Ingestion of foreign bodies among prisoners: a ten years retrospective study at University Hospital of Southern Italy.

INTRODUCTION: We studied 21 episodes of ingestion of foreign bodies (IFO) among 15 prisoners. PATIENTS AND METHODS: Rectrospective research in pts admitted to emergency from June 2005 to May 2105. Ingestion, management and pts outcome were analyzed. Prisoners with previous esophagogastroduodenal disease were excluded. RESULTS: All pts were males and ingestions were intentional. Esophagogastroduoduenoscopy (EGDS) was performed in 10pts (8 cases with successful removal, 1 case we did not find anything e 1 of unsuccessful EGDS, that required emergency surgey. 9 pts rejected EGDS: in 2 pts were not necessary.Among the 9 pts that rejected EGDS, 5 discharged voluntary. No mortality neither morbidity. Only 1 pt required surgery.The IFO were 34 (23 sharp, 6 flat,5 indefined). We did not observe any food bolus impaction. Multiple ingestion was found in 11 pts. Recurrent episodes were found in 4 pts. DISCUSSION: Almost all episodes can be treated conservatively with observation and endoscopy but the management of this pts has a financial impact on healthcare cost and on security costs. Prevention strategies are important to predict patient group at high risk for recurrent IFO.

Modelling the aquatic toxicity of ionic liquids by means of VolSurf in silico descriptors.

VolSurf+ in silico physicochemical descriptors for both the cationic and the anionic counterparts of ionic liquids (ILs) have been derived. These descriptors, suitable for molecular modelling of IL structures which, due to their amphiphilic nature, interact strongly with biological matrices, can be related to aquatic toxicity by means of a partial least squares statistical model. This model gives an insight into the relationships between structural physicochemical properties and aquatic toxicity as well as a satisfactory quantitative structure-property correlation, allowing prediction of aquatic toxicity scores of ILs.

Cyto- and enzyme toxicities of ionic liquids modelled on the basis of VolSurf+ descriptors and their principal properties.

Five in silico principal properties (PPs) for 218 heterocyclic cations and four PPs for 38 organic and inorganic anionic counterparts of ionic liquids (ILs) were derived by the VolSurf+ approach. VolSurf+ physicochemical descriptors take into account several cationic structural features of ILs such as heterocyclic aromatic and non-aromatic cationic cores, alkyl chain length, presence of oxygen atoms in the substituents as well as the properties of a wide variety of inorganic and organic anions. Combination of these cation and anion PPs can provide descriptors for over 8000 ILs, thus allowing the development of QSPR models for IL cytotoxicity (IPC-81 rat cell line) and enzyme toxicity (acetylcholinesterase inhibition). The adoption of a Partial Least Squares approach, relating PPs and toxicities, provided affordable predictions for ILs in both learning and external validation sets, implying the possibility to extend the predictive model to a set of 520 ILs. This allows us to establish priorities in selecting ILs for experimental hazard assessment as required by the REACH regulation.

Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma.

BACKGROUND: Airway inflammation in asthma involves both large and small airways, and the combination of inhaled corticosteroids (ICS) and long acting beta-2 agonists (LABA) is the mainstay of therapy. Available inhaled combinations differ in terms of drug delivery to the lung and the ability to reach small airways. AIM: To evaluate whether treatment with an extra-fine inhaled combination provides additional effects vs a nonextra-fine combination on airway function. METHODS: After a 1- to 4-week run-in period, patients with asthma were randomized to a double blind, double dummy, 12-week treatment with either extra-fine beclomethasone/formoterol (BDP/F) 400/24 microg daily or fluticasone propionate/salmeterol (FP/S) 500/100 microg daily. Methacholine (Mch) bronchoprovocation challenge and single breath nitrogen (sbN2) test were performed. RESULTS: Thirty patients with asthma (15 men), mean age 43, mean forced expiratory volume in the first second (FEV(1)) 71.4% of predicted, were included. A significant increase (P < 0.01) versus baseline was observed in predose FEV(1) in both BDP/F and FP/S groups (0.37 +/- 0.13 l and 0.36 +/- 0.12 l, respectively). PD(20)FEV(1) Mch improved significantly from 90.42 (+/-30.08) microg to 432.41 (+/-122.71) microg in the BDP/F group (P = 0.01) but not in the FP/S group. A trend toward improvement vs baseline was observed for BDP/F in closing capacity (CC), whereas no differences were recorded in other sbN(2) test parameters. CONCLUSION: The findings of this pilot study suggest that an extra-fine inhaled combination for the treatment of asthma has beneficial effects on both large and small airways function as expressed by Mch and sbN(2) tests.

Measurement of composite shrinkage using a fibre optic Bragg grating sensor.

