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Saibeni S, Bezzio C, Bossa F, Privitera AC, Marchi S, Roselli J, Mazzuoli S, Geccherle A, Soriano A, Principi MB, Viola A, Sarpi L, Cappello M, D'Incà R, Mastronardi M, Bodini G, Guerra M, Benedetti A, Romano M, Cicala M, Di Sabatino A, Scaldaferri F, De Rosa T, Giardino AM, Germano V, Orlando A, Armuzzi A. Golimumab improves health-related quality of life of patients with moderate-to-severe ulcerative colitis: Results of the go-care study. Dig Liver Dis 2024; 56:83-91. [PMID: 37574431 DOI: 10.1016/j.dld.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND In recent years, improvement of Health-Related Quality of Life (HRQoL) in Ulcerative colitis (UC) has become a relevant measure for treatment efficacy. METHODS We report results from a multicenter prospective study in Italy investigating HRQoL in adult patients with UC treated with golimumab (GLM). Patients who had shown clinical response after a 6-week induction phase (w0), were followed for an additional 48 weeks (w48) (total 54-week treatment). RESULTS Of the 159 patients enrolled 90 completed the study. Compared to values at the beginning of treatment (n = 137), significant improvements were observed for mean total Inflammatory Bowel Disease Questionnaire (IBDQ) scores at w0 (168.5) and w48 (181.7). Patients with baseline PMS above the median tended to have greater improvements in IBDQ at w0 (OR 2.037, p = 0.033) and w48 (OR 3.292, p = 0.027). Compared to beginning of GLM treatment, the mean Full Mayo Score (FMS) decreased by 5.9 points at w48, while mean Partial Mayo Score (PMS) decreased by 3.9 points at w0 and by 4.9 points at w48. CONCLUSIONS GLM improved HRQoL, disease activity and inflammatory biomarkers in UC patients with moderate-to-severely active disease. The greater the burden of disease activity at baseline, the greater the improvement of HRQoL after 24 and 48 weeks of treatment.
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Affiliation(s)
- S Saibeni
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Milan, Italy
| | - C Bezzio
- IBD Unit, Gastroenterology IBD Unit, Rho Hospital, ASST Rhodense, Milan, Italy
| | - F Bossa
- Foudation Casa della Sofferenza, UOC Gastroenterology and Digestive Endoscopy, San Giovanni Rotondo, Foggia, Italy
| | | | - S Marchi
- Department of Translational Research, University of Pisa, Italy
| | - J Roselli
- Gastroenterology, Biomedical and Experimental and Clinical Sciences, "Mario Serio" University of Florence, Italy
| | - S Mazzuoli
- IBD Unit U.O.C. of Gastroenterology "Monsignor Raffaele Dimiccoli" Hospital, ASL Barletta, Italy
| | - A Geccherle
- IBD Unit IRCCS "Sacro Cuore-Don Calabria" Negrar di Valpolicella, Verona, Italy
| | - A Soriano
- Department of Internal Medicine, Gastroenterology Division and IBD Center, Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia Arcispedale S. Maria Nuova, 42121 Reggio Emilia, Italy
| | - M B Principi
- U.O.C. of Gastroenterology, "Azienda Policlinico- Universitaria", Bari, Italy
| | - A Viola
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - L Sarpi
- Gastroenterology and Digestive Endoscpy, Hospital "Media Valle del Tevere" Pantalla -Todi, Perugia, Italy
| | - M Cappello
- Gastroenterology and Hepatology Section, Promise, University of Palermo, Italy
| | - R D'Incà
- U.O.C of Gastroenterology, "University Azienda", Padua, Italy
| | - M Mastronardi
- U.O.S IBD IRCCS "S. De Bellis" Castellana Grotte, Bari Italy
| | - G Bodini
- Policlinico San Martino, University of Genoa, Italy
| | - M Guerra
- Foudation Casa della Sofferenza, UOC Gastroenterology and Digestive Endoscopy, San Giovanni Rotondo, Foggia, Italy
| | - A Benedetti
- Clinic of Gastroenterology, Hepatology and Digestive Endoscopy, Università Politecnica delle Marche-Ospedali Riuniti, Ancona, Italy
| | - M Romano
- Precision Medicine Department, University "l. Vanvitelli" Naples, Italy
| | - M Cicala
- U.O.C. of Gastroenterology and Digestive Endoscopy, "Campus Bio Medico" University, Rome, Italy
| | - A Di Sabatino
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia Italy; First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - F Scaldaferri
- CEMAD (Digestive Disease Center) - UOS IBD UNIT, Fondazione Policlinico Universitario ‟A Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - T De Rosa
- Medical Affairs MSD Italy, Rome, Italy
| | | | - V Germano
- Medical Affairs MSD Italy, Rome, Italy
| | - A Orlando
- IBD Unit A.O. Ospedali Riuniti "Villa Sofia Cervello", Palermo, Italy
| | - A Armuzzi
- IBD Center, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy.
