Polyethylene microplastics alter root functionality and affect strawberry plant physiology and fruit quality traits.

Strawberry, a globally popular crop whose fruit are known for their taste and health benefits, were used to evaluate the effects of polyethylene microplastics (PE-MPs) on plant physiology and fruit quality. Plants were grown in 2-L pots with natural soil mixed with PE-MPs at two concentrations (0.2% and 0.02%; w/w) and sizes (⌀ 35 and 125 µm). Plant physiological responses, root histochemical and anatomical analyses as well as fruit biometric and quality features were conducted. Plants subjected to ⌀ 35 µm/0.2% PE-MPs exhibited the most severe effects in terms of CO2 assimilation due to stomatal limitations, along with the highest level of oxidative stress in roots. Though no differences were observed in plant biomass, the impact on fruit quality traits was severe in ⌀ 35 µm/0.2% MPs treatment resulting in a drop in fruit weight (-42%), soluble solid (-10%) and anthocyanin contents (-25%). The smallest sized PE-MPs, adsorbed on the root surface, impaired plant water status by damaging the radical apparatus, which finally resulted in alteration of plant physiology and fruit quality. Further research is required to determine if these alterations also occur with other MPs and to understand more deeply the MPs influence on fruit physio-chemistry.

Shedding light on the effects of LED streetlamps on trees in urban areas: Friends or foes?

Streetlamp illumination disturbs the natural physiological processes and circadian rhythms of living organisms, including photosynthesizing "citizens". The light-emitting diode (LED) technology has replaced high-pressure sodium lamps. Therefore, the effects of LED streetlamps on urban trees need to be elucidated as these new lamps have a different light spectrum (with a peak in the blue and red regions of the spectrum, i.e., highly efficient wavebands for photosynthesis) compared to older technologies. To address the above-mentioned issue, two widely utilised tree species in the urban environment, including Platanus × acerifolia (P) and Tilia platyphyllos (T), were grown with or without the effect of LED streetlamps using two realistic illumination intensities (300 and 700 µmol m-2 s-1). Gas exchanges and biochemical features (starch, soluble sugar, and chlorophyll content) of illuminated vs non-illuminated trees were compared during the whole vegetative season. Our results showed that both tree species were strongly influenced by LED streetlamps at physiological and biochemical levels. Specifically, the mature leaves of P and T streetlamp-illuminated trees had a lower CO2 assimilation rate at dawn and had higher chlorophyll content, with lower starch content than controls. Our results showed that the differences between the effects of the two selected light intensities on the physiochemical attributes of P and T trees were not statistically significant, suggesting the absence of a dose-dependent effect. The most significant difference between T and P trees concerning the LED-triggered species-specific effect was that the delay in winter dormancy occurred only in P individuals. This study provided insights into the extent of LED streetlamp disturbance on trees. Our findings might raise awareness of the necessity to provide less impacting solutions to improve the wellness of trees in the urban environment.

Evaluating diagnostic accuracy of anti-tissue Transglutaminase IgA antibodies as first screening for Celiac Disease in very young children.

BACKGROUND: Small bowel biopsy is the gold standard for Celiac Disease (CD) diagnosis, nevertheless serum assays are the first step in ascertaining a diagnosis of CD. New ESPGHAN Criteria 2012 (European Society of Pediatric Gastroenterology Hepatology and Nutrition) suggest using exclusively anti-tissue Transglutaminase IgA antibodies (anti-tTGA) as initial approach to symptomatic subjects. The aim of our study was to evaluate the diagnostic accuracy of anti-tTGA as initial screening assay for CD in a large cohort of pediatric patients. METHODS: We selected 730 subjects aged between 6 months and 4 years ("Group A") and 348 subjects younger than 2 years (which are part of the 730 subjects) ("Group B"). We performed anti-Deamidated Gliadin Peptides IgA and IgG antibodies (a-DGP IgA/IgG) and anti-tTGA assays by ELISA test. We evaluated the agreement between anti-tTGA and a-DGP IgA/IgG assays and compared the diagnostic accuracy of a-DGP IgA/IgG with that of anti-tTGA in both groups of patients. RESULTS: There was a substantial agreement between anti-tTGA and a-DGP IgA in "Group A" and an almost perfect agreement in "Group B"; the strength of agreement between anti-tTGA and a-DGP IgG was moderate in "Group A" and substantial in "Group B". anti-tTGA were more sensitive and specific than a-DGP IgA/IgG in both groups. CONCLUSIONS: anti-tTGA could be used as initial screening assay for CD in all subjects from 6 months of age according to ESPGHAN Criteria 2012.

