| Create a free account, build a dictionary with saved terms to re-use later! |
(4 coded questions)  |
Show articles that do not have abstracts
|
| Humans or Animals | | Humans Animals
| | | Ages | | All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined
| | | Type of Article | | Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S. Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT
| | | Language | | English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French
| |
|
(1-25 of 1,224) |
Sort By:
|
Took: 2.783 seconds to search 17,750,454 |
Roberto Gasparri,Francesco Leo,Giulia Veronesi,Tommaso De Pas,Tommaso DePas,Marco Colleoni,Patrick Maisonneuve,Giuseppe Pelosi,Viviana Galimberti,Lorenzo Spaggiari BACKGROUND: Advanced breast carcinoma almost always leads to a malignant pleural effusion, conditioning the performance status of patients and consequently quality of life. The treatment of malignant pleural effusion should be a priority in the management of such patients. The results of video-thor... ( view more )acoscopic approach (VATS) chemical pleurodesis was analyzed in patients with recurrent pleural effusion from breast carcinoma. METHODS: From October 1998 to June 2004, 71 consecutive patients with breast carcinoma-related pleural effusion were treated by the same thoracic-surgeon team with intracavitary nebulization of 8 g of asbestos-free sterilized talc via VATS. Multiple pleural biopsies were performed to determine biologic characteristics of recurrent disease. RESULTS: Talc pleurodesis was performed in all cases, with no intraoperative or postoperative complications. Median length of hospital stay was 5 days (range, 5-8). The overall success rate of the surgical procedure was 89% (confidence interval [CI], 79-95%) with a mean follow-up of 22 months (range, 2-81 mos). The overall survival time was 17 months (range, 2-80). Biopsies showed a switch on receptor status and c-erB-2 status from negative (primary tumor) to positive (pleural metastasis) in 11 (15%) patients. In another 7 (9.8%) patients, we obtained completely new information that was hitherto unknown. CONCLUSION: Talc pleurodesis via VATS is an effective and safe procedure that yields a high rate of success at the first attempt and achieves long-term control of malignant pleural effusion due to breast carcinoma. Concomitant biopsies performed during the VATS procedure were a determining factor in the subsequent decision-making process. ( view less ) Anna Giardini,Daniele Catone,Stefano Stranges,Mauro Satta,Mario Tacconi,Susanna Piccirillo,Stefano Turchini,Nicola Zema,Giorgio Contini,Tommaso Prosperi,Pietro Decleva,Devis Di Tommaso,Giovanna Fronzoni,Mauro Stener,Antonello Filippi,Maurizio Speranza Circular dichroism in the angular distribution of valence photoelectrons emitted from randomly oriented 3-hydroxytetrahydrofuran enantiomers (ThS and ThR) has been observed in gas-phase experiments using circularly polarized vacuum ultraviolet (VUV) light. The measured dichroism for both ThS and Th... ( view more )R, acquired at the single magic angle theta=234.73 degrees and at photon energies of 22, 19, 16, and 14 eV, points to an asymmetric forward-backward scattering of the photoelectrons from their highest occupied molecular orbitals (HOMO) HOMO-1 and HOMO-2, of up to 5%, depending on the photon energy. The asymmetry reverses on exchange of either the helicity of the radiation or the configuration of Th. The photoionization dichroic D parameters of ThS and ThR have been measured and their values discussed in the light of LCAO B-spline density functional theory (DFT) predictions. While an acceptable agreement is found between the dichroic parameter measured and calculated at the highest photon energy for the HOMO and HOMO-2 orbitals of Th, a significant discrepancy is observed for the HOMO-1 state which is attributed to the floppiness of Th, in particular to the comparatively large sensitivity of the size and shape of its HOMO-1 on nuclear vibrational motion. ( view less ) Lucia Margari,Margari Lucia,Anna Presicci,Presicci Anna,Patrizia Ventura,Ventura Patrizia,Maura Buttiglione,Buttiglione Maura,Cosma Andreula,Andreula Cosma,Tommaso Perniola,Perniola Tommaso Congenital bilateral perisylvian syndrome (CBPS) is a rare neurological disorder characterised by pseudobulbar palsy, cognitive deficits and epilepsy associated with bilateral perisylvian cortical dysplasia on neuroimaging studies. We report a long-term follow-up of a 18-years girl diagnosed with C... ( view more )BPS according to the typical clinical and magnetic resonance imaging (MRI) features. The patient showed faciopharyngoglossomasticatory diplegia, severe dysarthria, ataxia, spastic quadriparesis and severe mental retardation. Brain MRI evidenced bilateral perisylvian cortical dysplasia. Since early life she suffered from complex febrile seizures and epilepsy consisting of complex partial attacks with affective manifestations associated with centro-temporal EEG abnormalities. During 18 years of follow-up she was treated with phenobarbital, carbamazepine, lamotrigine, gabapentin but did not show any significant clinical improvement. Subsequently, monotherapy with phenytoin (PHT) was followed by a significant clinical improvement. At age 17, because of adverse effects, PHT was gradually substituted by topiramate (TPM). Full control of seizures was obtained at the age of 17 years with TPM. EEG abnormalities throughout