Advancements in Gas Separation for Energy Applications: Exploring the Potential of Polymer Membranes with Intrinsic Microporosity (PIM)

Membrane-based Polymers of Intrinsic Microporosity (PIMs) are promising candidates for energy-efficient industrial gas separations, especially for the separation of carbon dioxide over methane (CO2/CH4) and carbon dioxide over nitrogen (CO2/N2) for natural gas/biogas upgrading and carbon capture from flue gases, respectively. Compared to other separation techniques, membrane separations offer potential energy and cost savings. Ultra-permeable PIM-based polymers are currently leading the trade-off between permeability and selectivity for gas separations, particularly in CO2/CH4 and CO2/N2. These membranes show a significant improvement in performance and fall within a linear correlation on benchmark Robeson plots, which are parallel to, but significantly above, the CO2/CH4 and CO2/N2 Robeson upper bounds. This improvement is expected to enhance the credibility of polymer membranes for CO2 separations and stimulate further research in polymer science and applied engineering to develop membrane systems for these CO2 separations, which are critical to energy and environmental sustainability. This review aims to highlight the state-of-the-art strategies employed to enhance gas separation performances in PIM-based membranes while also mitigating aging effects. These strategies include chemical post-modification, crosslinking, UV and thermal treatment of PIM, as well as the incorporation of nanofillers in the polymeric matrix.

Multicentric Italian case-control study on 25OH vitamin D levels in children and adolescents with Prader-Willi syndrome

PURPOSE

25OHD levels in patients with Prader-Willi Syndrome (PWS), the most frequent cause of genetic obesity with a peculiar fat mass distribution, are still debated. Insulin resistance (IR), Body Mass Index-SDS (BMI-SDS), Growth Hormone Therapy (GHT), and puberty onset seem to interact with 25OHD levels. The objectives of the study are: (1) To analyze 25OHD levels in pediatric PWS patients in comparison with a control group (CNT) (2) To evaluate a possible correlation between BMI-SDS, HOMA-IR, puberty, GHT, and 25OHD levels.

METHODS

This is a retrospective case-control, multicenter study. Data were collected among 8 different Italian Hospitals (outpatient clinics), over a period of four years (2016-2020). We included 192 genetically confirmed PWS and 192 CNT patients, aged 3-18 years, matched 1:1 for age, gender, BMI-SDS, Tanner stage, sun exposure, and month of recruitment.

RESULTS

No statistically significant differences in 25OHD levels were observed between the PWS population and the CNT (PWS 24.0 ng/mL vs CNT 22.5 ng/mL, p > 0.05), OR = 0.89 (95% CI 0.58-1.35). We observed a slight, although non-significant, reduction in 25OHD levels comparing NW and OB populations. HOMA-IR, puberty onset, genotype and GHT (previous or ongoing) did not show statistically significant correlation with 25OHD levels.

CONCLUSIONS

Our findings could be useful for clinicians to optimize the therapeutic management as well as to increase awareness of PWS.

Ionic Liquids-Polymer of Intrinsic Microporosity (PIMs) Blend Membranes for CO2 Separation

Membranes with high CO₂ solubility are essential for developing a separation technology with low carbon footprint. To this end, physical blend membranes of [BMIM][Ac] and [BMIM][Succ] as Ionic Liquids (ILs) and PIM-1 as the polymer were prepared trying to combine the high permeability properties of PIM-1 with the high CO₂ solubility of the chosen ILs. Membranes with a PIM-1/[BMIM][Ac] 4/1 ratio nearly double their CO₂ solubility at 0.8 bar (0.86 cm³ (STP)/cm³ cmHg), while other ratios still maintain similar solubilities to PIM-1 (0.47 cm³ (STP)/cm³ cmHg). Moreover, CO₂ permeability of PIM-1/[BMIM][Ac] blended membranes were between 1050 and 2090 Barrer for 2/1 and 10/1 ratio, lower than PIM-1 membrane, but still highly permeable. The here presented self-standing and mechanically resistant blend membranes have yet a lower permeability compared to PIM-1 yet an improved CO₂ solubility, which eventually will translate in higher CO₂/N₂ selectivity. These promising preliminary results will allow us to select and optimize the best performing PIM-1/ILs blends to develop outstanding membranes for an improved gas separation technology.

