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Ledda RE, Schirò S, Leo L, Milanese G, Branchi C, Commisso C, Borgia E, Mura R, Zilioli C, Sverzellati N. Diagnostic performance of chest CT average intensity projection (AIP) reconstruction for the assessment of pleuro-parenchymal abnormalities. Clin Radiol 2024:S0009-9260(24)00197-1. [PMID: 38693034 DOI: 10.1016/j.crad.2024.04.006] [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] [Received: 09/12/2023] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024]
Abstract
AIM The comparison between chest x-ray (CXR) and computed tomography (CT) images is commonly required in clinical practice to assess the evolution of chest pathological manifestations. Intrinsic differences between the two techniques, however, limit reader confidence in such a comparison. CT average intensity projection (AIP) reconstruction allows obtaining "synthetic" CXR (s-CXR) images, which are thought to have the potential to increase the accuracy of comparison between CXR and CT imaging. We aim at assessing the diagnostic performance of s-CXR imaging in detecting common pleuro-parenchymal abnormalities. MATERIALS AND METHODS 142 patients who underwent chest CT examination and CXR within 24 hours were enrolled. CT was the standard of reference. Both conventional CXR (c-CXR) and s-CXR images were retrospectively reviewed for the presence of consolidation, nodule/mass, linear opacities, reticular opacities, and pleural effusion by 3 readers in two separate sessions. Sensitivity, specificity, accuracy and their 95% confidence interval were calculated for each reader and setting and tested by McNemar test. Inter-observer agreement was tested by Cohen's K test and its 95%CI. RESULTS Overall, s-CXR sensitivity ranged 45-67% for consolidation, 12-28% for nodule/mass, 17-33% for linear opacities, 2-61% for reticular opacities, and 33-58% for pleural effusion; specificity 65-83%, 83-94%, 94-98%, 93-100% and 79-86%; accuracy 66-68%, 74-79%, 89-91%, 61-65% and 68-72%, respectively. K values ranged 0.38-0.50, 0.05-0.25, -0.05-0.11, -0.01-0.15, and 0.40-0.66 for consolidation, nodule/mass, linear opacities, reticular opacities, and pleural effusion, respectively. CONCLUSION S-CXR images, reconstructed with AIP technique, can be compared with conventional images in clinical practice and for educational purposes.
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Affiliation(s)
- R E Ledda
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
| | - S Schirò
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
| | - L Leo
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
| | - G Milanese
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
| | - C Branchi
- Radiological Sciences Unit, Diagnostic Department, University Hospital of Parma, Parma, Italy.
| | - C Commisso
- Radiology Unit, Diagnostic Department, University Hospital of Parma, Parma, Italy.
| | - E Borgia
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
| | - R Mura
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
| | - C Zilioli
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
| | - N Sverzellati
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
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Massimi L, Cinalli G, Frassanito P, Arcangeli V, Auer C, Baro V, Bartoli A, Bianchi F, Dietvorst S, Di Rocco F, Gallo P, Giordano F, Hinojosa J, Iglesias S, Jecko V, Kahilogullari G, Knerlich-Lukoschus F, Laera R, Locatelli D, Luglietto D, Luzi M, Messing-Jünger M, Mura R, Ragazzi P, Riffaud L, Roth J, Sagarribay A, Pinheiro MS, Spazzapan P, Spennato P, Syrmos N, Talamonti G, Valentini L, Van Veelen ML, Zucchelli M, Tamburrini G. Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era. Childs Nerv Syst 2024; 40:1221-1237. [PMID: 38456922 DOI: 10.1007/s00381-024-06332-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017-2019), COVID (2020-2021), and post-COVID period (2022-June 2023) looking for possible epidemiological and/or clinical changes. MATERIAL AND METHODS An English language questionnaire was sent to ESPN members about year of the event, patient's age and gender, presence of immune-deficit or other favoring risk factors, COVID infection, signs and symptoms at onset, site of primary infection, type of intracranial complication, identified germ, type and number of surgical operations, type and duration of medical treatment, clinical and radiological outcome, duration of the follow-up. RESULTS Two hundred fifty-four cases were collected by 30 centers coming from 14 different European countries. There was a statistically significant difference between the post-COVID period (129 children, 86 cases/year, 50.7% of the whole series) and the COVID (40 children, 20 cases/year, 15.7%) or the pre-COVID period (85 children, 28.3 cases/year, 33.5%). Other significant differences concerned the presence of predisposing factors/concurrent diseases (higher in the pre-COVID period) and previous COVID infection (higher in the post-COVID period). No relevant differences occurred as far as demographic, microbiological, clinical, radiological, outcome, morbidity, and mortality data were concerned. Paranasal sinuses and middle ear/mastoid were the most involved primary site of infection (71% and 27%, respectively), while extradural or subdural empyema and brain abscess were the most common ICSO (73% and 17%, respectively). Surgery was required in 95% of cases (neurosurgical and ENT procedure in 71% and 62% of cases, respectively) while antibiotics in 99% of cases. After a 12.4-month follow-up, a full clinical and radiological recovery was obtained in 85% and 84% of cases, respectively. The mortality rate was 2.7%. CONCLUSIONS These results suggest that the occurrence of ICSO was significantly increased after the pandemic. Such an increase seems to be related to the indirect effects of the pandemic (e.g., immunity debt) rather than to a direct effect of COVID infection or to seasonal fluctuations. ICSO remain challenging diseases but the pandemic did not affect the management strategies nor their prognosis. The epidemiological change of sinusitis/otitis and ICSO should alert about the appropriate follow-up of children with sinusitis/otitis.
