Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario

Introduction

COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time.

Methods

Consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann–Whitney U test for continuous variables.

Results

A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop −12% versus −3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36).

Conclusions

Our study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts.

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The COVID-19 outbreak had an impact on access to lung cancer (LC) diagnosis and treatment.

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A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019.

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Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease.

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The Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts.

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A reverse migration from high-volume to low-volume cancer centers was noted during the pandemic.

Determination of antioxidant capacity and flavonoid composition of onion (Allium cepa L.) landrace 'Krishnapuram' bulb using HPLC-ESI-ITMS

This study reports for the first-time antioxidant activity and flavonoid composition of KP onion landrace which is useful for future breeding programs and to obtain geographical indication (GI) tag for the benefit of farmers. The present study was aimed to determine antioxidant capacity and flavonoid composition of bulbs of red onion (Allium cepa L.) landrace 'Krishnapuram' (KP) from India using high-performance liquid chromatography (HPLC)-Electrospray Ionization (ESI)-multistage Ion Trap Mass Spectrometry (ITMS). The antioxidant activity was assayed by Ferric Reducing Antioxidant Power (FRAP) and hypochlorous acid (HClO)-induced oxidative damage in human erythrocytes. The total phenolic (TPC) contents in KP onion bulb extract (with 80% methanol) found to be 1.10 ± 0.2 mg GAE/g FW and 38.88 ± 1.0 lM QE/g. The FRAP activity measured for the bulb extract was 13.20 ± 0.1 μM QE/g. KP onion bulb extracts protected red blood cells (RBC) effectively (23%) against the oxidative damage induced by HClO. HPLC-ESI-ITMS analysis showed the presence of eight flavonols and five anthocyanins. Quercetin 3,4' -O-diglucoside (384.71 ± 0.49 mg/kg FW) and cyanidin 3-(6″-malonylglucoside) (20.95 ± 0.60 mg/kg FW) were detected as major flavonol and anthocyanin, respectively. The study suggests that KP onion has a considerable antioxidant activity due to the presence of high TPC. Moreover, quercetin glucosides are found to be more abundant than quercetin. The differences in quercetin glycosides content among different red onions could be useful for breeding programmes in the future.

A clinical, pathological and immunohistochemical series of 9 cases of primary cutaneous apocrine carcinomas of the head and neck

BACKGROUND/OBJECTIVES

Primary cutaneous apocrine carcinoma is a rare malignant adnexal skin tumour that can recur locally, spread to regional lymph nodes and metastatize to visceral organs. Wide dissemination and death from disease are much less common. The axilla is the most common site of presentation. It is infrequently reported in the head and neck region.

METHODS

All cases diagnosed as primary cutaneous apocrine carcinoma of the head and neck were retrospectively collected from the archives of the Division of Pathological Anatomy, University of Florence from 1996 to 2016. There was no history or clinical evidence of breast cancer. Clinical data and follow-up were collected by the clinicians.

RESULTS

Nine cases were found, with a mean age of 76 years, ranging in size between 0.3 and 3.5 cm. Clinically, they were frequently mistaken for basal cell carcinomas. Histopathologically, all the tumours showed decapitation secretion, a tubular, solid or mixed (tubulo-papillary and solid-tubular) growth pattern and were predominantly classified as grade 2 tumours. GCDFP-15 and hormone receptors were variably expressed. HER2 and podoplanin were negative in all cases. In one case, spreading to regional lymph nodes was observed. No cases were associated with death due to the disease.

CONCLUSION

As immunohistochemical analysis lacks specificity in distinguishing primary cutaneous apocrine carcinoma from a cutaneous metastasis of breast carcinoma, detailed clinical history, breast examination, adequate treatment and follow-up are necessary to confirm a diagnosis of primary cutaneous apocrine carcinoma.

Changing Trends in Mastectomy and Breast Reconstruction. Analysis of a Single-institution Experience Between 2004-2016

BACKGROUND/AIM

Recently, "conservative" mastectomy with immediate breast reconstruction (M-R) has become the gold standard when the breast must be removed. We analyzed the evolution in the choice of mastectomy type in our Unit, focusing on factors associated with renounce to reconstruction and risk factors for its failure.

PATIENTS AND METHODS

Clinical-pathological and surgical features of 132 patients who underwent mastectomy in our Unit from 2004 to 2016 were analyzed. M-R rate and different mastectomy techniques' rates between 2004-2009 and 2010-2016 were compared.

RESULTS

M-R was associated with younger age at diagnosis (p<0.001) and early tumor stage (p=0.03). M-R rate increased from 49.1% to 72.2% (p=0.002) in the last years, with prominent use of nipple-sparing-mastectomy (p<0.001). M-R failure rate was associated with previous or subsequent irradiation/chemotherapy in 92.3% of cases.

CONCLUSION

M-R and particularly nipple-sparing-mastectomy represented the standard in more recent years; reconstruction failure was associated with irradiation/chemotherapy, especially in implant-based reconstructions.

Shape, Position and Dimension of the Nipple Areola Complex in the Ideal Male Chest: A Quick and Simple Operating Room Technique

INTRODUCTION

The anatomical features of the chest identify an individual as male or female and even the smallest details of these features determine the appropriate appearance for each gender. In female-to-male patients, the creation of an aesthetically pleasing male chest is the most important step. Incorrect positioning of the nipple areola complex (NAC) on the chest wall and suboptimal shaping and sizing of the NAC are common pitfalls in male NAC creation.

PATIENTS AND METHODS

We have analyzed the anatomical chest features of 26 water polo players, to verify our hypothesis of the relationship between the pectoralis major muscle and NAC and to create a method for repositioning the NAC that is applicable in the operating room, is easy, practical and reproducible without the use of formulas and based on an easily identifiable landmark.

