Work scheme to isolate the different micro-organisms found in hydrogen-producing reactors: a study of effectiveness by pyrosequencing analysis.

AIM: The aim of this research was to create a work scheme for the isolation of the different micro-organisms commonly found in hydrogen-producing reactors and to test its effectiveness. METHODS AND RESULTS: Methods were selected to isolate anaerobic spore-forming fermenters, anaerobic fermenters that do not form spores, facultative aerobic fermenters and lactic acid bacteria. The methods were tested in two samples taken from a hydrogen-producing reactor fed with cheese whey. 16S rRNA gene sequences from isolates were compared with pyrosequencing analysis from the same samples. The isolates represented more than 88% of the abundance detected by pyrosequencing. Organisms from the genera Clostridium, Rahnella, Megasphaera, Lactobacillus, Propionibacterium, Bifidobacterium, Chryseobacterium and Acetobacter were isolated. Hydrogen-producing capacity was confirmed for the Clostridium, Rahnella and Megasphaera isolates. Coculture experiments indicate that Megasphaera prevented the total inhibition of Clostridium by Lactobacillus. CONCLUSION: The work scheme proposed was effective to isolate most of the micro-organisms detected by pyrosequencing analysis. Physiological studies suggested a key role of Megasphaera. SIGNIFICANCE AND IMPACT OF THE STUDY: We showed the high culturability of the microbial communities from hydrogen-producing bioreactors. The isolates can be used to perform physiological studies to understand the H2 -producing process.

Effect of puerperal metritis on reproductive and productive performance in dairy cows in Argentina.

The objectives of this study were to evaluate the reproductive and productive performance of dairy cows with and without puerperal metritis and to evaluate the effectiveness of using a long-acting ceftiofur preparation. Dairy cows in one dairy farm, calving from July 2009 to January 2010, were examined between 3 and 14 days postpartum and classified on the basis of vaginal discharge into three groups: cows with normal discharge (control; C); cows with a bloody mucus purulent or pathologic nonfetid discharge (PnFD), and cows with bloody mucopurulent or purulent fetid discharge (PFD). Cows in C and PnFD groups were not treated, whereas those in the PFD group were randomly allocated to receive 2.2 mg/kg of ceftiofur subcutaneously behind the ear (PFD-T) or remain untreated (PFD-No T). From the 640 cows examined, 58.2% formed the C group, 13.4% formed the PnFD group, and 28.4% formed the PFD group. Survival curves differed between cows in the C group and PFD-No T group (P = 0.0013) and between PFD-No T versus PFD-T group (P = 0.0006). Survival curves of PnFD were intermediate and did not differ from those in the C group (P = 0.2) and PFD-T group (P = 0.1) but tended to be different from the PFD-No T group (P = 0.056). The postpartum interval to achieve a 25% pregnancy rate was 72 days for cows in the C group, 73 days for the PFD-T group, 83 days for PnFD group, and 95 days for the PFD-No T group. The chance of pregnancy in a cow in the C group was 1.98 times higher (95% confidence interval = 1.33, 3.08) and in cows in the PFD-T group was 2.16 times higher (95% confidence interval = 1.37, 3.50) than that in the PFD-No T group. Finally, the chance of pregnancy in cows in the PnFD group tended to be higher (P = 0.08) than that in the PFD-No T group but did not differ from the other two groups. Cumulative 305-day milk production was higher (P < 0.0001) in C group than those with vaginal discharge, regardless of fetidness and regardless of treatment. It is concluded that puerperal metritis affects the reproductive and productive performance of dairy cows and the treatment with ceftiofur was effective in reducing the adverse effects on reproductive performance but not on milk production.

Valorization of artichoke wastewaters by integrated membrane process.

