrid was cultivated on a 7-ha field and at harvesting it was half ensiled in plastic silo bags and half dried to hay. Forty-four lactating cows were equally allotted into 2 groups fed a isonitrogenous and isoenergetic total mixed ration containing as the sole forage either sorghum hay (H group) or sorghum silage (S group). Milk from the 2 groups was used to produce 3 batches/diet of Caciocavallo ripened for 30, 60, and 90 d. Milk yield and composition as well as cheese chemical and fatty acid composition were not markedly affected by the diet treatment and ripening time. By contrast, ripening induced increased levels of the appearance attribute "yellowness," along with the "overall flavor," the odor/flavor attributes "butter" and "hay," the "salty," "bitter," and "umami" tastes, and the texture attribute "oiliness," whereas the appearance attribute "uniformity" and the texture attribute "elasticity" were reduced. The silage-based diet induced higher perceived intensities of several attributes such as "yellowness"; "overall flavor"; "butter"; "grass" and "hay" odor/flavors; "salty," "bitter," and "umami" tastes; and "tenderness" and "oiliness" textures. In S cheese we also observed higher amounts of ketones and fatty acids. Conversely, H cheese showed the terpene α-pinene, which was not detected in S cheese, and a higher intensity of the appearance attribute "uniformity." These differences allowed the trained panel to discriminate the products, determined an increased consumer liking for 90-d ripened cheese, and tended to increase consumer liking for hay cheese.

Effects of an automatic milking system on milk yield and quality of Mediterranean buffaloes.

A study was carried out to evaluate the effects of an automatic milking system (AMS) on milk yield and composition of buffalo (Mediterranean-type Bubalus bubalis) cows. Performed from January 2015 to December 2015 in an organic buffalo dairy farm equipped with both a traditional tandem milking parlor and an AMS, the study involved 90 primiparous buffaloes randomly allotted to a tandem or AMS group from 5 to 10 d of lactation onward. Number of milkings per day and daily milk yield of each cow were recorded, and individual milk sampling was carried out twice a month. Compared with the tandem, the AMS group showed significantly higher daily milk yield and persistence of lactation. Use of the AMS resulted in higher protein and casein contents, and lower somatic cell and total bacterial counts, whereas fat, freezing point, and pH were unaffected by the system. We conclude that, in terms of milk yield and quality, automatic milking may be a suitable alternative to conventional milking for buffaloes.

The inclusion of fresh forage in the lactating buffalo diet affects fatty acid and sensory profile of mozzarella cheese.

The aim of this study was to determine the effect of inclusion of fresh forage in diet for lactating buffalo on properties of mozzarella cheese under intensive farming conditions. Thirty-two buffalo cows were equally allotted into 2 groups fed diets with (fresh group, FRS) or without (control group, CTL) fresh sorghum. The study consisted of 2 trials. In the first one, animals from group FRS were fed a diet containing 10 kg of fresh sorghum (10-FRS diet) that was doubled to 20 kg (20-FRS diet) in the second trial. All diets were isonitrogenous and isoenergetic, and fresh forage accounted for 13.4 and 26.5 of dietary dry matter, respectively, for the 10-FRS and 20-FRS diet. In each trial, milk from the 2 groups was used to produce 3 batches/diet of Mozzarella di Bufala Campana Protected Designation of Origin cheese. Milk yield and composition were not influenced by dietary treatment. The use of 10-FRS diet did not affect any properties of mozzarella. As the inclusion rate of fresh sorghum doubled to 20 kg, an increment of unsaturated fatty acid percentages and a lowering of short-chain and saturated fatty acids were observed. Moreover, the sensory characteristics of mozzarella were modified, although no effects were observed on consumer acceptance. We conclude that the use of green fodder can represent a low-cost feeding strategy to improve the healthiness of buffalo mozzarella under intensive farming conditions with no detrimental effect on consumer blind acceptance.

Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity.