RESULTS

In our reference group, the NAC has a constant relationship with the pectoralis major muscle, positioned on average 3 cm medial to the lateral border of the pectoralis muscle and 2.5 cm above the inferior pectoralis major insertion. This supports our hypothesis and our surgical technique. We use the index finger to find a vertical axis and a line 2.5 cm above the inferior pectoralis shadow to find the horizontal axis. We also introduce a modification to the receiving site to recreate an oval areola more similar to that of an ideal male chest.

CONCLUSIONS

Our anatomical study and statistical analysis support a consistent relationship between the position and shape of the NAC and the borders of the pectoral muscle. We have used this relationship to develop our "trick," which is easily applicable in the operating room to find the NAC position without using formulas and numbers. This method allowed us to place the NAC in a position very close to that of a typical male subject, and it permitted us to reduce the surgery time.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Combination of negative pressure wound therapy and systemic steroid therapy in postsurgical pyoderma gangrenosum after reduction mammoplasty; a case of proven efficacy and safety

Pyoderma gangrenosum (PG) is a rare non-infective inflammatory disease of unknown etiology characterized by cutaneous papulo-pustoles that rapidly evolve into painful ulcerative lesions. Postoperative PG (PPG) is a clinical variant of PG in which pathergic response occurs at surgical sites. It is important to include PG in the differential diagnosis of breast ulceration. An incorrect diagnosis and treatment can potentially worsen the patient state, causing disfigurement with extensive scarring, an unpleasant aesthetic result and produce consequent psychological trauma. We report a case of PPG after bilateral breast reduction mammoplasty treated with negative pressure wound therapy (NPWT) as local treatment for wound dehiscence in combination with systemic steroid therapy. This synergism led to a good aesthetic result. NPWT improved wound perfusion, it decreased the exudate, and promoted adherence of the mammary gland to the pectoral muscle. After 31 days deep sutures were placed to directly close the wound and the patient was discharged. PPG is a rare, devastating occurrence after surgery. Surgeons must know that PPG is an evenience that can occur in otherwise healthy patients and must be considered in the differential diagnosis in case of necrotic ulcers and apparent infection status. NPWT resulted to have benefits in the treatment of PPG, with a role in limiting the size of the defect, avoiding pathergic self-reaction and allowing a faster recovery with higher chances of achieving a better result.

Masculine Chest-Wall Contouring in FtM Transgender: a Personal Approach

BACKGROUND

Chest-wall contouring surgery is one of the first steps in sexual reassignment in female-to-male (FtM) transsexuals that contributes to strengthening of the self-image and facilitates living in the new gender role. The main goal is to masculinize the chest by removing the female contour. Chest contour, scar placement, scar shape, scar length, nipple-areola position, nipple size and the areola size are the key points.

METHODS

Between July 2013 and June 2016, 25 FtM transgender patients underwent surgical procedures to create a masculine chest-wall contour. In our study, we just considered 16 patients who have undergone chest surgery with the double incision method.

RESULTS

The patients' survey revealed a high satisfaction rate with the aesthetic result. In our group, no complications occurred, and two patients have undergone supplementary surgery for axillary dog-ear revision and nipple reconstruction.

CONCLUSION

The authors propose a new technical approach and indications for FtM transgender patients' surgery. A longer scar that emphasizes the pectoralis muscle, a smaller nipple and a resized and refaced areola are the key points of our technique to give a masculine appearance to the chest. The scars are permanent, but most of them will fade and the patients are enthusiastic with their new "male" chest appearance. The high level of satisfaction, the great aesthetic result and the low rate of complications suggest to us the use of this technique in medium- and large-size breasts.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Skin substitutes based on allogenic fibroblasts or keratinocytes for chronic wounds not responding to conventional therapy: a retrospective observational study

Chronic wounds are an expression of underlying complex pathologies and have a high incidence. Skin substitutes may represent an alternative approach to treat chronic ulcers. The aim of this retrospective observational study was to evaluate the wound reduction using skin substitutes based on allogenic fibroblasts or keratinocytes in 30 patients not responding to conventional therapy. Wound bed was prepared, then keratinocytes on Laserskin(®) to treat superficial wounds or fibroblasts on Hyalograft 3D(R) to treat deep leg ulcers were applied, and finally wounds were treated with a secondary dressing composed of nanocrystalline silver. Once a week constructs were removed and new bioengineered products were applied, as well as nanocrystalline silver medication. In none of the cases under examination did any complications arise relating to the treatment. We also achieved a reduction in wound dimension and exudates, and an increase in wound bed score. Postoperative assessment shows a degree of healing that is statistically higher in the group treated with keratinocytes as compared with the fibroblast group. This retrospective study improves our understanding and defines the clinical indications for the various uses of the two types of skin substitutes.

MSCs seeded on bioengineered scaffolds improve skin wound healing in rats

Growing evidence has shown the promise of mesenchymal stromal cells (MSCs) for the treatment of cutaneous wound healing. We have previously demonstrated that MSCs seeded on an artificial dermal matrix, Integra (Integra Lifesciences Corp., Plainsboro, NJ) enriched with platelet-rich plasma (Ematrix) have enhanced proliferative potential in vitro as compared with those cultured on the scaffold alone. In this study, we extended the experimentation by evaluating the efficacy of the MSCs seeded scaffolds in the healing of skin wounds in an animal model in vivo. It was found that the presence of MSCs within the scaffolds greatly ameliorated the quality of regenerated skin, reduced collagen deposition, enhanced reepithelization, increased neo-angiogenesis, and promoted a greater return of hair follicles and sebaceous glands. The mechanisms involved in these beneficial effects were likely related to the ability of MSCs to release paracrine factors modulating the wound healing response. MSC-seeded scaffolds, in fact, up-regulated matrix metalloproteinase 9 expression in the extracellular matrix and enhanced the recruitment of endogenous progenitors during tissue repair. In conclusion, the results of this study provide evidence that the treatment with MSC-seeded scaffolds of cutaneous wounds contributes to the recreation of a suitable microenvironment for promoting tissue repair/regeneration at the implantation sites.