MKRN3 circulating levels in Prader-Willi syndrome: a pilot study

CONTEXT

Hypogonadism in Prader-Willi syndrome (PWS) is generally attributed to hypothalamic dysfunction or to primary gonadal defect. MKRN3, a maternal imprinted gene located on 15q11.2-q13 region, encodes makorin ring finger protein 3, whose deficiency causes precocious puberty, an extremely rare symptom in PWS.

OBJECTIVE

This study aimed to evaluate MKRN3 levels in patients with PWS and to analyze its correlation with sexual hormone levels, insulin resistance and Body Mass Index (BMI).

METHODS

We performed an observational cross-sectional study and enrolled 80 patients with genetically confirmed diagnosis of PWS with median age of 9.6 years.

RESULTS

MKRN3 levels were measurable in 49 PWS patients with a geometric mean of 34.9 ± 22 pg/ml (median: 28.4). Unmeasurable levels of MKRN3 were found in 31 patients. No statistically significant differences were found between patients with and without measurable MKRN3 levels for any clinical, biochemical, or genetic characteristics. However, MKRN3 levels were inversely correlated with HOMA-IR index (p: 0.005) and HbA1c (p: 0.046) values. No statistically significant correlations were found between MKRN3 and LH, estradiol and testosterone concentrations, pubertal development and genetic defect, whereas a direct correlation with FSH was found (p: 0.007).

CONCLUSIONS

The typical genetic defect of PWS should lead to unmeasurable levels of the MKRN3 protein due to the inactivation of the paternal allele. Measurable circulating MKRN3 could suggest the possible involvement of tissue-specific imprinting mechanisms and other regulatory factors in gene expression. Correlations with HOMA-IR index, HbA1c, and FSH suggest peripheral actions of MKRN3, but future studies are warranted to investigate this topic.

Highly Dispersed Few-Nanometer Chlorine-Doped SnO2 Catalyst Embedded in a Polyaniline Matrix for Stable HCOO- Production in a Flow Cell

With the spread of alternative energy plants, electrolysis processes are becoming the protagonists of the future industrial generation. The technology readiness level for the electrochemical reduction of carbon dioxide is still low and is largely based on precious metal resources. In the present work, tin ions are anchored on a polyaniline matrix, via a sonochemical synthesis, forming a few atomic layers of chlorine-doped SnO₂ with a total loading of tin atom load of only 7 wt %. This catalyst is able to produce formate (HCOO^-) with great selectivity, exceeding 72% of Faradaic efficiency in the first hour of testing in 1 M KHCO₃ electrolyte, with a current density of more than 50 mA cm^-2 in a 2 M KHCO₃ electrolyte flow cell setup. Catalyst stability tests show a stable production of HCOO^- during 6 h of measurement, accumulating an overall TON_HCOO^- of more than 10,000 after 16 h of continuous formate production. This strategy is competitive in drastically reducing the amount of metal required for the overall catalysis.

Layered Double Hydroxide-Based Gas Sensors for VOC Detection at Room Temperature

Miniaturized low-cost sensors for volatile organic compounds (VOCs) have the potentiality to become a fundamental tool for indoor and outdoor air quality monitoring, to significantly improve everyday life. Layered double hydroxides (LDHs) belong to the class of anionic clays and are largely employed for NO x detection, while few results are reported on VOCs. In this work, a novel LDH coprecipitation method is proposed. For the first time, a study comparing four LDHs (ZnAl-Cl, ZnFe-Cl, ZnAl-NO3, and MgAl-NO3) is carried out to investigate the sensing performances. As explored through several microscopy and spectroscopy analyses, LDHs show a morphology characterized by a large surface area and a three-dimensional hierarchical flowerlike architecture with micro- and nanopores that induce a fast diffusion and highly effective surface interaction of the target gases. The fabricated sensors, operating at room temperature, are able to reversibly and selectively detect acetone, ethanol, ammonia, and chlorine vapors, reaching significant sensing response values up to 6% at 21 °C. The results demonstrate that by changing the LDHs' composition, it is possible to modulate the sensitivity and selectivity of the sensor, helping the discrimination of different analytes, and the consequent integration on a sensor array paves the way for electronic nose development.