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2
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Orlando A, Mocciaro F, Ventimiglia M, Renna S, Rispo A, Scribano ML, Testa A, Aratari A, Bossa F, Angelucci E, Onali S, Cappello M, Giunta M, Scimeca D, Macaluso FS, Castiglione F, Papi C, Annese V, Biancone L, Kohn A, Di Mitri R, Cottone M. Azathioprine for prevention of clinical recurrence in Crohn's disease patients with severe endoscopic recurrence: an IG-IBD randomized double-blind trial. Eur Rev Med Pharmacol Sci 2021; 24:11356-11364. [PMID: 33215456 DOI: 10.26355/eurrev_202011_23627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The recurrence of Crohn's Disease after ileo-colonic resection is a crucial issue. Severe endoscopic lesions increase the risk of developing early symptoms. Prevention and treatment of post-operative Endoscopic Recurrence (ER) have been studied with conflicting results. We compare effi cacy of azathioprine (AZA) vs. high-dose 5-aminosalicylic acid (5-ASA) in preventing clinical recurrence and treating severe post-operative ER. PATIENTS AND METHODS We performed a 1-year multicenter randomized double-blind double-dummy trial. Primary end-points were endoscopic improvement and therapeutic failure (clinical recurrence or drug discontinuation due to lack of efficacy or adverse events) 12 months after randomization. We also performed a post-trial analysis on symptomatic and endoscopic outcomes 10 years after the beginning of the trial, with a median follow-up of 60 months. RESULTS Therapeutic failure occurred in 8 patients (17.4%) within 12 months from randomization, with no significant difference between patients treated with 5-ASA (20.8%, 5 patients) and those with AZA (13.6%, 3 patients). Therapeutic failure was due to clinical recurrence in the 5-ASA group and to adverse events in the AZA group. Endoscopic improvement at 12 months was observed in 8 patients, 2 (11.8%) in the 5-ASA group and 6 (30%) in the AZA group. No serious adverse event was recorded. At the post-trial analysis (median follow-up 60 months), 47.8% (22/46) of patients experienced clinical recurrence: 54.2% (13/24) in the 5-ASA group and 40.9% (9/22) in the AZA group, p=0.546. Patients treated with AZA had lower risk of drug escalation. Clinical recurrence was associated with smoking (p=0.031) and previous surgery (p=0.003). CONCLUSIONS Our trial indicates that there was no difference in terms of treatment failure between 5-ASA and AZA in patients with severe ER. The main limit of AZA is its less favorable safety profile.
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Affiliation(s)
- A Orlando
- IBD Unit, Villa Sofia-Cervello Hospital, Palermo, Italy.
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3
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Labine M, Cappello M, Garon R, Skogberg J, Shahrour W, Elmansy H. Case report: Caustic foreign body insertion into the male urethra. Urol Case Rep 2020; 33:101397. [PMID: 33102095 PMCID: PMC7574152 DOI: 10.1016/j.eucr.2020.101397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 11/02/2022] Open
Abstract
Self-insertion of foreign bodies into the male urethra is a rare presentation. We report a unique case of urethral insertion involving three AAA batteries and the resulting battery acid leakage and urinary obstruction. This report discusses the approach to management, extraction techniques and effects of battery acid within the male urethra.
