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Stacchiotti S, Van der Graaf W, Doms H, Sanfilippo R, Marreaud S, Van Houdt W, Judson I, Kasper B, Litiere S, Gelderblom H. 1629MO First-line chemotherapy (CT) in advanced well-differentiated/dedifferentiated liposarcoma (WD/DD LPS): An EORTC Soft Tissue and Bone Sarcoma Group (STBSG) retrospective analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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2
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Saba L, Micheletti G, Brinjikji W, Garofalo P, Montisci R, Balestrieri A, Suri JS, DeMarco JK, Lanzino G, Sanfilippo R. Carotid Intraplaque-Hemorrhage Volume and Its Association with Cerebrovascular Events. AJNR Am J Neuroradiol 2019; 40:1731-1737. [PMID: 31558503 DOI: 10.3174/ajnr.a6189] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 07/15/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Our aim was to assess the relationship between volume and percentage of intraplaque hemorrhage measured using CT and the occurrence of cerebrovascular events at the time of CT. MATERIALS AND METHODS One-hundred-twenty-three consecutive subjects (246 carotid arteries) with a mean age of 69 years who underwent CTA were included in this retrospective study. Plaque volume of components and subcomponents (including intraplaque hemorrhage volume) was quantified with dedicated software. RESULTS Forty-six arteries were excluded because no plaque was identified. In the remaining 200 carotid arteries, a statistically significant difference was found between presentation with cerebrovascular events and lipid volume (P = .002), intraplaque hemorrhage volume (P = .002), percentage of lipid (P = .002), percentage of calcium (P = .001), percentage of intraplaque hemorrhage (P = .001), percentage of lipid-intraplaque hemorrhage (P = .001), and intraplaque hemorrhage/lipid ratio (P = .001). The highest receiver operating characteristic area under the curve was obtained with the intraplaque hemorrhage volume with a value of 0.793 (P = .001), percentage of intraplaque hemorrhage with an area under the curve of 0.812 (P = .001), and the intraplaque hemorrhage/lipid ratio with an area under the curve value of 0.811 (P = .001). CONCLUSIONS Results of our study suggest that Hounsfield unit values <25 have a statistically significant association with the presence of cerebrovascular events and that the ratio intraplaque hemorrhage/lipid volume represents a strong parameter for the association of cerebrovascular events.
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Affiliation(s)
- L Saba
- From the Departments of Radiology (L.S., G.M., P.G., A.B.)
| | - G Micheletti
- From the Departments of Radiology (L.S., G.M., P.G., A.B.)
| | | | - P Garofalo
- From the Departments of Radiology (L.S., G.M., P.G., A.B.)
| | - R Montisci
- Vascular Surgery (R.M., R.S.), Azienda Ospedaliero Universitaria, Monserrato (Cagliari), Italy
| | - A Balestrieri
- From the Departments of Radiology (L.S., G.M., P.G., A.B.)
| | - J S Suri
- Stroke Monitoring and Diagnostic Division (J.S.S.), AtheroPoint, Roseville, California
- Point-of-Care Devices (J.S.S.), Global Biomedical Technologies, Roseville, California
- Department of Electrical Engineering (J.S.S.), University of Idaho, Moscow, Idaho (Affiliated)
| | - J K DeMarco
- Department of Radiology (J.K.D.), Walter Reed Medical Center, Bethesda, Maryland
| | - G Lanzino
- Neurosurgery (G.L.), Mayo Clinic, Rochester, Minnesota
| | - R Sanfilippo
- Vascular Surgery (R.M., R.S.), Azienda Ospedaliero Universitaria, Monserrato (Cagliari), Italy
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Sanfilippo R, Fabbroni C, Fumagalli E, Bertulli R, Stacchiotti S, baldi G, Fucà G, Morosi C, Gronchi A, De Tos A, Collini P, Casali P. Reversion of resistance to mTOR inhibitors with the addition of exemestane in patients with malignant PEComa. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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4
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Saba L, Lanzino G, Lucatelli P, Lavra F, Sanfilippo R, Montisci R, Suri JS, Yuan C. Carotid Plaque CTA Analysis in Symptomatic Subjects with Bilateral Intraparenchymal Hemorrhage: A Preliminary Analysis. AJNR Am J Neuroradiol 2019; 40:1538-1545. [PMID: 31395662 DOI: 10.3174/ajnr.a6160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/28/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE The presence of IPH is considered the most dangerous feature because it is significantly associated with clinical ipsilateral cerebrovascular events. Our aim was to explore the characterization of plaque with CT in symptomatic subjects with bilateral intraplaque hemorrhage. MATERIALS AND METHODS Three-hundred-forty-three consecutive patients with recent anterior circulation ischemic events (<2 weeks) and CT of the carotid arteries (performed within 14 days of the cerebrovascular event) evaluated between June 2012 and September 2017 were analyzed for plaque volume composition to identify all subjects with bilateral intraplaque hemorrhage. Plaque volume was semiautomatically measured, and tissue components were classified according to the attenuation values such as the following: calcified (for values of ≥130 HU), mixed (for values of ≥60 and <130 HU), lipid (for values of ≥25 and <60 HU), and intraplaque hemorrhage (for values of <25 HU). Twenty-one subjects (15 men; mean age, 70 ± 11 years; range, 44-87 years) had bilateral intraplaque hemorrhage and were included in the analysis. RESULTS Volume measurement revealed significantly larger plaques on the symptomatic side compared with the asymptomatic one (mean, 28 ± 9 versus 22 ± 8 mm, P = .007). Intraplaque hemorrhage volume and percentage were also significantly higher in the plaque ipsilateral to the cerebrovascular event (P < .001 and < .001, respectively). The volume of other plaque components did not show a statically significant association except for lipid and lipid + intraplaque hemorrhage percentages (23% versus 18% and 11% versus 15%), which were significantly different between the symptomatic and the asymptomatic sides (.016 and .011, respectively). The intraplaque hemorrhage/lipid ratio was higher on the symptomatic side (0.596 versus 0.171, P = .001). CONCLUSIONS In patients with bilateral intraplaque hemorrhage and recent ischemic symptoms, the plaque ipsilateral to the symptomatic side has significantly larger volume and a higher percentage of intraplaque hemorrhage compared with the contralateral, asymptomatic side.
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Affiliation(s)
- L Saba
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - G Lanzino
- Department of Neurologic Surgery (G.L.), Mayo Clinic, Rochester, Minnesota
| | - P Lucatelli
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology (P.L.), Sapienza University of Rome, Rome, Italy
| | - F Lavra
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - R Sanfilippo
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - R Montisci
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - J S Suri
- Diagnostic and Monitoring Division (J.S.S.), Atheropoint, Roseville, California.,Department of Electrical Engineering (J.S.S.), University of Idaho, Moscow, Idaho
| | - C Yuan
- Center for Biomedical Imaging Research (C.Y.), Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.,Department of Radiology (C.Y.), University of Washington, Seattle, Washington
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Rosso A, Beuck L, Vertino A, Sanfilippo R, Freiwald A. Cribrilinids (Bryozoa, Cheilostomata) associated with deep-water coral habitats at the Great Bahama Bank slope (NW Atlantic), with description of new taxa. Zootaxa 2018; 4524:401-439. [PMID: 30486103 DOI: 10.11646/zootaxa.4524.4.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Indexed: 11/04/2022]
Abstract
Four cribrilinid bryozoans associated with deep-water corals (578-682 m depth) from the Great Bahama Bank slope, are described, two of them are new. The generic allocation of some species prompted us to raise the subgenera Puellina, Cribrilaria, and Glabrilaria to genus rank. The new combination Cribrilaria saginata (Winston, 2005) n. comb. is proposed. Genus Glabrilaria is reported from the NW Atlantic for the first time based on the description of Glabrilaria hirsuta Rosso n. sp. and Glabrilaria polita Rosso n. sp. The new genus Teresaspis Rosso n. gen. is erected, and Teresaspis lineata (Canu Bassler, 1928) n. comb. is proposed as its type species. The new genus Harmelinius Rosso n. gen. is erected for Cribrilina uniserialis (Harmelin, 1978). Both genera have uniserial colonies formed by slightly caudate zooids with extensive gymnocyst and a frontal shield of flattened costae. Teresaspis lineata n. comb., however, has costae with pelmatidia that are connected by few intercostal bridges and separated by intercostal spaces, four orificial costa-like processes with the proximal pair arching above the orifice, hyperstomial acleithral ovicells with a pseudoporous ooecium formed by the distal zooid or a kenozooid, two types of kenozooids (large with costate frontal shield and small with smooth shield and central opesia), and an ancestrula with costate frontal shield. Avicularia are apparently absent in this species. In contrast, the type species of Harmelinius Rosso n. gen. has costae lacking pelmatidia and which are separated by slit-like intercostal spaces. The hyperstomial cleithral ovicells have smooth ooecia with a median suture and without pseudopores, and are formed by a distal kenozooid associated with a small avicularium. Additional paired oral avicularia are occasionally present, as are large kenozooids with a central opesia. Oral spines or spine-like processes are absent. Taxonomy of the above reported cribrilinid genera is discussed in detail together with the geographic distribution of all mentioned taxa.
