Understanding the Postharvest Phytochemical Composition Fates of Packaged Watercress (Nasturtium officinale R. Br.) Grown in a Floating System and Treated with Bacillus subtilis as PGPR

The physiological changes and phytochemical pathways of processed watercress (Nasturtium officinale R. Br.) undergone during storage are not well known. The objective of this work was to evaluate the respiration rate and the inherent and external quality of watercress inoculated with B. subtilis and packaged as a fresh-cut product and stored at 4 °C for 11 days. Watercress was grown using continuous flotation (FL) in a greenhouse using substrate disinfection and inoculated or not with Bacillus subtilis as a plant-growth-promoting rhizobacteria (PGPR). The fresh-cut watercress respiration rate and phytochemical profile changed during the shelf life. The inherent phytochemical compounds were retained during the storage of the fresh-cut salad bags. The best results were found in watercress grown in a disinfected substrate but were less satisfactory when seeds and substrates were inoculated with PGPR. In general, the external quality and the pigment contents progressively decreased during the shelf life and the browning enzyme activities responsible for phenolic oxidation increased at different intensities throughout storage. At the end of the shelf-life period, the fresh weight loss of the fresh-cut product was less than 1% of the original weight. The results demonstrated that watercress grown in FL is a standardised baby leaf vegetable that is suitable for processing in the fresh-cut industry and for storing for more than 10 days. Unclear results were obtained for Bacillus subtilis in the postharvest period due to the inconsistent responses of the different analysed parameters.

Areca catechu-From farm to food and biomedical applications

The family Arecaceae includes 181 genera and 2,600 species with a high diversity in physical characteristics. Areca plants, commonly palms, which are able to grow in nearly every type of habitat, prefer tropical and subtropical climates. The most studied species Areca catechu L. contains phytochemicals as phenolics and alkaloids with biological properties. The phenolics are mainly distributed in roots followed by fresh unripe fruits, leaves, spikes, and veins, while the contents of alkaloids are in the order of roots, fresh unripe fruits, spikes, leaves, and veins. This species has been reputed to provide health effects on the cardiovascular, respiratory, nervous, metabolic, gastrointestinal, and reproductive systems. However, in many developing countries, quid from this species has been associated with side effects, which include the destruction of the teeth, impairment of oral hygiene, bronchial asthma, or oral cancer. Despite these side effects, which are also mentioned in this work, the present review collects the main results of biological properties of the phytochemicals in A. catechu. This study emphasizes the in vitro and in vivo antioxidant, antimicrobial, anticancer, and clinical effectiveness in humans. In this sense, A. catechu have demonstrated effectiveness in several reports through in vitro and in vivo experiments on disorders such as antimicrobial, antioxidant, or anticancer. Moreover, our findings demonstrate that this species presents clinical effectiveness on neurological disorders. Hence, A. catechu extracts could be used as a bioactive ingredient for functional food, nutraceuticals, or cosmeceuticals. However, further studies, especially extensive and comprehensive clinical trials, are recommended for the use of Areca in the treatment of diseases.

Rosmarinus plants: Key farm concepts towards food applications

Rosmarinus species are aromatic plants that mainly grow in the Mediterranean region. They are widely used in folk medicine, food, and flavor industries and represent a valuable source of biologically active compounds (e.g., terpenoids, flavonoids, and phenolic acids). The extraction of rosemary essential oil is being done using three main methods: carbon dioxide supercritical extraction, steam distillation, and hydrodistillation. Furthermore, interesting antioxidant, antibacterial, antifungal, antileishmanial, anthelmintic, anticancer, anti-inflammatory, antidepressant, and antiamnesic effects have also been broadly recognized for rosemary plant extracts. Thus the present review summarized data on economically important Rosmarinus officinalis species, including isolation, extraction techniques, chemical composition, pharmaceutical, and food applications.

Veronica Plants-Drifting from Farm to Traditional Healing, Food Application, and Phytopharmacology

The Veronica genus, with more than 200 species, belongs to the Plantaginaceae family and is distributed over most of the Northern Hemisphere and in many parts of Southern Hemisphere. These plants are traditionally used in medicine for wound healing, in the treatment of rheumatism, and in different human diseases. This paper reviews the chemical composition of some valuable Veronica species, the possibilities Veronica extracts have in food preservation and as food ingredients, and their functional properties. Veronica species represent a valuable source of biological active secondary metabolites, including iridoid glycosides and phenolic compounds. In particular, due to presence of these phytochemicals, Veronica species exhibit a wide spectrum of biological activities, including antimicrobial and antioxidant. In fact, some studies suggest that some Veronica extracts can inhibit foodborne pathogens, such as Listeria monocytogenes, but only a few of them were performed in food systems. Moreover, anticancer, anti-inflammatory, and other bioactivities were reported in vitro and in vivo. The bioactivity of Veronica plants was demonstrated, but further studies in food systems and in humans are required.