Successful combined approach to a severe Fournier's gangrene

We present a case of a successful reconstruction of a severe Fournier's gangrene (FG) involving the scrotum, the perineum, the right ischial area and extended to the lower abdomen. There are many different surgical techniques to repair and reconstruct the defect following debridement in FG. The authors treated this complex wound using negative pressure wound therapy (NPWT), dermal regeneration template and a split-thickness skin graft. Complete recovery was achieved and no major complications were observed. The patient showed a satisfying functional and aesthetic result.

Dealcoholated red wine induces autophagic and apoptotic cell death in an osteosarcoma cell line

Until recently, the supposed preventive effects of red wine against cardiovascular diseases, the so-called "French Paradox", has been associated to its antioxidant properties. The interest in the anticancer capacity of polyphenols present in red wine strongly increased consequently to the enormous number of studies on resveratrol. In this study, using lyophilized red wine, we present evidence that its anticancer effect in a cellular model is mediated by apoptotic and autophagic cell death. Using a human osteosarcoma cell line, U2Os, we found that the lyophilized red wine was cytotoxic in a dose-dependent manner with a maximum effect in the range of 100-200 μg/ml equivalents of gallic acid. A mixed phenotype of types I/II cell death was evidenced by means of specific assays following treatment of U2Os with lyophilized red wine, e.g., autophagy and apoptosis. We found that cell death induced by lyophilized red wine proceeded through a mechanism independent from its anti-oxidant activity and involving the inhibition of PI3K/Akt kinase signaling. Considering the relative low concentration of each single bioactive compound in lyophilized red wine, our study suggests the activation of synergistic mechanism able to inhibit growth in malignant cells.

A novel combined surgical approach to head and neck dermatofibrosarcoma protuberans

INTRODUCTION

The surgical management of dermatofibrosarcoma protuberans has historically been a challenge, particularly in the head and neck and other aesthetic areas. The current priority is to achieve local oncologic control and a good reconstructive outcome. Here, we present our experience using a novel combined approach with a dermal regenerative template, sub-atmospheric pressure and skin graft.

MATERIALS AND METHODS

Five patients presenting at the Department of Plastic and Reconstructive Surgery of the University of Florence between January 2010 and October 2011 were included in the study following Institutional Review Board approval. All patients underwent a wide local excision of dermatofibrosarcoma protuberans affecting the head and neck.

RESULTS

The combined approach using the negative-pressure device, a dermal regenerative template and skin grafting proved effective in the management of this type of sarcoma with a good aesthetic and functional outcome, particularly on the neck or the supraclavicular region.

CONCLUSION

Although the present multi-step technique requires patient compliance, it results in good local oncologic control of the resection margins. It is possible to perform a wider excision in the event of positive margins without interfering with the last reconstructive outcome.

Effects of some endocrine disruptors on cell cycle progression and murine dendritic cell differentiation

Endocrine disruptor chemicals (EDCs), which are predominantly present in the environment, are able to mimic or antagonise the biological activity of hormones primarily through the interaction with specific receptors. The main consequences are adverse effects on the growth and development of reproductive organs, the induction of cancer and effects on neuronal differentiation. In this study, we investigated the ability of certain EDCs, Bisphenol A (BPA), Bisphenol B (BPB), Bisphenol F (BPF), 4-n Nonylphenol (NP) and Octylphenol (OP), belonging to a homogeneous group of phenol origin, to interfere with specific cellular processes, namely, proliferation, by using MCF-7 breast carcinoma cells, and differentiation, by using murine bone marrow dendritic cells. We correlated the data on cell growth with the stimulation of cell cycle progression, which could become a step in the development of cancer, and we established a proliferation ranking between the tested EDCs: NP>BPA>OP>BPB>BPF. In addition, we investigated the ability of NP, BPA and OP to induce the differentiation of dendritic cells, the powerful antigen-presenting cells of the immune system. The differentiation and activation of these cells could affect a well-regulated immune response and determine an allergic sensitisation. We found that BPA and NP were active in determining differentiation.

Quercetin downregulates Mcl-1 by acting on mRNA stability and protein degradation

Background:

We recently demonstrated that quercetin, a flavonoid naturally present in food and beverages belonging to the large class of phytochemicals, was able to sensitise leukaemic cells isolated from patients with chronic lymphocytic leukaemia (CLL) when associated with recombinant tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) or anti-CD95. We also showed that quercetin potentiated the effect of fludarabine on resistant B cells from CLL patients. Resistance to therapy in CLL depends on the expression and activity of anti-apoptotic proteins of the Bcl-2 family. Among these, myeloid cell leukaemia-1 (Mcl-1) has been associated with apoptotic resistance in CLL. Therefore, we investigate here whether the sensitising activity of this flavonoid, which leads to increased apoptosis in both cell lines and CLL, could be related to Mcl-1 expression and stability.