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Key Words
- Bryozoa, taxonomy, new genera, new species, Holocene, bathyal, species distribution, Cribrilaria, Glabrilaria, Teresaspis, Harmelinius
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Affiliation(s)
- A Rosso
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, University of Catania, Corso Italia 57, 95129, Catania, Italy. CoNISMa (Consorzio Interuniversitario per le Scienze del Mare), Piazzale Flaminio, 9, 00196, Roma, Italy.
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Sanfilippo R, Jones R, Provenzano S, Antoniou G, Blay JY, Fumagalli E, Stacchiotti S, Bertulli R, Mir O, Hindi N, Brahmi M, Dufresne A, Dei Tos A, Casali P. mTOR inhibitors in uterine and extra-uterine malignant PEComas: A multicenter international case series retrospective analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Saba L, Francone M, Bassareo PP, Lai L, Sanfilippo R, Montisci R, Suri JS, De Cecco CN, Faa G. CT Attenuation Analysis of Carotid Intraplaque Hemorrhage. AJNR Am J Neuroradiol 2017; 39:131-137. [PMID: 29191874 DOI: 10.3174/ajnr.a5461] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/20/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Intraplaque hemorrhage is considered a leading parameter of carotid plaque vulnerability. Our purpose was to assess the CT characteristics of intraplaque hemorrhage with histopathologic correlation to identify features that allow for confirming or ruling out the intraplaque hemorrhage. MATERIALS AND METHODS This retrospective study included 91 patients (67 men; median age, 65 ± 7 years; age range, 41-83 years) who underwent CT angiography and carotid endarterectomy from March 2010 to May 2013. Histopathologic analysis was performed for the tissue characterization and identification of intraplaque hemorrhage. Two observers assessed the plaque's attenuation values by using an ROI (≥ 1 and ≤2 mm2). Receiver operating characteristic curve, Mann-Whitney, and Wilcoxon analyses were performed. RESULTS A total of 169 slices were assessed (59 intraplaque hemorrhage, 63 lipid-rich necrotic core, and 47 fibrous); the average values of the intraplaque hemorrhage, lipid-rich necrotic core, and fibrous tissue were 17.475 Hounsfield units (HU) and 18.407 HU, 39.476 HU and 48.048 HU, and 91.66 HU and 93.128 HU, respectively, before and after the administration of contrast medium. The Mann-Whitney test showed a statistically significant difference of HU values both in basal and after the administration of contrast material phase. Receiver operating characteristic analysis showed a statistical association between intraplaque hemorrhage and low HU values, and a threshold of 25 HU demonstrated the presence of intraplaque hemorrhage with a sensitivity and specificity of 93.22% and 92.73%, respectively. The Wilcoxon test showed that the attenuation of the plaque before and after administration of contrast material is different (intraplaque hemorrhage, lipid-rich necrotic core, and fibrous tissue had P values of .006, .0001, and .018, respectively). CONCLUSIONS The results of this preliminary study suggest that CT can be used to identify the presence of intraplaque hemorrhage according to the attenuation. A threshold of 25 HU in the volume acquired after the administration of contrast medium is associated with an optimal sensitivity and specificity. Special care should be given to the correct identification of the ROI.
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Affiliation(s)
- L Saba
- From the Departments of Radiology (L.S.)
| | | | | | - L Lai
- Department of Radiological, Oncological, and Pathological Sciences (L.L.), Sapienza University of Rome, Rome, Italy
| | - R Sanfilippo
- Vascular Surgery (R.S., R.M.), Azienda Ospedaliero Universitaria of Cagliari - Polo di Monserrato, Cagliari, Italy
| | - R Montisci
- Vascular Surgery (R.S., R.M.), Azienda Ospedaliero Universitaria of Cagliari - Polo di Monserrato, Cagliari, Italy
| | - J S Suri
- Point of Care Devices (J.S.S.), Global Biomedical Technologies, Roseville, California.,AtheroPoint (J.S.S.), Roseville, California.,Department of Electrical Engineering (J.S.S.), Idaho State University, Pocatello, Idaho
| | - C N De Cecco
- Department of Radiology and Radiological Science (C.N.D.C.), Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina
| | - G Faa
- Cardiology (M.F., P.P.B., G.F.)
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De Sanctis R, Giordano L, Colombo C, De Paoli A, Navarria P, Sangalli C, Buonadonna A, Sanfilippo R, Bertola G, Fiore M, Marrari A, Navarria F, Bertuzzi A, Casali PG, Basso S, Santoro A, Quagliuolo V, Gronchi A. Long-term Follow-up and Post-relapse Outcome of Patients with Localized Retroperitoneal Sarcoma Treated in the Italian Sarcoma Group-Soft Tissue Sarcoma (ISG-STS) Protocol 0303. Ann Surg Oncol 2017; 24:3872-3879. [DOI: 10.1245/s10434-017-6105-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Indexed: 12/17/2022]
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Vincenzi B, Stacchiotti S, Collini P, Pantano F, Rabitti C, Perrone G, Iuliani M, Baldi A, Badalamenti G, Sanfilippo R, Santini D, Onetti Muda A, Gronchi A, Casali P, Dei Tos A, Tonini G. Human equilibrative nucleoside transporter 1 as a predictor of efficacy to gemcitabine in advanced leiomyosarcoma and angiosarcoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw343.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Callegaro D, Miceli R, Brunelli C, Colombo C, Sanfilippo R, Radaelli S, Casali PG, Caraceni A, Gronchi A, Fiore M. Long-term morbidity after multivisceral resection for retroperitoneal sarcoma. Br J Surg 2015; 102:1079-87. [DOI: 10.1002/bjs.9829] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/17/2015] [Accepted: 03/12/2015] [Indexed: 11/06/2022]
Abstract
Abstract
Background
More than 60 per cent of patients treated surgically for primary retroperitoneal sarcoma survive for at least 5 years. Extended surgical resection has been proposed for primary disease, but long-term morbidity data are lacking. A cross-sectional study was conducted to assess the long-term morbidity of patients undergoing surgery for retroperitoneal sarcoma.
Methods
Patients operated on between January 2002 and December 2011 were eligible for the study. Long-term morbidity was evaluated based on a semistructured clinical interview. Lower limb function was assessed by means of the Lower Extremity Functional Scale (LEFS), a self-report questionnaire with a total score ranging from 0 (low functioning) to 80 (high functioning). Pain was investigated by means of the Brief Pain Inventory – Short Form, with pain intensity scores reported on a scale from 0 (no pain) to 10 (worst pain).
Results
Some 243 patients underwent surgery, and 101 of 160 patients who were alive at the time of the investigation responded to the study invitation letter. Finally, 95 patients were enrolled in the study. Sensory impairment of the limbs was reported in 72 patients (76 per cent). The median LEFS score was 60 (i.q.r. 43–73). Mean scores for the pain intensity items varied from 1·23 to 2·68. In multivariable analysis, there was no difference in median levels of creatinine at survey between patients who did or did not undergo nephrectomy (difference between median values 13 (95 per cent c.i. −4 to 30) µmol/l; P = 0·170).
Conclusion
Severe chronic pain and lower limb motor impairment after multivisceral resection for retroperitoneal sarcomas are rare. Long-term renal function is not significantly impaired when nephrectomy is performed.