Angiopoietin-like 8 (ANGPTL8) as a potential predictor of NAFLD in paediatric patients with Prader-Willi Syndrome

PURPOSE

Angiopoietin-like 8 (ANGPTL8) is a liver- and adipose tissue-produced protein that predicts non-alcoholic fatty liver disease (NAFLD) and altered metabolic homeostasis in the general population as well as in persons with common and genetic obesity, including the Prader-Willi syndrome (PWS). However, its metabolic correlate in paediatric patients with respect to PWS is unknown.

METHODS

This cross-sectional study investigated circulating ANGPTL8 and adipocytokines levels in 28 PWS and 28 age-, sex- and BMI-matched children and adolescents (age, 7.0-17.8y) in relation to NAFLD and metabolic homeostasis assessed by OGTT, paediatric metabolic index (PMI) and fatty liver index (FLI), liver ultrasonography (US), as well as dual-energy X-ray absorptiometry (DEXA) for analysis of fat (FM) and fat-free mass (FFM).

RESULTS

At the set level of significance, PWS children showed lower values of FFM (p < 0.01) but healthier insulin profiles (p < 0.01) and PMI values (p < 0.05) than matched controls. By US, the prevalence of NAFLD was similar between groups but less severe in PWS than controls. Analysis of ANGPTL8 levels showed no difference between groups, yet only in PWS ANGPTL8 levels were associated with ALT levels, FLI values and NAFLD. In stepwise multivariable regression analysis on merged data, ANGPTL8 levels were independently predicted by BMI SDS, leptin levels and NAFLD.

CONCLUSION

ANGPTL8 levels are similar in PWS and controls and, overall, they are directly associated with the presence and severity of NAFLD in patients with PWS.

Novel insights in dimethyl carbonate-based extraction of polyhydroxybutyrate (PHB)

BACKGROUND

Plastic plays a crucial role in everyday life of human living, nevertheless it represents an undeniable source of land and water pollution. Polyhydroxybutyrate (PHB) is a bio-based and biodegradable polyester, which can be naturally produced by microorganisms capable of converting and accumulating carbon as intracellular granules. Hence, PHB-producing strains stand out as an alternative source to fossil-derived counterparts. However, the extraction strategy affects the recovery efficiency and the quality of PHB. In this study, PHB was produced by a genetically modified Escherichia coli strain and successively extracted using dimethyl carbonate (DMC) and ethanol as alternative solvent and polishing agent to chloroform and hexane. Eventually, a Life Cycle Assessment (LCA) study was performed for evaluating the environmental and health impact of using DMC.

RESULTS

Extraction yield and purity of PHB obtained via DMC, were quantified, and compared with those obtained via chloroform-based extraction. PHB yield values from DMC-based extraction were similar to or higher than those achieved by using chloroform (≥ 67%). To optimize the performance of extraction via DMC, different experimental conditions were tested, varying the biomass state (dry or wet) and the mixing time, in presence or in absence of a paper filter. Among 60, 90, 120 min, the mid-value allowed to achieve high extraction yield, both for dry and wet biomass. Physical and molecular dependence on the biomass state and solvent/antisolvent choice was established. The comparative LCA analysis promoted the application of DMC/ethanol rather than chloroform/hexane, as the best choice in terms of health prevention. However, an elevated impact score was achieved by DMC in the environmental-like categories in contrast with a minor contribution by its counterpart.

CONCLUSION

The multifaceted exploration of DMC-based PHB extraction herein reported extends the knowledge of the variables affecting PHB purification process. This work offers novel and valuable insights into PHB extraction process, including environmental aspects not discussed so far. The findings of our research question the DMC as a green solvent, though also the choice of the antisolvent can influence the impact on the examined categories.

