ABSTRACT
In the present work, we propose silk fibroin/alginate (SF/Alg) beads embedding simvastatin-loaded biodegradable microparticles as a versatile platform capable of tuning SVA release and in so doing osteogenic effects. In a first part of the study, microparticles of poly(lactic-co-glycolic) acid incorporating simvastatin either as lactone (SVL) or as hydroxyacid form (SVA) were prepared by spray-drying. While SVA-loaded microparticles released the drug in three days, long-term release of SVA could be obtained from SVL-loaded microparticles. In this latter case, SVL was promptly transformed to the osteogenic active SVA during release. When tested on mesenchymal stem cells, a time- and dose-dependent effect of SVL-loaded microparticles on cell proliferation and alkaline phosphatase (ALP) activity was found. Thereafter, SVL-loaded microparticles were embedded in SF/Alg beads to limit the initial simvastatin burst and to achieve easier implantation as well. Microparticle-embedded beads showed no cytotoxicity while ALP activity increased. If correctly exploited, the developed system may be suitable as osteogenic polymer scaffolds releasing correct amount of the drug locally for long time-frames.
Subject(s)
Alginates/chemistry , Drug Delivery Systems , Fibroins/chemistry , Mesenchymal Stem Cells/drug effects , Simvastatin/analogs & derivatives , Cells, Cultured , Humans , Lactic Acid , Polyglycolic Acid , Polylactic Acid-Polyglycolic Acid Copolymer , Simvastatin/administration & dosageABSTRACT
In this work nasal powder formulations of thalidomide were designed and studied to be used by persons affected by hereditary hemorrhagic telangiectasia as a complementary anti-epistaxis therapy, with the goal of sustaining the effect obtained with thalidomide oral treatment after its discontinuation for adverse effects. Three nasal powders were prepared using as carriers ß-CD or its more hydrophilic derivatives such as hydropropyl-ß-CD and sulphobutylether-ß-CD and tested with respect to technological and biopharmaceutical features after emission with active and passive nasal powder devices. For all formulated powders, improved dissolution rate was found compared to that of the raw material, making thalidomide promptly available in the nasal environment at a concentration favouring an accumulation in the mucosa. The very limited transmucosal transport measured in vitro suggests a low likelihood of significant systemic absorption. The topical action on bleeding could benefit from the poor absorption and from the fact that about 2-3% of the thalidomide applied on the nasal mucosa was accumulated within the tissue, particularly with the ß-CD nasal powder.
Subject(s)
Epistaxis/drug therapy , Powders/administration & dosage , Telangiectasia, Hereditary Hemorrhagic/drug therapy , Thalidomide/administration & dosage , Administration, Intranasal , Animals , Chemistry, Pharmaceutical/methods , Drug Carriers/chemistry , Humans , Nasal Mucosa/drug effects , Rabbits , Solubility , beta-Cyclodextrins/administration & dosageABSTRACT
Flucytosine (5-fluorocytosine, 5-FC) is a fluorinated analogue of cytosine currently approved for the systemic treatment of fungal infections, which has recently demonstrated a very promising antivirulence activity against the bacterial pathogen Pseudomonas aeruginosa. In this work, we propose novel inhalable hyaluronic acid (HA)/mannitol composite dry powders for repositioning 5-FC in the local treatment of lung infections, including those affecting cystic fibrosis (CF) patients. Different dry powders were produced in one-step by spray-drying. Powder composition and process conditions were selected after in depth formulation studies aimed at selecting the 5-FC/HA/mannitol formulation with convenient aerosolization properties and drug release profile in simulated lung fluids. The optimized 5-FC/HA/mannitol powder for inhalation (HyaMan_FC#3) was effectively delivered from different breath-activated dry powder inhalers (DPI) already available to CF patients. Nevertheless, the aerodynamic assessment of fine particles suggested that the developed formulation well fit with a low-resistance DPI. HyaMan_FC#3 inhibited the growth of the fungus Candida albicans