An ErbB-3 antibody, MP-RM-1, inhibits tumor growth by blocking ligand-dependent and independent activation of ErbB-3/Akt signaling.

The ErbB receptors, such as ErbB-1 and ErbB-2, have been intensely pursued as targets for cancer therapeutics. Although initially efficacious in a subset of patients, drugs targeting these receptors led invariably to resistance, which is often associated with reactivation of the ErbB-3-PI3K-Akt signaling. This may be overcome by an ErbB-3 ligand that abrogates receptor-mediated signaling. Toward this end, we have generated a mouse monoclonal antibody, MP-RM-1, against the extracellular domain (ECD) of ErbB-3 receptor. Assessment of human tumor cell lines, as well as early passage tumor cells revealed that MP-RM-1 effectively inhibited both NRG-1ß-dependent and -independent ErbB-3 activation. The antagonizing effect of MP-RM-1 was of non-competitive type, as binding of [(125)I]-labeled NRG-1ß to ErbB-3 was not influenced by the antibody. MP-RM-1 treatment led, in most instances, to decreased ErbB-3 expression. In addition, MP-RM-1 was able to inhibit the colony formation ability of tumor cells and tumor growth in two human tumor xenograft nude mouse models. Treatment with the antibody was associated with a decreased ErbB-3 and Akt phosphorylation and ErbB-3 expression in the excised tumor tissue. Collectively, these results indicate that MP-RM-1 has the potential to interfere with signaling by ErbB-3 and reinforce the notion that ErbB-3 could be a key target in cancer-drug design.

Relations between strain and gender dependencies of irinotecan toxicity and UGT1A1, CES2 and TOP1 expressions in mice.

Irinotecan hydrochloride (CPT-11) can display severe toxicities in individual cancer patients. CPT-11 is bio-activated through CES, detoxified through UGT1A1 and inhibits TOP1. CPT-11 toxicity and UGT1A1, CES2 and TOP1 mRNAs and UGT1A1 protein were determined in male and female C57BL/6, B6D2F1 and B6CBAF1, as potential models for tailoring CPT-11 delivery. CPT-11 was administered intravenously (40-90 mg/kg/day for 4 days at 7h after light onset). The relations between dose and lethal toxicity or body weight loss were steep and similar in C57BL/6 (lethality, p=0.001; weight loss, p=0.002) and B6D2F1 (p=0.01; p=0.03, respectively), but weak in B6CBAF1. Females displayed less toxicity than males (p<0.001). Mean mRNA expression of UGT1A1 was highest in B6CBAF1 (p=0.039) and in females (p<0.001). Both CES2 and TOP1 varied according to strain and gender (p<0.001). The three gene expression data explained the most severe toxicity of CPT-11 in male B6D2F1, but displayed inconsistent relations with toxicity in the other groups. Mean UGT1A1 protein expression was highest in males as compared to females, and so by approximately 8-fold in C57BL/6 as compared to B6D2F1 (p<0.0001). Genetic background and gender significantly altered the molecular prediction of irinotecan toxicity by UGT1A1, CES2 and TOP1 mRNA expressions.

Dog-ears: a useful artifice in the closure of extensive wounds.

BACKGROUND: Wounds too extensive to permit primary repair by suturing can be closed using a skin graft or skin flap and the choice of method depends on a series of factors. Practice and personal experience play a role, as well as the characteristics of the lesion and its site. Each case poses special problems, so it is not possible to establish firm rules. OBJECTIVE: To present a surgical technique for the closure of a circular defect located on the dorsum of the foot, which resulted from the extirpation of a melanoma by surgery. METHODS: In this case we used a mixed procedure consisting of skin flaps and a double full-thickness skin graft. For this operation we used dog-ears resulting from the circular exeresis performed for the extirpation of the tumour. RESULTS: The reconstructive results were good and there were no postoperative complications. CONCLUSIONS: We consider this procedure particularly suitable for certain anatomical sites, such as the dorsum of the foot, where the skin is less elastic and thinner; and for patients who are not willing to accept skin removal from other sites or for flaps to be made with more invasive operations and more constructed scars.

[Controversies regarding distribution, instrumentation, and competence of hemodynamics laboratories]. / Controversie in tema di distribuzione, strumentazione e competenze dei laboratori di emodinamica.

