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Jelmoni AJM, Mascaro L, Mariola C, Conde MM, Uralov D, Caniglia F, Chebaro K, Rosellini E, Zaed I, Milani D, Cannizzaro D. Trends in Female Authorship Over 5-Year Publication History in Neurovascular Surgery. World Neurosurg 2024; 184:219-226. [PMID: 38266985 DOI: 10.1016/j.wneu.2024.01.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/24/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Affiliation(s)
- Alice J M Jelmoni
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Luca Mascaro
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Carlotta Mariola
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Marian Mora Conde
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy.
| | - Daniel Uralov
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | | | - Kamel Chebaro
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Elena Rosellini
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Davide Milani
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Delia Cannizzaro
- Department of Neurosurgery, ASST Ovest Milano Legnano Hospital, Legnano (Milan), Italy
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Milani D, Zaed I, Ricciardi L, Chibbaro S, Venier A, Marchi F, Ganau M, Cardia A. Defining the Learning Curve of the Exoscope in Spine Surgery. World Neurosurg 2024; 182:e1-e4. [PMID: 38097168 DOI: 10.1016/j.wneu.2023.12.045] [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: 10/31/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION In recent years, introduction of the exoscope system has been responsible for a new era of optics in surgery. Such a system has started to be widely used in neurosurgery. More recently, the exoscope has also been increasingly used for spinal procedures. Thus, we aimed to explore the potential for exoscope-assisted spinal procedures and define the advantages and drawbacks of implementing the system into our daily routine. METHODS To achieve the aim of the study, we retrospectively reviewed the case series of patients treated by a senior surgeon and analyzed the results, complications, and operative time. The operating times were compared between the exoscope-assisted procedures and microscope-assisted procedures. RESULTS A total of 24 spinal procedure were performed with the exoscope in a 2-month period. In this first patient series performed by a single surgeon without experience with the exoscope, the learning curve seemed to be relatively low, with mastery of the instrument achieved after the performance of only a few cases. Comparing the cases after the plateau of the learning curve had been reached with those performed during the still active phase of the learning curve, a significant difference was found in the operative times. No statistically significant difference was detected in terms of blood loss or intraoperative complications. CONCLUSIONS Based on our first experience, use of the exoscope shows promising potential for opening up new frontiers in spinal microsurgery. In addition, it has a low learning curve for experienced surgeons.
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Affiliation(s)
- Davide Milani
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Ismail Zaed
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
| | - Luca Ricciardi
- Department of Neuroscience, Mental Health and Sense Organs, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Salvatore Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - Alice Venier
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Francesco Marchi
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Mario Ganau
- Department of Neurosurgery, John Radcliffe Hospital, Headley Way, Oxford, UK
| | - Andrea Cardia
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
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Bono BC, Milani D, Ferreli F, Olei S, Raspagliesi L, Tropeano MP, Lasio GB, Pessina F. Endoscopic Trans-Sphenoidal Resection of a Giant Pituitary Neuroendocrine Tumor with Third Ventricle Invasion and Obstructive Hydrocephalus: Surgical Anatomy and Two-Dimensional Operative Video. World Neurosurg 2024; 181:107. [PMID: 37871690 DOI: 10.1016/j.wneu.2023.10.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023]
Affiliation(s)
- Beatrice C Bono
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy.
| | - Davide Milani
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Otorhinolaryngology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Simone Olei
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Luca Raspagliesi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Maria Pia Tropeano
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Giovanni B Lasio
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Federico Pessina
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
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Ferreli F, Lasagna C, Canali L, Baram A, Bono BC, Tropeano MP, Pirola F, Morenghi E, Mercante G, Spriano G, Milani D, Lasio G, Colombo G. A randomized prospective comparative study on sinonasal morbidity and quality of life of transsphenoidal endoscopic surgery for pituitary adenomas: endonasal versus trans-septal approach. Eur Arch Otorhinolaryngol 2024; 281:257-266. [PMID: 37673831 DOI: 10.1007/s00405-023-08216-1] [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: 05/05/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Endoscopic endonasal transsphenoidal approach (Endonasal approach) is commonly used to treat pituitary adenomas. The extent of dissection possibly changes the anatomy and the physiology of the nasal cavities and could give rise to post-operative morbidity and the quality of life (QoL). The purpose of this study was to investigate sinonasal morbidity and general QoL in patients who underwent surgery for treatment of pituitary adenoma, comparing Endonasal and endoscopic trans-septal transsphenoidal approach (Trans-septal approach). METHODS A prospective observational study, recruiting 40 patients undergoing surgery for pituitary adenoma, 20 via Endonasal approach and 20 via Trans-septal approach at our institution. Surveys with Sinonasal Outcome Test-22 (SNOT-22), Chronic Sinusitis Survey (CSS), and Short Form Health Survey 36 version 2 (SF-36v2) were obtained to collect QoL data pre- and postoperatively. RESULTS All the 40 patients completed the questionnaires. At 6 months postoperatively, the SNOT-22 and CSS score shows significant improvements both in Endonasal approach (p = 0.01) and in Trans-septal approach (p = 0.02). No significant difference in sinonasal morbidity is observed between the two groups for SNOT-22 (p = 0.13) and CSS scores, except for sinus headache (p = 0.49), with a better score in Endonasal approach. The mean SF-36v2 scores remain the same in pre- and post-operative periods, but an improvement in time is seen in general health (p = 0.027), and general health compared to one year ago (p < 0.001). CONCLUSIONS Endoscopic transsphenoidal surgery has negligible morbidity and does not negatively affect the nasal function in the long term. Endonasal approach and Trans-septal approach are comparable in terms of morbidity outcomes and general QoL, leaving the choice of the approach to the surgeon preference.
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Affiliation(s)
- Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy.
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
- IRCCS Humanitas Research Hospital, Via Alessandro Manzoni, 56, 20089, Rozzano, Milan, Italy.
| | - Chiara Lasagna
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Luca Canali
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Ali Baram
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Beatrice C Bono
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Maria Pia Tropeano
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Francesca Pirola
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Emanuela Morenghi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Biostatistics Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Davide Milani
- Neurosurgery Department, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland
| | - Giovanni Lasio
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giovanni Colombo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy
- Department of Otorhinolaryngology, Ospedale Nuovo di Legnano, ASST Ovest Milanese, Milan, Italy
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Cannizzaro D, Anania CD, De Robertis M, Pizzi A, Gionso M, Ballabio C, Ubezio MC, Frigerio GM, Battaglia M, Morenghi E, Capo G, Milani D, Attuati L, Tomei M, Riva M, Costa F, Galbusera F, Politi LS, Ortolina A, Fornari M. The lumbar adjacent-level syndrome: analysis of clinical, radiological, and surgical parameters in a large single-center series. J Neurosurg Spine 2023; 39:479-489. [PMID: 37486878 DOI: 10.3171/2023.5.spine235] [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] [Received: 01/02/2023] [Accepted: 05/11/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE The development of specific clinical and neurological symptoms and radiological degeneration affecting the segment adjacent to a spinal arthrodesis comprise the framework of adjacent-level syndrome. Through the analysis of a large surgical series, this study aimed to identify possible demographic, clinical, radiological, and surgical risk factors involved in the development of adjacent-level syndrome. METHODS A single-center retrospective analysis of adult patients undergoing lumbar fusion procedures between January 2014 and December 2018 was performed. Clinical, demographic, radiological, and surgical data were collected. Patients who underwent surgery for adjacent-segment disease (ASD) were classified as the ASD group. All patients were evaluated 1 month after the surgical procedure clinically and radiologically (with lumbar radiographs) and 3 months afterward with CT scans. The last follow-up was performed by telephone interview. The median follow-up for patients included in the analysis was 67.2 months (range 39-98 months). RESULTS A total of 902 patients were included in this study. Forty-nine (5.4%) patients required reoperation for ASD. A significantly higher BMI value was observed in the ASD group (p < 0.001). Microdiscectomy and microdecompression procedures performed at the upper or lower level of an arthrodesis without fusion extension have a statistically significant impact on the development of ASD (p = 0.001). Postoperative pelvic tilt in the ASD group was higher than in the non-ASD group. Numeric rating scale, Core Outcome Measures Index, and Oswestry Disability Index scores at the last follow-up were significantly higher in patients in the ASD group and in patients younger than 65 years. CONCLUSIONS Identifying risk factors for the development of adjacent-level syndrome allows the implementation of a prevention strategy in patients undergoing lumbar arthrodesis surgery. Age older than 65 years, high BMI, preexisting disc degeneration at the adjacent level, and high postoperative pelvic tilt are the most relevant factors. In addition, patients older than 65 years achieve higher levels of clinical improvement and postsurgical satisfaction than do younger patients.
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Affiliation(s)
- Delia Cannizzaro
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Carla D Anania
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Mario De Robertis
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Andrea Pizzi
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Matteo Gionso
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Chiara Ballabio
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
| | - Maria Cleofe Ubezio
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
| | - Gian Marco Frigerio
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 3Department of Neuroradiology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milan
| | - Massimiliano Battaglia
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 3Department of Neuroradiology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milan
| | - Emanuela Morenghi
- 4Biostatistics Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milan
| | - Gabriele Capo
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Davide Milani
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Luca Attuati
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Massimo Tomei
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Marco Riva
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Francesco Costa
- 5Department of Neurosurgery, Spine Surgery Unit-NCH4, Fondazione IRCCS Istituto Nazionale Neurologico "Carlo Besta," Milan, Italy; and
| | | | - Letterio S Politi
- 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan
- 3Department of Neuroradiology, Humanitas Clinical and Research Center-IRCCS, Rozzano-Milan
| | - Alessandro Ortolina
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
| | - Maurizio Fornari
- 2Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano-Milan
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Zaed I, Marchi F, Milani D, Cabrilo I, Cardia A. Role of Enhanced Recovery after Surgery (ERAS) Protocol in the Management of Elderly Patients with Glioblastoma. J Clin Med 2023; 12:6032. [PMID: 37762972 PMCID: PMC10531564 DOI: 10.3390/jcm12186032] [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] [Received: 07/07/2023] [Revised: 08/17/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE Among the already difficult management of neuro-oncological patients, the elderly population remains vulnerable. Because of the pathology and the comorbidities, they present a significantly higher rate of medical issues related to surgical management. Despite this, the surgical option, if feasible, remains the gold standard in these patients, and an Enhanced Recovery After Surgery (ERAS) protocol could improve the postoperative safety of the patients. With this purpose, we prepared this study with the aim of defining the postoperative hospital length of stay (LOS), but also of evaluating the postoperative morbidity, perioperative complications, and postoperative pain scores. METHODS This was a retrospective, single-cohort study performed at an academic hospital (Department of Neurosurgery, Neurocenter of South Switzerland, Switzerland) on elderly patients who underwent craniotomy for glioblastoma. Patients were enrolled in a novel ERAS protocol from January 2022 to December 2022. Since this is a feasibility study and a direct comparison was not possible, we used a historical cohort of elderly patients who had undergone elective craniotomy surgery for glioblastoma as a control group. RESULTS A total of 19 patients treated in our center for glioblastoma multiforme (GBM) who were aged over 75 years were included in this study. Among those, seven were newly recruited patients included in the ERAS protocol, while the remaining twelve were part of a historical cohort of previously treated patients. From a statistical point of view, the two cohorts were comparable in terms of baseline demographics. In the follow-up, it was shown that in the ERAS group, there was a reduction in the use of opioids after the surgical procedures that could be seen at 30 days (36.2% vs. 71.7%, p < 0.001), but also at 3 months, after surgery (33.0% vs. 80.0%, p < 0.001). A significant difference has also been documented in terms of mobilization and ambulation: compared to the historical cohort, in the ERAS group, there was a higher rate of mobilization (60.0% vs. 10.0%, p < 0.001), but also of ambulation (36.1% vs. 10.0%, p < 0.001). CONCLUSIONS The ERAS protocol for the management of glioblastoma in elderly patients seems to be an effective option for reducing LOS in the hospital, as well as for reducing the number of days spent in the ICU, improving the general recovery of the patient, and reducing the costs associated with hospitalization.
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Cannizzaro D, Zaed I, Olei S, Fernandes B, Peschillo S, Milani D, Cardia A. Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68. Front Surg 2023; 10:1228955. [PMID: 37744724 PMCID: PMC10511771 DOI: 10.3389/fsurg.2023.1228955] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Intracranial aneurysms occur in 3%-5% of the general population. While the precise biological mechanisms underlying the formation, growth, and sudden rupture of intracranial aneurysms remain partially unknown, recent research has shed light on the potential role of inflammation in aneurysm development and rupture. In addition, there are ongoing investigations exploring the feasibility of employing new drug therapies for controlling the risk factors associated with aneurysms. CD68, a glycosylated glycoprotein and the human homolog of macrosialin, is prominently expressed in monocyte/macrophages within inflamed tissues and has shown potential application in oncology. An observational study was conducted with the aim of comparing the histological characteristics of aneurysm walls with preoperative MRI scans, specifically focusing on CD68 activity. Method An observational pilot study was conducted to investigate the histological characteristics of the aneurysm wall that could be potentially associated with aneurysm growth and rupture. A total of 22 patients diagnosed with ruptured and unruptured intracranial aneurysms who had undergone conventional clipping between January 2017 and December 2022 were included in the study. Results A histopathological analysis of the aneurysm wall was performed in all patients, particularly focusing on the presence of CD68. A preoperative MRI with gadolinium was conducted in 10 patients with unruptured aneurysms and six patients with ruptured aneurysms. An emergency clipping was performed in the remaining six patients. The results showed that CD68 positivity and wall enhancement were significantly associated with intracranial aneurysm wall degeneration, growth, and rupture. Conclusion The histological and radiological inflammatory findings observed in the wall of cerebral aneurysms, as well as the CD68 positivity, are significantly associated with the risk of intracranial aneurysm growth and rupture. This study highlights the crucial importance of considering clinical and medical data when making treatment decisions for intracranial aneurysms. Furthermore, it emphasizes the relevance of evaluating wall enhancement in MRI scans as part of the diagnostic and prognostic process.