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Affiliation(s)
- D Callegaro
- Department of Surgery, Pain Therapy and Rehabilitation Unit, Milan, Italy
| | - R Miceli
- Department of Biostatistics, Pain Therapy and Rehabilitation Unit, Milan, Italy
| | - C Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Milan, Italy
- European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - C Colombo
- Department of Surgery, Pain Therapy and Rehabilitation Unit, Milan, Italy
| | - R Sanfilippo
- Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Radaelli
- Department of Surgery, Pain Therapy and Rehabilitation Unit, Milan, Italy
| | - P G Casali
- Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Caraceni
- Palliative Care, Pain Therapy and Rehabilitation Unit, Milan, Italy
| | - A Gronchi
- Department of Surgery, Pain Therapy and Rehabilitation Unit, Milan, Italy
| | - M Fiore
- Department of Surgery, Pain Therapy and Rehabilitation Unit, Milan, Italy
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Laroche-Clary A, Chaire V, Le Morvan V, Neuville A, Bertucci F, Salas S, Sanfilippo R, Pourquier P, Italiano A. BRCA1 haplotype and clinical benefit of trabectedin in soft-tissue sarcoma patients. Br J Cancer 2015; 112:688-92. [PMID: 25602962 PMCID: PMC4333490 DOI: 10.1038/bjc.2014.624] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/13/2014] [Accepted: 11/25/2014] [Indexed: 01/03/2023] Open
Abstract
Background: This study aimed to determine whether the BRCA1 haplotype was associated with trabectedin efficacy in soft-tissue sarcoma (STS) patients. Methods: We analysed BRCA1 single-nucleotide polymorphisms (SNPs) in tumour specimens from 135 advanced STS patients enrolled in published phase 2 trials or in a compassionate-use programme of trabectedin. Forty-four advanced STS patients treated with doxorubicin and 85 patients with localised STS served as controls. The 6-month nonprogression rate and overall survival (OS) were analysed according to BRCA1 haplotype using log-rank tests. Results: A favourable BRCA1 haplotype (presence of at least one AAAG allele) was significantly associated with an improved 6-month nonprogression rate. It was the only variable significantly associated with OS. No correlations were found between outcomes for patients with localised or advanced STS treated with doxorubicin. Conclusions: The BRCA1 haplotype represents a potential DNA repair biomarker that can be used for the prediction of response to trabectedin in STS patients.
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Affiliation(s)
- A Laroche-Clary
- 1] INSERM U916 and University of Bordeaux, Bordeaux, France [2] Institut Bergonié, Bordeaux, France
| | - V Chaire
- 1] INSERM U916 and University of Bordeaux, Bordeaux, France [2] Institut Bergonié, Bordeaux, France
| | - V Le Morvan
- 1] INSERM U916 and University of Bordeaux, Bordeaux, France [2] Institut Bergonié, Bordeaux, France
| | | | - F Bertucci
- Institut Paoli Calmettes, Marseille, France
| | - S Salas
- Assistance Publique des Hôpitaux de Marseille, Hôpital la Timone, Marseille, France
| | - R Sanfilippo
- Adult Sarcoma Medical Oncology Unit, Department of Cancer Medicine, Instituto Nazionale Tumori, Milan, Italy
| | - P Pourquier
- 1] INSERM U916 and University of Bordeaux, Bordeaux, France [2] Institut Bergonié, Bordeaux, France
| | - A Italiano
- 1] INSERM U916 and University of Bordeaux, Bordeaux, France [2] Institut Bergonié, Bordeaux, France
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Morosi C, Stacchiotti S, Marchianò A, Bianchi A, Radaelli S, Sanfilippo R, Colombo C, Richardson C, Collini P, Barisella M, Casali P, Gronchi A, Fiore M. Correlation between radiological assessment and histopathological diagnosis in retroperitoneal tumors: Analysis of 291 consecutive patients at a tertiary reference sarcoma center. Eur J Surg Oncol 2014; 40:1662-70. [DOI: 10.1016/j.ejso.2014.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 09/28/2014] [Accepted: 10/06/2014] [Indexed: 12/21/2022] Open
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Uboldi S, Frapolli R, Bello E, Brich S, Bozzi F, Sanfilippo R, Casali P, Gronchi A, Galmarini C, Sousa-Faro JF, Pilotti S, D'Incalci M. 590 A dose dense schedule improves antitumor activity of trabectedin in myxoid liposarcoma with type III FUS-CHOP chimera. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hindi N, Sanfilippo R, Stacchiotti S, Fumagalli E, Libertini M, Provenzano S, Palassini E, Bertulli R, Marrari A, Galli L, Formica V, Chiuri V, Natale D, Collini P, Dei Tos A, Casali P. Systemic Therapy in Perivascular Epithelioid Cell Tumors (Pecoma). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.39] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Guido A, Mastandrea A, Rosso A, Sanfilippo R, Tosti F, Riding R, Russo F. Commensal symbiosis between agglutinated polychaetes and sulfate-reducing bacteria. Geobiology 2014; 12:265-275. [PMID: 24636469 DOI: 10.1111/gbi.12084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 02/19/2014] [Indexed: 06/03/2023]
Abstract
Pendant bioconstructions occur within submerged caves in the Plemmirio Marine Protected Area in SE Sicily, Italy. These rigid structures, here termed biostalactites, were synsedimentarily lithified by clotted-peloidal microbial carbonate that has a high bacterial lipid biomarker content with abundant compounds derived from sulfate-reducing bacteria. The main framework builders are polychaete serpulid worms, mainly Protula with subordinate Semivermilia and Josephella. These polychaetes have lamellar and/or fibrillar wall structure. In contrast, small agglutinated terebellid tubes, which are a minor component of the biostalactites, are discontinuous and irregular with a peloidal micritic microfabric. The peloids, formed by bacterial sulfate reduction, appear to have been utilized by terebellids to construct tubes in an environment where other particulate sediment is scarce. We suggest that the bacteria obtained food from the worms in the form of fecal material and/or from the decaying tissue of surrounding organisms and that the worms obtained peloidal micrite with which to construct their tubes, either as grains and/or as tube encompassing biofilm. Peloidal worm tubes have rarely been reported in the recent but closely resemble examples in the geological record that extend back at least to the early Carboniferous. This suggests a long-lived commensal relationship between some polychaete worms and heterotrophic, especially sulfate-reducing, bacteria.
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Affiliation(s)
- A Guido
- Department of Biology, Ecology and Earth Sciences, University of Calabria, Cosenza, Italy
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Di Giandomenico S, Frapolli R, Bello E, Uboldi S, Licandro SA, Marchini S, Beltrame L, Brich S, Mauro V, Tamborini E, Pilotti S, Casali PG, Grosso F, Sanfilippo R, Gronchi A, Mantovani R, Gatta R, Galmarini CM, Sousa-Faro JMF, D'Incalci M. Mode of action of trabectedin in myxoid liposarcomas. Oncogene 2013; 33:5201-10. [PMID: 24213580 DOI: 10.1038/onc.2013.462] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/04/2013] [Accepted: 09/05/2013] [Indexed: 12/11/2022]
Abstract
To elucidate the mechanisms behind the high sensitivity of myxoid/round cell liposarcoma (MRCL) to trabectedin and the suggested selectivity for specific subtypes, we have developed and characterized three MRCL xenografts, namely ML017, ML015 and ML004 differing for the break point of the fusion gene FUS-CHOP, respectively of type I, II and III. FUS-CHOP binding to the promoters of some target genes such as Pentraxin 3 or Fibronectin 1, assessed by chromatin immunoprecipitation, was strongly reduced in the tumor 24 h after the first or the third weekly dose of trabectedin, indicating that the drug at therapeutic doses causes a detachment of the FUS-CHOP chimera from its target promoters as previously shown in vitro. Moreover, the higher sensitivity of MRCL types I and II appears to be related to a more prolonged block of the transactivating activity of the fusion protein. Doxorubicin did not affect the binding of FUS-CHOP to target promoters. Histologically, the response to trabectedin in ML017 and ML015 was associated with a marked depletion of non-lipogenic tumoral cells and vascular component, as well as lipidic maturation as confirmed by PPARγ2 expression in western Blot. By contrast, in ML004 no major changes either in the cellularity or in the amount of mature were found, and consistently PPARγ2 was null. In conclusion, the data support the view that the selective mechanism of action of trabectedin in MRCL is specific and related to its ability to cause a functional inactivation of the oncogenic chimera with consequent derepression of the adypocytic differentiation.
