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We report an in situ high pressure investigation of the structural change in vitreous As(2)S(3) up to 60 GPa using the diamond anvil cell and energy dispersive x-ray absorption spectroscopy. The main finding of the present study is a gradual elongation of the average As-S bond length, which takes place in the pressure range of 15-50 GPa. This change is interpreted as a signature of the coordination number increase around As atoms. The negative shift of the As K absorption edge position confirms the progressive metallization of the glass at high pressure. The observed changes are reversible after pressure release.

We present a concept for the payload SAGACE, the Spectroscopic Active Galaxies And Cluster Explorer, devoted to study the evolution of Universe structures using different observables, all of them in the mm/submm wavelength. The SAGACE payload is made of a passively cooled 3 m telescope, a cryogenic Fourier Transform Spectrometer (FTS) and detector arrays to be operated at 0.3 K by a 3He fridge. The detectors are Ti/Au Transition Edge Sensor (TES) bolometers with a NEP

To estimate the opacity of very high‐energy photons with the background light, we have modelled the extragalactic optical and infrared diffuse light using available information on cosmic sources in the universe from far‐UV to sub‐millimeter wavelengths over a wide range of cosmic epochs. To this end we have used number counts, redshift distributions, luminosity functions of extragalactic sources and direct measurements or upper limits to the extragalactic backgrounds by COBE. From the redshift‐dependent background spectrum, the photon‐photon opacities for sources of high‐energy emission at any redshifts were then computed. We have applied our photon‐photon opacity estimates to the analysis of spectral data at TeV energies on a few BLAZARs of particular interest (including a z = 0.54 quasar detected by MAGIC, 3C279). We find no evidence in current data for any truly diffuse background components in addition to those from resolved sources. We have tested in particular the effects of a photon background orig...

Extended x-ray absorption fine structure has been measured at the K edge of copper in CuScO2 and CuLaO2 to investigate the local origin of negative thermal expansion (NTE) along the c axis. A positive expansion of the Cu-O bond has been measured within the entire temperature interval to be contrasted with the negative expansion of the distance between average atomic positions measured by diffraction; the inadequacy of the riding correction to diffraction data has been evidenced. The weak temperature dependence of the parallel mean-square relative displacement (MSRD) indicates a rather stiff Cu-O bond, while the large perpendicular MSRD measures an intense relative motion of copper with respect to oxygen atoms perpendicular to the c axis. The comparison between the two compounds enlightens the relevance of the correlation of perpendicular motion to quantitatively explain the apparent NTE of the Cu-O bond.

The appearance of an increased pulmonary artery (PA) pressure is an important moment in the clinical history of mitral stenosis. A direct measurement of PA pressure levels is possible only with rightsided cardiac catheterization. This technique, being invasive is not risk-free and, consequently, many noninvasive methods for the evaluation of PA pressure have been proposed.1 These procedures usually lack sensitivity and are limited in their ability to detect and quantify mild to moderate modifications of PA pressure. The introduction of Doppler echocardiography allowed the development of new procedures.2–6 Unfortunately this method is not applicable in the absence of Doppler-detectable tricuspid regurgitation.7 Furthermore, the computed systolic PA pressure value is approximate because a clinical estimation of the right atrial pressure is necessary. Moreover, a good acoustic window and satisfactory flow tracings are indispensable. To avoid the aforementioned drawbacks we attempted a different approach to the noninvasive estimation of PA pressure, devising a method based on the modifications induced by an increased PA pressure on the power spectrum of the pulmonary component of the second heart sound. We used fast-Fourier analysis to examine the acoustic characteristics of this heart sound and to define its frequency distribution in patients with normal and increased PA pressure to search for a relation between the PA pressure level and the spectral characteristics of the pulmonary component of the second heart sound.

A comparative study of the effects of oral and sublingual captopril on the hemodynamics of the peripheral musculocutaneous vasculature was carried out on ten patients with essential hypertension. Both routes of administration of captopril lead to lower blood pressure and decreased regional resistance, and to an increased arterial blood flow at rest. The first measurable effect and the peak effect on blood pressure and peripheral hemodynamics appear slightly earlier with sublingual administration. The data provided in this study support the usefulness of the sublingual route in clinical situations in which oral administration of captopril is not feasible.

