Abstract: PURPOSE: This study is aimed at verifying if the surgeon's experience has an impact on the risk of conversion to open surgery of laparoscopic left colectomy performed in obese patients. METHODS: A multiple logistic regression analysis was performed of 181 laparoscopic left hemicolectomies completed between April 2001 and June 2006. The results were analysed statistically in relation to the learning curve, by comparing factors that could have had an impact on the risk of conversion in the first 91 cases and in the last 90 cases. RESULTS: The overall conversion rate was 11%. Only weight level was found to be predictive of conversion to open surgery. No death was observed. Sixteen patients presented postoperative complications (8.8%), with no significant differences between obese and nonobese patients (P=0.95). The conversion rate was higher in the group of the first 91 cases: 15.6% versus 6.6% (P=0.05). Average body mass index of converted patients resulted as being higher than that of nonconverted ones (29.97+/-3.76 vs. 25.48+/-3.72; P<0.001) during the first period of the learning curve, but the difference was not observed during the second period (P=0.87). On multiple logistic regression analysis, obesity was found to be predictive of conversion only during the first period. CONCLUSIONS: The data indicate that the laparoscopic colorectal surgery is feasible and effective in obese patients both when the surgeon is expert in laparoscopic colorectal resection and at the initial phase of the experience. At the initial phase of the experience obesity constitutes a higher risk of conversion to open surgery.

Abstract: Air microbial sampling is a subject of great interest in different fields of human activity; however, generally accepted indications, concerning both the sampling methods to be used and the interpretation of the results, are still lacking. The whole theme is greatly debated and several problems remains to be solved. The aim of this article is to provide knowledge relating to the problems associated with air microbial sampling, underlining the aspects to be considered in order to choice the sampling method on the basis of the objective of the sampling itself and on the knowledge of the characteristics and limits of the different methods.

Abstract: The regulatory functions of Rab proteins in membrane trafficking lie in their ability to perform as molecular switches that oscillate between a GTP- and a GDP-bound conformation. The role of tomato LeRab11a in secretion was analyzed in tobacco protoplasts. Green fluorescent protein (GFP)/red fluorescent protein (RFP)-tagged LeRab11a was localized at the trans-Golgi network (TGN) in vivo. Two serines in the GTP-binding site of the protein were mutagenized, giving rise to the three mutants Rab11S22N, Rab11S27N and Rab11S22/27N. The double mutation reduced secretion of a marker protein, secRGUS (secreted rat beta-glucuronidase), by half, whereas each of the single mutations alone had a much smaller effect, showing that both serines have to be mutated to obtain a dominant negative effect on LeRab11a function. The dominant negative mutant was used to determine whether Rab11 is involved in the pathway(s) regulated by the plasma membrane syntaxins SYP121 and SYP122. Co-expression of either of these GFP-tagged syntaxins with the dominant negative Rab11S22/27N mutant led to the appearance of endosomes, but co-expression of GFP-tagged SYP122 also labeled the endoplasmic reticulum and dotted structures. However, co-expression of Rab11S22/27N with SYP121 dominant negative mutants decreased secretion of secRGUS further compared with the expression of Rab11S22/27N alone, whereas co-expression of Rab11S22/27N with SYP122 had no synergistic effect. With the same essay, the difference between SYP121- and SYP122-dependent secretion was then evidenced. The results suggest that Rab11 regulates anterograde transport from the TGN to the plasma membrane and strongly implicate SYP122, rather than SYP121. The differential effect of LeRab11a supports the possibility that SYP121 and SYP122 drive independent secretory events.

Abstract: It is well known that there is an elevated risk of diffusion of pathogenic micro-organisms in swimming pools. Preventive measures aimed at protecting the health of swimmers are complex because of the variety of micro-organisms involved, the different ways in which these can be transmitted and the involvement of both aquatic and environmental factors. In industrialised countries, the circulation of many pathogens which were common in the past has progressively decreased in recent years; in contrast, infections caused by emerging pathogens such as Pseudomonas, atypical mycobacteria, Aeromonas, Legionella, Cryptosporidium, Norwalk virus, adenovirus and rotavirus have increased in frequency. Such infections affect not only the gastrointestinal tract but also other body sites, in particular the skin, conjunctiva, respiratory tract and auditory apparatus. Opportunistic pathogens capable of causing potentially serious infections in debilitated and immunocompromised subjects may also be involved. It is clearly necessary, therefore, that preventive interventions and effective monitoring programs, regarding both pool water and environmental quality, be implemented in all swimming facilities.

