Effects of olive mill wastewater physico-chemical treatments on polyphenol abatement and Italian ryegrass (Lolium multiflorum Lam.) germinability.

Direct spreading on agricultural lands may represent an environmentally friendly disposal method and a possible use of water and nutrients from olive mill wastewaters (OMWs). However, the agronomic use of OMWs is limited, among others by polyphenols, which exert phytotoxic effects. Activated charcoal (AC) has been recognized as a very effective agent for polyphenol abatement, as it enables an irreversible process of phenol adsorption. Addition of calcium hydroxide (Ca(OH)2) has also been described as a cheap and effective method in polyphenols abatement. However, the effects of Ca(OH)2 addition to OMW on seed germination are unclear. In this paper, the effects of AC and/or Ca(OH)2 on OMW polyphenols abatement, and Lolium multiflorum seed germination have been investigated. The highest polyphenols removal, approximately 95%, was observed when 80 g L(-1) of AC was added to OMWs (the maximum dose in this investigation). The addition of Ca(OH)2 not only improved the effectiveness of the AC treatment but also resulted in a significant rise in Lolium seed germination at the highest AC doses (60 and 80 g L(-1)). Considering the high salinity (7300 µS cm(-1)) of these wastewaters, low quantities of Ca(OH)2 may also exert a protective effect on soil structure counteracting the sodium-induced dispersion through the binding action of calcium cation on clays and organic matter.

Diet and pancreatic cancer: many questions with few certainties.

UNLABELLED: BACKGROUND, OBJECTIVES: Pancreatic cancer ranks fourth for cancer mortality for men and women in the United States. This is a particularly devastating cancer since the case-fatality proportion approaches 90% within 12 months following diagnosis. Therefore, understanding the etiology and identifying the risk factors are essential for the primary prevention of this deadly disease. Of the few potentially modifiable risk factors that have been identified, cigarette smoking, history of diabetes mellitus, and obesity seem to be among the most consistent, but the effect of dietary factors is still unclear. The aim of our study is to review of the literature examining the potential role of carbohydrates, fatty acids, meat, fruit and vegetables, alcohol. DISCUSSION: Although large prospective cohort studies with questionnaire based analyses will continue to have much to offer in defining predisposing factors for difficult diseases, such as pancreatic cancer, unfortunately dietary questionnaires do not reflect the bioavailability of the nutrients from various foods, the level of absorption from the digestive tract, or individual differences in metabolism. CONCLUSIONS: Greater use of participant-derived biological samples, banked plasma, germline DNA, and tumour tissue samples may help to the understanding of pancreatic cancer pathogenesis.

[Biliary tract carcinoma. Case report]. / Il carcinoma della via biliare principale. Contributo clinico.

Carcinoma of the main biliary way is a condition that often leads to a fatal outcome owing to the rapid growth and late onset of the symptoms. The importance of a correct, timely diagnosis is stressed, with reference to a clinical case in which even CT scanning did not confirm either the presence of the neoformation or the dilation of the intra and extrahepatic bile ways. The usefulness of humoral markers for the diagnosis of the disease in its preclinical phase in the interests of surgical treatment that is as radical as possible is underlined.

Solid-phase synthesis of cyclic analogues related to the hypoglycaemic peptide hGH(6-13): comparison of two i-->i + 4 lactam cyclization procedures.

The use of 1,3-diisopropylcarbodiimide (DIC) for the synthesis of cyclic analogues of the hypoglycaemic peptide fragment derived from the N-terminus of human growth hormone (hGH), namely hGH[6-13], is described. Different strategies were examined to achieve improved yields for the on resin side-chain to side-chain cyclization of the corresponding linear peptides containing reverse beta-turn motifs. When compared with the more reactive Castro's reagent, the results confirm that DIC in the presence of HOBt can be successfully employed to minimize the formation of intermolecular oligomeric byproducts associated with the preparation of cyclic hGH[6-14] peptide analogues based on an i-->(i + 4)Lys-->Glu or Glu-->Lys cyclization strategy.

[The thyroidectomized follow-up]. / Il follow-up dei tiroidectomizzati.

Thyroid neoplasties are largely benign, and only 1% of all over malignant neoplasties with clinical diagnosis regard the thyroid. The histologic characteristics of the thyroid neoplasties assume fundamental importance both in diagnosis and in therapy. The authors underline the importance of the surgical treatment of malignant neoplasties of the thyroid with the problems connected to the choice of the entity of the demolition of the organ and the post-operative thyrohyoid residue and the importance of the correct follow-up for few patients, consenting to optmize the available resources.

