Physical activity in solid organ transplant recipients: organizational aspects and preliminary results of the Italian project.

Most of the difficulties when trying to realize the proposal to prescribe physical activity for transplantation patients come from patient attitudes and cultural beliefs that ignore the benefits of exercise, but there also are organizational aspects arising from the difficulties that these patients face in accessing supervised exercise facilities. To address these difficulties, the Italian study project "Transplant … and Now Sport" was developed based on a model of cooperation among transplantation specialists, sports physicians, and exercise specialists organized as a team combining their specific skills to effectively actuate the physical exercise programs. This preliminary report is based on 26 patients (16 male, 10 female; 47.8±10.0 years old; 21 kidney and 5 liver transplantations; time from transplantation 2.3±1.4 years) who performed prescribed and supervised exercises consisting of 3 sessions per week of aerobic and strengthening exercises for 1 year. Preliminary results show a significant decrease in body mass index (t=1.966; P<.05) and a significant increase in peak aerobic power (t=4.535; P<.01) and maximum workload (t=4.665; P<.01) on the incremental cycling test. Also maximum strength of knee extensors (t=2.933; P<.05) and elbow flexors (t=2.450; P<.05) and countermovement jump performance (t=2.303; P<.05) significantly increased. Creatinine and proteinuria tended to decrease, but the differences were not significant. In health-related quality of life assessed by the SF-36 questionnaire, the Bodily Pain, General Health, Vitality, Social Functioning, and Role Emotional scale scores showed a significant improvement (P<.05). Preliminary results of the study protocol "Transplant…and Now Sport" show the positive effects of the model based on cooperation among transplantation centers, sports medicine centers, and gyms in the administration of a supervised exercise prescription. These data should be considered a contribution to developing and promoting further detailed exercise protocols and to fostering improved posttransplantation health and survival, helping to ensure that physical activity becomes a safe routine medical treatment plan of patient management.

[Karyotypes of four species of chironomids (Diptera, Chironomidae) from Northern Italy].

Karyotypes of 4 chironomid species were studied: Cryptochironomus obreptans Walker, Criptochironomus sp., Chironomus plumosus Linnaeus and Stictochironomus rosenscholdi Zetterstedt. All these species belong to the subfamily Chironominae. Each species is characterized by the specific karyotype structure. The first species in the list has 2n = 4, while the other 3 species have 2n = 8.

Demographic structure and microevolution of an Italian alpine isolated population.

The isonymic method has been generally accepted in population genetic studies and surnames have been successfully used to investigate human populations as if they were genetic markers associated to the Y chromosome. In this study we analysed the microevolution dynamics of Postua, a mountain village of North Western Italy, by means of demographic methods. The uniqueness of this community is due to its past geographical and cultural isolation and to the high frequency of marriage between relatives. During the study period considered (1640-1989) the population underwent several fluctuations in size and other demographic parameters such as the endogamy, isonimy and consanguinity rates. Until the first half of the XIX century Postua appears to be a village characterised by a closed and isolated community, with high endogamy (80-90%) and isonimy (up to 34.4%). Only at the beginning of the XX century, when the population started to be subjected to significant immigration fluxes, data show a progressive reduction of the isolation. The population showed two demographic peaks, the first around the second half of the XVIII century (1639 inhabitants) and the second at the end of the XIX century (1464 inhabitants). The S/Nratio was low (0.2-0.3) and relatively constant until the beginning of the last century, and only in the last three decades of the XX century, when the population was subjected to immigration, Postua showed a significant increase in the S/Nratio values (to about 0.9). The surname frequency was constant until the 1850 when almost all surnames were the same as those already present in the XVII century. From the first half of the XIX century, the founder surnames decreased, whereas new surnames started to increase and became persistent in the population.

Alu insertion polymorphisms at 11 loci in a Piedmont (Northern Italy) sample.

Eleven human-specific Alu insertion polymorphic loci (ACE, APO, A25, B65, D1, FXIIIB, HS2.36, HS2.43, HS3.23, PV92, TPA25) were analyzed in a population sample of 263 unrelated healthy individuals native of Piedmont (North-Western Italy). Alu insertion frequency and heterozygosity values were highly variable in all loci, except for the HS2.36 locus.

