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Rofaiel R, Kohli S, Mura M, Hosseini-Moghaddam SM. A 53-year-old man with dyspnoea, respiratory failure, consistent with infliximab-induced acute interstitial pneumonitis after an accelerated induction dosing schedule. BMJ Case Rep 2017; 2017:bcr-2017-219956. [PMID: 28500116 DOI: 10.1136/bcr-2017-219956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
A 53-year-old man with ulcerative colitis (UC) suffered fatal acute interstitial pneumonitis (AIP) post completing an accelerated infliximab induction course. This is the first case reported in this setting. A literature review found four similar cases of infliximab-induced interstitial lung disease in the setting of treating patients with UC using standard infliximab regimens had successful treatment of the subjects post infliximab discontinuation. Unfortunately, the patient we are presenting, who had an accelerated infliximab induction course, did not survive. Although a prior small trial along more recent new small studies continue to show a benefit in reducing the need for early colectomy with the accelerated infliximab induction regimen as salvage therapy, it should be used cautiously until more safety data are available. Further larger trials are required to investigate rare side effects that may be associated with this regimen such as rapidly progressive lung toxicity as seen in this patient.
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Mura M, Mehta A, Ramachandra C, Pisano F, Ciuffreda M, Crotti L, Schwartz P, Shim W, Gnecchi M. The KCNH2-IVS9-28A/G mutation causes aberrant isoform expression and hERG trafficking defect in cardiomyocytes derived from patients affected by long QT syndrome type 2. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fisher JH, Al-Hejaili F, Kandel S, Hirji A, Shapera S, Mura M. Multi-dimensional scores to predict mortality in patients with idiopathic pulmonary fibrosis undergoing lung transplantation assessment. Respir Med 2017; 125:65-71. [DOI: 10.1016/j.rmed.2017.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 02/16/2017] [Accepted: 03/03/2017] [Indexed: 10/20/2022]
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Hosein K, Le J, Mura M. Assessing the Therapeutic Response to Pirfenidone in Idiopathic Pulmonary Fibrosis: Can We Do Better than with Forced Vital Capacity Alone? Lung 2016; 195:101-105. [DOI: 10.1007/s00408-016-9963-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
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Khadawardi H, Mura M. A simple dyspnoea scale as part of the assessment to predict outcome across chronic interstitial lung disease. Respirology 2016; 22:501-507. [PMID: 27862639 DOI: 10.1111/resp.12945] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/06/2016] [Accepted: 08/23/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVE The Medical Research Council dyspnoea score (MRCDS) is a simple, objective scale to assess dyspnoea, the main complaint in patients with chronic interstitial lung disease (ILD). We sought to investigate whether MRCDS is a predictor of outcome in patients with chronic ILD. METHODS One hundred and fifteen patients (50 idiopathic pulmonary fibrosis (IPF) and 65 non-IPF ILD) were retrospectively studied. Baseline (time of diagnosis) MRCDS and 3-6-month changes were considered. Endpoints were (i) 18-month clinical progression, defined as either: ≥10% absolute reduction in forced vital capacity (FVC) percent predicted; ≥50-m decline in 6-min walk distance; hospitalization for respiratory causes; lung transplantation (LTx) assessment or death and (ii) 18-month survival. RESULTS At the end of the observation period, 54 subjects (47%) experienced clinical progression (including 22 deaths and 3 LTx). In patients with IPF, a longitudinal increase in MRCDS predicted clinical progression significantly (area under the curve (AUC) = 0.76, sensitivity = 62%, specificity = 91%); baseline MRCDS was a strong predictor of mortality (AUC = 0.80, sensitivity = 87%, specificity = 57%). In patients with non-IPF ILD, longitudinal increases in MRCDS, but not baseline values, were predictive of both clinical progression (AUC = 0.81, sensitivity = 85%, specificity = 77%) and mortality (AUC = 0.76, sensitivity = 91%, specificity = 61%). Considering the whole population, MRCDS increase and FVC decline were independent predictors of mortality. CONCLUSION Longitudinal increases of MRCDS predict poor outcome in chronic ILD, with good accuracy. Baseline MRCDS remains a strong predictor of mortality in IPF. MRCDS should be included in the global assessment of the clinical course of chronic ILD.