3D printer waste, a new source of nanoplastic pollutants

Plastics pollution has been recognized as a serious environmental problem. Nevertheless, new plastic uses, and applications are still increasing. Among these new applications, three-dimensional resin printers have increased their use and popularity around the world showing a vertiginous annual-sales growth. However, this technology is also the origin of residues generation from the alcohol cleaning procedure at the end of each printing. This alcohol/resin mixture can originate unintentionally very small plastic particles that usually are not correctly disposed, and as consequence, could be easily released to the environment. In this work, the nanoparticle generation from 3D printer's cleaning procedure and their physicochemical characterization is reported. Nano-sized plastic particles are easily formed when the resin residues are dissolved in alcohol and placed under UV radiation from sunlight. These nanoparticles can agglomerate in seawater showing an average hydrodynamic diameter around 1 μm, whereas the same nanoparticles remain dispersed in ultrapure water, showing a hydrodynamic diameter of ≈300 nm. The formed nanoparticles showed an isoelectric point close to pH 2, which can facilitate their interaction with other positively charged pollutants. Thus, these unexpected plastic nanoparticles can become an environmental issue and public health risk.

25OH vitamin D levels in pediatric patients affected by Prader-Willi syndrome

PURPOSE

Obesity, insulin resistance, and puberty seem to influence and been inversely associated with 25-hydroxy vitamin D (25OHD) levels. To our knowledge, a study on 25OHD in children and adolescents with Prader-Willi syndrome (PWS), a genetic form of obesity, is not yet available.

OBJECTIVE

To analyze the 25OHD values in pediatric PWS subjects in comparison with a control group (CNT), highlighting the possible correlations with IR, BMD, body composition, pubertal stage, and GH therapy (GHT).

METHODS

Auxological and laboratory parameters, HOMA-IR, Vitamin D status, and bone density and body composition by DEXA scan were analyzed in 52 PWS and 110 controls (CNT), gender-, age-, and BMI-SD matched. None of them was on calcium or vitamin D. 20 PWS were on growth hormone (GH) therapy and 32 were previously treated.

RESULTS AND CONCLUSION

Altogether, PWS had similar values of 25OHD compared to CNT.16 PWS (30.7%) and 27 CNT (24.5%) had low 25OHD levels (< 20 ng/ml) (p = NS). 25OHD of PWS on GHT were comparable to those previously treated. In both groups, univariate analysis showed a negative correlation between 25OHD and fat mass% (FM%). GH therapy and pubertal stage were positively correlated with bone parameters analyzed by DXA. Multivariate regression confirmed only FM% as negative predictor of 25HOD in PWS patients, as previously described. GHT does not seem to influence 25OHD in PWS.

CONCLUSION

Our data showed that PWS had similar values of 25OHD compared to CNT. As already described, FM seems to be the only parameter influencing 25OHD levels. Finally, GHT does not seem to influence 25OHD metabolism in PWS.

Coupling Resistive Switching Devices with Neurons: State of the Art and Perspectives

Here we provide the state-of-the-art of bioelectronic interfacing between biological neuronal systems and artificial components, focusing the attention on the potentiality offered by intrinsically neuromorphic synthetic devices based on Resistive Switching (RS). Neuromorphic engineering is outside the scopes of this Perspective. Instead, our focus is on those materials and devices featuring genuine physical effects that could be sought as non-linearity, plasticity, excitation, and extinction which could be directly and more naturally coupled with living biological systems. In view of important applications, such as prosthetics and future life augmentation, a cybernetic parallelism is traced, between biological and artificial systems. We will discuss how such intrinsic features could reduce the complexity of conditioning networks for a more natural direct connection between biological and synthetic worlds. Putting together living systems with RS devices could represent a feasible though innovative perspective for the future of bionics.

Defining the role of nanonetting in the electrical behaviour of composite nanofiber/nets

The electrical behaviour of MWCNT-based composite nanofiber/nets can be tuned by controlling the morphology of the secondary nanoweb.

Disorders of glucose metabolism in Prader-Willi syndrome: Results of a multicenter Italian cohort study

BACKGROUND AND AIMS

Prader-Willi syndrome (PWS) is characterized by a high incidence of altered glucose metabolism (AGM). However, epidemiological data on impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) are still discordant.