and the production of the virulence factor pyoverdine by P. aeruginosa at 5-FC concentrations that did not affect the viability of both wild type (16HBE14o-) and CF (CFBE41o-) human bronchial epithelial cells. Finally, pharmacokinetics of HyaMan_FC#3 inhalation powder and 5-FC solution after intratracheal administration in rats were compared. In vivo results clearly demonstrated that, when formulated as dry powder, 5-FC levels in both bronchoalveolar lavage fluid and lung tissue were significantly higher and sustained over time as compared to those obtained with the 5-FC solution. Of note, when the same 5-FC amount was administered intravenously, no significant drug amount was found in the lung at each time point from the injection. To realize a 5-FC lung concentration similar to that obtained by using HyaMan_FC#3, a 6-fold higher dose of 5-FC should be administered intravenously. Taken together, our data demonstrate the feasibility to deliver 5-FC by the pulmonary route likely avoiding/reducing the well-known side effects associated to the high systemic 5-FC doses currently used in humans. Furthermore, our results highlight that an appropriate formulation design can improve the persistence of the drug at lungs, where microorganisms causing severe infections are located.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Antifungal Agents/administration & dosage , Drug Repositioning , Dry Powder Inhalers , Flucytosine/administration & dosage , Hyaluronic Acid/chemistry , Mannitol/chemistry , Administration, Inhalation , Aerosols/chemistry , Animals , Anti-Bacterial Agents/pharmacokinetics , Anti-Bacterial Agents/pharmacology , Antifungal Agents/pharmacokinetics , Antifungal Agents/pharmacology , Candida albicans/drug effects , Candidiasis/drug therapy , Flucytosine/pharmacokinetics , Flucytosine/pharmacology , Humans , Lung/microbiology , Lung Diseases, Fungal/drug therapy , Male , Particle Size , Powders , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/drug effects , Rats, WistarABSTRACT
BACKGROUND: Peptide based vaccines may suffer from limited stability and inefficient delivery to professional antigen-presenting cells (APCs), such as dendritic cells (DCs). In order to overcome such limitations, several types of biodegradable nanoparticles (NPs) have been developed as carrier system for antigens. The present study describes for the first time the extensive biological characterization of cationic NPs made of poly (D,L-lactide-co-glycolide) (PLGA) and polyethylenimine (PLGA/PEI) as delivery system for protein/peptide antigens, with potential in therapeutic cancer vaccine development. RESULTS: Flow cytometry as well as confocal laser scanning microscopy (CLSM) showed that PLGA/PEI NPs are more readily taken up than PLGA NPs by both human CD14(+) monocytes and mouse Hepa 1-6 hepatoma cell line. No signs of toxicity were observed in either cellular setting. Sequential image acquisition by TEM showed an intracellular apical localization for PLGA NPs and a perinuclear localization for PLGA/PEI NPs. Both NPs showed a clathrin-dependent as well as a caveolin-dependent internalization pathway and, once in the cells, they formed multivesicular endosomes (MVE). Finally, an ex vivo priming experiment showed that PLGA/PEI NPs are comparable to PLGA NPs in delivering a non-self antigen (i.e., ovalbumin - OVA) to immature dendritic cells (imDCs), which matured and induced autologous naïve CD4(+) T cells to differentiate to memory (i.e., central memory and effector memory) cells. Such a differentiation was associated with a Th1 phenotype suggesting a downstream activation and amplification of a CD8(+) T cell cytotoxic response. The same OVA antigen in a soluble form was unable to induce maturation of DCs, indicating that both NP formulations provided an intrinsic adjuvanting effect combined to efficient antigen delivery. CONCLUSIONS: Our study represents the first report on side-by-side comparison of PLGA and PLGA/PEI NPs as strategy for protein antigen delivery. PLGA/PEI NPs are superior for cellular uptake and antigen delivery as compared to PLGA NPs. Such an evidence suggests their great potential value for vaccine development, including therapeutic cancer vaccines.