Results:

B cells isolated from CLL patients showed different levels of Mcl-1 protein expression, resulting, in several cases, in increased sensitivity to fludarabine. Quercetin significantly enhanced the downregulation of Mcl-1 in B cells isolated from selected patients expressing detectable levels of Mcl-1. In U-937 cells, quercetin increased Mcl-1 mRNA instability in the presence of actinomycin D. When cells were treated with MG-132, a proteasome inhibitor, Mcl-1 protein level increased. However, quercetin, in the presence of Z-Vad-FMK, continued to lower Mcl-1 protein expression, indicating its independence from caspase-mediated degradation. In contrast, co-treatment of quercetin and MG-132 did not revert the effect of MG-132 mono-treatment, thus suggesting a possible interference of quercetin in regulating the proteasome-dependent degradation of Mcl-1. Gossypol, a small-molecule inhibitor of Bcl-2 family members, mimics the activity of quercetin by lowering Mcl-1 expression and sensitising U-937 cells to apoptosis induced by recombinant TRAIL and the Fas-ligand.

Conclusion:

This study demonstrates that in U-937 cells, quercetin downregulates Mcl-1 acting directly or indirectly on its mRNA stability and protein degradation, suggesting that the same mechanism may bypass resistance to apoptosis in leukaemic cells isolated from CLL patients and sensitise B cells to apoptosis induced by drugs and death receptor inducers.

Layer-specific genes reveal a rudimentary laminar pattern in human nodular heterotopia

OBJECTIVE

To define distinctive features of nodular heterotopia in specimens derived from drug-resistant patients with epilepsy by evaluating mRNA expression of three different layer-specific markers: Rorbeta, Er81, and Nurr1.

METHODS

We analyzed the expression profile of these genes, recognized as markers mainly expressed in layer IV for Rorbeta, in layer V for Er81, and in layer VI for Nurr1, in surgical samples from 14 epileptic patients, using in situ hybridization. Six patients had subcortical nodular heterotopia and 8 patients were controls. The intrinsic organization of nodular formations and of the overlaying neocortex was assessed.

RESULTS

In all patients, the 3 selected genes showed high cortical laminar specificity. In subcortical nodular heterotopia, the different gene expression profiles revealed a rudimentary laminar organization of the nodules. In the overlaying cortex, fewer cells expressed the 3 genes in the appropriate specific layer as compared to controls.

CONCLUSIONS

These data provide new insights into possible ontogenetic mechanisms of nodular heterotopia formation and show the potential role of layer-specific markers to elucidate the neuropathology of malformations of cortical development.

Autologous Lipofilling: Coenzyme Q10 Can Rescue Adipocytes from Stress-Induced Apoptotic Death

BACKGROUND

Autologous fat transplantation (or lipofilling) is an excellent technique for correction of cosmetic defects. The success of the procedure relies strongly on the techniques of harvesting and transferring viable adipocytes. The purpose of this study was to evaluate effects of two harvesting methods and coenzyme Q10 on the viability and apoptotic death of adipocytes collected for autologous lipofilling.

METHODS

Human adipose tissue from six patients was collected by Luer-Lok syringe according to Coleman's technique or by means of an aspirator with a 680-mmHg vacuum. Half of each sample collected using Coleman's technique was treated with 10 muM Coenzyme Q10, and the other half served as untreated control. Viability and apoptosis were assessed by immunoenzymatic, biochemical, and morphological methods.

RESULTS

The harvesting of adipose tissue by aspirator reduced the viability and increased apoptotic death significantly more than harvesting tissue using Coleman's technique. Biochemical and morphological analyses confirmed that treatment of adipose tissue with coenzyme Q10 reduced and even inhibited apoptotic death of harvested adipocytes.

CONCLUSION

Coenzyme Q10 can rescue adipocytes from stress-induced apoptotic death.

Inhibition of Vibrio parahaemolyticus by a bacteriocin-like inhibitory substance (BLIS) produced by Vibrio mediterranei 1

AIMS

The aim of this research was to identify and partially purify new bacteriocin-like substances from strains of halophilic 'non-cholera' vibrios isolated from food sources.

METHODS AND RESULTS

Forty-five halophilic Vibrio spp. strains were screened for antimicrobial production. Vibrio mediterranei 1, a nonpathogenic strain, showed antimicrobial activity towards Vibrio parahaemolyticus spp. and related species. The bacteriocin-like inhibitory substance (BLIS), released by the bacteria into growth media, was concentrated by ultrafiltration and characterized. BLIS was sensitive to proteinase K, was stable in the pH range 5-9, was resistant to organic solvents and was heat stable up to 75 degrees C. Initial purification of BLIS by size exclusion chromatography showed an apparent molecular mass of 63-65 kDa.

CONCLUSIONS

This study reports the ability of V. mediterranei 1 to produce a bacteriocin-like substance inhibiting growth of V. parahaemolyticus spp. and other closely related bacteria.

SIGNIFICANCE AND IMPACT OF THE STUDY

The strong activity of BLIS towards the human and fish pathogen V. parahaemolyticus and the persistence of antimicrobial properties under a variety of different conditions suggest its potential application in food microbiology.

Vitamin E in early stages of sea bass (Dicentrarchus labrax) development

This study reports titration of vitamin E levels in the sea bass (Dicentrarchus labrax) using high-pressure liquid chromatography. The first part of the work is devoted to vitamin E detection in: (1) plasma of maturing females and males characterized by different body sizes; (2) seminal fluid and eggs; and (3) developing embryos of sea bass fed with vitamin E. In the second part of the study, variations of vitamin E levels during larval development are analyzed. The results show a direct correlation between plasma vitamin E content and body size for both adult male and female sea bass. High vitamin E levels were found in seminal fluid, in eggs before and after fertilization, and in embryos during development and at hatching, whereas vitamin E level was low in dead embryos and in embryos with limited survival. During larval development, the vitamin E content decreased slowly but steadily during the first four days of larval growth; subsequently, it progressively increased from day 9 to day 40. In teratogenic larvae, vitamin E content was significantly higher than in normal larvae. This study provides evidence on how vitamin E exerts an antioxidant defense in sea bass reproduction.