Solid-Phase synthesis of a dendritic peptide related to a retinoblastoma protein fragment utilizing a combined boc- and fmoc-chemistry approach.

Dendritic peptides, often presented as multiple antigen peptides (MAPs), are widely used in immunological-based fields of research, although their synthesis can be extremely challenging. In this paper, a tetrameric dendritic MAP-like presentation of the retinoblastoma protein [649-654] sequence (4RB(649-654)) has been prepared using solid-phase peptide synthesis (SPPS) methods. During the synthesis of this dendritic molecule, numerous modifications to the synthetic protocols were examined. These modifications included the introduction of a combination Boc- and Fmoc-chemistry approach and also the use of 1,8-diazabicyclo[5.4.0]-undec-7-ene as a Fmoc-deprotection agent. The use in combination of Boc- and Fmoc-based synthetic strategies resulted in the production of the desired peptide molecule, 4RB(649-654), in high purity and acceptable yields following purification by reversed phase HPLC.

[Pseudomyxoma peritonei with appendiceal and ovarian mucinous cystadenoma. A case report. Correlations with synchronous or metachronous colorectal carcinomas]. / Pseudomixoma peritonei con cistoadenoma mucinoso appendicolare ed ovarico. Contributo clinico. Rapporti con i carcinomi colo-rettali sincroni o metacroni.

Mucocele is a rare pathology which is difficult to diagnose prior to surgery. The clinical symptoms are aspecific. Diagnosis is generally made at the time of surgery. Explorative laparoscopy is not advised owing to the possibility of encouraging metastatic diffusion. Surgery associated with ex tempore freezer tests must be carried out with the greatest caution to avoid rupture of organs and the spread of mucin. Appendectomy and removal of the adnexa is recommended in benign forms, with or without omentectomy. Omentectomy is necessary together with hystero-adnexectomy and right hemicolectomy in malignant forms, as well as lymph node cleaning and removal of all mucin in pseudomyxoma peritonei.

[Early gastric cancer. The therapeutic options]. / Early gastric cancer. Opzioni terapeutiche.

The best therapeutic treatments for early gastric cancer are evaluated. Due to the difficulty of preoperative and intraoperative staging, it's reasonable to consider early gastric cancer as a composite disease; while some mucous localizations can benefit of minor therapeutic treatments, the submucous cancer must be treated as the parietal gastric cancer.

Solid phase synthesis of cyclic peptides: model studies involving i-(i+4) side chain-to-side chain cyclisation.

Conditions for the synthesis of i-(i + 4) side chain-to-side chain head-to-tail Lys-->Glu and Glu-->Lys linked cyclic peptides related to hypoglycaemic analogues of human growth hormone hGH [6-13] have been examined. The success of the cyclisation reaction with the corresponding resin-bound, partially protected linear peptides was found to be both reagent as well as sequence dependent, with competing inter-chain oligomerisation predominating in some cases. The results also indicated that protection with the bulky Fmoc group of the amino acid residues immediately adjacent to the side chain-deprotected Lys and Glu residues, which participate in the cyclisation reaction, enhanced the rate of lactam formation.

Intensive training and cardiac autonomic control in high level athletes.

PURPOSE: We aimed to evaluate in a longitudinal study the effect of intensive training on cardiac autonomic control in athletes using 24-h heart rate variability analysis. METHODS: Time and frequency domain measures of heart rate variability were calculated from 24-h Holter monitoring in 15 high level bicyclists (mean age 21 +/- 4 yr) after 1 month of detraining and after 5 months of vigorous training. At the same times echocardiographic left ventricular mass and dimensions and maximal oxygen consumption (VO2max) were assessed. RESULTS: In detrained athletes, VO2max values, left ventricular mass and dimensions, and time and frequency domain measures of vagal modulation of heart rate were higher than in a group of untrained subjects of similar age while heart rate and the low-to-high frequency ratio were lower, indicating an enhanced vagal modulation of heart rate in athletes as compared with that in control subjects. After 5 months of vigorous training, left ventricular mass and dimensions and VO2max increased in athletes, while heart rate decreased further. In contrast, no changes were detectable in time and frequency domain measures of heart rate variability over the entire 24-h and in both waking and sleeping hours. CONCLUSIONS: This study demonstrates that an increased cardiac vagal control is detectable in detrained athletes; however, after intensive training, despite a significant decrease in heart rate, time and frequency domain measures of heart rate variability reflecting cardiac vagal control remain unchanged. Thus, other mechanisms than changes in cardiac autonomic control could be involved in determining the profound bradycardia of athletes.