Subject(s)
Antigen Presentation/immunology , Antigens/immunology , Cancer Vaccines/immunology , Dendritic Cells/immunology , Lactic Acid/pharmacology , Polyethyleneimine/pharmacology , Polyglycolic Acid/pharmacology , Animals , Antigens/administration & dosage , CD4-Positive T-Lymphocytes/immunology , Caveolin 1/metabolism , Cell Line, Tumor , Clathrin/metabolism , Humans , Immunologic Memory/immunology , Mice , Microscopy, Confocal , Multivesicular Bodies/metabolism , Nanoparticles , Ovalbumin/immunology , Polylactic Acid-Polyglycolic Acid Copolymer , T-Lymphocytes, Cytotoxic/immunology , Vaccines, Subunit/immunologyABSTRACT
In this paper we propose polysaccharide hydrogels combining alginate (ALG) and hyaluronan (HA) as biofunctional platform for dermal wound repair. Hydrogels produced by internal gelation were homogeneous and easy to handle. Rheological evaluation of gelation kinetics of ALG/HA mixtures at different ratios allowed understanding the HA effect on ALG cross-linking process. Disk-shaped hydrogels, at different ALG/HA ratio, were characterized for morphology, homogeneity and mechanical properties. Results suggest that, although the presence of HA does significantly slow down gelation kinetics, the concentration of cross-links reached at the end of gelation is scarcely affected. The in vitro activity of ALG/HA dressings was tested on adipose derived multipotent adult stem cells (Ad-MSC) and an immortalized keratinocyte cell line (HaCaT). Hydrogels did not interfere with cell viability in both cells lines, but significantly promoted gap closure in a scratch assay at early (1 day) and late (5 days) stages as compared to hydrogels made of ALG alone (p<0.01 and 0.001 for Ad-MSC and HaCaT, respectively). In vivo wound healing studies, conducted on a rat model of excised wound indicated that after 5 days ALG/HA hydrogels significantly promoted wound closure as compared to ALG ones (p<0.001). Overall results demonstrate that the integration of HA in a physically cross-linked ALG hydrogel can be a versatile strategy to promote wound healing that can be easily translated in a clinical setting.
Subject(s)
Alginates/pharmacology , Hyaluronic Acid/pharmacology , Hydrogels/pharmacology , Wound Healing/drug effects , Animals , Cell Line , Cell Movement/drug effects , Cell Survival/drug effects , Cross-Linking Reagents/pharmacology , Disease Models, Animal , Glucuronic Acid/pharmacology , Hexuronic Acids/pharmacology , Humans , Male , Mesenchymal Stem Cells/cytology , Mesenchymal Stem Cells/drug effects , Rats, Wistar , Rheology/drug effectsABSTRACT
In this paper we propose an in situ forming ionically cross-linked alginate (Alg) hydrogel delivering a Tea Tree Oil microemulsion (MeTTO) and potentially useful as an advanced dressing for infected wounds. Alg hydrogels were prepared by a spray-by-spray deposition method with the aim to minimize the discomforts during application. From pseudoternary phase diagrams, it was found that proper combination of TTO, water, polysorbate 80 and ethanol gave stable spherical MeTTO with good antimicrobial activity. On this basis, MeTTO at 20% TTO was selected for further inclusion in an Alg hydrogel prepared by alternating sprays of Alg/MeTTO and calcium chloride solutions. Homogeneous dispersion of MeTTO inside cross-linked Alg was assessed by different macroscopic and microscopic methods demonstrating the superior propensity of MeTTO to be integrated in the water-based hydrogel as compared to TTO. Antimicrobial effect of Alg/MeTTO hydrogels on Escherichia Coli strains was remarkable, highlighting the potential of the system as bioactive wound dressing.