Phosphorylation of p27BBP/eIF6 and its association with the cytoskeleton are developmentally regulated in Xenopus oogenesis

p27BBP/eIF6 is an evolutionarily conserved regulator of ribosomal function. It is necessary for 60S biogenesis and impedes improper joining of 40S and 60S subunits, regulated by protein kinase C or Efl1p. No data on p27BBP/eIF6 during early development of Metazoa are available. We studied the distribution, post-translational changes and association with the cytoskeleton of p27BBP/ eIF6 during Xenopus oogenesis and early development. Results indicate that p27BBP/eIF6 is present throughout oogenesis, partly associated with 60S subunits, partly free and with little cytoskeleton bound. During prophase I, p27BBP/eIF6 is detected as a single band of 27-kDa. Upon maturation induced by progesterone or protein kinase C, a serine-phosphorylated 29 kDa isoform appears and is kept throughout development to the neurula stage. Confocal microscopy showed that the distribution of p27BBP/eIF6 and its association with the cytoskeleton varies according to oogenesis stages. Briefly, in stage 6 oocytes, p27BBP/eIF6 has a limited dot-like distribution, and does not co-localize with cytokeratin, whereas upon maturation it spreads throughout the cytoplasm. After fertilization, a large fraction coalesces around cytomembranes and a cytochalasin B-sensitive co-localization with cytokeratin occurs. RNAse removes p27BBP/eIF6 from the cytokeratin fibres. Developmental data suggest a role of p27BBP/eIF6 in controlling ribosomal availability or regulating cross-talk between ribosomes and the cytoskeleton.

Characterization of coloured compounds obtained by enzymatic extraction of bakery products

Melanoidins, the brown-colored polymers formed through Maillard type reaction in several heat-treated foods, represent a significant part of our diet, with an average intake of grams per day. Most of the studies on the physiological effects of these compounds have been performed using the water soluble melanoidin fractions. But dietary melanoidins formed on the surface of bakery products are poorly soluble in water as well as in organic solvents. In this work, an enzymatic solubilization procedure was developed on a gluten-glucose model system and it was applied to bread and biscuits. The soluble material obtained was tested for its antioxidant activity, for its effect on phase-I and phase-II xenobiotic enzymes and for potential cytotoxic effects. Soluble melanoidins from model system and biscuits exhibit a strong antioxidant activity and do not show any cytotoxicity on Caco-2 cells. Melanoidins extracted from biscuits was able to inhibit the activity of Phase I (NADPH-cytochrome-c reductase) and Phase II (Glutathione-S-transferase) enzymes, whereas the low molecular weight melanoidins isolated from gluten-glucose model system inhibit the activity of NADPH-cytochrome-c reductase.

Ins and outs of apoptosis in cardiovascular diseases

AIM

Cardiovascular disease (CVD) is the term used to define a group of disorders of the heart and blood vessels. Apoptosis, also known as programmed cell death (PCD), is genetically programmed "cell suicide" that plays an essential role in physiological processes such as embryo development, synaptogenesis, tissue turnover and the negative selection of T-cells, as well as in many diseases, such as cancer, and autoimmune and neurodegenerative diseases. The aim of this paper is to review the most recent data concerning the role of apoptosis in CVD, concentrating on the key apoptotic pathways in cardiomyocytes that may represent potential targets for therapeutic interventions.

DATA SUMMARY

The function of apoptosis in regulating CVD has recently been extensively investigated as a possible mechanism explaining the pathophysiological significance of various forms of CVD. Despite the difficulties of studying apoptosis in cardiomyocytes, a large number of studies of cellular and animal models suggest that they have the main apoptotic pathways that are also active in other cell types. However, the role of apoptosis in human pathologies, such as heart failure, ischemic heart disease and cardiac hypertrophy is still controversial. We revised classical (TUNEL) and novel experimental approaches (knock-out and transgenic mice; high-throughput genomics and proteomics) to address the role of apoptosis in CVD, concentrating on potential targets for therapeutic intervention.

CONCLUSION

Knowledge of the basic mechanisms regulating apoptosis activation and inhibition in cardiomyocytes may have important clinical and therapeutic implications.

Mutation at the CK2 phosphorylation site on Cdc28 affects kinase activity and cell size in Saccharomyces cerevisiae

We have recently reported that protein kinase CK2 phosphorylates both in vivo and in vitro residue serine-46 of the cell cycle regulating protein Cdc28 of budding yeast Saccharomyces cerevisiae, confirming a previous observation that the same site is phosphorylated in Cdc2/Cdk1, the human homolog of Cdc28. In addition, S. cerevisiae in which serine-46 of Cdc28 has been mutated to alanine show a decrease of 33% in both cell volume and protein content, providing the genetic evidence that CK2 is involved in the regulation of budding yeast cell division cycle, and suggesting that this regulation may be brought about in G1 phase of the mammalian cell cycle. Here, we extended this observation reporting that the mutation of serine-46 of Cdc28 to glutamic acid doubles, at least in vitro, the H1-kinase activity of the Cdc28/cyclin A complex. Since this mutation has only little effects on the cell size of the cells, we hypothesize multiple roles of yeast CK2 in regulating the G1 transition in budding yeast.

