The aim of the present study was to evaluate the changes of common laboratory parameters in the natural evolution of liver cirrhosis, as well as their relationships with the occurrence of ascites onset and death. Routine laboratory findings of 458 patients suffering from liver cirrhosis admitted to a 9-year follow-up period were retrospectively investigated, but only data of the 138 subjects (95 males and 43 females) who died within the follow-up period were considered. Data were grouped into different classes according to the months elapsed before ascites onset or death. The statistical differences among the various groups were evaluated employing analysis of variance and Turkey's test. No laboratory parameter showed statistically significant changes before or at the time of ascites onset, while significant modifications occurred in four liver indexes (albumin, total bilirubin, platelet count and gammaglobulin percentage) during the course of the illness, thus confirming the reliable prognostic value of these laboratory parameters in liver cirrhosis.

Adult↗

PubMedDate not supplied

Sudden Infant Death Syndrome (SIDS): a study of cardiac conduction system.

The theory that Sudden Infant Death Syndrome (SIDS) may be related to lethal cardiac arrhythmias or heart block due to structural abnormalities of the conduction system is attractive and still of particular interest. We analyze 69 autopsied cases of SIDS (46 males and 23 females, infants ranging in age from 3 to 365 days) and 24 age-matched cases of explained death (ED) as controls (16 males and 8 females), infants who died from extracardiac cause (cerebral and respiratory). SIDS and ED groups were divided into three subgroups according to the age: (A) from 3 to 60 days; (B) from 61 to 120 days; (C) from 121 to 365 days. Histological observations were focused on the cardiac conduction system (CCS) which was examined on serial sections with the technique devised by one of the present authors (L. Rossi). The following findings were observed: resorptive degeneration (97.10% of SIDS, 75% of ED), His bundle dispersion (33. 33% of SIDS, 16.66% of ED), Mahaim fibers (21.73% of SIDS, 8.3% of ED), cartilaginous meta-hyperplasia (5.79% of SIDS, 4.16% of ED), persistent fetal dispersion (24.63% of SIDS, 16.66% of ED), intramural right bundle (20.29% of SIDS, 25% of ED), left sided His bundle (20.29% of SIDS and 8.3% of ED), hemorrhage of the atrio-ventricular junction (15.94% of SIDS), septation of the bifurcation (13.04% of SIDS), atrio-ventricular node (AVN) dispersion (7.24% of SIDS), sino-atrial node hypoplasia (5.79% of SIDS), Zahn node (1.45% of SIDS), His bundle hypoplasia (1.45% of SIDS), intramural left bundle (1.45% of SIDS), AVN dualism (2.89% of SIDS), and His bundle dualism (2.89% of SIDS, 4.16% of ED). Only the presence of resorptive degeneration was significantly higher in SIDS than in ED cases (p = 0.004). Regarding the subgroups, the only significant difference was the higher presence of intramural right bundle in SIDS-A than in SIDS-B (p = 0.01). Despite the non-specificity of most of these findings, we believe that these changes, associated with particular conditions and/or neurovegetative stimuli, could cause potentially malignant arrhythmias. These data suggest the need for an accurate approach and examination of the cardiac conduction system in all cases of sudden death in infancy

Arrhythmias, Cardiac↗

PubMedDate not supplied

Pathology of the heart and conduction system in a case of sudden death due to a cardiac fibroma in a 6-month-old child.

A 6-month-old female infant considered to be in good health died suddenly and unexpectedly. Post-mortem examination was requested, with clinical diagnosis of sudden infant death syndrome. Gross examination revealed, however, the presence of a cardiac mass 4.5 X 4 x 3.5 cm in diameter. Histological examination of the heart confirmed the presence of a cardiac fibroma. In the present case, the sudden death could have been due to the left ventricular outflow obstruction, as much as to conductive disturbances caused by overstretching and compression of the atrioventricular node and of the bundle branches. Hemodynamic and conductive abnormalities are presumed to have provoked bradycardia degenerating into ventricular fibrillation and sudden death. Necroscopy studies of sudden death should always include histological examination of the cardiac conduction system but seldom do.

Female↗

PubMedDate not supplied

Early laparoscopic cholecystectomy for acute cholecystitis: a safe procedure.