the years have been reduced according to the clinical course. These findings emphasised the importance of long-term follow-up, suggesting that the prognosis for epilepsy may not be predicted based on the early response to treatment or on the presence of structural encephalic abnormalities, as reported in the literature. ( view less ) Roberto Orecchia,Barbara A Jereczek-Fossa,Gianpiero Catalano,Fausto Chiesa,Tommaso De Pas,Giovanna Masci,Marco Krengli,Andrea Vavassori,Fiora De Paoli,Chris Robertson,Emanuela Marrocco,Filippo De Braud,Tommaso DePas OBJECTIVE: We undertook a prospective phase II study to assess the feasibility and activity of a new induction chemotherapy regimen followed by hyperfractionated irradiation in locally advanced squamous cell head and neck cancer. METHODS: 25 patients with locally advanced head and neck cancer were ... ( view more )treated with 4 cycles of vinorelbine (20 mg i.v. day 1, 3), cisplatin (60 mg/m(2) i.v. day 1) and 5-fluorouracil (200 mg/m(2) continuous i.v. infusion day 1-21) (ViFuP regimen) followed by bifractionated radiotherapy (bidRT) up to 74.4 Gy in 62 fractions of 1.2 Gy twice daily. RESULTS: Chemotherapy was well tolerated, 6 patients developed grade 3 and one patient grade 4 neutropenia. Response to chemotherapy was observed in 19 patients (76%) including three complete responses and 16 partial responses. Planned bidRT was completed in 25 patients and all but one received planned bidRT dose without interruptions. Radiotherapy was well tolerated, mucositis was the most common side effect (grade 3-12 patients, grade 4-1 patient). At evaluation after the completion of bidRT, 13 patients had complete response (52%), 7 partial response (28%), 2 stable disease and 3 tumor progression. At the median follow-up of 18.2 months, 11 patients were alive and free of disease, and 14 patients had died (12 of tumor). Late xerostomy was observed in all but one 3-month survivors. Late mandibular necrosis was seen in 1 patient. CONCLUSIONS: bidRT preceded by ViFuP seems a feasible and active combination in locally advanced head and neck cancer. Good patient compliance did not compromise the delivery of planned dose of bidRT. However, short median duration of response (14.6 months) and moderate median overall survival (18.7 months) indicate the need for more intensive therapeutic strategies. On the basis of these results, modifications of our treatment schedule (shortening the overall treatment time by reduction of chemotherapy cycles and the use of chemotherapy concomitantly with irradiation) are planned for the future study. ( view less ) Maria Silvia Giretti,Tommaso Simoncini Cell movement is required in relevant physiological processes such as embryonic development, tissue and organ differentiation, inflammation, immune response and wound healing, along with pathological phenomena, such as cancer metastatic spread. Cell motility is tightly controlled by a complex and o... ( view more )ften redundant array of intracellular signaling pathways largely devoted to the dynamic regulation of the actin cytoskeletal network and of its relationship with the cell membrane and the extracellular matrix. Sex steroids, particularly estrogen and progesterone, are effective regulators of cell migration and tissue organization, and recent evidence indicates that this is in part obtained through the regulation of the cytoskeleton. Intriguingly, many of these regulatory actions related to cell movement are achieved through rapid, non-classical signaling of sex steroid receptors to kinase cascades, independently from nuclear alteration of gene expression or protein synthesis. The identification of the mechanistic basis for these rapid actions on cell cytoskeleton and cell movement has special relevance for the characterization of the effects of sex steroids in physiological conditions, such their role in the control of inflammation, brain or vascular cell remodelling, angiogenesis or wound healing, as well as in the context of pathological conditions such as steroid-sensitive cancer cell invasion and metastasis. This review highlights the physiological and clinical conditions where the regulatory effects on the cytoskeleton and cell movement of sex steroids might have a special importance, as well as the recent advances in the characterization of the mechanisms, providing insights and working hypotheses on possible clinical applications for the modulation of these pathways. ( view less ) Philip Wenzel,Hanke Mollnau,Matthias Oelze,Eberhard Schulz,Jennifer M Dias Wickramanayake,Johanna Müller,Swenja Schuhmacher,Marcus Hortmann,Stephan Baldus,Tommaso Gori,Ralf P Brandes,Thomas Münzel,Andreas Daiber Chronic nitroglycerin treatment results in development of nitrate tolerance associated with endothelial dysfunction (ED). We sought to clarify how mitochondria- and NADPH oxidase (Nox)-derived reactive oxygen species (ROS) contribute to nitrate tolerance and nitroglycerin-induced ED. Nitrate tolera... ( view more )nce was induced by nitroglycerin infusion in male Wistar rats (100 microg/h/4 day) and in C57/Bl6, p47(phox/) and gp91(phox/) mice (50 microg/h/4 day). Protein and mRNA expression of Nox subunits were unaltered by chronic nitroglycerin treatment. Oxidative stress was determined in vascular rings and mitochondrial fractions of nitroglycerin-treated animals by L-012 enhanced chemiluminescence, revealing a dominant role of mitochondria for nitrate