Subject(s)
Alginates/chemistry , Emulsions/chemistry , Hydrogels/chemistry , Tea Tree Oil/chemistry , Aerosols , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/pharmacology , Escherichia coli/drug effects , Glucuronic Acid/chemistry , Hexuronic Acids/chemistry , Microbial Sensitivity Tests , Microscopy, Electron, Scanning/methods , PolysorbatesABSTRACT
The World Health Organization classification of myelodysplastic syndromes (MDS) is based on morphological evaluation of marrow dysplasia. We performed a systematic review of cytological and histological data from 1150 patients with peripheral blood cytopenia. We analyzed the frequency and discriminant power of single morphological abnormalities. A score to define minimal morphological criteria associated to the presence of marrow dysplasia was developed. This score showed high sensitivity/specificity (>90%), acceptable reproducibility and was independently validated. The severity of granulocytic and megakaryocytic dysplasia significantly affected survival. A close association was found between ring sideroblasts and SF3B1 mutations, and between severe granulocytic dysplasia and mutation of ASXL1, RUNX1, TP53 and SRSF2 genes. In myeloid neoplasms with fibrosis, multilineage dysplasia, hypolobulated/multinucleated megakaryocytes and increased CD34+ progenitors in the absence of JAK2, MPL and CALR gene mutations were significantly associated with a myelodysplastic phenotype. In myeloid disorders with marrow hypoplasia, granulocytic and/or megakaryocytic dysplasia, increased CD34+ progenitors and chromosomal abnormalities are consistent with a diagnosis of MDS. The proposed morphological score may be useful to evaluate the presence of dysplasia in cases without a clearly objective myelodysplastic phenotype. The integration of cytological and histological parameters improves the identification of MDS cases among myeloid disorders with fibrosis and hypocellularity.
Subject(s)
Bone Marrow/pathology , Myelodysplastic Syndromes/classification , Adult , Aged , Female , Humans , Male , Middle Aged , Myelodysplastic Syndromes/pathology , Severity of Illness Index , World Health OrganizationABSTRACT
Maternal obesity and nutrient excess in utero increase the risk of future metabolic diseases. The mechanisms underlying this process are poorly understood, but probably include genetic, epigenetic alterations and changes in fetal nutrient supply. We have studied the microRNA (miRNA) expression profile in amnion from obese and control women at delivery to investigate if a specific miRNA signature is associated with obesity. The expression profile of 365 human miRNAs was evaluated with the TaqMan Array in amnion from 10 obese and 5 control (prepregnancy body mass index (BMI) >30 and <25 kg m(-2), respectively) women at delivery. Target genes and miRNA-regulated pathways were predicted by bioinformatics. Anthropometric and biochemical parameters were also measured in mothers and newborns. Seven miRNAs were expressed only in obese women (miR-422b, miR-219, miR-575, miR-523, miR-579, miR-618 and miR-659), whereas 13 miRNAs were expressed at a higher level and 12 miRNAs at a lower level in obese women than in controls. MicroRNAs significantly downregulated the neurotrophin, cancer/ErbB, mammalian target of rapamycin, insulin, adipocytokine, actin cytoskeleton and mitogen-activated protein kinase signaling pathways. In conclusion, we show that the miRNA profile is altered in amnion during obesity and hypothesize that this could affect pathways important for placental growth and function, thereby contributing to an increase in the newborn's risk of future metabolic diseases.