Acute cholecystitis is increasingly managed by laparoscopic cholecystectomy. Some reports have shown conversion and complication rates that are increased in comparison to elective laparoscopic cholecystectomy. This study reviews the combined experience of two hospitals where the intention was to perform early laparoscopic cholecystectomy for acute cholecystitis. A total of 152 cases of laparoscopic cholecystectomy for acute cholecystitis (evidence of acute inflammation clinically and pathologically) were identified. Conversion to open cholecystectomy was required in 14 cases (9%) in the total series. Laparoscopic cholecystectomy was performed within 2 days of admission in 76% (115 of 152) of patients. Conversion was significantly less likely in patients undergoing laparoscopic cholecystectomy within 2 days of admission (4 of 115) compared to those undergoing surgery beyond 2 days (10 of 37; P<0.0001). Eleven patients (7%) had postoperative complications; however, there were no cases of injury to the biliary system and no perioperative deaths. This series shows that laparoscopic cholecystectomy can be performed safely in patients with acute cholecystitis and suggests that early laparoscopic cholecystectomy is preferable to delaying surgery. Although the conversion rate to open surgery is higher than for elective cholecystectomy, the majority of patients (91%) still derive the well-recognized benefits of laparoscopic cholecystectomy. Early laparoscopic cholecystectomy is an acceptable approach to acute cholecystitis for the experienced laparoscopic surgeon.

Acute Disease↗

PubMedDate not supplied

Poly(ADP-ribose) synthesis: a useful parameter for identifying apoptotic cells.

Cell death by apoptosis was analysed in HeLa cells either treated with the antitumoral drug bleomycin or depleted of growth factors by long-term culture without medium change. The interference of apoptosis with normal cell cycle progression was followed by flow cytometry in cells stained with propidium iodide and with antibody to S-phase-related PCNA protein. Bleomycin-treated cells showed a net accumulation in G2/M phase paralleled by the appearance of material with a subdiploid DNA content. Cells with a subdiploid DNA content were also present in growth factor-depleted cultures and were shown to derive from all the cell cycle phases. To identify apoptotic features in HeLa cell cultures, we applied a recently developed assay based on the simultaneous analysis in the single cell of three parameters, namely chromatin condensation, DNA degradation and poly(ADP-ribose) synthesis. Apoptotic cells were visualized by sequential reactions: Hoechst staining, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling assay and immunoreaction with anti-poly(ADP-ribose) monoclonal antibody. Positive reactions were obtained for cells at different stages of the apoptotic programme showing condensed nuclei, fragmented chromatin and apoptotic bodies.

Apoptosis↗

PubMedDate not supplied

Activities of the Commission of the European Communities concerning materials and articles intended to come into contact with foodstuffs--a review.

The removal of technical barriers to trade and consumer protection were the basic considerations behind the Council Resolution which gave the Commission of the European Communities the task of approximating the laws of the Member States as regards materials and articles intended to come into contact with foodstuffs. Considerable progress has been made in 14 years of Commission activity, but much remains to be done to construct a single market, the prime objective of the Treaty of Rome. This article provides a brief account of the principal results obtained, together with an outline of the strategy pursued by the Commission in its activities and the basic reasons behind the choices made. It also discusses prospects and future programmes.

European Union↗

PubMedDate not supplied

European Community controls for high temperature testing of food contact materials.

High temperature testing above 121 degrees C is currently in accordance with national legislation, although amended Council Directive 82/711/EEC will include a framework of temperatures and times, the most stringent of which will require 2 h testing of materials and articles at 175 degrees C with olive oil. The background debate that preceded the establishment of this proposed framework is described, as well as the difficulties that were encountered over agreeing the appropriate testing for microwave susceptors. The further work that will be required for implementation (and will need to be undertaken by groups such as CEN) is outlined as are areas such as testing above 175 degrees C that may require consideration for future EC control.

Cooking↗

PubMedDate not supplied

Future European Community directives and petition procedures.

The underlying principles of current European Community legislation in the area of food contact materials and articles are reviewed, and the prospects for extension to new areas are assessed. Future Directives are broadly described although it is not possible to timetable the programme for ultimate agreement and implementation. To assist in understanding Directives and for the practical purposes of enforcement Commission documents are outlined covering a 'Compendium of Methods of Analysis', a 'Practical Guide for users of EEC Directives on Food Packaging' and a 'Framework Document for Research Requirements in Support of Regulations'. Finally procedures for authorization of new substances at Community and national levels are described.

European Union↗

PubMedDate not supplied

A review of the research requirements for Europe to support legislation in the area of food contact materials and articles.

