Effect of blood haemoglobin concentration on V(O2,max) and cardiovascular function in lowlanders acclimatised to 5260 m

[EN] The principal aim of this investigation was to determine the influence of blood haemoglobin concentration ([Hb]) on maximal exercise capacity and maximal O(2) consumption (V(O(2),max)) in healthy subjects acclimatised to high altitude. Secondarily, we examined the effects of [Hb] on the regulation of cardiac output (CO), blood pressure and muscular blood flow (LBF) during exercise. Eight Danish lowlanders (three females and five males; 24 +/- 0.6 years, mean +/- S.E.M.) performed submaximal and maximal exercise on a cycle ergometer after 9 weeks at an altitude of 5260 m (Mt Chacaltaya, Bolivia). This was done first with the high [Hb] resulting from acclimatisation and again 2-4 days later, 1 h after isovolaemic haemodilution with Dextran 70 to near sea level [Hb]. After measurements at maximal exercise while breathing air at each [Hb], subjects were switched to hyperoxia (55 % O(2) in N(2)) and the measurements were repeated, increasing the work rate as tolerated. Hyperoxia increased maximal power output and leg V(O(2),max), showing that breathing ambient air at 5260 m, V(O(2),max) is limited by the availability of O(2) rather than by muscular oxidative capacity. Altitude increased [Hb] by 36 % from 136 +/- 5 to 185 +/- 5 g l(-1) (P < 0.001), while haemodilution (replacing 1 l of blood with 1 l of 6 % Dextran) lowered [Hb] by 24 % to 142 +/- 6 g l(-1) (P < 0.001). Haemodilution had no effect on maximal pulmonary or leg V(O(2),max), or power output. Despite higher LBF, leg O(2) delivery was reduced and maximal V(O(2)) was thus maintained by higher O(2) extraction. While CO increased linearly with work rate irrespective of [Hb] or inspired oxygen fraction (F(I,O(2))), both LBF and leg vascular conductance were systematically higher when [Hb] was low. Close and significant relationships were seen between LBF (and CO) and both plasma noradrenaline and K(+) concentrations, independently of [Hb] and F(I,O(2)). In summary, under conditions where O(2) supply limits maximal exercise, the increase in [Hb] with altitude acclimatisation does not improve maximal exercise capacity or V(O(2),max), and does not alter peak CO. However, LBF and vascular conductance are higher at altitude when [Hb] is lowered to sea level values, with both relating closely to catecholamine and potassium concentrations. This suggests that the lack of effect of [Hb] on V(O(2),max) may involve reciprocal changes in LBF via local metabolic control of the muscle vasculature.

Why is VO2 max after altitude acclimatization still reduced despite normalization of arterial O2 content?

[EN] Acute hypoxia (AH) reduces maximal O2 consumption (VO2 max), but after acclimatization, and despite increases in both hemoglobin concentration and arterial O2 saturation that can normalize arterial O2 concentration ([O2]), VO2 max remains low. To determine why, seven lowlanders were studied at VO2 max (cycle ergometry) at sea level (SL), after 9-10 wk at 5,260 m [chronic hypoxia (CH)], and 6 mo later at SL in AH (FiO2 = 0.105) equivalent to 5,260 m. Pulmonary and leg indexes of O2 transport were measured in each condition. Both cardiac output and leg blood flow were reduced by approximately 15% in both AH and CH (P < 0.05). At maximal exercise, arterial [O2] in AH was 31% lower than at SL (P < 0.05), whereas in CH it was the same as at SL due to both polycythemia and hyperventilation. O2 extraction by the legs, however, remained at SL values in both AH and CH. Although at both SL and in AH, 76% of the cardiac output perfused the legs, in CH the legs received only 67%. Pulmonary VO2 max (4.1 +/- 0.3 l/min at SL) fell to 2.2 +/- 0.1 l/min in AH (P < 0.05) and was only 2.4 +/- 0.2 l/min in CH (P < 0.05). These data suggest that the failure to recover VO2 max after acclimatization despite normalization of arterial [O2] is explained by two circulatory effects of altitude: 1) failure of cardiac output to normalize and 2) preferential redistribution of cardiac output to nonexercising tissues. Oxygen transport from blood to muscle mitochondria, on the other hand, appears unaffected by CH.