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4
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Villani A, Cappello M, Costa C, Fabbrocini G, Scalvenzi M. Advanced basal cell carcinoma treated with vismodegib: impact on the lives of patients and their families. Clin Exp Dermatol 2020; 45:1044-1046. [PMID: 32415864 DOI: 10.1111/ced.14287] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/17/2022]
Abstract
Locally advanced basal cell carcinoma (laBCC) represented an uncommon, difficult-to-treat form of skin cancer until the recent approval of the Hedgehog inhibitor vismodegib. Approximately 80% of laBCCs occur in the head and neck region, causing disfiguring skin changes that have an impact on patient quality of life (QoL). Because the lives of patients with advanced BCCs are severely disrupted, it would be expected that the QoL family members involved in caregiving would also be affected. The aim of our study was to quantify the QoL of both patients and family members during vismodegib treatment using the Dermatology Life Quality Index and the Family Dermatology Life Quality Index, respectively.
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Affiliation(s)
- A Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Cappello
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - C Costa
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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5
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Villani A, Costa C, Cappello M, Fabbrocini G, Scalvenzi M. The effectiveness of vismodegib in patients with advanced periocular basal cell carcinoma: a case series of 13 patients. J DERMATOL TREAT 2020; 33:602-603. [DOI: 10.1080/09546634.2020.1771262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- A. Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - C. Costa
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - M. Cappello
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - G. Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - M. Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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6
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Brosseau C, Danger R, Durand M, Durand E, Foureau A, Lacoste P, Tissot A, Roux A, Reynaud-Gaubert M, Kessler R, Mussot S, Dromer C, Brugière O, Mornex JF, Guillemain R, Claustre J, Magnan A, Brouard S, Velly J, Rozé H, Blanchard E, Antoine M, Cappello M, Ruiz M, Sokolow Y, Vanden Eynden F, Van Nooten G, Barvais L, Berré J, Brimioulle S, De Backer D, Créteur J, Engelman E, Huybrechts I, Ickx B, Preiser T, Tuna T, Van Obberghe L, Vancutsem N, Vincent J, De Vuyst P, Etienne I, Féry F, Jacobs F, Knoop C, Vachiéry J, Van den Borne P, Wellemans I, Amand G, Collignon L, Giroux M, Angelescu D, Chavanon O, Hacini R, Martin C, Pirvu A, Porcu P, Albaladejo P, Allègre C, Bataillard A, Bedague D, Briot E, Casez‐Brasseur M, Colas D, Dessertaine G, Francony G, Hebrard A, Marino M, Protar D, Rehm D, Robin S, Rossi‐Blancher M, Augier C, Bedouch P, Boignard A, Bouvaist H, Briault A, Camara B, Chanoine S, Dubuc M, Quétant S, Maurizi J, Pavèse P, Pison C, Saint‐Raymond C, Wion N, Chérion C, Grima R, Jegaden O, Maury J, Tronc F, Flamens C, Paulus S, Philit F, Senechal A, Glérant J, Turquier S, Gamondes D, Chalabresse L, Thivolet‐Bejui F, Barnel C, Dubois C, Tiberghien A, Pimpec‐Barthes F, Bel A, Mordant P, Achouh P, Boussaud V, Méléard D, Bricourt M, Cholley B, Pezella V, Brioude G, D'Journo X, Doddoli C, Thomas P, Trousse D, Dizier S, Leone M, Papazian L, Bregeon