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Affiliation(s)
- L Massimi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
| | - G Cinalli
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - P Frassanito
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - V Arcangeli
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Auer
- Department of Neurosurgery, Johannes Kepler University Linz, Kepler University Hospital GmbH, Linz, Austria
| | - V Baro
- Pediatric and Functional Neurosurgery, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Bartoli
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - F Bianchi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Dietvorst
- University Hospitals Leuven, Leuven, Belgium
| | - F Di Rocco
- Hôpital Femme-Mère-Enfant, Université de Lyon, Lyon, France
| | - P Gallo
- Birmingham Children's Hospital, Birmingham, UK
| | - F Giordano
- University of Florence, Florence, Italy
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - J Hinojosa
- Hospital Sant Joan de Déu, Barcelona, Spain
| | - S Iglesias
- Hospital Regional Universitario de Malaga, Malaga, Spain
| | - V Jecko
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - G Kahilogullari
- Department of Neurosurgery, Ankara University, Ankara, Turkey
| | - F Knerlich-Lukoschus
- Division Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - R Laera
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - D Locatelli
- Neurosurgery Department, Università Dell'Insubria, Ospedale di Circolo e Macchi Foundation, Varese, Italy
| | - D Luglietto
- Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - M Luzi
- Azienda Ospedaliero Universitaria Delle Marche, Ancona, Italy
| | | | - R Mura
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - P Ragazzi
- Department of Pediatric Neurosurgery, Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - L Riffaud
- Rennes University Hospital, Rennes, France
| | - J Roth
- Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - A Sagarribay
- Hospital Dona Estefânia-Centro Hospitalar Universitário, Lisboa, Portugal
- Hospital CUF Descobertas, Lisboa, Portugal
| | - M Santos Pinheiro
- Centro Hospitalar Lisboa Norte-Hospital Santa Maria, Lisboa, Portugal
| | - P Spazzapan
- University Medical Center-Ljubljana, Ljubljana, Slovenia
| | - P Spennato
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - N Syrmos
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - L Valentini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M L Van Veelen
- Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands
| | - M Zucchelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto Scienze Neurologiche Di Bologna, Boulogne, Italy
| | - G Tamburrini
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
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Buccoliero AM, Caporalini C, Moscardi S, Cetica V, Mei D, Conti V, Nozzoli F, Bonaudo C, Battista F, Giordano F, Mura R, Spacca B, Mussa F, D'Onofrio V, Guerrini R, Genitori L, Scagnet M. Leat-associated seizures the possible role of EAAT2, pyruvate carboxylase and glutamine synthetase. Epilepsy Res 2024; 199:107258. [PMID: 38086219 DOI: 10.1016/j.eplepsyres.2023.107258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Drug-resistant epilepsy is a common condition in patients with brain neoplasms. The pathogenesis of tumor-associated seizures is poorly understood. Among the possible pathogenetic mechanisms, the increase in glutamate concentration has been proposed. Glutamate transporters, glutamine synthetase and pyruvate carboxylase are involved in maintaining the physiological concentration of glutamate in the intersynaptic spaces. In our previous research on angiocentric gliomas, we demonstrated that all tumors lacked the expression of the main glutamate transporter EAAT2, while the expression of glutamine synthetase and pyruvate carboxylase was mostly preserved. METHODS In the present study, we evaluated the immunohistochemical expression of EAAT2, glutamine synthetase and pyruvate carboxylase in a heterogeneous series of 25 long-term epilepsy-associated tumors (10 dysembryoplastic neuroepithelial tumors, 7 gangliogliomas, 3 subependymal giant cell astrocytomas, 3 rosette forming glioneuronal tumors, 1 diffuse astrocytoma MYB- or MYBL1-altered and 1 angiocentric glioma). In order to evaluate the incidence of variants in the SLC1A2 gene, encoding EAAT2, in a large number of central nervous system tumors we also queried the PedcBioPortal. RESULTS EAAT2 protein expression was lost in 9 tumors (36 %: 3 dysembryoplastic neuroepithelial tumors, 1 ganglioglioma, 3 subependymal giant cell astrocytomas, 1 diffuse astrocytoma MYB- or MYBL1-altered and 1 angiocentric glioma). Glutamine synthetase protein expression was completely lost in 2 tumors (8 %; 1 ganglioglioma and 1 diffuse astrocytoma MYB- or MYBL1-altered). All tumors of our series but rosette forming glioneuronal tumors (in which neurocytic cells were negative) were diffusely positive for pyruvate carboxylase. Consultation of the PedcBioPortal revealed that of 2307 pediatric brain tumors of different histotype and grade, 20 (< 1%) had variants in the SLC1A2 gene. Among the SLC1A2-mutated tumors, there were no angiocentric gliomas or other LEATs CONCLUSIONS: In conclusion, unlike angiocentric gliomas where the EAAT2 loss is typical and constant, the current study shows the loss of EAAT2 expression only in a fraction of the LEATs. In these cases, we may hypothesize some possible epileptogenic role of the EAAT2 loss. The retained expression of pyruvate carboxylase may contribute to determining a pathological glutamate excess unopposed by glutamine synthetase that resulted expressed to a variable extent in the majority of the tumors. Furthermore, we can assume that the EAAT2 loss in brain tumors in general and in LEATs in particular is more conceivably epigenetic.
