Corpus callosum volumetrics and clinical progression in early multiple sclerosis.

OBJECTIVE: Corpus callosum (CC) is commonly affected in multiple sclerosis (MS), with known association between CC atrophy and MS clinical activity. In this study, we assessed the association of callosal atrophy, lesions volume and residual CC volume with the clinical disability of early MS patients. SUBJECTS AND METHODS: Thirteen MS subjects (9 female, mean age 36.9 years), studied with magnetic resonance imaging (MRI) were selected. MRI scans were performed at baseline (T0), at 6 (T1), 12 (T2), and 24 months (T3) from baseline. CC was segmented into three sections (genu, body, and splenium); callosal boundaries were outlined and all CC lesions were manually traced. Normal CC and CC lesion volumes were measured using a semiautomatic software. RESULTS: From January 2014 to December 2016, all selected patients had confluent lesions on MRI at T3 with a significant increase in the size of confluent lesions compared to baseline (p=0.0007). At T1, a significant increase in the size of confluent (p=0.02) and single lesions located in the callosal body (p=0.04) was detected in patients with EDSS ≥1.5. Also, CC residual volume (CCR) rather than the whole CC volume (CCV) significantly correlated (p=0.03) with the clinical progression of MS in the whole cohort. CONCLUSIONS: In early MS patients with higher EDSS at baseline, a significant increase in confluent CC lesions size is evident, particularly in the callosal body. Also, median CCR is significantly associated with MS progression in the whole MS group, regardless of initial EDSS. Given their significant association with disability, we encourage measuring CC body lesions and residual CC size for therapeutic decisions and prognostic planning in early MS.

Antifungal activity of oils macerates of North Sardinia plants against Candida species isolated from clinical patients with candidiasis.

Antibiotic resistance is one of the bigger problem of public health: the rise of multi-drug resistant organisms causes a challenge in the treatment of infective diseases. Anti-Candida resistance to conventional antifungal agents has increased in the last period. Our research was intended to evaluate antimicrobial activity of oil macerate (OM) of Helichrysum microphyllum Cambess. subsp. tyrrhenicum Bacch., Brullo & Giusso and OM of Hypericum perforatum subsp. angustifolium against several clinical strains. The study included 30 patients with candidiasis who had not received any antifungal treatment before they were enrolled. A collection of 30 clinical isolates belonging to 5 different species of Candida spp. was selected for this study. The data obtained showed an interesting activity of both Oil Macerate especially against C. krusei and C. parapsilosis. On the contrary, H. microphyllum Oil Macerate has had a better activity than the H.perforatum especially in relation to C. glabrata and C. krusei.

Treatment of acne with a combination of propolis, tea tree oil, and Aloe vera compared to erythromycin cream: two double-blind investigations.

INTRODUCTION: Antibiotics that suppress Propionibacterium acnes are the standard treatment for acne but are becoming less effective, due to the appearance of antibiotic-resistant strains. Many plants are known to have innate antimicrobial action and can be used as alternatives to antibiotics; thus, it is necessary to prove their effectiveness in vivo. This study aimed to evaluate the anti-acne efficacy of a new cream based on three natural extracts, comparing it to erythromycin cream and placebo. PATIENTS AND METHODS: Sixty patients with mild to moderate acne vulgaris were randomly divided into three groups: treated with cream containing 20% propolis, 3% "tea tree oil", and 10% "Aloe vera" (PTAC) (n=20); or with 3 % erythromycin cream (ERC) (n=20); or with placebo (n=20). At baseline, after 15 and 30 days, investigators evaluated response to treatment by counting acne lesions through noninvasive measurements and macrophotography. RESULTS: All the clinical and instrumental values studied were statistically different from placebo except for sebometry, pHmetry, and erythema index values, measured on healthy skin. Unlike in the placebo group, papular and scar lesions showed high erythema reduction after 15 and 30 days of PTAC and ERC application. CONCLUSION: The PTAC formulation was better than ERC in reducing erythema scars, acne severity index, and total lesion count.

Total hip prosthesis complication, periprosthetic infection with external fistulizing due to Enterobacter cloacae complex multiple drugs resistance: A clinical case report.