BACKGROUND: The approval of 9-δ-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex) for the management of treatment-resistant multiple sclerosis (MS) spasticity opened a new opportunity for many patients. The aim of our study was to describe Sativex effectiveness and adverse events profile in a large population of Italian patients with MS in the daily practice setting. METHODS: We collected data of all patients starting Sativex between January 2014 and February 2015 from the mandatory Italian medicines agency (AIFA) e-registry. Spasticity assessment by the 0-10 numerical rating scale (NRS) scale is available at baseline, after 1 month of treatment (trial period), and at 3 and 6 months. RESULTS: A total of 1615 patients were recruited from 30 MS centres across Italy. After one treatment month (trial period), we found 70.5% of patients reaching a ≥20% improvement (initial response, IR) and 28.2% who had already reached a ≥30% improvement (clinically relevant response, CRR), with a mean NRS score reduction of 22.6% (from 7.5 to 5.8). After a multivariate analysis, we found an increased probability to reach IR at the first month among patients with primary and secondary progressive MS, (n=1169, OR 1.4 95% CI 1.04 to 1.9, p=0.025) and among patients with >8 NRS score at baseline (OR 1.8 95% CI 1.3-2.4 p<0.001). During the 6 months observation period, 631(39.5%) patients discontinued treatment. The main reasons for discontinuation were lack of effectiveness (n=375, 26.2%) and/or adverse events (n=268, 18.7%). CONCLUSIONS: Sativex can be a useful and safe option for patients with MS with moderate to severe spasticity resistant to common antispastic drugs.

Fatty acid and sensory profiles of Caciocavallo cheese as affected by management system.

The effect of season of the year associated with changes in feeding and management system (pasture-based vs. confinement) on milk and cheese fatty acid profile and on sensory properties of Caciocavallo cheese was evaluated on 3 mountain dairy farms. Each farm used a pasture-based feeding system from April to June and from September to October (PS), and a confinement system for the rest of the year (CS). As a consequence of grazing, PS milk showed higher percentages of C18:3, cis-9,trans-11 conjugated linoleic acid, and trans-11 C18:1, and a reduced percentage of C16:0. The fatty acid profile of cheese largely reflected that of the corresponding raw milk from which cheese was made. This led to a significant decrease of atherogenic index in cheeses produced from cows on pasture. Based on sensory analysis, cheese from animals kept on pasture was more yellow and had a lower intensity of butter and smoked odors than did CS cheese. In addition, grazing induced a lower intensity of bitter and a higher intensity of spicy flavors compared with cheese from CS animals. In regard to texture, pasture feeding resulted in higher intensity of friability and graininess. All cheeses performed well in consumer tests; the panel found all samples more than acceptable for overall liking, and for liking according to appearance, taste/flavor, and texture. Overall liking of Caciocavallo cheese, as assessed by slope analysis, was affected primarily by taste/flavor (raw slope k=0.88) and texture (k=0.97), whereas appearance had a lesser effect (k=0.72). The acidic and sensory profiles of cheese were well discriminated, with healthier cheeses produced by grazing cows. Therefore, wider use of pasture should be promoted to accentuate this favorable feature. Based on the specific nutritional and sensory characteristics of mountain Caciocavallo cheese, particularly that obtained from grazing animals, efforts should be made to indicate the quality of this cheese to the consumer and improve product recognition.

Olanzapine-induced neutropenia in a patient with systemiclupus erythematosus: a role of FcγRIIIb polymorphism?

In this study, we report the case of a Chinese patient with systemic lupus erythematosus (SLE) who developed neutropenia after treatment by olanzapine for the SLE-related psychiatric symptoms. The relationship between agranulocytosis, SLE and olanzapine is still unknown. Fcγ receptor IIIb (FcγRIIIb) is a low-affinity receptor, constitutively expressed only by neutrophils; NA1 and NA2 have been identified as representing polymorphisms of FcγRIIIb. NA1 is associated with the incidence of autoimmune neutropenia and is particularly frequent in Asiatic ethnic groups. The Chinese patient resulted to be homozygous for NA1. We suggest that the presence of NA1 allele may be a predisposing factor to olanzapine-induced agranulocytosis in patients with SLE. Hence, the analysis of FcγRIIIb polymorphism should be investigated in other cases of antipsychotic-induced agranulocytosis.

Short communication: Translational efficiency of casein transcripts in Mediterranean river buffalo.

Buffalo milk is characterized by the presence of all 4 casein fractions (α(S1), ß, α(S2), and κ) encoded by the 4 tightly linked autosomal genes (CSN1S1, CSN2, CSN1S2, and CSN3, respectively). In the present paper, we report for the first time a quantitative characterization of buffalo casein transcripts and show that the 4 genes are not transcribed and translated with the same efficiency. In particular, the analysis of individual milk samples obtained from 9 Mediterranean river buffaloes showed that the most abundant casein fractions were ß (53.45%) and α(S1) (20.61%), followed by α(S2) and κ, at 14.28 and 11.66%, respectively. Quantification of the corresponding mRNA showed that the percentage of transcripts of the 4 caseins was 16.48, 23.18, 55.87, and 4.47% for α(S1), ß, α(S2), and κ, respectively. Translation efficiency was 0.25 for CSN1S2, 1.31 for CSN1S1, 2.39 for CSN2, and 2.69 for the CSN3 transcripts, respectively. A comparison of nucleotide sequences with the Kozak consensus sequence was also carried out to investigate if the mRNA sequences might be responsible for the observed differences.