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Affiliation(s)
| | | | - Selene Moscardi
- Pathology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Valentina Cetica
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Davide Mei
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Valerio Conti
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Filippo Nozzoli
- Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Camilla Bonaudo
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), Careggi University Hospital, Florence, Italy
| | - Francesca Battista
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), Careggi University Hospital, Florence, Italy
| | - Flavio Giordano
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Regina Mura
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Barbara Spacca
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Federico Mussa
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | - Renzo Guerrini
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Lorenzo Genitori
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), Careggi University Hospital, Florence, Italy
| | - Mirko Scagnet
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
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Agushi R, Scagnet M, Spacca B, Mura R, Grandoni M, Mussa F, Genitori L. Is endoscope-assisted strip craniectomy the future of metopic suture craniosynostosis treatment? An 11-year experience with 62 patients. J Neurosurg Pediatr 2023; 32:75-81. [PMID: 36964738 DOI: 10.3171/2023.2.peds22409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 02/14/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Endoscopic mini-invasive treatment for sporadic trigonocephaly is becoming a widely accepted surgical treatment. In most centers this treatment is performed in association with postoperative helmeting. The aim of the present study was to review and report the authors' 11-year experience of endoscope-assisted metopic suturectomy for treatment of 62 trigonocephaly patients without helmet use. METHODS For this retrospective study, clinical data of 62 consecutive pediatric patients (age 3-8 months) were obtained from the data bank of the "Anna Meyer" Children Hospital. These patients had been diagnosed with trigonocephaly (type II and III) and undergone surgery performed with a mini-invasive endoscopic technique during the period from January 2011 to January 2022. No helmet was used postoperatively in these patients, and they were evaluated through craniometric measurements, pre-/postoperative photographs, and parents' impressions, as well as thorough clinical examinations during follow-up appointments. RESULTS The mean patient follow-up period was 6 ± 1.3 years. The female/male ratio was 1:2; 52% of the patients presented with type II trigonocephaly and the remaining patients with type III. The mean age at surgery was 153 ± 44 days (5 ± 1.5 months, range 3-8 months). In 92% of the patients the surgical outcome was defined as good to excellent. However, 4 patients presented with an unsatisfactory outcome, including 1 patient with a CSF collection requiring surgical repair 2 months after the first surgery and 1 patient who developed infection of the surgical wound and needed a second surgery. In the latter patient the outcome was evaluated as satisfactory, and no sequelae regarding the infection were encountered during follow-up. CONCLUSIONS According to the authors' experience, endoscopic metopic suturectomy alone, without the use of a helmet, is a valid surgical option for trigonocephaly treatment, and its application can be considered in patients of older age groups (up to 8 months). Thus, in the right patient selection context, this technique represents the treatment of choice.
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Noris A, Giordano F, Peraio S, Lenge M, Mura R, Macconi L, Barzaghi R, Genitori L. Loculated hydrocephalus: is neuroendoscopy effective and safe? A 90 patients' case series and literature review. Childs Nerv Syst 2023; 39:711-720. [PMID: 36443473 PMCID: PMC10024651 DOI: 10.1007/s00381-022-05747-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 11/03/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Loculated hydrocephalus is a complex condition in which different non-communicating compartments form within the ventricular system due to different etiology, mainly intraventricular hemorrhage and infection. Since the end of the twentieth century, neuroendoscopy has been explored as a therapeutic option for loculated hydrocephalus with non-univocal results. METHODS We performed a retrospective analysis of 90 patients who underwent endoscopic treatment for loculated hydrocephalus from January 1997 to January 2021 (mean age: 2 years, range 7-21). We included 37 (41.1%) children with multiloculated hydrocephalus, 37 (41.1%) with isolated lateral ventricle, 13 (14.4%) with excluded temporal horn, and 3 (3.3%) with isolated fourth ventricle. We compared our results with those available in literature. RESULTS A mean of 1.91 endoscopic procedure/patient were performed (only one endoscopy in 42.2% of cases). Complications of neuroendoscopy and of shunt surgeries were recorded in 17 (18.9%) and 52 (57.8%) children, respectively. Twenty-six (28.9%) children were shunt-free at the last follow-up, 47.8% have only one shunt. DISCUSSION The first goal of neuroendoscopy is to increase the rate of shunt-free patients but, when it is not possible, it aims at simplifying shunt system and reducing the number of surgical procedures. In our series, neuroendoscopy was able to achieve both these goals with an acceptable complication rate. Thus, our results confirmed neuroendoscopy as a valid tool in the long-term management of loculated hydrocephalus. Neuronavigation and intraoperative ultrasound could increase the success rate in cases with distorted anatomy.
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Affiliation(s)
- Alice Noris
- Neurosurgery Unit, Department of Neurosciences, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | - Flavio Giordano
- Neurosurgery Unit, Department of Neurosciences, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy.
| | - Simone Peraio
- Neurosurgery Unit, Department of Neurosciences, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | - Matteo Lenge
- Neurosurgery Unit, Department of Neurosciences, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | - Regina Mura
- Neurosurgery Unit, Department of Neurosciences, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | - Letizia Macconi
- Radiology Department, Meyer Children's Hospital, 50139, Florence, Italy
| | - Raffaella Barzaghi
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute and Vita-Salute University, 20132, Milan, Italy
| | - Lorenzo Genitori
- Neurosurgery Unit, Department of Neurosciences, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
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Caporalini C, Giordano F, Moscardi S, Di Stefano G, Lenge M, Di Giacomo G, Basile M, Zin A, Mura R, Scagnet M, Alaggio R, Sardi I, Genitori L, Buccoliero AM. Primary Intracerebral Alveolar Soft Part Sarcoma: Report of a Case and Review of the Literature. Int J Surg Pathol 2021; 30:195-199. [PMID: 34142883 DOI: 10.1177/10668969211027293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Alveolar soft part sarcomas (ASPSs) are rare malignant tumors representing ∼1% of all soft tissue sarcomas. Most ASPS occurring in the central nervous system are metastases. In contrast, primary intracranial ASPSs are extremely rare and only 8 cases have been previously reported in English literature. Here, we report a case of primary alveolar soft part sarcoma in a 16-year-old female patient with no evidence of primary extracranial tumors. Histologically this case fulfilled the criteria of ASPS, and a molecular confirmation has been archived. To date, only 9 primary intracranial ASPS cases, including ours, have been reported in the literature. This report highlights the clinical and pathological characteristics, differential diagnosis, and molecular analysis of primary ASPS of the central nervous system.