INTRODUCTION: The Enterobacter cloacae is a microorganism found in the intestinal flora of the majority of animals, including humans. Primary infections caused by E. cloacae are rare in immunocompetent patients, but are very common in hospital settings in newborns and immunocompromised patients, and can be aggravated by the insurgence of antibiotic resistance. The incidence of periprosthetic hip infections is just below 2%. CASE PRESENTATION: A 76year old woman with multiple comorbidities underwent surgical implantation of intermediary total hip prosthesis of the left hip, in a different health facility, in February 2014, after the basicervical fracture of the upper femur extremity due to trauma. After an episode of dislocation of the prosthetic implant, in September 2014, she underwent a surgical operation to implant the acetabular component. A month later not in our facility, following a re-hospitalization for the dislocation of the arthroprosthesis, an infection from E. cloacae complex was discovered. After 2 years of chronic infection she came to our attention; the clinical picture featured coxalgia and secreting fistula in the surgical wound. Following a specific antibiotic therapy, carried out intravenously over the course of a month, we decided to intervene removing the left hip arthroprosthesis and placing an antibiotic spacer following the direction deduced from the antibiogram study of August 2016. CONCLUSION: The patient was hospitalized in our facility and 2 months later she underwent another operation to remove the antibiotic spacer and to place a new total hip arthroprosthesis. Multiple swabs showed the complete healing from the infection, which was confirmed a couple of months later.

Change in Caco-2 cells following treatment with various lavender essential oils.

Lavender is an aromatic evergreen shrub diffused in the Mediterranean basin appreciated since antiquity. The genus Lavandula is part of Lamiaceae family and includes more than 20 species, among which true lavender (L. vera D.C. or L. angustifolia Miller.) and spike lavender (L. latifolia Medikus); there are also numerous hybrids known as lavandins (L. hybrida Rev.). L. vera, spike lavender and several hybrids are the most intensely used breeding species for the production of essential oils. Lavender and lavandin essential oils have been applied in food, pharmaceutical and other agro industries as biological products. In their chemical composition, terpenes linalool and linalyl acetate along with terpenoids such as 1,8-cineole are mostly responsible for biological and therapeutic activities. This study evaluates cytotoxic activity of essential oils derived from four lavender species on human epithelial colorectal adenocarcinoma cells. Analysis of pre- and post-treatment cell morphology has been performed using scanning electron microscope.

How long does the volumizing effect of a Zingiber officinale-based lip plumper last?

OBJECTIVE: Lip plumpers should enhance lip volume. It has been shown that no noticeable result was obtained after long term use of these products. The present study has been carried out to assess lip plumpers' short term effectiveness within 2 h from application. METHODS: Effectiveness was assessed using non-invasive techniques. The effect on vascularisation was analyzed with the Mexameter MX 16® , and the volume enhancing effect was assessed by anthropometric measures and profilometry analysis from 3D scanning electron microscope (SEM) images using Alicona's MEX software. Sixty female volunteers were recruited for the study and the measurements were taken 15, 30, 60, 90 and 120 min after product application. RESULTS: Product application produced a statistically significant increase of lip vascularisation during the first 15 min, which stayed unchanged until the 30th min, then decreased in intensity. The volumizing effect was revealed by 3D profilometry analysis only, not by anthropological measurements. The use of 3D SEM images showed an increase of 0.50 mm in the protrusion of the lip vermilion (MHP parameter) during the first 15 min from product application. CONCLUSION: Results suggest that the lip plumper temporarily enhances vasodilation and increases lip volume.

A new contrast agent for radiological and dissection studies of the arterial network of anatomic specimens.

PURPOSE: The aim of the present study is to propose a new contrast agent that can be easily applied both to CT and dissection studies to replace lead oxide based formulas for comparative anatomical analyses of the vascularisation of cadaveric specimens. METHODS: The infusion material was an epoxy resin, especially modified by the addition of barium sulphate to enhance its radiopacity. The final copolymer was toxicologically safe. To test the properties of the new material, several cadaveric limb injections were performed. The injected specimens were both CT scanned to perform 3D vascular reconstructions and dissected by anatomical planes. RESULTS: There was a perfect correspondence between the image studies and the dissections: even the smallest arteries on CT scan can be identified on the specimen and vice versa. The properties of the epoxy allowed an easy dissection of the vessels. CONCLUSIONS: The new imaging techniques available today, such as CT scan, can evaluate the vascular anatomy in high detail and 3D. This new contrast agent may help realising detailed vascular studies comparing CT scan results with anatomical dissections. Moreover, it may be useful for teaching surgical skills in the field of plastic surgery.