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Paul C, Lin-Shaw A, Joseph M, Kwan K, Sergiacomi G, Mura M. Successful Treatment of Fibrosing Organising Pneumonia Causing Respiratory Failure with Mycophenolic Acid. Respiration 2016; 92:279-282. [PMID: 27607231 DOI: 10.1159/000448846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/02/2016] [Indexed: 11/19/2022] Open
Abstract
Organising pneumonia (OP) is usually promptly responsive to corticosteroid treatment. We describe a series of 3 cases of severe, progressive, biopsy-proven fibrosing OP causing respiratory failure. All cases presented with peribronchial and subpleural consolidations, had a fibro-inflammatory infiltrative component in the alveolar septa, and only had a partial and unsatisfactory response to corticosteroids. However, they responded to mycophenolic acid (MPA) treatment with resolution of respiratory failure as well as clinical and functional improvement. MPA as an additional treatment option for aggressive forms of fibrosing OP and interstitial lung disease needs to be further explored.
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van der Geest LJ, Siemerink MJ, Mura M, Mourits MP, Lapid-Gortzak R. Refractive outcomes after phacovitrectomy surgery. J Cataract Refract Surg 2016; 42:840-5. [DOI: 10.1016/j.jcrs.2016.03.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 02/22/2016] [Accepted: 03/01/2016] [Indexed: 11/29/2022]
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Mehta A, Ramachandra C, Mura M, Crotti L, Schwartz P, Gnecchi M, Shim W. Symptomatic and Asymptomatic Discrimination by Single Nucleotide Polymorphisms in LQTS2 Patients: A DNA-Based Patient Stratification. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mura M, Ciuffreda M, Dusi V, Laarej K, Gnecchi M. Modeling Heart Failure in Danon Disease Using Patient-Specific Induced Pluripotent Stem Cell-Derived Cardiomyocytes. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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85
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Mura M, Iannetta D, Buschini E, de Smet MD. T-shaped macular buckling combined with 25G pars plana vitrectomy for macular hole, macular schisis, and macular detachment in highly myopic eyes. Br J Ophthalmol 2016; 101:383-388. [PMID: 27234876 DOI: 10.1136/bjophthalmol-2015-308124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/04/2016] [Accepted: 05/09/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To report our experience using the T-shaped macular buckle (MB) with or without pars plana vitrectomy (PPV) as primary surgery or with a previous failed surgical approach in patients affected by high myopia and macular hole (MH) with or without macular detachment and with or without macular schisis. The primary goal was to evaluate complete closure of the MH and reattachment of the retina. DESIGN Retrospective case series of 21 consecutive patients who underwent T-shaped MB implant alone or combined with PPV at the Academic Medical Center in Amsterdam, The Netherlands, between January 2013 and November 2014. The mean axial length was 31.22 mm. The mean follow-up period was 7 months. RESULTS Retinal reattachment was achieved in 100% of cases while MH closure was achieved in 90.5%. No major perioperative complications were observed. Best corrected visual acuity improved in 71.4% of patients. CONCLUSIONS MB combined with PPV should be considered as the preferred surgical approach both in primary and recurrent retinal detachment secondary to MH in high myopic eyes.