tolerance development. Isometric tension studies revealed that genetic deletion or inhibition (apocynin, 0.35 mg/h/4 day) of Nox improved ED, whereas nitrate tolerance was unaltered. Vice versa, nitrate tolerance was attenuated by co-treatment with the respiratory chain complex I inhibitor rotenone (100 microg/h/4 day) or the mitochondrial permeability transition pore blocker cyclosporine A (50 microg/h/4 day). Both compounds improved ED, suggesting a link between mitochondrial and Nox-derived ROS. Mitochondrial respiratory chain-derived ROS are critical for the development of nitrate tolerance, whereas Nox-derived ROS mediate nitrate tolerance-associated ED. This suggests a crosstalk between mitochondrial and Nox-derived ROS with distinct mechanistic effects and sites for pharmacological intervention. ( view less ) Luca Laurenti,Silvia De Matteis,Mario Sabatelli,Amelia Conte,Patrizia Chiusolo,Federica Sorà,Nicola Piccirillo,Tommaso Za,Michela Tarnani,Elena Rossi,Giuseppe Leone,Simona SicaThe acronym POEMS refers to polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes. This disease is progressive and weakening for patients and lead to death generally for neurological problem without therapy. We treated four patients affected by POEMS syndrome with front-line chemoth... ( view more )erapy and autologous peripheral blood stem cell transplantation (aPBSCT). After a median follow-up of 40.5 months (range 12-52), all patients are alive with slow but progressive improvement in neurological disease, skin changes, performance status and without evidence of clonal plasmacytosis and organomegaly. In conclusion early diagnosis is crucial to obtain best response and improve clinical outcome. ( view less ) Alessandro Arcovito,Tommaso Moschetti,Paola D'Angelo,Giordano Mancini,Beatrice Vallone,Maurizio Brunori,Stefano Della Longa Neuroglobin (Ngb) is a member of the globin family expressed in the vertebrate brain, involved in neuroprotection. A combined approach of X-ray diffraction (XRD) on single crystal and X-ray absorption spectroscopy (XAS) in solution, allows to determine the oxidation state and the structure of the F... ( view more )e-heme both in the bis-histidine and the CO-bound (NgbCO) states. The overall data demonstrate that under X-ray the iron is photoreduced fairly rapidly, and that the previously reported X-ray structure of ferric Ngb [B. Vallone, K. Nienhaus, M. Brunori, G.U. Nienhaus, Proteins 56 (2004) 85-92] very likely refers to a photoreduced species indistinguishable from the dithionite reduced protein. Results from the XAS analysis of NgbCO in solution are in good agreement with XRD data on the crystal. However prolonged X-ray exposure at 15K determines CO release. This preliminary result paves the way to experiments aimed at the characterization of pentacoordinate ferrous Ngb, the only species competent in binding external ligands such as O2, CO or NO. ( view less ) Igor Branchi,Ivana D'Andrea,Monica Armida,Tommaso Cassano,Antonella Pèzzola,Rosa Luisa Potenza,Maria Grazia Morgese,Patrizia Popoli,Enrico Alleva To investigate the psychiatric symptoms accompanying the early phases of Parkinson's disease (PD), we injected adult rats with 10.5 mug 6-hydroxydopamine (6-OHDA) bilaterally into the dorsal striatum. The resulting neurodegeneration led, 12 weeks after injection, to a mild (36%) reduction of striat... ( view more )al dopamine. We tested the behavioral response of sham and 6-OHDA-lesioned animals at different time points after injection to evaluate the onset and progression of behavioral abnormalities. The results showed that such a mild reduction of dopamine levels was associated with a decrease in anxiety-like behavior, an increase in "depression"-like behavior, and a marked change in social behavior. Learning and memory abilities were not affected. Overall, the PD rat model used here displays behavioral alterations having face validity with psychiatric symptoms of the pathology and thus appears to be a valuable tool for investigating the neural bases of the early phases of PD. (c) 2008 Wiley-Liss, Inc. ( view less ) Tommaso Cai,Gabriella Nesi,Galliano Tinacci,Enzo Zini,Nicola Mondaini,Vieri Boddi,Sandra Mazzoli,Riccardo Bartoletti PURPOSE: We evaluated the impact of epirubicin perioperative instillation in improving subsequent bacillus Calmette-Guerin instillation efficacy in high risk patients with nonmuscle invasive bladder cancer. MATERIALS AND METHODS: Between January 2005 and June 2007, 161 patients affected by high ris... ( view more )k nonmuscle invasive bladder cancer were enrolled in this prospective, randomized, controlled, double-blind study. A total of 80 patients were assigned to group A (perioperative epirubicin 80 mg/50 ml normal saline) plus delayed bacillus Calmette-Guerin instillations (5 x 108 colony-forming units in 50 ml saline) and 81 to group B (delayed bacillus Calmette-Guerin alone). The main outcome measures were time to first recurrence and recurrence rate. All data obtained from a median followup of 15.3 months in group A and 14.8 months in group B, were analyzed. RESULTS: At the end of followup 46 of 80 patients in group A (57.5%) had no evidence of disease, just like 41 of 81 in group B (50.6%). No statistical difference was observed between the 2 groups in terms of recurrence rate (p = 0.82) or time to first recurrence (p = 0.095). Kaplan-Meier analysis of recurrence showed no significant differences