METHODS AND RESULTS

We performed a multicenter study based on 274 PWS patients [144 females, aged 20.3 ± 10.4 yrs (range: 8.1-50.1 years)] evaluating the prevalence for AGM in the entire group, and according to age (children <10 yrs; adolescents 10-18 yrs, and adults >18 yrs), Body Mass Index (BMI = kg/m(2)), gender, genotypes (deletion or uniparental disomy for chromosome 15), and GH therapy (GHT) (untreated, previously or currently treated). Altogether, AGM was detected in 67 (24.4%) of patients (0.7% IFG, 10.2% IGT, 13.5% T2DM). The prevalence of AGM was correlated to age (p = 0.001), BMI (p = 0.001) and HOMA-IR (p = 0.001). However, gender, genotype, and GHT did not influence AGM development in univariate analysis. These data were confirmed as positive predictors when inserted in a multivariate analysis model.

CONCLUSION

This study is the first report on the prevalence of AGM in a large population of PWS. Overall, PWS subjects show a high prevalence of AGM that appears more common in obese and adult subjects. Our data confirm the main role of obesity on the individual metabolic risk clustering in PWS, and thus reinforce the concept that improvement in weight control remains the most important goal of any PWS treatment program.

Non-Alcoholic Fatty Liver Disease (NAFLD) in children and adolescents with Prader-Willi Syndrome (PWS)

We tested the hypothesis that patients with Prader-Willi syndrome (PWS) may be at lower risk of developing non-alcoholic fatty liver disease (NAFLD) because of a higher insulin sensitivity. Twenty-one PWS patients and 42 control subjects closely similar for age, gender, pubertal stage and body mass index (CNT), were studied. Metabolic profile and body composition were assessed. NAFLD was established by a validated method of US grading (range from G0 to G3). PWS patients showed a significantly better metabolic profile (lower waist circumference, fasting glucose levels, HOMA-IR, cholesterol, transaminase levels and trunk fat mass/fat mass ratio). Furthermore, NAFLD G1stage was significantly more frequent in PWS subjects (P < 0.05), whereas G2 stage was significantly more frequent in control patients (P < 0.05). NAFLD grading seems to correlate with body composition in PWS, also after adjustment for sex and GH treatment. To our knowledge, this is the first report suggesting a reduced risk of NAFLD in PWS children.

Silver nanoparticle ink technology: state of the art

Printed electronics will bring to the consumer level great breakthroughs and unique products in the near future, shifting the usual paradigm of electronic devices and circuit boards from hard boxes and rigid sheets into flexible thin layers and bringing disposable electronics, smart tags, and so on. The most promising tool to achieve the target depends upon the availability of nanotechnology-based functional inks. A certain delay in the innovation-transfer process to the market is now being observed. Nevertheless, the most widely diffused product, settled technology, and the highest sales volumes are related to the silver nanoparticle-based ink market, representing the best example of commercial nanotechnology today. This is a compact review on synthesis routes, main properties, and practical applications.

Ionic liquid-enhanced soft resistive switching devices

Left: SEM showing dendrites bridging the electrodes. Right: Retention test showing a final on/off ratio of 700 after 10 000+ s. The addition of IL to switching matrix triggers non-volatile memory and 10-fold reduction of operating voltage.

Dual step irradiation process for in situ generation and patterning of silver nanoparticles in a photocured film

Novel dual step irradiation process for the in situ generation and patterning of silver nanoparticles in a photocured matrix was developed.

Green and low-cost synthesis of PANI–TiO2 nanocomposite mesoporous films for photoelectrochemical water splitting

Green and low-cost synthesis procedure for preparation of PANI/TiO₂ mesoporous nanocomposite films with enhanced photocatalytic performance, thanks to a synergic reaction mechanism between PANI and TiO₂ under UV light irradiation.

Rice husk as bio-source of silica: preparation and characterization of PLA–silica bio-composites

Silica has been extracted from rice husk, employing a simple extraction for preparing poly(lactic acid) bio-composites with different filler contents.

Takotsubo syndrome and brachydactyly: a new heart-hand syndrome?

The Takotsubo syndrome (TTS) is a transient myocardic hypoadyskinesis so called for its typically aspect like the cages used by Japanese fisherman to trap octopus. Presently, several etiologies were considered for the development of TTS, the most accredited ones suggest that stress, adrenoreceptor hyperactivity and estrogens are the most important causes of transient morphofunctional alterations of left ventricle. We describe the case of 60 year-old woman with a chest pain occurred after a quarrel. Because of this, she went to the Emergency Department (ED) where T wave flat in lead D-I, increase of CK-MB mass and Troponin I were found. Subsequently, a coronary-ventriculography was performed and a diagnosis of Takotsubo syndrome was made. Also a bilateral IV toe brachydactyly was noted. In medical literature, there are many syndromes described about the association between skeletal alteration of the hands and heart abnormalities (heart-hand syndrome). The Authors wonder if this case can belong to this kind of complex malformations as well as if a molecular-genetic trait can link the two clinical aspects.