In this work an integrated membrane system was developed on laboratory scale to fractionate artichoke wastewaters. In particular, a preliminary ultrafiltration (UF) step, based on the use of hollow fibre membranes, was investigated to remove suspended solids from an artichoke extract. The clarified solution was then submitted to a nanofiltration (NF) step. Two different 2.5 × 21 in. spiral-wound membranes (Desal DL and NP030) with different properties were investigated. Both membranes showed a high rejection towards the phenolic compounds analysed (chlorogenic acid, cynarin and apigenin-7-O-glucoside) and, consequently, towards the total antioxidant activity (TAA). On the other hand, the Desal DL membrane was characterized by a high rejection towards sugar compounds (glucose, fructose and sucrose) (100%) when compared with the NP030 membrane (4.02%). The performance of selected membranes in terms of permeate flux, fouling index and water permeability recovery was also evaluated. On the base of experimental results, an integrated membrane process for the fractionation of artichoke wastewaters was proposed. This conceptual process design permitted to obtain different valuable products: a retentate fraction (from the NP030 membrane) enriched in phenolic compounds suitable for nutraceutical, cosmeceutical or food application; a retentate fraction (from the Desal DL membrane), enriched in sugar compounds, of interest for food applications; a clear permeate (from the Desal DL membrane) which can be reused as process water or for membrane cleaning.

Microbial community composition and reactor performance during hydrogen production in a UASB reactor fed with raw cheese whey inoculated with compost.

This study investigated the microbial community developed in a UASB reactor for hydrogen production and correlated it to reactor performance. The reactor was inoculated with kitchen waste compost and fed with raw cheese whey at two organic loading rates, 20 gCOD/Ld and 30 gCOD/Ld. Hydrogen production was very variable, using an OLR of 30 gCOD/Ld averaged 1.0 LH(2)/Ld with no methane produced under these conditions. The hydrogen yield was also very variable and far from the theoretical. This low yield could be explained by selection of a mixed fermentative population with presence of hydrogen producing organisms (Clostridium, Ruminococcus and Enterobacter) and other non-hydrogen producing fermenters (Lactobacillus, Dialister and Prevotella). The molecular analysis of the raw cheese whey used for feeding revealed the presence of three predominant organisms that are affiliated with the genera Buttiauxella (a low-yield hydrogen producer) and Streptococcus (a lactic acid-producing fermenter). Although these organisms did not persist in the reactor, the continuous addition of these fermenters could decrease the reactor's hydrogen yield.

Recovery and concentration of polyphenols from olive mill wastewaters by integrated membrane system.

The purpose of this work was to analyse the potentialities of an integrated membrane system for the recovery, purification and concentration of polyphenols from olive mill wastewater (OMW). The proposed system included some well-known membrane operations such as microfiltration (MF) and nanofiltration (NF), as well as others not yet investigated for this specific application, such as osmotic distillation (OD) and vacuum membrane distillation (VMD). The OMW was directly submitted to a MF operation without preliminary centrifugation. This step allowed to achieve a 91% and 26% reduction of suspended solids and total organic carbon (TOC), respectively. Moreover, 78% of the initial content of polyphenols was recovered in the permeate stream. The MF permeate was then submitted to a NF treatment. Almost all polyphenols were recovered in the produced permeate solution, while TOC was reduced from 15 g/L to 5.6 g/L. A concentrated solution enriched in polyphenols was obtained by treating the NF permeate by OD. In particular, a solution containing about 0.5 g/L of free low molecular weight polyphenols, with hydroxytyrosol representing 56% of the total, was produced by using a calcium chloride dihydrate solution as brine. The obtained solution is of interest for preparing formulations to be used in food, cosmetic and pharmaceutical industry. Besides the OD process, VMD was applied as another way for concentrating the NF permeate and the performance of both processes was compared in terms of evaporation fluxes.

Parasites as fish population tags and pseudoreplication problems: the case of striped red mullet Mullus surmuletus in the Spanish Mediterranean.

Studies of parasites as fish population tags often apply a single round of sampling to identify potential stocks or predict harvest localities. However, the lack of replication generates pseudoreplication, implicitly assuming that infection levels are more similar between samples from the same locality than between samples from different localities. We evaluated this assumption in the case of the striped red mullet Mullus surmuletus in three localities of the Spanish Mediterranean separated by c. 300 km. Samples of 25 fish of similar size were collected in each locality in the summer and autumn of two consecutive years. Prevalence and abundance of three long-lived parasite taxa differed significantly among localities, indicating their potential as stock indicators. However, a cluster analysis (for prevalence) and a MANOVA (for abundance) indicated strong inter-sample variability, even within the same locality, with poor spatial segregation among samples. A linear discriminant analysis (LDA) based on the abundance of 17 parasite taxa correctly assigned over 80% of fish to their locality, and 95% bootstrap confidence intervals of percent classified fish per locality were narrow, indicating good and stable predictive power. However, when a LDA based on data from the first year was used to predict the locality of fish from the second year, predictive power dropped drastically (46% of correct allocation). Overall, we interpret that parasite communities of mullets change at a much lower spatial scale than that adopted in this study. This finding strongly suggests the need for proper replication to make reliable inferences about stock structure in fish populations based on parasitological data.