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Affiliation(s)
- S Di Giandomenico
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - R Frapolli
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - E Bello
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - S Uboldi
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - S A Licandro
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - S Marchini
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - L Beltrame
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - S Brich
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - V Mauro
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - E Tamborini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - S Pilotti
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - P G Casali
- Adult Sarcoma Medical Treatment Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - F Grosso
- Department of Oncology, SS Antonio e Biagio General Hospital, Alessandria, Italy
| | - R Sanfilippo
- Adult Sarcoma Medical Treatment Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - A Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - R Mantovani
- Dipartimento di Bioscienze, Università degli Studi di Milano, Milan, Italy
| | - R Gatta
- Dipartimento di Bioscienze, Università degli Studi di Milano, Milan, Italy
| | | | | | - M D'Incalci
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
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Montisci R, Sanfilippo R, Bura R, Branca C, Piga M, Saba L. Status of the Circle of Willis and Intolerance to Carotid Cross-clamping During Carotid Endarterectomy. Eur J Vasc Endovasc Surg 2013; 45:107-12. [DOI: 10.1016/j.ejvs.2012.11.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 11/12/2012] [Indexed: 11/27/2022]
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Montisci R, Sanfilippo R, Bura R, Branca C, Piga M, Saba L. Status of the Circle of Willis and Intolerance to Carotid Cross-clamping During Carotid Endarterectomy. J Vasc Surg 2013. [DOI: 10.1016/j.jvs.2012.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saba L, Montisci R, Raz E, Sanfilippo R, Suri JS, Piga M. Association between carotid artery plaque type and cerebral microbleeds. AJNR Am J Neuroradiol 2012; 33:2144-50. [PMID: 22627799 DOI: 10.3174/ajnr.a3133] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE CMBs have become increasingly recognized with the widespread use of MR imaging techniques that are sensitive to iron deposits. The purpose of this study was to correlate the presence of CMBs and carotid plaque characteristics. MATERIAL AND METHODS Seventy consecutive patients (47 men; 23 women; mean age, 65 years) were prospectively analyzed. Carotid arteries were studied using a 16-detector row CT scanner, whereas the brain was explored with an MR imaging 1.5T system. CMBs were studied using a T2*-weighted GRE sequence. CMBs were classified by an ordinal scale and carotid plaques were characterized based on their composition as fatty, mixed, or calcified. Patients were classified as symptomatic and asymptomatic. Chi-square and multiple logistic regression analyses, as well as ROCs, were calculated. RESULTS The prevalence of CMBs was 30%. A statistically significant difference in CMB prevalence was observed between symptomatic (46%) and asymptomatic (19%) patients (P value = .0021; OR = 3.7). Correlation analysis demonstrated an association between the number of CMBs and the symptoms (P = .0001). A statistically significant association was observed between the presence of fatty plaque and CMBs (P = .0019). CONCLUSIONS The results of this study suggest an association between the presence of carotid artery fatty plaque, symptoms, and CMBs. Moreover, we found that the presence (and entity) of CMBs may represent an indicator of cerebrovascular symptom severity.
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Affiliation(s)
- L Saba
- Departments of Radiology, Azienda Ospedaliero Universitaria, di Cagliari, Cagliari, Italy.
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Gronchi A, Miceli R, Colombo C, Stacchiotti S, Collini P, Mariani L, Sangalli C, Radaelli S, Sanfilippo R, Fiore M, Casali P. Frontline extended surgery is associated with improved survival in retroperitoneal low- to intermediate-grade soft tissue sarcomas. Ann Oncol 2012; 23:1067-73. [DOI: 10.1093/annonc/mdr323] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Stacchiotti S, Palassini E, Sanfilippo R, Vincenzi B, Arena M, Bochicchio A, De Rosa P, Nuzzo A, Turano S, Morosi C, Dei Tos A, Pilotti S, Casali P. Gemcitabine in advanced angiosarcoma: a retrospective case series analysis from the Italian Rare Cancer Network. Ann Oncol 2012; 23:501-8. [DOI: 10.1093/annonc/mdr066] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Saba L, Sanfilippo R, Montisci R, Suri JS, Mallarini G. Carotid artery wall thickness measured using CT: inter- and intraobserver agreement analysis. AJNR Am J Neuroradiol 2011; 34:E13-8. [PMID: 22081682 DOI: 10.3174/ajnr.a2796] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY The purpose of this work was to compare inter- and intraobserver agreement in the analysis of CAWT by using MDCTA. The CAWT in 35 patients was quantified by 4 observers. Bland-Altman statistics were used to measure the agreement between observers. The results of our study demonstrated that the CAWT measured by using MDCTA shows a good reproducibility between observers by considering inter- and intraobserver agreement.
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Affiliation(s)
- L Saba
- Department of Radiology, Azienda Ospedaliero Universitaria, Cagliari 09045, Italy.
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Stacchiotti S, Palassini E, Morosi C, Messina A, Negri T, Pilotti S, Bertulli R, Sanfilippo R, Gronchi A, Casali P. 9420 POSTER Sirolimus in Epithelioid Hemangioendothelioma. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72564-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sanfilippo R, Constantinidou A, Bertulli R, Coco P, Fumagalli E, Scurr M, Morosi C, Pilotti S, Judson IR, Casali PG. Sensitivity of well-differentiated/dedifferentiated liposarcoma (WD/DD) and myxoid round cell/liposarcoma (MRCL) to high-dose ifosfamide: Combined analysis from two European referral institutions. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fiore M, Colombo C, Radaelli S, Prestianni P, Sanfilippo R, Morosi C, Perrone F, Stacchiotti S, Casali PG, Gronchi A. Activity of toremifene in sporadic desmoid-type fibromatosis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Saba L, Pascalis L, Sanfilippo R, Anzidei M, Bura R, Montisci R, Mallarini G. Carotid artery wall thickness and leukoaraiosis: preliminary results using multidetector row CT angiography. AJNR Am J Neuroradiol 2011; 32:955-61. [PMID: 21349963 DOI: 10.3174/ajnr.a2396] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE LA is a condition caused by chronic cerebral ischemia and it represents an independent risk for stroke. The purpose of this work was to determine whether CAWT studied by using MDCTA is correlated with LA and its severity. MATERIALS AND METHODS Ninety-eight patients ≥60 years of age were retrospectively studied by using multidetector row CT. Supra-aortic vessel analysis and brain CT were performed in the same procedure. In each patient, CAWT was measured with an internal digital caliper, and the presence and severity of LA were assessed. Correlation coefficients by using Spearman statistics and ROC curves were calculated. A P value < .05 was considered statistically significant. RESULTS Measurements of the distal common CAWT ranged from 0.5 to 1.53 mm. A correlation between LA and increased CAWT was observed (Pearson correlation, 0.33; P < .001). On the basis of a threshold of 0.9 mm, an important statistical association between increased CAWT and LA (P < .0001) was found. With the same threshold, ROC curve analysis indicated a sensitivity of 55% and a specificity of 75% for LA. CONCLUSIONS The results of this study show a statistically significant correlation between increased CAWT and LA (and its severity).
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Affiliation(s)
- L Saba
- Department of Radiology, Azienda Ospedaliero Universitaria Cagliari, Italy.
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Marchini S, Frapolli R, Nerini I, Pilotti S, Casali P, Grosso F, Sanfilippo R, Gronchi A, Tercero J, D'incalci M. 278 Myxoid liposarcoma tumors with different chimera subtypes xenografted in nude mice are characterized by different response to trabectedin and gene expression profile. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71985-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Saba L, Sanfilippo R, Montisci R, Mallarini G. Associations between carotid artery wall thickness and cardiovascular risk factors using multidetector CT. AJNR Am J Neuroradiol 2010; 31:1758-63. [PMID: 20634310 DOI: 10.3174/ajnr.a2197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE It has been demonstrated that the increase in CAWT is associated with an increased risk of stroke and its severity. The aim of this study was to determine whether CAWT evaluated by MDCTA is associated with the following cardiovascular risk factors: hypertension, diabetes mellitus, dyslipidemia, and smoking. MATERIALS AND METHODS This was a retrospective study. One hundred sixty-eight patients (120 men; mean age, 68.96 years ± 11.2 years SD) were analyzed by using a multidetector row CT scanner. In each patient, CAWT was measured by using an internal digital caliper. Continuous data were described as the mean value ± SD and were compared by using the Student t test. We performed simple logistic regressions to evaluate the association between CAWT and the following: hypertension, diabetes mellitus, dyslipidemia, and smoking. A P value < .05 indicated statistical significance. RESULTS The distal common CAWT varied from 0.5 to 1.5 mm. We observed that hypertension and diabetes mellitus were associated with increased (>1 mm) CAWT (P = .0041 and P = .0172, respectively). There was no significant association between increased CAWT and dyslipidemia or smoking. CONCLUSIONS In our selected group, the results of this work show that an increased CAWT is associated with the cardiovascular risk determinants hypertension and diabetes. Further studies are necessary to evaluate whether it is possible to apply our observations to the general population.
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Affiliation(s)
- L Saba
- Departments of Radiology, Azienda Ospedaliero Universitaria, di Cagliari-Polo di Monserrato s.s. 554, Monserrato, Cagliari, Italy.
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Saba L, Sanfilippo R, Pascalis L, Montisci R, Mallarini G. Study of endoleaks after endovascular repair by using MDCTA. Eur Rev Med Pharmacol Sci 2010; 14:775-784. [PMID: 21061837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE Our purpose was to investigate the multi-detector-row CT angiography (MDCTA) application in endoleak detection. METHODS Fifty-nine patients that underwent endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm with endoluminal stent graft were retrospectively studied. MDCTA scans were obtained after administration of 110-130 mL of contrast material using a 4-6 mL/sec flow rate. We made unenhanced, arterial (15-20 sec) and delayed (100 sec) acquisitions. For each patient four MDCTA datasets (pre-EVAR, 1, 6, and 12 months follow-up) were obtained. Each examination was studied by two observers. Kappa value was calculated in order to evaluate inter-observer agreement. RESULTS Twenty-one endoleaks were detected in eighteen patients. Fifteen and eighteen endoleaks were detected by using biphasic arterial CT and biphasic delayed CT respectively (sensitivity of 71.4% and 85.7% respectively). We observed a positive correlation between the presence of endoleak and the increasement in aneurysm size. Interobserver agreement was 88.1% and kappa value was 0.685. CONCLUSIONS Biphasic CT for endoleak detection is significantly superior to arterial and delayed phases respectively. We observed a good interobserver agreement.