F, Coltey B, Dufeu N, Dutau H, Garcia S, Gaubert J, Gomez C, Laroumagne S, Mouton G, Nieves A, Picard C, Rolain J, Sampol E, Secq V, Perigaud C, Roussel J, Senage T, Mugniot A, Danner I, Haloun A, Abbes S, Bry C, Blanc F, Lepoivre T, Botturi‐Cavaillès K, Loy J, Bernard M, Godard E, Royer P, Henrio K, Dartevelle P, Fabre D, Fadel E, Mercier O, Stephan F, Viard P, Cerrina J, Dorfmuller P, Feuillet S, Ghigna M, Hervén P, Le Roy Ladurie F, Le Pavec J, Thomas de Montpreville V, Lamrani L, Castier Y, Mordant P, Cerceau P, Augustin P, Jean‐Baptiste S, Boudinet S, Montravers P, Dauriat G, Jébrak G, Mal H, Marceau A, Métivier A, Thabut G, Lhuillier E, Dupin C, Bunel V, Falcoz P, Massard G, Santelmo N, Ajob G, Collange O, Helms O, Hentz J, Roche A, Bakouboula B, Degot T, Dory A, Hirschi S, Ohlmann‐Caillard S, Kessler L, Schuller A, Bennedif K, Vargas S, Bonnette P, Chapelier A, Puyo P, Sage E, Bresson J, Caille V, Cerf C, Devaquet J, Dumans‐Nizard V, Felten M, Fischler M, Si Larbi A, Leguen M, Ley L, Liu N, Trebbia G, De Miranda S, Douvry B, Gonin F, Grenet D, Hamid A, Neveu H, Parquin F, Picard C, Stern M, Bouillioud F, Cahen P, Colombat M, Dautricourt C, Delahousse M, D'Urso B, Gravisse J, Guth A, Hillaire S, Honderlick P, Lequintrec M, Longchampt E, Mellot F, Scherrer A, Temagoult L, Tricot L, Vasse M, Veyrie C, Zemoura L, Dahan M, Murris M, Benahoua H, Berjaud J, Le Borgne Krams A, Crognier L, Brouchet L, Mathe O, Didier A, Krueger T, Ris H, Gonzalez M, Aubert J, Nicod L, Marsland B, Berutto T, Rochat T, Soccal P, Jolliet P, Koutsokera A, Marcucci C, Manuel O, Bernasconi E, Chollet M, Gronchi F, Courbon C, Hillinger S, Inci I, Kestenholz P, Weder W, Schuepbach R, Zalunardo M, Benden C, Buergi U, Huber L, Isenring B, Schuurmans M, Gaspert A, Holzmann D, Müller N, Schmid C, Vrugt B, Rechsteiner T, Fritz A, Maier D, Deplanche K, Koubi D, Ernst F, Paprotka T, Schmitt M, Wahl B, Boissel J, Olivera‐Botello G, Trocmé C, Toussaint B, Bourgoin‐Voillard S, Séve M, Benmerad M, Siroux V, Slama R, Auffray C, Charron D, Lefaudeux D, Pellet J. Blood CD9 + B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2019; 19:3162-3175. [PMID: 31305014 DOI: 10.1111/ajt.15532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/03/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 01/25/2023]
Abstract
Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.
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Affiliation(s)
- Carole Brosseau
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Richard Danger
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Maxim Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Eugénie Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurore Foureau
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Philippe Lacoste
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Adrien Tissot
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Antoine Roux
- Hôpital Foch, Suresnes, France.,Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Versailles, France
| | | | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie et Transplantation Pulmonaire, Paris, France
| | | | | | - Johanna Claustre
- Clinique Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U1055, Grenoble, France
| | - Antoine Magnan
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Centre d'Investigation Clinique (CIC) Biothérapie, CHU Nantes, Nantes, France
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7
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Scalvenzi M, Costa C, Cappello M, Villani A. Reply to Woltsche N.
