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Mascilini F, Moro F, De Leo R, Scambia G, Fagotti A, Testa AC. Intraoperative ultrasound assistance for surgical removal of lost intrauterine device. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 53:705-706. [PMID: 29947114 DOI: 10.1002/uog.19167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
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Moro F, Pasciuto T, Djokovic D, Di Legge A, Granato V, Moruzzi MC, Mancari R, Zannoni GF, Fischerova D, Franchi D, Scambia G, Testa AC. Role of CA125/CEA ratio and ultrasound parameters in identifying metastases to the ovaries in patients with multilocular and multilocular-solid ovarian masses. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 53:116-123. [PMID: 29978587 DOI: 10.1002/uog.19174] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 06/21/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To investigate ultrasound features and the best cut-off value of the cancer antigen 125/carcinoembryonic antigen (CA125/CEA) ratio to discriminate ovarian metastases from benign and primary malignant ovarian neoplasms in two selected groups of morphological ovarian masses, namely multilocular masses with five or more locules and multilocular-solid masses. METHODS Patients with multilocular (five or more locules) or multilocular-solid ovarian masses, operated on within 3 months of ultrasound examination, and with tumor markers (CEA and CA125) available at diagnosis, were identified retrospectively from three ultrasound centers. The masses were described using the International Ovarian Tumor Analysis (IOTA) terminology. Ultrasound and clinical characteristics were compared between those with an ovarian neoplasm (including benign and primary malignant neoplasms) and those with an ovarian metastasis. Receiver-operating characteristics curve (ROC) analysis was used to evaluate the ability of CA125, CEA and CA125/CEA to differentiate between ovarian neoplasms and ovarian metastases, and their predictive performance was assessed. RESULTS In total, 350 (88.4%) patients with an ovarian neoplasm (including 99 benign, 43 borderline and 197 primary epithelial ovarian carcinomas, seven malignant rare tumors and four other types of invasive ovarian tumor) and 46 (11.6%) patients with an ovarian metastasis were analyzed. On ultrasound examination, ovarian neoplasms were smaller than ovarian metastases (median largest diameter, 97 (range, 20-387) mm vs 146 (range, 43-259) mm, respectively; P < 0.0001) and presented with a lower number of cysts with > 10 locules (18.9% vs 54.3%; P < 0.0001). ROC curve analysis showed that the best cut-off value of CEA for distinguishing between ovarian neoplasms and ovarian metastases was 2.33 ng/mL. The predictive performance of this CEA cut-off value was: area under the curve (AUC), 0.791 (95% CI, 0.711-0.870); accuracy, 73.7%; sensitivity, 73.1%; specificity, 78.3%; positive predictive value (PPV), 96.2%; and negative predictive value (NPV), 27.7%. The best cut-off value of CA125/CEA for distinguishing between ovarian neoplasms and ovarian metastases was 11.92. The predictive performance of this CA125/CEA cut-off value was: AUC, 0.758 (95% CI, 0.683-0.833); accuracy, 79.8%; sensitivity, 82.3%; specificity, 60.9%; PPV, 94.1%; and NPV, 31.1%. CONCLUSIONS CA125/CEA ratio and CEA alone did not show any significant difference in their ability to distinguish between ovarian neoplasms (including benign and malignant) and ovarian metastases in masses with multilocular and those with multilocular-solid morphology. Therefore, in this morphological subgroup of ovarian masses, CEA alone is sufficient to differentiate between ovarian neoplasms and ovarian metastases. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Pozzati F, Moro F, Pasciuto T, Gallo C, Ciccarone F, Franchi D, Mancari R, Giunchi S, Timmerman D, Landolfo C, Epstein E, Chiappa V, Fischerova D, Fruscio R, Zannoni GF, Valentin L, Scambia G, Testa AC. Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:792-800. [PMID: 29978567 DOI: 10.1002/uog.19171] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of ovarian pure clear cell carcinoma. METHODS This was a retrospective study involving data from 11 ultrasound centers. From the International Ovarian Tumor Analysis (IOTA) database, 105 patients who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016 were identified with a histologically confirmed pure clear cell carcinoma of the ovary. An additional 47 patients diagnosed with pure clear cell carcinoma between 1999 and 2016 and with available complete preoperative ultrasound reports were identified retrospectively from the databases of the departments of gynecological oncology in the participating centers. The ultrasound images of all tumors were described using IOTA terminology. Clinical and ultrasound characteristics were analyzed for the whole group, and separately, for patients with and those without histologically confirmed endometriosis, and for patients with evidence of tumor developing from endometriosis. RESULTS