Distinction between Neural and Vascular BOLD Oscillations and Intertwined Heart Rate Oscillations at 0.1 Hz in the Resting State and during Movement.

In the resting state, blood oxygen level-dependent (BOLD) oscillations with a frequency of about 0.1 Hz are conspicuous. Whether their origin is neural or vascular is not yet fully understood. Furthermore, it is not clear whether these BOLD oscillations interact with slow oscillations in heart rate (HR). To address these two questions, we estimated phase-locking (PL) values between precentral gyrus (PCG) and insula in 25 scanner-naïve individuals during rest and stimulus-paced finger movements in both hemispheres. PL was quantified in terms of time delay and duration in the frequency band 0.07 to 0.13 Hz. Results revealed both positive and negative time delays. Positive time delays characterize neural BOLD oscillations leading in the PCG, whereas negative time delays represent vascular BOLD oscillations leading in the insula. About 50% of the participants revealed positive time delays distinctive for neural BOLD oscillations, either with short or long unilateral or bilateral phase-locking episodes. An expected preponderance of neural BOLD oscillations was found in the left hemisphere during right-handed movement and unexpectedly in the right hemisphere during rest. Only neural BOLD oscillations were significantly associated with heart rate variability (HRV) in the 0.1-Hz range in the first resting state. It is well known that participating in magnetic resonance imaging (MRI) studies may be frightening and cause anxiety. In this respect it is important to note that the most significant hemispheric asymmetry (p<0.002) with a right-sided dominance of neural BOLD and a left-sided dominance of vascular BOLD oscillations was found in the first resting session in the scanner-naïve individuals. Whether the enhanced left-sided perfusion (dominance of vascular BOLD) or the right-sided dominance of neural BOLD is related to the increased level of anxiety, attention or stress needs further research.

Brain-heart communication: Evidence for "central pacemaker" oscillations with a dominant frequency at 0.1Hz in the cingulum.

OBJECTIVES: In the brain and heart, oscillations at about 0.1Hz are conspicuous. It is therefore worthwhile to study the interaction between intrinsic BOLD oscillations (0.1Hz) and slow oscillations in heart rate interval (RRI) signals and differentiate between their neural and vascular origin. METHODS: We studied the phase-coupling with a 3T scanner with high scanning rate between BOLD signals in 22 regions and simultaneously recorded RRI oscillations in 23 individuals in two resting states. RESULTS: By applying a hierarchical cluster analysis, it was possible to separate two clusters of phase-coupling between slow BOLD and RRI oscillations in the midcingulum, one representative for neural and the other for vascular BOLD oscillations. About half of the participants revealed positive time delays characteristic for neural BOLD oscillations and neurally-driven RRI oscillations. CONCLUSIONS: The results suggest that slow vascular and neural BOLD oscillations can be differentiated and that intrinsic oscillations (0.1Hz) originate in the cingulum or its close vicinity and contribute to heart rate variability (HRV). SIGNIFICANCE: The study provides new insights into the dynamics of resting state activities, helps to explain HRV, and offers the possibility to investigate slow rhythmic neural activity changes in different brain regions without EEG recording.

Digestion of DNA regions to discriminate ochratoxigenic and non-ochratoxigenic strains in the Aspergillus niger aggregate.

Aspergillus strains belonging to the Aspergillus niger aggregate, either isolated from Italian grapes or received from public collections, were analysed in order to discriminate between the ochratoxin A (OTA) producing and the non-producing strains by means of the analysis of Internal Transcribed Spacers (ITS), Intergenic Spacers (IGS) and of a beta-tubulin gene portion. A. niger and Aspergillus awamori were identified observing the macro- and microscopic features of the colonies and the strains ochratoxigenicity was evaluated through Thin Layer Chromatography and/or High Performance Liquid Chromatography. PCR amplification of ITS, IGS and beta-tubulin gene portion produced 600, 440 and 550 bp amplicons, respectively, in all the analysed strains. The digestion of the IGS amplicon with Hinf I and of the other two amplicons with Rsa I, revealed one main profile type ("T-C-C") associated with the A. niger aggregate strains which lack the ability to produce OTA.

Comparison of three different mesh materials in tension-free inguinal hernia repair: prolene versus Vypro versus surgisis.

