Background: This study was designed to determine the debated prognostic significance of reverse transcriptase–polymerase chain reaction (RT–PCR) positivity in melanoma patients' sentinel lymph node ...(SLN) negative by conventional histopathology (PATH). Patients and methods: Patients with primary stage I–II cutaneous melanoma underwent radioguided sentinel lymphadenectomy. Their SLNs were assessed for tyrosinase (Tyr) and melanoma antigens recognized by T-cells (MART-1) mRNA expression using RT–PCR, in parallel with hematoxylin and eosin staining and immunohistochemistry. Tyr and MART-1 expression in the SLNs were correlated with PATH assay results, standard prognostic factors, time to progression and overall survival. Results: Twenty-three of the 124 patients (18.5%) had positive SLNs by both PATH and RT–PCR (PATH+/PCR+). Sixteen patients (13%) were negative by PATH and positive by RT–PCR (PATH−/PCR+). Eighty-five patients (68.5%) had SLNs that were negative by both PATH and RT–PCR (PATH−/PCR−). At a median follow-up of 30 months, recurrence rates among the three cohorts were statistically different (PATH+/PCR+, 60%; PATH−/PCR+, 31%; PATH−/PCR−, 9.4%). Seven of 23 (30%) and two of 16 (12.5%) patients died in the PATH+/PCR+ and PATH−/PCR+ SLN groups, respectively, whereas no patient died in the PATH−/PCR− SLN group. Conclusions: RT–PCR is more sensitive than PATH to detect SLN metastases and it is a reliable predictor of disease relapse in stage I–II melanoma patients.
: Lamb meat, when used in the weaning diet of children, is presumed to have a lower allergenicity than other forms of red meat. In children with atopic dermatitis and multiple food ...hypersensitivities, consumption of lamb meat has also resulted in significant clinical improvements in the severity of the eczematous lesions. Lamb meat is also of special interest in infant nutrition because it provides a somewhat unique fatty acid (FA) profile that mirrors what is thought to be optimal for neonatal growth and development. However, very little is known about how the processing of fresh meat (FM) into prepared infant foods influences its FA composition. In this study, we compared the FA profile of FM from suckling lambs with those of homogenized (HO) and lyophilized (LIO) baby foods prepared primarily with lamb meat. The results show that the content of total omega‐3 polyunsaturated FAs was the highest in FM (more than 3‐fold) compared to commercial baby food, due to largely higher contents of α‐linolenic acid (1.5‐fold higher), eicosapentaenoic acid (6‐fold higher), and docosahexaenoic acid (10‐fold higher). Furthermore, arachidonic acid was more than 6‐fold higher in FM compared to LIO and HO. Results from this study suggest the possibility of enhancing the FA profile of commercial baby food based on meat by using lamb meat, but care should be taken during processing so that important FAs are not lost.
Practical Application: In this article, we have documented that meat from the suckling lamb is an interesting and potentially important source of omega‐3‐FAs, especially some of the long‐chain polyunsaturated FAs (LC‐PUFAs) that are essential for optimal neonatal growth and development. These results may have special implications to the infant food industry, in that products made using meat from suckling lambs may provide not only exceptional amounts of these FAs, but also other limiting essential nutrients such as iron. This may be especially important in regions of the world, such as Italy, where use of lamb meat as a weaning food is common during infancy.
The occurrence of parkinsonism in Alzheimer's disease (AD) is quite common, however the molecular and neurochemical changes underlying such extrapyramidal features in AD have been not fully ...understood. Post-mortem as well as in vivo imaging study have produced conflicting results as regards the existence of dopaminergic changes in AD. Aim of the present study was to investigate in vivo the nigro-striatal dopaminergic function in a group of AD patients with parkinsonism. Thirteen patients with AD and extrapyramidal features not related to past neuroleptic use (AD-P) underwent SPECT with 123I-FP-CIT, a ligand of dopamine transporter, and the data were compared with those obtained in 15 patients with Diffuse Lewy Body Dementia (DLBD), 20 patients with Parkinson's disease (PD), and 8 healthy elderly controls. The analysis of the data was performed by regions-of-interest approach and calculations of the striatal-to-non specific (occipital lobes) radioactivity ratios were made. The 123I-FP-CIT striatal uptake in patients with AD-P was similar to that obtained in the control population. Both the DLBD and PD groups showed significantly lower 123I-FP-CIT uptake in all striatal areas with respect to AD-P and control groups (p < 0.005). The lack of dopamine transporter changes in our series of AD-P patients can indicate that dopaminergic presynaptic function is preserved in this population and that different dopaminergic changes such as postsynaptic ones, or different neurotransmitter alterations might underlie the extrapyramidal features in AD.
Laparoscopic adrenalectomy has proved to be the technique of choice for managing benign pathologies of the adrenals and isolated adrenal metastases, especially those arising from lung tumor, but the ...procedure should not be performed for primitive adrenal carcinoma. The Authors wanted to test the advantages of the Harmonic Scalpel in laparoscopic adrenalectomy.
From April 1995 to April 2001, the authors investigated their series of laparoscopic adrenalectomies performed at the Careggi General Hospital, Division of General and Vascular Surgery, Florence, Italy. This study enrolled 91 patients with various adrenal pathologies. The transperitoneal approach was used, with the patient in a lateral position, as suggested by Gagner. Special care was taken to improve the surgical approach to the adrenals by the use of new technological devices such as the Harmonic Scalpel. The operative time required by the surgical procedure was computed by dividing the study into three periods: 1995-1997, 1998-1999, 2000-2001. The first period was necessary to complete the learning curve. In the second period, a steady state in surgical time was reached. During the third period, the Harmonic Scalpel was introduced. The differences between the three periods were tested using a nonparametric analysis (Mann-Whitney U test or Kruskal-Wallis test) as appropriate. A two-tailed p value of 0.05 or less was considered statistically significant. The authors investigated the cost of the operation performed in each of the two groups using, respectively, the conventional laparoscopic device (1998-1999) and the Harmonic Scalpel (2000-2001). The following expenses were considered: Harmonic Scalpel impulse generator and disposable shears, operating room cost per hour, and endoclip applier.