In the last few years we have witnessed a substantial growth in the number of catheterization laboratories, especially in the northern regions of Italy, a phenomenon which has met some controversy and has been discussed in a Symposium at the ANMCO National Conference (Florence, May 20-23, 2000). The controversy is essentially between those who believe in the implementation of catheterization laboratories in all cardiology units equipped with a cardiological intensive care unit (and the creation of a functional network with the tutorial centers) and those who refer to the existing guidelines, standards and VRQ which envisage a geographical distribution of laboratories on the basis of a balance between needs of the population and the minimum quantity of procedures performed by each center in order to guarantee the best quality and cost-effectiveness. The aim of the Symposium was to clarify whether the two "innovations" of these last few years, namely the introduction of new portable radiological equipment on the one hand and the effectiveness of primary angioplasty in the treatment of acute myocardial infarction on the other, may influence the redefinition of criteria regarding the distribution of laboratories, taking into account as well the expansion of indications for coronary angioplasty and coronary angiography. After a lively discussion, the proceedings can be summed up as follows: no agreement was reached regarding the role of portable radiological equipment in the decisional process regarding the setting up of a new catheterization laboratory; primary angioplasty should be carried out in centers with an adequate volume of activity and a functioning inter-hospital organizational structure for this demanding activity; otherwise it does not offer any advantages over fibrinolytic therapy; the proposal of a new organizational model is based on the creation of transverse inter-hospital cardiology departments, the size of which is based on the overall size of the user population, with interventional laboratories distributed in the reference hospitals and diagnostic laboratories in hospitals equipped with a cardiologic intensive care unit (where there is a sufficiently large user population to guarantee at least the minimum number of procedures envisaged by the standards); both parts should work in close cooperation. On this last point there was a contrasting opinion and it was not possible to reach a consensus. The Scientific Societies should formally express their views on this controversial topic, so that guidelines, standards and VRQ can be updated rapidly. The latter should constitute the reference for the procedures of accreditation to which all laboratories and cardiology departments are subjected to, and it is likely that this will be the best way to overcome the present controversy.

[Electrocardiography and myocardial viability]. / Elettrocardiografia e vitalità miocardica.

After an acute myocardial infarction, the cardiologist cannot discard data regarding myocardial viability. The most frequently used diagnostic methods for this are echocardiographic or scintigraphic techniques; unfortunately, these techniques are operator sensitive or expensive. However, also by simple electrocardiography is it possible to obtain important information about myocardial viability, in an objective and economic way. There are three electrocardiographic modifications potentially related to myocardial viability: 1) spontaneous modifications after an acute myocardial infarction: early or late T wave normalization, and Q wave regression; 2) exercise-induced modifications: ST segment elevation, T wave normalization, ventricular arrhythmias; 3) dobutamine-induced modifications: ST segment elevation and T wave normalization. In this editorial, the authors report the literature data on the various electrocardiographic signs and analyze their accuracy and utility in myocardial viability assessment.

Effects of transdermal nitroglycerin on left ventricular function after acute myocardial infarction.

Progressive left ventricular dysfunction in acute myocardial infarction patients is associated with a poor prognosis. It has been shown that some therapeutic measures which have the potential for limiting the infarct size and preserving ventricular function, are also able to reduce the incidence of congestive heart and improve survival. The aim of this protocol was to assess the effects of transdermal nitroglycerin administered within 72 hours after the onset of acute myocardial infarction and for the following 6 months, on left ventricular function. A total of 98 consecutive acute myocardial infarction patients were randomly allocated, within 72 hours of onset of symptoms, to a double-blind 6-month-therapy with either 10 mg/24 hour transdermal nitroglycerin or placebo. Patients underwent two-dimensional echocardiography at entry, after 2 weeks, 3 months and 6 months. In the nitroglycerin group, end-diastolic volume increased during the follow-up (+6.7%, p < 0.05) while end-systolic volume remained nearly unchanged; ejection fraction and stroke volume increased progressively (+6.3%, p < 0.05, +14.2%, p < 0.05, respectively) and a important reduction of percent of dyssynergic segments was present (-19.2%, p < 0.005). In the placebo group end-diastolic volume and end-systolic volume slightly increased during the follow-up (+2% and +4.9% respectively); ejection fraction and stroke volume remained nearly unchanged during the study; percent of dyssynergic segments showed an important decrease after 2 weeks and 6 months (-21.3%, p < 0.005). A clinically relevant increase (> 20%) in ejection fraction was present more frequently in the nitroglycerin than in the placebo group (p < 0.001). In conclusion, the early (within 72 hours) and prolonged (6 months) administration of transdermal nitroglycerin in acute myocardial infarction improves ejection fraction and stroke volume but does not modify ventricular remodeling.