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Affiliation(s)
- Delia Cannizzaro
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Simone Olei
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Simone Peschillo
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Davide Milani
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Andrea Cardia
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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Turrina C, Schoenen M, Milani D, Klassen A, Rojas Gonzaléz DM, Cvirn G, Mela P, Berensmeier S, Slabu I, Schwaminger SP. Application of magnetic iron oxide nanoparticles: Thrombotic activity, imaging and cytocompatibility of silica-coated and carboxymethyl dextrane-coated particles. Colloids Surf B Biointerfaces 2023; 228:113428. [PMID: 37379701 DOI: 10.1016/j.colsurfb.2023.113428] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
Coated iron oxide nanoparticles (IONs) are promising candidates for various applications in nanomedicine, including imaging, magnetic hyperthermia, and drug delivery. The application of IONs in nanomedicine is influenced by factors such as biocompatibility, surface properties, agglomeration, degradation behavior, and thrombogenicity. Therefore, it is essential to investigate the effects of coating material and thickness on the behavior and performance of IONs in the human body. In this study, IONs with a carboxymethyl dextran (CMD) coating and two thicknesses of silica coating (TEOS0.98, and TEOS3.91) were screened and compared to bare iron oxide nanoparticles (BIONs). All three coated particles showed good cytocompatibility (>70%) when tested with smooth muscle cells over three days. To investigate their potential long term behavior inside the human body, the Fe2+ release and hydrodynamic diameters of silica-coated and CMD (carboxymethyl dextrane)-coated IONs were analyzed in simulated body fluids for 72 h at 37 °C. The ION@CMD showed moderate agglomeration of around 100 nm in all four simulated fluids and dissolved faster than the silica-coated particles in artificial exosomal fluid and artificial lysosomal fluid. The particles with silica coating agglomerated in all tested simulated media above 1000 nm. Increased thickness of the silica coating led to decreased degradation of particles. Additionally, CMD coating resulted in nanoparticles with the least prothrombotic activity, and the thick silica coating apparently decreased the prothrombotic properties of nanoparticles compared to BIONs and ION@TEOS0.98. For magnetic resonance applications, ION@CMD and ION@TEOS3.91 showed comparatively high relaxation rates R2 values. In magnetic particle imaging experiments ION@TEOS3.91 yielded the highest normalized signal to noise ratio values and in magnetic hyperthermia studies, ION@CMD and ION@TEOS0.98 showed similar specific loss power. These findings demonstrate the potential of coated IONs in nanomedicine and emphasize the importance of understanding the effect of coating material and thickness on their behavior and performance in the human body.
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Affiliation(s)
- Chiara Turrina
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Boltzmannstraße 15, 85748 Garching, Germany
| | - Max Schoenen
- Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty, RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Davide Milani
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Boltzmannstraße 15, 85748 Garching, Germany
| | - Anna Klassen
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Boltzmannstraße 15, 85748 Garching, Germany
| | - Diana M Rojas Gonzaléz
- Chair of Medical Materials and Implants, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering, Technical University of Munich, Boltzmannstraße 15, 85748 Garching, Germany
| | - Gerhard Cvirn
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Petra Mela
- Chair of Medical Materials and Implants, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering, Technical University of Munich, Boltzmannstraße 15, 85748 Garching, Germany
| | - Sonja Berensmeier
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Boltzmannstraße 15, 85748 Garching, Germany
| | - Ioana Slabu
- Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty, RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Sebastian P Schwaminger
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Boltzmannstraße 15, 85748 Garching, Germany; Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; BioTechMed, Mozartgasse 12, 8010 Graz, Austria.
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Turrina C, Klassen A, Milani D, Rojas-González DM, Ledinski G, Auer D, Sartori B, Cvirn G, Mela P, Berensmeier S, Schwaminger SP. Superparamagnetic iron oxide nanoparticles for their application in the human body: Influence of the surface. Heliyon 2023; 9:e16487. [PMID: 37274707 PMCID: PMC10238907 DOI: 10.1016/j.heliyon.2023.e16487] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023] Open
Abstract
Iron oxide nanoparticles (IONs) are of great interest in nanomedicine for imaging, drug delivery, or for hyperthermia treatment. Although many research groups have focused on the synthesis and application of IONs in nanomedicine, little is known about the influence of the surface properties on the particles' behavior in the human body. This study analyzes the impact of surface coatings (dextran, polyvinyl alcohol, polylactide-co-glycolide) on the nanoparticles' cytocompatibility, agglomeration, degradation, and the resulting oxidative stress induced by the particle degradation. All particles, including bare IONs (BIONs), are highly cytocompatible (>70%) and show no significant toxicity towards smooth muscle cells. Small-angle X-ray scattering profiles visualize the aggregation behavior of nanoparticles and yield primary particle sizes of around 20 nm for the investigated nanoparticles. A combined experimental setup of dynamic light scattering and phenanthroline assay was used to analyze the long-term agglomeration and degradation profile of IONs in simulated body fluids, allowing fast screening of multiple candidates. All particles degraded in simulated endosomal and lysosomal fluid, confirming the pH-dependent dissolution. The degradation rate decreased with the shrinking size of particles leading to a plateau. The fastest Fe2+ release could be measured for the polyvinyl-coated IONs. The analytical setup is ideal for a quick preclinical study of IONs, giving often neglected yet crucial information about the behavior and toxicity of nanoparticles in the human body. Moreover, this study allows for the development and evaluation of novel ferroptosis-inducing agents.
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Affiliation(s)
- Chiara Turrina
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Germany
| | - Anna Klassen
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Germany
| | - Davide Milani
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Germany
| | - Diana M. Rojas-González
- Chair of Medical Materials and Implants, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering, Technical University of Munich, Germany
| | - Gerhard Ledinski
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Austria
| | - Doris Auer
- Division of Medical Physics and Biophysics, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Barbara Sartori
- Institute of Inorganic Chemistry, Graz University of Technology, Stremayrgasse 9/IV, Graz, 8010, Austria
| | - Gerhard Cvirn
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Austria
| | - Petra Mela
- Chair of Medical Materials and Implants, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering, Technical University of Munich, Germany
| | - Sonja Berensmeier
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Germany
| | - Sebastian P. Schwaminger
- Chair of Bioseparation Engineering, TUM School of Engineering and Design, Technical University of Munich, Germany
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Austria
- BioTechMed-Graz, Austria
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Meossi C, Carrer A, Ciaccio C, Estienne M, Silipigni R, Sciacca FL, Pantaleoni C, D'Arrigo S, Milani D. Clinical features and magnesium levels: Novel insights in 15q11.2 BP1-BP2 copy number variants. J Intellect Disabil Res 2023. [PMID: 37129092 DOI: 10.1111/jir.13038] [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] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/16/2023] [Accepted: 04/10/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Investigating copy number variations (CNVs) such as microdeletions or microduplications can significantly contribute to discover the aetiology of neurodevelopmental disorders. 15q11.2 genomic region, including NIPA1 and NIPA2 genes, contains a recurrent but rare CNV, flanked by the break points BP1 and BP2. Both BP1-BP2 microdeletion and microduplication have been associated with intellectual disability (ID), neuropsychiatric/behavioural disturbances and mild clinical features, even if with incomplete penetrance and variable expressivity. The pathogenic role of this CNV is quite unclear though. Unknown variants in other DNA regions and parent-of-origin effect (POE) are some of the mechanisms that have been proposed as an explanation of the wide phenotypic variability. As NIPA1 and NIPA2 encode for proteins that mediate magnesium (Mg2+ ) metabolism, it has been suggested that urinary Mg2+ levels could potentially represent informative and affordable biomarkers for a rapid screening of 15q11.2 duplications or deletions. Furthermore, magnesium supplementation has been proposed as possible therapeutic strategy. METHODS Thirty one children with ID and/or other neurodevelopmental disorders carrying either a duplication or a deletion in 15q11.2 BP1-BP2 region have been recruited. When available, blood samples from parents have been analysed to identify the CNV origin. All participants underwent family and medical data collection, physical examination and neuropsychiatric assessment. Electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) scan were performed in 15 children. In addition, 11 families agreed to participate to the assessment of blood and urinary Mg2+ levels. RESULTS We observed a highly variable phenotypic spectrum of developmental issues encompassing ID in most subjects as well as a variety of behavioural disorders such as autism and attention-deficit disorder/attention-deficit hyperactivity disorder. Dysmorphic traits and malformations were detected only in a minority of the participants, and no clear association with growth anomalies was found. Abnormal brain MRI and/or EEG were reported respectively in 64% and 92% of the subjects. Inheritance assessment highlighted an excess of duplication of maternal origin, while cardiac alterations were detected only in children with 15q11.2 CNV inherited from the father. We found great variability in Mg2+ urinary values, without correlation with 15q11.2 copy numbers. However, the variance of urinary Mg2+ levels largely increases in individuals with 15q11.2 deletion/duplication. CONCLUSIONS This study provides further evidence that 15q11.2 BP1-BP2 CNV is associated with a broad spectrum of neurodevelopmental disorders and POE might be an explanation for clinical variability. However, some issues may question the real impact of 15q11.2 CNV on the phenotype in the carriers: DNA sequencing could be useful to exclude other pathogenic gene mutations. Our results do not support the possibility that urinary Mg2+ levels can be used as biomarkers to screen children with neurodevelopmental disorders for 15q11.2 duplication/deletion. However, there are evidences of correlations between 15q11.2 BP1-BP2 CNV and Mg2+ metabolism and future studies may pave the way to new therapeutic options.
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Affiliation(s)
- C Meossi
- Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Carrer
- Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C Ciaccio
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - M Estienne
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - R Silipigni
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F L Sciacca
- Laboratory of Clinical Pathology and Medical Genetics, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - C Pantaleoni
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - S D'Arrigo
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - D Milani
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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11
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Bedi MS, Raheja A, Katiyar V, Mishra S, Garh K, Narwal P, Ganeshkumar A, Sharma R, Tandon V, Milani D, Sarvadei F, Suri A, Kale SS. 'SimSpine': A cost-effective spinal endoscopy training prototype for neurosurgical residents skills training. World Neurosurg 2023; 173:e683-e698. [PMID: 36889639 DOI: 10.1016/j.wneu.2023.02.133] [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] [Received: 11/24/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To develop and compare the SimSpine (Indigenously developed, low-cost model) and EasyGo (Karl Storz, Germany) systems for simulation of endoscopic discectomy. METHODS 12 neurosurgery residents six PGY 1-4 or equivalent (junior) and PGY 5-6 or equivalent (senior) each were randomly allocated (1:1) to either EasyGo or SimSpine endoscopic visualization systems for endoscopic lumbar discectomy simulation on the same physical simulator. After the first excercise, they switched over to the other system and the exercise was repeated. Time taken to dock the system, time to reach annulus, time required for task completion, dural violation and volume of disc material removed were used for calculating objective efficiency score (Ef). Subjective scoring (NETS criteria)1 was performed by four blinded mentors based on recorded video at two separate occasions two weeks apart. Cumulative scoring (CS) was calculated based on Ef and NETS scores. RESULTS Performance metrics were similar across the two platforms, irrespective of participant seniority (p>0.05). Time to reach disc space and discectomy time improved for both EasyGo (p=0.07 and p=0.03 respectively) and SimSpine (p=0.01 and p=0.04 respectively) between first and second exercises. Ef and CS were better (p=0.04 and p=0.03 respectively) when EasyGo was used as the first device compared to SimSpine. CONCLUSIONS SimSpine is a cost-effective viable alternative to EasyGo endospine for endoscopic lumbar discectomy simulation-based training.
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Affiliation(s)
- Manbachan Singh Bedi
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Varidh Katiyar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Shashwat Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwaljeet Garh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Priya Narwal
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Akshay Ganeshkumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ravi Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Tandon
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Davide Milani
- Department of Neurosurgery, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Franco Sarvadei
- Humanitas Clinical and Research Center-IRCCS, Dept of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashank S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Franzini A, Milani D, Attuati L, Navarria P, Pessina F, Picozzi P. Gamma Knife Radiosurgery for SUNCT: A Case Series. Stereotact Funct Neurosurg 2023; 101:86-92. [PMID: 36731452 DOI: 10.1159/000528632] [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] [Received: 10/08/2022] [Accepted: 12/03/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The treatment of medically refractory patients with chronic short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is challenging. Stereotactic radiosurgery targeting the trigeminal nerve and sphenopalatine ganglion (SPG) has been used as a less-invasive treatment. The outcomes of this procedure have been described in a few case reports. OBJECTIVES The objective of the study was to report on the effect of Gamma Knife radiosurgery (GKRS) in 5 patients with chronic SUNCT. METHODS Retrospective review of our GKRS database identified 5 patients with chronic SUNCT who underwent GKRS targeted to the trigeminal nerve and SPG. A maximum dose of 80-85 Gy and 80 Gy was, respectively, delivered to the trigeminal nerve and SPG. Pain intensity and facial numbness were evaluated using the Barrow Neurological Institute (BNI) scores. RESULTS These 5 patients were clinically followed for a mean period of 26.2 months. Within a period ranging from 2 days to 9 months, GKRS was successful in reducing pain attacks and autonomic symptoms in all 5 patients. At the last assessments, BNI pain scores of I, II, and IIIa were achieved in 1, 1, and 3 patients, respectively. Two patients developed nonbothersome facial numbness (BNI facial numbness score II). CONCLUSIONS These 5 cases show that GKRS targeted to both the trigeminal nerve and the SPG is effective in reducing pain and autonomic symptoms of patients with SUNCT, although nonbothersome trigeminal sensory disturbances may occur.