[The MMPI-2 test in the evaluation of the mobbing syndrome]. / Il test MMPI-2 nella valutazione della sindrome da mobbing.

MMPI-2 test is widely used in psychodiagnostic evaluation as well as in the evaluation of psychic pathologies related to psychosocial adversative events in working activities. A more efficacious use of MMPI-2 test in the working context can be achieved by the individuation of indexes able to facilitate the evaluation of mobbing syndrome. This work is based on the analysis of 150 cases (39.7% women and 60.7% men, 30 to 60 years of age), evaluated through an accurate examination of working history and a series of clinic conversations, followed by psychodiagnostic evaluation. The average of T-scores on the clinical scale, the content scale, the PK addition scale and the validation scale were calculated from tests. Pathologic high T-scores on the scales Hs, D. Hy e Pa were found in subjects having positive mobbing anamnesis. These results strongly indicate the presence of clinical specificities in workers exposed to working harassments, and that these specificities can be efficaciously evidenced by the MMPI-2 test.

Obras de estabilización de procesos erosivos en suelos loéssicos (Cárcavas) / Infraestructure for stabilization of gully erosion in loess

En el sur de la provincia de Córdoba (región central de Argentina) se encuentran numerosos arroyos afectados por procesos erosivos de carcavamiento. En este artículo en particular se presenta en caso de estudio del arroyo "El Gato", el cual cruza la Ruta Nacional Nº 8 cerca del pueblo de Sampacho. Allí se observa un severo proceso de incisión de su cauce como consecuencia del fenómeno de erosión en cárcava al que se encuentra sometido. Este fenómeno se materializa mediante la formación de un escalón en el lecho fluvial sobre el cual se desarrolla una cascada de aproximadamente 13 m de altura; presentando una fosa de socavación debido al impacto del agua. El impacto de este proceso es altamente significativo, ya que afecta negativamente su área cercana, reduciendo áreas de uso agrícola y dañando las obras de infraestructura existentes (caminos, ferrocarriles, puentes y poliductos). Asimismo, el impacto ambiental es altamente negativo, fundamentalmente por las consecuencias asociadas a la incisión del cauce, el descenso del nivel freático y el incremento del transporte de sedimentos hacia aguas abajo. En este trabajo se presentan los estudios básicos realizados para caracterizar el fenómeno y se describe la solución adoptada para estabilizar el cauce de este arroyo. Además, se presentan las modificaciones realizadas en la etapa de obra y los detalles del seguimiento durante la operación y mantenimiento de la misma (AU)

Gabapentin but not vigabatrin is effective in the treatment of acquired nystagmus in multiple sclerosis: How valid is the GABAergic hypothesis?

Acquired nystagmus occurs frequently in patients with multiple sclerosis and is often the cause of illusory motion of the environment (oscillopsia), and blurring of vision. Based primarily on the beneficial effect of gabapentin on acquired pendular nystagmus (APN), a GABAergic mechanism in controlling nystagmus has been hypothesised. If increasing GABA concentrations in the CNS are critical for the treatment of nystagmus, then a selective GABAergic drug should be highly successful. However, as gabapentin is not a selective GABAergic agent, vigabatrin, a "pure" GABAergic medication, and gabapentin, were compared in a single blind cross over trial in eight patients with definite multiple sclerosis. Patients were randomly assigned to begin with gabapentin (1200 mg daily) or vigabatrin (2000 mg daily). Neuro-ophthalmological and electro-oculographic (EOG) evaluations were performed four and three times, respectively. Treatment efficacy was based on improving visual acuity and EOG indices (amplitude or frequency of nystagmus, or both) by at least 50% of pretreatment values. Three out of eight patients dropped out due to adverse effects. In the remaining five patients gabapentin improved symptomatic pendular or gaze evoked jerk nystagmus in four. Three patients decided to continue gabapentin therapy. Importantly, vigabatrin proved useful in only one out of five patients, suggesting that gabapentin effectiveness may be related to additional non-GABAergic mechanisms of action. Interaction with cerebral glutamate transmission by inhibition of NMDA receptor might be an alternative hypothesis for the therapeutic action of gabapentin.