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Affiliation(s)
- L Saba
- Department of Science of the Images, A.O.U. di Cagliari, Cagliari, Italy.
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Sanfilippo R, Grosso F, D'Incalci M, Dileo P, Pilotti S, Morosi C, Fiore M, Tercero JC, Gronchi A, Casali PG. Surgery of residual disease of myxoid liposarcoma (MLS) patients responding to trabectedin. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Dileo P, Sanfilippo R, Grosso F, Fumagalli E, Blay J, Domont J, Le Cesne A, Tercero JC, Casali PG. Trabectedin (T) in advanced, pretreated synovial sarcomas (SS): A retrospective analysis of 39 patients (pts) from three European institutions. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Saba L, Sanfilippo R, Atzeni M, Ribuffo D, Montisci R, Mallarini G. Superior mesenteric artery spontaneous and isolated dissection diagnosed by using MDCTA. Eur Rev Med Pharmacol Sci 2010; 14:235-238. [PMID: 20391965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We report the case of a 49-year-old man admitted to our Institute because he suffered acute abdominal pain induced by eating. Sonography don't revealed pathological findings. Then underwent a multi-detector row computed tomography angiography (MDCTA) that revealed an intimal flap separating true and false lumens that was located 2 cm from the origin of the superior mesenteric artery (SMA) and with an extension of 8 cm. Since the dissection was limited without occlusion of the SMA and the mesenteric marginal artery served as a collateral vessel on the distal side of the SMA, the treatment has been conservative. Improved CT technology facilitates the diagnosis of superior mesenteric artery dissection. Prompt diagnosis and treatment result in the lowest mortality rate and minimize the prevalence of intestinal infarction. Only 107 cases (including the present case) of isolated spontaneous SMA dissection without associated aortic dissection were identified from the literature.
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Affiliation(s)
- L Saba
- Department of Radiology, Azienda Ospedaliero Universitaria, Cagliari, Polo di Monserrato, Cagliari, Italy.
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Saba L, Sanfilippo R, Montisci R, Mallarini G. Assessment of intracranial arterial stenosis with multidetector row CT angiography: a postprocessing techniques comparison. AJNR Am J Neuroradiol 2010; 31:874-9. [PMID: 20053812 DOI: 10.3174/ajnr.a1976] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE It was demonstrated the some patients with stroke have intracranial stenosis of 50% or greater and the identification of intracranial arterial stenosis is extremely important in order to plan a correct therapeutical approach. The aim of this study was to assess the image quality and intertechnique agreement of various postprocessing methods in the detection of intracranial arterial stenosis. MATERIAL AND METHODS Eighty-five patients who were studied by using a multidetector row CT scanner were retrospectively analyzed. A total of 2040 segments were examined in the 85 subjects. Intracranial vasculature was assessed by using MPR, CPR, MIP, and VR techniques. Two radiologists reviewed the CT images independently. Cohen weighted kappa statistic was applied to calculate interobserver agreement and for image accuracy for each reconstruction method. Sensitivity, specificity, PPV, and NPV were also calculated by using the consensus read as the reference. RESULTS Two hundred fifteen (10.5%) stenosed artery segments were identified by the observers in consensus. The best intermethod kappa values between observers 1 and 2 were obtained by VR and MIP (kappa values of 0.878 and 0.861, respectively), whereas MPR provided the lowest value (kappa value of 0.282). VR showed a sensitivity for detecting stenosed segments of 88.8% and 91.6% for observers 1 and 2, respectively. The highest positive predictive value was also obtained by VR at 95% and 99% for observers 1 and 2, respectively. Image accuracy obtained by using VR was the highest among all reconstruction methods in both observers (185/255 and 177/255 for observers 1 and 2, respectively). CONCLUSIONS The results of our study suggest that VR and MIP techniques provide the best interobserver and intertechnique concordance in the analysis of intravascular cranial stenosis.
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Affiliation(s)
- L Saba
- Department of Radiology, Policlinico Universitario, University of Cagliari, Monserrato, Cagliari, Italy.
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Saba L, Montisci R, Sanfilippo R, Mallarini G. Imaging of the endoleak after endovascular aneurysm repair procedure by using multidetector computer tomography angiography. J Cardiovasc Surg (Torino) 2009; 50:515-526. [PMID: 19734835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Abdominal aortic aneurysms (AAA) are an important cause of death in elderly men. Most used treatment options are endovascular aneurysm repair (EVAR) and open surgical repair. After the endovascular stent graft placement, however, several complications may occur and an important complication of EVAR is endoleak formation which occurs in approximately one-fourth of patients. Endoleak represents a blood flow outside the stent graft lumen but within the aneurysm sac. For these reasons, unlike the minimal imaging follow-up that is typically performed after surgical repair, patients undergoing EVAR require a life-long postoperative surveillance imaging. In the last years, with the advent of multidetector-row CT (MDCT) scanners and the use of specific angiographic protocols (multidetector CT angiography, MDCTA), CT imaging became the most commonly used examination for endoleak detection. Moreover, the volume data obtained can be further rendered to generate high quality two-dimensional (2D) and three-dimensional (3D) images, that allow a better distinction between Endoleak type II, III and IV. Purpose of this study was to review and describe MDCTA potentialities in the detection of endoleak after EVAR procedures.
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Affiliation(s)
- L Saba
- Department of Sciences of the Images, University Polyclinic, Monserrato, Cagliari, Italy.
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Saba L, Montisci R, Sanfilippo R, Mallarini G. Multidetector row CT of the brain and carotid artery: a correlative analysis. Clin Radiol 2009; 64:767-78. [PMID: 19589415 DOI: 10.1016/j.crad.2009.03.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2008] [Revised: 03/16/2009] [Accepted: 03/19/2009] [Indexed: 01/02/2023]
Abstract
AIM To evaluate the association between types of carotid plaque, the presence of prior ischaemic events detectable with CT, and patient's symptoms. MATERIALS AND METHODS Between January 2004 and May 2006, 112 patients were evaluated using multidetector row computed tomography angiography (MDCTA) of the carotid arteries and computed tomography (CT) of the brain. Carotid arteries were categorized by evaluating the degree of stenosis according to North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, the type of plaque, and the presence of plaque ulceration. The brain was assessed via CT for the presence, type, and position of lesions. Chi-square tests, Student's t test, and simple logistic regression analysis were performed and the Cohen kappa test was applied for interobserver variability measurement. RESULTS The Chi-square test indicated a statistically significant association between the presence of fatty plaques (p=0.005) and CT-detectable lesions in the brain (p=0.004). Moreover, the number of patients with CT-detectable brain lesions was greater in patients with >70% stenosis than in those with <70% stenosis (p=0.007). Logistic regression confirmed the association between fatty plaque and symptoms (p=0.001), between >70% stenosis and symptoms (p=0.041), and an inverse association between calcified plaque and symptoms (p=0.009). CONCLUSION MDCTA allows adequate evaluation of the type of plaque. The results of the present study indicate that there is an association between cerebral lesions, symptoms, and fatty plaque in the carotid artery. The degree of stenosis also correlated with cerebral lesions and symptoms. According to the obtained data, the type of carotid plaque should be included among primary parameters in the classification of patients' risk class.
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Affiliation(s)
- L Saba
- Department of Imaging Science, Policlinico Universitario, s.s. 554 Monserrato (Cagliari) 09045, Italy.
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Grosso F, Sanfilippo R, Virdis E, Piovesan C, Collini P, Dileo P, Morosi C, Tercero JC, Jimeno J, D'Incalci M, Gronchi A, Pilotti S, Casali PG. Trabectedin in myxoid liposarcomas (MLS): a long-term analysis of a single-institution series. Ann Oncol 2009; 20:1439-44. [PMID: 19465423 DOI: 10.1093/annonc/mdp004] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Trabectedin has been approved in Europe as second-line therapy for advanced soft tissue sarcomas. A previous analysis showed that myxoid liposarcomas (MLS) are particularly sensitive to the drug. We report on the long-term efficacy of trabectedin in a subgroup of that series. METHODS Since September 2002, 32 advanced pretreated MLS patients received trabectedin at our center. Data were reviewed focusing on their long-term outcome. RESULTS Trabectedin was given as a 24-h continuous infusion every 21 days. A total of 376 and a median of 12 courses per patient (range 2-26; interquartiles range (IQR) 8-15) were delivered. Response rate per RECIST was 50% [95% confidence interval (CI) 32% to 68%], median progression-free survival (PFS) was 17 months (95% CI 13.5-30.1) and median overall survival is still not reached. In 10 patients, therapy was stopped in the absence of any evident disease, mostly after complete surgery of residual lesions. In these 10 patients, at a median follow-up of 25 months, PFS was 28.1 months (95% CI 25.6-36.4) from treatment start. DISCUSSION These data indicate that the high response rate of MLS to trabectedin translates into prolonged PFS. Surgery of residual metastatic disease is already used quite extensively in metastatic MLS. Trabectedin may give further significance to this kind of surgery.
