Endoscopic submucosal tunnel dissection vs conventional endoscopic submucosal dissection for large colorectal neoplasms: a single-centre retrospective study.

BACKGROUND: Colorectal endoscopic submucosal dissection (ESD) is still not widely used due to its technical difficulty and the risk of complications. Several techniques, such as traction techniques, pocket techniques and others, have been proposed to facilitate it. One modified pocket technique especially suitable for large lesions is endoscopic submucosal tunnel dissection (ESTD). The aim of this study was to evaluate the safety and efficacy of ESTD and compare ESTD to the conventional ESD (CESD) for treating large colorectal lesions. METHODS: The charts of consecutive patients referred to the Arcispedale Santa Maria Nuova (Reggio Emilia, Italy) for colorectal ESD between January 2014 and February 2021 for colorectal neoplasms > 40 mm were retrospectively analysed. The primary outcome of the study was the en bloc resection rate. Secondary outcomes were complete and curative resection rates, procedure speed, the adverse events rate and the recurrence rate. RESULTS: There were 59 patients (M:F ratio 29:30, median age 70 years [range 50-93 years]). Of 59 colorectal lesions > 40 mm, 25 were removed by ESTD and 34 by CESD. The en bloc resection rate was 100% in both groups and the complete resection rate was similar (ESTD 92% vs CESD 97.1%, p = 0.569), while the curative resection rate was higher in the CESD group, but not significantly (94.1% vs 76%, p = 0.061). Procedure speed was significantly faster with ESTD (22 vs 17 mm2/min, p = 0.045), and the overall incidence of adverse events was low (6.8%). Eight patients were referred to surgery due to non-curative resection. During follow-up, no recurrence was observed in either treatment group. CONCLUSION: ESTD achieves a very high en bloc resection rate and is faster than CESD.

Determination of fatty acid content in meat and meat products: The FTIR-ATR approach.

The aim of the study was to investigate the feasibility of Fourier Transformed Infrared Spectroscopy (FTIR) on Attenuated Total Reflectance (ATR) in the determination of the fatty acid content in meat and meat products. The Multivariate calibrations were developed and proposed for Saturated Fatty Acids (SFA), Monounsatured Fatty Acids (MUFA), Polyunsatured Fatty Acids (PUFA) and Palmitic Acid. SFA and MUFA models, developed using the first derivative and the selected region 3022.33-650.15 cm-1, gave the best performance, with a coefficient of calibration r2 0.9834 and 0.9775, respectively, and the relative Root Mean Square Error of Calibration (RMSEC) 0.594 and 0.699. The best model for PUFA was obtained for region 4000.12-650.15 using the first derivative (r2 0.9817, RMSEC 0.724). Palmitic acid, chosen as the case study of single fatty acids, showed a best linear regression for the first derivative approach in region 4000.12-650.15. Results were less satisfactory in prediction in the proposed models.

Influence of cultivation system on bioactive molecules synthesis in strawberries: spin-off on antioxidant and antiproliferative activity.

Strawberries (Fragaria ananassa L., cv. favette) were studied to investigate the influence of cultivation practices (biodynamic, conventional) on the synthesis of bioactive molecules (ascorbic acid, ellagic acid, anthocyanins, flavonols) and to evaluate their antioxidant activity. Additionally, the in vitro bioactivity, in terms of antioxidant and antiproliferative activity, of the same strawberry samples in human colon carcinoma (Caco-2) cells was also studied. Compared to conventional strawberries, biodynamic fruits had a significantly higher content of ascorbic acid (P < 0.01), pelargonidin-3-glucoside (P < 0.05), cyanidin-3-glucoside (P < 0.01), ellagic acid (P < 0.01), quercetin, and kaempferol (both P < 0.01). Antioxidant activity of biodynamic strawberry crude extract was significantly higher than that of the conventional one (P < 0.05); in addition, while the antioxidant activity of water-soluble fraction was very similar in both biodynamic and conventional strawberries, that of water-insoluble fraction of biodynamic fruits was significantly higher (P < 0.05). The same crude extract of biodynamic strawberry samples effectively corresponded to an increase of bioactivity, in terms of both cellular antioxidant activity and antiproliferative activity, in Caco-2 cells differentiated to normal intestinal epithelia and in undifferentiated Caco-2, respectively. Further studies are needed to confirm whether the practice of biodynamic agriculture is likely to increase the bioactivity of other varieties of fruits and vegetables.