Gender expression and group size: a test in a hermaphroditic and a gonochoric congeneric species of Ophryotrocha (Polychaeta).

Hermaphroditism and gonochorism are two contrasting forms of sexuality. Hermaphroditic species are generally seen as species adapted to conditions of low density, stabilized by poor mate search efficiency and high costs of searching. They can adjust allocation of reproductive resources to each sex function in response to current social conditions, making reproduction more efficient, at least in principle. By contrast, gonochorism (separate sexes) is advantageous when mates are frequent, making it ineffective to maintain two sex functions in a single individual. This, however, also rules out the need for a flexible response to mating opportunities as known for hermaphrodites. In the hermaphroditic marine polychaete worm Ophryotrocha diadema we showed earlier that group size is assessed through a chemical cue. In this study we verified the accuracy of the response to gradients of the chemical cue used to assess group size by O. diadema by checking reduction in egg production as the group of partners increases, as expected according to sex allocation theory. Furthermore we compared the effect of such a gradient with a similar gradient in a closely related gonochoric species (O. labronica). Here sex allocation adjustment is not predicted, thus an adaptive change in egg production in response to group-size cues is not expected. In fact, our results show that the group-size effect only occurs in O. diadema and not in O. labronica. Moreover, our study provides evidence of high perceptual abilities of chemical cues in O. diadema, suggesting that perceiving social cues and adjusting sex allocation appropriately are special properties of hermaphrodites.

A measure of sexual selection in hermaphroditic animals: parentage skew and the opportunity for selection.

The role of sexual selection in shaping the mating system of hermaphrodites is currently widely accepted. However, a quantification of the intensity of sexual selection in hermaphroditic animals has never been accomplished. We evaluated the opportunity for sexual selection for both the female and the male functions in the simultaneous outcrossing hermaphrodite Ophryotrocha diadema by measuring focal hermaphrodites' paternal and maternal offspring in experimental replicated monogamous and promiscuous populations, using genetic markers to estimate paternity. Opportunity for sexual selection for each of the two sexual functions was quantified by means of the Crow's index, i.e. the ratio of variance in progeny number to the squared mean number of progeny. In addition, the extent to which the reproductive success was shared among competing individuals was estimated by means of the Nonacs's B index. We documented that the strength of selection on the male and female function in hermaphrodites with external fertilization depends on the reproductive context. Under a promiscuous regime, hermaphrodites have higher opportunities for selection for both the male and the female function than under the monogamous regime. Moreover, the reproductive skew for the female function becomes greater than that for the male function, moving from monogamy to promiscuity. In our model system, allocation to one sexual function is opposed by any degree of allocation to the other, indicating that sex-specific patterns of selection operate in this model species.

Polymorphic Alu insertions in five North-West Italian populations.

We analyzed the frequencies of eight human polymorphic Alu insertion loci in population samples from five towns in North-West Italy: Postua, Cavaglià, Biella, Torino, and Genova. All loci under scrutiny were found to be polymorphic in all samples, with the two exceptions of locus A25 in Postua, which was fixed for the absence of the Alu element, and APO in Genova, where the Alu insertion was fixed. Heterozigosity values were highly variable in all loci. F(ST) values for all loci indicate that most of the variability is found within populations, while between population variability is lower. In the multidimensional scaling (MDS) analysis plot, the studied populations are separated from the main group represented by European populations. The Postua sample is set apart also from neighboring towns as Cavaglià and Biella, confirming previous observations of the demographic isolation of this population.

Genotoxic effect of copper on salivary gland polytene chromosomes of Chironomus riparius Meigen 1804 (Diptera, Chironomidae).

The genotoxic action of copper (Cu) on the polytene chromosomes of Chironomus riparius was investigated by analysing structural and functional chromosome aberrations of fourth instars larvae hatched from eggs subject to acute (48 h) exposure with three environmentally relevant concentrations of aqueous Cu (0.005, 0.01, 0.05 mg/l). A dose dependent relationship was observed between Cu concentration and frequency of chromosomal aberrations. A significantly higher frequency of functional alterations, specifically decondensed centromeres and telomeres, and reduction in activity of Balbiani rings, was observed in treated material compared to control. A comparison of breakpoints resulting from treatment with chromium and lead from earlier studies with those Cu-induced identified a series of chromosomal weak points particularly vulnerable to trace metals. We also show that the appearance of structural and functional chromosome aberrations are more sensitive indicators of acute Cu toxicity in chironomid larvae than changes in external morphology.