Abstract: OBJECTIVE: The objective of this study was to assess the relationship between active smoking as well as environmental tobacco smoke (ETS) exposure and severe small for gestational age (SGA) at term in a sample of pregnant Italian women. METHODS: A case-control study was conducted in nine cities in Italy between October 1999 and September 2000. Cases of severe SGA were singleton, live born, at term children with a birth weight <or= 5(th) percentile for gestational age. Controls (10:1 to cases) were enrolled from among singleton at term births that occurred in the same hospitals one or two days after delivery of the case, with a birth weight > 10(th) percentile for gestational age. A total of 84 cases of severe SGA and 858 controls were analyzed. A self-administered questionnaire was used to assess active smoking and ETS exposure, as well as potential confounders. RESULTS: Multivariate logistic regression analysis showed a relationship between active smoking during pregnancy and severe SGA (adjusted odds ratio (OR) 2.10, 95% confidence interval (CI) 1.13-3.68). ETS exposure was associated with severe SGA (adjusted OR 2.51, 95% CI 1.59-3.95) with a dose-response relationship to the number of smokers in the home.

Abstract: The regulation of pH in cellular compartments is crucial for intracellular trafficking of vesicles and proteins and the transport of small molecules, including hormones. In endomembrane compartments, pH is regulated by vacuolar H(+)-ATPase (V-ATPase), which, in plants, act together with H(+)-pyrophosphatases (PPase), whereas distinct P-type H(+)-ATPases in the cell membrane control the pH in the cytoplasm and energize the plasma membrane. Flower colour mutants have proved useful in identifying genes controlling the pH of vacuoles where anthocyanin pigments accumulate. Here we show that PH5 of petunia encodes a P(3A)-ATPase proton pump that, unlike other P-type H(+)-ATPases, resides in the vacuolar membrane. Mutation of PH5 reduces vacuolar acidification in petals, resulting in a blue flower colour and abolishes the accumulation of proanthocyanidins (condensed tannins) in seeds. Expression of PH5 is directly activated by transcription regulators of the anthocyanin pathway, in conjunction with PH3 and PH4. Thus, flower coloration, a key-factor in plant reproduction, involves the coordinated activation of pigment synthesis and a specific pathway for vacuolar acidification.

Abstract: The aim of this study was to evaluate the efficacy of a mobile laminar airflow (LAF) unit in reducing bacterial contamination at the surgical area in an operating theatre supplied with turbulent air ventilation. Bacterial sedimentation was evaluated during 76 clean urological laparotomies; in 34 of these, a mobile LAF unit was added. During each operation, settle plates were placed at four points in the operating theatre (one at the patient area and three at the perimeter), a nitrocellulose membrane was placed on the instrument table and an additional membrane near the wound. During four operations, particle counting was performed to detect particles > or =0.5 microm. Mean bacterial sedimentation on the nitrocellulose membrane on the instrument table was 2730 cfu/m(2)/h under standard ventilation conditions, whereas it decreased significantly to a mean of 305 cfu/m(2)/h when the LAF unit was used, i.e. within the suggested limit for ultraclean operating theatres (P=0.0001). The membrane near the wound showed a bacterial sedimentation of 4031 cfu/m(2)/h without the LAF unit and 1608 cfu/m(2)/h with the unit (P=0.0001). Particle counts also showed a reduction when the LAF unit was used. No significant difference was found at the four points in the operating theatre between samplings performed with, and without, the LAF unit. Use of a mobile LAF unit with turbulent air ventilation can reduce bacterial contamination at the surgical area in high-risk operations (e.g. prosthesis implant).

Abstract: This study investigated the exposure to organohalogens compounds in drinking water from 9 Italian towns (Udine, Genova, Parma, Modena, Siena, Roma, L'Aquila, Napoli and Catania). Overall, 1199 samples collected from 72 waterworks were analyzed. THMs, trichloroethylene and tetrachloroethylene were evaluated using the head-space gas chromatographic technique (detection limit of 0.01 microg/l; chlorite and chlorate analysis was performed by ion chromatography (detection limit of 20 microg/l). THMs were evidenced in 925 samples (77%) (median value: 1.12 micro/l; range: 0.01-54 mciro/l) and 7 were higher than the THMs Italian limit of 30 microg/l. Chlorite and chlorate levels were higher than the detection limit in 45% for chlorite and in 34% for chlorate samples; median values were 221 microg/l and 76 microg/l, respectively. Chlorite values were higher than the chlorite Italian limit (700 microg/l) in 35 samples (8.7%). Trichloroethylene and tetrachloroethylene were measured in 29% and 44% of the investigated samples and showed values lower than the Italian limit (highest levels of 6 microg/l and 9 microg/l, respectively). The low levels detected of THMs, trichloroethylene and tetrachloroethylene have no potentials effects on human health, whereas, the levels of chlorite and chlorates should be further evaluated and their potential effects for the populations using these drinking waters, better understood.