et al
. Managing adverse effects by dose reduction during routine treatment of locally advanced basal cell carcinoma with the hedgehog inhibitor vismodegib: a single‐centre experience. J Eur Acad Dermatol Venereol 2019; 33:e145-e147. [DOI: 10.1111/jdv.15469] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M. Scalvenzi
- Department of Dermatology University of Naples Federico II Naples Italy
| | - C. Costa
- Department of Dermatology University of Naples Federico II Naples Italy
| | - M. Cappello
- Department of Dermatology University of Naples Federico II Naples Italy
| | - A. Villani
- Department of Dermatology University of Naples Federico II Naples Italy
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8
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Scalvenzi M, Costa C, De Fata Salvatores G, Cappello M, Villani A. Clinical and dermoscopic features of Spitz naevus by sex, age and anatomical site: a study of 913 Spitz naevi. Br J Dermatol 2018; 179:769-770. [PMID: 29569227 DOI: 10.1111/bjd.16564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- M Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, Dermatology Unit, University of Naples Federico II, Via Pansini, 5, 80131, Napoli, Italy
| | - C Costa
- Section of Dermatology, Department of Clinical Medicine and Surgery, Dermatology Unit, University of Naples Federico II, Via Pansini, 5, 80131, Napoli, Italy
| | - G De Fata Salvatores
- Section of Dermatology, Department of Clinical Medicine and Surgery, Dermatology Unit, University of Naples Federico II, Via Pansini, 5, 80131, Napoli, Italy
| | - M Cappello
- Section of Dermatology, Department of Clinical Medicine and Surgery, Dermatology Unit, University of Naples Federico II, Via Pansini, 5, 80131, Napoli, Italy
| | - A Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, Dermatology Unit, University of Naples Federico II, Via Pansini, 5, 80131, Napoli, Italy
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9
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Costa C, Cappello M, Argenziano G, Piccolo V, Scalvenzi M. Dermoscopy of uncommon variants of dermatofibrosarcoma protuberans. J Eur Acad Dermatol Venereol 2017; 31:e366-e368. [PMID: 28191686 DOI: 10.1111/jdv.14167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Costa
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, Naples, 80131, Italy
| | - M Cappello
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, Naples, 80131, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania, 80131, Naples, Italy
| | - V Piccolo
- Dermatology Unit, University of Campania, 80131, Naples, Italy
| | - M Scalvenzi
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, Naples, 80131, Italy
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La Barbera D, Bonanno B, Rumeo MV, Alabastro V, Frenda M, Massihnia E, Morgante MC, Sideli L, Craxì A, Cappello M, Tumminello M, Miccichè S, Nastri L. Alexithymia and personality traits of patients with inflammatory bowel disease. Sci Rep 2017; 7:41786. [PMID: 28150800 PMCID: PMC5288771 DOI: 10.1038/srep41786] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/28/2016] [Indexed: 12/22/2022] Open
Abstract
Psychological factors, specific lifestyles and environmental stressors may influence etiopathogenesis and evolution of chronic diseases. We investigate the association between Chronic Inflammatory Bowel Diseases (IBD) and psychological dimensions such as personality traits, defence mechanisms, and Alexithymia, i.e. deficits of emotional awareness with inability to give a name to emotional states. We analyzed a survey of 100 patients with IBD and a control group of 66 healthy individuals. The survey involved filling out clinical and anamnestic forms and administering five psychological tests. These were then analyzed by using a network representation of the system by considering it as a bipartite network in which elements of one set are the 166 individuals, while the elements of the other set are the outcome of the survey. We then run an unsupervised community detection algorithm providing a partition of the 166 participants into clusters. That allowed us to determine a statistically significant association between psychological factors and IBD. We find clusters of patients characterized by high neuroticism, alexithymia, impulsivity and severe physical conditions and being of female gender. We therefore hypothesize that in a population of alexithymic patients, females are inclined to develop psychosomatic diseases like IBD while males might eventually develop behavioral disorders.