Can immune disorders influence therapeutic approaches in treatment of epilepsy among neurologists? A first cooperative national recognition in Italy.

Functional disturbances of the immune system have been detected more often among persons affected by epilepsy than in the general population. In the February-July period of 2007 a specific questionnaire on the relationship between epilepsy and immunological response was sent to 27 specialized Centres for Epilepsy in nine Italian regions. 15,388 epileptic patients attended twenty-seven Centers during this six-month period. 3.3 percent (n=502) of these patients suffered an immune disease. This is the first National survey on the relationship between epilepsy and immunological response in current clinical practice.

Cognitive deficits in multiple sclerosis: a review of functional MRI studies.

Cognitive dysfunction frequently occurs during the course of multiple sclerosis (MS). In patients with MS the severity of cognitive manifestations is not closely related to indices of structural brain damage. Neuroplasticity may contribute to the maintenance of normal performance despite scattered brain lesions. Changes in functional organization of the cerebral cortex have been reported by functional magnetic resonance imaging (fMRI) studies in MS. fMRI studies provide an interesting way of understanding how the brain changes its functional organization in response to MS, and might be useful in the study of the effects of rehabilitative or pharmacological therapy on brain plasticity. The purpose of this review is to examine major fMRI studies focusing on cognitive dysfunction in MS.

Behavior and milk production of buffalo cows as affected by housing system.

To verify the effect of 2 housing systems (with and without a pool and an ample outdoor lot) on behavior and milk yield, 45 lactating buffalo cows were group-housed in a free stall open-sided barn with concrete floor where they received 10 m(2)/head as space allowance (group NP); 43 cows were group-housed in a similar barn, but had access to an outdoor yard (36 m(2)/head) and a concrete pool of 208 m(2) (group WP). Animals were subjected to 8 sessions of instantaneous scan sampling at approximately 10-d intervals. Behavioral variables were expressed as proportions of subjects observed in each category of posture and activity. In addition, rapid behaviors such as agonistic, social, and reproductive interactions, social licking, and self-grooming were recorded continuously. These variables were expressed as number of interactions per animal. At the end of each hour of observation, temperature and relative humidity were recorded. In WP the proportion of animals observed wallowing was 0.476 +/- 0.034, whereas lower proportions were observed standing (0.389 +/- 0.029) or lying (0.141 +/- 0.021) outside the pool. In NP the proportions of animals observed standing and lying were 0.452 +/- 0.042 and 0.548 +/- 0.042, respectively. A significant relationship between mean temperatures recorded on observation days and proportion of animals in the pool was observed (r(s) = 0.41). Fewer animals from group WP were observed idling compared with buffaloes from group NP (0.44 +/- 0.024 vs. 0.509 +/- 0.024, respectively), whereas more WP animals were involved in investigative activities than NP cows (0.099 +/- 0.009 vs. 0.042 +/- 0.009, respectively). A greater number of social interactions (sniffing and nuzzling) and social lickings were observed in group WP than in group NP (0.120 +/- 0.010 vs. 0.067 +/- 0.010, and 0.151 +/- 0.018 vs. 0.090 +/- 0.018, respectively). The WP buffalo cows had a greater milk yield than NP cows (11.73 +/- 0.31 vs. 10.78 +/- 0.28 kg/d, respectively), whereas no differences between groups were observed for protein (4.86 +/- 0.04 vs. 4.80 +/- 0.03% for WP and NP, respectively) and fat contents (8.49 +/- 0.14 vs. 8.38 +/- 0.13% for WP and NP, respectively). We conclude that the provision of a pool and an ample outdoor paddock can have beneficial effects on welfare and milk production of buffaloes.

Influence of inherited and acquired thrombophilic defects on the clinical manifestations of mixed cryoglobulinaemia.