Cadmium influences the 5-Fluorouracil cytotoxic effects on breast cancer cells.

The aim of the research was to evaluate a heavy metal, Cadmium (Cd), which was used to produce alterations in human breast cancer cell line MCF-7. Moreover, we analyzed both immunohistochemical and ultrastructural alterations induced by the antineoplastic drug, 5-Fluorouracil (5-FU), after exposure to different concentrations of Cadmium. Also, we compared the effects of these compounds on actin and tubulin cytoskeleton proteins. Under ultramicroscopic observation, control cells looked polymorphous with filopodia. In cells already treated with small concentrations of Cd, after brief times of incubation, we observed an intense metabolic activity with larger, clearer, and elongated mitochondria characterized by thin and numerous dilated cristae. 5-FU-treated cells showed cytotoxicity signs with presence of pore-like alterations in the cell membrane and evident degeneration of cytoplasm and cell nuclei. The addition of 5-FU (1.5 µM) to the cells treated with Cd (5 µM-20 µM) did not induce significant ultrastructural changes in comparison with cells treated only with Cd. In Cd+5FU-treated cells mitochondria with globular aspect and regular cristae indicated the active metabolic state. In cells treated only with Cd we observed alterations in actin distribution, while tubulin branched out throughout the cytoplasm. With the association of Cd+5FU, we observed less morphological alterations in both tubulin and actin cytoskeleton proteins. Although the mechanism remains unknown at present, our findings suggest that Cd prevents the cytotoxic effect of 5-FU on breast cancer cells. These preliminary results could have an important clinical application in patients with breast cancer.

Scanning electron microscopic findings of the gliding surface of the A1 pulley in trigger fingers and thumbs.

The gliding surface of the A1 pulley was studied in 20 cases of primary trigger finger by scanning and transmission electron microscope. In 12 normal specimens, the whole deep surface was covered uniformly by an amorphous extracellular matrix. In the pathological samples, there was the same general surface appearance but, also, areas, varying in shape and dimension where loss of the extracellular matrix had exposed the collagen fibres and a few cells of the middle layer of the pulley. There were also changes typical of "chondroid-metaplasia". These data were confirmed by transmission electron microscopy. The fragmented areas are probably the result of altered forces of friction between the pulley and the flexor tendon and may be the "gate" through which the forces of friction cause chondroid-metaplasia in the underlying fibrous tissue, a phenomenon recognised to be one step in the pathogenesis of trigger finger.

Ectopic plantar nail: a report of two cases.

Ectopic nail is an extremely rare condition related to acquired or congenital anomalies. Almost 40 cases are reported in the literature, mostly in Japanese patients. In the majority of these patients, ectopic nails developed in the dorsal aspect of the fingers; they are associated in some cases with acquired or congenital growth anomalies or to polydactyly. Recently, we observed two male adult patients with true ectopic nails of the foot (sole and heel). Both patients were not affected by ectodermic dysplasia or foot malformations. The lesion relapsed after surgical excision in one case. Histology showed features of a well-developed and normal nail plate and matrix. A transmission electron microscope study was done in one case, showing typical aspects of onychocytes. The other nail was reproduced by a silicone replica technique and its superficial texture, shape and relationship with surrounding tissue were analysed by scanning electron microscopy.

Analysis of the microtopography of the skin by silicone replicas after repeated exposure to actinic radiation at high altitudes.