Studio e caratterizzazione del colore rosso dell'epicarpo nella pera Max Red Bartlett, mutante della cv William

Durante il secolo scorso sono state individuate alcune mutazioni per il colore della buccia della varietà William che invece di essere giallo arriva a maturazione con diverse tonalità di colore rosso. L’intensità e la tipologia del fenotipo dovuto a questa mutazione mostra una variabilità all’interno dei diversi cloni rossi di questa cultivar: Max Red Bartlett, Rosired e Sensation. Questa mutazione è ereditabile e usando come genitore uno dei sopra-citati mutanti per il rosso sono state prodotte altre cultivar caratterizzate da buccia rossa come Cascade. Max Red Bartlett presenta una intensa colorazione rossa nelle prime fasi di maturazione per poi striarsi perdendo di lucentezza e non ricoprendo totalmente la superficie del frutto. Max Red Bartlett ha inoltre il problema di regressione del colore. Questa mutazione infatti non è stabile e dopo qualche anno può regredire e presentare il fenotipo di William. Diverso è invece lo sviluppo per esempio di Rosired che durante le prime fasi di accrescimento del frutto è identica a Williams (di colore verde con la parte del frutto rivolta verso il sole leggermente rossastra) per poi virare e mantenere un vivo colore rosso su tutta la superficie del frutto. Questa tesi si è proposta di caratterizzare questa mutazione che coinvolge in qualche modo la via biosintetica per la sintesi del colore. In particolare si è cercato di investigare sui probabili geni della via degli antociani coinvolti e in quale modo vengono espressi durante la maturazione del frutto, inoltre si è cercato di trovare quali specifiche molecole venissero diversamente sintetizzate. Le cultivar utilizzate sono state William e Max Red Bartlett. Di quest’ultima era già disponibile una mappa molecolare, ottenuta sulla popolazione di’incrocio di Abate Fetel (gialla) x MRB (rossa) con AFLP e SSR, quest’ultimi hanno permesso di denominare i diversi linkage group grazie alla sintenia con le altre mappe di pero e di melo. I semenzali appartenenti a questa popolazione, oltre a dimostrare l’ereditarietà del carattere, erano per il 50% gialli e 50% rossi. Questo ha permesso il mappaggio di questo carattere/mutazione che si è posizionato nel linkage group 4. Una ricerca in banca dati eseguita in parallelo ha permesso di trovare sequenze di melo dei geni coinvolti nella via biosintetica degli antociani (CHS, CHI, F3H, DFR, ANS e UFGT), sulle quali è stato possibile disegnare primer degenerati che amplificassero su DNA genomico di pero. Le amplificazioni hanno dato frammenti di lunghezza diversa. Infatti nel caso di F3H e DFR l’altissima omologia tra melo e pero ha permesso l’amplificazione quasi totale del gene, negli altri casi invece è stato necessario utilizzare primer sempre più vicini in modo da facilitare l’amplificazione. I frammenti ottenuti sono stati clonati sequenziati per confermare la specificità degli amplificati. Non sono stati evidenziati polimorfismi di sequenza in nessuna delle sei sequenze tra William e Max Red Bartlett e nessun polimorfismo con Abate, per questo motivo non è stato possibile mapparli e vedere se qualcuno di questi geni era localizzato nella medesima posizione in cui era stato mappato il “colore/mutazione”. Sulle le sequenze ottenute è stato possibile disegnare altri primer, questa volta specifici, sia per analisi d’espressione. Inizialmente è stato sintetizzato il cDNA dei geni suddetti per retrotrascrizione da RNA estratto sia da bucce sia da foglie appena germogliate (le quali presentano solo in questa fase una colorazione rossastra in MRB ma non in William). Al fine di osservare come varia l’espressione dei geni della via biosintetica delle antocianine durante la fase di maturazione dei frutti, sono stati fatti 4 campionamenti, il primo a 45gg dalla piena fioritura, poi a 60, 90, 120 giorni. Foglie e bucce sono state prelevate in campo e poste immediatamente in azoto liquido. Dai risultati con Real Time è emerso che vi è una maggiore espressione nelle prime fasi di sviluppo in Max Red Bartlett per poi calare enormemente in giugno. Si potrebbe ipotizzare che ci sia una reazione di feed back da parte della piante considerando che in questa fase il frutto non si accresce. I livelli di espressione poi aumentano verso la fase finale della maturazione del frutto. In agosto, con l’ultimo campionamento vi è una espressione assai maggiore in Max Red Bartlett per quei geni posti a valle della via biosintetica per la sintesi delle antocianine. Questo risultato è confermato anche dal livello di espressione che si riscontra nelle foglie. In cui i geni F3H, LDOX e UFGT hanno un livello di espressione nettamente maggiore in Max Red Bartlett rispetto a William. Recentemente Takos et al (2006) hanno pubblicato uno studio su un gene regolatore della famiglia Myb e ciò ha permesso di ampliare i nostri studi anche su questo gene. L’altissima omologia di sequenza, anche a livello di introni, non ha permesso di individuare polimorfismi tra le varietà Abate Fetel e Max Red Bartlett, per nessun gene ad eccezione proprio del gene regolatore Myb. I risultati ottenuti in questa tesi dimostrano che in pero l’espressione relativa del gene Myb codificante per una proteina regolatrice mostra una netta sovra-espressione nel primo stadio di maturazione del frutto, in Max Red Bartlett 25 volte maggiore che in William. All’interno della sequenza del gene un polimorfismo prodotto da un microsatellite ha permesso il mappaggio del gene nel linkage group 9 in Max Red Bartlett e in Abate Fetel. Confrontando questo dato di mappa con quello del carattere morfologico rosso, mappato nel linkage group 4, si deduce che la mutazione non agisce direttamente sulla sequenza di questo gene regolatore, benché sia espresso maggiormente in Max Red Bartlett rispetto a William ma agisca in un altro modo ancora da scoprire. Infine per entrambe le varietà (William e Max Red Bartlett) sono state effettuate analisi fenotipiche in diversi step. Innanzi tutto si è proceduto con una analisi preliminare in HPLC per osservare se vi fossero differenze nella produzione di composti con assorbenza specifica delle antocianine e dei flavonoidi in generale. Si è potuto quindi osservare la presenza di due picchi in Max Red Bartlett ma non in William. La mancanza di standard che coincidessero con i picchi rilevati dallo spettro non ha permesso in questa fase di fare alcuna ipotesi riguardo alla loro natura. Partendo da questo risultato l’investigazione è proceduta attraverso analisi di spettrometria di massa associate ad una cromatografia liquida identificando con una certa precisione due composti: la cianidina-3-0-glucoside e la quercitina-3-o-glucoside. In particolare la cianidina sembra essere la molecola responsabile della colorazione della buccia nei frutti di pero. Successive analisi sono state fatte sempre con lo spettrometro di massa ma collegato ad un gas cromatografo per verificare se vi fossero delle differenze anche nella produzione di zuccheri e più in generale di molecole volatili. L’assenza di variazioni significative ha dimostrato che la mutazione coinvolge solo il colore della buccia e non le caratteristiche gustative e organolettiche di William che restano inalterate nel mutante.