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Mura M, Abu-Kheil Y, Ciuti G, Visentini-Scarzanella M, Menciassi A, Dario P, Dias J, Seneviratne L. Vision-based haptic feedback for capsule endoscopy navigation: a proof of concept. JOURNAL OF MICRO-BIO ROBOTICS 2016. [DOI: 10.1007/s12213-016-0090-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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87
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Mura M, Parrini S, Ciuti G, Ferrari V, Freschi C, Ferrari M, Dario P, Menciassi A. A computer-assisted robotic platform for vascular procedures exploiting 3D US-based tracking. Comput Assist Surg (Abingdon) 2016; 21:63-79. [DOI: 10.1080/24699322.2016.1185467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Buschini E, Iannetta D, Lesnik Oberstein SY, Bijl HM, Mura M. Subretinal versus intravitreal injection of recombinant tissue plasminogen activator in post-traumatic submacular haemorrhages. Acta Ophthalmol 2016; 94:307-9. [PMID: 26283643 DOI: 10.1111/aos.12816] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/27/2015] [Indexed: 11/28/2022]
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89
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Mura M, Iannetta D, Nasini F, Barca F, Peiretti E, Engelbrecht L, de Smet MD, Verbraak F. Use of a new intra-ocular spectral domain optical coherence tomography in vitreoretinal surgery. Acta Ophthalmol 2016; 94:246-52. [PMID: 26842922 DOI: 10.1111/aos.12961] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/24/2015] [Indexed: 01/08/2023]
Abstract
PURPOSE To describe the use of a novel intra-ocular side-scanning probe enabling the acquisition of spectral-domain optical coherence tomography (SD-OCT) images during surgery in a series of patients with complex forms of retinal detachment. METHODS A 23-gauge, side-scanning SD-OCT probe (C7 System; LightLab Imaging, Inc/St Jude Medical, St. Paul, MN, USA) in a 20-gauge catheter, was used to acquire the intra-operative OCT images in seven patients with vitreoretinal diseases. Twenty-five gauge pars plana vitrectomy (PPV) was performed in every patient in a standard fashion. After enlarging the temporal sclerotomy to a 20-gauge port, all the patients were scanned with intra-ocular side-scanning SD-OCT, during different steps of the surgery based on surgeon needs. Scans were recorded real time and directly evaluated on a screen during surgery. Optical coherence tomography (OCT) scans were judged beneficial when they would recognize structures otherwise not seen on biomicroscopy. RESULTS The intra-ocular SD-OCT has been helpful in acquiring extra information during vitreoretinal surgery such as the detection of the presence of otherwise invisible membranes (epiretinal membrane, subretinal membrane), the location of small tears and the identification of the retinal plane under suboptimal conditions for visualization. CONCLUSION The use of an intra-ocular SD-OCT can expand upon visual cues during surgery, helping in the decision-making process and allowing additional deliberate surgical manoeuvres aimed at improving surgical outcomes.
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Mura M, Barca F, Dell'Omo R, Nasini F, Peiretti E. Iatrogenic retinal breaks in ultrahigh-speed 25-gauge vitrectomy: a prospective study of elective cases. Br J Ophthalmol 2015; 100:1383-7. [DOI: 10.1136/bjophthalmol-2015-307654] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/30/2015] [Indexed: 11/04/2022]
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Lindenmaier TJ, Kirby M, Paulin G, Mielniczuk L, Cunningham IA, Mura M, Licskai C, Parraga G. Pulmonary Artery Abnormalities in Ex-smokers with and without Airflow Obstruction. COPD 2015; 13:224-34. [DOI: 10.3109/15412555.2015.1074666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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92
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Di Liscia A, Schellino M, Balbo A, Bandiera A, Cimino S, Di Lonardo T, Floccia M, Mura M, Salamone F, Ravera R, Repetto L. Early assessment of distress in cancer patients treated in DH setting. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv347.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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93
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Mura M, Hopkins TG, Michael T, Abd-Latip N, Weir J, Aboagye E, Mauri F, Jameson C, Sturge J, Gabra H, Bushell M, Willis AE, Curry E, Blagden SP. LARP1 post-transcriptionally regulates mTOR and contributes to cancer progression. Oncogene 2015; 34:5025-36. [PMID: 25531318 PMCID: PMC4430325 DOI: 10.1038/onc.2014.428] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/20/2014] [Accepted: 10/21/2014] [Indexed: 12/24/2022]
Abstract
RNA-binding proteins (RBPs) bind to and post-transcriptionally regulate the stability of mRNAs. La-related protein 1 (LARP1) is a conserved RBP that interacts with poly-A-binding protein and is known to regulate 5'-terminal oligopyrimidine tract (TOP) mRNA translation. Here, we show that LARP1 is complexed to 3000 mRNAs enriched for cancer pathways. A prominent member of the LARP1 interactome is mTOR whose mRNA transcript is stabilized by LARP1. At a functional level, we show that LARP1 promotes cell migration, invasion, anchorage-independent growth and in vivo tumorigenesis. Furthermore, we show that LARP1 expression is elevated in epithelial cancers such as cervical and non-small cell lung cancers, where its expression correlates with disease progression and adverse prognosis, respectively. We therefore conclude that, through the post-transcriptional regulation of genes such as mTOR within cancer pathways, LARP1 contributes to cancer progression.