We investigated the superficial microtopography of the normal skin of 11 volunteers (not exposed to sunlight during the last 4 months), before and after sun exposure for 5 days at high altitudes of 2900-4559 m. The experiments were carried out on Mount Rosa in Italy, and cutaneous replicas using silicone resin were taken every day after 7 h of sun exposure. Casts were taken from the forehead, glabella, dorsum nasi, radial side (protected with a cream SPF 9.72) and ulnar side of the back of the hands, the only areas not protected. A total of 422 replicas were metallized with gold-palladium and observed under Zeiss 940A scanning electron microscope. The images were elaborated and analysed on computer with appropriate software supplying geometrical features of cutaneous surface using parameters proposed by Takahashi (1994). A Student's test for paired series was used to analyse the differences before and after 1-5 days of exposure giving uniform and significant data compared with controls. Using cutaneous replicas we demonstrated that repeated exposure of skin to sunlight in a short time elicits temporary defence mechanisms with increased obstruction of cutaneous pores, deepening of primary cutaneous furrows and shallowing of part of the secondary furrows; the two latter alterations are the consequence of reactive oedema.

Salmonella enterica serovar-host specificity does not correlate with the magnitude of intestinal invasion in sheep.

The colonization of intestinal and systemic tissues by Salmonella enterica serovars with different host specificities was determined 7 days after inoculation of 1 to 2-month-old lambs. Following oral inoculation, S. enterica serovars Abortusovis, Dublin, and Gallinarum were recovered in comparable numbers from the intestinal mucosa, but serovar Gallinarum was recovered in lower numbers than the other serovars from systemic sites. The pattern of bacterial recovery from systemic sites following intravenous inoculation was similar. The magnitude of intestinal invasion was evaluated in ovine ligated ileal loops in vivo. Serovars Dublin and Gallinarum and the broad-host-range Salmonella serovar Typhimurium were recovered in comparable numbers from ileal mucosa 3 h after loop inoculation, whereas the recovery of serovar Abortusovis was approximately 10-fold lower. Microscopic analysis of intestinal mucosae infected with serovars Typhimurium and Dublin showed dramatic morphological changes and infiltration of inflammatory cells, whereas mucosae infected with serovars Abortusovis and Gallinarum were indistinguishable from uninfected mucosae. Together these data suggest that Salmonella serovar specificity in sheep correlates with bacterial persistence at systemic sites. Intestinal invasion and avoidance of the host's intestinal inflammatory response may contribute to but do not determine the specificity of serovar Abortosovis for sheep. Intestinal invasion by serovar Abortusovis was significantly reduced after mutation of invH but was not reduced following curing of the virulence plasmid, suggesting that the Salmonella pathogenicity island 1 influences but the virulence plasmid genes do not influence the ability of serovar Abortusovis to invade the intestinal mucosa in sheep.

Ultrastructural anatomy of contracted capsules around textured implants in augmented breasts.

The development of a capsule around an implant is part of the physiological response to a foreign body. Capsular contracture is the most specific and frustrating complication of augmentation mammaplasty, and a lot of studies have been devoted to it. The aim of the current study is to examine the fine architecture of the contracted capsule around textured implants in humans. Eight capsules from augmented and contracted breasts with gel-filled, textured-surface silicone implants were studied after standard preparation for light and scanning electron microscopy, and after partial digestion in sodium hydroxide. Two capsules from contracted breasts around smooth implants and two noncontracted capsules around textured implants were prepared and studied in the same fashion as controls. A multilayer structure of the contracted capsule was seen, and the architecture of the various layers is described. The inner surface presents irregular craterlike depressions. The arrangement of collagen fibers varies in capsule layers. The effect of a textured-surface implant on the mechanism of capsule contraction based on the observed capsular architecture is that only part of the capsule is effective mechanically in producing a contracting force. A thin vascular layer was identified near the inner surface in contracted capsules around textured implants, and the authors' think that this layer is probably the key structure in the histological development and growth of the capsule.

Dating of palaeoanthropological nuragic skeletal tissues using electron paramagnetic resonance (EPR) spectrometry.

