Age estimation from dry bone measurements: evidence from a sample of soldiers exiled in two concentration camps in Bari.

The mandible undergoes remodelling and morphological alterations throughout the life of an individual, and it is subjected to sex- and age-related structural changes. Personal identification from skeletal remains represents one of the most difficult challenges for a forensic anthropologist. The study of mandibular morphology is an important aid in determining the sex and age of skeletal remains. The objective of this study was to evaluate the age-related changes of three mandibular dimensions through dry bone measurements: bigonial width, ramus height and gonial angle. A total of 93 skeletal remains were included in this study, from a group of soldiers of Yugoslav origin who lived in two concentration camps in Bari (southern Italy) during World War II. These are included in the collection of the Forensic Anthropology Laboratory of the Institute of Forensic Medicine of Bari. The measurements were recorded after comprehensive examination by a forensic anthropologist and a forensic odonto-stomatologist. The data obtained were analysed statistically using a bivariate test and a multivariate linear regression model, using the Statal 13MP software. The results indicate that the bigonial width and gonial angle vary significantly according to age. In conclusion, this study confirms that the mandible is useful for age estimation in the identification of skeletal remains using these specific mandibular measurements when performed on dry bone without radiological distortion.

A convenient method for the stereoselective conversion of aryl peptidyl ketones into the corresponding aryl aminomethin derivatives, a novel class of modified peptides.

In this paper we describe a reductive amination procedure that can be employed in the preparation of a novel class of pseudopeptides in which a specific amide bond is replaced by a CH(Ar)NH group. The developed methodology, performed using NaBH(3)CN and TiCl(4), is characterized by the formation of diastereomeric intermediates in a relative 1:1 ratio. It provides aryl aminomethin pseudopeptides in moderate but satisfactory yields and with definite stereochemistry on the asymmetric centres next to the modified peptide bond.

An efficient and highly selective deprotection of N-Fmoc-alpha-amino acid and lipophilic N-Fmoc-dipeptide methyl esters with aluminium trichloride and N,N-dimethylaniline.

A novel procedure for the deprotection of the carboxyl group of amino acid methyl esters is presented. The process is carried out by the reagent system aluminium trichloride/N,N-dimethylaniline that can successfully be applied to unblock the carboxyl moiety either of N-Fmoc-protected amino acid methyl esters and N-Fmoc-protected short dipeptide methyl esters. The chiralities of the optically pure amino acid or peptide precursors are maintained totally unchanged.

Facile approach to enantiomerically pure alpha-amino ketones by Friedel-Crafts aminoacylation and their conversion into peptidyl ketones.

In this article we describe a versatile and straightforward preparative approach to chiral aryl alpha-amino ketones via a Friedel-Crafts-type reaction of stable and enantiomerically pure N-Fmoc protected L-amino acid chlorides with toluene in the presence of aluminum trichloride. The developed methodology provided aryl alpha-amino-p-methylphenyl ketones, which can be obtained and isolated as free bases or recovered as their N-acetyl derivatives, after treatment with acetic anhydride in chloroform at room temperature, subsequent to the Lewis acid induced removal of the 9-fluorenylmethoxycarbonyl protecting group. The Friedel-Crafts-like process and the cleavage of the amino function masking group can selectively be performed since, as verified in all cases, the alpha-aminoacylation step occurred with kinetics that were faster than those required to remove the N-protection. The presented approach was also explored as a facile and useful synthetic tool for the preparation of optically pure ketone di- and tripeptides. These compounds can be obtained in exceptionally overall yields without need of chromatographic purification. Moreover, either aryl alpha-amino ketones or modified di- and tripeptides, in all cases, can be isolated in very high chemical and optical purity without recourse to resolution of diastereomeric mixtures, since the chiralities of the asymmetric amino acid educts were completely conserved throughout the entire process.

Site selectivity in the synthesis of O-methylated hydroxamic acids with diazomethane.

In this paper we report the results obtained by treating some selected hydroxamic acids with diazomethane in ethereal media. The multitask reagent diazomethane was used either as a base to induce deprotonation of the chosen hydroxamic acids or as conjugated acid which undergoes one-pot methylation processes of the generated anions. Product distributions clearly showed that a high site selectivity is expressed by the different deprotonated species in the alkylation processes. Under the adopted conditions, the prevalent site of methylation is in all the cases the oxygen of the hydroxamic acid. While in aliphatic hydroxamic acids only O-alkylation is observed, in the aromatic substrates, the NH group competes with the OH function as the nucleophilic site, although the OH reactivity still dominates.

MCP-1 and EGF renal expression and urine excretion in human congenital obstructive nephropathy.