Artemisia umbelliformis Lam. and Génépi Liqueur: Volatile Profile as Diagnostic Marker for Geographic Origin and To Predict Liqueur Safety

Artemisia umbelliformis, commonly known as "white génépi", is characterized by a volatile fraction rich in α- and β-thujones, two monoterpenoids; under European Union (EU) regulations these are limited to 35 mg/L in Artemisia-based beverages because of their recognized activity on the human central nervous system. This study reports the results of an investigation to define the geographical origin and thujone content of individual plants of A. umbelliformis from different geographical sites, cultivated experimentally at a single site, and to predict the thujone content in the resulting liqueurs through their volatile fraction. Headspace solid phase microextraction (HS-SPME) combined with gas chromatography-mass spectrometry (GC-MS) and non-separative HS-SPME-MS were used as analytical platforms to create a database suitable for chemometric description and prediction through linear discriminant analysis (LDA). HS-SPME-MS was applied to shorten analysis time. With both approaches, a diagnostic prediction of (i) plant geographical origin and (ii) thujone content of plant-related liqueurs could be made.

Single access laparoscopic left hemicolectomy with or without inferior mesenteric artery preservation: our preliminary experience

AIM

We report our preliminary experience in single access laparoscopic left hemicolectomy (SALLH) with or without inferior mesenteric artery preservation, showing the results of a selected group of patients.

METHODS

This retrospective case series enclosed all patients operated between October 2009 and June 2012 of a left hemicolectomy with single laparoscopic access for benign and malignant diseases. The mean follow-up was 18 months. Intraoperative and postoperative results were recorded.

RESULTS

This retrospective case series enclosed 24 patients. Mean operative time was 157.8 min. The mean final skin incision length was 3.65 cm. All operations were completed by a single access laparoscopic approach. There were no conversion or intraoperative mortality. There were no required any intraoperative blood transfusion. Only three cases of postoperative complication were registered. The mean flatus canalization was two days. The mean discharge time was seven days. At a mean 18-month follow-up there were no incisional hernia or deaths.

CONCLUSION

As best of our knowledge, we report one of the largest experience gained in Italy about SALLH. We think that although SALC could be safe and feasible, it cannot be considered as a "new standard" procedure used by anyone. In contrast we retain that it is mandatory that SALC continued to be evaluated into larger multicentric RCT.

Hydrodistillation and in situ microwave-generated hydrodistillation of fresh and dried mint leaves: a comparison study

BACKGROUND

Hydrodistillation (HD) has been used since ancient times for the extraction of essential oils (EO). Despite the intrinsic limitations of this technique, it remains the most common method both in the laboratory and on an industrial scale. The main drawbacks are the long extraction time involved and the risk of thermal degradation. Over the last decade, microwave-assisted extraction (MAE) and in situ microwave-generated hydrodistillation (MGH) have been shown to be the most promising techniques in improving plant extraction and hydrodistillation.

RESULTS

In this study we compare HD with MGH in the extraction of several mint species cultivated in Piedmont: Mentha spicata L. var. rubra, Mentha spicata L. var. viridis and Mentha piperita L. MGH requires either fresh plant or rehydrated material, it is extremely fast and allows a reduction in energy consumption and overall cost. All the EO have been analyzed by gas chromatography-mass spectrometry. A mechanism of microwave-generated essential oil extraction has been proposed to explain the differences in the composition of the oil obtained from this environmentally friendly technique.

CONCLUSIONS

The yields and composition percentages of the EO obtained by HD and in situ MGH of fresh and dried mint leaves lie in a relatively narrow range, although MGH is faster. MW polarization effects and the water solubility of the components influence extract composition.

Beneficial effects of fibrin glue (Quixil) versus Lichtenstein conventional technique in inguinal hernia repair: a randomized clinical trial

INTRODUCTION

In inguinal hernia repair, many complications are due to mesh fixation technique. Therefore, new types of atraumatic methods of fixation have been proposed. In this article, we present the results of a prospective multicentric parallel randomized controlled trial aiming to compare two mesh fixation techniques: fibrin sealant (QUIXIL(®), Omrix Biopharmaceuticals S.A., Belgium) and Lichtenstein technique.