between group A and group B (p = 0.0952). On multivariate analysis the early single dose instillation of epirubicin was not indicated as an independent prognostic factor (HR 0.50, 95% CI 0.32-1.18). CONCLUSIONS: The present study showed no statistically significant differences in terms of disease-free time and recurrence rate between high risk patients with nonmuscle invasive bladder cancer who had undergone perioperative epirubicin instillation plus delayed bacillus Calmette-Guerin and those who had undergone delayed bacillus Calmette-Guerin alone. ( view less ) Giorgio Bencivenni,Tommaso Lanza,Rino Leardini,Matteo Minozzi,Daniele Nanni,Piero Spagnolo,Giuseppe ZanardiThe radical reaction of tributyltin hydride with o-iodo- N-methylanilides derived from alpha-azido acids provides an excellent access to alpha-(aminocarbonyl)iminyl radicals through 1,5-hydrogen transfer reaction of initially formed aryl radicals followed by beta-elimination of dinitrogen from ensu... ( view more )ing alpha-azido-alpha-(aminocarbonyl)alkyl radicals. The outcoming iminyls display a peculiar tendency to form corresponding nitriles by beta-elimination of aminocarbonyl radicals. ( view less ) Chiara Balducci,Lucia Bibi,Thomas Berg,Emanuele Persichetti,Roberto Tiribuzi,Sabata Martino,Silvia Paciotti,Rita Roberti,Aldo Orlacchio,Tommaso Beccari The lysosomal enzyme di-N-acetylchitobiase hydrolyzes N-acetylglucosamine from the reducing-end of the N,N' diacetylchitobiose core of N-linked-oligosaccharides. The presence of chitobiase in the tissues of different species is probably responsible for differences in the structure of oligosaccharid... ( view more )es accumulated in the lysosomal storage disease beta-mannosidosis. The disease has so far been described in humans, cats, cattle and goats. Low chitobiase activity has been observed in the tissues of ruminants and it has been hypothesized that in cattle this low level of expression is due to evolutionary changes in the promoter region. A cDNA encoding the mouse chitobiase has been isolated, sequenced and its identity confirmed by expression in COS-7 cells. Comparison of the mouse genomic sequence with the cDNA sequence revealed the presence of seven exons within the chitobiase gene. The gene spans about 15 kb and a single transcription initiation site was determined by 5'RACE. Chitobiase is differentially and ubiquitously expressed in mouse tissues as demonstrated by qRT-PCR analysis. Chitobiase is differentially expressed at lower levels in bovine tissues. In two bovine tissues (heart and muscle) mRNA was not detectable. Mouse and bovine promoters have been isolated and sequenced and their activities compared. The activity of the bovine promoter is very low and might explain the low activity of chitobiase observed in cattle. ( view less ) Devis Di Tommaso,Nora H de Leeuw Density functional theory (Perdew-Burke-Ernzerhof) based methods have been used to study the structure and hydration environment of the building blocks of CaCO 3 in aqueous solutions of calcium bicarbonate and calcium carbonate. Car-Parrinello molecular dynamics simulations of Ca(2+)/CO3(2-) and Ca... ( view more ) (2+)/HCO3(-) in explicit water were performed to investigate the formation of CaCO3 and the hydration shell of the solvated hetero-ion pair. Our simulations show that the formation of the monomer of CaCO3 occurs with an associative mechanism and that the dominant building block of calcium (bi)carbonate in aqueous solution is Ca[eta(1)-(H)CO3](H2O)5, i.e., the preferred hydration number is five, while the (bi)carbonate is coordinated to the calcium in a monodentate mode. This result agrees with static calculations, where a hybrid approach using a combination of explicit solvent molecules and a polarizable continuum model has been applied to compute the solvation free energies of calcium bicarbonate species. Furthermore, the discrete-continuum calculations predict that the Ca(HCO3)2 and Ca(HCO3)3(-) species are stable in an aqueous environment preferentially as Ca(HCO3)2(H2O)4 and Ca(HCO3)3(H2O)2(-), respectively. ( view less ) Antonino Raco,Alessandro Frati,Antonio Santoro,Tommaso Vangelista,Maurizio Salvati,Roberto Delfini,Giampaolo Cantore OBJECT: Because of the anatomical complexity of the paraclinoid region, the surgical treatment of aneurysms arising in the C(6) segment of the internal carotid artery is extremely challenging. The authors' aim in this study was to describe the extended clinical follow-up and assess the short-term a... ( view more )nd long-term effectiveness of surgical treatment for these aneurysms, focusing on the clinical outcome and degree of aneurysm occlusion and recurrence. METHODS: The authors retrospectively analyzed the clinical records for patients treated surgically between 1973 and 2004 at the University of Rome, "La Sapienza." Aneurysms were classified into the following 3 groups according to the site where they arose: the anteromedial, anterior or anterolateral, and posteromedial wall of the C(6) segment. RESULTS: Of the 108 aneurysms in 104 patients treated, 63 (58%) were large or giant. Eighty-eight aneurysms in 84 patients were clipped, 16 underwent a high-flow bypass, 2 were trapped, 1 was wrapped, and 1 was left untreated. The mean follow-up was 126 months; 47 patients had a follow-up of > 10 years. Of the 88 aneurysms that were clipped, 6 (6.8%) had an incomplete occlusion that required an immediate reoperation in 