[Primary lymphoma of the small intestine. A clinical case report and review of the literature]. / Il linfoma primitivo dell'intestino tenue. Descrizione di un caso clinico e revisione della letteratura.

The authors present a case of small bowel primitive lymphoma found in a 66-years-old female. After having briefly reviewed the literature they direct their attention to the clinical-instrumental diagnostic difficulties of this neoplasm which is often discovered only when it has already invaded various organs. Therefore surgical therapy is not always radical. This fact in addition to the fatally rapid postoperative course led the authors to discuss the problems involved in a correct treatment of this pathology.

[Ileal and axillary metastasis of primary unknown site melanoma. Clinical case]. / Metastasi ileale ed ascellare da melanoma primitivo a sede ignota. Caso clinico.

The incidence of Cutaneous Melanoma is 4-5% of all the tumors of the skin. This incidence increases several folds in the last years. Metastases of Melanoma involve lungs, skin, soft tissue, liver, bone, brain, but in 20-30% of the patients involve gastrointestinal (GI) tract. In 60-70% of the cases GI metastases involve small bowel, in 15-20% stomach, in 10-20% large bowel, in 5% esophagus. In 8% of the patients the primary cutaneous melanoma is not known. The prognosis of the patients with metastatic melanoma is poor with an average survival of 5 months. One patient male, 51 years old, underwent surgery for metastases from melanoma in the lymph nodes of the right axilla and in the gastrointestinal tract (ileum). An ileo-ileo anastomosis and a lymphoadenectomy of the nodes of the right axilla were performed. After a first chemotherapy with DTIC (800 mg/m2) + a-IFN(3MU three times every week) and another with CDDP (30 mg/m2 day 1-3), DTIC (250 mg/m2 day 1-3) and VDS (2.5 mg/m2 day 1) with no response, the patient was treated with chemo-immunotherapy sec. Bernengo, slightly modified: CDDP 75 mg/m2; IL-2 18 MU (9MU b.d.) day 3-6 and 17-21; a-IFN 5MU three times every week. This therapy had a partial response of short-course (three months) and the patient died 15 months after surgery. The authors hope that immunotherapy and genetic therapy improve the survival of the patients with metastatic melanoma in the next years.

[Low ileorectal anastomosis in the surgery of ulcerative rectocolitis]. / L'ileorettoanastomosi bassa nella chirurgia della rettocolite ulcerosa.

The authors report their experience of 23 patients with ulcerative colitis treated with surgery from 1991 to 1994. At admission 8 patients had a high-grade illness, 10 patients had a middle-grade illness, 5 patients had a toxic megacolon. All the patients were treated with systemic medical management (mesalazine + methylprednisolone) and topical medical management with rectal steroid (methylprednisolone) and rectal mesalazine by enema, and with nutritional support (Total Parenteral Nutrition). The 5 patients with toxic megacolon, after 48 hours of unsuccessful medical management, underwent surgery with deferred urgency; the other 18 patients underwent surgery after one-four months. The authors prefer the ileorectal anastomosis (IRA), since the rectal lesions are more susceptible to topical therapy. A single-stage IRA was performed in 17 patients. A sigmoid resection has been employed in the first stage in the 18th patient with a local development of the disease in the sigma; a following relapse of the lesions required a total colectomy with a low ileorectal anastomosis. A first-stage subtotal colectomy with ileostomy and Hartmann closure of the rectum with low ileorectal anastomosis at a later date was performed in the 5 patients with toxic megacolon. One of these, 18 years old, died after a heart failure. After surgery, as soon as the patients start moving their bowels all of these had again a systemic therapy with mesalazine for a short period and after they had a topical therapy with mesalazine + methylprednisolone by enema, for a long period. The average postoperative period of admission was 16.3 days. The functional results have been encouraging with an average of 1.6 bowel movements daily and an average of 0.4 nocturnal bowel movements. All the patients had a normal anal sphincter function with an acceptable stool frequency. In male patients there no urinary or sexual defects. In one case of these, there was a low grade of dysplasia, revealed by endoscopic biopsy. The authors conclude that today surgical treatment of ulcerative colitis is not well established.

Comparison of verapamil versus felodipine on heart rate variability after acute myocardial infarction.