Nutritional value of traditional Italian meat-based dishes: influence of cooking methods and recipe formulation.

The present study provides a picture of the compositional figure and nutritive value of meat-based dishes typical of Italian culinary tradition. Recipes specific for a bovine meat cut (top-side) were selected among the most widespread ones in Italy: in pan, pizzaiola, cutlet, meat ball, and escalope. The total fat and cholesterol content varied depending on the ingredients utilized (extra-virgin olive oil, parmesan, egg). Meat-based dishes that utilized extra-virgin olive oil showed a significant reduction in palmitic and stearic acids and a parallel increase in oleic acid compared with raw meat; furthermore, the ratio among saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids shifted in favour of monounsaturated fatty acids. B vitamins were affected at different extent by heating; by contrast, vitamin E content increased because of the new sources of this vitamin, which masked losses due to heating. Ingredients (parmesan, discretionary salt) induced significant increases in the calcium and sodium concentrations compared with raw meat. The total iron content did not show marked differences in most of the meat-based dishes compared with raw meat; by contrast, losses in the heme-iron concentration were detected depending on the severity of heating treatments. Our findings suggest that heme iron, because of its important health aspects, might be a useful index of the nutritional quality of cooked meats.

Amphiphilic poly(vinyl alcohol) derivatives as complexing agents for fenretinide.

Poly(vinyl alcohol) (PVA) substituted with oleyl chains and tetraethyleneglycol monoethyl ether chains (TEGMEE) at 1.5% and 1% degrees of substitution respectively (mol of substituent to mol of hydroxyvinyl monomer) has previously been shown to self-assemble in water, providing aggregates selectively cytotoxic toward tumor cells vs normal cells. These polymers have also been shown to increase the long-term survival of nude mice injected with both human and murine neuroblastoma cell lines. In the present work, we changed the substitution degree of the oleyl chains on the poly(vinyl alcohol) backbone and maintained constant at 1% the degree of TEGMEE substitution. We evaluated the main physicochemical characteristics of the final polymers, their cytotoxicity toward tumor cells, and their complexing ability for hydrophobic molecules. The aim was to investigate the possibility of improving intrinsic antitumor efficacy of the polymer by changing the degree of oleyl chain substitution and further increase activity by complexation with antitumor drugs. The polymers were prepared at oleyl chain substitution degrees ranging from 0.5 to 3% (mol of substituent to mol of hydroxyvinyl monomer). The most active was again the 1.5% substituted polymer. It was further characterized by exhibiting the highest complexing ability toward hydrophobic molecules allowing the formation of a complex with fenretinide (HPR). The polymer-HPR complex was stable in aqueous environment and released the free drug prevalently in the presence of fluid hydrophobic phases. It was cytotoxic toward tumor cells with minimal activity toward normal cells. Antitumor activity exceeded that of the separate complex components resulting from the concomitant effect of the polymer and the HPR solubilized by complexation.

Thermochemical and kinetic studies of a bisphenol antioxidant.

The results of a thermodynamic and kinetic investigation on the homolytic reactivity of 3,3'-di-tert-butyl-5,5'-dimethyl(1,1'-biphenyl)-2,2'-diol (1) are reported. EPR studies of the equilibration between 1, 2,4,6-trimethylphenol, and the corresponding radicals obtained by abstraction of a hydroxylic hydrogen allowed us to determine the OH bond dissociation energy (BDE) of investigated bisphenol as 83.10 kcal/mol. This value is considerably larger than that reported for the structurally related 2,6-di-tert-butyl-4-methylphenol (BHT), i.e., 81.02 kcal/mol. Absolute rate constants for the reaction of 1 with alkyl, alkoxyl, and peroxyl radicals, at or nearly to room temperature, were also determined by competition kinetics in the first two cases and by autoxidation studies under controlled conditions in the last one. The experimental data indicate that this bisphenol is a moderately efficient antioxidant and polymerization inhibitor.

Timed-kill curves for Cryptococcus neoformans isolated from patients with AIDS.