Improvements in diabetic care as measured by HbA1c after a physician education project.

OBJECTIVE: To measure the quality of diabetic care as indicated by HbA1c testing frequency and HbA1c values and to demonstrate improvement in care after an appropriate quality improvement intervention. RESEARCH DESIGN AND METHODS: The quality improvement project used computerized claims and laboratory data relating to HbA1c testing among the private practices of nine physicians caring for diabetic Medicare patients. Nine indicators evaluated three main areas: HbA1c testing frequency, HbA1c values, and frequency of office visits. A quality improvement intervention consisting of a physician component and a patient component was implemented. RESULTS: There were 835 patients and 4,367 visits studied. After the intervention, statistically significant improvements in HbA1c testing frequency and values were noted. Rates of seized opportunities for testing HbA1c improved from 17.7 to 33.9% (P < 0.0001). The percentage of patients with a current HbA1c value improved from 31.3 to 47.6% (P < 0.0001). The median HbA1c values fell from 8.5 to 7.8% (P < 0.006). Patients achieving good or fair control (HbA1c < or = 8%) improved from 43.8 to 56.9% (P = 0.007). The median time between physician visits fell from 70 days to 60 days (P < 0.0001). CONCLUSIONS: The study revealed that HbA1c testing was underused but that after a quality improvement initiative, a significant increase in testing use could be achieved. The quality improvement initiative also resulted in significant improvements in glycemic control. The techniques and interventions used in this study could be used to intervene in larger populations and practice settings to improve medical care for diabetic patients.

Neurotological auditory brain stem response findings in human immunodeficiency virus-positive patients without neurologic manifestations.

Neurologic manifestations of human immunodeficiency virus (HIV) infection, rather than being a late complication of the disease, are principally correlated with the early central nervous system (CNS) localization of HIV. The CNS may be infected in the early stages of acquired immunodeficiency syndrome (AIDS) without evidence of neurologic disorders. Evoked potentials (visual, auditory, and somatosensory) and electronystagmographic test batteries have proven to be very sensitive in showing subclinical CNS disorders due to HIV. In this study, auditory brain stem response (ABR) and electronystagmographic test battery findings (smooth pursuit, saccades, caloric test) were performed in 29 neurologically asymptomatic, HIV-positive subjects at different stages of the disease. Compared to results of a control group, the ABR latencies of waves V, I, and III and interpeaks I-V and III-V were significantly increased in HIV patients. The same parameters did not differ significantly among the stages of the disease. In HIV-positive subjects, the accuracy of saccades was significantly reduced, while latency was normal. The velocity and the gain of pursuit were significantly reduced in HIV-positive patients, and 15 of 29 patients showed corrective saccades. Caloric tests revealed qualitative nystagmus abnormalities in 82% of HIV patients, while quantitative parameters were normal. The present results confirm that CNS involvement by HIV occurs early in the course of the disease. In particular, HIV does not seem to affect the labyrinth or the eighth cranial nerve, as demonstrated by the normality of the I-III value of the ABR and of the quantitative parameters of the caloric responses, but it does appear to involve the brain stem acoustic pathways, pontocerebellar pathways, and supratentorial areas.

[Personal, familial and environmental factors influencing the inclination of smoking in adolescents: differences between sexes and between city and small-town dwellers]. / Fattori personali, familiari ed ambientali che influenzano la previsione di fumare degli adolescenti: differenze tra i sessi e tra grande e piccola città.