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Affiliation(s)
| | - Flavio Giordano
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Selene Moscardi
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Matteo Lenge
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Massimo Basile
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Angelica Zin
- Institute of Pediatric Research (IRP), 460888Fondazione Città della Speranza, Padova, Italy
| | - Regina Mura
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Mirko Scagnet
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Rita Alaggio
- 9342Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italy
| | - Iacopo Sardi
- 9335Anna Meyer Children's University Hospital, Florence, Italy
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Maria Bacci G, Giordano F, Sardi I, Evans G, Pathmanaban O, Fonte C, Trabalzini F, Nappini S, Mura R, Caputo R. Optical coherence tomography significance in managing complex neurofibromatosis 2-related papilledema: Report of a case. JRSM Open 2021; 12:2054270420981454. [PMID: 33489243 PMCID: PMC7804359 DOI: 10.1177/2054270420981454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This case describes the strong utility of optical coherence tomography in
multidisciplinary management of a complex case of type 2 neurofibromatosis.
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Affiliation(s)
- Giacomo Maria Bacci
- Pediatric Ophthalmology Unit, Children’s
Hospital A. Meyer, University of Florence, Florence 50139, Italy
- Giacomo Maria Bacci.
| | - Flavio Giordano
- Department of Neurosurgery, Children's
Hospital A. Meyer, University of Florence, Florence 50139, Italy
| | - Iacopo Sardi
- Neuro-oncology Unit, Children’s Hospital A.
Meyer, University of Florence, Florence 50139, Italy
| | - Gareth Evans
- Department of Genomic Medicine, Division of
Evolution and Genomic Science, University of Manchester, St Mary’s Hospital, Manchester M13
9PL, UK
| | - Omar Pathmanaban
- Department of Neurosurgery, Salford Royal
Hospital, Manchester Academic Health Science Centre, University of Manchester, Manchester M6
8HD, UK
| | - Carla Fonte
- Neuro-oncology Unit, Children’s Hospital A.
Meyer, University of Florence, Florence 50139, Italy
| | - Franco Trabalzini
- Otolaryngology Department, Children's Hospital
A. Meyer, University of Florence, Florence 50139, Italy
| | - Sergio Nappini
- Neurovascular Interventional Unit, Careggi
University Hospital, Florence 50139, Italy
| | - Regina Mura
- Department of Neurosurgery, Children's
Hospital A. Meyer, University of Florence, Florence 50139, Italy
| | - Roberto Caputo
- Pediatric Ophthalmology Unit, Children’s
Hospital A. Meyer, University of Florence, Florence 50139, Italy
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Giordano F, Lenge M, Donati P, Mongardi L, Di Giacomo G, Mura R, Taverna M, Cini C, Peraio S, Poggi G, Tuccinardi G, Giglio S, Genitori L. Exclusive Neurogenic Bladder and Fecal Incontinency in an Achondroplasic Child Successfully Treated with Lumbar Foraminal Decompression. Pediatr Neurosurg 2021; 56:471-476. [PMID: 34320505 DOI: 10.1159/000517652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 06/06/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Achondroplasia is a genetic disorder characterized by defects in the development of endochondral bone resulting in skeletal abnormalities like stenosis of the foramen magnum and of the spine, shortened limb bones, and macrocephaly. Congenital spinal stenosis is frequent and due to premature fusion of the pedicles to the laminae. CASE PRESENTATION We report a case of neurogenic bladder and fecal incontinence due to lumbar stenosis successfully treated with L1-L5 partial laminectomy and foraminotomy in a 7-year-old achondroplasic child. DISCUSSION/CONCLUSION To our knowledge, this is the first case report of exclusive neurogenic bladder and fecal incontinence in an achondroplasic child. Neurogenic bladder and fecal incontinence without motor impairment may be early and exclusive clinical findings of lumbar stenosis in children with achondroplasia.
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Affiliation(s)
- Flavio Giordano
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Matteo Lenge
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy, .,Department of Neuroscience, Child Neurology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy,
| | - Pierarturo Donati
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Lorenzo Mongardi
- Department of Neurosurgery, Nuovo Ospedale Cona, University of Ferrara, Ferrara, Italy
| | - Gianpiero Di Giacomo
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy.,Department of Neuroscience, Child Neurology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Regina Mura
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Maria Taverna
- Department of Surgery, Pediatric Urology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Chiara Cini
- Department of Surgery, Pediatric Urology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Simone Peraio
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Giovanni Poggi
- Department of Pediatrics, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Germana Tuccinardi
- Neuroanesthesiology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Sabrina Giglio
- Clinical Genetics Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Lorenzo Genitori
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
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9
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Giordano F, Caporalini C, Peraio S, Mongardi L, Buccoliero AM, Cavallo MA, Genitori L, Lenge M, Mura R, Melani F, L'Erario M, Lelli L, Pennica M. Post-mortem histopathology of a pediatric brain after bilateral DBS of GPI for status dystonicus: case report and review of the literature. Childs Nerv Syst 2020; 36:1845-1851. [PMID: 32613424 DOI: 10.1007/s00381-020-04761-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/22/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE To investigate the effects of deep brain stimulation (DBS) electrodes on the brain of a dystonic pediatric patient submitted to bilateral DBS of the globus pallidus internus (GPI). METHODS An 8-year-old male patient underwent bilateral DBS of GPI for status dystonicus. He died 2 months later due to multiorgan failure triggered by bacterial pneumonia. A post-mortem pathological study of the brain was done. RESULTS At visual inspection, no grossly apparent softening, hemorrhage, or necrosis of the brain adjacent to the DBS lead tracts was detected. High-power microscopic examination of the tissue surrounding the electrode trajectories showed lymphocyte infiltration, astrocytic gliosis, microglia, macrophages, and clusters of multinucleate giant cells. Significant astrocytosis was confirmed by GFAP staining in the electrode site. The T cell lymphocyte activity was overexpressed with activated macrophages detected with CD3, CD20, CD45, and CD68 stains respectively. There was no gliosis or leukocyte infiltration away from the surgical tracks of the electrodes. CONCLUSION This is the first post-mortem examination of a child's brain after bilateral DBS of GPI. The comparison with adult post-mortem reports showed no significant differences and confirms the safety of DBS implantation in the pediatric population too.