Subject(s)
Adiponectin/metabolism , Amnion/metabolism , Metabolic Syndrome/prevention & control , MicroRNAs/metabolism , Mothers , Obesity/complications , Adult , Computational Biology , Female , Fetal Blood/metabolism , Gene Expression Profiling , Humans , Infant Nutritional Physiological Phenomena , Infant, Newborn , Male , Obesity/blood , Pregnancy , Prenatal Exposure Delayed Effects , Signal TransductionABSTRACT
Combination therapies for cancer aim to exploit either additive or synergistic effects arising from the action of two species with the final goal to maximize the therapeutic efficacy. In this work, we develop multifunctional nanoparticles (NPs) for co-delivery of the conventional anticancer drug docetaxel (DTX) and the second generation photosensitizer zinc-phthalocyanine (ZnPc) as potential dual carrier system for the combination of chemotherapy and photodynamic therapy (PDT). Biodegradable and amphiphilic block copolymers based on poly(ε-caprolactone) (PCL=B) and poly(ethylene oxide) (PEO=A), with AB and ABA architectures, were assembled in "core-shell" NPs and loaded with both DTX and ZnPc employing the melting/sonication method. Hydrodynamic diameters within the range 60-100nm and low polydispersity indexes were obtained. Zeta potential was negative for all the formulations and unaffected by drug encapsulation. Concerning drug loading ability of NPs, the entrapment efficiency was related to initial ZnPc/DTX ratio. Steady-stationary and time-resolved emission fluorescence measurements pointed out the embedding of monomeric ZnPc in the NPs, excluding the presence of ZnPc self-supramolecular oligomers. The release of DTX was biphasic whereas ZnPc remained mainly associated with NPs. Singlet oxygen generation was observed when ZnPc-loaded NPs were irradiated at 610nm within a 45min time range, despite that ZnPc was not released in the medium. Stability of NPs in the presence of serum proteins and plasma was excellent and no toxicity toward red blood cells was found. NPs cytotoxicity was evaluated in HeLa cells irradiated for 30min with a halogen lamp. After 72h, viability of cells treated with ZnPc/DTX-loaded NPs strongly decreased as compared to NPs loaded only with DTX, thus showing a combined effect of both DTX and ZnPc. Superior antitumor activity of ZnPc/DTX-loaded NPs as compared to DTX-loaded NPs was confirmed in an animal model of orthotopic amelanotic melanoma, thus pointing to the application of PEO-PCL NPs in the combined chemo-photodynamic therapy of cancer.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Drug Carriers/administration & dosage , Nanoparticles/administration & dosage , Animals , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/chemistry , Antineoplastic Combined Chemotherapy Protocols/chemistry , Apoptosis/drug effects , Cell Line, Tumor , Cell Survival/drug effects , Docetaxel , Drug Carriers/chemistry , Drug Stability , Female , Hemolysis/drug effects , Humans , Indoles/administration & dosage , Indoles/chemistry , Isoindoles , Melanoma, Amelanotic/drug therapy , Melanoma, Amelanotic/pathology , Mice , Mice, Nude , Nanoparticles/chemistry , Organometallic Compounds/administration & dosage , Organometallic Compounds/chemistry , Photochemotherapy , Photosensitizing Agents/administration & dosage , Photosensitizing Agents/chemistry , Plasma/chemistry , Singlet Oxygen/chemistry , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Taxoids/administration & dosage , Taxoids/chemistry , Tumor Burden/drug effects , Zinc CompoundsABSTRACT
AIM: The aim of this study was to analyze the role of ultrasonography in the prenatal diagnosis of women with confirmed rubella infection in pregnancy. METHODS: We performed a retrospective, population-based study on 175 women referred to our Centre of Infectious Disease in Pregnancy of AOU Federico II for rubella infection, in the period between January 1999 and December 2009. In confirmed cases of infection we performed periodic ultrasonographic assessment of fetal anatomy looking for prenatal findings of rubeovirus infection. Neonatal outcomes were collected. RESULTS: Among 175 women, 48 (27.4%) were confirmed cases, in 83 (47.4%) cases rubella infection remain suspected. The remaining 44 (25.1%) women were excluded to having rubella infection in pregnancy. No defined probable cases were found. Among children born to mother with confirmed rubella infection, 9 (18.7%) resulted infected by rubella virus. In particular 6 newborns (66% of the affected) were asymptomatic, two babies showed incomplete congenital rubella syndrome (CRS), due to the presence of deafness in the absence of other congenital abnormalities without showing any USG findings. Only one baby showed a complete CRS: USG prenatal rubella infection findings were IUGR, polydramnios, cardiomegaly, defects of atrial septum, hepatosplenomegaly, ascites, echogenic bowel, placentomegaly. USG specificity and sensitivity was 100% and 11% respectively. CONCLUSION: USG has an important role in the detection rubella intrauterine infection in case of severe abnormalities. The obstetricians should understand the limitations of ultrasound in detection of deafness and minor abnormalities.
