1H NMR spectroscopy of glioblastoma stem-like cells identifies alpha-aminoadipate as a marker of tumor aggressiveness

Patients suffering from glioblastoma multiforme (GBM) face a poor prognosis with median survival of about 14months. High recurrence rate and failure of conventional treatments are attributed to the presence of GBM cells with stem-like properties (GSCs). Metabolite profiles of 42 GSC lines established from the tumor tissue of adult GBM patients were screened with 1H NMR spectroscopy and compared with human neural progenitor cells from human adult olfactory bulb (OB-NPCs) and from the developing human brain (HNPCs). A first subset (n=12) of GSCs exhibited a dramatic accumulation of the metabolite α-aminoadipate (αAAD), product of the oxidation of α-aminoadipic semialdehyde catalyzed by the ALDH7A1 aldehyde dehydrogenase (ALDH) family in lysine catabolism. αAAD was low/not detectable in a second GSC subset (n=13) with the same neural metabolic profile as well as in a third GSC subset (n=17) characterized by intense lipid signals. Likewise, αAAD was not detected in the spectra of OB-NPCs or HNPCs. Inhibition of mitochondrial ATP synthase by oligomycin treatment revealed that the lysine degradative pathway leading to αAAD formation proceeds through saccharopine, as usually observed in developing brain. Survival curves indicated that high αAAD levels in GSCs significantly correlated with poor patient survival, similarly to prostate and non-small-cell-lung cancers, where activity of ALDH7A1 correlates with tumor aggressiveness

[Ross procedure in a patient with mitro-aortic endocarditis]

Infective endocarditis (IE) affecting the heart valves is burdened by a high risk of mortality and complications. In the aortic valve IE, when valve replacement is essential, there is evidence of good results with the use of pulmonary autographs (Ross procedure), but the application of this technique remains limited due to its poor dissemination. We present a complex case of mitro-aortic IE treated with the Ross procedure associated with removal of vegetation from the mitral valve in a 28-year-old patient undergoing hemodialytic treatment, already undergoing cardiac surgery through sternotomy in the past

Assisted reproductive technologies and metabolic syndrome complications. Medico-legal reappraisal

In the last 40 years, the number of elderly patients that require Assisted Reproductive Technologies (ART) has risen enormously, especially after heterolougus fertilization techniques have become available. In recent years, the incidence of peripartum cardiomyopathy (PPCM) has substantially grown, as a consequence of the combined effect of increased maternal age, consequent high prevalence of hypertension and metabolic syndrome (MS). That cohort of women may be exposed to a greater number of cardiac, obstetric and anesthesiological complications, therefore the incidence of medico-legal issues, litigation, liabilities and claims over the past years has significantly risen. Cardiovascular and hormonal changes during pregnancy can challenge even the healthiest of individuals, and in that pregnant population the risk is even greater. These patients should be monitored before the ART, during pregnancy, delivery and puerperium, to avoid heart failure, thrombotic problems, embolic complications, stroke and death. Management issues regarding pregnancy and delivery are elaborate, including anesthesia considerations. This new population of women needs an accurate cardiac risk stratification with a thorough cardiovascular history and examination, 12 lead ECG, and transthoracic echocardiogram. Therefore, a comprehensive multidisciplinary assessment and management can provide the best opportunity to improve maternal and neonatal outcome

Congenital aorto-right ventricular fistula associated with pulmonary hypertension in an old female patient

We report a late clinical presentation of an aorto-right ventricular fistula (RVF) extending from the right sinus of Valsalva into the RV outflow tract with significant left-to-right shunt and severe pulmonary hypertension. A three-dimensional transesophageal echocardiogram and a chest-computed tomography scans were performed to better characterize the abnormality. Aorto- RVF can be either congenital or acquired, secondary to endocarditis, Valsalva aneurysm rupture, chest trauma, or aortic dissection

Driving mechanism of tectonic activity in the northern Apennines: Quantitative insights from numerical modeling

It is shown, by numerical modeling, that the recent deformation pattern observed in the northern Apennines, mainly characterized by progressive eastward migration and bowing of the belt, thrusting activity along its external front, and tensional tectonics in the internal area, can be reproduced, at a first approximation, by applying a belt-parallel (SE-NW) compression to the chain, which is simulated as a structural system characterized by a high mechanical strength and decoupled from the surrounding zones. The above compressional regime, obtained by imposing kinematic boundary conditions to the model, causes the outward escape of crustal wedges from the chain, in particular the northeastward displacement of the Romagna-Marche-Umbria Units and the counterclockwise rotation and northwestward displacement of the Ligurian Units. This kinematics produces compressional to transcompressional strain along the external front of the chain and tensional to transtensional strain in the internal area, in line with the observed features that concern both strain style and orientation of principal strains. Evidence and arguments supporting the kinematic boundary conditions and the model parameterization adopted in modeling are discussed. Numerical experiments have also been carried out to evaluate the influence of major features of the model parameterization and boundary conditions we have adopted in modeling and to provide insights into the possible influence of strong decoupling earthquakes in the central Apennines on tectonic and seismic activity in the northern Apennines. Copyright 2004 by the American Geophysical Union

Through the magnifying glass: provincial aspects of industrial growth in post-Unification Italy

This article presents estimates of industrial production in post-Unification Italy's 69 provinces in the census years 1871, 1881, 1901, and 1911. Initially industry was largely artisanal, and located in the former political capitals; but even then the waterfalls of the subalpine north-west attracted what factory industry there was. Contrary to widespread opinion, in the aftermath of Unification the industrial and overall growth leaders were actually in the south, where selected provinces reaped the gains from the freer foreign trade, and infrastructure investment, that accompanied the loss of independence. Over the later nineteenth century industry concentrated into the ‘industrial triangle’; but even there industrialization remained sharply local, and excluded the right bank of the upper Po. The early twentieth century, in turn, brought a measure of industrial diffusion—to the centre/north-east, where it was tied to the production of perishables on recently improved land—and concentration within the north-western triangle itself, into its major cities, as progress in energy transmission effectively moved the waterfalls into the plains