Infection with Cryptococcus neoformans is an increasing problem in immunocompromised patients, particularly those with acquired immune deficiency syndrome (AIDS). Amphotericin B and fluconazole are currently acceptable therapies for cryptococcal meningitis; however, their effects remain suboptimal and recurrence or treatment failure is still a problem. Antifungal susceptibility testing may be an important tool for guiding therapy, but for C. neoformans, a reliable method is still not available. This retrospective study evaluated minimal inhibitory concentration (MIC) for amphotericin B and fluconazole, and minimal fungicidal concentration (MFC) and timed-kill curves for amphotericin B against 16 clinical isolates of C. neoformans obtained from AIDS patients with cryptococcal meningitis. No correlation between clinical outcome and MIC was observed for amphotericin B. In selected cases, the MFC seemed to be a better predictor of outcome than MIC. In this study, amphotericin B timed-kill curves appeared to show a correlation with clinical outcome of the 16 patients with AIDS-associated cryptococcal meningitis. These in vitro tests must be further evaluated in prospective studies to confirm their potential usefulness for guiding cryptococcal meningitis therapy.

EPR properties of two new cyclic phosphinylhydrazyl radicals and of their inclusion complexes with cyclodextrins

Two phosphorus-containing hydrazines, namely morpholin-4-ylphosphoramidic acid diethyl ester (1a) and (2,2,6,6-tetramethylpiperidin-1-yl)phosphoramidic acid diethyl ester (2a), have been synthesized. The corresponding hydrazyl radicals (1b and 2b) have been obtained, by in situ oxidation, and their properties have been investigated by EPR spectroscopy. The 1b radical shows spectra strongly dependent on temperature due to the inversion of the morpholin ring and to rotation about the N-N bond. Since, in the investigated temperature range, both motions take place in the EPR time scale, a kinetic study of these process could be made by analyzing the spectral line-shape variations. The 2b radical is highly persistent and shows a strong temperature and solvent dependence of the phosphorus splitting. The latter property was usefully exploited to study the guest-host interaction of this radical with cyclodextrins. A method is also proposed for the determination of affinity constants for cyclodextrins of nonparamagnetic compounds.

An EPR Investigation of the Kinetics of Inclusion of a Persistent Radical in Water-Soluble Calix

Distinct EPR signals are observed for the free and included species for the inclusion of the neutral benzyl tert-butyl nitroxide probe into a calix[4]arene host in water (shown schematically). Computer simulation of the EPR spectra recorded at various temperature enabled direct determination of the activation and kinetic parameters for this inclusion process.

Composition and calcium status of acid whey from pasteurized, UHT-treated and in-bottle sterilized milk.

Whey extracts were obtained from pasteurized, UHT-treated and in-bottle sterilized milks. After acidic precipitation of casein the concentration of protein, NPN, lactose, lipid, calcium, magnesium and potassium was determined. Among the parameters examined, protein content was significantly reduced in the whey extracts from UHT-treated and in-bottle sterilized milks compared with that from pasteurized milk, while lactose content was increased. Calcium extracted in whey was at least 80% of total calcium of the milk. The total calcium to protein ratio of whey was increased as a function of the thermal treatment of milk, while ionic calcium was about 50% of total calcium in all whey extracts. In vitro protein digestibility was found to be significantly lower in whey from UHT-treated and in-bottle sterilized milks than in that from pasteurized milk. Parallel estimation of the percentage of ionic calcium and of the solubility of proteins in the pH range 2-10 indicated that calcium was not involved in the pH-dependent solubility of proteins extracted in the whey, the extent of solubility being essentially a function of the thermal treatment of milk. The results suggest that calcium was not responsible for the formation of soluble protein macroaggregates with impaired digestibility that are present in whey from milk subjected to heat treatment of increasing intensity.

Medium effects on the antioxidant activity of dipyridamole.

Very strong medium effects have been observed when testing the antioxidant activity of dipyridamole (DP) in different media such as benzene, tert-butanol, methanol solutions and egg yolk lecithin unilamellar and multilamellar vesicles. Actually, dipyridamole behaves as a very poor antioxidant in benzene while its ability to inhibit the lipid peroxidation reaction increases with increasing solvent polarity, being the highest in lipid vesicles. This behavior can not be rationalized on the basis of the classical chain breaking mechanism which operates in the case of phenolic and amine antioxidants and involving the transfer of a hydrogen atom to peroxyl radicals. An explanation is instead given in terms of an electron transfer reaction which leads to the oxidation of DP by the chain carrying peroxyl radical to give the dipyridamole cation radical, DP+*, and the peroxyl anion LOO-, and whose rate constant is expected to increase in strongly polar media. EPR and electrochemical data supporting this interpretation have been collected.