Max Bill in Italia . Lo spazio logico dell'architettura

I Max Bill is an intense giornata of a big fresco. An analysis of the main social, artistic and cultural events throughout the twentieth century is needed in order to trace his career through his masterpieces and architectures. Some of the faces of this hypothetical mural painting are, among others, Le Corbusier, Walter Gropius, Ernesto Nathan Rogers, Kandinskij, Klee, Mondrian, Vatongerloo, Ignazio Silone, while the backcloth is given by artistic avant-gardes, Bauhaus, International Exhibitions, CIAM, war events, reconstruction, Milan Triennali, Venice Biennali, the School of Ulm. Architect, even though more known as painter, sculptor, designer and graphic artist, Max Bill attends the Bauhaus as a student in the years 1927-1929, and from this experience derives the main features of a rational, objective, constructive and non figurative art. His research is devoted to give his art a scientific methodology: each work proceeds from the analysis of a problem to the logical and always verifiable solution of the same problem. By means of composition elements (such as rhythm, seriality, theme and its variation, harmony and dissonance), he faces, with consistent results, themes apparently very distant from each other as the project for the H.f.G. or the design for a font. Mathematics are a constant reference frame as field of certainties, order, objectivity: ‘for Bill mathematics are never confined to a simple function: they represent a climate of spiritual certainties, and also the theme of non attempted in its purest state, objectivity of the sign and of the geometrical place, and at the same time restlessness of the infinity: Limited and Unlimited ’. In almost sixty years of activity, experiencing all artistic fields, Max Bill works, projects, designs, holds conferences and exhibitions in Europe, Asia and Americas, confronting himself with the most influencing personalities of the twentieth century. In such a vast scenery, the need to limit the investigation field combined with the necessity to address and analyse the unpublished and original aspect of Bill’s relations with Italy. The original contribution of the present research regards this particular ‘geographic delimitation’; in particular, beyond the deep cultural exchanges between Bill and a series of Milanese architects, most of all with Rogers, two main projects have been addressed: the realtà nuova at Milan Triennale in 1947, and the Contemporary Art Museum in Florence in 1980. It is important to note that these projects have not been previously investigated, and the former never appears in the sources either. These works, together with the most well-known ones, such as the projects for the VI and IX Triennale, and the Swiss pavilion for the Biennale, add important details to the reference frame of the relations which took place between Zurich and Milan. Most of the occasions for exchanges took part in between the Thirties and the Fifties, years during which Bill underwent a significant period of artistic growth. He meets the Swiss progressive architects and the Paris artists from the Abstraction-Création movement, enters the CIAM, collaborates with Le Corbusier to the third volume of his Complete Works, and in Milan he works and gets confronted with the events related to post-war reconstruction. In these years Bill defines his own working methodology, attaining an artistic maturity in his work. The present research investigates the mentioned time period, despite some necessary exceptions. II The official Max Bill bibliography is naturally wide, including spreading works along with ones more devoted to analytical investigation, mainly written in German and often translated into French and English (Max Bill himself published his works in three languages). Few works have been published in Italian and, excluding the catalogue of the Parma exhibition from 1977, they cannot be considered comprehensive. Many publications are exhibition catalogues, some of which include essays written by Max Bill himself, some others bring Bill’s comments in a educational-pedagogical approach, to accompany the observer towards a full understanding of the composition processes of his art works. Bill also left a great amount of theoretical speculations to encourage a critical reading of his works in the form of books edited or written by him, and essays published in ‘Werk’, magazine of the Swiss Werkbund, and other international reviews, among which Domus and Casabella. These three reviews have been important tools of analysis, since they include tracks of some of Max Bill’s architectural works. The architectural aspect is less investigated than the plastic and pictorial ones in all the main reference manuals on the subject: Benevolo, Tafuri and Dal Co, Frampton, Allenspach consider Max Bill as an artist proceeding in his work from Bauhaus in the Ulm experience . A first filing of his works was published in 2004 in the monographic issue of the Spanish magazine 2G, together with critical essays by Karin Gimmi, Stanislaus von Moos, Arthur Rüegg and Hans Frei, and in ‘Konkrete Architektur?’, again by Hans Frei. Moreover, the monographic essay on the Atelier Haus building by Arthur Rüegg from 1997, and the DPA 17 issue of the Catalonia Polytechnic with contributions of Carlos Martì, Bruno Reichlin and Ton Salvadò, the latter