Outcrossing hermaphroditic polychaete worms adjust their sex allocation to social conditions.

Sex allocation theory predicts that simultaneous hermaphrodites shift sex allocation facultatively in response to variation in local group size. This study was performed to evaluate the relative investment in each sex function by the simultaneously hermaphroditic polychaete worm Ophryotrocha diadema and to test whether allocation to each sex depends on the number of reproductive competitors. Four experimental groups were set up (in a 2 x 2 factorial design) with small or large group size and with small or large enclosures to control for potential confounding effects of density. We measured the proportion of female and male investment in focal individuals. Results revealed that individuals regulated their reproductive output so that when reproductive competitors were present, the number of female gametes was strongly reduced and the male function increased. In contrast, under monogamy, individuals in small groups produced lower numbers of sperm but had a higher egg output than worms in large groups. Density did not affect sex allocation in our experiment. Our findings provide qualitative support for Local Mate Competition theory, but also show that the pattern of sex allocation specific to this species is more complex than expected by current theory.

Comparison of allergen immunotherapy and drug treatment in seasonal rhinoconjunctivitis: a 3-years study.

Drug treatment and specific immunotherapy (SIT) are both effective in seasonal rhinoconjunctivitis, but the former acts only on allergic symptoms while the latter modifies the natural history of the disease. Only a few studies compared the clinical efficacy of the two treatments with contrasting results. We planned a study to compare the efficacy of SIT (15 patients) and drug treatment (15 patients) in moderate to severe seasonal rhinoconjunctivitis caused by sensitization to grass pollen. SIT was performed by a 5-grass extract standardized in IR and absorbed onto calcium phosphate (Phostal, Stallergénes, Antony, France) using the conventional build-up phase in 12 weeks and a maintenance treatment with monthly injection for three years. Drug treatment was done with cetirizine as antihistamine, mometasone furoate as nasal topical steroid, and levocabastine eyedrops. All patients registered during the pollen season their symptoms and drug consumption. After one year 12 of 15 patients treated with SIT had less symptoms and drug consumption in respect to baseline compared to none in drug treated group (p = 0.021) and after three years 15 of 15 were improved in group A compared to one of 15 in group B (p = 0.008). These findings indicate an higher efficacy of SIT in patients with seasonal rhinitis not only in the long term but also in the first year of treatment.

Insertional polymorphism of a non-LTR mobile element (NLRCth1) in European populations of Chironomus riparius (Diptera, Chironomidae) as detected by transposon insertion display.

The midge Chironomus riparius is distributed all over the Palearctic region and is well characterized both at the morphological and cytogenetic levels. Here we describe a population study based on the insertional polymorphism of the retroposon NLRCth1, by means of a S-SAP (sequence-specific amplification polymorphism) derived technique (transposon insertion display; TID). While a previous study of allozyme polymorphism in Russian samples showed little variability, all the amplicons we identified are polymorphic. Genetic distances between 6 natural populations were calculated according to Nei and did not show a positive correlation with geographic distances. The genetic diversity detected among individuals of a given population was one order of magnitude higher than that among populations. However, the value of phi(ST) was significant (p < 0.001) and indicates that natural populations are more genetically differentiated than random samples of individuals.

Neuropathology considerations: clinical and SEMG/biofeedback applications.

SEMG investigation protocols are described within the neurological framework. A neuroanatomic pathway is utilized including muscular disease, neuromuscular junction conditions, peripheral neuropathy, radiculopahy, myleopathy, brainstem disorders, cerebellar disorders, subcortical and cortical disease. SEMG findings within the clinical presentation of those pathologies are aimed at improving the diagnostic process and serve to focus the SEMG neuromuscular reeducation (biofeedback) component of the overall treatment plan.

Diffuse muscular coactivation (DMC) as a potential source of pain in fibromyalgia -- part 1.