Smoking is a major health hazard. Most cigarette smokers start by the age of 18 years. The purpose of this study was to assess the prevalence of the intention to smoke among the students of a metropolitan compared to a non-metropolitan high school. The influence of age, sex, demographic and socio-economic variables, and the role of smoking models of family members and friends, were examined. Nine hundred forty-five students (529 males and 416 females; mean age 15.8 +/- 1.5 years) attending a high school in Naples and 442 students (223 males and 219 females; mean age 16.1 +/- 1.6 years) in Capua, a small town 40 Km distant from Naples, filled in an extensive questionnaire on smoking. The prevalence of intention to smoke was 10.4% in Naples and 9.3% in Capua. It was related to age (p < 0.01) in Naples, but not in Capua. The prevalence of smokers was 24.2% in Naples (males 21.6%, females 27.6%; p = 0.038) and 24.1% in Capua (males 29.2%, females 19%; p = 0.017). As expected, in both cities intention to smoke was associated (p < 0.001) with the strength of existing smoking habit. Students smoking over 21 cigarettes/week were more likely to continue than students smoking less 21 cigarettes/week, both in Naples and in Capua. More than half of smoking students, in both cities, were irresolute about their habit in the subsequent year. In Naples, intention to smoke of male students was associated with mother's (p = 0.02) and siblings' (p < 0.0001) smoking habit; in female students intention to smoke was associated with father's (p = 0.02), mother's (p < 0.001), parents' (p < 0.01) and siblings' smoking habit (p = 0.0002). In Capua an association was evident, in male students, between intention to smoke and paternal smoking habit (p = 0.04); in female students, intention to smoke was associated with siblings' smoking habit (p = 0.03). In Naples and in Capua, for both sexes, intention to smoke was related to smoking habits of the best friend of the same sex (p < 0.0005), the best friend of the opposite sex (p < 0.00005) and friends (p < 0.00001). Multivariate analysis showed, in Naples, an independent relation between adolescent intention to smoke and age (p = 0.01), smoking status of student (p < 0.0001) and friends' smoking habit (p = 0.01). In male students intention to smoke was associated with age (p = 0.003), smoking habit of student (p < 0.0001), mother's (p = 0.02) and friends' (p = 0.02), whereas in females it was associated with smoking behavior of student (p < 0.0001). In Capua student intention to smoke was related to the smoking status of the student (p < 0.0001) and of the best friend of the opposite sex (p < 0.04); in male as in female students, intention to smoke was associated with smoking habit of the student (p < 0.0001). In conclusion, prevalence of adolescents' intention to smoke is similar in two distinct populations of high school students of a city and a small town. Smoking is at higher prevalence among females in the city and among males in the small town. Intention to smoke increases with age, in the great city, and is related to student's existing habit and peer models. More than half of smoking students, in both cities, were irresolute about their habit in the subsequent year. This study has identified some variables associated with adolescents' intention to smoke; we feel that these findings may contribute to a better understanding of smoking behavior among adolescents and may have preventive implications.

[Family and friends who smoke: influence on adolescents]. / Familiari ed amici fumatori: influenza sugli adolescenti.

BACKGROUND: Smoking is the leading preventable cause of death. Most cigarette smokers take up the habit during adolescence. The purpose of this study was to assess the prevalence of cigarette smoking behavior among the students of a metropolitan high school as compared to those attending a non-metropolitan high school, examining age, sex and demographic and socioeconomic differences, as well as the influence of smoking models (family members and friends) on smoking behavior among adolescents. METHODS AND RESULTS: Nine hundred seventy-eight students (544 males, 434 females; mean age 15.8 +/- 1.5 years) attending a high school in the city of Naples and 467 students (235 males, 232 females; mean age 16 +/- 1.5 years) from a high school of Capua, a small town 40 kilometers away from Naples, filled out an extensive questionnaire on smoking. The prevalence of smokers was 24.2% (males 21.8%, females 28.2%; p = 0.02) in Naples and 23.8% in Capua (males 29.8%, females 19.2%; p < 0.001) and was related to age (p < 0.001) both in Naples and in Capua. In Naples, smoking behavior among male students was associated with smoking by sibling (p = 0.00005), whereas an association with father (p = 0.0003), mother (p = 0.00005), parental (p = 0.0002) and sibling (p = 0.00002) smoking was observed among females. In Capua, an association was evident only between smoking in female students and sibling smoking habits (p = 0.02). In both Naples and Capua, smoking status of the students was related to smoking habits of best friends of the same sex, best friends of the opposite sex and friends. Multivariate analysis showed an independent relationship in Naples between adolescent smoking behavior and smoking status of siblings (p = 0.01), best friends of the same sex (p < 0.001) and best friends of the opposite sex (p < 0.001). In males, smoking behavior was associated with the smoking behavior of best friends of the same (p < 0.001) and of the opposite sex (p = 0.01), whereas in females, it was linked with the smoking behavior of siblings (p = 0.05), mother (p < 0.05) and best friends of the same sex (p < 0.001). In Capua, student smoking was related to smoking among friends (p < 0.001) and this held true for both males (p = 0.05) and females (p < 0.0001). CONCLUSIONS: The prevalence of smoking habits among teenagers is similar in two distinct populations of high school students from a city and from a small town. Smoking showed a higher prevalence among females in the city and among males in the small town. It increases with age and is related to peer and family smoking models. This study has identified several variables associated with smoking status among adolescents. We thus feel that these findings may contribute to a better understanding of smoking behavior among teenagers and may have prevention implications.