Median age of the 152 patients was 53.5 (range, 28-92) years and 92/152 (60.5%) tumors were FIGO Stage I. Most tumors (128/152, 84.2%) were unilateral. On ultrasound examination, all tumors contained solid components and 36/152 (23.7%) were completely solid masses. The median largest diameter of the lesion was 117 (range, 25-310) mm. Papillary projections were present in 58/152 (38.2%) masses and, in most of these (51/56, 91.1%), vascularized papillary projections were seen. Information regarding the presence, site and type of pelvic endometriosis at histology was available for 130/152 patients. Endometriosis was noted in 54 (41.5%) of these. In 24/130 (18.6%) patients, the tumor was judged to have developed from endometriosis. Patients with, compared to those without, evidence of tumor developing from endometriosis were younger (median 47.5 vs 55.0 years, respectively), and ground-glass echogenicity of cyst fluid was more common in pure clear cell cancers developing from endometriosis (10/20 vs 13/79 (50.0% vs 16.5%), respectively). CONCLUSIONS Ovarian pure clear cell carcinoma is usually diagnosed at an early stage and typically appears as a large unilateral mass with solid components. Patients with clear cell carcinoma developing from endometriosis are younger than other patients with clear cell carcinoma, and clear cell cancers developing from endometriosis more often manifest ground-glass echogenicity of cyst fluid. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Bachmann C, Ciattaglia S, Cismondi F, Eade T, Federici G, Fischer U, Franke T, Gliss C, Hernandez F, Keep J, Loughlin M, Maviglia F, Moro F, Morris J, Pereslavtsev P, Taylor N, Vizvary Z, Wenninger R. Overview over DEMO design integration challenges and their impact on component design concepts. FUSION ENGINEERING AND DESIGN 2018. [DOI: 10.1016/j.fusengdes.2017.12.040] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Carbonara M, Fossi F, Zoerle T, Ortolano F, Moro F, Pischiutta F, Zanier ER, Stocchetti N. Neuroprotection in Traumatic Brain Injury: Mesenchymal Stromal Cells can Potentially Overcome Some Limitations of Previous Clinical Trials. Front Neurol 2018; 9:885. [PMID: 30405517 PMCID: PMC6208094 DOI: 10.3389/fneur.2018.00885] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/01/2018] [Indexed: 12/12/2022] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In the last 30 years several neuroprotective agents, attenuating the downstream molecular and cellular damaging events triggered by TBI, have been extensively studied. Even though many drugs have shown promising results in the pre-clinical stage, all have failed in large clinical trials. Mesenchymal stromal cells (MSCs) may offer a promising new therapeutic intervention, with preclinical data showing protection of the injured brain. We selected three of the critical aspects identified as possible causes of clinical failure: the window of opportunity for drug administration, the double-edged contribution of mechanisms to damage and recovery, and the oft-neglected role of reparative mechanisms. For each aspect, we briefly summarized the limitations of previous trials and the potential advantages of a newer approach using MSCs.
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Spadaro S, Karbing DS, Dalla Corte F, Mauri T, Moro F, Gioia A, Volta CA, Rees SE. An open-loop, physiological model based decision support system can reduce pressure support while acting to preserve respiratory muscle function. J Crit Care 2018; 48:407-413. [PMID: 30317049 DOI: 10.1016/j.jcrc.2018.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/04/2018] [Accepted: 10/04/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess whether a clinical decision support system (CDSS) suggests PS and FIO2 maintaining appropriate breathing effort, and minimizing FIO2. MATERIALS Prospective, cross-over study in PS ventilated ICU patients. Over support (150% baseline) and under support (50% baseline) were applied by changing PS (15 patients) or PEEP (8 patients). CDSS advice was followed. Tension time index of inspiratory muscles (TTies), respiratory and metabolic variables were measured. RESULTS PS over support (median 8.0 to 12.0 cmH2O) reduced respiratory muscle activity (TTies 0.090 ± 0.028 to 0.049 ± 0.030; p < .01), and tended to increase tidal volume (VT: 8.6 ± 3.0 to 10.1 ± 2.9 ml/kg; p = .08). CDSS advice reduced PS (6.0 cmH2O, p = .005), increased TTies (0.076 ± 0.038, p < .01), and tended to reduce VT (8.9 ± 2.4 ml/kg, p = .08). PS under support (12.0 to 4.0 cmH2O) slightly increased respiratory muscle activity, (TTies to 0.120 ± 0.044; p = .007) with no significant CDSS advice. CDSS advice reduced FIO2 by 12-14% (p = .005), resulting in median SpO2 = 96% (p < .02). PEEP changes did not result in changes in physiological variables, or CDSS advice. CONCLUSION The CDSS advised on low values of PS often not prohibiting extubation, while acting to preserve respiratory muscle function and preventing passive lung inflation. CDSS advice minimized FIO2 maintaining SpO2 at safe and beneficial values.