OBJECTIVE: To investigate the contribution of inherited and acquired thrombophilic defects to the clinical manifestations of mixed cryoglobulinaemia vasculitis. METHODS: The following thrombophilic defects were investigated in 64 consecutive patients with HCV-associated mixed cryoglobulinaemia: aPLs, lupus anti-coagulant, homocysteinaemia, protein C and protein S concentrations, activated protein C resistance, plasminogen activator inhibitor-1 4G4G and 5G5G genotypes, and the presence of mutations of factor V (Leiden and H1299R), of prothrombin (G20210A) and of methyl tetrahydrofolate reductase (C677T and A1298C). Additional variables were demographic data, duration of the disease, cryocrit level and vascular risk factors (diabetes, hypertension, hypercholesterolaemia and smoking habit). The following clinical manifestations of mixed cryoglobulinaemia were analysed as dependent covariates: severity of purpura, presence of necrotic skin ulcers, presence of peripheral neuropathy and presence of kidney disease. RESULTS: Logistic regression analysis identified hyperhomocysteinaemia as a risk factor for severe purpura (P < 0.0001) and for the presence of skin ulcers (P < 0.0001), whereas none of the other thrombophilic defects influenced the clinical presentation of mixed cryoglobulinaemia. Purpura improved in two patients after lowering homocysteine with vitamin supplementation. CONCLUSIONS: Hyperhomocysteinaemia may be a risk factor for severe cutaneous manifestations in mixed cryoglobulinaemia.

99mTc-HMPAO brain SPECT in the monitoring of cerebral vasculitis therapy. / 99mTc-HMPAO SPECT cerebral en la monitorización de la terapia de vasculitis.

OBJECTIVE: The central nervous system (CNS) may be involved in a variety of inflammatory diseases of the blood vessels, generally known as vasculitis. The clinical diagnosis of such involvement in early stages is difficult, since a mild cognitive impairment can be the only symptom. It was hypothesized that brain-perfusion SPECT would be able to reveal CNS involvement and to monitor the course of the disease. The purpose of this study was assess if and when an improvement of cerebral perfusion can be registered by SPECT during the follow-up of these diseases. MATERIAL AND METHODS: Eighteen patients affected by Systemic Lupus Erythematosus (SLE), 22 by undifferentiated vasculitis (UV), 5 by Behcet's disease (BD) and 5 by primary Sjogren's Syndrome (pSS) were enrolled in this prospective study. A 99mTc-HMPAO brain perfusion SPECT was performed before the treatment and was repeated during the follow-up at different time intervals. Image analysis was performed on 10 cerebral areas using a specific software. RESULTS: In the SLE patients, no significant improvement of brain perfusion was found. On the contrary, in the UV the cerebral uptake of the tracer significantly improved from the twenty-fourth month (18/22 patients). Patients with BD showed an improvement of scintigraphic findings (5/5 patients), while a similar result was obtained only in 2 of the patients with pSS. CONCLUSIONS: In conclusion, brain SPECT seems to be able to monitor the disease in UV, indicating the moment when an improvement of the cerebral perfusion is achieved. In SLE patients this scintigraphic technique did not show a significant improvement in CNS perfusion.

Effect of group size and maize silage dietary levels on behaviour, health, carcass and meat quality of Mediterranean buffaloes.

The effects of different dietary levels of maize silage (10% v. 36% DM) and group size (7 v. 14 animals) were assessed on growth performance and in vivo digestibility of 28 male fattening buffaloes. In addition, the effects of diet on meat quality and group size on behaviour and immune response were separately evaluated. Animals were weighed and assigned to three groups. The high silage - low size group (HL) was fed a total mixed ration (TMR) containing 36% DM of maize silage and consisted of seven animals (age 12.7±2.6 months; BW 382.2±67.7 kg at the start of the study). The low silage - low size group (LL) was fed a TMR containing 10% DM of maize silage and consisted of seven animals (age 13.0±2.7 months; BW 389.4±72.3 kg). The high silage - high size group (HH) was fed the 36% maize silage DM diet and consisted of 14 animals (age 13.9±3.25 months; BW 416.5±73.9 kg). Total space allowance (3.2 indoor+3.2 outdoor m2/animal) was kept constant in the three groups, as well as the ratio of animals to drinkers (seven animals per water bowl) and the manger space (70 cm per animal). Growth performance, carcass characteristics and digestibility were influenced neither by dietary treatment nor by group size, even if the group fed 36% maize silage diet showed a higher fibre digestibility. No effect of diet was found on meat quality. Group size did not affect the behavioural activities with the exception of drinking (1.04±0.35% v. 2.60±0.35%; P<0.01 for groups HL and HH, respectively) and vigilance (2.58±0.46% v. 1.20±0.46%; P<0.05 for groups HL and HH, respectively). Immune responses were not affected by group size.

Buffering capacity and H+ membrane conductance of gram-negative bacteria.