[Wegener's and Stewart's granulomatosis: a case report of Stewart's granulomatosis]. / Le granulomatosi centrofacciali di Wegener e di Stewart: su un caso clinico di granuloma centrofacciale di Stewart.

Wegener's and Stewart's diseases are two rare pathologies of unknown origin; both can cause disruptive facial lesions. Wegener's disease is a systemic pathology and generally involves the kidneys and lungs. Granulomatosis lesions are characterized by the necrotizing vasculitis involving the small vessels. From a diagnostic point of view the systemic features of Wegener's disease and the specific immunological findings (i.e. IgG autoantibodies vs. monocyte and neutrophil cytoplasm) make it possible to diagnose the disease precisely. Stewart's disease can be differentiated from Wegener's disease by the absence of any systemic lesions and the lack of necrotizing vasculitis. Pathogenesis of the disease is still unknown although immunohistochemical findings indicate that it is related to extranodal Tcell lymphomas. Stewart's disease is very aggressive with massive destruction of the midface tissues and prognosis is very poor (from a few months to 23 years). Surgery is generally ineffective in such disorders. The treatment for Wegener's disease includes the use of systemic steroids, immunosuppressive drugs and the sulfametoxazole-thrimethoprime association while radiotherapy associated with chemotherapy appears most effective in Stewart's disease. The authors describe a case of Stewart's disease prevalently involving the nasal cavities, ethmoid and paranasal sinuses. Diagnosis was made on the basis of immunohistochemical, histomorphological and immunological data. Treatment--based initially on systemic steroids with the association thrimethoprimsulfometoxazole--induced significant disease remission. Subsequent use of cytostatic drugs has made it possible to control the disease progression to date.

Distortion products in normal hearing patients with tinnitus.

Otoacoustic emissions are the result of cochlear active non-linear micromechanical mechanisms which probably originate within the OHC. OAE findings in patients with tinnitus are not univoque and there is no clear correlation between OAE modifications and tinnitus. We investigated distortion products in 20 normal hearing patients with tinnitus; all patients were selected with restrictive criteria (audiogram within 20 dB for all the frequencies, ABR and other tests normal, no history of ototoxic, nootropic drug intake, normal psychological evaluation, etc.). 12 patients out of 20 (60%) showed DP alterations. This finding is interpreted as an abnormality or a dysregulation of the efferent system (olivo-cochlear pathways) or of the other structures of the control loop which could modify outer hair cell activity in an otherwise normal cochlea with the development of tinnitus.

[Otoneurological manifestations in Fhar's disease. A case report]. / Manifestazioni otoneurologiche nel morbo di Fhar. Descrizione di un caso clinico.

Fhar's disease is a rare idiopathic CNS pathology characterized by widespread calcifications of the basal ganglia, cerebellar nuclei and endocranial vessels. The origin of this disease is unknown and a lack of thyroid and parathyroid pathologies is the main statement. From the clinical point of view, extrapyramidal manifestations are common while vertigo and equilibrium disorders are rare. In the present case vertigo and disequilibrium were the main symptoms. Fhar's disease was diagnosed by CT and MRI showing calcification of the basal ganglia without any metabolism disorders or thyroid and parathyroid pathology. A battery of neurotological tests showed alterations of VOR and ocular movement. In particular the saccades movements showed significant hypometria while the smooth-pursuit showed gain diminution and corrective saccades. These anomalies imply dysfunction of sub-cortical centers regulating and modulating ocular movement. VOR alterations included both qualitative anomalies of nystagmus (i.e. dysrhythmia, square waves) and quantitative alterations (i.e. bilateral deficit response to caloric and rotatory stimuli). These alterations could be due to the impairment of cerebellum-vestibular and vestibular-thalamic pathways. Acoustic evoked potentials (ABR, MLR) ruled out central acoustic pathway dysfunction.