The investigations on the origin of negative thermal expansion (NTE) in crystals can greatly benefit from the joint use of Bragg diffraction and extended x-ray absorption fine structure (EXAFS). In this paper, the relative merits of the two techniques are critically discussed, and recent results on CuCl (zincblende structure) and Cu2O and Ag2O (cuprite structure) are compared. The tension effect giving rise to NTE can be correlated to the anisotropy of the mean square relative displacements.

Based on the indications in the literature of the transmission of highly pathogenic bacteria in musculoskeletal allograft implants, the cultural results for allografts removed and implanted in conditions of asepsis between 1997 and 2000 in BTM were analyzed: 4014 allografts (3117 from a living donor, 897 from a cadaver) and 3479 implants (2191 with allografts from living donors and 1288 with allografts from cadavers). Explanted tissues: these were positive to culture in 292 out of 3117 (9.4%) allografts from living donors; the bacteria isolated showed low pathogenicity. Out of 897 allografts 117 cadaver donors bacteria with low pathogenicity were isolated in 68 (7.6%) and high pathogenicity in 12 (1.3%). Implants: cultures were positive in 116/2191 (5.3%) implants with allografts from living donors and in 55/1288 (4.3%) implants with allografts from cadavers. The bacteria isolated are the same as those shown in the explants. In living donors contamination is similar as regards incidence and type of microorganism to that observed in surgical theatres during routine surgery. Contamination seems to be greater in allografts removed from cadavers who died as a result of trauma, in the presence of positive hemocultures, prolonged catheterization and intubation, explantation of the pelvis and removal of several organs and tissues prior to musculoskeletal allograft.

To show the relevance of cosmetic appearance in the adequate treatment of patients with exstrophy-epispadias complex (EEC), and to indicate that surgery by experienced teams can improve the long-term treatment forecast and the patient's body image.From 1978 to 2002, 71 patients diagnosed with EEC were treated in the authors' institution; 24 (aged 2-23 years) were selected to undergo different surgical procedures. The criterion for surgery considered interviews conducted by the psychology team with the parents and children. The plastic surgery and paediatric urology teams carried out the procedures jointly; the follow-up was 0.33-7 years.Five female patients and six male had abdominoplasty to treat multiple scars; eight had intermittent catheterization conduits repositioned from the right iliac fossa to the umbilicus. Six female patients had plastic surgery of the external genitalia and three had a broad mobilization of the urogenital sinus. Thirteen male patients had a small penis and had the corpora cavernosa fully mobilized and the penis reconstructed. Five female patients and one male had anterior osteotomy. One patient with no left testis had it replaced and one patient with uterine prolapse had the uterus fixed to the posterior abdominal wall. Six patients had a second procedure, in two because the outcome of the initial operation was poor and in the others to complement the initial treatment. In all but one patient there was an improvement in the objective criteria, e.g. school absences, difficulty in establishing long-lasting social relationships and refusal to participate in sports activities. However, none of the patients would attempt sexual intercourse.Body image, self-esteem, sexuality, sexual function and fertility are deemed crucial by adolescents; in patients with EEC customised surgical procedures can give a satisfactory aesthetic outcome, and be a further reason for adequately following occasional urinary complications and renal function, to avoid loss to follow-up.

Kaposi's sarcoma (KS) is a lympho-angioproliferative disorder characterized by angiomatous nodules and plaques that mainly affect the skin. The disease is consistently associated with human herpesvirus-8 (HHV8) and with a state of preexistent immunosuppression. Dendritic cells (DCs) have an instrumental role in the activation and function of both innate and adaptative immune responses. At least 2 distinct subsets have been characterized in peripheral blood based on phenotypic markers: myeloid DCs (CD11c+), associated with Ag uptake, T cell activation and ability to secrete IL-12, and plasmacytoid DCs, high virus-induced IFN-alpha producing cells. Because of the role of both DC subtypes in antiviral and antitumor induced responses, we hypothesized that DCs could be involved in the onset and evolution of KS.Thirty-five patients with mediterranean KS assigned to different clinical stages were compared with 51 healthy control subjects. Peripheral blood DCs were quantified and functionally characterised by flow cytometry directly on whole blood samples. The production of the regulatory cytokines, IL-12 and IL-10, was assessed as intracellular accumulation after incubation with or without lipopolysaccharide (LPS).Myeloid DCs identified as lineage-/HLA-DR+/CD11c+ cells were significantly lower in KS patients than in controls (0.54+/-0.25 vs 0.69 +/-0.26% of the peripheral blood mononuclear cells; p0.017). Furthermore, CD11c+ DCs were lower in patients with more diffuse disease. Plasmacytoid DCs, identified as lineage-/HLA-DR+/CD123+ cells, were lower in KS patients (0.23+/-0.19 vs 0.36+/-0.17; p0.001). DCs from KS patients were more mature, as assessed by expression of the maturation marker CD83, and showed an impaired ability to produce IL-12 upon LPS stimulation, as compared with controls.The numerical and functional alterations of peripheral blood DCs observed in KS patients suggest an involvement of these cells in the onset and evolution of the disease.