Fibromyalgia is characterized by diffuse pain, the origin of which remains obscure. This study explored a phenomenon labeled Diffuse Muscle Coactivation (DMC) as a possible source of pain in fibromyalgia. DMC is defined as an increase from resting levels (tonus) in the electrical activity of any muscle during a movement which does not involve that muscle and is not part of the agonist-antagonist unit. When compared to controls this activity in persons with fibromyalgia was 1.75 times more prevalent and demonstrated significantly higher peak amplitudes. Possible neurological mechanisms are discussed.

Characteristics of diffuse muscular coactivation (DMC) in persons with fibromyalgia -- part 2.

This study examined the electrical characteristics (Root Mean Square -- RMS and median frequency) of Diffuse Muscular Coactivation (DMC) associated with the tender points of fibromyalgia. DMC is defined as an increase from resting levels (tonus) in the electrical activity of any muscle during a movement which does not involve that muscle and is not part of the agonist -- antagonist unit. The results show an increase in RMS in fibromyalgia sufferers as compared to controls. Coactivation was stronger proximal to the neck and decreased in intensity as the area recorded moved distally. Median frequency changed over time but not significantly between groups. Possible neurological mechanisms are discussed.

On the evolution of redundancy in genetic codes.

We simulate a deterministic population genetic model for the coevolution of genetic codes and protein-coding genes. We use very simple assumptions about translation, mutation, and protein fitness to calculate mutation-selection equilibria of codon frequencies and fitness in a large asexual population with a given genetic code. We then compute the fitnesses of altered genetic codes that compete to invade the population by translating its genes with higher fitness. Codes and genes coevolve in a succession of stages, alternating between genetic equilibration and code invasion, from an initial wholly ambiguous coding state to a diversified frozen coding state. Our simulations almost always resulted in partially redundant frozen genetic codes. Also, the range of simulated physicochemical properties among encoded amino acids in frozen codes was always less than maximal. These results did not require the assumption of historical constraints on the number and type of amino acids available to codes nor on the complexity of proteins, stereochemical constraints on the translational apparatus, nor mechanistic constraints on genetic code change. Both the extent and timing of amino-acid diversification in genetic codes were strongly affected by the message mutation rate and strength of missense selection. Our results suggest that various omnipresent phenomena that distribute codons over sites with different selective requirements--such as the persistence of nonsynonymous mutations at equilibrium, the positive selection of the same codon in different types of sites, and translational ambiguity--predispose the evolution of redundancy and of reduced amino acid diversity in genetic codes.

On the dynamic persistence of cooperation: how lower individual fitness induces higher survivability.

We study a model in which cooperation and defection coexist in a dynamical steady state. In our model, subpopulations of cooperators and defectors inhabit sites on a lattice. The interactions among the individuals at a site, in the form of a prisoner's dilemma (PD) game, determine their fitnesses. The chosen PD payoff allows cooperators, but not defectors, to maintain a homogeneous population. Individuals mutate between types and migrate to neighboring sites with low probabilities. We consider both density-dependent and density-independent versions of the model. The persistence of cooperation in this model can be explained in terms of the life cycle of a population at a site. This life cycle starts when one cooperator establishes a population. Then defectors invade and eventually take over, resulting finally in the death of the population. During this life cycle, single cooperators migrate to empty neighboring sites to found new cooperator populations. The system can reach a steady state where cooperation prevails if the global "birth" rate of populations is equal to their global "death" rate. The dynamic persistence of cooperation ranges over a large section of the model's parameter space. We compare these dynamics to those from other models for the persistence of altruism and to predator-prey models.

NOR regions of polychaete worms of the genus Ophryotrocha studied by chromosome banding techniques and FISH.

This article reports the results of cytogenetic analyses carried out on 10 species of polychaete worms belonging to the genus Ophryotrocha (Dorvilleidae). Nucleolar organizer regions (NORs) were characterized by Ag staining, C-banding, CMA3 staining, and ribosomal fluorescent in situ hybridization (rDNA FISH). Extensive intraspecific variation in NOR number and distribution were observed in O. costlowi, O. sp. macrovifera, O. notoglandulata, O.l. labronica, O. l. pacifica (2n = 6), O. p. puerilis, O. diadema (2n = 8), O. hartmanni, O. gracilis (2n = 10). In O. sp. robusta (2n = 10), Ag-NORs were always located on a single chromosome pair. CMA3 staining suggests a possible trend toward a GC-rich rDNA compartmentalization. In O.l. labronica, O. p. puerilis, O. diadema, and O. sp. robusta rDNA FISH shows that Ag and FISH signals coincide. Results from C-banding seem to indicate that the increased genome size (GS) observed in O. sp. macrovifera (0.8 pg) and O. hartmanni (1.16 pg) compared to the base GS value of the genus (0.4 pg) cannot be attributed to variation in the heterochromatin content.