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Affiliation(s)
- Andrea Franzini
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Davide Milani
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Luca Attuati
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Pierina Navarria
- Department of Radiation Oncology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Federico Pessina
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Piero Picozzi
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
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13
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Cannizzaro D, Milani D, Zaed I, Tropeano MP, Nicolosi F, Costa F, Servadei F, Fornari M, D'Angelo V, Cardia A. Tentorial Notch Meningiomas: Innovative Preoperative Management and Literature Review. Front Surg 2022; 9:840271. [PMID: 35356497 PMCID: PMC8959495 DOI: 10.3389/fsurg.2022.840271] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTentorial meningiomas account for only 3–6% of all intracranial meningiomas. Among them, tentorial incisura (notch) location must be considered as a subgroup with specific surgical anatomy and indications, morbidity, and mortality. In this study, we propose an update on preoperative management in order to reduce postoperative deficits.MethodsWe retrospectively collected adult patients treated for incisural meningioma between January 1992 and December 2016 in two different neurosurgical departments. Demographic, clinical, and neuroradiological preoperative and postoperative data were analyzed. In the most recent subgroup of tumors, a preoperative digital simulation was performed to define a volumetric digital quantification of the tumor resection. A review of the pertinent literature has been also done.ResultsWe included 26 patients. The median age was 58.4 years. Onset neurological signs were cranial nerve deficit in 9 patients, hemiparesis in 7, gait disturbance in 3, and intracranial hypertension in 3 patients. Simpson grade I removal was achieved in 12 patients, II in 10, III in 3, and IV in 1 patient. An overall rate of 23% postoperative complications was observed. The average follow-up duration was 68.5 months. Residual tumor was reported in 8 patients. Five patients underwent gamma knife radiosurgery. In 34.6% of patients, the surgical approach was chosen with preoperative digital planning estimating the potential volume of postoperative residual tumor, the target for radiosurgical treatment.ConclusionsA multidisciplinary approach to plan incisural meningiomas management is important. To lower postoperative morbidity and mortality, a careful preoperative case analysis is useful. A planned residual tumor, supported by preoperative simulation imaging, could be safely treated with radiosurgery.
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Affiliation(s)
- Delia Cannizzaro
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Davide Milani
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
- *Correspondence: Ismail Zaed
| | - Maria Pia Tropeano
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Federico Nicolosi
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Francesco Costa
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Franco Servadei
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Maurizio Fornari
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Vincenzo D'Angelo
- Department of Neurosurgery, Hospital “Casa Sollievo Della Sofferenza”, San Giovanni Rotondo, Italy
| | - Andrea Cardia
- Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
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14
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Cozzi R, Ambrosio MR, Attanasio R, Battista C, Bozzao A, Caputo M, Ciccarelli E, De Marinis L, De Menis E, Faustini Fustini M, Grimaldi F, Lania A, Lasio G, Logoluso F, Losa M, Maffei P, Milani D, Poggi M, Zini M, Katznelson L, Luger A, Poiana C. Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors. Eur J Endocrinol 2022; 186:P1-P33. [PMID: 35000899 PMCID: PMC8859924 DOI: 10.1530/eje-21-0977] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022]
Abstract
Prolactinomas are the most frequent pituitary adenomas. Prolactinoma may occur in different clinical settings and always require an individually tailored approach. This is the reason why a panel of Italian neuroendocrine experts was charged with the task to provide indications for the diagnostic and therapeutic approaches that can be easily applied in different contexts. The document provides 15 recommendations for diagnosis and 54 recommendations for treatment, issued according to the GRADE system. The level of agreement among panel members was formally evaluated by RAND-UCLA methodology. In the last century, prolactinomas represented the paradigm of pituitary tumors for which the development of highly effective drugs obtained the best results, allowing to avoid neurosurgery in most cases. The impressive improvement of neurosurgical endoscopic techniques allows a far better definition of the tumoral tissue during surgery and the remission of endocrine symptoms in many patients with pituitary tumors. Consequently, this refinement of neurosurgery is changing the therapeutic strategy in prolactinomas, allowing the definitive cure of some patients with permanent discontinuation of medical therapy.
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Affiliation(s)
- Renato Cozzi
- Division of Endocrinology, Niguarda Hospital, Milan, Italy
- Correspondence should be addressed to R Cozzi;
| | - Maria Rosaria Ambrosio
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Claudia Battista
- Endocrinology Unit, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (FG), Italy
| | - Alessandro Bozzao
- Neuroradiology, S. Andrea Hospital, NESMOS Department (Neuroscience, Mental Health, Sensorial Organs), Sapienza University of Rome, Rome, Italy
| | - Marco Caputo
- Laboratorio Analisi Cliniche e Microbiologia, Synlab SRL, Calenzano, Florence, Italy
| | | | - Laura De Marinis
- Pituitary Unit, Department of Endocrinology, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy
| | | | | | - Franco Grimaldi
- AME President, Endocrinology and Metabolism Unit, University Hospital S. Maria della Misericordia, Udine, Italy
| | - Andrea Lania
- Department of Biomedical Sciences, Endocrinology Unit, Rozzano, Italy
| | - Giovanni Lasio
- Department of Neurosurgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | | | - Marco Losa
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Pietro Maffei
- Department of Medicine (DIMED), 3rd Medical Clinic, Padua University Hospital, Padua, Italy
| | - Davide Milani
- Department of Neurosurgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Maurizio Poggi
- Endocrinology, Department of Clinical and Molecular Medicine, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Michele Zini
- Endocrinology Unit, Azienda Ospedaliera S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | | | - Anton Luger
- Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria
| | - Catalina Poiana
- ‘Carol Davila’ University of Medicine and Pharmacy – Endocrinology, “C.I. Parhon” National Institute of Endocrinology – Pituitary and Neuroendocrine Disorders, Bucharest, Romania
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Carrone F, Ariano S, Piccini S, Milani D, Mirani M, Balzarini L, Lania AG, Mazziotti G. Update on vertebral fractures in pituitary diseases: from research to clinical practice. Hormones (Athens) 2021; 20:423-437. [PMID: 33606197 DOI: 10.1007/s42000-021-00275-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/01/2020] [Accepted: 01/26/2021] [Indexed: 12/20/2022]
Abstract
Derangement of pituitary hormone axes can induce changes in bone remodeling and metabolism with possible alterations in bone microarchitectural structure and increased susceptibility to fractures. Vertebral fractures (VFs), which are a hallmark of skeletal fragility, have been described in a very large number of patients with pituitary diseases. These fractures are clinically relevant, since they predispose to further fractures and may negatively impact on patients' quality of life. However, the management of skeletal fragility and VFs in the specific setting of pituitary diseases is a challenge, since the awareness for this disease is still low, prediction of VFs is uncertain, the diagnosis of VFs cannot be solely based on a clinical approach and also needs a radiological and morphometric approach, the risk of fractures may not be decreased via treatment of pituitary hormone disorders, and the effectiveness of bone-active drugs in this setting is not always evidence-based. This review is an update on skeletal fragility in patients with pituitary diseases, with a focus on clinical and therapeutic aspects concerning the management of VFs.
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Affiliation(s)
- Flaminia Carrone
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy
| | - Salvatore Ariano
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy
| | - Sara Piccini
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy
| | - Davide Milani
- Neurosurgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, MI, Italy
| | - Marco Mirani
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy
| | - Luca Balzarini
- Department of Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, MI, Italy
| | - Andrea Gerardo Lania
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, MI, Italy.
| | - Gherardo Mazziotti
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, MI, Italy.
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16
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Chibbaro S, Signorelli F, Milani D, Cebula H, Scibilia A, Bozzi MT, Messina R, Zaed I, Todeschi J, Ollivier I, Mallereau CH, Dannhoff G, Romano A, Cammarota F, Servadei F, Pop R, Baloglu S, Lasio GB, Luca F, Goichot B, Proust F, Ganau M. Primary Endoscopic Endonasal Management of Giant Pituitary Adenomas: Outcome and Pitfalls from a Large Prospective Multicenter Experience. Cancers (Basel) 2021; 13:cancers13143603. [PMID: 34298816 PMCID: PMC8304085 DOI: 10.3390/cancers13143603] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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] [Received: 05/02/2021] [Revised: 06/22/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Giant pituitary adenomas are highly invasive tumors whose treatment is challenging. Surgery is their management mainstay. However, there is no consensus about the type of approach. Open transcranial, microscopic, and endoscopic trans-sphenoidal approaches have all been employed, alone or in combination. Extended endoscopic endonasal techniques may represent a versatile and safe one-stage approach. Our research aimed at evaluating prospectively their applicability, effectiveness, and safety in a multicenter series, to acquire further evidence toward its use in the treatment of those challenging lesions. Ninety-six patients were recruited and followed-up for 52.4 months on average. Most of them (81.2%) presented with visual deficits and >50% had various degrees of adenohypophysis insufficiency. Resection of at least 75% of initial volume was achieved in all cases, with 98.7% visual improvement, >50% endocrine deficit recovery and a permanent complication rate of 4.2%, indicating extended endoscopic endonasal approaches as a valuable treatment option. Abstract Purpose: To evaluate factors influencing clinical and radiological outcome of extended endoscopic endonasal transtuberculum/transplanum approach (EEA-TTP) for giant pituitary adenomas (GPAs). Methods: We recruited prospectively all consecutive GPAs patients undergoing EEA-TTP between 2015 and 2019 in 5 neurosurgical centers. Preoperative clinical and radiologic features, visual and hormonal outcomes, extent of resection (EoR), complications and recurrence rates were recorded and analyzed. Results: Of 1169 patients treated for pituitary adenoma, 96 (8.2%) had GPAs. Seventy-eight (81.2%) patients had visual impairment, 12 (12.5%) had headaches, 3 (3.1%) had drowsiness due to hydrocephalus, and 53 (55.2%) had anterior pituitary insufficiency. EoR was gross or near-total in 46 (47.9%) and subtotal in 50 (52.1%) patients. Incomplete resection was associated with lateral suprasellar, intraventricular and/or cavernous sinus extension and with firm/fibrous consistence. At the last follow-up, all but one patient (77, 98.7%) with visual deficits improved. Headache improved in 8 (88.9%) and anterior pituitary function recovered in 27 (50.9%) patients. Recurrence rate was 16.7%, with 32 months mean recurrence-free survival. Conclusions: EEA-TTP is a valid option for GPAs and seems to provide better outcomes, lower rate of complications and higher EoR compared to one- or multi-stage microscopic, non-extended endoscopic transsphenoidal, and transcranial resections.
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Affiliation(s)
- Salvatore Chibbaro
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Francesco Signorelli
- Neurosurgery Unit, Department of Basic Medical Sciences, Neurosciences, Sense Organs, University “Aldo Moro”, 70124 Bari, Italy;
- Correspondence: ; Tel.: +39-0805592900
| | - Davide Milani
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Helene Cebula
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Antonino Scibilia
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Maria Teresa Bozzi
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Raffaella Messina
- Neurosurgery Unit, Department of Basic Medical Sciences, Neurosciences, Sense Organs, University “Aldo Moro”, 70124 Bari, Italy;
| | - Ismail Zaed
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Julien Todeschi
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Irene Ollivier
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Charles Henry Mallereau
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Guillaume Dannhoff
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Antonio Romano
- Neurosurgery Department, Parma and Reggio Emilia Hospital, University of Parma, 43126 Parma, Italy;
| | - Francesco Cammarota
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Franco Servadei
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Raoul Pop
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Seyyid Baloglu
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Giovanni Battista Lasio
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Florina Luca
- Endocrinology Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (F.L.); (B.G.)
| | - Bernard Goichot
- Endocrinology Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (F.L.); (B.G.)
| | - Francois Proust
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Mario Ganau
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
- Neurosurgery Department, Oxford University Hospital, Oxford OX3 9DU, UK
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Biamonte E, Betella N, Milani D, Lasio GB, Ariano S, Radice S, Lavezzi E, Mazziotti G, Lania A. Impact of age on postsurgical outcomes of nonfunctioning pituitary adenomas. Endocrine 2021; 72:915-922. [PMID: 33242176 DOI: 10.1007/s12020-020-02554-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/17/2020] [Accepted: 11/11/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The management of pituitary adenomas in the elderly has become a relevant clinical issue, in relationship with improved life expectancy and spreading use of imaging techniques. In this single-center and retrospective study, we investigated the impact of age on peri- and postsurgical outcomes in patients undergoing transnasal sphenoidal (TNS) surgery for pituitary adenomas. METHODS One-hundred-sixty-nine patients (62% males) undergoing endoscopic transphenoidal (TNS) surgery for nonfunctioning pituitary adenomas (NFPAs) were enrolled. Patients were subdivided into three groups according to age tertiles: ≤56 (group 1), 57-69 (group 2), and ≥70 (group 3) years. Postsurgical and endocrinological outcomes were evaluated and compared among the three age groups. RESULTS 37/169 patients (21.9%) developed at least one perisurgical complication, without significant association with the patients' age (P = 0.838), Charlson co-morbidity score (P = 0.326), and American Society of Anesthesiologist score (P = 0.616). In the multivariate regression analysis, the adenoma size resulted the only determinant of perisurgical complication (odds ratio [OR] 1.07, 95% confidence interval [C.I.] 1.00-1.13; P = 0.044). The development and the recovery of at least one pituitary hormone deficiency were observed in 12.2% and 14.2% of patients, respectively. The risk of developing new pituitary hormone deficiencies was correlated with cavernous sinus invasion as evaluated by magnetic resonance imaging (hazard ratio [HR] 4.19, 95% C.I. 1.39-12.66; P = 0.010), whereas the probability to normalize at least one pituitary hormone deficiency was significantly correlated with younger age of patients (HR 0.27, 95% CI 0.12-0.61; P = 0.002). CONCLUSIONS The results of this study reinforce the concept that endoscopic TNS surgery is a safe therapeutic option in the elderly patients with NFPA, even in presence of comorbidities and high anesthetic risk.
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Affiliation(s)
- E Biamonte
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - N Betella
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
| | - D Milani
- Neurosurgery Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
| | - G B Lasio
- Neurosurgery Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
| | - S Ariano
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - S Radice
- Neurosurgery Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
| | - E Lavezzi
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
| | - G Mazziotti
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy.