Oxidative conversion of 6-nitrocatecholamines to nitrosating products: a possible contributory factor in nitric oxide and catecholamine neurotoxicity associated with oxidative stress and acidosis

Oxidation of 6-nitrodopamine (1) and 6-nitronorepinephrine (2), as well as of the model compounds 4-nitrocatechol and 4-methyl-5-nitrocatechol, with horseradish peroxidase (HRP)/H(2)O(2), lactoperoxidase (LPO)/H(2)O(2), Fe(2+)/H(2)O(2), Fe(2+)-EDTA/H(2)O(2) (Fenton reagent), HRP or Fe(2+)/EDTA in combination with D-glucose-glucose oxidase, or Fe(2+)/O(2), resulted in the smooth formation of yellowish-brown pigments positive to the Griess assay. In the case of 1, formation of the Griess positive pigment (GPP-1) promoted by HRP/H(2)O(2) proceeded through the intermediacy of two main dimeric species that could be isolated and identified as 3 and the isomer 4, featuring the 4-nitro-6,7-dihydroxyindole system linked to a unit of 1 through ether bonds. Spectroscopic (FAB-MS, (1)H NMR) and chemical analysis of GPP-1 indicated a mixture of oligomeric species related to 3 and 4 in which oxidative modification of the nitrocatechol moiety of 1 led to the generation of reactive nitro groups supposedly linked to sp(3) hybridized carbons. In the pH range 3-6, GPP-1 induced concentration- and pH-dependent nitrosation of 2,3-diaminonaphthalene, but very poor (up to 2%) nitration of 600 microM tyrosine. At pH 7.4, 1 exerted significant toxicity to PC12 cells, while GPP-1 proved virtually innocuous. By contrast, when assayed on Lactobacillus bulgaricus cells at pH 3.5, 1 was inactive whereas GGP-1 caused about 70% inhibition of cell growth. Overall, these results hint at novel pH-dependent mechanisms of nitrocatecholamine-induced cytotoxicity of possible relevance to ischemia- or inflammation-induced catecholaminergic neuron damage.

Transcriptional response of a human colon adenocarcinoma cell line to sodium butyrate

Taking advantage of the DNA array screening technology, we analysed the effect of sodium butyrate on mRNA transcription in human HT29 colon adenocarcinoma cells. Out of 588 mRNA species analysed, only 119 resulted expressed. Among these, 60 exhibited a variable degree of modulation after butyrate treatment. Genes linked to the cell growth, apoptosis and oxidative metabolism appeared the most significantly affected. Furthermore, many of the differentially expressed genes are transcription factors and this may account for the variability of the biological effects of butyrate. The pattern of butyrate-affected genes may represent a reference in further analyses of gene expression of intestinal cells and tissues.

Correlation between medium acidification and pathogenicity in environmental halophilic non-cholera vibrios

AIMS

The metabolic characterization and pathogenicity of vibrios isolated from seafood were studied.

METHODS AND RESULTS

Strains of halophilic vibrios, grown in the presence of 0.5% glucose, induced high medium acidification and were non-culturable after 24 h, while moderately acidifying strains were culturable, produced cytotoxins, and remained lethal when inoculated intraperitoneally in mice. Highly acidifying strains failed to elicit pathogenicity in vivo and in vitro.

CONCLUSION

The high acidification of the medium and the self-killing activity of NCVs might be considered a significant phenotypic marker of virulence and/or cytotoxicity.

SIGNIFICANCE AND IMPACT OF THE STUDY

We suggest the medium acidification test as possible screening method for pathogenic NCVs in food microbiology.

Effects of de-alcoholated red wine and its phenolic fractions on platelet aggregation

BACKGROUND AND AIM

Platelet aggregation is involved in atherosclerosis and pharmacological inhibition of platelet activity may reduce the risk of coronary thrombosis and myocardial infarction. Red wine polyphenols may reduce platelet aggregability. This study evaluates the effect of de-alcoholated red wine (DRW) and its phenolic fractions on rat platelet aggregation and cyclic AMP (c-AMP) content.

METHODS AND RESULTS

DRW was fractionated into four classes of phenolic compounds: phenolic acids (fraction 1), procyanidins, catechins and monomeric anthocyanidins (fraction 2), flavonols and resveratrol (fraction 3) and polymeric anthocyanidins (fraction 4). The effect of each fraction on ADP-induced rat platelet aggregation and c-AMP content was compared with that of DRW and pure phenolic compounds (quercetin, catechin, resveratrol, caffeic acid). DRW completely inhibited ADP-induced platelet aggregation. Fraction 2 also showed a significant anti-aggregating activity, whereas the effects of fractions 3 and 4 and the pure phenolics were not significant. A significant increase in platelet c-AMP content was observed after the addition of DRW and fraction 2.

CONCLUSIONS

Our data indicate that DRW and its catechin-anthocyanidin fraction exert a significant effect on platelet aggregation in vitro, perhaps by enhancing platelet c-AMP levels.

The use of the V-Y fasciocutaneous island advancement flap in reconstructing postsurgical defects of the leg

BACKGROUND

Soft tissue cover in the lower limb is difficult due to limited tissue mobility.

OBJECTIVE

To present the V-Y fasciocutaneous island advancement flap as an alternative for reconstructing postsurgical defects of the leg.

METHODS

Eleven patients with defects on the leg following tumor excision were reconstructed using the V-Y fasciocutaneous island advancement flap.

RESULTS

There were no major complications, except for one partial distal flap necrosis in a patient who was a smoker.

CONCLUSION

The V-Y fasciocutaneous island advancement flap is a viable alternative for reconstructing surgical defects of the leg.