Fibre Bragg grating is used to determine resin-based composite shrinkage. Two composite resins (Freedom from SDI and Z100 from 3M) were tested to determine the polymerization contraction behaviour. Each sample of resin was prepared with an embedded fibre Bragg grating. A LED activation unit with wavelength from 430 nm to 470 nm (Dabi Atlante) was used for resin polymerization. The wavelength position of the peak in the optical reflection spectra of the sensor was measured. The wavelength shift was related to the shrinkage deformation of the samples. Temperature and strain evolution during the curing phase of the material was monitored. The shrinkage in the longitudinal direction was 0.15 +/- 0.02% for resin Z100 (3M) and 0.06+/-0.01% for Freedom (SDI); two-thirds of shrinkage occurred after the first 50 s of illumination.

Role of the "National Reference Centre for Genetically Modified Organisms (GMO) detection" in the official control of food and feed.

The National Reference Centre for Genetically Modified Organisms (GMO) detection was established in 2002 within the Istituto Zooprofilattico Sperimentale Lazio e Toscana, with the aim of providing scientific and technical support to the National Health System and to the Ministry of Health within the scope of the regulation of GMO use in food and feed.The recently adopted EU legislation on GMOs (Regulation CE no. 1829/2003 and no. 1830/2003) introduced more rigorous procedures for the authorisation, labelling and analytical control of food and feed consisting, containing or derived from GMOs. The National Reference Centre, besides its institutional tasks as one of the laboratories of the Italian National Health System, collects and analyses data and results of the national official control of GMOs; carries out scientific research aimed at developing, improving, validating and harmonising detection and quantification methods, in cooperation with other scientific institutions, the Community Reference Laboratory and within the European Network of GMOs laboratories (ENGL); collaborates with the Ministry of Health in the definition of control programmes and promotes educational and training initiatives. Objectives defined for 2004-2006, activities in progress and goals already achieved are presented.

Increased accuracy of biopsy Gleason score obtained by extended needle biopsy.

PURPOSE: Accurate tumor grading is critical for adequate prostate cancer treatment. Nonetheless, the Gleason score of standard sextant biopsy correctly predicts the Gleason score of the radical prostatectomy specimen in about 50% of cases. We investigated if extended needle biopsy could improve biopsy Gleason score accuracy. MATERIALS AND METHODS: Laparoscopic transperitoneal radical prostatectomy was performed in 135 patients. Prostate cancer was diagnosed in 89 cases by standard sextant transrectal (6 to 8 cores) biopsy and in 46 by extended needle (12 core transperineal under transrectal guidance) biopsy. Preoperative evaluation included digital rectal examination, prostatic specific antigen measurement, transrectal ultrasonography and endorectal coil magnetic resonance imaging in all patients. All biopsy and prostatectomy specimens were reviewed by a single pathologist. RESULTS: Clinical characteristics were similar in the 2 groups. The concordance between prostate biopsy and radical prostatectomy Gleason score was 32 of 46 cases (70%) and 44 of 89 (49%) for 12 core and standard transrectal biopsy, respectively (z test p = 0.0127). Biopsy under grading was found in 11 of 46 cases (24%) and 35 of 89 (39%) (z test p = 0.0366), and biopsy over grading was found in 3 of 46 (6%) and 10 of 89 (11%) (z test p = 0.1894) with 12 core and standard transrectal biopsy, respectively. Primary Gleason pattern was predicted exactly by biopsy in 40 of 46 cases (87%) and 56 of 89 (63%) with 12 core and standard sextant biopsy, respectively (z test p = 0.0018). CONCLUSIONS: Extended needle biopsy significantly increases the accuracy of biopsy Gleason score for assessing final prostate cancer grade.

LTB4 is present in exudative pleural effusions and contributes actively to neutrophil recruitment in the inflamed pleural space.

The pleural space is a virtual compartment between the lung and chest wall that becomes filled with fluid and inflammatory cells during a variety of respiratory diseases. Here, we study the potential role of the eicosanoid metabolite leukotriene B4 (LTB4) in disparate diseases leading to acute (pneumonia) or chronic (tuberculosis, cancer) inflammation of the pleural space. LTB4 concentrations were significantly higher in pleural fluid due to pneumonia, tuberculosis and cancer with respect to congestive heart failure and correlated with neutrophil elastase, which is used as an indication of state of activation of neutrophils in the pleural space. Moreover, pleural LTB4 was biologically active, as an anti-LTB4 antibody partially neutralized the chemotactic activity of parapneumonic, tuberculous and cancer effusions. Macrophages, neutrophils, lymphocytes, mesothelial cells and cancer cells all expressed mRNA for 5-lipoxygenase, the enzyme that initiates leukotriene synthesis leading to the production of LTB4, in exudative pleural effusions. Upon stimulation in transudative pleural effusions, pleural macrophages produced, in a time-dependent fashion, a significantly higher concentration of LTB4 than mesothelial cells. These studies demonstrate that different cell types are capable of producing LTB4 in the inflamed pleural space and that this mediator may play a crucial role in the recruitment of neutrophils into the pleural space.