1 case and at 2 years in another. Overall 6 patients (5.8%) had surgery-related permanent complications. CONCLUSIONS: Mortality and morbidity rates depend mainly on the patient's preoperative Hunt and Hess grade subarachnoid hemorrhage, whereas surgical morbidity principally reflects excessive manipulation of the optic nerve or ischemic problems due to excessive temporary trapping undertaken without adequate neuroprotection. In expert hands, surgery (clipping and bypass procedures) is a definitive treatment for C(6) aneurysms and has an acceptable complication rate. ( view less ) Yoko Kamotani,Tommaso Bersano-Begey,Nobuhiro Kato,Yi-Chung Tung,Dongeun Huh,Jonathan W Song,Shuichi Takayama Cell culture systems are often static and are therefore nonphysiological. In vivo, many cells are exposed to dynamic surroundings that stimulate cellular responses in a process known as mechanotransduction. To recreate this environment, stretchable cell culture substrate systems have been developed... ( view more ), however, these systems are limited by being macroscopic and low throughput. We have developed a device consisting of 24 miniature cell stretching chambers with flexible bottom membranes that are deformed using the computer-controlled, piezoelectrically actuated pins of a Braille display. We have also developed efficient image capture and analysis protocols to quantify morphological responses of the cells to applied strain. Human dermal microvascular endothelial cells (HDMECs) were found to show increasing degrees of alignment and elongation perpendicular to the radial strain in response to cyclic stretch at increasing frequencies of 0.2, 1, and 5 Hz, after 2, 4, and 12h. Mouse myogenic C2C12 cells were also found to align in response to the stretch, while A549 human lung adenocarcinoma epithelial cells did not respond to stretch. ( view less ) Mathieu Rougemaille,Tommaso Villa,Rajani Kanth Gudipati,Domenico LibriIn eukaryotes, copying the genetic information from a DNA template into RNA is not sufficient itself to confer functional competence to the DNA-encoded message. mRNAs have to be processed by enzymes and packaged with proteins within nuclei to generate mRNP (messenger ribonucleoprotein) particles, b... ( view more )efore these can be exported to the cytoplasm. Processing and packaging factors are believed to interact with the nascent mRNA co-transcriptionally, which protects the highly reactive RNA molecule from a presumably aggressive nuclear environment while providing early commitment to its functional fate. In this review, we will describe the factors that are believed to provide the appropriate 'dress code' to the mRNA and the mechanisms underlying the proofreading events that guarantee its quality, focusing on yeast as a model system. ( view less ) Loris Salvador,Salvatore Mirone,Roberto Bianchini,Tommaso Regesta,Fabio Patelli,Giuseppe Minniti,Mauro Masat,Elena Cavarretta,Carlo Valfrè OBJECTIVE: Mitral valve repair with artificial chordae for degenerative mitral regurgitation is widely adopted. We evaluated long-term results of mitral repair with expanded polytetrafluoroethylene sutures (GORE-TEX CV-5; W. L. Gore & Associates, Inc, Flagstaff, Ariz). METHODS: Between November 198... ( view more )6 and November 2006, 608 consecutive patients underwent mitral repair with artificial neochordae. Mean age was 55 +/- 11 years (15-85 years); 433 (71.2%) were male. Valve disease was purely degenerative in 555 patients (91.3%). Prolapse of anterior, posterior, or both leaflets was present in 47 (7.7%), 308 (50.7%), and 253 (41.6%), respectively. Atrial fibrillation was associated in 117 (19.2%). In 125 cases (20.5%), additional surgical procedures were performed. Follow-up was complete at a median of 5.7 years (interquartile range 2.2-9.8 years, range 0-19.4 years). RESULTS: In-hospital mortality was less than 1% (6 deaths). Overall and cardiac late mortalities were 6.6% and 3.9% (34 and 24 deaths). Kaplan-Meier survival at 15 years was 84% (95% confidence interval 75%-90%). Freedoms from endocarditis, thromboembolic events, reoperation, and recurrent mitral regurgitation at 15 years were 97% (95% confidence interval 93%-99%), 92% (87%-95%), 92% (88%-95%), and 85% (78%-91%), respectively. Sinus rhythm was restored in 75% (33 patients) after surgical atrial fibrillation correction. Calcification of GORE-TEX neochordae was never reported. CONCLUSION: Mitral valve repair with GORE-TEX artificial chordae is effective, safe, and associated with low operative mortality and low rates of valve-related complications at long-term follow-up. Artificial chordae showed excellent biologic adaptation, retaining flexibility and tension with time. ( view less ) Salomone Di Saverio,Fausto Catena,Donatella Santini,Luca Ansaloni,Tommaso Fogacci,Stefano Mignani,Antonio Leone,Filippo Gazzotti,Stefano Gagliardi,Angelo De Cataldis,Mario Taffurelli BACKGROUND: The Van Nuys Prognostic Index (VNPI) is a simple score for predicting the risk of local recurrence (LR) in patients with Ductal Carcinoma In Situ (DCIS) conservatively treated. This score combines three independent predictors of Local Recurrence. The VNPI has recently been updated with ... ( view more )the addition of age as a fourth parameter into the scoring system (University of Southern California/ VNPI). PATIENTS AND METHODS: Our database consisted of 408 women with DCIS. Applying the USC/VNPI we reviewed retrospectively 