Effect of environmental pollution on the chromosomal variability of Chironomus riparius Meigen 1804 (Diptera, Chironomidae) larvae from two Piedmont stations.

Different frequencies of chromosomal alterations in salivary gland polytene chromosomes AB, CD and EF were described in larvae of Chironomus riparius (syn. Chironomus thummi) from the trace metal-polluted station of Santena on the river Banna, near Turin, and from the unpolluted station of Corio (40 Km from Turin) which was taken as a reference area. In a sample of 56 larvae from Santena, no specimen with the standard karyotype in all cells of the salivary glands was found. Different types of aberrations were found: 33 paracentric and five pericentric inversions, three deficiencies, four amplified sections and one chromatid break. Fifteen out of the 38 inversions and two amplified sections appeared to be inherited, while all the other aberrations were somatic. Most of the aberrations' breakpoints were located on both sides of the centromere regions, where constitutive heterochromatin is present. Also functional alterations were observed (mainly telomere and centromere decondensations and nine novel puffs). In a sample of 49 larvae of a population from the well-preserved area of Corio only six somatic and one inherited paracentric inversions were found. These results suggest that the strong destabilization of the genomes of C. riparius larvae from Santena could be a reaction to the activity of the toxic substances present in the polluted sediments of the river Banna.

Compound action potential and cochlear microphonic extracted from electrocochleographic responses to condensation or rarefaction clicks.

In electrocochleography (ECochG) compound action potential (CAP) and summation potential (SP) are usually separated from the cochlear microphonic (CM) by the CM cancellation technique consisting in averaging the responses evoked by rarefaction and condensation clicks. With the aim of analysing the ECochG responses evoked by monophasic clicks, we developed a numerical method based on the theory of optimal filtering, which makes no assumptions about the unknown potentials. The application of the filtering technique to the ECochG recordings obtained from 6 normally hearing children and 10 children with cochlear hearing loss allowed us to perform CAP extraction in cases where CM was not cancelled by the conventional method. Differences in SP amplitude and polarity were found between rarefaction and condensation click-evoked responses in cochlear hearing losses.

[Breast conservation: safe for early breast cancer].

Between 1981-1993 581 women with primary breast cancer were treated by breast conservation. Their mean age was 56 +/- 12 years and 63% were postmenopausal and 37% pre- or perimenopausal. The median follow-up time was 56 months. 45% had pathological Stage I disease, 49% Stage II, 2.5% Stage III and 3.5% clinical Stage I-II disease. 54% of lesions were excised with good margins, 10% with close margins (< 0.5 cm), 9% with microscopic residual, 3% with macroscopic residual, and in 24% margins were not reported. Adjuvant therapy, consisting of combination chemotherapy and/or hormones, was given to 69%. Radiotherapy, usually 50 Gy tangential photon irradiation to the whole breast, was given to 564 (97%); an electron or photon "boost" to the tumor with a median dose of 17.5 Gy was given to 378 (65%). Most of those with positive nodes received 50 Gy to the lymphatic drainage system. 1 year after radiotherapy cosmetic results were rated as "good" or "excellent" in 80%, "moderate" in 17% and "poor" in 3%. The 5-year actuarial survival was 97% in Stage I and 88% in Stage II. 37 patients (6.5%) developed breast recurrence; 11 of these (2%) had simultaneous distant metastases. 5 (< 1%) developed axillary or supraclavicular lymph node metastases, and 81 (14%) developed distant metastases. Most local recurrences were in those younger than 40, and in those with primary tumors > 1.75 cm. The satisfactory level of local control achieved is attributed to the high doses of radiation (up to 75 Gy) administered to those with high risk lesions.