Polylactic acid and polylactic acid-based nanocomposite photooxidation

The importance of photooxidation in promoting formation of anhydride functional groups and thus promoting hydrolysis/biodegradation of polylactic acid and PLA nanocomposites were elucidated. PLA-based nanocomposites were prepared by adding 5% wt filler content of sodium montmorillonite (ClNa), sodium montmorillonite partially exchanged with Fe(III) (ClFe), organically modified montmorillonite (Cl20A), unmodified sepiolite (SEP), and fumed silica (SiO2). The pure PLA and nanocomposites were UV-light irradiated in artificial accelerated conditions representative of solar irradiation (λ > 300 nm) at 60 °C in air. The chemical modifications resulting from photooxidation were followed by IR and UV-visible spectroscopies. The infrared analyses of PLA photooxidation show the formation of a band at 1845 cm(-1) due to the formation of anhydrides. A photooxidation mechanism based on hydroperoxide decomposition is proposed. The mechanism proposed is confirmed by an increase in anhydride formation rate: the main responsible for this acceleration was identified as transition metals contained in the nanofillers as impurities and involved in the catalytic hydroperoxide decomposition.

MWNT Surface Self-Assembling in Fire Retardant Polyethylene-Carbon nanotubes nanocomposites

Multiwall carbon nanotubes (MWNT) were melt blended at different concentration with linear low density polyethylene (LLDPE). The nanotubes impart the fire-retardant characteristics to the polymer by formation of a thin protective film of MWNT/carbon char generated on the surface of the nanocomposites. The film formation mechanism is discussed

New hybrid organic–inorganic nanocomposites based on functional [Ti16O16(OEt)24(OEMA)8] nano-fillers

New hybrid nanocomposites based on a methacrylate functionalized titanium-oxo cluster as nano-cross-linker show improved mechanical properties, optical transparency and photochromic activity.

Seroprevalence of Helicobacter pylori infection in a group of hospitalized geriatric patients

BACKGROUND

In recent years several epidemiological surveys have reported the association between Helicobacter Pylori (HP), chronic ischemic heart disease (CHD) and cerebrovascular disease (CVD). None involved the geriatric population in which these diseases are prevalent.

METHODS

We investigated the HP seropositivity prevalence in a group of over 75-year-old subjects recruited among all patients consecutively admitted for various diseases in an Internal Medicine Department during a period of 9 months.

INTERVENTION

We measured HP IgG antibodies employing a commercially available kit based on reverse flow chromatography highly feasible and simple to perform and we investigated all patients for past or present CHD/CVD.

RESULTS

From our data, the prevalence of seropositivity to Hp does not differ from other wider age stratified studies; more in detail; in the over 90-year-old patients we found the same HP seropositivity prevalence as in younger group but were not able to confirm the progressive lowering or seroprevalence in extreme geriatric age.

CONCLUSIONS

No clear correlation between HP seroprevalence and CHD and CVD was found, but a link with CHD seems possible for the determinant (age) is common to both conditions.

Diphtheria antitoxin levels in the 14-30-year age group in Italy

In order to verify diphtheria immunity a seroepidemiological survey was performed in 1996-1997. Serum samples were obtained from 501 subjects 14 years old, recruited at 8 schools in Rome, and from 490 subjects 20-30 years old recruited from 15 Italian regions. Serum diphtheria antitoxin was titrated using the Vero cell assay. The minimum protection level of antitoxin was set at 0.01 IU ml-1. The results show that the younger population have a good immunity to diphtheria while a large proportion of young adults is devoid of protective levels of diphtheria antitoxin. Out of the 501 subjects 14 years old, 495 (98.8%) had a diphtheria antitoxin titre > or = 0.01 IU ml(-1). Only 6 (1.2%) teenagers were susceptible. Out of the 490 subjects 20-30 years old, 109 (22.2%) were susceptible, 381 (77.8%) had a diphtheria antitoxin titre > or = 0.01 IU ml(-1). The data stress for booster immunization at the end of junior high school.