Transesophageal echocardiographic evaluation of the morphologic and hemodynamic cardiac changes during ventricular fibrillation.

To analyze cardiac motion during ventricular fibrillation (VF), we used transesophageal echocardiography to study nine male subjects, aged 44 +/- 7 years, affected by heart disease who have poor left ventricular function, during implantation of an Implantable Cardioverter Defibrillator, when VF is induced several times to determine the defibrillation threshold. Wall and valvular motion, transmitral and transaortic blood flow, and blood echoreflectivity were evaluated in all patients. Moreover, in basal conditions, during VF, 1 and 5 minutes after restoration of basal rhythm, we calculated the left ventricular end-diastolic volume (EDLVV) and area (EDLVA), the left ventricular end-systolic volume and area, the ejection fraction, and the fractional area change with a four-chamber echocardiographic view. At the onset of VF, the myocardium and valves exhibited a chaotic motion. About 10 seconds later the oscillatory movement of the heart walls became more ample and regular; the mitral valve showed a cyclic closure and opening with a forward flow, and the aortic valve exhibited similar behavior, although at a lower intensity. A spontaneous echo contrast appeared inside the atrial and ventricular cavities, gradually becoming an incrt homogeneous mass that was completely flushed away with the restoration of the basal rhythm. When VF started, EDLVV (286 +/- 98 ml) and EDLVA (50 +/- 16.5 cm2) decreased abruptly (EDLVV = 182 +/- 65 ml, p < 0.02; EDLVA = 38 +/- 9.2 cm2,p < 0.05); so did ejection fraction (31.8% +/- 15% versus 11% +/- 5%; p < 0.003) and fractional area change (25.8% +/- 6.5% versus 7% +/- 3.4%; p < 0.001). When the basal rhythm was restored, the heart extended again and EDLVV, EDLVA, ejection fraction, and fractional area change after 1 and 5 minutes were similar to those calculated before induction of VF. This behavior was observed during both the first and last induced VF. Thus during VF, great variations of heart morphology and dynamics, as well as blood echoreflectivity, occur; the heart seems to make attempts to organize its dynamics during the arrhythmia. Repeated episodes of VF and defibrillation with low energies do not seem to worsen left ventricular dynamics even in impaired hearts.

Nitroglycerin infusion during upright tilt: a new test for the diagnosis of vasovagal syncope.

The aim of our present study was to assess the value of nitroglycerin infusion during upright posture as a new provocative test for diagnosis of vasovagal syncope. To this purpose 40 patients with unexplained syncope (17 men and 23 women, mean age 47 years) and 25 asymptomatic control subjects with negative baseline head-up tilt underwent two other tilting tests, one during nitroglycerin infusion and one during isoproterenol infusion. The protocol of the nitroglycerin test consisted of a maximum of five successive stages of 5 minutes in the supine position plus 10 minutes 80-degree upright tilt at progressively increasing infusion rates (increments of 0.86 microgram/kg/hr every stage). During the nitroglycerin test a positive response (syncope in association with sudden hypotension and bradycardia) occurred in 21 (53%) patients with unexplained syncope, an exaggerated response (minor symptoms in association with slowly increasing hypotension alone) occurred in 10 (25%), a negative response in 9 (22%), and drug intolerance in 0. During the isoproterenol test these percentages were 25%, 25%, 32%, and 18%, respectively. Only 2 (8%) control subjects had a positive response to nitroglycerin test and 2 (8%) to isoproterenol test. Thus the nitroglycerin test seems to be a useful alternative tool for diagnosis of vasovagal syncope; it is equally specific but more sensitive and feasible than the isoproterenol test.

[The usefulness of transesophageal echocardiography in the diagnosis of arrhythmogenic cardiomyopathy of the right ventricle]. / Utilità dell'ecocardiografia transesofagea nella diagnosi di cardiomiopatia aritmogena del ventricolo destro.