METHOD

Adult patients with primary uncomplicated inguinal hernia were randomized in two groups: fibrin sealant group (FSG) and Lichtenstein group (LTG). The two groups underwent a follow-up of 15 months. Operative time is the primary outcome. Intraoperative and postoperative outcomes were analyzed. Moreover, a differential cost analysis was performed. Patients and evaluators (with exception of the surgeon who treated the patient) were blinded.

RESULTS

A total of 102 patients, 50 in FSG and 52 in LTG, were enrolled from January 2009 to June 2010, and two patients were lost to follow-up at the twelfth month. No significant differences in baseline and clinical characteristics were observed in the two groups. Operative time was longer in LTG (median/ interquartile range: 35 min/30-42.5 min vs. 31 min/28-35 min; effect size: 0.65/95% CI 0.50-0.91; p < 0.05). No differences in intraoperative complications were observed. No significant differences were observed in early complication rate (RR = 0.62; p > 0.05). Numbness rate was lower in the FSG at 1 week (RR = 0.43; p < 0.01) and at 1 month (RR = 0.17; p < 0.05). No significant differences were observed after 6 months. Postoperative pain was lower in the FSG at 1 week (0/0-1 vs. 1/0-2; p < 0.05) and at 1 month (0/0-0 vs. 0/0-1; p < 0.05). Pain disappeared in all patients after 6 months. Analgesic assumption rate was lower in the FSG (RR = 0.42; p < 0.05). Twenty per cent of FSG and 9.62% of LTG patients were discharged within 12 h; 78% of FSG and 90.38% of LTG patients were discharged within 24 h. The only one recurrence we observed was in FSG group. About costs, although fibrin sealant needed for one mesh fixation is about 10 times more costly than the needed sutures, the total costs of the two procedures did not change significantly. This was mainly due to reduction in operative time.

CONCLUSIONS

The use of fibrin sealant determined a significant reduction in short-term numbness rate and postoperative pain. There was no relevant difference in total costs per patient between the two procedures.

Laparascopic colon resection for cancer: evidence based results

About 90-92% of patients with carcinoma of the colon are treated surgically. For other surgeons, laparoscopic surgery for the treatment of malignancies remains controversial because of concerns about the adequacy of lymphadenectomy, the extent of resection, early findings of port-site metastasis and the lack of data on long-term results. In our experience, there are no differences between the laparoscopic and laparotomic techniques, and only advantages if the laparoscopic technique is use correctly. We essentially agree with the good results of many studies published in the last ten years, but we are extremely confident that it is necessary to have a good learning curve and a high-volume cases hospital to obtain good results through a laparoscopic approach. So laparoscopic colorectal surgery should be performed only by surgeons who have completed training in this approach and who perform the procedure often enough to maintain a good level of competence.

Single incision laparoscopic anterior resection for cancer using a 'QuadiPort Access System®'

BACKGROUND: Single incision laparoscopic surgery (SILS) is developing rapidly and different devices are already available. However there is limited data in the literature about single port laparoscopic colorectal surgery. AIMS: We report the first case of a single incision laparoscopic anterior resection for cancer using the device 'QuadiPort Access System?'. METHODS: A 66 year old female affected by adenocarcinoma of the rectosigmoid junction underwent a radical single incision laparoscopic anterior resection performed by an experienced laparoscopic team. RESULTS: The preoperative staging was T2N0M0. The total operative time was 135 min. Length of hospital stay was 6 days. The length of the specimen was 27 cm and 21 nodes were isolated. The pathological examination showed adenocarcinoma staged T3N2MX; G2. There was no postoperative morbidity and at the 6 month follow-up, the patient presented in well condition with no complications and free from cancer. CONCLUSION: Single incision laparoscopic anterior resection for locally advanced high rectal cancer seems to be feasible and the 'QuadiPort Access System?' seems to be a valid device. To evaluate outcomes and costeffectiveness of SILS versus the standard laparoscopic colorectal surgery multicenter prospective randomised trials are necessary and the 'QuadiPort Access System?' could prove to be the device of choice.

Deep pelvic endometriosis (Adamyan IV stage): Multidisciplinary laparoscopic treatments

Background: Few small studies have confirmed the feasibility of laparoscopic colorectal resection for Deep Infiltrating Endometriosis (DIE), albeit with a wide range of complications. Aim: The aim of this study is to evaluate retrospectively the feasibility and clinical outcome of laparoscopic segmental bowel resection for DIE. Methods: We have retrospectively reviewed the data of patients undergoing laparoscopic rectosigmoidal resection for bowel endometriosis from January 2000 and June 2008. Data analysis included age, preoperative symptoms, operative procedure, operating room time, intraoperative and postoperative complication, length of stay and Quality of life. Results: 56 colorectal laparoscopic resection for DIE were performed. No conversion occurred. There were no intraoperative complication; 35 patients had a temporary ileostomy and 15 required reoperation for major complication. Conclusion: DIE should be managed in specialised centers with a multidisciplinary equipe; it represents a difficult surgery which require a high surgeon skill and it must be practiced considering both the risks and the benefits.