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Affiliation(s)
- Flavio Giordano
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy. .,Functional and Epilepsy Neurosurgery Unit, Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Viale Pieraccini 24, 50139, Florence, Italy.
| | - Chiara Caporalini
- Division of Pathology, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Simone Peraio
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Lorenzo Mongardi
- Department of Neurosurgery, Sant'Anna Hospital University of Ferrara, Ferrara, Italy
| | - Anna Maria Buccoliero
- Division of Pathology, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | | | - Lorenzo Genitori
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Matteo Lenge
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy.,Child Neurology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Regina Mura
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Federico Melani
- Child Neurology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Manuela L'Erario
- Pediatric Anesthesiology and Intensive Care Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Leonardo Lelli
- Diagnostic Imaging Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Michele Pennica
- Pediatric Anesthesiology and Intensive Care Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
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10
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Pillon M, Carraro E, Mussolin L, Conter V, Tondo A, Aricò M, Mura R, Sala A, Vinti L, Buffardi S, Pierani P, d'Amore ESG, Basso G. Primary mediastinal large B-cell lymphoma: Outcome of a series of pediatric patients treated with high-dose methotrexate and cytarabine plus anti-CD20. Pediatr Blood Cancer 2018; 65. [PMID: 29049862 DOI: 10.1002/pbc.26855] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 09/14/2017] [Accepted: 09/19/2017] [Indexed: 11/08/2022]
Abstract
Between 2007 and 2013, 13 children diagnosed with primary mediastinal large B-cell lymphoma (PMLBL) were treated according to a modified version of AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) LNH-97 protocol based on high-dose methotrexate, anthracyclines, and addition of anti-CD20. Ten patients achieved a continuous complete remission with front-line therapy. The overall 5-year survival was 91.7%, and event-free survival was 83.9%, with only one patient dying of progressive disease. Despite the few cases, these results demonstrate that this therapy, which includes anti-CD20, given in a multicenter setting, is feasible with acceptable toxicity in children with PMLBL.
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Affiliation(s)
- Marta Pillon
- Pediatric Hematology and Oncology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - E Carraro
- Pediatric Hematology and Oncology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - L Mussolin
- Pediatric Hematology and Oncology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Institute of Paediatric Research-Fondazione Città della Speranza, Padova, Italy
| | - V Conter
- Department of Paediatrics, Ospedale San Gerardo, University of Milano-Bicocca, Fondazione MBBM, Monza, Italy
| | - A Tondo
- Department of Paediatric Haematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, Italy
| | - M Aricò
- Paediatric Unit, Medical Department, Azienda Sanitaria Provinciale Ragusa, Ragusa, Italy
| | - R Mura
- Department of Paediatric Haematology-Oncology, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - A Sala
- Department of Paediatrics, Ospedale San Gerardo, University of Milano-Bicocca, Fondazione MBBM, Monza, Italy
| | - L Vinti
- Department of Paediatric Haemato-Oncology, IRCCS Ospedale Bambino Gesù, Roma, Italy
| | - S Buffardi
- Department of Paediatric Haemato-Oncology, Santobono-Pausilipon Children's Hospital, Napoli, Italy
| | - P Pierani
- Division of Pediatric Hematology and Oncology, Ospedale G.Salesi, Ancona, Italy
| | - E S G d'Amore
- Department of Pathology, San Bortolo Hospital, Vicenza, Italy
| | - G Basso
- Pediatric Hematology and Oncology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
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11
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Consoli A, Renieri L, Mura R, Nappini S, Ricciardi F, Pecchioli G, Ammannati F, Mangiafico S. Five to ten years follow-up after coiling of 241 patients with acutely ruptured aneurysms. A single centre experience. Interv Neuroradiol 2012; 18:5-13. [PMID: 22440595 DOI: 10.1177/159101991201800101] [Citation(s) in RCA: 6] [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] [Received: 09/24/2011] [Accepted: 11/19/2011] [Indexed: 11/17/2022] Open
Abstract
Endovascular treatment has assumed a role of first choice in the management of ruptured intracranial aneurysms. We describe the clinical and morphological data after the treatment of 258 ruptured intracranial aneurysms in 241 patients, in order to evaluate the safety and the efficacy of the endovascular treatment. Two hundred and forty-one patients with saccular ruptured aneurysms were treated at our institution between 2000 and 2005. After the endovascular treatment a clinical and angiographic follow-up was conducted. The clinical follow-up was carried out with a medical examination and telephonic interviews and mRS was used for evaluation. Two hundred and forty-nine acutely ruptured aneurysms were successfully treated and immediately after the endovascular procedure 81.9% of the aneurysms resulted completely occluded, 12.1% had a residual neck and 6% revealed a residual sac. The evolution of each grade was evaluated at six months and two years. During the follow-up we observed five early and one late re-bleedings. Twenty-four patients underwent a second procedure. After the discharge and up to ten years 73.1% of patients had a good clinical outcome (mRS0-1), 8.9% died and the remainder showed moderate-severe disability (mRS2-3). The long-term stability of the anatomical result is a critic-al issue of this approach because eventual re-bleedings may occur even after several months or years. A careful clinical and radiological follow-up for up to two years after the embolization may prevent recurrences but may not be sufficient.
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Affiliation(s)
- A Consoli
- Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
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12
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Abstract
Chordoid glioma is a rare low-grade tumor located in the third ventricle-hypothalamic region. Since its first report, 37 cases have been described in the literature. We report on an additional case that we considered significant because of its incidental detection and its uneventful surgical removal.