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
| | - A Lania
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
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Pessina F, Navarria P, Clerici E, Bellu L, Franzini A, Milani D, Simonelli M, Persico P, Politi LS, Casarotti A, Fernandes B, Olei S, Sollini M, Chiti A, Scorsetti M. Role of 11C Methionine Positron Emission Tomography (11CMETPET) for Surgery and Radiation Therapy Planning in Newly Diagnosed Glioblastoma Patients Enrolled into a Phase II Clinical Study. J Clin Med 2021; 10:jcm10112313. [PMID: 34070698 PMCID: PMC8198980 DOI: 10.3390/jcm10112313] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: We investigated the role of [11C]-methionine PET in a cohort of newly diagnosed glioblastoma multiforme (GBM) patients to evaluate whether it could modify the extent of surgical resection and improve radiation therapy volume delineation. (2) Methods: Newly diagnosed GBM patients, ages 18-70, with a Karnofsky performance scale (KPS) ≥ 70 with available MRI and [11C]-methionine PET were included. Patients were treated with different amounts of surgical resection followed by radio-chemotherapy. The role of [11C]-methionine PET in surgical and RT planning was analyzed. A threshold of SUVmax was searched. (3) Results: From August 2013 to April 2016, 93 patients were treated and included in this analysis. Residual tumor volume was detected in 63 cases on MRI and in 78 on [11C]-methionine PET, including 15 receiving gross total resection. The location of uptake was mainly observed in FLAIR abnormalities. [11C]-methionine uptake changed RT volume in 11% of patients. The presence of [11C]-methionine uptake in patients receiving GTR proved to influence survival (p = 0.029). The threshold of the SUVmax conditioning outcome was five. (4) Conclusions: [11C]-methionine PET allowed to detect areas at higher risk of recurrence located in FLAIR abnormalities in patients affected by GBM. A challenging issue is represented by integrating morphological and functional imaging to better define the extent of surgical resection to perform.
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Affiliation(s)
- Federico Pessina
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
| | - Pierina Navarria
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
- Correspondence: ; Tel.: +390-282-247-458
| | - Elena Clerici
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
| | - Luisa Bellu
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
| | - Andrea Franzini
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Davide Milani
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Matteo Simonelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Oncology and Hematology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Pasquale Persico
- Oncology and Hematology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Letterio S. Politi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Neuroradiology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Alessandra Casarotti
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Bethania Fernandes
- Pathology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Simone Olei
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Diagnostic Imaging Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Pathology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Marta Scorsetti
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
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Gennaro N, Bonifacio C, Corato M, Milani D, Politi LS. Quadriparesis caused by retropharyngeal and epidural abscess in COVID-19 patients. Neurol Sci 2021; 42:1683-1685. [PMID: 33675434 PMCID: PMC7936585 DOI: 10.1007/s10072-021-05160-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/01/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Nicolò Gennaro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
- Radiology Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Cristiana Bonifacio
- Radiology Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Manuel Corato
- Neurology Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Davide Milani
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Letterio S Politi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
- Neuroradiology Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
- Radiology Department and Hematology & Oncology Division, Boston Children's Hospital, Boston, MA, USA.
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20
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Franzini A, Tropeano MP, Olei S, De Robertis M, Rossini Z, Attuati L, Milani D, Pessina F, Clerici E, Navarria P, Picozzi P. Gamma Knife Radiosurgery for the Treatment of Trigeminal Neuralgia in Patients with Multiple Sclerosis: A Single-Center Retrospective Study and Literature Review. World Neurosurg 2021; 149:e92-e100. [PMID: 33640527 DOI: 10.1016/j.wneu.2021.02.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Trigeminal neuralgia (TN) in patients with multiple sclerosis (MS) is a challenging condition to manage that is treated with Gamma Knife radiosurgery (GKRS). The aim of this report is to assess the safety, efficacy, and durability of GKRS for the treatment of TN in patients with MS. Our findings are compared with those of the existing literature and discussed. METHODS We retrospectively reviewed all patients at our institution who underwent GKRS for the treatment of TN secondary to MS and had 1 or more years of follow-up. Preoperative and postoperative pain intensities and facial numbness were evaluated with the Barrow Neurological Institute scores. Durability of successful pain relief was statistically evaluated with Kaplan-Meier analysis. The prognostic role of perioperative factors was investigated and analyzed using Cox proportional hazards regression. RESULTS There were 29 patients with MS-TN who underwent GKRS at our institution. Two patients underwent bilateral treatment. Four patients underwent repeat GKRS for pain recurrence. The median period of follow-up assessment was 33 months. Rates of reasonable pain reduction at 1, 3, and 5 years were 70%, 57%, and 57% respectively. All patients who underwent repeat GKRS had durable pain reduction. No prognostic factor for successful pain reduction was found. CONCLUSIONS Our study shows that GKRS for the treatment of TN secondary to MS is a safe and effective procedure in controlling pain in the short term but often fails to provide long-term pain control. GKRS can be safely repeated to prolong the time of pain reduction.
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Affiliation(s)
- Andrea Franzini
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy.
| | - Maria Pia Tropeano
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Simone Olei
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Mario De Robertis
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Zefferino Rossini
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Luca Attuati
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Davide Milani
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Federico Pessina
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Elena Clerici
- Department of Radiation Oncology, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Pierina Navarria
- Department of Radiation Oncology, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
| | - Piero Picozzi
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (Mi), Italy
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21
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Matten KJ, Gillis PL, Milani D, Parrott JL, Bartlett AJ, Toito J, Balakrishnan VK, Prosser RS. Bioaccumulation of sediment-associated dinonylnaphthalene sulfonates in the freshwater mussel Lampsilis siliquoidea and oligochaete Tubifex tubifex. Chemosphere 2021; 264:128391. [PMID: 33032227 DOI: 10.1016/j.chemosphere.2020.128391] [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] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Naphthalene sulfonic acids (NSAs) are used primarily as additives in a wide range of industrial products (e.g., rubber materials, coatings, sealants, fuels, paints). Based on modeled physicochemical properties, NSAs would likely partition into sediments or the tissues of biota in an aquatic system. This study examined the potential for three NSAs, dinonylnaphthalene disulfonic acid (DNDS), barium dinonylnaphthalene sulfonate (BaDNS), and calcium dinonylnaphthalene sulfonate (CaDNS), to accumulate in the tissue of a freshwater mussel (Lampsilis siliquoidea) and oligochaete worm (Tubifex tubifex). The ability of L. siliquoidea to depurate accumulated chemical was also assessed. Mussels were exposed via sand spiked with CaDNS for 25 d, and then transferred to clean water where their ability to depurate the chemical over an additional 28 d was monitored. Worms were exposed to each of the three NSAs via spiked sediment for 28 d. NSA concentrations were measured separately in gill, foot, and remaining soft tissues (viscera) for mussels and in whole body tissue samples of worms. For L. siliquoidea, the largest concentration of CaDNS was measured in the gill tissue; once removed from CaDNS exposure, mussels were able to depurate up to 87% of the CaDNS from their tissues in 28 days. The biota-sediment accumulation factors (28-d BSAFs) for T. tubifex were 2.8-5.2, 0.53-0.76, and 0.83-1.11 for DNDS, BaDNS, and CaDNS, respectively. For mussel gill and viscera, BCFK values were 14.07 and 16.39, respectively. When BAFKs were calculated using the concentration of CaDNS in sand, they were 1.11 and 1.29 for mussel gill and viscera, respectively. These values are much lower than what would be necessary to classify this chemical as bioaccumulative; however, the BSAFs for DNDS in T. tubifex indicated a potential biomagnification concern if this compound were to occur in the aquatic environment.
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Affiliation(s)
- K J Matten
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - P L Gillis
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - D Milani
- Watershed Hydrology and Ecology Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - J L Parrott
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - A J Bartlett
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - J Toito
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - V K Balakrishnan
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - R S Prosser
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada.
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Silipigni R, Milani D, Tolva G, Monfrini E, Giacobbe A, Marchisio PG, Guerneri S. Complex genomic alterations and intellectual disability: an interpretative challenge. J Intellect Disabil Res 2021; 65:113-124. [PMID: 33140510 DOI: 10.1111/jir.12797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/16/2020] [Accepted: 10/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Complex chromosomal rearrangements (CCRs) are structural rearrangements involving more than three chromosomes or having more than two breaks; approximately 70% are not associated with any clinical phenotype. Here, we describe a CCR segregating in a two-generation family. METHOD A 4-year-old male was evaluated for developmental delay, mild intellectual disability and epicanthus. Karyotype, fluorescence in situ hybridisation (FISH) analysis and array comparative genomic hybridisation (aCGH) analysis were performed on the patient and of all family members. RESULT Array CGH analysis of the proband detected two non-contiguous genomic gains of chromosome 2 at bands q32.3q33.2 and bands q36.1q36.3. Both karyotype and FISH analysis revealed a recombinant chromosome 2 with a direct insertion of regions q32.3q33.2 and q36.1q36.3 into region q12. Both of these regions were also present in their original location. Karyotype and FISH analysis of the father revealed a de novo direct insertion of regions q32.3q33.2 and q36.1q36.3 into region q12. Moreover, a de novo balanced translocation involving the q arm of the same chromosome 2 and the p arm of chromosome 10 was observed in the father of the proband. The single nucleotide polymorphism (SNP) array analysis and haplotype reconstruction confirmed the paternal origin of the duplications. Karyotype, FISH analysis and array CGH analysis of other family members were all normal. CONCLUSION This report underlines the importance of using different methods to correctly evaluate the origin and the structure of CCRs in order to provide an appropriate management of the patients and a good estimation of the reproductive risk of the family.
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Affiliation(s)
- R Silipigni
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - D Milani
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Tolva
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Monfrini
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - A Giacobbe
- Child and Adolescent Neuropsychiatric Service (UONPIA), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P G Marchisio
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Guerneri
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Cellini M, Biamonte E, Mazza M, Trenti N, Ragucci P, Milani D, Ferrante E, Rossini Z, Lavezzi E, Sala E, Mantovani G, Arosio M, Fornari M, Balzarini L, Lania AG, Mazziotti G. Vertebral Fractures Associated with Spinal Sagittal Imbalance and Quality of Life in Acromegaly: A Radiographic Study with EOS 2D/3D Technology. Neuroendocrinology 2021; 111:775-785. [PMID: 32980840 DOI: 10.1159/000511811] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 04/09/2020] [Accepted: 09/12/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Acromegaly is commonly complicated by arthropathy and skeletal fragility with high risk of vertebral fractures (VFs). OBJECTIVE This study aimed to assess whether VFs may be associated with sagittal spine deformities, arthropathy, impaired quality of life (QoL), pain, and disability. METHODS Thirty-eight patients with acromegaly (median age: 55 years, 20 males) and 38 matched control subjects were evaluated by a low-dose sagittal and coronal planes, X-ray imaging system (EOS®-2D/3D) for morphometric VFs, radiological signs of spine arthropathy, and spine deformities (Cobb thoracic index ≥40°, pelvic incidence minus lumbar lordosis ≥10°, pelvic tilt >20°, and sagittal vertical axis ≥4 cm) determining sagittal spine imbalance. Acromegalic patients were also evaluated by questionnaires for QoL (Acromegaly QoL Questionnaire [AcroQoL] and Short Form-36 [SF-36]) and pain and disability (Western Ontario and McMaster University [WOMAC]). RESULTS Acromegalic patients showed higher prevalence of thoracic hyperkyphosis (i.e., Cobb thoracic index ≥40°; p = 0.04) and pelvic tilt >20° (p = 0.02) than control subjects. VFs were found in 34.2% of acromegalic patients (p = 0.003 vs. control subjects), in relationship with higher prevalence of hyperkyphosis (p = 0.03), pelvic tilt >20° (p = 0.04), sagittal vertical axis ≥4 cm (p = 0.03), and moderate/severe subchondral degeneration (p = 0.01). Moreover, patients with VFs had lower AcroQoL general health (p = 0.007) and SF-36 general health (p = 0.002) scores and higher WOMAC pain (p = 0.003) and global (p = 0.009) scores than patients who did not fracture. CONCLUSIONS In acromegaly, VFs may be associated with spine deformities and sagittal imbalance, spine arthropathy, impaired QoL, and disability.
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Affiliation(s)
- Miriam Cellini
- Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy
| | - Emilia Biamonte
- Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy
| | - Massimiliano Mazza
- Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy
| | - Nicoletta Trenti
- Department of Radiology, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Pasquala Ragucci
- Department of Radiology, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Davide Milani
- Department of Neurosurgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Emanuele Ferrante
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Zefferino Rossini
- Department of Neurosurgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Elisabetta Lavezzi
- Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy
| | - Elisa Sala
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maura Arosio
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maurizio Fornari
- Department of Neurosurgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Luca Balzarini
- Department of Radiology, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Andrea G Lania
- Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy,
- Department of Biomedical Sciences, Humanitas University, Milan, Italy,
| | - Gherardo Mazziotti
- Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Matten KJ, Bartlett AJ, Milani D, Gillis PL, Parrott JL, Toito J, Balakrishnan VK, Prosser RS. The influence of organic carbon on the toxicity of sediment-associated dinonylnaphthalene sulfonic acids to the benthic invertebrates Tubifex tubifex and Hyalella azteca. Environ Pollut 2020; 267:115604. [PMID: 33254677 DOI: 10.1016/j.envpol.2020.115604] [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] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/14/2020] [Accepted: 09/02/2020] [Indexed: 06/12/2023]
Abstract
Naphthalene sulfonic acids (NSAs) are used extensively in industrial applications as dispersants in dyes, rubbers, and pesticides, and as anti-corrosive agents in coatings, gels, and sealants. This study examined the toxicity of three NSA congeners, barium dinonylnaphthalene sulfonate (BaDNS), calcium dinonylnaphthalene sulfonate (CaDNS), and dinonylnaphthalene disulfonic acid (DNDS), to two benthic species, Tubifex tubifex and Hyalella azteca. Two substrates with different levels of organic carbon (sediment [2%] and sand [0%]) were used in toxicity tests. Juvenile production was the most sensitive endpoint for T. tubifex: the 28-d EC50s were <18.2, 22.2, and 64.0 μg/g dw in sand and 281.3, 361.6, and 218.9 μg/g dw in sediment for BaDNS, CaDNS, and DNDS, respectively. The 28-d LC50s for H. azteca were similar among compounds: 115.3, 82.1, and 49.0 μg/g dry weight (dw) in sand, and 627.3, 757.9, and >188.5 μg/g dw in sediment, for BaDNS, CaDNS, and DNDS, respectively. However, when LC50s were estimated based on concentrations of NSAs measured in overlying water (which can be an important route of exposure for H. azteca), BaDNS and CaDNS were 3-4 orders of magnitude more toxic than DNDS. The NSAs examined were >3-fold more toxic when present in substrates with no organic carbon (e.g., sand) for all H. azteca endpoints where LC/EC50s could be calculated and for sublethal endpoints for T. tubifex. The organic carbon content of the sediment appears to have acted as a sink and reduced NSA toxicity by decreasing bioavailability. Environmental sediment samples were collected from 12 river sites across southern Ontario. The maximum concentration of CaDNS observed in sediment collected from this region was 2.8 μg/g dw in sediment with 2% organic carbon; 100-fold lower than the lowest EC10 in the current study.