Long-term results of laparoscopic treatment for advanced rectal cancer

BACKGROUND

The management of advanced rectal cancer has changed into a multidisciplinary treatment model. Only limited randomized data are available for patients with rectal cancer treated laparoscopically.

AIM

We report a multimodal treatment of advanced rectal cancer: preoperative oncological treatment, use of endoscopic stent (for malignant obstruction), minimal invasive treatment.

METHODS

The Authors reported a series of 45 laparoscopic rectal resections for adenocarcinoma, some of them with malignant obstruction. Long-term oncological results were reviewed.

RESULTS

The 30-day mortality was 2.2%. Of 45 adenocarcinoma, 4 cases were obstructed. Successful stent positioning was obtained in all patients and treated with radiochemiotherapy before laparoscopic resection. The 5-year global survival rate (including stage IV) was 62.2%; for stage II was 77.9% and 53.8% for stage III.

CONCLUSION

This study indicates that laparoscopy for advanced rectal cancer have good long-term results. In high and middle rectal malignant obstructions, we considered the use of stents to be useful.

Vesicoureteral reflux after kidney transplantation: clinical significance in the medium to long-term

103 patients who received a cyclosporine-treated primary cadaver kidney transplant (TX) at our center between 1985 and 1989, whose graft survived for more than 1 year and who accepted to undergo voiding cystography after TX were analyzed and grouped according to the highest grade (regardless to whether active or passive) of vesicourteral reflux (VUR): group 0, absent (n = 14); group 1-2, grade I or II (n = 62); group 3, grade III (n = 27). Patient follow-up ranged from 5 to 10 (median 7) years. Patient and graft survivals and prevalence of hypertension (defined as the persistent need of antihypertensive therapy), did not differ significantly between groups (Mantel-Cox test p: n.s. in all cases). GFR (Cockroft and Gault) and proteinuria were evaluated with ANOVA for repeated measures at 1, 2, 3, 4 and 5 years in the 96 patients (group 0: 13, group 1-2: 56, group 3: 27) whose grafts lasted for 5 years or more. Neither GFR values (p: n.s.) nor GFR behaviour over time (p: n.s.) differed between groups, although a progressive decline of GFR was noted in all groups (p < 0.002). Proteinuria neither showed any significant differences between groups in values (p: n.s.) or behaviour over time (p: n.s.), nor any trend in behaviour over time in all groups as a whole (p: n.s.). Finally, in the first 5 years after TX the 3 groups did not differ for number of urinary tract infections (UTIs) (mean value for all patients: 2.5, range 0-22, episodes/pt/5 years) (p: n.s.), or for number of UTIs with leukocyturia (mean 0.6, range 0-6, episodes/pt/5 years) (p: n.s.), or for number of febrile UTIs (mean 0.3, range 0-5, episodes/pt/5 years) (p: n.s.), or for number of UTIs with sepsis (mean 0.1, range 0-2, episodes/pt/5 years) (p: n.s.). The same results were obtained when, instead of episodes/ pt/5 years, percentages of patients without or with 1 or more of such episodes in the same period were considered. In conclusion, VUR does not seem to be hazardous for the transplanted kidney in the medium to long-term.

[Diagnosis and treatment of gastrointestinal carcinoid. Report of a clinical case with duodenal site]

Carcinoid tumors are among the most frequently neuroendocrine neoplasms of the gastrointestinal tract. They occur more commonly as benign diseases but malignant ones can also be found. The peak age incidence varies with the location of the tumor, with appendiceal tumors being diagnosed at an overage of 36 years, whereas non appendiceal tumors are found typically in the fifth sixth decades of life. There is no sex predilection of the tumors. Most carcinoid tumors are found within the appendix (40-50%) or small intestine (25%). Less common sites include the rectum (15%), main bronchus (10%), duodenum (3-8%) and stomach (2%). Most carcinoid tumors are found incidentally at operation and cause no symptoms. If symptoms do occur, they can be either non specific include intermittent crampy abdominal pain, vomiting and distension caused by intestinal obstruction. The prognosis depends on the site of the tumor and its size. Most carcinoid tumors (75%) are less than 1 cm in size and only 5% are greater than 2 cm. The incidence of metastatic disease is related directly to the size of the tumor at all locations. Carcinoid tumor with size less than 1 cm give linfonodal metastasis only in 3-5%; the other with size over 2 cm give metastasis in the 70-75% of the cases. The 5-years survival for all carcinoid tumors are approximately 85%. Five years rate is higher (> 80%) in carcinoid tumors of appendix and rectum than in gastroduodenal, ileal and colonic neoplasm (< 60%). In this paper the authors report a case of malignant carcinoid of the duodenum.