We present the final band-merged ELAIS catalogue at 6.7, 15, 90, and 175 $��$m, and the associated data at u,g,r,i,z,J,H,K, and 20cm. The origin of the survey, infrared and radio observations, data-reduction and optical identifications are briefly reviewed, and a summary of the area covered, and completeness limit for each infrared band is given. A detailed discussion of the band-merging and optical association strategy is given. The total catalogues consists of 2860 sources. For extragalactic sources observed in 3 or more infrared bands, colour-colour diagrams are presented and discussed in terms of the contributing infrared populations. Spectral energy distributions are shown for selected sources and compared with cirrus, M82 and Arp220 starburst, and AGN dust torus models. Spectroscopic redshifts are tabulated, where available. For the N1 and N2 areas, the INT ugriz Wide Field Survey, permits photometric redshifts to be estimated for galaxies and quasars. These agree well with the spectroscopic redshifts, within the uncertainty of the photometric method. The redshift distribution is given for selected ELAIS bands and colour-redshift diagrams are discussed. There is a high proportion of ultraluminous infrared galaxies in the ELAIS Catalogue ($> 10 %$ of 15 $��$m sources), many with Arp220-like colours. 10 hyperluminous infrared galaxies and 10 EROs are found in the survey. The large numbers of ultraluminous galaxies imply very strong evolution in the star-formation rate between z = 0 and 1., 21 pages, 31 figures. Accepted for publication in MNRAS

To evaluate left ventricular morphology and function in a large population of patients with beta thalassaemia.Echo Doppler assessment of left ventricular function and correlation of cardiovascular data with haematological data.Thalassaemia unit in a tertiary referral centre.197 young adults with beta thalassaemia, following an adequate transfusional and chelation treatment regimen, without clinical signs of cardiopulmonary involvement. The control group consisted of 213 healthy subjects.Left ventricular volumes, mass index, and mass/volume ratio were increased. Diastolic and systolic shapes were different, the left ventricle maintaining an ellipsoidal shape. The ejection fraction was reduced, and was50% in 33 patients. Stroke volume and cardiac index were increased, and systemic vascular resistance was decreased. Fractional shortening and mean velocity of circumferential shortening were decreased. Meridional end systolic and peak systolic stress were increased, as was circumferential end systolic stress. The contractile state was reduced while the functional preload index did not differ. Left ventricular diastolic function, evaluated from the mitral inflow, showed a slightly prolonged isovolumic relaxation time, increased flow velocity integrals, and an increased E/A ratio. Among the haematological data, only serum ferritin showed a weak negative correlation with left ventricular ejection fraction. The patients with the highest serum ferritin (2500 ng/ml) had the lowest ejection fraction.Patients with beta thalassaemia on an adequate transfusion and chelation treatment regimen show abnormal left ventricular remodelling with increased volumes, mass, and mass/volume ratio. Systolic chamber function and contractile state are reduced, with a slightly increased afterload. These findings seem mainly to be related to the increased cardiac output caused by chronic anaemia. Left ventricular performance is better preserved when chelation treatment is adjusted to maintain the serum ferritin concentration at1000 ng/ml.