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Mura M. Myopic macular holes. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lucarini G, Mura M, Ciuti G, Rizzo R, Menciassi A. Electromagnetic Control System for Capsule Navigation: Novel Concept for Magnetic Capsule Maneuvering and Preliminary Study. J Med Biol Eng 2015; 35:428-436. [PMID: 26345712 PMCID: PMC4551543 DOI: 10.1007/s40846-015-0055-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/11/2015] [Indexed: 12/22/2022]
Abstract
The gastrointestinal tract is home of some of the most deadly human diseases. The main problems are related to the difficulty of accessing it for diagnosis or intervention and concomitant patient discomfort. The flexible endoscopy technique has established itself in medical practice due to its high diagnostic accuracy and reliability; however, several technical limitations still remain and the procedure is poorly tolerated by patients. The use of magnetic fields to control and steer endoscopic capsules is increasing in minimally invasive procedures. In fact, magnetic coupling is one of the few physical phenomena capable of transmitting motion beyond a physical barrier, allowing for the compact design of the device itself. In this framework, the authors present the preliminary design and assessment of a magnetic coupling for magnetic endoscopic capsules considering an electromagnetic approach. In particular, a novel toroidal electromagnet is proposed as the control and driving system. The system concept, design, and preliminary results are reported.
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Cafarelli A, Mura M, Diodato A, Schiappacasse A, Santoro M, Ciuti G, Menciassi A. A computer-assisted robotic platform for Focused Ultrasound Surgery: Assessment of high intensity focused ultrasound delivery. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:1311-1314. [PMID: 26736509 DOI: 10.1109/embc.2015.7318609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In the last century, medicine showed considerable advancements in terms of new technologies, devices and diagnostic/therapeutic strategies. Those advantages led to a significant reduction of invasiveness and an improvement of surgical outcomes. In this framework, a computer-assisted surgical robotic platform able to perform non-invasive Focused Ultrasound Surgery (FUS) - the FUTURA platform - has the ambitious goal to improve accuracy, safety and flexibility of the treatment, with respect to current FUS procedures. Aim of this work is to present the current implementation of the robotic platform and the preliminary results about high intensity focused ultrasound (HIFU) delivery in in-vitro conditions, under 3D ultrasound identification and monitoring. Tests demonstrated that the average accuracy of the HIFU delivery is lower than 0.7 mm in both X and Y radial directions and 3.7 mm in the axial direction (Z) with respect to the HIFU transducer active surface.
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Huang J, Mehta S, Mura M. Early decline in six-minute walk distance from the time of diagnosis predicts clinical worsening in pulmonary arterial hypertension. Respiration 2015; 89:365-73. [PMID: 25791910 DOI: 10.1159/000370124] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/18/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The six-minute walk distance (6MWD) is commonly used to assess pulmonary arterial hypertension (PAH). However, the role of 6MWD in predicting outcomes in PAH is controversial. Clinical worsening is being increasingly considered as a clinically meaningful end point in PAH. OBJECTIVES We aimed to investigate whether early longitudinal changes in 6MWD (Δ6MWD) in meters and percent predicted (%pred) from the time of diagnosis predict clinical worsening of PAH. METHODS One hundred patients with group I PAH were retrospectively assessed. 6MWD was calculated using American (%pred US) or Canadian (%pred CAN) reference equations. Δ6MWD at 6 months were recorded. Clinical worsening was defined as either: development of right heart failure, hospital admission for PAH, referral for lung transplantation or initiation of prostanoids after oral therapy failed. Optimal 6-month differences in 6MWD to detect worsening were defined with receiver operating characteristics (ROC) analysis. RESULTS Progressors, i.e. patients with clinical worsening, and nonprogressors showed significant differences in Δ6MWD. The most clinically significant declines in 6MWD at 6 months were ≥35 m, ≥8%pred US and ≥6%pred CAN. ROC and Cox proportional hazard analyses showed equivalent results for 6MWD %pred and meters. Six-month declines in 6MWD predicted worsening with a high specificity (94%) but a low sensitivity (33%). CONCLUSIONS Early declines in 6MWD (within the first 6 months) predict future clinical worsening of PAH with high specificity. Δ6MWD may still be part of a comprehensive assessment of a patient's clinical status. However, given the poor sensitivity, a decline in 6MWD should be used with other clinical tools to make an appropriate assessment of the progression of PAH.