Abstract: INTRODUCTION: The aim of this study was to evaluate the efficacy of ClO2 with regard to viruses which show a particular resistance to oxidizing agent such as HAV and Norwalk and Norwalk-like viruses, and which play an important role in the epidemiology of viral foodborne diseases. In the food industry, disinfection of processing systems and equipment is a very important instrument to prevent secondary contamination and to guarantee food safety. Among disinfectants, chlorine dioxide (ClO2) presents a good efficacy at wide range of pH values, its action is rapid and generates few reaction byproducts if compared to hypoclorite. Experimental studies have highlighted that ClO2 shows a good bactericidal activity and it is also active towards viruses. Furthermore, the low concentrations and low contact times required to obtain microbial load reduction are favourable elements for the application of this compound in the industrial sanitizing practices. METHODS: As it is impossible to cultivate the Norwalk virus in vitro, we tested the resistance of Feline calicivirus (F9 strain) vs. ClO2, in comparison with HAV (strain HM-175) and Coxsackie B5. Chlorine dioxide was used at concentrations ranging from 0.2 to 0.8 mg/l in water solution, at pH 7 and at +20 degrees C. Viral suspensions were added to disinfecting solution and, at pre-set times, were sampled to undergo to titration after blocking the disinfectant action with thiosulphate 0.05 M. On the basis of the data obtained, for each virus and in relation to different concentrations, mean reduction times were calculated for 99%, 99.9% and 99.99% using the regression analysis model. RESULTS: As regards Feline calicivirus, at a concentration of 0.8 mg/l of ClO2, we obtained the complete elimination of the viral titre in 2 min while 30 min were required at concentrations of 0.2 mg/l. Coxsackie B5 showed a similar behaviour, being completely inactivated in 4 min with 0.4 mg/l of ClO2 and after 30 min at a concentration of 0.2 mg/l. Inactivation was quicker for HAV, which was eliminated after only 30 sec at a concentration of 0.8 mg/l and after 5 min at 0.4 mg/l. CONCLUSION: Our data show that for complete inactivation of HAV and Feline calicivirus, concentrations > or = 0.6 mg/l are required. This observation is true for Coxsackie B5 too, but this virus has shown a good sensitivity at all concentration tested according to regression analysis results. For Feline calicivirus and HAV, at low concentrations of disinfectant, prolonged contact times were needed to obtain a 99.99% reduction of viral titres (about 16 and 20 minutes respectively).

Abstract: BACKGROUND: Hydroperoxide lyase (HPL) is a key enzyme in plant oxylipin metabolism that catalyses the cleavage of polyunsaturated fatty acid hydroperoxides produced by the action of lipoxygenase (LOX) to volatile aldehydes and oxo acids. The synthesis of these volatile aldehydes is rapidly induced in plant tissues upon mechanical wounding and insect or pathogen attack. Together with their direct defence role towards different pathogens, these compounds are believed to play an important role in signalling within and between plants, and in the molecular cross-talk between plants and other organisms surrounding them. We have recently described the targeting of a seed 9-HPL to microsomes and putative lipid bodies and were interested to compare the localisation patterns of both a 13-HPL and a 9/13-HPL from Medicago truncatula, which were known to be expressed in leaves and roots, respectively. RESULTS: To study the subcellular localisation of plant 9/13-HPLs, a set of YFP-tagged chimeric constructs were prepared using two M. truncatula HPL cDNAs and the localisation of the corresponding chimeras were verified by confocal microscopy in tobacco protoplasts and leaves. Results reported here indicated a distribution of M.truncatula 9/13-HPL (HPLF) between cytosol and lipid droplets (LD) whereas, as expected, M.truncatula 13-HPL (HPLE) was targeted to plastids. Notably, such endocellular localisation has not yet been reported previously for any 9/13-HPL. To verify a possible physiological significance of such association, purified recombinant HPLF was used in activation experiments with purified seed lipid bodies. Our results showed that lipid bodies can fully activate HPLF. CONCLUSION: We provide evidence for the first CYP74C enzyme, to be targeted to cytosol and LD. We also showed by sedimentation and kinetic analyses that the association with LD or lipid bodies can result in the protein conformational changes required for full activation of the enzyme. This activation mechanism, which supports previous in vitro work with synthetic detergent micelle, fits well with a mechanism for regulating the rate of release of volatile aldehydes that is observed soon after wounding or tissue disruption.