In a thorax surgery domain the V.A.T.S. is the important new treatment for particular thorax diseases. authors would like to show the advantages using V.A.T.S. for the therapy of peripheric lung nodules, also using a CT-guided extemporary cytologic tipization. The CT-guided biopsy and then an extemporary cytologic tipization, represent the first steps for lung nodules candidated to the V.A.T.S. These lesions have got singular aspects: benign lesions, methastasts, specific and unknown lesions. In that way traditional surgery is for primitive lung neoplasm in order to have a certain oncologic solution and because it is possible to test the complication of large resection. The CT-guided cytologic tipization can be done by a particular kit invented from the authors: a flessible needle works like an anchor and is a good repair of a nodule in order to proceed with V.A.T.S. This method has been utilized for 45 patients with good results.

Understanding the molecular basis of the metastatic spread of cancer and the underlying mechanisms is crucial for the development and appropriate clinical use of novel therapeutic agents directed at prevention of metastasis. Retinoids have been reported to inhibit cell proliferation, modulate cell differentiation, enhance apoptosis and to prevent the conversion of in situ cancer to locally invasive malignancy by suppressing the invasive process as well as by inhibiting angiogenesis. Fenretinide (4-HPR), a synthetic derivative of retinoic acid, is less toxic than natural retinoids and is active in the prevention and treatment of a variety of tumours in animal models. Its efficacy in cancer chemoprevention and therapy has been investigated in clinical trials.In order to evaluate the effects of 4-HPR on the late stages of tumour progression, chemically transformed BALB/c 3T3 cells, showing a fully malignant phenotype, were exposed to 4-HPR (0.25-10 microM; 72 hours pre-treatment) and then analysed for in vitro invasive ability. The possible mechanisms of action responsible for the anti-invasive activity of 4-HPR were investigated, analysing cellular adhesion, motility, and proteolytic capability.Data showed that 4-HPR significantly inhibited the invasive phenotype of chemically transformed cells; the reduction in Matrigel invasion was dose-dependent and seemed not to be related to cytotoxic effects or reduction in cell proliferation rates induced by 4-HPR assayed doses. The 4-HPR-induced decrease in chemotactic motility of transformed cells correlated well with the invasion inhibition. 4-HPR, at active concentrations, differently affected cell adhesion to the extracellular matrix, depending on the coating substrate used (laminin, collagen IV, fibronectin and vitronectin). 4-HPR treatment significantly enhanced cell adhesion to laminin, while reducing cell-vitronectin attachment. It did not modify the attachment of the cells to fibronectin and collagen IV. Zymographic analysis failed to demonstrate 4-HPR involvement in the modulation of the activity and expression of gelatine degrading enzymes.These data suggest that 4-HPR inhibits tumour cell invasion through a basement-like matrix, by suppressing chemotactic motility and by altering cell-matrix interactions.

Several natural products have been found to exhibit a chemopreventive activity both in in vivo and in vitro experimental systems. Among them, protease inhibitors seem to play a key role in the regulation of growth and phenotypic expression of transformed cells as well as in the regulation of the late events of carcinogenesis. We evaluated the effect of antipain (AP), a natural protease inhibitor, on chemically induced BALB/c 3T3 cell transformation, on invasion and chemotactic motility of transformed cells and on their gelatinase expression.BALB/c 3T3 cells were plated and exposed to 2.5 micrograms/ml 3-MCA or 50 micrograms/ml, 1,2-DBE. The effect of a non-cytotoxic dosage of AP (10 microM) was studied by: a) pretreating cells with AP for 48 hours before the carcinogen exposure; b) adding AP simultaneously to the carcinogen treatment; c) chronic addition of AP at each medium change throughout the experimental duration. The effectiveness of the treatment was analysed as the ability to reduce or inhibit the occurrence of transformed foci. Modulation of the invasive phenotype by anti-transforming dosages of AP was evaluated by in vitro Matrigel invasion assay. Gelatin zymography was performed in order to assess AP regulation of proteolytic enzymes, such as metalloproteases, involved in invasion and metastasis.AP treatment can reduce the transformation rate both in 3-MCA- and 1,2-DBE-initiated cells. Its effectiveness depends on the administration schedule, and chronic addition seems to be the most effective treatment. The concentration of AP, which is effective in the antitransformation assay, is not able to significantly affect the migration and invasion of chemically transformed cells or their gelatinase activity.AP can suppress chemically induced BALB/c 3T3 cell transformation through mechanisms which do not involve modulation of the invasive phenotype.