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Moro F, Magoga G, Pasciuto T, Mascilini F, Moruzzi MC, Fischerova D, Savelli L, Giunchi S, Mancari R, Franchi D, Czekierdowski A, Froyman W, Verri D, Epstein E, Chiappa V, Guerriero S, Zannoni GF, Timmerman D, Scambia G, Valentin L, Testa AC. Imaging in gynecological disease (13): clinical and ultrasound characteristics of endometrioid ovarian cancer. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:535-543. [PMID: 29418038 DOI: 10.1002/uog.19026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/17/2018] [Accepted: 01/26/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of ovarian pure endometrioid carcinomas. METHODS This was a retrospective multicenter study of patients with a histological diagnosis of pure endometrioid carcinoma. We identified 161 patients from the International Ovarian Tumor Analysis (IOTA) database who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016, and another 78 patients from the databases of the departments of gynecological oncology in the participating centers. All tumors were described using IOTA terminology. In addition, one author reviewed all available ultrasound images and described them using pattern recognition. RESULTS Median age of the 239 patients was 55 years (range, 19-88 years). On ultrasound examination, two (0.8%) endometrioid carcinomas were described as unilocular cysts, three (1.3%) as multilocular cysts, 37 (15.5%) as unilocular-solid cysts, 115 (48.1%) as multilocular-solid cysts and 82 (34.3%) as solid masses. Median largest tumor diameter was 102.5 mm (range, 20-300 mm) and median largest diameter of the largest solid component was 63 mm (range, 9-300 mm). Papillary projections were present in 70 (29.3%) masses. Most cancers (188 (78.7%)) were unilateral. In 49 (20.5%) cases, the cancer was judged by the pathologist to develop from endometriosis. These cancers, compared with those without evidence of tumor developing from endometriosis, more often manifested papillary projections on ultrasound (46.9% (23/49) vs 24.7% (47/190)), were less often bilateral (8.2% (4/49) vs 24.7% (47/190)) and less often associated with ascites (6.1% (3/49) vs 28.4% (54/190)) and fluid in the pouch of Douglas (24.5% (12/49) vs 48.9% (93/190)). Retrospective analysis of available ultrasound images using pattern recognition revealed that many tumors without evidence of tumor developing from endometriosis (36.3% (41/113)) had a large central solid component entrapped within locules, giving the tumor a cockade-like appearance. CONCLUSIONS Endometrioid cancers are usually large, unilateral, multilocular-solid or solid tumors. The ultrasound characteristics of endometrioid carcinomas developing from endometriosis differ from those without evidence of tumor developing from endometriosis, the former being more often unilateral cysts with papillary projections and no ascites. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Moro F, Bitonti G, Mascilini F, Testa AC, Scambia G. Intraoperative transvaginal ultrasound examination during myomectomy. J Ultrasound 2018; 22:109-110. [PMID: 30019287 DOI: 10.1007/s40477-018-0310-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/14/2018] [Indexed: 01/20/2023] Open
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Mascilini F, Moro F, Di Grazia FM, Leombroni M, Distefano MG, Fanfani F, Scambia G, Testa AC. Clinical and ultrasound features of non-gestational ovarian choriocarcinoma. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:121-123. [PMID: 29080278 DOI: 10.1002/uog.18943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 10/20/2017] [Indexed: 06/07/2023]
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Testa AC, Moro F, Pasciuto T, Moruzzi MC, Di Legge A, Fuoco G, Autorino R, Collarino A, Gui B, Zannoni GF, Gambacorta A, Miccò M, Rufini V, Scambia G, Ferrandina G. PRospective Imaging of CErvical cancer and neoadjuvant treatment (PRICE) study: role of ultrasound to assess residual tumor in locally advanced cervical cancer patients undergoing chemoradiation and radical surgery. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:110-118. [PMID: 29119649 DOI: 10.1002/uog.18953] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/28/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine the diagnostic performance of two-dimensional (2D) ultrasound parameters, three-dimensional (3D) power Doppler and contrast-enhanced indices in detecting residual disease in locally advanced cervical cancer patients triaged to neoadjuvant treatment followed by radical surgery. METHODS Between October 2010 and June 2014, we screened 108 women with histologically documented locally advanced cervical cancer Stage IB2-IVA, of whom 88 were included in the final analysis. 2D ultrasound parameters, 3D power Doppler and contrast-ultrasound parameters were assessed 5 weeks after the end of neoadjuvant chemoradiation therapy. The pathological response was defined as complete (absence of any residual tumor after treatment) or partial (including microscopic and/or macroscopic residual tumor at pathology examination). The two response groups were compared and receiver-operating characteristics (ROC) curves generated to determine the best cut-off value of sonographic tumor diameter to predict residual disease. Histology was considered as reference. RESULTS Complete pathological response to chemoradiation was observed in 40 (45.5%) patients and partial response in 48 (54.5%). The presence of residual disease, as confirmed at pathology examination, was detected by 2D grayscale ultrasound with a sensitivity of 64.6% and specificity of 65%. Color Doppler examination in the cases with lesions visualized on grayscale imaging detected the presence of residual disease, confirmed at pathology, with a sensitivity of 87.1% and specificity of 21.4%. The best area under the ROC curve (0.817) was for the detection of pathological residual disease of at least 6 mm in diameter, using a cut-off value of 12 mm for the largest tumor diameter assessed using 2D grayscale ultrasound (sensitivity, 95%; specificity, 70.6%). Neither 3D vascular indices nor contrast-ultrasound parameters obtained for lesions suspected at ultrasound following chemoradiation differed significantly between patients with histological complete and those with partial response. CONCLUSIONS Our results show that grayscale and color Doppler ultrasound have a low level of diagnostic performance in detecting residual disease after neoadjuvant chemoradiation in patients with locally advanced cervical cancer. The best performance was achieved in detection of macroscopic (≥ 6 mm) residual disease. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Moro F, Pozzati F, Mascilini F, Magoga G, Pasciuto T, Zannoni G, Scambia G, Testa AC. Ultrasound characteristics of ovarian metastases from low-grade appendiceal mucinous neoplasms. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:699-700. [PMID: 28782238 DOI: 10.1002/uog.18829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/13/2017] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
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Lucchetti J, Marzo CM, Passoni A, Moro F, di Clemente A, Bagnati R, Cervo L, Gobbi M. Brain disposition, metabolism and behavioral effects of the synthetic opioid AH-7921 in rats. Neuropharmacology 2018; 133:51-62. [DOI: 10.1016/j.neuropharm.2018.01.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 11/15/2022]
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Mistrangelo M, Mobiglia A, Mussa B, Bellò M, Pelosi E, Goss M, Bosso MC, Moro F, Sandrucci S. The Sentinel Node in Anal Carcinoma. TUMORI JOURNAL 2018; 88:S51-2. [PMID: 12369553 DOI: 10.1177/030089160208800344] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background Anal cancer is a rare condition. The inguinal lymph nodes are the most common site of metastasis in this neoplasm. The inguinal lymph node status is an important prognostic indicator and the presence of metastases is an independent prognostic factor for local failure and overall mortality. Depending on the primary tumor size and histological differentiation, metastasis to superficial inguinal lymph nodes occurs in 15-25% of cases. Methods and Study Design To evaluate the inguinal lymph node status we performed a search for the sentinel node in a female patient affected by squamous anal carcinoma. Results Identification and examination of the sentinel node was positive and postoperative histology showed the presence of bilateral lymph node metastases. Conclusions We suggest that examination of the sentinel node in anal cancer could be an efficient way to establish the inguinal lymph node status, which would help the clinician to plan and perform adequate treatment.