259 patients who were treated with breast conserving surgery with or without radiotherapy (RT). Of these patients 63.5% had a low VNPI score, 32% intermediate and 4.5% a high score. In the low score group, the majority of the patients underwent Conservative Surgery (CS) without RT while in the intermediate group, almost half of the patients received RT. Eighty-three percent (83%) of the patients with high VNPI were treated with Conservative Surgery plus RT. Nodal assessment by Sentinel Lymph Node Biopsy was obtained in 32 patients since 2002. RESULTS: Twenty-one Local Recurrences were observed (8%) with a mean follow up of 130 months: sixteen were invasive. No statistically significant differences in Disease Free Survival were reached in all groups of VNPI score between patients treated with Conservative Surgery or Conservative Surgery plus RT. However it was noted that the higher the VNPI score, the lower was the risk of local recurrence in the group treated additionally with RT, even though it was not statistically significant. Further analysis included those patients treated with Conservative Surgery alone and followed up. Disease-free survival (DFS) at 10 years was 94% with low VNPI and 83% in both intermediate and high score (P < 0.05). No significant differences were observed in the subgroups of VNPI. The Local Relapse rate after Conservative Surgery alone, increased with tumor size, margin width, and pathology classification (P < 0,05), while age was not found to be a significant factor. Lesions with only mammographic appearances are associated with lower DFS but it did not reach significance (P = ns), while assumption of estrogenic hormones and familial history of breast cancer are significant factors associated with a higher risk of local recurrence. After multivariate analysis including seven clinical and pathological factors, the only significant predictors of local recurrence remained margin width of surgical excision, previous therapy with estrogens (contraceptives or Hormone Replacement Therapy) and the Van Nuys pathologic classification. The overall survival breast cancer specific was 99% and no differences were observed between groups (P = ns). The comparison of patients treated with a total mastectomy and those conservatively treated showed a significantly better local relapse free survival rate obtained with mastectomy (98.2% vs. 89.7% at 10 years P = 0.02). However, the overall cause-specific survival did not prove any better outcome (98.7% in both groups). Of the 32 patients who underwent a Sentinel Lymph Node Biopsy, four were found to have micrometastases and all of them had a previous Directional Vacuum Assisted Biopsy. CONCLUSIONS: Although in our series there is not a significant difference in LR rates by the parameter of age, the new USC/VNPI is still a simple and reliable scoring system for therapeutic management of DCIS. We did not find any statistically significant advantage in groups treated with the addition of RT. Obtaining wide surgical margins appears to be the strongest prognostic factor for local recurrence, regardless of other pathological factors or the addition of adjuvant radiation therapy. However, only prospective randomized studies can precisely predict the risk of LR of conservatively treated DCIS. The clinical significance of Sentinel Lymph Nodes micrometastases Immuno-Histo-Chemistry-detected found in DCIS patients remains uncertain. However, we hypothesize that the anatomical disruption after preoperative biopsy procedures increases the likelihood of epithelial cell displacement and the frequency of IHC-positive Sentinel Lymph Nodes, both of which are directly proportional to the degree of manipulation. ( view less ) Elena Rossi,Tommaso Za,Angela Ciminello,Giuseppe Leone,Valerio De Stefano It is uncertain whether the presence of inherited thrombophilia influences the risk of developing symptomatic pulmonary embolism (PE) and whether different thrombophilic alterations are associated with different risks of symptomatic PE. To investigate such issue, we retrospectively studied 920 pati... ( view more )ents with proximal deep vein thrombosis (DVT) of the legs with or without symptomatic PE referred for thrombophilia screening; patients with overt cancer or antiphospholipid antibodies had been excluded. Three hundred fifty-four patients (38.5%) had deficiency of antithrombin (AT, n = 16), protein C (PC, n = 26), protein S (PS, n = 22), factor V Leiden (FVL, n = 168), prothrombin G20210A (PT-GA, n = 87), or multiple abnormalities (n = 35), and 566 had none of the studied thrombophilic abnormalities. Symptomatic PE complicated the first DVT in 242 patients (26%); the risk of PE was increased in patients with AT deficiency (relative risk [RR] 2.4, 95% confidence interval [CI] 1.6-3.6) or with PT-GA (RR 1.5, 95%CI 1.1-2.0) and decreased in those with FVL (RR 0.7, 95%CI 0.5-1.0) in comparison with those with unknown inherited defect. These data suggest that patients with proximal DVT have different risks of symptomatic PE according to the type of inherited thrombophilia. ( view less ) Khashayar Shakiba,James F Bena,Kimberly M McGill,Jill Minger,Tommaso Falcone OBJECTIVE: To investigate the need for further surgery after laparoscopic excision of endometriosis or hysterectomy. METHODS: In this retrospective study, women who had surgery for endometriosis-associated pain at the Cleveland Clinic were assessed for requirement