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Affiliation(s)
- K J Matten
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - A J Bartlett
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - D Milani
- Watershed Hydrology and Ecology Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - P L Gillis
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - J L Parrott
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - J Toito
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - V K Balakrishnan
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - R S Prosser
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada.
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25
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Matten KJ, Parrott JL, Bartlett AJ, Gillis PL, Milani D, Toito J, Balakrishnan VK, Prosser RS. Toxicity of dinonylnaphthalene sulfonates to Pimephales promelas and epibenthic invertebrates. Sci Total Environ 2020; 741:140260. [PMID: 32886965 DOI: 10.1016/j.scitotenv.2020.140260] [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] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/08/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
Dinonylnaphthalene sulfonic acids (NSAs) are high production volume chemicals that are used primarily as additives in a wide range of industrial products (i.e., coatings, sealants, fuels, metal-extractants, paints, rubber materials). This study examined the effect of three NSA congeners on freshwater organisms: barium dinonylnaphthalene sulfonate (BaDNS), calcium dinonylnaphthalene sulfonate (CaDNS), and dinonylnaphthalene disulfonic acid (DNDS). Chronic effects were characterized by exposing fertilized fathead minnow eggs to sediment-associated NSAs and measuring various developmental and growth endpoints for 21 d. No effects in hatch success and larval growth were observed when fathead minnow eggs were exposed to CaDNS and DNDS concentrations up to 246 and 798 μg/g dry weight, respectively, in spiked sediment (~2% organic carbon). However, when NSAs were associated with substrate containing no organic carbon (sand), EC50s for fathead minnow hatch success, larval growth, biomass production, and overall survival were 58.3, 18.8, 15.5, and 13.8 μg/L, respectively, for CaDNS. Acute effect characterization was also conducted in water-only exposures for the three NSA congeners using the freshwater amphipod Hyalella azteca, the pulmonate snail Planorbella pilsbryi, and larval freshwater mussels Lampsilis cardium and Lampsilis siliquoidea. The sulfonate salts (BaDNS and CaDNS) were significantly more acutely toxic to all tested invertebrates in the water-only exposures, with LC50s ranging from 0.47 to 12.1 μg/L, compared to DNDS (LC50s ≥ 98.2 μg/L). This is the first study to provide empirical data on the aquatic toxicity of three NSA congeners.
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Affiliation(s)
- K J Matten
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - J L Parrott
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - A J Bartlett
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - P L Gillis
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - D Milani
- Watershed Hydrology and Ecology Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - J Toito
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - V K Balakrishnan
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Burlington, ON, Canada
| | - R S Prosser
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada.
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26
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Cavallo LM, Mazzatenta D, d'Avella E, Catapano D, Fontanella MM, Locatelli D, Luglietto D, Milani D, Solari D, Vindigni M, Zenga F, Zona G, Cappabianca P. The management of clival chordomas: an Italian multicentric study. J Neurosurg 2020:1-10. [PMID: 32886913 DOI: 10.3171/2020.5.jns20925] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/20/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In the last 2 decades, the endoscopic endonasal approach in the treatment of clival chordomas has evolved to be a viable strategy to achieve maximal safe resection of this tumor. Here, the authors present a multicentric national study, intending to analyze the evolution of this approach over a 20-year time frame and its contribution in the treatment of clival chordomas. METHODS Clival chordoma cases surgically treated between 1999 and 2018 at 10 Italian neurosurgical departments were included in this retrospective study. Clinical, radiological, and surgical findings, adjuvant therapy, and outcomes were evaluated and compared according to classification in the treatment eras from 1999 to 2008 and from 2009 to 2018. RESULTS One hundred eighty-two surgical procedures were reviewed, with an increase in case load since 2009. The endoscopic endonasal transclival approach (EETA) was performed in 151 of 182 cases (83.0%) and other approaches were performed in 31 cases (17%). There was an increment in the use of EETA, neuronavigation, and Doppler ultrasound after 2008. The overall postoperative complication rate was 14.3% (26 of 182 cases) consisting of 9 CSF leaks (4.9%), 7 intracranial hemorrhages (3.8%), 5 cases of meningitis (2.7%), and 5 cerebral ischemic injuries (2.7%). Gross-total resection (GTR) was achieved in 93 of 182 cases (51.1%). Extent of resection (EOR) improved in the second era of the study. Signs and/or symptoms at presentation worsened in 27 cases (14.8%), and the Katz Index worsened in 10 cases (5.5%). Previous treatment, dural involvement, EETA, and intraoperative Doppler ultrasound correlated with GTR. Patients received adjuvant proton beam radiation in 115 of 182 cases (63.2%), which was administered more in the latter era. Five-year progression-free survival (PFS) and overall survival (OS) were 62.3% and 73.5%, respectively. GTR, EETA, proton beam therapy, and the chondroid subtype correlated with a better survival rate. The mean follow-up was 62 months. CONCLUSIONS Through multicentric data collection, this study encompasses the largest series in the literature of clival chordomas surgically treated through an EETA. An increase in the use of this approach was found among Italian neurosurgical departments together with an improved extent of resection over time. The satisfactory rate of GTR was marked by low surgical morbidity and the preservation of patient quality of life. Surgical outcome was reinforced, in terms of PFS and OS, by the use of proton beam therapy, which was increasingly performed along the period of study.
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Affiliation(s)
- Luigi Maria Cavallo
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
| | - Diego Mazzatenta
- 2Department of Biomedical and Neuromotor Sciences, University of Bologna, IRCCS Institute of Neurological Sciences of Bologna, "Bellaria" Hospital, Bologna
| | - Elena d'Avella
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
| | - Domenico Catapano
- 3Division of Neurosurgery, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo
| | | | - Davide Locatelli
- 5Division of Neurosurgery, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi, Varese
| | | | - Davide Milani
- 7Division of Neurosurgery, Humanitas Research Hospital, Rozzano
| | - Domenico Solari
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
| | - Marco Vindigni
- 8Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine
| | - Francesco Zenga
- 9Department of Neuroscience, "Rita Levi Montalcini", Neurosurgery Unit, University of Turin; and
| | - Gianluigi Zona
- 10Neurosurgery and Neurotraumatology, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Paolo Cappabianca
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
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Farinelli L, Barba M, Beltrami B, Baranzini M, Milani D, Lattanzi W, Manzotti S, Gigante A. Effects of NGF and BDNF on chondrocytes: a microarray analysis. J BIOL REG HOMEOS AG 2020; 34:83-89. Congress of the Italian Orthopaedic Research Society. [PMID: 33261260] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Osteoarthritis (OA) represents an inflammation-driven injury of articular tissues, progressively leading to structural and functional joint impairment. The main symptom of OA is pain. Although it has been well established that OA represents a whole joint disease, the source of pain remains to be clarified. Nowadays, it has been well established that neurotrophines expression is evident in joints affected by OA. In addition, elevated NGF levels are found in the synovial fluid of patients with inflammatory or degenerative rheumatic diseases, including OA, rheumatoid arthritis and spondylarthritis. Growing evidences indicate that blocking NGF signaling using an anti NGF agent (i.e. tanezumab) provides effective pain relief. This study analyzed the effects of NGF and BDNF on cultured human chondrocytes by evaluating and their effects on chondrogenesis, chondrocyte differentiation and cartilage degeneration through a microarray analysis. The whole transcriptome analysis performed in this study highlighted how NGF and BDNF could be able to induce a proinflammatory response in human chondrocytes. Moreover, NGF and BDNF treatments seems to be able to induce the activation of several genes involved in the OA pathogenesis as IL17AR, HLA-DRB1, GDF-15, NR1D1, MCF2L and TGF-Beta.
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Affiliation(s)
- L Farinelli
- Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona
| | - M Barba
- Istituto di Anatomia Umana e Biologia Cellulare, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - B Beltrami
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IRCCS) Milan, Italy
| | - M Baranzini
- Istituto di Anatomia Umana e Biologia Cellulare, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - D Milani
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IRCCS) Milan, Italy
| | - W Lattanzi
- Istituto di Anatomia Umana e Biologia Cellulare, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - S Manzotti
- Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona
| | - A Gigante
- Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona
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Cannizzaro D, Tropeano MP, Milani D, Spaggiari R, Zaed I, Mancarella C, Lasio GB, Fornari M, Servadei F, Cardia A. Microsurgical versus endoscopic trans-sphenoidal approaches for clivus chordoma: a pooled and meta-analysis. Neurosurg Rev 2020; 44:1217-1225. [PMID: 32472379 DOI: 10.1007/s10143-020-01318-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/03/2020] [Accepted: 05/11/2020] [Indexed: 12/25/2022]
Abstract
Chordoma is a rare slow-growing neoplastic bone lesion. However, they show an invasive local growth and high recurrence rate, leading to an overall survival rate of 65% at 5 years and 35% at 10 years. We conducted a pooled and meta-analysis comparing recurrence rate, post-operative-complications, and survival in patients undergoing either microsurgical (MA) or endoscopic approaches (EA). Search of literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify surgical series of clivus chordomas published between January 1990 and March 2018 on Pubmed, Scopus, and Cochrane. Two different statistical analyses have been performed: a pooled analysis and a single-arm meta-analysis of overall recurrence rate and subgroup meta-analysis of complications in the subgroups open surgery and endoscopic surgery. After full-text screening, a total of 58 articles were included in the pooled analysis and 27 studies were included for the study-level meta-analysis. Pooled analysis-the extent of resection was the only association that remained significant (subtotal: HR = 2.18, p = 0.004; partial: HR = 4.40, p < 0.001). Recurrence was more prevalent among the surgical patients (45.5%) compared to endoscopic ones (23.7%). Meta-analysis-results of the cumulative meta-analysis showed an overall rate of recurrence of 25.6%. MA recurrence rate was 31.8% (99% CI 14-52.8), EA recurrence rate was 19.4% (5.4-39.2). CSF leak rate for the endoscopic group was 10.3% (99%CI 5-17.3) and 9.5% (99%CI 1.2-24.6) for the open surgery group. The partial removal versus total removal has an influence on recurrence rate (p < 0.001). MA recurrence rate was 31.8%; EA recurrence rate was 19.4%. The extent of resection is confirmed as a statistically significant factor affecting the risk for recurrence both with the pooled analysis and with the meta-analysis. Meta-analysis demonstrated that older patients tend to recur more than young patients, especially in surgical group.
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Affiliation(s)
- Delia Cannizzaro
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
| | - Maria Pia Tropeano
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy.
| | - Davide Milani
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
| | - Riccardo Spaggiari
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
| | | | - Giovanni Battista Lasio
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
| | - Maurizio Fornari
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
| | - Franco Servadei
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
| | - Andrea Cardia
- Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Viale Alessandro Manzoni 56, Rozzano, Milan, Italy
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Tresoldi AS, Carosi G, Betella N, Del Sindaco G, Indirli R, Ferrante E, Sala E, Giavoli C, Morenghi E, Locatelli M, Milani D, Mazziotti G, Spada A, Arosio M, Mantovani G, Lania AGA. Clinically Nonfunctioning Pituitary Incidentalomas: Characteristics and Natural History. Neuroendocrinology 2020; 110:595-603. [PMID: 31525736 DOI: 10.1159/000503256] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 07/18/2019] [Accepted: 09/05/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Available data on pituitary incidentalomas mostly derive from small-scale studies, with heterogeneous inclusion criteria and limited follow-up. No paper has focused specifically on clinically nonfunctioning pituitary in-cidentalomas (CNFPIs). OBJECTIVE To describe the charac-teristics and the natural history of patients diagnosed with CNFPIs. METHODS Retrospective multicenter cohort study evaluating hormonal, imaging, and visual field characteristics at diagnosis and during follow-up of CNFPIs investigated in 2 Pituitary Centers. RESULTS Three hundred and seventy-one patients were included (50.9% microadenomas, 35.6% males). Men were older and more likely to have a macroadenoma (p < 0.01). Totally, 23.7% of patients presented secondary hormonal deficits (SHDs), related to tumor size (higher in macroadenomas; p < 0.001) and age (higher in older patients; p < 0.001). Hypogonadism was the most frequent SHD (15.6%). Two hundred and ninety-six patients had follow-up data, 29.1% required surgery after first evaluation, and 97 had at least 3 years of follow-up. In total, 15.3% adenomas grew (more macroadenomas), but only in microadenomas patients with longer follow-up showed a higher growth trend. Totally, 5.2% of patients developed new SHDs (micro- vs. macroadenomas p = 1.000), and in 60% of them this was not associated with an increase in tumor size. Thirteen additional patients required surgery during follow-up (1 microadenoma at diagnosis). CONCLUSIONS Macroadenomas and age are risk factors for SHD in CNFPIs, which occur at diagnosis in a quarter of patients. During follow-up, macroadenomas tend to grow more often, but microadenomas display higher growth trend as follow-up increases. Deterioration of pituitary function is not always related to adenoma growth.