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Moro F, Orrù A, Marzo CM, Di Clemente A, Cervo L. mGluR2/3 mediates short-term control of nicotine-seeking by acute systemic N-acetylcysteine. Addict Biol 2018; 23:28-40. [PMID: 27558879 DOI: 10.1111/adb.12443] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/24/2016] [Accepted: 08/01/2016] [Indexed: 12/26/2022]
Abstract
Chronic self-administration of nicotine induces maladaptive changes in the cortico-accumbal glutamate (Glu) network. Consequently, re-exposure to nicotine-associated cues raises extracellular Glu in the nucleus accumbens reinstating drug-seeking. Restoring basal concentrations of extracellular Glu, thereby increasing tonic activation of the presynaptic group II metabotropic Glu receptors (mGluR2/3) with N-acetylcysteine (N-AC), might offer a valid therapeutic approach for maintaining smoking abstinence. Although N-AC modulates nicotine-seeking behavior by drug-associated stimuli in abstinent rats, it is still unclear whether it occurs through activation of mGluR2/3. Male Wistar rats were trained to associate discriminative stimuli (SD s) with the availability of intravenous nicotine (0.03 mg/kg/65 µl/2-second/infusion) or oral saccharin (100 µl of 50 mg/l) self-administration versus non-reward. Reinforced response was followed by a cue signaling 20-second time-out (CSs). Once the training criterion was met, rats underwent lever press extinction, without reinforcers, SD s and CSs. Re-exposure to nicotine or saccharin SD+ /CS+ , but not non-reward SD- /CS- , revived responding on the previously reinforced lever. Acute N-AC, 100 but not 60 or 30 mg/kg i.p., reduced cue-induced nicotine-seeking. N-AC 100 mg/kg did not modify cue-induced saccharin-seeking behavior or influenced locomotor activity. Blocking mGluR2/3 with the selective antagonist LY341495, 1 mg/kg i.p., completely prevented the antirelapse activity of N-AC. The finding that N-AC prevents cue-induced nicotine-seeking by stimulating mGluR2/3 might indicate a therapeutic opportunity for acute cue-controlled nicotine-seeking. Future studies could evaluate the persistent effects of chronic N-AC in promoting enduring suppression of nicotine-cue conditioned responding.
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Moro F, Baima Poma C, Zannoni GF, Vidal Urbinati A, Pasciuto T, Ludovisi M, Moruzzi MC, Carinelli S, Franchi D, Scambia G, Testa AC. Imaging in gynecological disease (12): clinical and ultrasound features of invasive and non-invasive malignant serous ovarian tumors. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:788-799. [PMID: 28101917 DOI: 10.1002/uog.17414] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 01/11/2017] [Accepted: 01/12/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To describe clinical and ultrasound features of different subclasses of malignant serous ovarian tumors according to the World Health Organization 2014 classification. METHODS Patients with a histological diagnosis of borderline tumor (BOT), non-invasive and invasive low-grade serous carcinoma (LGSC) and high-grade serous carcinoma (HGSC), who had undergone preoperative ultrasound examination, were retrospectively identified from two ultrasound centers. The masses were described using the terms of the International Ovarian Tumor Analysis Group. RESULTS Sixty-four (15.8%) women had a serous BOT, 11 (2.7%) a non-invasive LGSC, 31 (7.6%) an invasive LGSC and 300 (73.9%) had a HGSC. The vast majority of BOTs (82.3%) and non-invasive LGSCs (90.9%) were Stage I according to the International Federation of Gynecology and Obstetrics (FIGO) classification scheme, whereas most invasive LGSCs (74.2%) and HGSCs (74.0%) were FIGO Stage III. On ultrasound examination, most borderline lesions were described as unilocular-solid (54.7%) or as multilocular-solid (29.7%) cysts. Papillary projections were present in 52 (81.3%) BOTs. Most non-invasive LGSCs (63.6%) were multilocular-solid cysts and 81.8% had papillary projections. Invasive LGSCs were multilocular-solid cysts in 54.8% of cases, and papillary projections were present in 32.3% of lesions. HGSCs were multilocular-solid (32.7%) or solid (64.0%) masses, with papillary projections in only 7% of cases. CONCLUSIONS Papillary projections were the most typical ultrasound feature of non-invasive (borderline and low-grade) malignant serous tumors, while the presence of solid components but few, if any, papillations was the most representative feature of invasive (low-grade and high-grade) serous tumors. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Moro F, Mascilini F, Casella E, Pasciuto T, Scambia G, Testa AC. Small cell lung cancer metastatic to the ovary diagnosed during pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:802-803. [PMID: 28233352 DOI: 10.1002/uog.17437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