OBJECTIVES: The aim of this study was to evaluate the usefulness of transesophageal echocardiography (TEE) for the diagnosis of arrhythmogenic right ventricle cardiomyopathy (ARVC). PATIENTS: Using TEE and the standard transthoracic echocardiography (TTE), we studied 19 patients affected with hyperkinetic ventricular arrhythmias with a LBBB pattern, as well as 10 normal control subjects (C). METHODS: We calculated the following parameters: the fractional area change (FAC) of the end-diastolic right ventricule (RV) area; the global wall motion score (WMS) by the algebraic sum of the score of each of the 9 wall segments including the inflow, outflow and apex of RV; the asynergy index (AI) by the percentage of the 9 segments with a score > or = 2; the average thickness of moderator band and papillar muscles (ATMP); the echo reflectivity score (ERS) and the structural abnormalities score (SAS) of RV. The diagnosis of ARVC was proposed when RV segmental wall motion abnormalities were visualized, or when a decrease of the ventricular FAC and dysmorphic aspects were contemporaneously present. The results of the two echocardiographic approaches were compared, and in arrhythmic patients (A) echocardiographic results were compared with those obtained by cineventriculography (CVG), which we had adopted as the reference diagnostic method. RESULTS: The comparison between A and C showed significant differences for all parameters if calculated by the TEE (p < 0.003-0.0001), except for ATMP if calculated by TTE (p < 0.003-0.0001). The comparison between TEE and TTE approaches did not show any difference in the C group while in the A group only FAC and ERS resulted similar; the values of the remaining parameters were significantly greater if calculated by TEE than by TTE (WMS = 7.3 +/- 4.1 vs 4.3 +/- 2.3: p < 0.01; AI = 22.6 +/- 18.5 vs 11.6 +/- 10.3: p < 0.05; ATMP = 6.1 +/- 0.9 vs 5 +/- 1.2 mm: p < 0.04; SAS = 2.2 +/- 0.8 vs 1.4 +/- 0.7: p < 0.002). In 17 of the 19 patients who were clinically suspected to be affected with ARVC the diagnosis was confirmed by CVG; 12 of them (70%) were correctly identified by TTE and 17 (100%) by TEE. One of the two negative patients was erroneously considered positive both by TTE and TEE. CONCLUSIONS: TEE is a usefull diagnostic tool for ARVC and is more accurate than TTE for the identification of the concealed or dubitative forms of the disease.

[Efficacy and tolerability of nicardipine retard and captopril in hypertension in the aged. Results of a multicenter study]. / Efficacia e tollerabilità della nicardipina retard e del captopril nell'ipertensione dell'anziano. Risultati di uno studio multicentrico.

The efficacy and tolerability of nicardipine retard and captopril were assessed in 174 over-60-year-olds suffering from slight or moderate essential hypertension. After 2-3 weeks of wash out the patients were randomly assigned to calcium antagonist (40 mg twice a day) or ace-inhibitor (25 mg twice a day) treatment which continued for 180 days. Monotherapy was combined with hydrochlorothiazide (12.5 mg/day) after 2 months in the event of an unsatisfactory reduction of arterial pressure in relation to basal values. Systolic and diastolic blood pressure was measured (1st and 5th Korotkoff's tone) at monthly intervals while lying and standing; heart rate was also measured using a palpatory method. Both nicardipine retard (no. 86) and captopril (no. 88) caused a significant reduction of clino- and orthostatic systolic and diastolic arterial pressure during the first two months of treatment. Respectively 70% and 51% of patients responded to treatment and the blood pressure reductions achieved using monotherapy remained unchanged during the course of the study. The association of hydrochlorothiazide resulted in a significant decrease in arterial pressure in non-responders, an effect which was observed with both nicardipine retard and captopril. No significant variation in heart rate was recorded between the two groups. Twenty-one patients in the nicardipine retard group and 16 in the captopril group suffered from slight to moderate side effects. Six patients dropped out of the nicardipine retard group and 15 patients out of the captopril group, an event for which side-effects were responsible in 1 and 3 cases respectively. In conclusion, nicardipine retard and captopril represent an efficacious form of treatment for geriatric hypertension and possess a satisfactory level of tolerability.

Successful catheter ablation by radiofrequency energy of posteroseptal accessory pathway in a patient with drug refractory Wolff-Parkinson-White syndrome.

A 45-year-old patient with the Wolff-Parkinson-White syndrome suffering from recurrent intractable reciprocating atrioventricular tachycardia (RAVT) is reported. He used amiodarone, sotalol, quinidine, propafenone and flecainide unsuccessfully. An electrophysiological study (EPS) performed with four catheters localized the site of the anomalous pathway in the ostium of the coronary sinus. In this region we could also record a Kent potential. In the ostium of the coronary sinus, radiofrequency energy was repeatedly applied until the conduction over the accessory pathway was abolished both in the anterograde and the retrograde direction. The Kent deflection detectable before ablation, could not be detected after it. During follow-up (1 month) the patient remained asymptomatic and the control EPS showed no evidence of pre-excitation, either anterogradely or retrogradely.