Importance of donor/recipient body weight ratio as a cause of kidney graft loss in the short to medium term

The importance of the donor/recipient body weight ratio (DRBWR) as a cause of kidney graft loss was evaluated in 112 non-diabetic, ciclosporin-treated, first cadaver kidney transplant recipients. According to the DRBWR, the patients were divided into three groups: 'low' (< or = 0.80), 'medium' (0.81-1.20), and 'high' (> 1.20). The three groups did not differ in patient or graft survival, and the DRBWR was not a predictor of graft failure at multivariate analysis (Cox models), even after only patients with graft survivals > 1 year were considered. The three groups did not differ in glomerular filtration rate (GFR) and proteinuria 6-60 months after renal transplantation. When the 55 patients with a follow-up period > 4 years were considered, no differences between groups were found in GFR or GFR evolution over time. Hypertension was significantly less frequent in group 'high' (Mantel-Cox p = 0.04), but very likely as a consequence of uneven recipient gender (an independent predictor of hypertension at multivariate analysis) distribution between groups, the significance being lost when survival curves were rebuilt by stratifying for recipient gender. DRBWR never resulted as a significant predictor of GFR at multivariate analysis when GFR values 6-60 months after transplantation were analyzed. We conclude that the DRBWR has no major effects on kidney graft function and survival in the short to medium term.

[Malignant tumors or the small intestine. Review of the literature and report of a clinical case]

The authors present one case of patients with adenocarcinoma of the small bowel. Primary malignant tumors of the small intestine are uncommon neoplasms accounting for 1-2 per cent of all gastrointestinal malignancies. Patients are usually seen late in the course of their illness when curative therapy is unlikely. The rarity of these neoplasms explains in part why the early signs and symptoms frequently go unrecognized and is undoubtedly a major factor contributing to their poor prognosis. Despite a fourfold greater length and a nearly tenfold greater mucosal surface area, the incidence of adenocarcinoma of the small intestine is about a fortieth that of the colon. This relative immunity of the small bowel to the development of the malignant tumors is unexplainable. Several theories have been suggested and include the following: a) the rapid transit time of the small intestine may reduce its exposure to dietary carcinogens; b) the relative sterility of the small intestine compared with the colon may lessen the formation of carcinogenic substances by the action of bacteria on components of bile or other substances within the intestinal lumen; c) certain mucosal enzymes such as benzopyrene hydroxylase that detoxify potential carcinogens are present in higher concentrations in the small intestine than in the colon; d) immunoglobulin A which is found in high concentrations in the small bowel, may protect it against carcinogenic viruses. Interestingly, patients deficient in IgA and those receiving immunosuppressive therapy have been found to have a higher incidence of small intestinal cancer. Adenocarcinoma is the most common primary malignant small bowel neoplasm.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical significance of vesicoureteral reflux after kidney transplantation

In this study 103 out of our 125 CsA-treated patients who received between January 1985 and December 1989 a first cadaver kidney transplant that functioned for at least one year were studied with voiding cystography (VC) for vesicoureteral reflux (VUR). All patients had an external uretero-neo-cystostomy. VUR occurred in 89 (86.4%) patients. Patients were grouped according to VUR: absence of VUR (group 0), VUR grade I-II (group 1-2), and VUR grade III (group 3). The 3 groups were comparable for male/female ratio, cause of renal failure, cause of donor death, recipient and dialytic age, immunosuppressive therapy, follow-up, time of VC performance after transplantation. At 6 months and 1, 2, 3, 4, and 5 years after transplantation graft function, number of rejection episodes, and number of urinary tract infections (UTIs) were similar in the 3 groups. In groups 1-2 and 3 hypertension was more frequent than in group 0 and occurred even after the 6th month (whereas this did not happen in group 0), but the differences between the 3 groups were not significant. However, when only the 13 patients who were followed for 5 years were considered, the prevalence of hypertension after 5 years was significantly higher in groups 1-2 and 3 (both 100.0%) than in group 0 (33.3%) (chi-square = 7.88; p < 0.02). Finally, 4.5% of patients with VUR and no patients without VUR had septic episodes linked to UTIs, but the difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)