Neutrophil airway influx by platelet-activating factor in asthma: role of adhesion molecules and LTB4 expression.

Platelet-activating factor (PAF)-induced neutrophil lung sequestration may require cell surface adhesion molecules (macrophage-1 antigen (MAC-1) and lymphocyte function-associated antigen-1 (LFA-1)). In this randomised, double-blinded, crossover study, the neutrophil kinetics after PAF and Lyso-PAF (L-PAF) airway challenge were investigated in nine mild-intermittent asthmatics. Neutrophils were measured in peripheral blood (PB) before and at 5, 15, 45 and 240 min after bronchoprovocation, and in induced sputum before and at 240 min after challenge. MAC-1 and LFA-1 expression were assessed by immunocytochemistry, and leukotriene B4 (LTB4) was measured by enzyme-immunoassay in induced-sputum supernatants. Compared with baseline, neutrophils in PB decreased 5 min after PAF, while at 240 min neutrophils in induced sputum increased. Compared with baseline and L-PAF, PAF decreased the percentages of MAC-1- and LFA-1-positive neutrophils in PB at 5 min, but increased the percentages of MAC-1 and LFA-1 in neutrophil-induced sputum. Moreover, compared with baseline and L-PAF, PAF-induced sputum revealed higher LTB4 levels, a finding that correlated with the elevated number of neutrophils in induced sputum. These findings suggest that macrophage-1 antigen and lymphocyte function-associated antigen-1 are involved in platelet-activating factor-induced neutrophil lung traffic, and that this process is modulated by enhanced leukotriene B4 release within the airways.

Airway inflammation in nonasthmatic amateur runners.

Elite athletes show a high prevalence of symptoms and signs of asthma, but no study has assessed the acute effects of endurance exercise on airway cells in nonasthmatic athletes. We measured exhaled nitric oxide (NO) and collected samples of induced sputum after 3% NaCl aerosol administration for 20 min in nonasthmatic middle-aged amateur runners after the Fourth Palermo International Marathon and 6--9 wk later (habitual training period) at baseline. After the marathon, exhaled NO (n = 9 subjects) was higher [27 +/- 9 parts/billion (ppb)] than at baseline (12 +/- 4 ppb; P < 0.0005). Polymorphonuclear neutrophil (PMN) counts in induced sputum were much higher in runners (91.2 +/- 3.6% of total cells postmarathon and 78.7 +/- 9.1% at baseline) than in sedentary control subjects (9.9 +/- 5.9%; P < 0.001). Expression of L-selectin and CD11b/CD18 in sputum PMNs was lower after the race than at baseline and inversely related to the amount of exhaled NO (r = -0.66 and -0.69, respectively; P < 0.05). Our data indicate that sputum PMNs are increased in nonasthmatic runners both after a marathon and at baseline and suggest that NO may modulate exercise-associated inflammatory airway changes.

15(S)-HETE modulates LTB(4) production and neutrophil chemotaxis in chronic bronchitis.

We evaluated the levels of 15(S)-hydroxyeicosatetraenoic acid [15(S)-HETE] and the expression of 15-lipoxygenase (15-LO) mRNA in induced sputum obtained from 10 control and 15 chronic bronchitis subjects. 15(S)-HETE was evaluated by reverse phase high-performance liquid chromatography separation followed by specific RIA. 15-LO mRNA expression was determined by primed in situ labeling. The levels of both soluble and cell-associated 15(S)-HETE resulted significantly higher in chronic bronchitis than in control subjects. The percentage of cells expressing 15-LO mRNA was significantly higher in chronic bronchitis than in control subjects (P < 0.01). Double staining for specific cell type markers and 15-LO mRNA showed macrophages and neutrophils positive for 15-LO, whereas similar staining of peripheral blood neutrophils did not show evidence for 15-LO expression, suggesting that expression of 15-LO in neutrophils takes place on migration into the airways. Because 15(S)-HETE inversely correlated with the percentage of neutrophils in sputum of chronic bronchitis subjects, we studied the effect of 15(S)-HETE on leukotriene B(4) (LTB(4)) production in vitro and evaluated the concentration of LTB(4) in induced sputum and the contribution of LTB(4) to the chemotactic activity of induced sputum samples ex vivo. The results obtained indicate that macrophages and neutrophils present within the airways of chronic bronchitis subjects express 15-LO mRNA; increased basal levels of 15(S)-HETE may contribute to modulate, through the inhibition of 5-lipoxygenase metabolites production, neutrophil infiltration and airway inflammation associated with chronic bronchitis.

15-Lipoxygenase expression and 15(S)-hydroxyeicoisatetraenoic acid release and reincorporation in induced sputum of asthmatic subjects.