The fact that hepatocellular carcinoma (HCC) has different epidemiological distributions in different parts of the world has facilitated the identification of a series of associated risk factors (Johnson 1996). For instance, a clear association has been shown between HCC and hepatitis B virus (HBV) in areas of the world where HCC has a high incidence (China, Southeast Asia and northern Africa) (Johnson 1996). HCC is also now known to be associated with other risk factors such as hepatitis C virus (HCV), aflatoxins, sex hormones and some metabolic diseases (Johnson 1996; Graham and Alistar 1996). Moreover, there is no doubt that different combinations of risk factors account for the variations in incidence to be found in different geographical areas: for example, exposure to aflatoxin and carriage of hepatitis B surface antigen (HBsAg) are both significant risk factors, but the combination of the two exposes the individual to a much higher risk (Zeman et al. 1985). Furthermore, new diagnostic methods have been developed that allow direct assessment of risk factors. Thus, in recent years it has been possible to detect the HBV surface antigen (HBsAg) and HCC antibodies, and it is now also possible to reveal aflatoxin adducts of DNA in biological fluids as a measure of aflatoxin exposure (Ross et al. 1992).

The paper presents the results of the Sn neutron transport and activation calculation to evaluate the activated corrosion product source terms related to the ITER divertor primary heat transfer system. The integrated radiation transport and activation methodological approach based on the calculation sequence VITAMIN(ENEA)-SCALE-ANITA has been used. The divertor cassette has been subdivided in five regions: inboard and outboard vertical targets, dome, inboard and outboard wings. The heat sink material is Glidcop Al-25 and the support material is AISI 316LN-IG. The divertor cassette body material is AISI 316LN-IG. The impact of various protective layer materials (Beryllium, CFC, Tungsten) on the neutron spectra and on the activation results have been investigated. The reaction rates and the activation data for both the steel and the copper alloy needed by the Pactole code have been produced by means of the RR-PACT module.

The algebraic coupled-channels formalism based on SO(3,1) symmetry, originally proposed by Alhassid and Iachello (1989) for the description of heavy-ion reactions in the Fraunhofer diffraction regime, appears to be applicable also to reactions in the Fresnel regime, at the cost of some modifications, whose importance increases with decreasing energy and is crucial in the proximity of the Coulomb barrier.

In osteosarcoma, resistance to chemotherapy and metastatic spread are the most important mechanisms responsible for the failure of current multimodal therapeutic programs. We have shown previously that overexpression of the MDR1 gene product P-glycoprotein is the most important predictor of an adverse clinical course in patients with osteosarcoma. treated with chemotherapy. In this study, we analyzed the relationship between P-glycoprotein expression and local aggressiveness and systemic dissemination of multidrug-resistant (MDR) human osteosarcoma cells. Compared to parental sensitive cells, MDR cells showed a decreased tumorigenicity,and metastatic ability in athymic mice, together with a reduced migratory and invasive ability and a lower homotypic adhesion ability in vitro, suggesting that P-glycoprotein overexpression is associated with a less malignant phenotype. These experimental observations were confirmed by clinical data. In fact, the time of appearance of lung metastases in a series of osteosarcoma patients treated with chemotherapy was significantly shorter in the group of cases with no expression of P-glycoprotein in the primary lesion compared to the group with P-glycoprotein overexpression. Moreover, the incidence of P-glycoprotein overexpression was found to be higher among patients with localized disease at the clinical onset than in patients with evidence of metastasis at the time of diagnosis. These data indicate that, in osteosarcoma, the MDR phenotype is not associated with a more aggressive behavior both in vitro and in clinical settings, suggesting that the previously shown association of the MDR phenotype with a worse outcome in osteosarcoma is not related to a higher metastatic ability of cells with P-glycoprotein overexpression but is more likely due to their lack of responsiveness to cytotoxic drugs.

In upper middle age healthy subjects the functional cardiac reserve is known to be decreased (Port et al., 1980; Aubert et al., 1994). On the other hand regular physical exercise improves the cardiovascular function (Nishimura et al., 1980). The aim of this study was to establish whether regular physical exercise is associated with a significant change in the ageing process of the cardiovascular system.