Dating of skeletons of Nuragic population living in Sardinia island centuries BP, based on the quantitative evaluation of the concentration of stable paramagnetic species produced by ionising radiation in tooth enamel was performed by using EPR spectrometry. Applying the additive dose method (60Co gamma rays) and comparative calculations based on analogous measurements done with Roman skeleton of the known age as discovered close to Nuragic tomb (Tombs of Giants, La Testa S. Teresa di Gallura, Sardinia) the age of Nuragic skeleton was evaluated as equal to about 3,200 years (1,200 years BC). The total error of EPR measurements and dose extrapolation was estimated for 10-12%. Crystallinity of bone mineral in Nuragic skeleton evaluated by the EPR technique, adapted earlier by some of the authors of the present paper for biomedical studies on mineralised tissues, is only little changed after the centuries of its deposition in the tomb when compared with contemporary bone tissue. Comparison of chemical composition of Nuragic skeleton contaminated through slow percolation by rain of floods with that of contemporary bone sample shows the increase of the concentration of Fe, PO4, SiO2, Al and Mg, Fe, SiO2, AP are not present in contemporary bones. As expected, the contamination was minimal in tooth enamel.

Ultrastructural characteristics of human foetal kidney. I: S.E.M. observations.

With the aim to studying the main steps which characterize the early development of the human foetal kidney, fragments of renal bud of 8-12 weeks of pregnancy have been processed for scanning electron microscopy. The results can be summarized as follows: first generation of nephrons appear after the 8th week of development; during this period kidney bud change from a condition of very simple organization to an higher differentiated structure, especially in cortical part of the bud, at level of juxtamedullar nephrons. It is possible to observe the differentiation of primary podocytes that arrive, with their deeper cytoplasmic projections at level of the capillaries wall, giving rise to the typical structures of filtration barrier. The tubular structures maintain the differentiation observed in the earlier phase of the development. The obtained results demonstrate that the developing kidney buds undergo deep changes, at level of the parenchime and vascular system, during the studied period.

Nuragic bone collagen retains its molecular structure.

The molecular structure of bone collagen was found to be preserved in Nuragic bone samples several centuries after burial. Enhanced birefringence of bone and dentin collagen fibres observed in polarized light after Sirus red staining was used to demonstrate this fact.

Structural and ultrastructural pattern of the embryonic and early foetal human liver.

With the aim of stressing the main steps which characterize the early development of the human foetal liver, fragments of hepatic buds of 7-12 weeks of pregnancy have been processed for light and scanning electron microscopy; Vial and Porter technique for isolated cells has been utilized too. The obtained results can be summarized as follows. At the 7th-8th weeks the hepatocytes show a globose shape, their surface is furnished with scattered and irregular evaginations and they are arranged in loose and narrow ribbons, separated by vascular spaces; the hepatocytes are tightly connected with haemopoietic cells, usually furnished with hyperchromatic nuclei. On the other hand, the hepatic parenchyma shows a compact pattern at the 11th-12th weeks. The hepatocytes have acquired a polyhydric shape and their faces are usually interlocked with the plasmatic membrane of the adjoining elements than in three fields: (a) the face projecting to the vascular walls with which they are going to form the Disse spaces; (b) the opposite side in which the membranes of neighbouring cells often appear spaced to line the primitive biliary canaliculi; and (c) the areas in which hemispheric and deep hollows of the hepatocyte surface hold haemopoietic elements. The obtained results demonstrate that the developing hepatic buds undergo deep structural changes, at level of the parenchyma and vascular system, in the studied period.

[Optical and scanning electron microscopy observation of the mucosa of human fetal tongue]. / Osservazioni al microscopio ottico ed elettronico a scansione della mucosa della lingua fetale umana.

The structural features of the human foetal tongue have been studied in foetuses from 8th to 20th week of pregnancy. The characteristics of the developing papillae as well as of epithelial and mesenchymal layers have been pointed out. An early differentiation of the mesenchymal tissue has been observed, concerning phenomena of cellular condensation and reticular fibers organization both in superficial and deep layers. The hypothesis of the existence of straight interactions between epithelium and mesenchyme also in the developing human tongue mucosa has been suggested. Also the observations at SEM demonstrate that from the 8th to the 20th week the epithelial surface of the tongue reaches a stable structural pattern. From 11th week a characteristic cellular polymorphism occurs: cells with microvilli that diminish progressively, ciliated cells that disappear almost completely at the 20th week and cells whose free surface show microplicae, definitive stage of the tongue cell evolution.