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Affiliation(s)
- D La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, Unit of Psychiatry, University Hospital, Palermo, Italy
| | - B Bonanno
- Department of Experimental Biomedicine and Clinical Neuroscience, Unit of Psychiatry, University Hospital, Palermo, Italy
| | - M V Rumeo
- Department of Experimental Biomedicine and Clinical Neuroscience, Unit of Psychiatry, University Hospital, Palermo, Italy
| | - V Alabastro
- Department of Experimental Biomedicine and Clinical Neuroscience, Unit of Psychiatry, University Hospital, Palermo, Italy
| | - M Frenda
- Department of Experimental Biomedicine and Clinical Neuroscience, Unit of Psychiatry, University Hospital, Palermo, Italy
| | - E Massihnia
- Unit of Nefrology II with Dialysis and Renal Transplantation, ARNAS Civico Di Cristina Benfratelli, Palermo, Italy
| | - M C Morgante
- Biomedical Department of Internal and Specialty Medicine, Regional Reference Center for Metabolism rare pathologies, University Hospital, Palermo, Italy
| | - L Sideli
- Department of Experimental Biomedicine and Clinical Neuroscience, Unit of Psychiatry, University Hospital, Palermo, Italy
| | - A Craxì
- Biomedical Department of Internal and Specialty Medicine, Unit of Gastroenterology, University Hospital, Palermo, Italy
| | - M Cappello
- Biomedical Department of Internal and Specialty Medicine, Unit of Gastroenterology, University Hospital, Palermo, Italy
| | - M Tumminello
- Department of Economics, Management and Statistics, University of Palermo, Palermo, Italy
| | - S Miccichè
- Department of Physics and Chemistry, University of Palermo, Palermo, Italy
| | - L Nastri
- Department of Experimental Biomedicine and Clinical Neuroscience, Unit of Psychiatry, University Hospital, Palermo, Italy
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11
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Simon I, Roumeguère T, Devuyst F, Cotton F, Tang BNT, Cappello M, Corbetta S, Idrissi M, Pozdzik A, Nortier J. [Recurrent episodes of brushite nephrolithiasis revealing primary hyperparathyroidism]. Rev Med Brux 2015; 36:172-176. [PMID: 26372980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Nephrolithiasis is a frequent disease observed in 1 to 20 % of the general population. This disease predominates in male patients (2:1) and is characterized by a high rate of recurrences (about 50 %). CASE REPORT We report the case of a 45-year old male patient who experienced during about ten years recurrent bilateral renal colic episodes due to brushite lithiasis. These stones were treated with multiple extracorporeal shock wave lithotripsy sessions. A pyeloureteral junction syndrome predisposing to bulky stones formation has been put in evidence and required a pyeloplasty. After more than ten years of disease activity, a biochemical screening diagnosed primary hyperparathyroidism (PHPT). Radiological assessment identified a parathyroid gland adenoma. Successful surgical removal of this lesion was followed by resolution of the symptomatic kidney stones formation. DISCUSSION PHPT is associated with kidney stones in about 20 % of the patients. Hypercalciuria is the main risk factor of stones formation but other predisposing factors are also probably involved. Patients carrying a polymorphism located in the coding sequence of the calcium-sensing receptor gene or in the regulatory region of this gene seem to experience an increased occurrence of urinary lithiasis. CONCLUSION The present case stresses the importance of a metabolic assessment in all patients with recurrent nephrolithiasis, especially in case of bilateral episodes.
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12
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Lazzaro C, Cappello M, Cortelezzi C, Costantino G, Fiorino G, Mastronardi M, Giannotta M, Galletti B, Cicala M, Vadalà di Prampero S, Gualberti G, Caprioli F, Gasbarrini A, Fattore G. A Health Technology-Related Cost Description Concerning Italian Ibd Centres Dealing With Crohn's Disease Results From Sole Study. Value Health 2014; 17:A370. [PMID: 27200785 DOI: 10.1016/j.jval.2014.08.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C Lazzaro
- Studio di Economia Sanitaria, Milan, Italy
| | | | - C Cortelezzi
- AOU di Circolo - Fondazione Macchi, Varese, Italy
| | | | - G Fiorino
- Istituto Clinico Humanitas, Rozzano (MI), Italy
| | | | - M Giannotta
- Azienda Ospedaliero Universitaria di Careggi, Firenze, Italy
| | | | - M Cicala
- Università Campus Bio Medico, Roma, Italy
| | - S Vadalà di Prampero
- Azienda Ospedaliero-Universitaria S. Maria della Misericordia di Udine, Udine, Italy