for subsequent surgery. One hundre... ( view more )d twenty patients who underwent hysterectomy with or without oophorectomy for endometriosis and 120 patients who had laparoscopic excision of their endometriotic lesions only (local excision group) formed the study population. Estimates of reoperation-free survival at 2, 5, and 7 years were calculated using Kaplan-Meier methods, and estimates of risk (hazard ratios) were computed using Cox proportional hazards models. A significance level of .05 was assumed for all tests. RESULTS: In women who underwent local excision with ovarian preservation, the surgery-free percentages were 79.4%, 53.3%, and 44.6%, respectively, at 2, 5, and 7 years. In women who underwent hysterectomy with ovarian preservation, the 2-, 5-, and 7-year reoperation-free percentages were 95.7%, 86.6%, and 77.0%, respectively. In women who underwent hysterectomy without ovarian preservation, the percentages were 96.0%, 91.7%, and 91.7%, respectively. However, in women between 30 and 39 years of age, removal of the ovaries did not significantly improve the surgery-free time. CONCLUSION: Local excision of endometriosis is associated with good short-term outcomes but, on long-term follow-up, has a high reoperation rate. Hysterectomy is associated with a low reoperation rate. Preservation of the ovaries at the time of hysterectomy remains a viable option. LEVEL OF EVIDENCE: II. ( view less ) Tommaso Bartalena,Devil Oboldi,Pier Luigi Guidalotti,Maria Francesca Rinaldi,Paola Bertaccini,Gabriella Napoli,Giampaolo Gavelli OBJECTIVES: Alterations in lung perfusion are a well-known feature of pulmonary hypertension (PH) seen on nuclear medicine studies. Abnormal radiotracer distribution in patients with PH may be caused by arterial thromboembolic occlusion, like in chronic thromboembolic pulmonary hypertension, by par... ( view more )enchymal destruction as in interstitial lung disease and pulmonary emphysema or by distal arteriopathy, like in idiopathic pulmonary arterial hypertension and other nonembolic forms. The different imaging pattern on radionuclide perfusion studies represents an important element for differential diagnosis. The aim of this study was to evaluate minimum intensity projection (minIP) images as an alternative to perfusion scintigraphy. We compared lung parenchyma attenuation patterns as depicted in minIP reconstructions with scintigraphic findings of lung perfusion in patients affected by pulmonary hypertension from various etiologies. METHODS: One hundred and seven consecutive patients affected by PH of different etiology (37 of those had chronic thromboembolic pulmonary hypertension) who had undergone both multidetector computed tomography pulmonary angiography and 99mTc-MAA perfusion scan were included. Five-millimeter thickness contiguous axial, coronal, and sagittal minIP images were reconstructed from the contrast enhanced computed tomography datasets. Two radiologists evaluated the images and qualitatively graded pulmonary attenuation as homogeneous, inhomogeneous with nonsegmental patchy defects, or inhomogeneous with segmental defects. The presence of parenchymal and pleural alterations was recorded. MinIP perfusion grading results were then compared with those of perfusion scintigraphy. RESULTS: In 87 of 107 patients (81.3%), the attenuation pattern seen on minIP images (39 homogeneous patterns, 13 with nonsegmental patchy defects, and 39 with segmental defects) correlated with the nuclear medicine scans. In the remaining 20 patients (18.7%), the imaging pattern was discordant because of 7 false-positive and 2 false-negative thromboembolic patterns at minIP and 11 false-positive thromboembolic patterns at perfusion scan. Air-trapping and parenchymal disease caused false-positive findings at minIP and perfusion scans, respectively. The sensitivity and specificity of minIP in detection of a chronic thromboembolic perfusion pattern were 94.5% and 90%, whereas perfusion scan had 100% sensitivity and 84% specificity. CONCLUSION: MinIP reconstructions can identify different patterns of pulmonary parenchymal attenuation, which show high concordance with perfusion patterns seen on radionuclide studies in patients with pulmonary hypertension. MinIP is a promising technique to evaluate lung perfusion in PH and may be used as an alternative to scintigraphy in the diagnostic work-up of these patients. ( view less ) Serena Catarzi,Tommaso Marcucci,Laura Papucci,Fabio Favilli,Martino Donnini,Francesco Tonelli,Maria Teresa Vincenzini,Teresa Iantomasi BACKGROUND: The etiology of Crohn's disease (CD) remains unknown, and the defective function of neutrophils appears to be associated with this pathology. Neutrophils undergo spontaneous apoptosis which, if not tightly regulated, can induce the development of chronic inflammatory disease. The Bcl-2 ... ( view more )protein family is also involved in the regulation of neutrophil apoptosis. METHODS: This study investigated the apoptosis and expression of some regulatory factors in CD patient and control polymorphonuclear neutrophils (PMN) in suspension and in adhesion on fibronectin, an extracellular matrix protein. These 2 conditions mimic circulating neutrophils before they are recruited at the intestinal levels, and their adhesion to tissue. RESULTS: Apoptosis in CD patient PMN was delayed in suspension and accelerated in adhesion, which is the opposite of what happens in controls. Higher