Buffering capacity and membrane H+ conductance were examined in seven Gram-negative species: Aquaspirillum serpens, Pseudomonas aeruginosa, Alcaligenes faecalis, Escherichia coli, Salmonella typhimurium, Proteus mirabilis and Aeromonas hydrophila. All strains of Enterobacteriaceae studied here showed a decrease in both parameters as the external pH increased, over the pH range studied. The other four species presented an increase in buffering capacity and membrane conductance to protons as the external pH increased from 5.5 to 7.0.

Response of the cortically blind hemifields to a moving visual scene.

Viewing a rotating field induces a counter-rotating tilt of the subjective vertical in normal subjects. A similar, though smaller, effect is observed when only one hemifield is stimulated. This technique was used with 7 hemianopic patients having retrogenicular lesions. It was hypothesized that the stimulation of a moving scene in the blind field produces an additional tilting effect to that produced by the stimulation of the normal hemifield alone. The visual rotation within only the blind field is expected to have a systematic tilting effect. Both predictions were confirmed in all 7 patients having either right or left hemianopic disorders.

Peripheral neuropathy without cryoglobulinemia in patients with hepatitis C virus infection.

BACKGROUND: An association between essential mixed cryoglobulinemia and hepatitis C virus infection has been documented by many reports. Some clinical manifestations such as purpura, arthralgia, vascular lesions and peripheral neuropathies are also connected with the presence of detectable cryoglobulins. The association between HCV infection, the presence of mixed cryoglobulinemia and peripheral neuropathy is well documented. The aim of this study was to define the possible presence of peripheral neuropathy in HCV patients without detectable cryoglobulins and the possible association with the different genotypes. METHODS: Twenty patients (11 females, 9 males) with chronic HCV hepatitis and without detectable cryoglobulins were submitted to neurological and electrophysiological studies to detect a possible peripheral neurological involvement. In all patients the HCV infection was assumed by the presence of antibodies to HCV with ELISA assay and then confirmed with recombinant immunoblot assay. HCV genotyping was obtained by INNO LIPA in 15 out of 20 patients. In 4 patients a sural nerve biopsy was possible. RESULTS: Genotype 1b was present in 80% of patients, while 1a in 13.3% and 4 in 6.6%. Thirteen patients had positive neurological anamnesis (65%), while neurological examination was positive in 40% of the cases. Electromyographic study was positive in 50% of subjects. The sural nerve biopsies agreed with axonal degeneration in amyelinated fibres. CONCLUSIONS: Our results suggest a possible peripheral neurological system involvement in patients with HCV infection without cryoglobulins.

MRI in the study of distal primary myopathopies and of muscular alterations due to peripheral neuropathies: possible diagnostic capacities of MR equipment with low intensity field (0.2 T) dedicated to peripheral limbs.

The purpose of this work was to investigate whether or not an magnetic resonance imaging (MRI) equipment with a low field intensity (0.2 T) used in the study of muscular alterations can diagnose primary or secondary myopathies, due to peripheral neuropathies. In this study the peripheral areas of all patients were examined. A total of 40 patients (23 males and 17 females) were tested. Their age ranged from 10 to 78 years age (mean age 40.8, SD +/- 19,45 years). The group includes 23 patients: 18 with Stainert Myotonic Distrophy, 5 were myositic, and the remaining 17 had peropheral neuropathies. Every patient received a clinic examination, followed by EMG and MRI. The MRI study was done with a system dedicated to the study of limbs (Artoscan, Esaote Biomedica) that used a 0.2 T permanent magnet. Spin-echo T1, T2-weighted, multiple-echo, and STIR sequences were used. A good correspondence was found between clinical and MRI data. Specifically, in the group of 23 myopathies, Sperman's index was found to be 0.80 in its correlation between the clinical examination and MRI; in the group of 17 myopathies it was found to be 0.63. A discrepancy was found among clinical examination, EMG, and MRI in patients with neuropathies who were showing a lack of myelin and mixed ones. The T2-weighted and STIR sequences had great sensitivity in showing initial changes in the muscles. The SE T1-weighted sequence was especially useful in detecting degeneration in the fibrous adipose tissue. The STIR sequence because of its high sensitivity and greater speed of response could be used instead of the SE T2 weighted particularly in the study of patients, who were noted to tolerate a prolonge period of scanning. However, because these sequences have a low signal noise ratio, they must always be associated with a SE sequence, whenever there would be need of a precise determination of the structures under study. The MRI low field intensity was also found to be a useful technique in screening familial groups having a great number of myotonic distrophies. It can have a great clinical role in revealing muscular alterations, even in asymptomatic patients.