BACKGROUND: Obstructive nephropathy is characterized at the histologic level by tubular atrophy and interstitial monocyte infiltration. The molecular mechanisms underlying these histologic changes are still poorly defined. Epidermal growth factor (EGF) produced by tubular cells seems to play a pivotal role in the modulation of tubular cell growth, while monocyte chemotactic peptide-1 (MCP-1) is a powerful and specific chemotactic and activating factor for monocytes. METHODS: Twenty-four patients with congenital ureteropelvic junction obstruction [UPJO; 10 with recurrent urinary tract infection (UTI) and 10 with no UTI] and 15 healthy children were studied. Diagnosis was made by renal ultrasound, intravenous pielography, and MAG3 scan. Urinary samples were collected before and after surgery. In 10 patients, urine was also collected directly from the affected pelvis at the time of surgery. Urinary EGF and MCP-1 levels were measured by enzyme-linked immunosorbent assay. MCP-1 and EGF gene expression were evaluated by in situ hybridization in 15 biopsies from congenital UPJO and in 10 normal kidneys. RESULTS: In normal kidneys, there was a high expression of EGF mRNA, whereas MCP-1 mRNA was undetectable. MCP-1 gene expression was strikingly increased at the tubulointerstitial level in UPJO biopsies compared with controls and was directly correlated with the extent of monocyte infiltration. In addition, UPJO kidney sections showed a marked reduction in EGF gene expression that was directly correlated with the degree of tubular damage. EGF urine concentration was significantly reduced in UPJO when compared with control and directly correlated with its renal gene expression. On the other hand, the MCP-1 urine concentration was strikingly increased in UPJO patients. It is noteworthy that a significant and inverse correlation was observed between the MCP-1 concentration in the urine collected from the obstructed pelvis and the MAG3 clearance of the obstructed kidney (r = -0.76). The presence of recurrent UTI was associated with a significantly higher MCP-1 excretion and a slight reduction in EGF urine concentration. The surgical correction of UPJO was followed by an improvement of renal function together with a significant reduction in MCP-1 excretion and a marked increase in EGF urine concentrations. Interestingly, EGF urine concentration measured before surgery was significantly correlated with the difference between the MAG3 clearance of the obstructed kidney before and after surgery. CONCLUSIONS: MCP-1 and EGF seem to be involved in the pathogenesis of tubulointerstitial damage in congenital obstructive nephropathy, and their urine excretion may represent a powerful prognostic marker in this form of renal disease.

Renal expression of monocyte chemotactic protein-1 and epidermal growth factor in children with obstructive hydronephrosis.

BACKGROUND/PURPOSE: The authors studied the potential role of ureteropelvic junction obstruction (UPJ-O) in causing progressive renal damage in children through the renal expression of epidermal growth factor (EGF) and monocyte chemotactic protein-1 (MCP-1) mRNA. METHODS: Renal tissues were harvested from 11 children with UPJ-O and from 10 normal kidneys to study the renal expression of EGF and MCP-1 detected by means of in situ hybridization. Five of the patients were found to have a history of urinary tract infection (UTI). RESULTS: Children with UPJ-O had marked reduction of EGF gene expression when compared with controls. Interstitial expression of MCP-1 mRNA was present in all UPJ-O cases. Both EGF and MCP-1 expression did not correlate with age, with differential renal function, and with renal thickness measured through MAG3 renal scan. Children with a history of UTI had a more severe reduction of the renal thickness of the affected kidney compared with those without UTI. MCP-1 expression was higher and EGF more reduced in children with a history of UTI. CONCLUSIONS: Our results suggest a potential role of EGF and MCP-1 in the pathogenesis of renal damage and growth failure in UPJ-O, especially in children with UTI. These important functional changes begin early in life, possibly during fetal life.

Synthesis of isoxazolidino analogues of 2',3'-dideoxynucleosides.

The complete set of the 4'-aza analogues of 2',3'-dideoxynucleosides was synthesized by cycloaddition of N-tetrahydropiranyl or N-trityl methylene nitrones on suitably protected vinyl nucleobases. The convertible nucleoside approach was used in the preparation of cytosine and 5-methyl cytosine analogues.

[Prognostic value of neonatal pyelectasia diagnosed in utero]. / Valutazione prognostica delle pielectasie neonatali diagnosticate in utero.

Sixty-six children (48 male-18 female) with prenatal diagnosis of pyelectasia that was conformed at birth were examined between 1986-1994. All newborns carried out urinalysis and urine culture and performed a renal sonogram to reconfirm the diagnosis at 1 month of age. After 3 month of life the pelvic dilatation was confirmed in 61 patients while 5 showed a complete disappearance, 61 patients underwent micturitional cystography that evidenced 30 renal units (RU) with moderate to severe vesicoureteral reflux. In the patients without reflux, a scintigraphy was carried out with DTPA or MAG 3 and/or IVP and evidenced a functional junctional pathology in 32 RU and an organic junctional pathology in 24 RU, a primary megaureter with pre-vesical stenosis in 6 RU and a pyelo-ureteral complete double system in 4 RU. The patients with organic stenosis or those patients with parenchymal damage due to the vesicoureteral reflux underwent surgical intervention during the 1st year of life while all the remaining patients are continuously monitored to date with biohumoral exams and echography. With these results we can safely confirm the important role of the sonogram in the initial diagnosis of pyelectasia and to its eventual modifications in order to benefit the patients with a nephro-urological pathology and direct them toward a correct follow up.