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Lucarini G, Ciuti G, Mura M, Rizzo R, Menciassi A. A New Concept for Magnetic Capsule Colonoscopy Based on an Electromagnetic System. INT J ADV ROBOT SYST 2015. [DOI: 10.5772/60134] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Traditional endoscopy based on flexible endoscopes is reliable and effective, but poorly tolerated by patients; it also requires extended training by physicians. In order to reduce the invasiveness of these procedures, wireless passive capsule endoscopy has been proposed and clinically used during the past decade. A capsule endoscope with an active locomotion mechanism is desirable for carrying out controllable interactive procedures that are normally not possible using passive devices. Due to many difficulties in embedding actuators in swallowable devices, many researchers and companies have adopted an external magnetic field actuation solution. Magnetic resonance modified systems or permanent magnets are used to manoeuvre capsules remotely; however, both these cases present some limitations: magnetic resonance systems are bulky and expensive and permanent magnets are intrinsically unstable to control, and it is impossible to switch them off. Within this framework, the authors present the design and assessment of a magnetic system for endoscopic capsules based on an electromagnetic approach. In particular, the use of a single electromagnet was proposed and investigated: magnetic attraction, locomotion forces and magnetic torques were modelled for guaranteeing the reliable navigation of the capsule and based on these specifications, an electromagnet was designed, developed and experimentally evaluated. The results demonstrated the feasibility of the proposed approach for active locomotion capsule endoscopy.
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Bustos ML, Mura M, Hwang D, Ludkovski O, Wong AP, Keating A, Waddell TK. Depletion of bone marrow CCSP-expressing cells delays airway regeneration. Mol Ther 2014; 23:561-9. [PMID: 25409745 DOI: 10.1038/mt.2014.223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 10/16/2014] [Indexed: 02/08/2023] Open
Abstract
The contribution of bone marrow cells (BMC) in lung repair is controversial. We previously reported a subpopulation of BMC that express Clara cell secretory protein (CCSP). To determine the contribution of endogenous CCSP(+) BMC to airway regeneration, we performed bone marrow transplantation studies using the CCtk mouse, which expresses a thymidine kinase suicide gene under regulation of the CCSP promoter. Mice were transplanted with wild-type or CCtk BMC and treated with ganciclovir to eliminate CCSP(+) cells. After airway injury using naphthalene, mice depleted of CCSP(+) BMC had more inflammatory cells in lung and decreased levels of oxygen in arterial blood. They also had reduced expression of airway epithelial genes and less Clara cells compared to control mice that had intact CCSP(+) BMC and bone marrow derived CCSP(+) cells in the airways. After naphthalene injury, administration of CCSP reproduced the beneficial effect of CCSP(+) BMC by improving recovery of airway epithelium, reducing lung inflammation and increasing oxygen in arterial blood from mice depleted of CCSP(+) BMC. Our data demonstrate that ablation of CCSP(+) BMC delays airway recovery and suggests the beneficial effect of CCSP(+) BMC in lung recovery is in part due to production of CCSP itself.
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Abstract
The development of a 25-gauge vitrectomy system represents a major step forward in vitreoretinal surgery. The main advantages of small-gauge incisions are reduction of surgical time, decreased postoperative inflammation, and fast postoperative recovery time. The use of this technique requires research, training, knowledge, and experience on the part of the vitreoretinal surgeon and the personnel in the operation room. At the same time the indications for 25-gauge vitrectomy have changed a lot in the last years due to improvement in materials and technology and the advent of new instruments. Nowadays, with the development of new surgical instrumentation and the improvement of surgical skills, we can approach the whole spectrum of vitreoretinal pathology. This chapter describes the instruments used in 25-gauge vitrectomy, explains how to set the vitrectomy machine for safe surgery and what the indications for 25-gauge vitrectomy are (with particular reference to vitreoretinal interface diseases, retinal detachment, and proliferative diabetic retinopathy) as well as the complications that can occur, and provides some pearls for challenging cases.
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