publication concentrating on a few Bill’s themes and architectures. An urge to studying and going in depth in Max Bill’s works was marked in 2008 by the centenary of his birth and by a recent rediscovery of Bill as initiator of the ‘minimalist’ tradition in Swiss architecture. Bill’s heirs are both very active in promoting exhibitions, researching and publishing. Jakob Bill, Max Bill’s son and painter himself, recently published a work on Bill’s experience in Bauhaus, and earlier on he had published an in-depth study on ‘Endless Ribbons’ sculptures. Angela Thomas Schmid, Bill’s wife and art historian, published in end 2008 the first volume of a biography on Max Bill and, together with the film maker Eric Schmid, produced a documentary film which was also presented at the last Locarno Film Festival. Both biography and documentary concentrate on Max Bill’s political involvement, from antifascism and 1968 protest movements to Bill experiences as Zurich Municipality councilman and member of the Swiss Confederation Parliament. In the present research, the bibliography includes also direct sources, such as interviews and original materials in the form of letters correspondence and graphic works together with related essays, kept in the max+binia+jakob bill stiftung archive in Zurich. III The results of the present research are organized into four main chapters, each of them subdivided into four parts. The first chapter concentrates on the research field, reasons, tools and methodologies employed, whereas the second one consists of a short biographical note organized by topics, introducing the subject of the research. The third chapter, which includes unpublished events, traces the historical and cultural frame with particular reference to the relations between Max Bill and the Italian scene, especially Milan and the architects Rogers and Baldessari around the Fifties, searching the themes and the keys for interpretation of Bill’s architectures and investigating the critical debate on the reviews and the plastic survey through sculpture. The fourth and last chapter examines four main architectures chosen on a geographical basis, all devoted to exhibition spaces, investigating Max Bill’s composition process related to the pictorial field. Paintings has surely been easier and faster to investigate and verify than the building field. A doctoral thesis discussed in Lausanne in 1977 investigating Max Bill’s plastic and pictorial works, provided a series of devices which were corrected and adapted for the definition of the interpretation grid for the composition structures of Bill’s main architectures. Four different tools are employed in the investigation of each work: a context analysis related to chapter three results; a specific theoretical essay by Max Bill briefly explaining his main theses, even though not directly linked to the very same work of art considered; the interpretation grid for the composition themes derived from a related pictorial work; the architecture drawing and digital three-dimensional model. The double analysis of the architectural and pictorial fields is functional to underlining the relation among the different elements of the composition process; the two fields, however, cannot be compared and they stay, in Max Bill’s works as in the present research, interdependent though self-sufficient. IV An important aspect of Max Bill production is self-referentiality: talking of Max Bill, also through Max Bill, as a need for coherence instead of a method limitation. Ernesto Nathan Rogers describes Bill as the last humanist, and his horizon is the known world but, as the ‘Concrete Art’ of which he is one of the main representatives, his production justifies itself: Max Bill not only found a method, but he autonomously re-wrote the ‘rules of the game’, derived timeless theoretical principles and verified them through a rich and interdisciplinary artistic production. The most recurrent words in the present research work are synthesis, unity, space and logic. These terms are part of Max Bill’s vocabulary and can be referred to his works. Similarly, graphic settings or analytical schemes in this research text referring to or commenting Bill’s architectural projects were drawn up keeping in mind the concise precision of his architectural design. As for Mies van der Rohe, it has been written that Max Bill took art to ‘zero degree’ reaching in this way a high complexity. His works are a synthesis of art: they conceptually encompass all previous and –considered their developments- most of contemporary pictures. Contents and message are generally explicitly declared in the title or in Bill’s essays on his artistic works and architectural projects: the beneficiary is invited to go through and re-build the process of synthesis generating the shape. In the course of the interview with the Milan artist Getulio Alviani, he tells how he would not write more than a page for an essay on Josef Albers: everything was already evident ‘on the surface’ and any additional sentence would be redundant. Two years after that interview, these pages attempt to decompose and single out the elements and processes connected with some of Max Bill’s works which, for their own origin, already contain all possible explanations and interpretations. The formal reduction in favour of contents maximization is, perhaps, Max Bill’s main lesson.