Resection of primary tumor at diagnosis in stage IV-S neuroblastoma: does it affect the clinical course?

PURPOSE: To determine whether resection of primary tumor has a favorable influence on outcome of infants (age 0 to 11 months) with stage IV-S neuroblastoma. PATIENTS AND METHODS: Between March 1976 and December 1993, 97 infants with previously untreated neuroblastoma diagnosed in 21 Italian institutions were classified as having stage IV-S disease. Seventy percent were younger than 4 months. Adrenal was the primary tumor site in 64 of 85 patients with a recognizable primary tumor. Liver was the organ most often infiltrated by the tumor (82 patients), followed by bone marrow and skin. RESULTS: The overall survival (OS) rate at 5 years in 80% and event-free survival (EFS) rate 68%. In 24 infants, the effect of resection of primary tumor could not be evaluated because of rapidly fatal disease progression (n = 8), absence of a primary tumor (n = 12), or partial resection (n = 4). Of 73 assessable patients, 26 underwent primary tumor resection at diagnosis: one died of surgical complications, one relapsed locally and died, and two others relapsed (one of these two locally) and survived, for a 5-year OS rate of 92% and EFS rate of 84%. Of the remaining 47 patients who did not undergo primary tumor resection at diagnosis 11 suffered unfavorable events, of whom five died, for an OS rate of 89% and EFS rate of 75% (no significant difference from previous group). Disease recurred at the primary tumor site in only one five who died, and in only one of six survivors of progression or relapse; in these patients, the primary tumor, located in the mediastinum, was successfully resected. CONCLUSION: Infants who underwent resection of the primary tumor at diagnosis had no better outcome than those in whom the decision was made not to operate.

Urothelium damage as the primary cause of ureteropelvic junction obstruction: a new hypothesis.

Ten infants under 6 months old underwent surgery for obstruction of the ureteropelvic junction. Craniocaudal light microscopy showed subdivision of the resected ureteropelvic junction into three portions: prestenotic, stenotic, and poststenotic. The prestenotic portion was characterized by dilatation of the ureteral lumen, flattening of its mucosal folds and thinning of the urothelium; the stenotic tract showed partial or total loss of the epithelium and fibrosis of the mucosal and fibromuscular coats. No modifications were detected in the poststenotic portion. We advance the hypothesis that a primary epithelial break might cause urine to spread inside the ureteral wall and consequently the mastocytes to migrate and degranulate within the mucosal and fibromuscular coats. The histamine and prostaglandins produced by the mastocytes could induce prolonged muscular spasm, in turn responsible for increasing the intrapelvic pressure and so causing enlargement of the epithelial break. A connective tissue reaction of the ureteral wall would thus occur, which should be considered a secondary event leading to fibrotic stenosis of the ureteropelvic junction.

Scintigraphy in assessment of the feasibility of separation of a set of xipho-omphalopagous conjoined twins.

An account is given of the assessment of a set of xipho-omphalopagous twins by means of Tc-99m microcolloid human serum albumin (HSA) and Tc-99m HIDA scintigraphy before their successful separation. The Tc-99m HSA examination showed the absence of connections between the two hearts and major vessels, as well as the independent vascularization of each liver parenchyma and absence of substantial intrahepatic shunts. Tc-99m HIDA disclosed bile secretion and the existence of intrahepatic ducts in both twins. In one, there was excretion into the intestine and the gallbladder and common bile duct were visualized, whereas in the other excretion was slow, either because of duct hypoplasia or as a result of the connections with the other twin. On separation, it was found that the liver parenchyma was composed of two fused parts (the livers of each twin). In one twin, cholangiography showed the gallbladder and intrahepatic and extrahepatic bile ducts with normal excretion into the intestine and excellent drainage, whereas in the other twin the gallbladder was absent, the common bile duct was hypoplastic, and excretion was poor. The two scintigraphic techniques employed provided evidence of bile duct function and enabled the separation to be planned, while intraoperative cholangiography gave a clear picture of the anatomical details before the reconstruction procedure.

Pediatric liver transplantation from neonatal donors.

Sixteen recipients of neonatal liver grafts were compared with 114 contemporaneous pediatric recipients of grafts from older donors. Graft and patient survival were worse in the neonatal group although the differences were not statistically significant. Patients with neonatal livers who had no technical complications required a longer time postoperatively to correct jaundice and a prolonged prothrombin time. These functional differences were limited to the 1st postoperative month and the end result was the same as with liver transplantation from older donors.