A depressed heart rate variability (HRV) is a powerful predictor of poor outcome in myocardial infarction patients. The beneficial effect of specific interventions on its recovery has been reported, but data concerning calcium antagonists are scarce. We evaluated the effect of a phenylalkylamine derivative, verapamil, and a dihydropyridine derivative, felodipine, on time- and frequency-domain measurements of HRV by 24-hour Holter monitoring in 60 patients with acute myocardial infarction (AMI). After a first Holter recording (65 +/- 8 hours from the onset of symptoms), patients were randomly assigned to continue standard treatment or to also receive verapamil retard (120 mg 3 times daily) or felodipine extended-release (10 mg/day). Holter recording was repeated after 7 days. After verapamil, mean RR interval increased from 823 +/- 92 to 907 +/- 95 ms and the SD of all normal RR (NN) intervals (SDNN) from 99 +/- 24 to 120 +/- 30 ms (p < 0.01); the root mean square successive difference (r-MSSD) and the percent of differences between adjacent NN intervals > 50 ms (pNN50) also increased (p < 0.01). After felodipine, only SDNN increased (p < 0.01). Regarding frequency-domain measurements, after receiving verapamil, very low frequency, low- and high-frequency powers increased (p < 0.01), whereas the low- to high-frequency ratio decreased (p < 0.01). After receiving felodipine, very low-frequency power increased (p < 0.01), whereas low- and high-frequency powers and the low- to high-frequency ratio remained unchanged. This study demonstrates that verapamil, but not felodipine, improves HRV in the early phase after AMI.

Twenty-four-hour blood pressure monitoring during treatment with extended-release felodipine versus slow-release nifedipine in elderly patients with mild to moderate hypertension: a randomized, double-blind, cross-over study.

OBJECTIVE: This double-blind, placebo-controlled randomized study was designed to compare the antihypertensive effect and tolerability of extended-release felodipine and slow-release nifedipine retard in elderly hypertensive patients. METHODS: Thirty patients of both sexes (mean age 71 years) with mild to moderate essential hypertension were recruited from our hypertension outpatient clinic. After a 2-week placebo period, felodipine extended-release (felodipine ER), 10 mg once daily, nifedipine slow-release retard (nifedipine SR), 20 mg twice daily or placebo were administered to each patient for 2 weeks according to a 3 x 3 latin-square design. At the end of each treatment period, the patients underwent 24-h noninvasive blood pressure monitoring. RESULTS: All of the patients completed the trial and no serious adverse experience was reported. In comparison with placebo, felodipine and nifedipine decreased mean 24-h diastolic blood pressure by 6.7 and 4.3 mmHg, respectively, with no significant difference between the two drugs. Mean 24-h systolic blood pressure also decreased after felodipine and nifedipine, with no difference between the two drugs. Both drugs reduced blood pressure variability, lowering the 24-h mean standard deviation of mean hourly blood pressure values. The trough:peak ratio for felodipine was 80% for systolic and 75% for diastolic blood pressure. CONCLUSION: Felodipine ER once daily lowers blood pressure in elderly hypertensives and is as effective as nifedipine SR twice daily. The high trough:peak ratio suggests that the dose and the between-dose interval of felodipine provides adequate therapeutic coverage.

[The laparoscopic approach to the polycystic liver and adnexal cysts]. / Approccio laparoscopico alla policistosi epatica e alle cisti annessiali.

Having re-examined the nosographic data acquired on the subject of hepatic polycystosis and uterine adnexal cysts, the authors report the results of their experience. On the basis of the evaluation of these results (no laparotomic conversion, no postoperative complications, reduced hospital stay), which are comparable to those reported in the literature, the authors conclude that the modern technology may be used to advantage in all cases where laparoscopic surgery is not difficult, does not require numerous tests and does not entail a high risk of complications.

[Heredity and colorectal cancer]. / Familiarità e cancro colorettale.

The authors underline the role of inheritance in colorectal cancer and reporting the genealogical study of two families with high incidence of colorectal cancers personally observed. They thought that the genetic endowment (oncogenes, suppressor genes, microsatellite instability, protein-kinase C) was implicated directly in the genesis of disease.

[The utility of isolating the recurrent nerve and parathyroids in the prevention of complications in thyroid surgery. The role of the superior laryngeal nerve and C cells]. / Utilità dell'isolamento del nervo ricorrente e delle paratiroidi nella prevenzione delle complicanze in chirurgia tiroidea. Il ruolo del laringeo superiore e delle cellule C.

The authors emphasize systematic isolation of the recurrent nerve and of the parathyroids, to prevent complications in surgery of the thyroid. Moreover they try to underline the significance of the superior laryngeal nerve and the role of parafollicular cells (today unknown) for a rational and modern therapy of the non-neoplastic diseases of the thyroid.