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Fischer U, Bachmann C, Catalan J, Eade T, Flammini D, Gilbert M, Jaboulay JC, Konobeev A, Leichtle D, Lu L, Malouch F, Moro F, Pereslavtsev P, Qiu Y, Sanz J, Sauvan P, Stankunas G, Travleev A, Turner A, Ogando F, Palermo I, Villari R. Methodological approach for DEMO neutronics in the European PPPT programme: Tools, data and analyses. FUSION ENGINEERING AND DESIGN 2017. [DOI: 10.1016/j.fusengdes.2017.01.053] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cecconello M, Conroy S, Marocco D, Moro F, Esposito B. Neural network implementation for ITER neutron emissivity profile recognition. FUSION ENGINEERING AND DESIGN 2017. [DOI: 10.1016/j.fusengdes.2017.02.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Del Nevo A, Martelli E, Agostini P, Arena P, Bongiovì G, Caruso G, Di Gironimo G, Di Maio P, Eboli M, Giammusso R, Giannetti F, Giovinazzi A, Mariano G, Moro F, Mozzillo R, Tassone A, Rozzia D, Tarallo A, Tarantino M, Utili M, Villari R. WCLL breeding blanket design and integration for DEMO 2015: status and perspectives. FUSION ENGINEERING AND DESIGN 2017. [DOI: 10.1016/j.fusengdes.2017.03.020] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND There is limited knowledge on composite allograft reconstructions in revision elbow arthroplasty. A major reason for the restricted use of freshly frozen allografts is the divergent legal requirements for allograft procurement in European countries. RESULTS The opportunities and limitations of this complex revision surgery of the elbow are outlined based on our own restricted experiences, as well as on current literature. Our experience is in accordance with that of other institutions. The results are heterogeneous and range from satisfying to poor. The main problems are the increased risk of infection and the lack of allograft incorporation. Therefore, salvage procedures such as resection arthroplasty still need to be considered. It is not possible to define universally applicable treatment guidelines due to the limited caseload, even when an acceptable functional outcome can be achieved in the majority of cases. Due to the lack of a "simple solution" or valid guidelines, treatment strategies should be individualized for each patient. Complications such as infection and failed allograft incorporation represent the key issues of this procedure and remain a major challenge in revision surgery.
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96
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Angelone M, Flammini D, Loreti S, Moro F, Pillon M, Villar R, Klix A, Fischer U, Kodeli I, Perel R, Pohorecky W. Copper benchmark experiment for the testing of JEFF-3.2 nuclear data for fusion applications. EPJ WEB OF CONFERENCES 2017. [DOI: 10.1051/epjconf/201714609004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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97
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Moro F, Zannoni GF, Arciuolo D, Pasciuto T, Amoroso S, Mascilini F, Mainenti S, Scambia G, Testa AC. Imaging in gynecological disease (11): clinical and ultrasound features of mucinous ovarian tumors. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:261-270. [PMID: 28782867 DOI: 10.1002/uog.17222] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/30/2016] [Accepted: 08/05/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound findings in patients with mucinous ovarian tumors. METHODS In this retrospective study, women with a histological diagnosis of mucinous ovarian tumor who had undergone preoperative ultrasound examination were identified from the database of a single ultrasound center. The histological examination was performed by the same pathologist in all cases, and the ultrasound appearance of the tumors was described using the terms and definitions of the International Ovarian Tumor Analysis group. RESULTS We identified 123 women with a histological diagnosis of mucinous ovarian tumor, of whom 57 (46%) had benign cystadenoma, 34 (28%) had gastrointestinal (GI)-type borderline tumor, 10 (8%) had endocervical-type borderline tumor and 22 (18%) had GI-type invasive carcinoma. On ultrasound examination, 65% (37/57) of cystadenomas were multilocular, of which 59% had ≤ 10 locules, and 79% (27/34) of GI-type borderline tumors were multilocular, of which 89% had > 10 locules. Conversely, 60% (6/10) of endocervical-type borderline tumors had papillations. Eighty-two percent (18/22) of invasive masses contained solid components and 55% (12/22) were multilocular-solid cysts. Bilateral mucinous cystadenomas were found in two women (4% of women with benign tumors) and bilateral borderline tumors of endocervical type in two women (20% of women with borderline tumors of endocervical type). No woman had a bilateral GI-type borderline tumor or a bilateral invasive tumor. CONCLUSIONS A multilocular cyst with 2-10 locules is representative of a benign cystadenoma, whereas a multilocular cyst with > 10 locules is indicative of a GI-type borderline tumor. Most invasive tumors of mucinous GI-type contain solid components, the most typical ultrasound appearance being that of a multilocular-solid tumor. Papillary projections are typical features of endocervical-type borderline tumors. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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98