BACKGROUND: Recent evidence shows that 15(S)-hydroxy-eicoisatetraenoic acid (15[S]-HETE) can be released and rapidly reincorporated into cellular lipids. These mechanisms exert several immunoregulatory functions that may be relevant in airway inflammation. OBJECTIVE: Our purpose was to evaluate the levels of both soluble and cell-associated 15(S)-HETE and to examine 15-lipoxygenase (15-LO) messenger RNA (mRNA) expression in sputum samples obtained from 10 control and 18 asthmatic subjects. METHODS: Levels of 15(S)-HETE were measured by reverse-phase HPLC separation followed by RIA in supernatants and in cell membrane-extracted phospholipids after acid hydrolysis. 15-LO mRNA was evaluated by primed in situ hybridization (PRINS). Combined immunocytochemistry and PRINS was used to identify the phenotype of cells bearing 15-LO transcripts. RESULTS: Levels of both soluble and cell-associated 15(S)-HETE were higher in asthmatic than in control subjects (P <.0001). The percentage of cells expressing 15-LO mRNA was higher in asthmatic than in control subjects (P <.01). On double staining for specific cell-type markers and 15-LO mRNA, macrophages were the major source for 15-LO. CONCLUSION: This study shows that the induced sputum technique allows the evaluation of 15-LO activity and that soluble, cell-associated 15(S)-HETE and 15-LO levels are higher in asthmatic than in control subjects. In addition, this study indicates that, in induced sputum, airway macrophages are the major source of 15(S)-HETE in asthma.

Identification and sequencing of beta-myrcene catabolism genes from Pseudomonas sp. strain M1.

The M1 strain, able to grow on beta-myrcene as the sole carbon and energy source, was isolated by an enrichment culture and identified as a Pseudomonas sp. One beta-myrcene-negative mutant, called N22, obtained by transposon mutagenesis, accumulated (E)-2-methyl-6-methylen-2,7-octadien-1-ol (or myrcen-8-ol) as a unique beta-myrcene biotransformation product. This compound was identified by gas chromatography-mass spectrometry. We cloned and sequenced the DNA regions flanking the transposon and used these fragments to identify the M1 genomic library clones containing the wild-type copy of the interrupted gene. One of the selected cosmids, containing a 22-kb genomic insert, was able to complement the N22 mutant for growth on beta-myrcene. A 5,370-bp-long sequence spanning the region interrupted by the transposon in the mutant was determined. We identified four open reading frames, named myrA, myrB, myrC, and myrD, which can potentially code for an aldehyde dehydrogenase, an alcohol dehydrogenase, an acyl-coenzyme A (CoA) synthetase, and an enoyl-CoA hydratase, respectively. myrA, myrB, and myrC are likely organized in an operon, since they are separated by only 19 and 36 nucleotides (nt), respectively, and no promoter-like sequences have been found in these regions. The myrD gene starts 224 nt upstream of myrA and is divergently transcribed. The myrB sequence was found to be completely identical to the one flanking the transposon in the mutant. Therefore, we could ascertain that the transposon had been inserted inside the myrB gene, in complete agreement with the accumulation of (E)-2-methyl-6-methylen-2,7-octadien-1-ol by the mutant. Based on sequence and biotransformation data, we propose a pathway for beta-myrcene catabolism in Pseudomonas sp. strain M1.

[Nd-YAG laser in otorhinolaryngology: our experience]. / Applicazioni del ND-YAG-laser in otorinolaringoiatria: nostre esperienze.

The Authors describe Nd-YAG Laser treatment in dealing with some of the most common hypertrophic-hyperplastic pathologies of the upper airways. Laser operations are performed under local anesthesia employing an Endo-Video-Telecamera in order to treat soft surgical targets not reachable otherwise. The Authors stress the numerous advantages of this techniques: high surgical accuracy, poor collateral intro- and post-operative effects, lack of post-operative intranasal packing, quick recovery time, absence of relapse, sparing of nasal physiology. Furthermore patient of the treatment acceptance and low sanitary expenses, are additional favorable factors. The Authors explain the details of the methods, emphasize the tolerability of the treatment and report the results obtained during two years of experience.

Computed tomography in the study of the eustachian tube.

A CT study was made of the eustachian tube in normal subjects as a control group and patients with chronic pathological inflammation of the middle ear. CT made it possible to perform contiguous scans at homologous depths of 1.5 mm, showing the whole interior of the tube in clear detail: the protympanum, the bony and cartilaginous portions, and the nasopharyngeal orifice. In most of the cases of pathological middle ear inflammations, the eustachian tube lumen was seen to be constricted and obstructed with isodense matter. Our present results also show the importance of extending CT investigations beyond the tympanic cavity and the mastoid to the eustachian tube in order to have more clinical data on its condition.