[Tertiary hyperparathyroidism during chronic kidney failure under dialysis treatment. Apropos a clinical case]

The authors describes a case of tertiary hyperparathyroidism (HPTH) in a uremic patient on intermittent dialysis treatment: the term refers to an adenoma with ensuing uncontrolled parathormone (PTH) secretion rate arising on the ground of hyperstimulated hypertrophied parathyroid glands. The syndrome was heralded clinically by bone pain, psychiatric disorder and biochemically by increased levels of calcium and alkaline phosphatase (AP), while parathormone (PTH), did not change from basal very high levels as commonly found in uraemic patients. As hypercalcemia in the hemodialyzed is an infrequent finding the only alternative explanation could have been hypercalcemic secondary HPTH related to hyperplastic autonomous parathyroids. For no clinical and laboratory findings as well as US findings and double scintigraphy (99mTc and 201mTl) may suggest differential diagnosis the patient underwent total parathyroidectomy which actually revealed an adenoma of the left superior parathyroid gland. Bone pain and psychiatric disturbances disappeared and now get well on chronic dialysis treatment and 1.25-OH Vit D3 supplement.

[Abdominal lymph nodes: the echographic evaluation criteria]

US patterns of abdominal lymph nodes were investigated in patients with neoplastic and non-neoplastic diseases, and in randomly-chosen subjects with no evidence of any pathologic condition. Major longitudinal diameter (DMax) was statistically evaluated, together with minor transverse diameter (DMin), roundness index (RI), and structural index (IS)-i.e., the presence of a central hyperechoic line (as the US sign of normal lymph node architecture). DMax proved to be useless for distinguishing between groups. The presence of a central hyperechoic line was the most useful parameter, although the extant 3 (DMin, RI, IS) were also useful for distinguishing between groups. By correlating each numerical parameter with the hyperechoic line sign an even better discrimination was obtained. Thus, it can be assumed that only a combined and comprehensive evaluation of the above parameters makes the best criterion to differentiate between neoplastic and non-neoplastic abdominal lymph nodes.

[Enlargement of the lymph nodes of the hilus hepatis: a further ultrasonographic sign of acute viral hepatitis]

Enlarged hilar lymph nodes are usually reported as the most frequent US finding in acute viral hepatitis. The authors compared this finding with other pathologic conditions--i.e., asymptomatic cholelithiasis and acute cholecystitis--and with gallbladder wall thickening, which is also observed in acute hepatitis. From their results, they drew the following conclusions: a) lymph node enlargement at the hepatic hilum was a very frequent finding (11/15) at US in the patients with acute viral hepatitis; b) its occurrence was statistically more frequent than in both cholelithiasis and cholecystitis; c) gallbladder wall thickening was found in 53.3% of the patients with acute hepatitis; d) lymph node enlargement and gallbladder wall thickening were not related. The authors suppose enlarged lymph nodes to be suggestive of hepatic damage in a pattern of immunological hyperactivity rather than the result of inflammatory gallbladder conditions during acute hepatitis. Since only 2 cases could be followed, the authors cannot discuss the prognostic significance of enlarged lymph nodes after cytolytic enzymatic signs of viral hepatitis have disappeared.

[Kinetic analysis of bromosulfophthalein in alcoholic liver disease]

The Authors evaluated BSF kinetics in 100 subjects affected by hepatic disorders of different degrees of progression produced by chronic alcoholic abuse in comparison with 22 healthy subjects. CBSF and Ke, model independent parameters, were found to discriminate better among groups; model dependent parameters showed, above all, a progressive reduction of fractional hepatic uptake (a) as liver damage worsens and a typical pattern of cirrhosis, especially of decompensated form, characterized by a high fractional hepatic plasma reflux (b). BSF kinetics also showed the early cholestatic effect produced by alcohol. Even if kinetic analysis proved useful, from a clinical point of view, the Authors feel that the simple 45 min BSF retention test and still better the one for Ki (uncorrected initial slope of the disappearance curve) are sufficient to detect and discriminate among the different stages of liver alcoholic diseases.