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Affiliation(s)
- Alberto Stefano Tresoldi
- Endocrinology, Diabetology and Medical Andrology Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giulia Carosi
- Endocrinology, Diabetology and Medical Andrology Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nazarena Betella
- Endocrinology, Diabetology and Medical Andrology Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giulia Del Sindaco
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rita Indirli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuele Ferrante
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Sala
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Giavoli
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuela Morenghi
- Biostatistics Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Marco Locatelli
- Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Davide Milani
- Neurosurgery Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Gherardo Mazziotti
- Endocrinology, Diabetology and Medical Andrology Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Anna Spada
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maura Arosio
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Mantovani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy,
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,
| | - Andrea Gerardo Antonio Lania
- Endocrinology, Diabetology and Medical Andrology Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
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Howland JR, Alexander AC, Milani D, Culp JM, Peru KM. Effects of oil sands process water mixtures on the mayfly Hexagenia and field-collected aquatic macroinvertebrate communities. Ecotoxicology 2019; 28:658-668. [PMID: 31218497 DOI: 10.1007/s10646-019-02061-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2019] [Indexed: 06/09/2023]
Abstract
Extraction of Canada's oil sands has created 1 billion m3 of tailings, which are stored in on-site tailings ponds. Due to limited storage capacity, the planned release of tailings into the surrounding environment may be required. This represents an environmental management challenge, as the tailings contain contaminants that are known toxins to aquatic communities. Of particular concern are naphthenic acids and their metallic counterparts, as they are the principal toxic components of tailings, are relatively soluble, and are persistent in aquatic environments. This study examines the acute toxicity of environmentally relevant 10:1 mixtures of two process water components: naphthenic acid and sodium naphthenate. We assess the effects of these simplified oil sands process water (OSPW) mixtures under planned and unplanned tailings release scenarios, using traditional and cutting-edge bioindicators for aquatic invertebrate taxa. We found that safe concentrations for mayflies and other aquatic macroinvertebrates were less than 1 mg/l, as no mayfly taxa survived repeated exposure to this dose in either the 48-h or 72-h acute toxicity test. In the 72-h test, no mayflies survived treatment levels greater than 0.5 mg sodium naphthenate/l. In the mesocosm study, even a 90% dilution of the OSPW mixture was not sufficient to protect sensitive macroinvertebrate communities. The results of this study highlight the potential environmental damage that will occur if OSPW is not carefully managed. This information will aid with the development of a management plan for oil sands tailings ponds, which will provide insight into the potential for process water release into the surrounding environment while conserving unique ecosystems downstream of development in the oil sands region.
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Affiliation(s)
- J R Howland
- Biology Department, University of New Brunswick, Fredericton, NB, Canada.
| | - A C Alexander
- Biology Department, University of New Brunswick, Fredericton, NB, Canada
- Watershed Hydrology and Ecology Research Division, Environment and Climate Change Canada, Fredericton, NB, Canada
| | - D Milani
- Water S&T Branch, Environment and Climate Change Canada, Burlington, ON, Canada
| | - J M Culp
- Watershed Hydrology and Ecology Research Division, Environment and Climate Change Canada, Fredericton, NB, Canada
- Cold Regions Research Center, Wilfrid Laurier University, Waterloo, ON, Canada
| | - K M Peru
- Watershed Hydrology and Ecology Research Division, Environment and Climate Change Canada, Saskatoon, SK, Canada
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Solari D, Zenga F, Angileri FF, Barbanera A, Berlucchi S, Bernucci C, Carapella C, Catapano D, Catapano G, Cavallo LM, D'Arrigo C, de Angelis M, Denaro L, Desogus N, Ferroli P, Fontanella MM, Galzio RJ, Gianfreda CD, Iacoangeli M, Lauretti L, Locatelli D, Locatelli M, Luglietto D, Mazzatenta D, Menniti A, Milani D, Nasi MT, Romano A, Ruggeri AG, Saladino A, Santonocito O, Schwarz A, Skrap M, Stefini R, Volpin L, Wembagher GC, Zoia C, Zona G, Cappabianca P. A Survey on Pituitary Surgery in Italy. World Neurosurg 2019; 123:e440-e449. [DOI: 10.1016/j.wneu.2018.11.186] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
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Fontana L, Bedeschi MF, Maitz S, Cereda A, Faré C, Motta S, Seresini A, D'Ursi P, Orro A, Pecile V, Calvello M, Selicorni A, Lalatta F, Milani D, Sirchia SM, Miozzo M, Tabano S. Characterization of multi-locus imprinting disturbances and underlying genetic defects in patients with chromosome 11p15.5 related imprinting disorders. Epigenetics 2018; 13:897-909. [PMID: 30221575 PMCID: PMC6284780 DOI: 10.1080/15592294.2018.1514230] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 12/12/2022] Open
Abstract
The identification of multilocus imprinting disturbances (MLID) appears fundamental to uncover molecular pathways underlying imprinting disorders (IDs) and to complete clinical diagnosis of patients. However, MLID genetic associated mechanisms remain largely unknown. To characterize MLID in Beckwith-Wiedemann (BWS) and Silver-Russell (SRS) syndromes, we profiled by MassARRAY the methylation of 12 imprinted differentially methylated regions (iDMRs) in 21 BWS and 7 SRS patients with chromosome 11p15.5 epimutations. MLID was identified in 50% of BWS and 29% of SRS patients as a maternal hypomethylation syndrome. By next-generation sequencing, we searched for putative MLID-causative mutations in genes involved in methylation establishment/maintenance and found two novel missense mutations possibly causative of MLID: one in NLRP2, affecting ADP binding and protein activity, and one in ZFP42, likely leading to loss of DNA binding specificity. Both variants were paternally inherited. In silico protein modelling allowed to define the functional effect of these mutations. We found that MLID is very frequent in BWS/SRS. In addition, since MLID-BWS patients in our cohort show a peculiar pattern of BWS-associated clinical signs, MLID test could be important for a comprehensive clinical assessment. Finally, we highlighted the possible involvement of ZFP42 variants in MLID development and confirmed NLRP2 as causative locus in BWS-MLID.
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Affiliation(s)
- L Fontana
- a Laboratory of Molecular Pathology, Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milano , Italy
| | - M F Bedeschi
- b Clinical Genetics Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S Maitz
- c Clinical Pediatric, Genetics Unit , MBBM Foundation, San Gerardo Monza , Monza , Italy
| | - A Cereda
- d Medical Genetics Unit , Papa Giovanni XXIII Hospital , Bergamo , Italy
| | - C Faré
- e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S Motta
- e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - A Seresini
- f Medical Genetics Laboratory , Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico , Milano , Italy.,g Fondazione Grigioni per il Morbo di Parkinson , Milano , Italy
| | - P D'Ursi
- h Department of Biomedical Sciences National Research Council , Institute for Biomedical Technologies , Segrate , Italy
| | - A Orro
- h Department of Biomedical Sciences National Research Council , Institute for Biomedical Technologies , Segrate , Italy
| | - V Pecile
- i Medical Genetics Division , Institute for maternal and child health IRCCS Burlo Garofolo , Trieste , Italy
| | - M Calvello
- e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy.,j Division of Cancer Prevention and Genetics, IEO , European Institute of Oncology IRCCS , Milano , Italy
| | - A Selicorni
- k UOC Pediatria , ASST Lariana , Como , Italy
| | - F Lalatta
- b Clinical Genetics Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - D Milani
- l Pediatric Highly Intensive Care Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S M Sirchia
- m Medical Genetics, Department of Health Sciences , Università degli Studi di Milano , Milano , Italy
| | - M Miozzo
- a Laboratory of Molecular Pathology, Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milano , Italy.,e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S Tabano
- a Laboratory of Molecular Pathology, Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milano , Italy
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Prosser RS, Gillis PL, Milani D, Holman EAM, Ikert H, Schissler D, Toito J, Palabrica V, Parrott JL, Bartlett AJ, Balakrishnan VK. Bioaccumulation of sediment-associated substituted phenylamine antioxidants in Tubifex tubifex and Lampsilis siliquoidea. Ecotoxicology 2018; 27:578-589. [PMID: 29644543 DOI: 10.1007/s10646-018-1931-7] [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] [Subscribe] [Scholar Register] [Accepted: 03/19/2018] [Indexed: 06/08/2023]
Abstract
Substituted phenylamine antioxidants (SPAs) are additives in a variety of commercial polymers (e.g., lubricants, plastics, etc.). Based on their physicochemical properties, if SPAs were to enter an aquatic system, they would likely partition into sediment and have the capacity to bioaccumulate in biota. This study investigated the potential of four sediment-associated SPAs, diphenylamine (DPA), N-phenyl-1-naphthalene (PNA), N-(1,3-dimethylbutyl)-N'-phenyl-1,4-phenylenediamine (DPPDA), and 4,4'-methylene-bis[N-sec-butylaniline] (MBA) to accumulate in the tissues of freshwater mussels (Lampsilis siliquoidea) and oligochaete worms (Tubifex tubifex). Mussels and worms were exposed to sediment spiked with individual SPAs for 28 d. The concentration of SPAs was measured in the gill, gonad, and remaining viscera of the mussels and entire body of the worms. The majority of biota-sediment accumulation factors (28-d BSAFs) for the different tissues of mussels were < 1. The highest concentrations of SPAs were consistently observed in the gill tissue of mussels relative to the gonad and viscera. The 28-d BSAFs for DPPDA and MBA for worms were < 1, and for DPA and PNA, they ranged from 0.38-2.13 and 1.54-33.24, respectively. The higher 28-d BSAFs observed for worms compared to mussels were likely because worms are endobenthic and feed on sediment-associated organic matter. PNA and DPPDA have similar octanol-water partition coefficients (Kow) but greater 28-d BSAFs were observed for PNA compared to DPPDA for both species. This observation provides evidence that biota may be able to metabolize and/or excrete SPAs with similar physicochemical properties at considerably different rates. The 28-d BSAFs observed for sediment-associated SPAs are lower than those typically required for a chemical to be classified as bioaccumulative.
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Affiliation(s)
- R S Prosser
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada.
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada.
| | - P L Gillis
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - D Milani
- Environment and Climate Change Canada, Watershed Hydrology and Ecology Research Division, Burlington, ON, Canada
| | - E A M Holman
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - H Ikert
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - D Schissler
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - J Toito
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - V Palabrica
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - J L Parrott
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - A J Bartlett
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
| | - V K Balakrishnan
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, ON, Canada
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Cannizzaro D, Mancarella C, Milani D, Fernandes B, Rossi M, Fornari M, Cardia A. Intraventricular liponeurocytoma: The role of surgery and adjuvant therapy. Interdisciplinary Neurosurgery 2018. [DOI: 10.1016/j.inat.2017.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Rossini Z, Milani D, Nicolosi F, Costa F, Lasio GB, D'Angelo VA, Fornari M, Colombo G. Endoscopic Transseptal Approach with Posterior Nasal Spine Removal: A Wide Surgical Corridor to the Craniovertebral Junction and Odontoid: Technical Note and Case Series. World Neurosurg 2017; 110:373-385. [PMID: 29203314 DOI: 10.1016/j.wneu.2017.11.153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/23/2017] [Accepted: 11/25/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND The transnasal approach to lesions involving the craniovertebral junction represents a technical challenge because of limited inferior exposure. The endoscopic transseptal approach (EtsA) with posterior nasal spine (PNS) removal is described. This technique can create a wide exposure of the craniovertebral junction, thereby increasing the caudal exposure. METHODS On patients undergoing anterior craniovertebral junction decompression, we calculated the degree of exposure on the sagittal plan through a paraseptal route, an EtsA without and with PNS removal. The horizontal exposure and working area with the latter approach were also evaluated. RESULTS Five patients underwent the transnasal procedure. The age of patients ranged from 34-71 years. All patients harbored basilar impression. The mean postoperative Nurick grade (1, 8) was improved versus the average preoperative grade (3). The average follow-up duration was 16 months. All patients underwent occipitocervical fixation. The mean vertical distances, from the clinoid recess to the inferior most limit with the paraseptal approach, EtsA without and with PNS removal were 38.52, 44.12, and 51.16 mm, respectively. The difference between our approach and a standard paraseptal route was statistically significant (P = 0.041; P< 0.05). The mean horizontal distances were 31.68 mm (mononostril entry) and 35.37 mm (binostril entry). The mean working area was 1795.53 mm2. CONCLUSIONS Endoscopic endonasal approaches to the craniovertebral junction are increasing, but the downward extension on the anterior cervical spine represents a limit. Therefore, many surgeons prefer transoral or transcervical approaches. The EtsA with PNS removal allows for a more caudal exposure than the standard paraseptal approach, with reduced nasal trauma.
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Affiliation(s)
- Zefferino Rossini
- Division of Neurosurgery, Università degli Studi di Milano, Milan, Italy; Division of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Davide Milani
- Division of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy.
| | - Federico Nicolosi
- Division of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Francesco Costa
- Division of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | | | | | - Maurizio Fornari
- Division of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Giovanni Colombo
- Division of Otorhinolaryngology, Humanitas Clinical and Research Center, Rozzano, Italy
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Prosser RS, Gillis PL, Holman EAM, Schissler D, Ikert H, Toito J, Gilroy E, Campbell S, Bartlett AJ, Milani D, Parrott JL, Balakrishnan VK. Effect of substituted phenylamine antioxidants on three life stages of the freshwater mussel Lampsilis siliquoidea. Environ Pollut 2017; 229:281-289. [PMID: 28601017 DOI: 10.1016/j.envpol.2017.05.086] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/13/2017] [Accepted: 05/30/2017] [Indexed: 06/07/2023]
Abstract
Substituted phenylamines (SPAs) are incorporated into a variety of consumer products (e.g., polymers, lubricants) in order to increase the lifespan of the products by acting as a primary antioxidant. Based on their physicochemical properties, if SPAs were to enter the aquatic environment, they would likely partition into sediment. No studies to date have investigated the effect of sediment-associated SPAs on aquatic organisms. The current study examined the effect of four SPAs (diphenylamine (DPA); N-phenyl-1-napthylamine (PNA); N-(1,3-dimethylbutyl)-N'-phenyl-1,4-phenylenediamine (DPPDA); 4,4'-methylene-bis[N-sec-butylaniline] (MBA)) on three different life stages of the freshwater mussel, Lampsilis siliquoidea. The viability of larvae (glochidia) of L. siliquoidea and Lampsilis fasciola was assessed after 48 h of exposure to SPAs in water. The 48-h EC50s for glochidia viability of L. siliquoidea were 5951, 606, 439, and 258 μg/L for DPA, PNA, DPPDA, and MBA, respectively, and 7946, 591, 137, and 47 μg/L, respectively, for L. fasciola. Juvenile (7-15 months) and adult L. siliquoidea were exposed to sediment-associated SPAs for 28 d. LC50s for juvenile mussels were 18, 55, 62, and 109 μg/g dry weight (dw) of sediment for DPA, PNA, DPPDA, and MBA, respectively. Adult mussels were exposed to sub-lethal concentrations of sediment-associated SPAs in order to investigate reactive oxygen species (ROS), lipid peroxidation and total glutathione in the gill, gonad, and digestive gland tissue, and viability and DNA damage in hemocytes. No significant concentration-dependent trend in any of these biochemical and cellular endpoints relative to the concentration of sediment-associated SPAs was observed in any tissues. Investigations into the concentration of SPAs in the aquatic environment are required before a conclusion can be made on whether these compounds pose a hazard to the different life stages of freshwater mussels.