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Moro F, Pozzati F, Di Legge A, De Blasis I, Scambia G, Testa AC. Adnexal tumor of probable Wolffian origin arising from retroperitoneal space. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:807-808. [PMID: 27514706 DOI: 10.1002/uog.17226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/05/2016] [Indexed: 06/06/2023]
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Ballerini A, Moro F, Nerini IF, Marzo CM, Di Clemente A, Ferrari M, D'Incalci M, Biondi A, Colombini A, Conter V, Porcu L, Cervo L, Rizzari C, Zucchetti M. Pharmacodynamic effects in the cerebrospinal fluid of rats after intravenous administration of different asparaginase formulations. Cancer Chemother Pharmacol 2017; 79:1267-1271. [PMID: 28424964 DOI: 10.1007/s00280-017-3307-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 04/11/2017] [Indexed: 01/27/2023]
Abstract
PURPOSE Asparaginase (ASNase) is used to treat various hematological malignancies for its capacity to deplete asparagine (ASN) in serum and cerebrospinal fluid (CSF). Since the biological mechanisms underlying CSF asparagine depletion in humans are not yet fully elucidated, this study compared, for the first time, the pharmacological properties of three clinically used ASNase formulations in a rodent model. METHODS Male Wistar rats were treated with E.coli-ASNase, PEG-ASNase, or ERW-ASNase at different doses. Serum and CSF amino-acid levels and ASNase activities were evaluated at 1 and 24 h after the intravenous administration of different ASNase doses. RESULTS All the ASNase formulations showed higher activities in serum after 1 h than 24 h and completely deplete ASN. Mean ASNase activity in the CSF at 1 h was higher with ERW-ASNase compared to PEG-ASNase (36 ± 29 vs 8 ± 7 U/L, p < 0.037) and similar to E.coli-ASNase (21 ± 9 U/L, ns). ERW-ASNase and E.coli-ASNase at the highest doses were able to deplete ASN in the CSF after 1 h. This effect was transient and not evident at 24 h after treatment. CONCLUSIONS Together with the ASN depletion in serum and CSF, a never before demonstrated transient penetration of ASNases into the CSF, more evident for non-pegylated formulations, was detected when the ASNases were administered at high dose.
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Lucchetti J, Marzo CM, Passoni A, Di Clemente A, Moro F, Bagnati R, Gobbi M, Cervo L. Brain Disposition of cis- para-Methyl-4-Methylaminorex ( cis-4,4'-DMAR) and Its Potential Metabolites after Acute and Chronic Treatment in Rats: Correlation with Central Behavioral Effects. J Pharmacol Exp Ther 2017; 361:492-500. [PMID: 28404688 DOI: 10.1124/jpet.117.240788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/03/2017] [Indexed: 11/22/2022] Open
Abstract
para-Methyl-4-methylaminorex (4,4'-DMAR) is a phenethylamine derivative with psychostimulant activity whose abuse has been associated with several deaths and a wide range of adverse effects. We recently validated a high-performance liquid chromatography-tandem mass spectrometry method to measure the compound's concentrations in plasma, and we applied it to describe the pharmacokinetic properties of 4,4'-DMAR after a single dose in rats. In this study, we investigated the brain disposition and metabolism of cis-4,4'-DMAR after intraperitoneal injection as well as its central behavioral effects. Locomotor activity increased after a single injection of 10 mg/kg, peaking at 2 hours and disappearing at 5 hours; in these conditions, brain absorption was very rapid, (tmax = 30-60 minutes) and large (brain-to-plasma ratio = 24); the half-life was approximately 50 minutes. After 14 daily doses, the compound's effect on locomotor activity was greater (approximately 20% compared with the effect after the first dose), but not for pharmacokinetic reasons. Using high-resolution mass spectrometry, we also identified four metabolites of cis-4,4'-DMAR in the plasma and brain of treated rats. Semiquantitative analysis indicated low brain permeability and very low brain concentrations, suggesting that these metabolites do not contribute to central behavioral effects; however, the metabolite originating from oxidation of the para-methyl group (M2) persisted in the plasma longer and at higher concentrations than the parent molecule and could be used to evaluate drug intake in human consumers. Finally, we describe the rewarding effect of cis-4,4'-DMAR in the conditioning place preference test, suggesting a high risk of addiction in humans.
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