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Affiliation(s)
- F Grosso
- Adult Sarcoma Medical Treatment Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
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Grosso F, Sanfilippo R, Jones RL, Collini P, Morosi C, Raspagliesi F, Tercero JC, D'Incalci M, Judson IR, Casali PG. Role of trabectedin (T) in the management of advanced uterine leiomyosarcoma (U-LM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10530 Background: To explore the clinical impact of T in U-LM. T has been approved in Europe for second line treatment of advanced soft tissue sarcomas (STS). Efficacy is well established in liposarcoma and leiomyosarcoma. U-LMs display peculiar clinical and genetic features compared to other STS. These differences may be responsible for the sensitivity of this subtype to therapy, thus justifying an evaluation of the activity of T in a relatively homogeneous series of U-LM patients. Methods: From April 2000, 56 patients (pts) with advanced disease, previously exposed to a median of 3 chemotherapy lines (range 1–5), received T within an expanded access programme at two European referral institutions for sarcoma. The clinical records were reviewed focusing on response and treatment outcome. Two pts were excluded from the analysis having received only 1 course of T. Median age was 56 yrs (range 29–73), median number of metastatic sites was 2 (range 1–4), the most frequent metastatic site was lung (88%), 24 patients had a local relapse. Results: A total of 252 courses were delivered (median 3, IQR2–6) and 36% of patients received more than 5 courses of T. Fifty-two patients were evaluable for response. A partial response was observed in 11 patients and stable disease in 15, for a PR rate of 21% and a tumor control rate of 50%. The median progression-free survival was 3.6 months (CI95% 2.6–6.7), with 41% of patients free from progression at 6 months. Conclusions: These results compare favourably with other systemic treatments in advanced U-LMS and support their sensitivity to T. This should prompt further studies to prospectively evaluate the efficacy of T in U-LMS and elucidate possible biological predictive factors (e.g. DNA repair protein expression). [Table: see text]
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Affiliation(s)
- F. Grosso
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - R. Sanfilippo
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - R. L. Jones
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - P. Collini
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - C. Morosi
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - F. Raspagliesi
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - J. C. Tercero
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - M. D'Incalci
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - I. R. Judson
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - P. G. Casali
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Mario Negri Institute for Pharmacological Research, Milan, Italy
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Sanfilippo R, Grosso F, Virdis E, Morosi C, Tercero JC, Gronchi A, Pilotti S, D'Incalci M, Casali PG. Rechallenge with trabectedin in patients with responding myxoid liposarcoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10575] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10575 Background: To determine the efficacy of rechallenge with trabectedin (T) in patients with myxoid liposarcoma who were responding to T at the time of discontinuation but subsequently developed progressive disease. Methods: Since September 2002, 32 patients with recurrent or advanced myxoid liposarcoma received T at our institution within an expanded access program. We report herein 8 patients who received T for a median of 10 cycles (range 5–15) prior to discontinuation. We used RECIST criteria to classify patient response to therapy. During the initial administration of T, a CR had been observed in 2 patients, a PR in 3 patients, SD in 2 patients, and one had had tumor shrinkage but did not meet RECIST definition of PR. The median PFS was 24 months from treatment start, and 14 months (range 9–27) from treatment-end. In 6 of the 8 patients, the treatment had been discontinued in the absence of any evidence of disease: 4 patients had undergone complete surgical resection (R0) of residual disease and 2 patients had achieved a radiological complete response (CR). The other two patients stopped treatment voluntarily, one with a partial response (PR) and one with stable disease (SD). All these patients resumed treatment at the time of progression. Results: Following rechallenge with T, no PD was seen at first assessment, and no patients had to discontinue or reduce the dose due to toxicity. Response rate according to RECIST was 50%. At a median follow up of 7 months (range 2.7–12), the median TTP has not yet been reached. Treatment is still ongoing in 5 patients. Conclusions: Rechallenge with T can be beneficial in some patients with myxoid liposarcoma. If further data confirm this, treatment of progressing patients previously responding to T may include this option. Furthermore, studies on optimization of treatment duration upfront may be worthwhile. [Table: see text]
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Affiliation(s)
- R. Sanfilippo
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - F. Grosso
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - E. Virdis
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - C. Morosi
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - J. C. Tercero
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - A. Gronchi
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - S. Pilotti
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - M. D'Incalci
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
| | - P. G. Casali
- Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy; PharmaMar, Madrid, Spain; Istituto Mario Negri, Milan, Italy
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Saba L, Pascalis L, Montisci R, Sanfilippo R, Mallarini G. Diagnostic sensitivity of multidetector-row spiral computed tomography angiography in the evaluation of type-II endoleaks and their source: comparison between axial scans and reformatting techniques. Acta Radiol 2008; 49:630-7. [PMID: 18568554 DOI: 10.1080/02841850802060860] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND After endovascular stent-graft placement, several complications may occur. Retrograde filling of the aneurysm (type-II endoleak) is the most common. PURPOSE To evaluate the accuracy, image quality, and interobserver agreement of multidetector-row spiral computed tomography angiography (MDCTA) in the diagnosis of type-II endoleak, by using various types of reformatting techniques in comparison to regular axial images. MATERIAL AND METHODS Twenty-four patients who had had endovascular repair of an infrarenal abdominal aortic aneurysm with stent graft were retrospectively studied. In 12 of 24 patients, a type-II endoleak was found. CT scans were obtained after intravenous administration of 130 ml of nonionic contrast material using a 4-6-ml/s flow rate. All patients were investigated with axial scans, multiplanar reconstruction (MPR), maximum intensity projection (MIP), shaded-surface display (SSD), and volume-rendering (VR) techniques. For each patient and for each reconstruction method, the image quality of the scans was scored as 0 for bad quality, 1 for poor quality, 2 for good quality, and 3 for excellent quality images. Two radiologists reviewed the CT images independently. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each reconstruction method, with the axial images as the reference method. Interobserver agreement and kappa value were also recorded. RESULTS MPR showed the highest sensitivity (83% and 67% for observers 1 and 2, respectively), PPV (91% and 80% for observers 1 and 2, respectively), and NPV (85% and 71% for observers 1 and 2, respectively), whereas VR showed the highest specificity (92% for both observer 1 and 2). CONCLUSION Reformatting techniques provide good-quality images; nevertheless, their efficacy in the study of type-II endoleak was found to be suboptimal in comparison to regular axial images. The MPR technique is probably the best choice in conjunction with axial images.
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Affiliation(s)
- L. Saba
- Department of Radiology and Vascular Surgery, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Monserrato, Monserrato (Cagliari), Italy Department of Radiology and Institute of Internal Medicine, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Cagliari, Cagliari, Italy
| | - L. Pascalis
- Department of Radiology and Vascular Surgery, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Monserrato, Monserrato (Cagliari), Italy Department of Radiology and Institute of Internal Medicine, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Cagliari, Cagliari, Italy
| | - R. Montisci
- Department of Radiology and Vascular Surgery, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Monserrato, Monserrato (Cagliari), Italy Department of Radiology and Institute of Internal Medicine, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Cagliari, Cagliari, Italy
| | - R. Sanfilippo
- Department of Radiology and Vascular Surgery, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Monserrato, Monserrato (Cagliari), Italy Department of Radiology and Institute of Internal Medicine, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Cagliari, Cagliari, Italy
| | - G. Mallarini
- Department of Radiology and Vascular Surgery, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Monserrato, Monserrato (Cagliari), Italy Department of Radiology and Institute of Internal Medicine, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Cagliari, Cagliari, Italy
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Saba L, Sanfilippo R, Montisci R, Conti M, Mallarini G. Accessory renal artery stenosis and hypertension: are these correlated? Evaluation using multidetector-row computed tomographic angiography. Acta Radiol 2008; 49:278-84. [PMID: 18365815 DOI: 10.1080/02841850701777408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Renal artery stenosis may produce hypertension, and this condition is referred to as renovascular hypertension (RVH). PURPOSE To evaluate, by using multidetector-row spiral computed tomographic angiography (MDCTA), whether a relationship between accessory renal artery stenosis and hypertension may be hypothesized. MATERIAL AND METHODS 214 patients (142 males, 72 females; mean age 66 years) who had previously undergone an MDCTA to study the abdominal vasculature were retrospectively studied. Patients with renal artery stenosis (RAS) were excluded from this analysis. The patients were studied by means of a four-detector-row CT, and scans were obtained after intravenous bolus administration of 110-140 ml of a nonionic contrast material with a 3-6 ml/s flow rate. As a second step, by means of statistical analysis, hypertension data were compared with findings of accessory artery stenosis. Two radiologists first independently reviewed the MDCTA images and then, in case of disagreement, in consensus. Interobserver agreement was calculated for all measurements. RESULTS The overall number of detected accessory renal arteries was 74 in 56 of the 214 patients. Accessory renal artery stenosis was detected in 21 of the 56 patients. There was a difference in the prevalence of hypertension between patients with (n = 21) and without (n = 35) accessory renal artery stenosis (P = 0.0187). Interobserver agreement was good (kappa value 0.733). CONCLUSION Any statistical association between the presence of accessory renal artery stenosis and hypertension could not be disclosed. However, accessory renal artery stenosis, detected by MDCTA, is an important pathological sign that the radiologist has to assess in the light of its possible association with hypertension.