[Case report: pleomorphic adenoma of the lateral nasal wall]. / Su un caso di adenoma pleomorfo della fossa nasale.

Pleomorphic adenoma is a tumor which most often originates from one of the major salivary glands; it is rarely located in the lacrymal glands and it is highly exceptional in the nasal cavity. Cases of pleomorphic adenoma in the nasal cavity have been described by Spiro (40 cases), Compagno and Wong (40 cases) and Suzuki et al. (41 cases). This type of tumor generally originates from the septal mucosa even though the seromucosal glands are mostly located in the lateral nasal wall. This pathology is more frequently found in females. The clinical signs of this tumor are non specific, slow unilateral nasal occlusion, rhinorrhea and, at times, epistaxis. Evolution is generally local although locoregional and distant metastases have been described in the literature. This sort of tumor has no specific appearance and thus diagnosis is based on histology. Indeed, microscopically nasal pleomorphic adenoma differs from salivary gland adenoma for the predominance of the cellular component over the connective component. The epithelial cells are small, oval-shaped and often arranged in cordons; they are sometimes organized in small acinous structures. The connective component can be mixoid, condroid or collagenous; follicles with squamous metaplasia and mitosis are rare. Histologically differentiating this disorder from olfactory esthesione-uroblastoma can prove difficult; the lack of extra cellular neurifibrillar structures, neurotubules and neurosecretory granules in nasal pleomorphic adenoma are the main distinguishing criteria. The present work reports a case of a 45-year-old man who had suffered of an increasing unilateral nasal obstruction from 1 year. Endoscopic examination showed a smooth surface neoplasm involving the entire nasal cavity. CT scan showed the deformation of the medial bone wall of the maxillary sinus and of the ethmoid although without any osteolysis. Median maxillectomy surgical exeresis of the neoplasm was performed with the facial degloving technique. Histology revealed a 5 cm pleomorphic adenoma originating from the lateral nasal wall. This origin is extremely rare because this tumor generally originates in the nasal septum. Immunohistochemical stains proved positive for epithelial membrane antigen (MNF 116), for myoepithelial cells (PS100) and for stromal cells (Vimentine) with the epithelial elements predominating. After 9 months of follow-up the patient is still disease free.

[The study of factors affecting ABR in high risk newborn infants]. / Studio sui fattori influenzanti i parametri dei potenziali acustici a breve nei neonati a rischio.

A.B.R. was employed to examine auditory pathways in a group of 78 newborn infants at risk and one of 20 normal infants. The impaired newborn group suffered of various risk factors or pathologies: 20 premature infants, 12 undersize (small for date), 12 with breathing distress, 11 hiv positive, 5 with neonatal jaundice, 4 suffered of convulsion, 4 at risk for hereditary deafness, 4 born by mothers with mellitus diabetes, 2 with dolichocefalia, 1 with the Albers-Schomberg syndrome, 1 with congenital heart disease and 1 with congenital glycogenosis. The results of A.B.R. of the risk group were compared statistically employing the "t Student's test" with those of the group of normal infants. The influence of risk factors in the first group on alterated A.B.R. parameters was then examined using a step-by-step logistic regression analysis method. The result showed a significant increase in a latency of waves V and III and inter-waves I-V and III-V in risk infants, while wave I and I-III internals were normal. These findings appear to demonstrate that in infants at risk, brainstem acoustic pathways are more sensitive to damage than the cochlea and acoustic nerve. This could be explained by the different degree of maturation that exists between the central acoustic pathways and the coclea and acoustic nerve. Analysis of the influence of pathologies and risk factors on A.B.R. indicate that birth weight followed by chronological age and length of the gestation period are significant in the development of A.B.R. alterations. The Albers-Schomberg syndrome, dolicocephalia, microcephalia, congenital glicogenosys, hiv infection, breathing difficulty and neonatal jaundice proved to be the main pathologies responsible for bringing about A.B.R. alterations.