Using mesh or a synthetic prosthesis during tension-free inguinal hernia repair has been shown to be safe and effective. We compared the final outcome in treating inguinal hernia in 45 patients using three different prosthetic materials: 15 patients underwent tension-free inguinal hernia repair using Prolene (polypropylene) mesh, 15 using Vypro (polyglactin and polypropylene) mesh, and 15 with Surgisis-a new bioactive material derived from porcine small intestinal submucosa. The aim of this study was to evaluate the safety and efficacy of tension-free inguinal repair using Surgisis, comparing it with conventional prosthetic materials. From January 2003 to December 2003, 45 male patients underwent Lichtenstein inguinal hernia repair. Median follow-up was 12 months, with a range of 1-16 months. Each patient underwent ultrasound evaluation of the inguinal region 1 month after surgery. All the procedures were completed under local anesthesia. There were no intraoperative complications, and all patients were discharged home the same day of surgery. No recurrent hernias and wound infections were observed in our post-operative follow-up period. Postoperative pain (visual analog score) and discomfort were lower in patients with Surgisis mesh. There was no statistically significant difference between the groups in terms of overall early and late complications; however, there was a tendency toward a higher incidence of pain and discomfort in Vypro and Prolene group. The median time to full recovery was significantly shorter in the Surgisis group. Surgisis mesh seems to be a promising new prosthetic material for hernia repair. Long-term follow-up is necessary to confirm these preliminary results.

Primary retrorectal adenocarcinoma: report of a case.

Primary adenocarcinomas of the retrorectal (presacral) space are uncommon and usually arise from cystic lesions developing from remnants of the embryological postanal gut (tail gut cysts) containing mucous-secreting epithelium. A singular case of a patient who presented with a retrorectal mass is described. A 70-year-old previously healthy man had a four-month history of perianal pain during defecation. Preoperative colonoscopy showed external compression of the lower rectum with normal mucosa; pelvic computed tomography demonstrated a 5.5 x 4.5 cm(2) retrorectal oval mass, originating from the posterior lower rectal wall, containing cystic components and some small calcifications. The tumor, after complete resection via transanal approach, was shown to be a very rare case of primary adenocarcinoma of the presacral space. The patient had an uneventful postoperative course and he is free from disease 4 years after surgery. Clinicopathological features and surgical treatment of this unusual tumor are discussed.

Laparoscopic resection of calcifying fibrous pseudotumor of the gastric wall. A unique case report.

Calcifying fibrous pseudotumor (CFPT) is a recently described peculiar lesion characterized by the presence of abundant hyalinized collagen with psammomatous or dystrophic calcifications and a lymphoplasmacytic infiltrate. Initially, a few cases of CFPT were observed in the subcutaneous and deep soft tissues, especially at the level of the extremities, trunk, scrotum, groin, neck, and axilla; more recently, several cases have been reported in the pleura. We present a case of CFPT of the gastric wall. To our knowledge, this is the first such case to be described. A previously healthy 49-year-old woman presented with a 5-month history of epigastric pain after eating, early satiety, and weight loss. Gastroscopy revealed a polypoid lesion covered by normal mucosa along the great curvature of the gastric body. The patient was submitted to surgical treatment consisting of laparoscopic wedge resection of the gastric body. Histologic examination of the specimen disclosed CFPT affecting the wall of the gastrointestinal tract. The postoperative course was uneventful, and the patient was discharged from the hospital 5 days after surgery. The patient was free of disease 6 months after excision. Herein we discuss the clinicopathological features and surgical treatment of this most unusual case.

Advanced theory of mind in high-functioning adults with autism.

Twenty-four high-functioning adults with autism (16 men) who passed a first-order theory-of-mind task and 24 nonautistic adults (10 men) attributed mental states to recordings of various verbal intonations and to photos of people's eyes to assess advanced theory of mind. Participants with autism performed significantly worse than nonautistic participants on both tasks. Thus, the previously described inattention to others' eyes exhibited by adults with autism is not solely responsible for their inability to attribute mental states from eyes, as they also did not correctly attribute mental states from voices. These findings support the view that a core deficit for people with autism lies in their theory of mind, that is, their inability to attribute mental states to others.