Hypertrophic cardiomyopathy (HCM) is a typical primary cardiac disease characterized by diastolic abnormal function due to both prolonged relaxation and decreased compliance (Sanderson et al., 1977; SpiritoMaron, 1990). Since the contribution of the atrial systole to ventricular filling is usually increased, the appearance of a fourth heart sound (S4) is a common finding in HCM. This sound is related to the ventricular compliance and to the atrial contractility. It is generated during the rapid setting into vibration of the left ventricular walls that results from the rapid rush of the blood due to the atrial contraction (Nishimura et al., 1989; Tavel, 1978). The aim of this study is to look for relationships between the frequency peak of S4 and various mono- and two-dimensional echocardiographic parameters in order to identify those cardiac structures involved in its genesis and obtaining an estimation of the stiffness of the acoustic vibrating system with a simply vibratory model (Baracca et al., 1991).

Over the past decade there have been considerable advances in cardiac electrostimulation technologies. However, there are still reports of electromagnetic interference with pacemakers and pacemaker patients. We have studied the effects of various electromagnetic sources (short-wave diathermy, electrosurgical knives, electrotherapy and radiofrequencies) on both humans and animals. The results of the studies were completely negative and, therefore, we are convinced that today's pacemakers are much more reliable and hence less subject to interference from external electromagnetic sources. We performed the following tests: (a) Short-wave diathermy: various electrode positions in pigs and 8 patients with pacemakers. (b) Electrosurgical knives: several tests on pigs with unipolar electrosurgical knife; 6 tests on humans during automatic defibrillator implantation using two-pole electrosurgical knives; 23 pacemaker patients underwent abdominal surgery (3 inguinal hernias, 12 gastric resections; 6 cholecystotomies, 2 aortic aneurysms-with two-pole electrosurgical knives). (c) Electrotherapy (TENS): on pigs. (d) Radiofrequency (RF) for transcatheter ablation-several tests on pigs.

The transmission and reflection properties of a plane isotropic-pseudochiral interface under excitation of plane waves is considered. The development of the solution is obtained by using the conventional boundary conditions in the transverse plane of the structure with respect to the normal axis of the interface plane. Several interesting characteristics of the reflected and transmitted plane waves have been obtained depending on the constitutive parameters and the pseudochirality admittance. >

With appropriate spatial resolution, images of spiral galaxies in thermal infrared (similar to 10 mu m and beyond) often reveal a bright central component, distinct from the stellar bulge, superimposed on a disk with prominent spiral arms. ISO and Spitzer studies have shown that much of the scatter in the mid-infrared colors of spiral galaxies is related to changes in the relative importance of these two components, rather than to other modifications, such as the morphological type or star formation rate, that affect the properties of the galaxy as a whole. With the Herschel imaging capability from 70 to 500 mu m, we revisit this two-component approach at longer wavelengths, to see if it still provides a working description of the brightness distribution of galaxies, and to determine its implications on the interpretation of global far-infrared properties of galaxies. We quantify the luminosity of the central component by both a decomposition of the radial surface brightness profile and a direct extraction in 2D. We find the central component contribution is variable within the three galaxies in our sample, possibly connected more directly to the presence of a bar than to the morphological type. The central component's relative contribution is at its maximum in the mid-infrared range and drops around 160 mu m to reach a constant value beyond 200 mu m. The central component contains a greater fraction of hot dust than the disk component, and while the colors of the central components are scattered, colors of the disk components are more homogenous from one galaxy to the next.

A case of an undetected myocardial infarction in a patient with diabetes mellitus in which the first clinical sign was a syncope due to rupture of the left ventricular inferior wall is described. Survival was enhanced by a fast diagnosis (aided by the availability of an ECO 2D in the emergency room), by emergency pericardiocentesis with temporary haemodynamic stabilization and by prompt access to the Cardiosurgical Unit. A prompt diagnosis and treatment can allow the survival of patients, even in the extreme case that the ventricular wall rupture represents the first clinical manifestation of the myocardial infarction. The left ventricular free wall rupture in the course of myocardial infarction has a subacute pattern in about 30%, due to various mechanisms such as thrombosis or pericardial adherence over the ruptured wall.