A strong science base is required to underpin the planning and decision making process involved in determining future European Community legislation in the area of food contact materials and articles. The generation of this science base should be undertaken on a Europe-wide basis and needs to be coordinated to avoid duplication of effort and to secure agreement on the underlying science being used to determine future strategy. This review considers possible work that might be required in the future to support legislation on food contact materials and classifies it in terms of short-term problem-solving and longer-term strategic research.

Europe↗

PubMedDate not supplied

Synthesis and biological application of a new heterodinucleotide with both anti-HSV and anti-HIV activity.

A new antiviral drug with both anti-HSV and anti-HIV activity was synthesized by coupling Acyclovir and the acyclic nucleoside phosphonate (R)PMPA. The heterodinucleotide ACVpPMPA encapsulated into autologous erythrocytes was added to human macrophages providing an effective in vitro protection from HSV-1 and HIV-1 replication.

Anti-HIV Agents↗

PubMedDate not supplied

Copper-dependent oxidative stress and neurodegeneration.

Copper is an essential trace element, but its redox reactivity leads to risks of damage to cell and tissues. These are well exemplified by several forms of neurodegenerative diseases, either arising as inherited disorders of copper metabolism, such as Menkes' and Wilson's disease, or as conformational diseases such as Alzheimer's disease and prion diseases. This review will cover some aspects of the involvement of copper-mediated oxidative stress in degenerative processes in the central nervous system, with special focus on the familial form of amyotrophic lateral sclerosis (FALS). Furthermore, a possible role of copper reactivity in inducing critical steps in the apoptotic pathways leading to neurodegeneration is envisaged.

Alzheimer Disease↗

PubMedDate not supplied

A comparison of Xeroform and SkinTemp dressings in the healing of skin graft donor sites.

The best donor site dressing would minimize pain while it increased the rate of healing. This study compares a standard fine-mesh gauze dressing, Xeroform (Sherwood Medical Industries Ltd., Markham, Ontario, Canada), to a new collagen-based dressing, SkinTemp (BioCore Inc., Topeka, Kan.). Eight patients requiring two donor sites of equal size received Xeroform gauze on one site and SkinTemp on the other. The Xeroform was covered for 24 hours and was then allowed to air-dry. Healing was determined to be complete once the gauze peeled off and complete epithelialization was observed. The SkinTemp was covered for 7 days and inspected on days 3, 5, and 7. Pain was measured daily with a standard visual analog scale. Mean Xeroform donor site size was 224.75 cm2, and SkinTemp size was 319.87 cm2. Donor site thickness was 0.012 to 0.014 inches for both. Mean length of healing was 10.62 days for Xeroform and 7.75 days for SkinTemp. Mean pain rating was 22.28 mm for Xeroform and 15.29 mm for SkinTemp. The overall preference of the eight subjects yielded five choosing SkinTemp and three choosing Xeroform, and seven reported SkinTemp as less painful. SkinTemp dressing appears to be less painful and has a better healing rate compared with Xeroform.

Adolescent↗

PubMedDate not supplied

An experimental animal model of intestinal obstruction to simulate in utero therapy for jejunoileal atresia.

OBJECTIVE: To obtain 'intestinal atresia-like' conditions in the fetal lamb model to subsequently allow in utero surgical repair. METHODS: Six time-dated pregnant sheep underwent general anesthesia at 75 days of gestation (term 145 +/- 5 days). After maternal laparotomy and hysterotomy, the fetal abdomen was opened. Once the jejunoileal intestinal loop was identified, the mesenteric vessels were isolated, ligated, and sectioned in 2 fetuses, and in the remaining 5 fetuses the bowel loop was ligated. Two further fetuses were used as controls and underwent sole laparotomy. Of the group of 7 fetuses 2 were reoperated at 100-105 days of gestational age and underwent intestinal recanalization. Eight fetuses were delivered at term by cesarean section and the remaining 1 by spontaneous delivery. One newborn underwent neonatal entero-enteric anastomosis. RESULTS: 4 out of 6 fetuses survived, in utero intestinal or vascular ligation having provoked an 'intestinal atresia-like' picture. The animal operated at birth died. The 2 control fetuses and the 2 fetuses with in utero intestinal recanalization survived until term. CONCLUSION: The present study shows that in utero treatment of intestinal obstruction is possible in an experimental model.

Animals↗