Subject(s)
Pregnancy Complications, Infectious , Rubella Syndrome, Congenital/diagnostic imaging , Rubella , Ultrasonography, Prenatal , Female , Humans , Pregnancy , Retrospective StudiesABSTRACT
Modern ultrasound imaging instrumentation for clinical applications allows real-time volumetric scanning of the patients' body. 4D imaging has been made possible thanks to the development of new echographic probes which consist in 2D phased arrays of piezoelectric transducers. In these new devices it is the system electronics which properly drives the matrix elements and focuses the beam in order to obtain a sequence of volumetric images. This paper introduces an ultrasound field simulator based on the Spatial Impulse Response method which is being properly developed to analyze the characteristics of the ultrasound field generated by a 2D phased array of transducers. Thanks to its high configurability by the user, it will represent a very useful tool for electronics designers in developing 4D ultrasound imaging systems components.
Subject(s)
Biomedical Technology/instrumentation , Computer Simulation , Models, Theoretical , Transducers , Ultrasonics/instrumentation , Acoustics , Pressure , Time FactorsSubject(s)
Anaphylaxis/etiology , Blood Transfusion/methods , Factor V Deficiency/therapy , Hemorrhage/therapy , Transfusion Reaction , Adult , Cesarean Section , Contraceptives, Oral/therapeutic use , Factor V Deficiency/complications , Factor VIIa/administration & dosage , Female , Follicular Cyst/diagnosis , Hemoperitoneum/diagnosis , Hemoperitoneum/surgery , Humans , Menstruation , Plasma , Pregnancy , Pregnancy Outcome , Recombinant Proteins/administration & dosage , Young AdultABSTRACT
AIM: The aim of this study was to evaluate the clinical significance and the management of fetal borderline lateral cerebral ventriculomegaly. METHODS: Fetuses with a sonographic diagnosis of lateral cerebral ventriculomegaly isolated or associated to other fetal malformations were followed monthly and a review of the English-language literature was made. RESULTS: Of 86 fetuses analyzed, 30 suffered from hydrocephaly (monolateral, bilateral), 56 showed also several other malformations . Chromosomal aberrations is possible also in case of isolated hydrocephaly. Neurological sequelae, mostly a mild to moderate delay in cognitive and/or motor development, is present in 10% of the cases. CONCLUSIONS: In most cases, isolated borderline lateral cerebral ventriculomegaly has no consequence. However, the risk of cerebral maldevelopment, delayed neurological development and, possibly, chromosomal aberrations is increased. The optimum management of these cases remains uncertain.