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Affiliation(s)
- L. Saba
- Department of Imaging Science and Department of Vascular Surgery, Policlinico Universitario, Cagliari, Italy; Institute of Radiology, University of Cagliari, Cagliari, Italy; Institute of Radiological Sciences, University of Sassari, Sassari, Italy
| | - R. Sanfilippo
- Department of Imaging Science and Department of Vascular Surgery, Policlinico Universitario, Cagliari, Italy; Institute of Radiology, University of Cagliari, Cagliari, Italy; Institute of Radiological Sciences, University of Sassari, Sassari, Italy
| | - R. Montisci
- Department of Imaging Science and Department of Vascular Surgery, Policlinico Universitario, Cagliari, Italy; Institute of Radiology, University of Cagliari, Cagliari, Italy; Institute of Radiological Sciences, University of Sassari, Sassari, Italy
| | - M. Conti
- Department of Imaging Science and Department of Vascular Surgery, Policlinico Universitario, Cagliari, Italy; Institute of Radiology, University of Cagliari, Cagliari, Italy; Institute of Radiological Sciences, University of Sassari, Sassari, Italy
| | - G. Mallarini
- Department of Imaging Science and Department of Vascular Surgery, Policlinico Universitario, Cagliari, Italy; Institute of Radiology, University of Cagliari, Cagliari, Italy; Institute of Radiological Sciences, University of Sassari, Sassari, Italy
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Saba L, Caddeo G, Sanfilippo R, Montisci R, Mallarini G. CT and ultrasound in the study of ulcerated carotid plaque compared with surgical results: potentialities and advantages of multidetector row CT angiography. AJNR Am J Neuroradiol 2007; 28:1061-6. [PMID: 17569958 PMCID: PMC8134149 DOI: 10.3174/ajnr.a0486] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Ulceration is a severe complication of carotid plaque. The purpose of this study was to evaluate the role and the diagnostic efficacy of multidetector row CT angiography (MDCTA) and ultrasound (US) echo color Doppler (US-ECD) in the study of patients with carotid plaque complicated by ulceration through the comparison with the surgical observation. MATERIALS AND METHODS From January 2004 to October 2005, 237 patients, for a total of 474 carotid arteries, studied at first with color Doppler US, were analyzed using CT angiography. A total of 103 patients underwent a carotid endarterectomy. We analyzed stenosis degree, plaque composition, and presence of ulcerations. In a second phase, the data were compared with the surgical results when the MDCTA indicated surgical intervention. RESULTS MDCTA found 31 ulcerations; the surgical confirmation underlined a 93.75% sensitivity and a 98.59% specificity. US-ECD performances were 37.5% and 91.5% for sensitivity and specificity, respectively. The number of patients who showed plaque ulcerations increased with the severity of stenosis. Furthermore, ulcerations of the carotid plaque occurred more often proximal than distal to the point of maximum stenosis, and this trend increased with the severity of the stenosis. We also determined that fatty plaques were more likely to be affected by ulcerations. CONCLUSIONS The results of our study suggest that MDCTA detects with higher sensitivity and specificity the presence of ulcerated plaque compared with US-ECD, which has been demonstrated to be less effective in this evaluation. Considering the high MDCTA sensitivity and specificity for detection of plaque ulceration, we therefore recommend MDCTA as a useful step for correct presurgical planning.
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Affiliation(s)
- L Saba
- Department of Imaging Science, Policlinico Universitario, Cagliari, Italy.
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Coco P, Fumagalli E, Bertulli R, Dileo P, Grosso F, Stacchiotti S, Piovesan C, Sanfilippo R, Accolla M, Casali PG. High-dose Ifosfamide (HDIFX) as a 14-day continuous infusion (ci) in advanced adult soft tissue sarcoma (STS): A single- institution retrospective case series analysis. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10067 Background: High-dose IFX (≥12 g/sqm) is active even in STS patients pretreated with standard-dose IFX, though with substantial toxicity. Prolonged continuous infusion, through a portable pump, may be an alternative way of administration. A Phase II study thereof is ongoing in Italy, but some pts have been treated off the study, either prior to its start or for practical reasons. Such consecutive pts seen at a single institution have been retrospectively reviewed. Methods: Between July 2001 and September 2006, 45 adult patients (M:F = 25:20; mean age 47 yrs; PS 0–1) with progressing advanced/metastatic STS, all previously treated with anthracyclines and standard-dose IFX, were given ciHDIFX, at the dose of 14 g/sqm as a 14-day continuous infusion every 4 weeks, using two portable infusional devices, with equidose Mesna, lasting 7 days each. Diagnosis was leyomiosarcoma in 12 patients, synovial sarcoma in 9, liposarcoma in 5, and other histological types in 19. Disease was advanced inoperable in 6 pts, and metastatic in 39. The total number of cycles was 176 (median number per pt: 4). Results: A PR was seen in 5 pts (synovial sarcoma, 2; leyomiosarcoma, 1, liposarcoma, 1; chondrosarcoma, 1), and SD in 22 (>6 mos in 12), for a clinical benefit rate = 37%. PFS at 6 months was 35%. Median PFS was 11 mos in pts with PR and 6 in those with SD. Median PFS was 8 months in 9 patients undergoing complete tumor resection. Most common side effects were nausea (G1–2 in 14 pts) and asthenia (G1–2 in 15 pts). G2 anemia was seen in 8 pts, G2 neutropenia in 6. One pt with a single kidney had a reversible G2 hypercreatininemia. No grade 3–4 toxicity were recorded. Conclusions: In this series, ciHDIFX was associated with a PR and 6-mos PFS rate in the range of active second-line agents in advanced STS. This regimen was exceedingly well tolerated. No significant financial relationships to disclose.
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Affiliation(s)
- P. Coco
- Istituto Nazionale Tumori, Milan, Italy
| | | | | | - P. Dileo
- Istituto Nazionale Tumori, Milan, Italy
| | - F. Grosso
- Istituto Nazionale Tumori, Milan, Italy
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Dileo P, Grosso F, Casanova M, Jimeno J, Marsoni S, Sanfilippo R, Podda M, Ferrari S, Bertulli R, Casali PG. Trabectedin (T) in metastatic Ewing's family tumors (EFT) patients (pts) progressing after standard chemotherapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10040] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10040 Background: T is a formerly marine-derived agent which is active in human cancers, such as ovarian cancer and adult soft tissue sarcomas (STS). Efficacy of T in pts with unresectable/metastatic pretreated advanced STS was demonstrated in phase II settings. Leiomyosarcoma and liposarcoma were shown to be sensitive, with myxoid liposarcoma being exceedingly responsive. Data are lacking on “small round blue cell” sarcomas, including EFT. In 2000 a phase II study was launched by SENDO in a sarcoma population including EFT. At Istituto Nazionale Tumori, Milano, Italy, some EFT pts were treated after the completion of this study. We analyzed treatment efficacy in EFT pts treated within these two settings. Methods: Overall 15/29 of the pts were female, and age ranged from 15 to 55 years. Pts received T at a starting dose between 1,650 and 1,100 mcg/sqm every 3 weeks as 24-hour or 3-hour infusion. Each pt received at least 2 cycles of treatment, except in case of disease progression or unacceptable toxicity. Tumor response was assessed by RECIST criteria after the first 2 cycles and then every other cycle. Dose reductions were based on the worst toxicity (hematological or non-hematological) in the previous cycle. Results: As of December 2006, 20 pts were treated in the Phase II study, and 9 on a compassionate use basis. Two pts were still on therapy. A total of 79 treatment cycles (2–14 per pt) were administered. Three pts (10.3%) demonstrated a partial response, 3 had a minor response (10.3%), and 4 (13.7%) stable disease. PFS rate at 6 months was 25%. The most common all-causality AEs were acute reversible liver toxicity, fatigue, and myelosuppression. Following the introduction of steroid pre-medication, thrombocytopenia and fatigue were less frequent. Conclusions: In this cohort, T was overall well tolerated and showed antitumor activity in pts with advanced EFT. This calls for further evaluation of this compound, alone or in combination, in pts suffering from EFT. No significant financial relationships to disclose.