Ethylene dibromide was capable of inducing in vitro transformation of BALB/c 3T3 cells either in the presence or in the absence of exogenous metabolic activation (S9-mix). This transforming effect was evidenced by the induction of a higher number of transformed foci as compared to the controls performed with untreated cells or solvent vehicle-treated cells. In the absence of exogenous activation, all assayed doses (ranging from 23.4 micrograms/ml to 187.9 micrograms/ml) exerted transforming activity. Number of foci obtained in EDB-treated plates antransformation frequency of the target cells were higher than those detected in the transformation test performed in the presence of S9-mix.

Modifications in the neurogenic control are important in cardiovascular adaptation to physical training. To examine the influence of such variations on arterial blood pressure, heart rate and limb blood flow the Authors have studied the reaction to cardiovascular stress tests of soccer players and sedentary controls. No difference was found in the blood flow response between athletes and sedentary subjects. However, the tests inducing sympathetic activation determined blood pressure response of different intensity, possibly related to the differences in the autonomic nervous system control.

Five cases of annulo-aortic ectasia are described: etiology was cystic medial necrosis in three, syphylitic aortitis in one and giant-cell aorto-arteritis in another. Apart from the latter patient, in whom the ascending aorta was not truly aneurysmal and aortic valve replacement and aneurysmorraphy were considered adequate, total replacement of the ascending aorta and valve was employed in every case. All patients survived without any complication related to the technique, and are completely asymptomatic 14 to 26 months after the operation. The available techniques for managing annulo-aortic ectasia are reviewed, and their merits and drawbacks discussed.

The effects of single orally-administered dose of enalapril and captopril on central and district-peripheral circulations have been studied in 20 patients with essential arterial hypertension. Either drug caused a decrease in arterial pressure, telesystolic and telediastolic parietal stress, and a reduction in the peripheral vascular resistance of upper limb district. Furthermore, at the upper limb district level, increases in arterial flow and venous-system capacity have been observed. The entity of these modifications induced by enalapril and captopril appeared comparable, according to the respective peak-time and used dosages. Under this study conditions, the difference between the drugs resulted to be essentially of chronological nature.

Conservative surgery of the mitral valve is a very appealing procedure. In the last 3 years (1984–1987), 40 patients, aged 11 to 72 years (mean age of 46,33 years), underwent mitral repair in our department, alone or in combination with other surgical procedures. Seventeen patients had mitral insufficiency (M.I.), (five congenital and 12 acquired), while 23 had mitral stenosis. All the patients had preoperative echocardiographic evaluation. Surgical procedures included open commissurotomy in 23 patients (57.5%), reconstruction of the septal commissure in five (12.5%), quandrangular resection for posterior leaflet prolapse in seven (17.5%), and repair of annulus dilatation by means of annuloplasty in five (12.5%). No hospital deaths were observed. All the patients entered a follow-up study in which 2D echocardiography and Doppler echocardiography were used to assess the long-term results of the procedures. After a mean follow-up of 36 months, the results can be summarized as follows: Mitral stenosis: good 73.9%; fair 26.1%; bad 0%. Mitral insufficiency: good (no regurgitation) 65%; fair (mild regurgitation) 25%; bad (waiting for valve replacement) 10%.

The need for and the efficacy of oral anticoagulation in patients who have undergone prosthetic valve replacement is widely demonstrated. The aim of this study is to assess how dicumarolic treatment is understood and actually accomplished by patients. A 30-question form was sent to 292 patients discharged following valve replacement, 5 to 45 months (mean: 19 months) after surgery. All of the 220 patients who submitted their answers, were effectively on oral anticoagulants. More than 95% of them knew exactly the suggested optimal prothrombin activity range. About one fifth of the patients has laboratory tests performed weekly, and nearly one half does so every 10-15 days. One fourth of the patients does not consult a physician for decision making about drug dosage. Difficulties in maintaining anticoagulation in the desired range, occurring at least once every month, are reported by 18.6% of patients. Haemorrhage was never experienced by 83.18%; in one single case thromboembolism was apparent. A few patients (2.27%) think of oral anticoagulation as a "difficult" treatment. We conclude that complete information is needed, about the aim, the modality, and the potential hazard of oral anticoagulation, so that a better understanding of the treatment and an improved cooperation between physicians and patients can result in benefits, in terms of the safety and efficacy of life-long antithrombotic therapy.