Max Abraham's and Tullio Levi-Civita's approach to Einstein Theory of Relativity

This work deals with the theory of Relativity and its diffusion in Italy in the first decades of the XX century. Not many scientists belonging to Italian universities were active in understanding Relativity, but two of them, Max Abraham and Tullio Levi-Civita left a deep mark. Max Abraham engaged a substantial debate against Einstein between 1912 and 1914 about electromagnetic and gravitation aspects of the theories. Levi-Civita played a fundamental role in giving Einstein the correct mathematical instruments for the General Relativity formulation since 1915. This work, which doesn't have the aim of a mere historical chronicle of the events, wants to highlight two particular perspectives: on one hand, the importance of Abraham-Einstein debate in order to clarify the basis of Special Relativity, to observe the rigorous logical structure resulting from a fragmentary reasoning sequence and to understand Einstein's thinking; on the other hand, the originality of Levi-Civita's approach, quite different from the Einstein's one, characterized by the introduction of a method typical of General Relativity even to Special Relativity and the attempt to hide the two Einstein Special Relativity postulates.

Sguardo sulla società tedesca contemporanea attraverso la proposta di traduzione di alcuni capitoli di Im Sparadies der Friseure: Eine kleine Sprachkritik di Wiglaf Droste e di Ein Buch namens Zimbo: Sie werden kaum ertragen was Ihnen mitgeteilt wird di Max Goldt.

Con il mio elaborato voglio descrivere brevemente la società tedesca e l'evoluzione della sua lingua attraverso la traduzione di alcuni graffianti testi degli scrittori Wiglaf Droste e Max Goldt.

Intensity-modulated radiotherapy for a rendu-osler-weber disease patient with recurrent severe epistaxis: a case report

We present a case of a Rendu-Osler-Weber disease patient with recurrent life threatening epistaxis demanding multiple blood transfusions despite of repetitive endoscopic laser and electrocoagulations, endovascular embolisation, septodermoplasty, and long-term intranasal dressings. As alternative treatment modalities repeatedly failed and the patient became almost permanently dependent on nasal dressing, we performed a highly conformal intensity-modulated radiotherapy of the nasal cavity; a total dose of 50 Gy in 2 Gy single fractions was applied. The therapy was very well tolerated, no acute toxicities occurred. Two weeks after the last radiation dose had been applied, the nasal dressing could be removed without problems. Endoscopical control revealed an almost avascular white mucosa without any trace of bleeding spots; previously existing hemangiomas and crusts had disappeared. After a 1-year-follow up, the patient had no significant recurrent epistaxis.

Targeted next generation sequencing as a diagnostic tool in epileptic disorders

Epilepsies have a highly heterogeneous background with a strong genetic contribution. The variety of unspecific and overlapping syndromic and nonsyndromic phenotypes often hampers a clear clinical diagnosis and prevents straightforward genetic testing. Knowing the genetic basis of a patient's epilepsy can be valuable not only for diagnosis but also for guiding treatment and estimating recurrence risks.