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Affiliation(s)
- P. Dileo
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - F. Grosso
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - M. Casanova
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - J. Jimeno
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - S. Marsoni
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - R. Sanfilippo
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - M. Podda
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - S. Ferrari
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - R. Bertulli
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
| | - P. G. Casali
- Istituto Nazionale Tumori, Milan, Italy; Pharmamar Oncology, Madrid, Spain; Sendo Oncology, Milan, Italy; Istituti Ortopedici Rizzoli, Bologna, Italy
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Saba L, Caddeo G, Sanfilippo R, Montisci R, Mallarini G. Efficacy and sensitivity of axial scans and different reconstruction methods in the study of the ulcerated carotid plaque using multidetector-row CT angiography: comparison with surgical results. AJNR Am J Neuroradiol 2007; 28:716-23. [PMID: 17416828 PMCID: PMC7977349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND PURPOSE Carotid plaque ulceration is an important risk factor for stroke, and its diagnosis may be very important to plan a correct therapeutic approach. We hypothesized that axial scans and various reconstruction methods could have different specificity and sensitivity in the study of plaque ulceration. The object of this study was to evaluate their role and diagnostic efficacy in patients with carotid plaque complicated by ulceration through the comparison with surgical results. MATERIALS AND METHODS From January 2004 to November 2005, 109 patients who underwent a carotid endarterectomy were analyzed using CT angiography for a total of 218 carotid arteries. We assessed every carotid for the presence of ulcerations. For each patient axial image, maximum intensity projection (MIP), multiplanar reconstruction (MPR), shaded surface display (SSD), and volume rendering (VR) reconstructions were obtained. RESULTS Multidetector row CT angiography (MDCT) found 32 ulcerations; surgical confirmation underlined an overall 93.9% sensitivity (95% confidence interval [CI] 0.858-1.021), and a 98.7% specificity (95% CI, 0.961-1.012). Axial scans and volume rendering images demonstrated the highest sensitivity (90.9% and 87.9%, respectively); SSD, on the contrary, showed the lowest sensitivity: 39.4% (95% CI sensitivity, 0.227-0.561). CONCLUSION Axial scans plus VR reconstruction techniques offer superior depiction of carotid plaque ulceration compared with MIP, MPR, and SSD.
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Affiliation(s)
- L Saba
- Department of Imaging Science, Policlinico Universitario, Cagliari, Italy.
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Grosso F, Dileo P, Sanfilippo R, Stacchiotti S, Bertulli R, Piovesan C, Jimeno J, D'Incalci M, Gescher A, Casali PG. Steroid premedication markedly reduces liver and bone marrow toxicity of trabectedin in advanced sarcoma. Eur J Cancer 2006; 42:1484-90. [PMID: 16737808 DOI: 10.1016/j.ejca.2006.02.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Revised: 02/09/2006] [Accepted: 02/22/2006] [Indexed: 11/16/2022]
Abstract
Trabectedin is a marine-derived cytoxic alkaloid which has shown promising antitumour activity in a variety of human malignancies including sarcoma. Fifty-four patients with advanced sarcoma (age 43 yrs, range 18-70), all pretreated with prior chemotherapy, were enrolled on a named individual basis for treatment with trabectedin. Diagnosis was adult soft tissue sarcoma (STS) in 46 patients, Ewing's family tumour (EFT) in 4, and osteosarcoma (OS) in 4. The initial 23 patients (total number of courses administered: 68) did not receive premedication prior to trabectedin, while the other 31 patients (total number of courses administered: 134) received premedication with dexamethasone 4 mg po bid 24 hours before therapy. Incidence of toxicity (grade 3-4), expressed as percentage of courses, was as follows: in patients without dexamethasone, elevation of transaminases 34%, neutropenia 24% and thrombocytopenia 25%; in patients with prior dexamethasone, elevation of transaminases 2%, neutropenia 2% and no thrombocytopenia. The median received dose intensity of trabectedin was superimposable in the two groups (404 microg and 400 microg per week, respectively), as well as progression-free survival (19% at 6 months). Among STS patients, 9% had objective responses. In this unselected patient series, premedication with dexamethasone strongly reduced drug-induced hepatotoxicity and myelosuppression.
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Affiliation(s)
- F Grosso
- Cancer Medicine Dept., Adult Sarcoma Medical Oncology Unit, Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milano, Italy.
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46
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Montisci R, Ruju C, Massoni G, Sanfilippo R, Brotzu G. Chronic venous ulcer treatment with fascial pedunculated graft. J Cardiovasc Surg (Torino) 2003; 44:249-53. [PMID: 12813393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
AIM Chronic venous ulcer treatment is often time consuming and requires a high degree of compliance from the patient. This derives not only from venous hypertension but also from chronic structural and metabolic changes of underlying tissues which impair the healing process. It therefore becomes necessary to improve the ulcer tissue condition in order to accelerate the healing process. This is obtained mainly with the improvement of local haemodynamics and secondly by direct action on the ulcer. The aim of the study is to evaluate the efficacy of a treatment with a pedunculated flap of fascia as an additional treatment of chronic venous ulcer. METHODS Four patients classified C6 according to the CEAP classification were treated for chronic venous ulcer with correction of venous hypertension (saphenectomy or ligature of incompetent perforating veins). The patients also underwent rotation of a fascial pedunculated flap transferred from the sural area to the perimalleolar area. After 7-15 days they had a free skin graft in the treated area. RESULTS All patients were discharged on the 3(rd) postoperative day after the flap rotation. In 3 patients the ulcer healed within 30 days and in a 4(th) patient within 45 days. No recurrence was observed. CONCLUSION With this method the healing time seems to be shortened compared to the typical evolution in patients treated with only reflux control followed by conservative therapy. Associating fascial flap in the treatment of chronic venous ulcers improves the bed on which the free skin graft is applied. We can also hypothesize that this procedure restores the aponeurotic barrier between deep venous circulation and superficial microcirculation with the ensuing improvement in local venous hypertension.
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Affiliation(s)
- R Montisci
- Department of Vascular and Thoracic Surgery, University Polyclinic Hospital, University of Cagliari, Cagliari, Italy.
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47
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Izzo V, Giudice G, Pirrone AM, Bellavia D, Sanfilippo R, Barbieri R. Lack of amplification phenomena of ribosomal RNA genes in sea urchin. J Submicrosc Cytol Pathol 2002; 34:409-13. [PMID: 12575840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Careful quantitative analyses by spot hybridization to homologous probes demonstrate that no rDNA amplification occurs during Paracentrotus lividus oogenesis. The same approach was used to measure the copy number of the genes involved in ribosome biogenesis. Surprisingly, differently from the organisms in which the lack of rDNA amplification phenomena was observed, a very low number of constitutive rDNA repeats was found in this organism.
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Affiliation(s)
- V Izzo
- Institute of Developmental Biology, CNR, Palermo, Italy
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48
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Cervello M, Sanfilippo R, Isola G, Virruso L, Scalia G, Cammarata G, Gambino R. Phosphorylation-dependent regulation of skeletogenesis in sea urchin micromere-derived cells and embryos. Dev Growth Differ 1999; 41:769-75. [PMID: 10646807 DOI: 10.1046/j.1440-169x.1999.00479.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sea urchin embryo micromeres when isolated and cultured in vitro differentiate to produce spicules. Although several authors have used this model, almost nothing is known about the signaling pathways responsible for initiating skeletogenesis. In order to investigate the potential involvement of phosphorylation events in spiculogenesis, the effect of inhibitors of protein kinases and phosphatases on skeleton formation was studied. Results obtained using both cultured micromeres and embryos revealed that protein tyrosine kinase and phosphatase inhibitors blocked skeleton formation, but not serine/threonine phosphatase inhibitors. The inhibitors showed a dose-dependent effect and when removed from micromere or embryo culture, spicule formation resumed. Inhibition of tyrosine phosphatases resulted in an increase in the tyrosine phosphorylation level of two major proteins and a modest decrease in the expression of the mRNA coding for type I fibrillar collagen. These findings strongly suggest that tyrosine phosphorylation and dephosphorylation is required for micromere differentiation and for normal skeletogenesis during sea urchin embryo development.
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Affiliation(s)
- M Cervello
- Istituto di Biologia dello Sviluppo, Consiglio Nazionale delle Ricerche, Palermo, Italy.
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