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Affiliation(s)
- Pasquale Gallina
- Department of Neurosurgery and Human Pathology, University of Florence, and CTO Hospital, Florence, Italy.
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13
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Abstract
The authors describe a rare case of hepatocellular carcinoma that metastasized to the pectineal muscle of the right thigh. The patient had been treated with surgical procedures and with multiple sessions of transarterial chemoembolization, one of which was complicated by a right femoral artery hematoma at the catheter insertion site. It is unclear whether the muscle metastasis was caused by blood-borne spread or by tumor-cell seeding caused by the TACE procedure.
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Affiliation(s)
- D Sirigu
- Brotzu Hospital, Cagliari, Italy
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14
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Bungaro S, Irving J, Tussiwand R, Mura R, Minto L, Molteni C, Citterio M, Hall A, Biondi A, Cazzaniga G. Genomic analysis of different clonal evolution in a twin pair with t(12;21) positive acute lymphoblastic leukemia sharing the same prenatal clone. Leukemia 2007; 22:208-11. [PMID: 17914410 DOI: 10.1038/sj.leu.2404973] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Meyborg M, Mura R, Tiefenbacher C, Becker R, Michaelsen J, Niroomand F. Comparative follow up of patients with implanted cardioverter-defibrillators after induction of sustained monomorphic ventricular tachycardias or ventricular fibrillation by programmed stimulation. Heart 2003; 89:629-32. [PMID: 12748217 PMCID: PMC1767667 DOI: 10.1136/heart.89.6.629] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To investigate the prognostic value of induced monomorphic ventricular tachycardia (VT) and ventricular flutter or fibrillation (VF) during programmed electrical stimulation in patients with a high risk for sudden arrhythmogenic cardiac death. DESIGN Prospective cohort study. PATIENTS 102 patients at high risk for arrhythmogenic sudden cardiac death who received an automated implantable cardioverter-defibrillator (AICD) were evaluated. 56 patients received the AICD for primary prevention and 46 for secondary prevention. 58 patients had induction of a monomorphic VT (VT group) and 44 had induction of a polymorphic VT, ventricular flutter, or ventricular fibrillation (VF group) during programmed electrical stimulation. Average follow up was 20 months in both groups. MAIN OUTCOME MEASURES Appropriate AICD protocol. RESULTS In patients who received the AICD for primary prevention, 16 of 32 patients in the VT group, compared with only four of 24 patients in the VF group, received an appropriate AICD protocol (p = 0.02). In the entire study population, 479 appropriate AICD protocols were recorded in 28 (48%) patients in the VT group and 28 appropriate protocols in 11 (25%) patients in the VF group. Cumulative Kaplan-Meier event-free survival curves were significantly different (p = 0.02). CONCLUSION Induction of VF during programmed electrical stimulation is of no prognostic value even in high risk patients without previously documented ventricular fibrillation.
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Affiliation(s)
- M Meyborg
- Klinikum der Universität Heidelberg, Innere Medizin III, Bergheimer Strasse 58, D-69115 Heidelberg, Germany
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16
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Lutz S, Mura R, Baltus D, Movsesian M, Kübler W, Niroomand F. Increased activity of membrane-associated nucleoside diphosphate kinase and inhibition of cAMP synthesis in failing human myocardium. Cardiovasc Res 2001; 49:48-55. [PMID: 11121795 DOI: 10.1016/s0008-6363(00)00222-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Chronic heart failure is associated with a decreased responsiveness of the heart to beta-adrenergic receptor agonists. We recently demonstrated a receptor-independent activation of G proteins and modulation of cardiac adenylyl cyclase activity by sarcolemmal membrane-associated nucleoside diphosphate kinase. We wondered whether changes in the activity of nucleoside diphosphate kinase occur in heart failure and contribute to or compensate for the impairment in myocardial receptor-mediated cAMP generation. METHODS Sarcolemmal membranes were purified from non-failing and failing human left ventricular myocardium. The protein level and activity of nucleoside diphosphate kinase were quantified. The influence of nucleoside diphosphate kinase on adenylyl cyclase activity was determined by measuring the effect of GDP on adenylyl cyclase activity in the absence and presence of nucleoside diphosphate kinase inhibitors. RESULTS The amount and activity of nucleoside diphosphate kinase in sarcolemmal membranes from failing hearts (n=13) were increased 3- to 4-fold compared to levels in membranes from non-failing myocardium (n=5). This increase in sarcolemmal nucleoside diphosphate kinase activity resulted in a 50% inhibition of adenylyl cyclase activity over a range of GDP and ATP concentrations. CONCLUSION The amount and activity of nucleoside diphosphate kinase are increased in sarcolemmal membranes of failing human myocardium, resulting in a substantial receptor-independent inhibition of adenylyl cyclase activity.