Phosphorylation of Cdc28 and regulation of cell size by the protein kinase CKII in Saccharomyces cerevisiae

The CDK (cyclin-dependent kinase) family of enzymes is required for the G(1)-to-S-phase and G(2)-to-M-phase transitions during the cell-division cycle of eukaryotes. We have shown previously that the protein kinase CKII catalyses the phosphorylation of Ser-39 in Cdc2 during the G(1) phase of the HeLa cell-division cycle [Russo, Vandenberg, Yu, Bae, Franza and Marshak (1992) J. Biol. Chem. 267, 20317-20325]. To identify a functional role for this phosphorylation, we have studied the homologous enzymes in the budding yeast Saccharomyces cerevisiae. The S. cerevisiae homologue of Cdc2, Cdc28, contains a consensus CKII site (Ser-46), which is homologous with that of human Cdc2. Using in vitro kinase assays, metabolic labelling, peptide mapping and phosphoamino acid analysis, we demonstrate that this site is phosphorylated in Cdc28 in vivo as well in vitro. In addition, S. cerevisiae cells in which Ser-46 has been mutated to alanine show a decrease in both cell volume and protein content of 33%, and this effect is most pronounced in the stationary phase. Because cell size in S. cerevisiae is regulated primarily at the G(1) stage, we suggest that CKII contributes to the regulation of the cell cycle in budding yeast by phosphorylation of Cdc28 as a checkpoint for G(1) progression.

Antioxidant effect of red wine polyphenols on red blood cells

The protective effect of red wine polyphenols against hydrogen peroxide (H(2)O(2))-induced oxidation was investigated in normal human erythrocytes (RBCs). RBCs, preincubated with micromolar amounts of wine extract and challenged with H(2)O(2), were analyzed for reactive oxygen species (ROS), hemolysis, methemoglobin production, and lipid peroxidation. All these oxidative modifications were prevented by incubating the RBCs with oak barrel aged red wine extract (SD95) containing 3.5 mM gallic acid equivalent (GAE) of phenolic compounds. The protective effect was less apparent when RBCs were incubated with wines containing lower levels of polyphenols. Furthermore, resveratrol and quercetin, well known red wine antioxidants, showed lower antioxidant properties compared with SD95, indicating that interaction between constituents may bring about effects that are not necessarily properties of the singular components. Our findings demonstrate that the nonalcoholic components of red wine, mainly polyphenols, have potent antioxidant properties, supporting the hypothesis of a beneficial effect of red wine in oxidative stress in human system.

Quercetin and anti-CD95(Fas/Apo1) enhance apoptosis in HPB-ALL cell line

Several malignant cell lines are resistant to CD95-(Apo1/Fas)-mediated apoptosis, even when the CD95 receptor is highly expressed. Sensitivity to CD95-induced apoptosis can be restored using different molecules. In this study, we showed that quercetin, a naturally occurring flavonoid, in association with the agonistic anti-CD95 monoclonal antibody, increases DNA fragmentation and caspase-3 activity in HPB-ALL cells. These cells have been selected for their known resistance to CD95-induced apoptosis. At molecular level, quercetin lowers the level of intracellular reactive oxygen species, reduces mitochondrial transmembrane potential, thereby leaving the expression of CD95 receptor unchanged.

ADP-ribose gates the fertilization channel in ascidian oocytes

We report an ion channel in the plasma membrane of unfertilized oocytes of the ascidian Ciona intestinalis that is directly gated by the second messenger ADP-ribose. The ion channel is permeable to Ca2+ and Na+ and is characterized by a reversal potential between 0 and +20 mV and a unitary conductance of 140 pS. Preinjection of the Ca2+ chelator 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (BAPTA) or antagonists of intracellular Ca2+ release channels into oocytes did not inhibit the ADP-ribose current, demonstrating that the channel is activated in a Ca2+-independent manner. Both the fertilization current and the current induced by the injection of nicotinamide nucleotides are blocked by nicotinamide, suggesting that the ADP-ribose channel is activated at fertilization in a nicotinamide-sensitive manner. These data suggest that ascidian sperm trigger the hydrolysis of nicotinamide nucleotides in the oocyte to ADP-ribose and that this mechanism is responsible for the production of the fertilization current.

Ins and outs of meiosis in ascidians

Ascidian oocytes are blocked in metaphase (M) of the first meiotic division. Fertilization triggers the completion of meiosis without any further arrest. In this review, we have analyzed the mechanisms that regulate the progression through meiosis in these oocytes. A primary signal from the fertilizing spermatozoon, probably soluble sperm factor(s), induces intracellular calcium release by activating the IP3 and CICR pathways and gates the fertilization current by triggering the generation of ADP ribose (ADPr). The calcium oscillations are not required for the inactivation of MPF observed at M-I release; however, ADPr may be indirectly involved in the activity of MPF associated kinase, Cdc2. MPF activity reaches a second peak at M-II followed by subsequent inactivation. Progression to M-II is dependent on the intracellular calcium oscillations. MAP kinase (MAPK) activity decreases at M-I exit and remains low during the completion of meiosis. Finally, although Cdc2, Cyclin B and MAPK-like proteins have been identified in ascidian oocytes, components of CSF still remain to be identified.

A soluble extract from human spermatozoa activates ascidian oocytes

A soluble extract from human spermatozoa induced calcium oscillations and extrusion of the first polar body when injected into oocytes of the ascidian Ciona intestinalis. The properties of calcium oscillations and time of polar body extrusion precisely mimic oocyte activation induced by C. intestinalis sperm or sperm extracts. The data suggest that human sperm extracts can activate oocytes of different phyla by the same mechanism as homologous spermatozoa. Injection of inositol 1,4,5-trisphosphate (IP3) into C. intestinalis oocytes mimicked to some extent the initial stages of oocyte activation, but the results demonstrate that ascidian oocyte activation by human sperm extract cannot be explained solely in terms of IP3-induced calcium release. Injection of other calcium releasing second messengers, cyclic adenosine diphosphate ribose, or calcium ions, does not lead to oocyte activation or release intracellular calcium in ascidian oocyte. It was concluded that human spermatozoa contain one or more molecules than can trigger intracellular calcium release in oocytes from different phyla.