The assessment of genomic alterations using DNA arrays following traumatic brain injury: a review.

Recent advances in DNA microarray technology have enabled the simultaneous evaluation of thousands of genes and the subsequent generation of massive amounts of biological data relevant to injury or diseases of the central nervous system (CNS). This technology has the potential to bridge the gap between molecular and systems neuroscience by efficiently revealing the discrete molecular aspects underlying the perturbations of complex systemic insults such as those resulting from traumatic brain injury (TBI). One of the more intriguing and as of yet not understood aspects of TBI that can be efficiently explored with DNA microarrays, is the sequence of molecular events that results in pronounced cell death in specific areas of the brain. The elucidation of these changes in gene expression underlying the mechanism of cell death following brain injury is of central importance in the design of future therapeutic agents. This review focuses on the technical aspects of microarray manufacture (photolithography, microspotting, and ink jet technology) and their utility in elucidating the molecular sequelae of brain injury.

Breast cancer screening in an urban population in northern Italy.

A mammographic and clinical screening for breast cancer started in June 1987 in the Health District of Brescia, Northern Italy, including the town and 23 surrounding municipalities. This paper describes the organization and the results of the first 12 months of screening. Of 7791 invited women aged 50-60 years, 5217 (67%) agreed to participate. There was a trend for response rates to decline with increasing age and education. Of the 5217 women examined, 66 (1.3%) were referred for biopsy and 64 (1.2%) underwent this procedure. A histologically confirmed malignancy was found in 42 women, corresponding to a prevalence of 8.1/1000. Positive predictive value of the screening was 65.6%. Among the 42 breast cancers, 4.8% were carcinoma in situ and 42.9% invasive tumors up to 10 mm in size. According to the p-TNM classification, 92.9% of all cancers were either TIS or in stage T1, 4.8% were in T2 and one tumor was classified in T4. Lymph node involvement was assessed in 41 cases, and 71.4% of all cancers detected by screening were negative for lymph node metastasis. In comparison, the classification of tumors found in women of the same age group and living in Brescia, histologically diagnosed in the urban hospitals during 1986, one year before the beginning of the screening, was as follows: 7.1% carcinoma in situ, and 16.7% invasive tumors up to 10 mm in size. 38.1%, 2.4% and 2.4% of all tumors were in stages T2, T3 and T4 respectively.

Carcinoma of the gastric stump following partial gastrectomy (Billroth II operation) for benign gastroduodenal lesions. Preliminary results.

A series of 110 patients out of 2,200, who had undergone Billroth II partial gastrectomy for benign lesions, between 1945 and 1980, was reviewed in order to perform clinical, biochemical and endoscopical examinations. In this group 9 patients (8.18%) showed gastric stump cancer and in 4 (3.63%) esophageal cancer was detected. The average time interval between previous operation and carcinoma diagnosis was of 28 years and 6 months. Eight patients out of 9 were males aging from 47 to 82, while the only woman was 65 (overall average: 63). The stump cancer presents at the same age and gives the same symptoms as primitive gastric carcinoma, but with worse results and prognosis. After having underlined some pathogenetic problems, the Authors show personal results and confirm the utility of an accurate endoscopical and clinical follow up especially for patients operated on since more than twenty years.

Extended operations for extracolic invasion by colon cancer.

Out of 618 cases of colon cancer treated between 1976 and 1986, 25 had an unusual local invasion. They underwent radical surgery with total resection of one or more adjacent organs. This group is made of 17 female and 8 male patients, with an average age of 58 years. All the patients underwent resection of the colon with radical excision of the locally invaded organs. Only one case of postoperative death is recorded. Postoperative surgical complications were rare. This experience confirms that colic resection extended to adjacent organs invaded by the tumor gives a low risk of relapse and satisfying long term results in relatively young patients with good general conditions and without remote metastases.

Gastric stricture following migration of the Angelchik prosthesis. A case report.

An unusual case of migration of an Angelchik esophageal antireflux prosthesis is reported. It was displaced at the middle third of gastric body, in a 49-year old female patient, who had undergone a surgical correction of hiatal hernia 6 months before and it had induced a severe narrowing of gastric lumen. Surgeons using this device should be aware of its various complications and employ it only in particular cases.