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Affiliation(s)
- S Lutz
- University of Heidelberg, Department of Cardiology, Bergheimer Strasse 58, D-69115, Heidelberg, Germany
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17
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Niroomand F, Mura R, Jakobs KH, Rauch B, Kübler W. Receptor-independent activation of cardiac adenylyl cyclase by GDP and membrane-associated nucleoside diphosphate kinase. A new cardiotonic mechanism? J Mol Cell Cardiol 1997; 29:1479-86. [PMID: 9201632 DOI: 10.1006/jmcc.1997.0384] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Regulation of adenylyl cyclase activity by guanine nucleoside tri- and diphosphates as well as by stimulatory and inhibitory receptors was studied in canine cardiac sarcolemmal membranes. Guanosine triphosphate (GTP) increased adenylyl cyclase activity by a maximum of 80%, with an EC50 value of 0.7 mumol/l. The addition of the beta-adrenoceptor agonist, isoprenaline (100 mumol/l), caused a further, about 100%, increase in GTP-stimulated activity. The nucleoside diphosphate (GDP) also activated cardiac adenylyl cyclase, but in a biphasic manner. At low concentrations (EC50 0.12 mumol/ l). GDP increased enzyme activity by about 80%, followed by a plateau at 0.5-2 mumol/l and a second increase to a maximum of 60% with an EC50 value of 14 mumol/l. The stable GDP analog, guanosine 5'-O-(2-thio)diphosphate (GDP beta S), also increased cardiac adenylyl cyclase activity, but in a monophasic manner, by a maximum of 150%, with an EC50 of 0.4 mumol/l. Addition of uracil diphosphate (UDP) (3 mmol/l), which completely inhibited transphosphorylation of GDP to GTP, did not reduce adenylyl cyclase stimulation by low concentrations of GDP, whereas enzyme stimulation by high GDP concentrations was almost completely attenuated. Furthermore, pretreatment of the membranes with cholera toxin led to an increased stimulation of adenylyl cyclase activity by high concentrations of GDP. These findings suggest that the second phase of adenylyl cyclase stimulation by GDP is due to transphosphorylation of GDP to GTP, associated with activation of Gs proteins, and that stimulation by GDP itself (first phase) and endogenously formed GTP (second phase) is additive. However, in contrast to exogenously added GTP, beta-adrenoceptor activation did not enhance GDP-stimulated adenylyl cyclase activity. Furthermore, in the presence of 1 mumol/l GDP, the addition of GTP did not cause any further increase in enzyme activity. On the other hand, the muscarinic acetylcholine receptor agonist carbachol inhibited both GTP- and GDP-activated adenylyl cyclase. The inhibition of GDP-stimulated activity was lost when formation of GTP from GDP was blocked. The contrasting effects of endogenously formed GTP and exogenous GTP suggest that the formation of GTP from GDP is closely linked to the activation site of adenylyl cyclase, i.e. the stimulatory Gs protein. This receptor-independent activation can apparently bypass beta-adrenoceptor-dependent activation of cardiac adenylyl cyclase.
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18
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Casula L, Archidiacono N, Grazia Pau M, Addis M, Mura R, Galanello R, Biddau P, Cao A, Nucaro A. Cytogenetic and molecular characterization of a variant translocation associated with acute promyelocytic leukemia and involving chromosomes 11, 15 and 17. Leukemia 1996; 10:1655-7. [PMID: 8847902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- L Casula
- Servizio di Oncoematologia Pediatrica, Ospedale Regionale per le Microcitemie [correction of Mcrocitemie] di Cagliari, Italy
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19
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Piacentini L, Mura R, Jakobs KH, Niroomand F. Stable GDP analog-induced inactivation of G(i) proteins promotes cardiac adenylyl cyclase inhibition by guanosine 5'-(beta gamma-imino)triphosphate and muscarinic acetylcholine receptor. Biochim Biophys Acta 1996; 1282:11-6. [PMID: 8679647 DOI: 10.1016/0005-2736(96)00029-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Low concentrations of GDP and its stable analog guanosine 5'-O-(2-thio)diphosphate (GDP beta S) have been shown to stimulate adenylyl cyclase activity in canine cardiac sarcolemmal membranes independent from a phosphate transfer reaction. The mechanism of this stimulation was further examined. The stable GTP analog guanosine 5'-(beta gamma-imino)triphosphate (Gpp(NH)p) increased basal adenylyl cyclase activity and inhibited forskolin-stimulated activity with EC50 (half-maximal effective concentration) values of 0.7 mumol/l and 10 nmol/l, respectively. In the presence of GDP beta S (5 mumol/l), which increased basal activity by about 150%, addition of Gpp(NH)p inhibited adenylyl cyclase activity by up to 50% with an EC50 value of 40 nmol/l. Activation of cardiac muscarinic acetylcholine receptors by carbachol amplified this Gpp(NH)p-induced inhibition of GDP beta S-stimulated adenylyl cyclase activity. The stimulatory effect of GDP beta S and the inhibitory effect of Gpp(NH)p on GDP beta S-stimulated adenylyl cyclase activity were both attenuated by increasing the Mg2+ concentration or substituting Mn2+ for Mg2+ in the assay. Furthermore, both effects were strongly reduced or abolished upon pretreatment of the sarcolemmal membranes with a low concentration of the SH reagent N-ethylmaleimide (10 mumol/l). These results suggest that the stimulatory effect of GDP beta S on basal adenylyl cyclase activity in canine cardiac sarcolemmal membranes is caused by inactivation of G(i) proteins, which are then rendered susceptible to activation by Gpp(NH)p and inhibitory receptors.
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20
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D'Angelo P, Mura R, Rizzari C, Conter V, Bellini F, Valsecchi MG, Manganini C, Silvestri D, Masera G. Prognostic value of nephromegaly at diagnosis of childhood acute lymphoblastic leukemia. Acta Haematol 1995; 94:84-9. [PMID: 7484018 DOI: 10.1159/000203979] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 01/25/2023]
Abstract
In order to assess the prognostic value of nephromegaly (kidney enlargement > or = 2 SD from mean for age) in children at diagnosis of acute lymphoblastic leukemia (ALL), kidney size was investigated by intravenous pyelogram (IP), according to the method of Ekl of and Ringertz, in 101 children diagnosed with ALL in the period of 1975-1983. In the same period 103 additional patients with ALL were not investigated with IP for logistical reasons. Characteristics at the diagnosis of ALL in the patients of the investigated and non-investigated (with IP) groups were quite similar and event-free-survival (EFS) curves superimposable. Eighty-nine (50 males and 39 females, median age 61 months) out of 101 patients underwent IP before starting any therapy and were evaluated in the study; 27 (30.3%) presented with nephromegaly (bilateral in 13 cases and unilateral in 14). With a median follow-up time of 14.4 years (range 11-19 years), the EFS at 15 years from diagnosis was 18.5% (SE 9.5) in the nephromegalic group and 48.4% (SE 6.4) in the non-nephromegalic group. The association of poorer EFS with nephromegaly was confirmed when the comparison was adjusted by white blood cell count and age at diagnosis in a Cox regression model. Nephromegaly at diagnosis of childhood ALL may have an independent prognostic value in patients treated with 'not intensive' protocols; however, this finding should be confirmed in patients treated uniformly with contemporary intensive protocols.