Down-regulation of protein kinase CKII activity by sodium butyrate

Butyrate, a dietary fiber derivative, is a well-known differentiating agent in cultured cell lines. In addition, its antineoplastic activity toward colon-rectum cancers has been documented both in vivo and in vitro. Despite the large amount of information on the potential clinical efficacy of butyrate, its mechanism of action at the molecular level has only been partially investigated. Here, we show that serine/threonine protein kinase CKII is a target of butyrate activity. In the human adenocarcinoma cell line, HT29, treated with 2 mM sodium butyrate, CKII activity decreases 50% at 24 and 48 hours after drug addition. The enzyme down-regulation is not due to changes in protein amount since the levels of the different CKII subunits remain constant during butyrate treatment. The data reported provide the first evidence that CKII down-regulation is involved in the signal transduction pathway started by butyrate.

Biochemical characterization of p16INK4- and p18-containing complexes in human cell lines

The regulation of the D-type cyclin-dependent kinase (CDK4 and CDK6) activity appears to be the key step in the progression of eukaryotic cells through the G1 cell cycle phase. One of the mechanisms involved in this process is the binding of some small proteic inhibitors, with a molecular mass ranging between 14 and 20 kDa, to these CDKs. We have evaluated the amount of two such inhibitors, namely p16(INK4) and p18, in normal and transformed cells, as well as the biochemical features of the macromolecular complexes containing these proteins. The results obtained indicated that (i) p18 gene expression, unlike p16(INK4) gene, is not regulated by pRb status, (ii) no evident relationship exists between the expression of p16(INK4) and p18 genes, (iii) significant amounts of the two proteins are not bound to CDKs but occur as free molecules, (iv) each inhibitor forms a complex with the CDK protein with a 1:1 stoichiometry, and (v) a competition exists between cyclin D and the inhibitor protein toward the CDK protein resulting in the absence of detectable cellular free kinase. Moreover, employing the human native partially purified p16(INK4)or the pure recombinant protein, we have been able to demonstrate in vitro the dissociation of CDK4-cyclin D1 complex and the formation of CDK4-p16(INK4) bimolecular complex. Our findings suggest that during the cell division cycle the members of the p16(INK4) protein family and cyclin Ds compete for binding to CDK4/CDK6 and that their quantitative ratio is essential for G1 --> S transition.

Maturation promoting factor in ascidian oocytes is regulated by different intracellular signals at meiosis I and II

Using the fluorescent dye Calcium Green-dextran, we measured intracellular Ca2+ in oocytes of the ascidian Ciona intestinalis at fertilization and during progression through meiosis. The relative fluorescence intensity increased shortly after insemination in a single transient, the activation peak, and this was followed by several smaller oscillations that lasted for approximately 5 minutes (phase 1). The first polar body was extruded after the completion of the phase 1 transients, about 9 minutes after insemination, and then the intracellular calcium level remained at baseline for a period of 5 minutes (phase 2). At 14 minutes postinsemination a second series of oscillations was initiated that lasted 11 minutes (phase 3) and terminated at the time of second polar body extrusion. Phases 1 and 3 were inhibited by preloading oocytes with 5 mM heparin. Simultaneous measurements of membrane currents, in the whole-cell clamp configuration, showed that the 1–2 nA inward fertilization current correlated temporally with the activation peak, while a series of smaller oscillations of 0.1-0.3 nA amplitude were generated at the time of the phase 3 oscillations. Biochemical characterization of Maturation Promoting Factor (MPF) in ascidian oocytes led to the identification of a Cdc2-like kinase activity. Using p13suc1-sepharose as a reagent to precipitate the MPF complex, a 67 kDa (67 × 10(3) Mr) protein was identified as cyclin B. Histone H1 kinase activity was high at metaphase I and decreased within 5 minutes of insemination reaching a minimum level during phase 2, corresponding to telophase I. During phase 3, H1 kinase activity increased and then decayed again during telophase II. Oocytes preloaded with BAPTA and subsequently inseminated did not generate any calcium transients, nonetheless H1 kinase activity decreased 5 minutes after insemination, as in the controls, and remained low for at least 30 minutes. Injection of BAPTA during phase 2 suppressed the phase 3 calcium transients, and inhibited both the increase in H1 kinase activity normally encountered at metaphase II and second polar body extrusion.

Purification and characterization of recombinant human 5'-methylthioadenosine phosphorylase: definite identification of coding cDNA

5'-Methylthioadenosine phosphorylase gene maps on the 9p21 chromosome, strictly linked to the important tumor suppressor gene p16INK4A. Chromosomal deletions encompassing both the phosphorylase and p16INK4A genes cause the complete absence of the enzymatic activity in a large number of tumors, thus resulting in well-defined metabolic differences between malignant and normal cells. Recently, the cloning of the phosphorylase gene has been reported on the basis of indirect evidence. In order to demonstrate definitely the identification of 5'-methylthioadenosine phosphorylase gene, we have cloned the putative enzyme coding sequence in a prokaryotic expression vector and expressed the protein in bacteria. The recombinant phosphorylase has been purified to homogeneity and its physicochemical, immunological and kinetic features have been characterized. The results obtained allowed the conclusive demonstration of 5'-methylthioadenosine phosphorylase gene cloning and the use of recombinant protein for further characterization.