The 91 laparoscopic adrenalectomies were performed with these indications: 31 incidentalomas (26 adenomas and 5 cysts), 25 cases of Conn's disease, 18 cases of Cushing's disease, 9 pheochromocytomas, 2 myelolipomas, 5 metastases (from lung, kidney, and breast) and 1 primitive carcinoma diagnosed preoperatively. Considering the whole series (1995-2001), there was a significant trend of reduction in operative time (p = 0.0001). Moreover looking at the first period (1995-1997), in which the learning curve was completed, the mean surgical time was 148 min, as compared with 125 mm. For the second period (1998-1999) (p = 0.0002). This represents a significant reduction in operative time. The authors noted a further reduction in the operative time when surgery was performed with the Harmonic Scalpel (2000-2001) (92 min; p = 0.001). The reduction in operative time attributable to the Harmonic Scalpel was confirmed also by a multivariate analysis of covariance general linear models procedure (GLM), which accounts for several confounders: age, gender, site and size of tumors, and histology (p = 0.0001). The rate was 3.3% for morbidity, 1.1% for mortality, and 2.2% for conversion. There was no difference in complications between patients treated with conventional devices and those treated with the Harmonic Scalpel.
The laparoscopic approach has proved to be an extremely reliable procedure for benign pathologies and isolated metastases. There may yet be doubts about its use for the treatment of adrenal carcinomas preoperatively diagnosed. When surgery is performed using Harmonic Scalpel, operative time is significantly reduced and surgery is easier and less expensive. Infact use of the Harmonic Scalpel allowed the cost per operation to be reduced $70. Moreover, if surgery is performed using the nondisposable clip applier, the expenses are reduced $105.
The identification of spikes (i.e., short and high variability in the measured signals due to very local emissions occurring in the proximity of a measurement site) is of interest when using ...continuous measurements of atmospheric greenhouse gases (GHGs) in different applications like the determination of long-term trends and/or spatial gradients, inversion experiments devoted to the top-down quantification of GHG surface–atmosphere fluxes, the characterization of local emissions, or the quality control of GHG measurements. In this work, we analyzed the results provided by two automatic spike identification methods (i.e., the standard deviation of the background (SD) and the robust extraction of baseline signal (REBS)) for a 2-year dataset of 1 min in situ observations of CO2, CH4 and CO at 10 different atmospheric sites spanning different environmental conditions (remote, continental, urban).The sensitivity of the spike detection frequency and its impact on the averaged mole fractions on method parameters was investigated. Results for both methods were compared and evaluated against manual identification by the site principal investigators (PIs).The study showed that, for CO2 and CH4, REBS identified a larger number of spikes than SD and it was less “site-sensitive” than SD. This led to a larger impact of REBS on the time-averaged values of the observed mole fractions for CO2 and CH4. Further, it could be shown that it is challenging to identify one common algorithm/configuration for all the considered sites: method-dependent and setting-dependent differences in the spike detection were observed as a function of the sites, case studies and considered atmospheric species. Neither SD nor REBS appeared to provide a perfect identification of the spike events. The REBS tendency to over-detect the spike occurrence shows limitations when adopting REBS as an operational method to perform automatic spike detection. REBS should be used only for specific sites, mostly affected by frequent very nearby local emissions. SD appeared to be more selective in identifying spike events, and the temporal variabilities in CO2, CH4 and CO were more consistent with those of the original datasets. Further activities are needed for better consolidating the fitness for purpose of the two proposed methods and to compare them with other spike detection techniques.
To assess the variation of soil respiration at different forest stages we measured it in a coppiced oak (Quercus cerris L.) chronosequence in central Italy during two campaigns, spanning 2 successive ...years, in four stands at different stages of the rotation: 1 year (S1), 5 years (S5), 10 years (S10) and 17 years (S17) after coppicing. The contribution of the different components of soil respiration flux (aboveground litter, belowground decomposition soil organic matter and root respiration) was estimated by a paired comparison of manipulative experiments between the recently coppiced stand (S1) and mature stand (S17).
Ninety percent of soil respiration values were between 1.7 and 7.8 μmol m−2 s−1, with an overall mean (±SD) of 4.0±2.7 μmol m−2 s−1. Spatial variation of soil respiration was high (CV=44.9%), with a mean range (i.e. patch size) of 4.8±2.7 m, as estimated from a semivariance analysis.
In the absence of limitation by soil moisture, soil respiration was related to soil temperature with the exponential Q10 model (average Q10=2.25). During summer, soil moisture constrained soil respiration and masked its dependence on soil temperature. Soil respiration declined over the years after coppicing. Assuming a linear decline with stand age, we estimated a reduction of 24% over a 20‐year‐rotation cycle. The response of soil respiration to temperature also changed with age of the stands: the Q10 was estimated to decrease from 2.90 in S1 to 2.42 in S17, suggesting that different components or processes may be involved at different developmental stages. The contribution of heterotrophic respiration to total soil respiration flux was relatively larger in the young S1 stand than in the mature S17 stand.
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