levels of Bax, Bcl-2, and Mcl-1 proteins were registered in freshly isolated CD patient PMN, in contrast to controls, in which Bcl-2 protein was undetectable. Among the studied pro- and antiapoptotic factors, Bax levels seem to be mainly related to the difference in apoptosis between PMN of CD patients and controls. CONCLUSIONS: For the first time it has been demonstrated by direct experimental evidence that apoptosis in CD patient PMN is regulated differently from that of control PMN. Abnormal expression of regulating apoptosis proteins is shown in CD patient PMN. These data suggest that the defective functionality of neutrophils can be the early event responsible for the altered mucosal immune response in CD, and that neutrophil apoptosis may offer a new target for specific drugs and therapy tools. ( view less ) Ilaria Lenci,Laura Tariciotti,Leonardo Baiocchi,Tommaso Maria Manzia,Luca Toti,Paolo Craboledda,Francesco Callea,Mario Angelico,Giuseppe Tisone A 64-year-old man with HBV-related cirrhosis presented with a liver nodule measuring 2.8 cm revealed by a routine ultrasound and concomitant increased alpha-fetoprotein (AFP) up to 400 UI/l. Contrast-enhanced CT was suggestive of hepatocellular carcinoma (HCC) and the patient underwent laser ablati... ( view more )on procedure. Five months later, because of raised AFP up to 1600 UI/l, ultrasonography and abdominal CT were repeated, showing an increased diameter of liver nodule, measuring 3.8 cm. The patient underwent down-staged trans-arterial chemoembolization (TACE) and then was entered into the active liver transplant (LT) list. Lamivudine was already started and the patient underwent LT showing HBV-DNA serum levels <10(3) log/copies at the time of surgery. Pathological analysis performed on the explanted liver showed, instead of the suspected HCC, hepatic yolk sac tumor with the presence of typical 'Schiller-Duval bodies'. The first 12 months of postoperative follow-up were excellent, with no evidence of tumor recurrence. ( view less ) Filomena Fezza,Sergio Oddi,Monia Di Tommaso,Chiara De Simone,Cinzia Rapino,Nicoletta Pasquariello,Enrico Dainese,Alessandro Finazzi-Agrò,Mauro Maccarrone Anandamide (N-arachidonoylethanolamide; AEA) acts as an endogenous agonist of both cannabinoid and vanilloid receptors. During the last two decades, its metabolic pathways and biological activity have been investigated extensively and relatively well characterized. In contrast, at present, the effe... ( view more )ctive nature and mechanism of AEA transport remain controversial and still unsolved issues. Here, we report the characterization of a biotinylated analog of AEA (b-AEA) that has the same lipophilicity of the parent compound. In addition, by means of biochemical assays and fluorescence microscopy, we show that b-AEA is accumulated inside the cells in a way superimposable on that of AEA. Conversely, b-AEA does not interact or interfere with the other components of the endocannabinoid system, such as type-1 and type-2 cannabinoid receptors, vanilloid receptor, AEA synthetase (N-acylphosphatidylethanolamine-hydrolyzing phospholipase D), or AEA hydrolase (fatty acid amide hydrolase). Together, our data suggest that b-AEA could be a very useful probe for visualizing the accumulation and intracellular distribution of this endocannabinoid. ( view less ) Tommaso Gori,Saverio Dragoni,Monica Lisi,Giuseppe Di Stolfo,Serena Sonnati,Massimo Fineschi,John D Parker OBJECTIVES: We describe and validate a novel noninvasive method that complements the data from "traditional" flow-mediated dilation (FMD) studies. BACKGROUND: The study of peripheral vascular reactivity provides important diagnostic and prognostic information in patients with (or at risk for) cardi... ( view more )ovascular disease. METHODS: High-resolution ultrasound and automatic computerized analysis were used to measure the diameter of the radial artery at rest and in conditions of locally decreased and increased shear stress (respectively, low-flow-mediated constriction [L-FMC] and flow-mediated dilation [FMD]). A composite end point (L-FMC + FMD) was also calculated. A total of 196 studies were performed. RESULTS: When the repeatability of the method was tested, the range of variation across measurements was 1.1% for L-FMC and 1.7% for FMD; the intraclass correlation coefficient was 0.80 and 0.68, respectively. Low-flow-mediated constriction, FMD, and their composite end point were significantly blunted after acute smoking, in coronary artery disease patients, and in hypertensive patients as compared with that seen in healthy age-matched volunteers (p < 0.01, analysis of variance). Low-flow-mediated constriction, but not FMD, was blunted (p < 0.05) after administration of fluconazole (an inhibitor of a cytochrome P450-derived endothelium-derived hyperpolarization factor) and aspirin (an inhibitor of cyclooxygenase). Flow-mediated dilation, but not L-FMC, was blunted (p < 0.05) by nitric oxide synthase inhibition. CONCLUSIONS: Low-flow-mediated constriction is a simple, rapid, and accurate measure of resting arterial tone that does not require further procedures as compared with "traditional" FMD measurements. While FMD measures endothelial responses to sudden increases in shear stress, L-FMC is a measure of the response to resting shear stress levels, and, therefore, it provides additional information that is complementary to FMD. ( view less )
|
|
|