Subject(s)
Abnormalities, Multiple/diagnostic imaging , Hydrocephalus/diagnostic imaging , Lateral Ventricles/abnormalities , Ultrasonography, Prenatal , Abortion, Legal , Adult , Cerebral Ventricles/abnormalities , Female , Humans , Predictive Value of Tests , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Prenatal Diagnosis , Retrospective Studies , Risk Assessment , Severity of Illness IndexABSTRACT
In order to investigate the relationships between Italian wild boar and major pig breeds, we studied the genetic variability of four wild boar populations in Italy (Arezzo, Pisa, Parma, Bergamo) using a 533-bp fragment of the mitochondrial control region. Sixty-nine wild boar samples were analysed, allowing the identification of 10 distinct haplotypes, which involve a total of 15 single nucleotide polymorphisms. Phylogenetic and network analyses were performed also considering several sequences of wild and domesticated forms available in the databases. The Bayesian phylogenetic tree and the Median-Joining network analyses show three main groups: the Italian (IT), European (EU) and Asian (AS) clades. The IT clade corresponds to the Maremma endemic wild boar population and also includes Sardinian individuals, while the EU and AS groups include wild boars as well as domestic pig breeds. Only two individuals from Pisa cluster in the IT group, whereas two haplotypes from Bergamo cluster in the AS group and all other samples cluster in the EU clade. These findings suggest that in Italy wild boar populations have a mixed origin, both EU and AS, and that an interbreeding between wild and domesticated strains has probably occurred. Eight of the 10 wild boars coming from the Migliarino-San Rossore-Massaciuccoli Regional Park (Pisa) belong to H2 and H3 haplotypes, and cluster into the EU clade, suggesting that this regional park is not anymore exclusive of the endemic Maremma wild boar.
Subject(s)
DNA, Mitochondrial/genetics , Genetic Variation , Phylogeny , Sus scrofa/genetics , Animals , Bayes Theorem , DNA Primers/genetics , Italy , Locus Control Region/genetics , Models, Genetic , Polymerase Chain Reaction , Polymorphism, Single Nucleotide/geneticsABSTRACT
We present a case of retroperitoneal abscess due to asymptomatic duodenal perforation by foreign body. Patient has been admitted for lumbar pain and subocclusive crisis, with a medical history negative for acute symptomatology. After both clinical and radiologic evaluation, an abscess-like mass was detected in the context of right psoas muscle. Patient underwent surgical operation and a lumbar abscess has been found containing a foreign body (toothpick). There has been a transduodenal migration of the foreign body, without clinical signs of duodenal perforation.
Subject(s)
Duodenal Diseases/etiology , Foreign Bodies , Foreign-Body Migration/complications , Intestinal Perforation/etiology , Psoas Abscess/etiology , Wood , Aged, 80 and over , Duodenal Diseases/diagnostic imaging , Duodenal Diseases/surgery , Eating , Foreign-Body Migration/diagnostic imaging , Foreign-Body Migration/surgery , Humans , Intestinal Perforation/diagnostic imaging , Intestinal Perforation/surgery , Male , Psoas Abscess/diagnostic imaging , Psoas Abscess/surgery , Radiography , Retroperitoneal Space/surgery , Treatment OutcomeSubject(s)
Arthrogryposis/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Humans , PregnancyABSTRACT
Placental chorioangioma is the most common benign tumor of placenta. The relationship of vascularized chorioangiomas to adverse pregnancy outcome is well recognized. We report 3 cases of placental chorioangioma. Hypervascularization of the lesions in all patients and the immune hydrops with adverse fetal outcome in 2 cases are the complications of our mini-series. Ultrasonography and Doppler ultrasonography findings were useful in establishing the prenatal diagnosis and the prognosis.
Subject(s)
Hemangioma/diagnostic imaging , Placenta Diseases/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Humans , PregnancyABSTRACT
Cryotherapy allows the destruction of unresectable liver malignancies. The abdominal approach is uneasy for recurrent colorectal metastases located in the upper part of the liver and close to the inferior vena cava, the hepatic veins and the diaphragm. A transpleurodiaphragmatic access was employed. From 1999 to 2003, ten patients with recurrent colorectal liver metastases underwent transdiaphragmatic cryotherapy via a right thoracotomy. Median diameter was 30 mm. One to 4 cryoprobes were used, depending on the size and location of the metastasis. There were no operative deaths, and only 3 patients developed minor complications. Computerized tomography examination of the liver performed one week, three months after cryotherapy, assessed treatment completeness in all patients. At 14 months, 9 patients were alive and 6 were disease-free. Two patients had liver recurrences outside the cryolesion. A transthoracic access may represent the safest and easiest surgical approach for liver tumor cryoablation in selected patients with non resectable recurrent metastases of the upper liver.