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Affiliation(s)
- R S Prosser
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada.
| | - P L Gillis
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - E A M Holman
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - D Schissler
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - H Ikert
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - J Toito
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - E Gilroy
- Greenhouse Science, Burlington, Ontario, Canada
| | - S Campbell
- Greenhouse Science, Burlington, Ontario, Canada
| | - A J Bartlett
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - D Milani
- Environment and Climate Change Canada, Watershed Hydrology and Ecology Research Division, Burlington, Ontario, Canada
| | - J L Parrott
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - V K Balakrishnan
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
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Rossini Z, Cardia A, Milani D, Lasio GB, Fornari M, D'Angelo V. VITOM 3D: Preliminary Experience in Cranial Surgery. World Neurosurg 2017; 107:663-668. [PMID: 28843760 DOI: 10.1016/j.wneu.2017.08.083] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/10/2017] [Accepted: 08/12/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Optimal vision and ergonomics are important factors contributing to achievement of good results during neurosurgical interventions. The operating microscope and the endoscope have partially filled the gap between the need for good surgical vision and maintenance of a comfortable posture during surgery. Recently, a new technology called video-assisted telescope operating monitor or exoscope has been used in cranial surgery. The main drawback with previous prototypes was lack of stereopsis. We present the first case report of cranial surgery performed using the VITOM 3D, an exoscope conjugating 4K resolution view and three-dimensional technology, and discuss advantages and disadvantages compared with the operating microscope. CASE DESCRIPTION A 50-year-old patient with vertigo and headache linked to a petrous ridge meningioma underwent surgery using the VITOM 3D. Complete removal of the tumor and resolution of symptoms were achieved. The telescope was maintained over the surgical field for the duration of the procedure; a video monitor was placed at 2 m from the surgeons; and a control unit allowed focusing, magnification, and repositioning of the camera. CONCLUSIONS VITOM 3D is a video system that has overcome the lack of stereopsis, a major drawback of previous exoscope models. It has many advantages regarding ergonomics, versatility, and depth of field compared with the operating microscope, but the holder arm and the mechanism of repositioning, refocusing, and magnification need to be ameliorated. Surgeons should continue to use the technology they feel confident with, unless a distinct advantage with newer technologies can be demonstrated.
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Affiliation(s)
- Zefferino Rossini
- Division of Neurosurgery, Università degli Studi di Milano, Milano, Italy; Division of Neurosurgery, HumanitasClinical and Research Center, Rozzano, Milano, Italy
| | - Andrea Cardia
- Division of Neurosurgery, HumanitasClinical and Research Center, Rozzano, Milano, Italy.
| | - Davide Milani
- Division of Neurosurgery, HumanitasClinical and Research Center, Rozzano, Milano, Italy
| | | | - Maurizio Fornari
- Division of Neurosurgery, HumanitasClinical and Research Center, Rozzano, Milano, Italy
| | - Vincenzo D'Angelo
- Division of Neurosurgery, HumanitasClinical and Research Center, Rozzano, Milano, Italy
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Prosser RS, Bartlett AJ, Milani D, Holman EAM, Ikert H, Schissler D, Toito J, Parrott JL, Gillis PL, Balakrishnan VK. Variation in the toxicity of sediment-associated substituted phenylamine antioxidants to an epibenthic (Hyalella azteca) and endobenthic (Tubifex tubifex) invertebrate. Chemosphere 2017; 181:250-258. [PMID: 28448906 DOI: 10.1016/j.chemosphere.2017.04.066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/13/2017] [Accepted: 04/15/2017] [Indexed: 06/07/2023]
Abstract
Substituted phenylamine antioxidants (SPAs) are produced in relatively high volumes and used in a range of applications (e.g., rubber, polyurethane); however, little is known about their toxicity to aquatic biota. Therefore, current study examined the effects of chronic exposure (28 d) to four sediment-associated SPAs on epibenthic (Hyalella azteca) and endobenthic (Tubifex tubifex) organisms. In addition, acute (96-h), water-only exposures were conducted with H. azteca. Mortality, growth and biomass production were assessed in juvenile H. azteca exposed to diphenylamine (DPA), N-phenyl-1-napthylamine (PNA), N-(1,3-dimethylbutyl)-N'-phenyl-1,4-phenylenediamine (DPPDA), or 4,4'-methylene-bis[N-sec-butylaniline] (MBA). Mortality of adult T. tubifex and reproduction were assessed following exposure to the four SPAs. The 96-h LC50s for juvenile H. azteca were 1443, 109, 250, and >22 μg/L and 28-d LC50s were 22, 99, 135, and >403 μg/g dry weight (dw) for DPA, PNA, DPPDA, and MBA, respectively. Reproductive endpoints for T. tubifex (EC50s for production of juveniles > 500 μm: 15, 9, 4, 3.6 μg/g dw, for DPA, PNA, DPPDA, and MBA, respectively) were an order of magnitude more sensitive than endpoints for juvenile H. azteca and mortality of adult worms. The variation in toxicity across the four SPAs was likely related to the bioavailability of the sediment-associated chemicals, which was determined by the chemical properties of the SPAs (e.g., solubility in water, Koc). The variation in the sensitivity between the two species was likely due to differences in the magnitude of exposure, which is a function of the life histories of the epibenthic amphipod and the endobenthic worm. The data generated from this study will support effect characterization for ecological risk assessment.
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Affiliation(s)
- R S Prosser
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada.
| | - A J Bartlett
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - D Milani
- Environment and Climate Change Canada, Watershed Hydrology and Ecology Research Division, Burlington, Ontario, Canada
| | - E A M Holman
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - H Ikert
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - D Schissler
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - J Toito
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - J L Parrott
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - P L Gillis
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - V K Balakrishnan
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
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Silibello G, Vizziello P, Gallucci M, Selicorni A, Milani D, Ajmone PF, Rigamonti C, De Stefano S, Bedeschi MF, Lalatta F. Daily life changes and adaptations investigated in 154 families with a child suffering from a rare disability at a public centre for rare diseases in Northern Italy. Ital J Pediatr 2016; 42:76. [PMID: 27576488 PMCID: PMC5006542 DOI: 10.1186/s13052-016-0285-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 08/03/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Living with a disabled child has profound effects on the entire family. With a prevalence of developmental disabilities around 2,5 %, there is a considerable need to promote improvements in the health care system. Little is known about changes and adaptations in the lives of affected families and this paucity of information hinders the improvement of services. This study sought to explore the needs and changes in the everyday life of families with children suffering from rare diseases of varying severity, with and without mental disability. The aim was to measure the socio-demographic characteristics, health care problems and living conditions of a large cohort of families with an affected member. METHODS A sample of 154 families was recruited between September 2011 and April 2013 to respond to a 136 item questionnaire that explored different areas of concern (diagnosis and follow-up of clinical specialists, relationship with pediatrician, rehabilitation, school, work, institutional and/or private support, child care needs and family relationships). RESULTS All parents answered the questionnaire. They were satisfied with the services provided in particular for diagnosis and follow-up, relationships with the family pediatrician, rehabilitation services and school, regardless of the severity of condition, presence of intellectual disability (ID) or absence of diagnosis. Negative scores were reported for institutional and/or private support and family relationships in severe conditions. CONCLUSIONS The Health Care System should maintain a family-centered care and a multi-agency working, improving quality of life of families with disabled child to allow adaptation. At present these services are uncoordinated and financial support is poor, resulting in a heavy burden for these families.
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Affiliation(s)
- G. Silibello
- Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P. Vizziello
- Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M. Gallucci
- Department of Psychology, University of Milano, Bicocca, Italy
| | - A. Selicorni
- Pediatric Genetic Unit, Department of Pediatrics, MBBM Foundation, A.O S Gerardo, Monza, Italy
| | - D. Milani
- Pediatric Highly Intensive Care Unit Department of Pathophysiology and Transplantation Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P. F. Ajmone
- Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C. Rigamonti
- Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S. De Stefano
- Clinical Genetics Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, Italy
| | - M. F. Bedeschi
- Clinical Genetics Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, Italy
| | - Faustina Lalatta
- Clinical Genetics Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, Italy
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40
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Milani D, Knuckey NW, Anderton RS, Cross JL, Meloni BP. The R18 Polyarginine Peptide Is More Effective Than the TAT-NR2B9c (NA-1) Peptide When Administered 60 Minutes after Permanent Middle Cerebral Artery Occlusion in the Rat. Stroke Res Treat 2016; 2016:2372710. [PMID: 27247825 PMCID: PMC4877491 DOI: 10.1155/2016/2372710] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 04/11/2016] [Indexed: 11/24/2022] Open
Abstract
We examined the dose responsiveness of polyarginine R18 (100, 300, and 1000 nmol/kg) when administered 60 minutes after permanent middle cerebral artery occlusion (MCAO). The TAT-NR2B9c peptide, which is known to be neuroprotective in rodent and nonhuman primate stroke models, served as a positive control. At 24 hours after MCAO, there was reduced total infarct volume in R18 treated animals at all doses, but this reduction only reached statistical significance at doses of 100 and 1000 nmol/kg. The TAT-NR2B9c peptide reduced infarct volume at doses of 300 and 1000 nmol/kg, but not to a statistically significant extent, while the 100 nmol/kg dose was ineffective. The reduction in infarct volume with R18 and TAT-NR2B9c peptide treatments was mirrored by improvements in one or more functional outcomes (namely, neurological score, adhesive tape removal, and rota-rod), but not to a statistically significant extent. These findings further confirm the neuroprotective properties of polyarginine peptides and for R18 extend its therapeutic time window and dose range, as well as demonstrating its greater efficacy compared to TAT-NR2B9c in a severe stroke model. The superior neuroprotective efficacy of R18 over TAT-NR2B9c highlights the potential of this polyarginine peptide as a lead candidate for studies in human stroke.
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Affiliation(s)
- D. Milani
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Neuroscience Research Institute, Nedlands, WA 6009, Australia
- Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, WA 6009, Australia
| | - N. W. Knuckey
- Western Australian Neuroscience Research Institute, Nedlands, WA 6009, Australia
- Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, WA 6009, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA 6009, Australia
| | - R. S. Anderton
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Neuroscience Research Institute, Nedlands, WA 6009, Australia
| | - J. L. Cross
- Western Australian Neuroscience Research Institute, Nedlands, WA 6009, Australia
- Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, WA 6009, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA 6009, Australia
| | - B. P. Meloni
- Western Australian Neuroscience Research Institute, Nedlands, WA 6009, Australia
- Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, WA 6009, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA 6009, Australia
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41
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Borio A, Milani D, Marmolino S, Mogno M, Serpella D, Costa P, Thiery A. 107. Intraoperative neurophysiologic monitoring in 145 surgical treatments for scoliosis. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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42
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Mussa A, Russo S, de Crescenzo A, Freschi A, Calzari L, Maitz S, Macchiaiolo M, Molinatto C, Baldassarre G, Mariani M, Tarani L, Bedeschi MF, Milani D, Melis D, Bartuli A, Cubellis MV, Selicorni A, Silengo MC, Larizza L, Riccio A, Ferrero GB. Fetal growth patterns in Beckwith-Wiedemann syndrome. Clin Genet 2016; 90:21-7. [PMID: 26857110 DOI: 10.1111/cge.12759] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/23/2016] [Accepted: 02/03/2016] [Indexed: 01/04/2023]
Abstract
We provide data on fetal growth pattern on the molecular subtypes of Beckwith-Wiedemann syndrome (BWS): IC1 gain of methylation (IC1-GoM), IC2 loss of methylation (IC2-LoM), 11p15.5 paternal uniparental disomy (UPD), and CDKN1C mutation. In this observational study, gestational ages and neonatal growth parameters of 247 BWS patients were compared by calculating gestational age-corrected standard deviation scores (SDS) and proportionality indexes to search for differences among IC1-GoM (n = 21), UPD (n = 87), IC2-LoM (n = 147), and CDKN1C mutation (n = 11) patients. In IC1-GoM subgroup, weight and length are higher than in other subgroups. Body proportionality indexes display the following pattern: highest in IC1-GoM patients, lowest in IC2-LoM/CDKN1C patients, intermediate in UPD ones. Prematurity was significantly more prevalent in the CDKN1C (64%) and IC2-LoM subgroups (37%). Fetal growth patterns are different in the four molecular subtypes of BWS and remarkably consistent with altered gene expression primed by the respective molecular mechanisms. IC1-GoM cases show extreme macrosomia and severe disproportion between weight and length excess. In IC2-LoM/CDKN1C patients, macrosomia is less common and associated with more proportionate weight/length ratios with excess of preterm birth. UPD patients show growth patterns closer to those of IC2-LoM, but manifest a body mass disproportion rather similar to that seen in IC1-GoM cases.