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Affiliation(s)
- P D'Angelo
- Department of Pediatrics, University of Milan, S. Gerardo Hospital, Monza, Italy
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21
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Mura R, D'Angelo P, Rizzari C, Biondi A, Giudici G, Crosti L, Castagni M, Cantu'-Rajnoldi A. Lineage switch in a childhood T-cell acute lymphoblastic leukemia. Pediatr Hematol Oncol 1992; 9:281-8. [PMID: 1525008 DOI: 10.3109/08880019209016598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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22
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Locasciulli A, Mura R, Fraschini D, Gornati G, Scovena E, Gervasoni A, Uderzo C, Masera G. High-dose methotrexate administration and acute liver damage in children treated for acute lymphoblastic leukemia. A prospective study. Haematologica 1992; 77:49-53. [PMID: 1398282] [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: 12/26/2022] Open
Abstract
BACKGROUND Methotrexate-induced hepatotoxicity following chronic low-dose administration has been extensively reported. Current protocols now include high-dose methotrexate (HDMTX), but there are few studies providing data on its acute hepatotoxicity in childhood leukemia. METHODS To evaluate the prevalence of HDMTX-induced acute hepatotoxicity, sixty-eight consecutive children with ALL were prospectively studied from diagnosis to the end of HDMTX courses with biochemical and clinical evaluation performed at regular intervals. RESULTS Prevalence of HDMTX-induced acute hepatotoxicity was 1.47% (1/68 patients). ALT values did not change in 22% (15/68) and decreased in 76.4% (52/68) after HDMTX infusion. Mean ALT levels calculated in all the patients decreased significantly during HDMTX administration when compared to the values reached during induction (p less than 0.0001). Direct hyperbilirubinemia was present only in the child with HDMTX-related hepatotoxicity. CONCLUSIONS The use of HDMTX in the treatment of childhood ALL is not associated with major evidence of direct acute hepatotoxic effects, while it may modify the pattern of preexisting liver diseases.
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Affiliation(s)
- A Locasciulli
- Clinica Pediatrica, Università di Milano, Ospedale S. Gerardo, Monza, Italy
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23
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Fiori GM, Murgia G, Cocco A, Putzolu G, Mura R, Targhetta R, Biddau P. [Prethrombotic states in pediatrics]. Pediatr Med Chir 1991; 13:139-45. [PMID: 1896379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- G M Fiori
- Servizio di Oncoematologia Infantile e Patologia, Università di Cagliari, Italia
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24
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Biddau P, Peri M, Murgia G, Putzolu G, Fiori GM, Mura R, Monni MC, Valli S, Targhetta R, Corda R. [Incidence, mortality and survival in childhood tumors in meridional Sardinia. The Cagliari province, 1981-1988]. Epidemiol Prev 1990; 12:19-24. [PMID: 2151132] [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: 12/30/2022]
Abstract
Childhood cancer incidence, mortality and relative survival rates have been estimated in the province of Cagliari for the years 1982-86. Cases were collected from pediatric and non pediatric units operating either in the province or elsewhere. Deaths were identified through the registry offices of municipal administrations. A total of 151 cases were identified, corresponding to an incidence rate of 115.0 per million. Survival rate at three years of diagnosis was 63.3%.
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Affiliation(s)
- P Biddau
- Istituto di Clinica Pediatrica, Università di Cagliari
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25
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Madeddu G, D'Ovidio NG, Casu AR, Mura R, Costanza C, Lai N, LeVeen HH. Evaluation of peritoneovenous shunt patency with Tc-99m labeled microspheres. J Nucl Med 1983; 24:302-7. [PMID: 6220137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The LeVeen peritoneovenous shunt (PVS) was investigated in 40 cirrhotic patients with refractory ascites. Five millicuries of Tc-99m-tagged human albumin microspheres (15-36 microns) were injected into the peritoneal cavity between the umbilicus and the left anterior superior iliac spine. The radiotracer was always detectable by scintigram in the lungs when the shunt was patent. In case of malfunction, by contrast, the radioactivity was either restricted to the venous tube or confined below the diaphragm for at least 4 hr. In the presence of complete obstruction, whereas the tube was not visualized after peritoneal injection, it was outlined by direct injection of 2 mCi of Tc-99m albumin microspheres into its subcutaneous tract, where it crossed the 12th rib, immediately above the valve. This technique sufficed to establish whether the site of obstruction was at the valve or in the tubing itself. In one patient, poor visualization of the tube and a delayed image of the lungs was caused by partial occlusion of the valve with fibrinoid debris. This radiotracer method proved simple, quick, and led to an immediate selective replacement when the shunt was not patent. Therefore, the use of this test is recommended for a definitive diagnosis, since there were neither false negatives nor false positives. No complications such as embolism or bacterial infection were encountered with Tc-99m human albumin microspheres, which are excellent tracers.
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Bagiella P, Mura R, Scarpa AL. [Ambulatory treatment of pulmonary tuberculosis of primary diagnosis at the antitubercular outpatient clinics in Sardinia]. G Ital Mal Torace 1971; 25:25-9. [PMID: 5131785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Mura R. [Indices of tubercular morbidity and tuberculin indices in the province of Sassari]. G Ital Mal Torace 1969:Suppl 1:45-7. [PMID: 5795058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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