[Germ cell tumors in children. Evaluation of regional cases over a 23 year period]. / Tumori a cellule germinali in età pediatrica. Valutazione della casistica regionale osservata nell'arco di 23 anni.

UNLABELLED: A retrospective study on germ cell tumors on children is reported. The purpose of this study was to evaluate some prognostic factors (age, sex, site, histology, treatment) as well as to compare the casistic of Puglia Region with the results of the National literature. 45 patients (30 females, 15 males) aging 2 days-12 years observed in three Pediatric Centres of Bari into 23 years. Primary site of the tumor was: ovary 9, testis 9, sacrococcygeal 16, and others site 11 (head 4, mediastinum 2, pelvis 2, abdomen 2, gluteus 1). HISTOLOGY: teratoma 31, choriocarcinoma 1, embryonal carcinoma 7, endodermal sinus tumor 5, germinoma 1. TREATMENT: surgery 35 patients, surgery+chemotherapy 6, surgery+chemotherapy+radiotherapy 4. Results of treatment: 37 of 41 valuable patients achieved a response (34 complete, 3 partial response); 4 patients had no response. Of the 37 patients that have had a complete or partial remission, 8 subsequently relapsed; of these 8 patients, 5 obtained a second remission after second line therapy, 3 are dead for progressive disease. Better prognosis was observed in children with gonadal tumors treated with surgery alone.

[Ulcerative rectocolitis in the pediatric age group. Radical surgical treatment by the pull-through procedure and direct ileo-anal anastomosis]. / La rettocolite ulcerosa nell'età pediatrica. Terapia chirurgica radicale mediante il procedimento dell'endo-rectal pull through ed anastomosi ileo anale diretta.

Ulcerous rectocolitis (URC) is today seen more frequently than in the past. Extended forms and/or those recalcitrant to medical therapy, make use today of radical surgical treatment with fewer functional and anatomic sequelae. Personal experience of seven cases admitted to the Paediatric Surgery Department of the University of Bari is reported, stress being laid in particular on the results of surgical therapy obtained with total colectomy associated with proctomucosectomy according to the Romualdi-Soave technique. After presenting some general remarks on the disease in paediatric age, stress is laid on the need to resort as quickly as possible to radical surgery, respecting the technical suggestions of Lester-Martin. It is maintained that before carrying out surgical therapy it is always advisable to carry out temporary ileostomy as it offers particular advantages deriving from the greater effectiveness of pharmacological therapy on the defunctionalides colon, the noteworthy recovery in general condition favoured by associated NPT and by recognition of the real extent of the disease which often does not correspond to the endoscopic aspects. Finally, it is maintained that Lester-Martin's technical modification if applied correctly leads to normal functional results (continence and number of alvus emptyings) and definitive, stable cure of the disease, thus rendering inopportune, at least in paediatric age, of the use of the ileal pocket.

[Histologic study of the pyelo-ureteral junction]. / Studio istologico sulla stenosi del giunto pielo-ureterale.

The ureter structure was analyzed under light microscope on serial sections in newborn children affected by obstruction of the pyelo-ureteric junction. In the obstructive segments, preceded by ureter portions dilated and provided with close-packed layers of smooth muscle layers, the tunica mucosa was lacking epithelial cover, its lamina propria was thickened, being built by conspicuous bundles of collagen fibers, and the tunica muscularis showed scarce and disrupted groups of muscle cells invaded by connective tissue. Numerous mastocytes were seen in the mucosa and muscularis tunicae. The results suggest that the breaking of the epithelium may be a primary pathogenetic event followed by passage of urine in the subjacent tissues in turn responsible for a diffuse connective reaction, and, therefore for a final fibrosis of the ureter wall. The role of the mastocytes in the etiopathogenesis of the pyelo-ureteric junction obstruction was also discussed.

Decrease in phorbol ester receptors in human brain tumors.

We have characterized the specific binding of [3H]-phorbol-12,13-dibutyrate in the white and gray matter of normal human brain and in cerebral tumors as an index of the availability of protein kinase C enzyme molecules. White matter has less than 50% phorbol-ester-binding capacity in comparison to gray matter. The binding is lower in tumors of glial origin when compared with normal white matter. Tumors of nonglial origin such as neurinoma and meningioma have a lower binding capacity than glial tumors. Metastatic tissues have the lowest binding capacity. The analysis of binding parameters in tumors and in the corresponding normal peritumoral tissues confirms the decreased binding capacity of neoplastic tissues in comparison to tissues not undergoing malignant transformation. These data suggest that brain glial tumors have a low availability of protein kinase C enzyme molecules and point to the potential involvement of this system in malignant transformation of human brain cells.