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Affiliation(s)
- A Mussa
- Department of Pediatric and Public Health Sciences, University of Turin, Turin, Italy
| | - S Russo
- Laboratory of Cytogenetics and Molecular Genetics, Istituto Auxologico Italiano, Milan, Italy
| | | | - A Freschi
- DiSTABiF, Second University of Naples, Naples, Italy
| | - L Calzari
- Laboratory of Cytogenetics and Molecular Genetics, Istituto Auxologico Italiano, Milan, Italy
| | - S Maitz
- Clinical Pediatric Genetics Unit, Pediatrics Clinics, MBBM Foundation, S. Gerardo Hospital, Monza, Italia
| | - M Macchiaiolo
- Rare Disease and Medical Genetics Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - C Molinatto
- Department of Pediatric and Public Health Sciences, University of Turin, Turin, Italy
| | - G Baldassarre
- Department of Pediatric and Public Health Sciences, University of Turin, Turin, Italy
| | - M Mariani
- Clinical Pediatric Genetics Unit, Pediatrics Clinics, MBBM Foundation, S. Gerardo Hospital, Monza, Italia
| | - L Tarani
- Department of Pediatric and Pediatric Neuropsychiatry, Sapienza University, Rome, Italy
| | - M F Bedeschi
- Medical Genetics Unit, IRCCS Ca' Granda Foundation, Ospedale Maggiore Policlinico, Milan, Italy
| | - D Milani
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - D Melis
- Clinical Pediatric Genetics, Department of Pediatrics, University "Federico II", Naples, Italy
| | - A Bartuli
- Rare Disease and Medical Genetics Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - M V Cubellis
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - A Selicorni
- Clinical Pediatric Genetics Unit, Pediatrics Clinics, MBBM Foundation, S. Gerardo Hospital, Monza, Italia
| | - M C Silengo
- Department of Pediatric and Public Health Sciences, University of Turin, Turin, Italy
| | - L Larizza
- Laboratory of Cytogenetics and Molecular Genetics, Istituto Auxologico Italiano, Milan, Italy
| | - A Riccio
- DiSTABiF, Second University of Naples, Naples, Italy.,Institute of Genetics and Biophysics "A. Buzzati-Traverso" - CNR, Naples, Italy
| | - G B Ferrero
- Department of Pediatric and Public Health Sciences, University of Turin, Turin, Italy
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43
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Costa F, Dorelli G, Ortolina A, Cardia A, Attuati L, Tomei M, Milani D, Balzarini L, Galbusera F, Morenghi E, Fornari M. Computed Tomography-Based Image-Guided System in Spinal Surgery. Oper Neurosurg (Hagerstown) 2015; 11 Suppl 2:59-67; discussion 67-8. [DOI: 10.1227/neu.0000000000000587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND
Image-guided navigation systems (IGS) grant excellent clinical and radiological results, minimizing risks correlated with spinal instrumentation. However, there is some concern regarding the real need for IGS and its indications.
OBJECTIVE
To analyze the accuracy, technical aspect, and radiation exposure data of the principal IGS based on computed tomography (CT) imaging.
METHODS
The data of all patients treated for spinal instrumentation with the aid of an IGS system from January 2003 to March 2013 were retrospectively analyzed. We defined 2 groups: group I with an IGS system based on a preoperative CT scan; group II relied on an intraoperative CT scan. Screw accuracy was assessed with a postoperative CT scan control. Radiation dosage for patients was defined by using the technical parameters and dose report data. Statistical analysis was performed using the Fisher exact test with a significance of 5% (P value < .05).
RESULTS
Two thousand twenty patients and 11 144 screws were analyzed. Group I had 794 patients (4246 screws); the accuracy was 96.1%. Group II had 1226 patients (6898 screws) treated, with 98.5% accuracy (P = .001). The radiation dose analysis showed better results in group II, with significant reduction of the effective dose to the patient.
CONCLUSION
The IGS based on an intraoperative CT scan grants excellent results, eliminating the rate of reoperation for misplaced instrumentations (screws, plate, and cage) or for inadequate bone decompression. However, this technology cannot replace the surgical skills, experience, and knowledge necessary for spine surgery.
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Affiliation(s)
- Francesco Costa
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Gianluigi Dorelli
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Alessandro Ortolina
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Andrea Cardia
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Luca Attuati
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Massimo Tomei
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Davide Milani
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Luca Balzarini
- Department of Radiology, Humanitas Clinical and Research Center, Rozzano, Italy
| | | | - Emanuela Morenghi
- Biostatistic Unit, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Maurizio Fornari
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
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Spena S, Milani D, Rusconi D, Negri G, Colapietro P, Elcioglu N, Bedeschi F, Pilotta A, Spaccini L, Ficcadenti A, Magnani C, Scarano G, Selicorni A, Larizza L, Gervasini C. Insights into genotype-phenotype correlations from CREBBP point mutation screening in a cohort of 46 Rubinstein-Taybi syndrome patients. Clin Genet 2014; 88:431-40. [PMID: 25388907 DOI: 10.1111/cge.12537] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/05/2014] [Accepted: 11/07/2014] [Indexed: 12/01/2022]
Abstract
The genetic basis of Rubinstein-Taybi syndrome (RSTS), a rare, sporadic, clinically heterogeneous disorder characterized by cognitive impairment and a wide spectrum of multiple congenital anomalies, is primarily due to private mutations in CREBBP (approximately 55% of cases) or EP300 (approximately 8% of cases). Herein, we report the clinical and the genetic data taken from a cohort of 46 RSTS patients, all carriers of CREBBP point mutations. Molecular analysis revealed 45 different gene alterations including 31 inactivating (21 frameshift and 10 nonsense), 10 missense and 4 splicing mutations. Bioinformatic tools and transcript analyses were used to predict the functional effects of missense and splicing alterations. Of the 45 mutations, 42 are unreported and 3 were described previously. Recurrent mutations maybe a key tool in addressing genotype-phenotype correlations in patients sharing the same defects (at the genomic or transcript level) and specific clinical signs, demonstrated here in two cases. The clinical data of our cohort evidenced frequent signs such as arched eyebrows, epicanthus, synophrys and/or frontal hypertrichosis and broad phalanges that, previously overlooked in RSTS diagnosis, now could be considered. Some suggested correlations between organ-specific anomalies and affected CREB-binding protein domains broaden the RSTS clinical spectrum and perhaps will enhance patient follow-up and clinical care.
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Affiliation(s)
- S Spena
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - D Milani
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Policlinico, Milano, Italy
| | - D Rusconi
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - G Negri
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - P Colapietro
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - N Elcioglu
- Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - F Bedeschi
- Clinical Genetics Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - A Pilotta
- Centro di Auxoendocrinologia, Department of Paediatrics, Spedali Civili, Brescia, Italy
| | - L Spaccini
- Department of Obstetrics and Gynecology, Children's Hospital V. Buzzi, Milano, Italy
| | - A Ficcadenti
- Rare diseases Regional Centre, Pediatric Institute of Maternal-Infantile Sciences Department, Polytechnic University of Marche, Salesi Hospital of United Hospitals of Ancona, Ancona, Italy
| | - C Magnani
- Neonatology and Neonatal Intensive Care Unit, Maternal and Child Department, Parma University, Parma, Italy
| | - G Scarano
- Medical Genetics Department, Gaetano Rummo Hospital, Benevento, Italy
| | - A Selicorni
- Department of Pediatrics, Università Milano Bicocca, Fondazione MBBM, San Gerardo Hospital, Monza, Italy
| | - L Larizza
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy.,Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - C Gervasini
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
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Lasio GB, Milani D. Letter to the editor: have 3D endoscopes succeeded in neurosurgery? Acta Neurochir (Wien) 2014; 156:1925. [PMID: 25160854 DOI: 10.1007/s00701-014-2209-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 08/15/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Giovanni Battista Lasio
- Neurosurgery Department, Pituitary Unit - Humanitas Clinical and Research Center, Via A. Manzoni 56, 20089, Rozzano, MI, Italy
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46
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Negri G, Milani D, Colapietro P, Forzano F, Della Monica M, Rusconi D, Consonni L, Caffi LG, Finelli P, Scarano G, Magnani C, Selicorni A, Spena S, Larizza L, Gervasini C. Clinical and molecular characterization of Rubinstein-Taybi syndrome patients carrying distinct novel mutations of the EP300 gene. Clin Genet 2014; 87:148-54. [PMID: 24476420 DOI: 10.1111/cge.12348] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 01/15/2014] [Accepted: 01/16/2014] [Indexed: 11/30/2022]
Abstract
Rubinstein-Taybi syndrome (RSTS) is a rare congenital neurodevelopmental disorder characterized by postnatal growth deficiency, skeletal abnormalities, dysmorphic features and cognitive deficit. Mutations in two genes, CREBBP and EP300, encoding two homologous transcriptional co-activators, have been identified in ˜55% and ˜3-5% of affected individuals, respectively. To date, only eight EP300-mutated RSTS patients have been described and 12 additional mutations are reported in the database LOVD. In this study, EP300 analysis was performed on 33 CREBBP-negative RSTS patients leading to the identification of six unreported germline EP300 alterations comprising one deletion and five point mutations. All six patients showed a convincing, albeit mild, RSTS phenotype with minor skeletal anomalies, slight cognitive impairment and few major malformations. Beyond the expansion of the RSTS-EP300-mutated cohort, this study indicates that EP300-related RSTS cases occur more frequently than previously thought (˜8% vs 3-5%); furthermore, the characterization of novel EP300 mutations in RSTS patients will enhance the clinical practice and genotype-phenotype correlations.
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Affiliation(s)
- G Negri
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
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47
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Luchetti A, Milani D, Ruffini F, Galli R, Falini A, Quattrini A, Scotti G, Comi G, Martino G, Furlan R, Politi LS. Monoclonal antibodies conjugated with superparamagnetic iron oxide particles allow magnetic resonance imaging detection of lymphocytes in the mouse brain. Mol Imaging 2012; 11:114-125. [PMID: 22469239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
We investigated the potential of antibody-vectorialized superparamagnetic iron oxide (SPIO) particles as cellular specific magnetic resonance contrast agents to image lymphocyte populations within the central nervous system (CNS), with the final goal of obtaining a reliable tool for noninvasively detecting and tracking specific cellular populations in vivo. We used superparamagnetic particles bound to a monoclonal antibody. The particle is the contrast agent, by means of its T₂* relaxation properties; the antibody is the targeting vector, responsible for homing the particle to target a surface antigen. To investigate the efficiency of particle vectorialization by these antibodies, we compared two types of antibody-vectorialized CD3-specific particles in vivo. We successfully employed vectorialized SPIO particles to image B220⁺ cells in a murine model of B-cell lymphoma. Likewise, we were able to identify CD3⁺ infiltrates in a murine model of multiple sclerosis. The specificity of the technique was confirmed by immunohistochemistry and electron microscopy of corresponding sections. Our findings suggest that indirect binding of the antibody to a streptavidinated particle allows for enhanced particle vectorialization compared to covalent binding of the antibody to the particle.
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Affiliation(s)
- Alessandro Luchetti
- Department of Clinical Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
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48
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Milani D, Bedeschi MF, Iascone M, Chiarelli G, Cerutti M, Menni F. De novo deletion of 1q31.1-q32.1 in a patient with developmental delay and behavioral disorders. Cytogenet Genome Res 2012; 136:167-70. [PMID: 22398643 DOI: 10.1159/000336979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2012] [Indexed: 11/19/2022] Open
Abstract
We describe the case of a 6-year-old boy with a de novo deletion of the long arm of chromosome 1 encompassing band 1q31.1-q32.1, minor facial anomalies, mild developmental delay, and behavioral disorders. His postnatal karyotype was normal. Using array-comparative genomic hybridization, we identified and characterized a de novo 1q interstitial deletion of about 15.6 Mb, which partially overlaps those of other reported cases. We considered the gene content of the deleted region in an attempt to compare the clinical features of our patient with these other cases, even though they were not characterized molecularly in detail. The most remarkable difference was the absence of microcephaly. To the best of our knowledge, this is the first report of a de novo 1q31.1-q32.1 deletion. Moreover, it illustrates how molecular delineation associated with fine clinical characterization can improve the genotype-phenotype correlations of classical cytogenetic abnormalities.
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Affiliation(s)
- D Milani
- UOD Genetica Medica, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milano, Italia. donatella.milani @ policlinico.mi.it
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49
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Luchetti A, Milani D, Ruffini F, Galli R, Falini A, Quattrini A, Scotti G, Comi G, Martino G, Furlan R, Politi LS. Monoclonal Antibodies Conjugated with Superparamagnetic Iron Oxide Particles Allow Magnetic Resonance Imaging Detection of Lymphocytes in the Mouse Brain. Mol Imaging 2012. [DOI: 10.2310/7290.2011.00032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We investigated the potential of antibody-vectorialized superparamagnetic iron oxide (SPIO) particles as cellular specific magnetic resonance contrast agents to image lymphocyte populations within the central nervous system (CNS), with the final goal of obtaining a reliable tool for noninvasively detecting and tracking specific cellular populations in vivo. We used superparamagnetic particles bound to a monoclonal antibody. The particle is the contrast agent, by means of its T2* relaxation properties; the antibody is the targeting vector, responsible for homing the particle to target a surface antigen. To investigate the efficiency of particle vectorialization by these antibodies, we compared two types of antibody-vectorialized CD3-specific particles in vivo. We successfully employed vectorialized SPIO particles to image B220+ cells in a murine model of B-cell lymphoma. Likewise, we were able to identify CD3+ infiltrates in a murine model of multiple sclerosis. The specificity of the technique was confirmed by immunohistochemistry and electron microscopy of corresponding sections. Our findings suggest that indirect binding of the antibody to a streptavidinated particle allows for enhanced particle vectorialization compared to covalent binding of the antibody to the particle.
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Affiliation(s)
- Alessandro Luchetti
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Milani
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Ruffini
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Rossella Galli
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Falini
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Quattrini
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Scotti
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Giancarlo Comi
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Gianvito Martino
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Furlan
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
| | - Letterio S. Politi
- From the Departments of Clinical Neuroimmunology, Neurosurgery, Stem Cell Research Institute, Neuroradiology, Neurology, Neuroimmunology, San Raffaele Scientific Institute, Milan, Italy
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50
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Cenzato M, Stefini R, Ambrosi C, Latronico N, Milani D. Surgical Resolution of Trigeminal Neuralgia Due to Intra-Axial Compression by Pontine Cavernous Angioma. World Neurosurg 2010; 74:544-6. [DOI: 10.1016/j.wneu.2010.03.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 03/19/2010] [Indexed: 10/18/2022]
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