| | | | - F Caprioli
- Università degli Studi di Milano, Milano, Italy
| | - A Gasbarrini
- Università Cattolica del Sacro Cuore, Rome, Italy
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13
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Lazzaro C, Cappello M, Cortelezzi C, Costantino G, Fiorino G, Mastronardi M, Giannotta M, Galletti B, Cicala M, Vadalà di Prampero S, Gualberti G, Caprioli F, Gasbarrini A, Meregaglia M. Health-Related Quality of Life in Italian Patients With Moderate and Severe Crohn's Disease: Interim Results from the Sole Study. Value Health 2014; 17:A570-A571. [PMID: 27201899 DOI: 10.1016/j.jval.2014.08.1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C Lazzaro
- Studio di Economia Sanitaria, Milan, Italy
| | | | - C Cortelezzi
- AOU di Circolo - Fondazione Macchi, Varese, Italy
| | | | - G Fiorino
- Istituto Clinico Humanitas, Rozzano (MI), Italy
| | | | - M Giannotta
- Azienda Ospedaliero Universitaria di Careggi, Firenze, Italy
| | | | - M Cicala
- Università Campus Bio Medico, Roma, Italy
| | - S Vadalà di Prampero
- Azienda Ospedaliero-Universitaria S. Maria della Misericordia di Udine, Udine, Italy
| | | | - F Caprioli
- Università degli Studi di Milano, Milano, Italy
| | - A Gasbarrini
- Università Cattolica del Sacro Cuore, Rome, Italy
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14
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Treger RS, Cook AG, Rai G, Maloney DJ, Simeonov A, Jadhav A, Thomas CJ, Williams DL, Cappello M, Vermeire JJ. Oxadiazole 2-oxides are toxic to the human hookworm, Ancylostoma ceylanicum, however glutathione reductase is not the primary target. Int J Parasitol Drugs Drug Resist 2012; 2:171-177. [PMID: 22844653 DOI: 10.1016/j.ijpddr.2012.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hookworm disease, characterized by severe anemia and cognitive and growth delays, currently affects an estimated 740 million people worldwide. Despite the prevalence of this parasitic disease, few effective drug therapies are in use today, and the heavy reliance upon benzimidazoles highlights the need for the development of novel chemotherapies. Recent work with the trematode parasite Schistosoma mansoni has identified oxadiazole 2-oxides as effective antischistosomal compounds that function by targeting and inhibiting the antioxidant enzyme, thioredoxin glutathione reductase. In this study, a related enzyme, glutathione reductase, from the human hookworm Ancylostoma ceylanicum was identified and characterized, and its in vitro activity in the presence of the oxadiazole 2-oxides was analyzed. Ex vivo worm killing assays were also conducted to establish the relationship between a given compound's effect upon worm survival and inhibition of recombinant glutathione reductase (rAceGR). Finally, the in vivo anthelminthic efficacy of furoxan (Fx) was assessed in the hamster model of hookworm infection. The predicted amino acid sequence of AceGR contained a prototypical glutathione reductase active site sequence, but no thioredoxin reductase consensus sequences, suggesting that the glutathione and thioredoxin pathways of A. ceylanicum are distinct. Although ten of the forty-two oxadiazole 2-oxides tested inhibited rAceGR activity by at least fifty percent, and fifteen compounds were toxic to parasites ex vivo, little overlap existed between these two results. We therefore suggest that AceGR is not the primary target of the oxadiazole 2-oxides in effecting parasite death. Lastly, oral treatment of A. ceylanicuminfected hamsters with furoxan resulted in significantly improved weight gains and reduced intestinal worm burdens compared to vehicle treated controls, supporting continued development of this molecule as a novel anthelminthic.
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Affiliation(s)
- R S Treger
- Program in International Child Health and Department of Pediatrics, Yale University School of Medicine, New Haven, CT
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15
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Ouazzani A, Sokolow Y, Hanebaly M, Rondelet B, Patino MR, Remmelink M, Jacobovitz D, Cappello M, Cogan E. [Pulmonary granulomatous necrotizing vasculitis: an extra-intestinal manifestation of ulcerative colitis or Wegener's granulomatosis?]. Rev Med Brux 2011; 32:93-97. [PMID: 21688593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Respiratory symptoms are rare manifestations of ulcerative colitis as well as intestinal manifestations in Wegener granulomatosis. We report the case of a 17-year old man previously diagnosed as having ulcerative colitis who presented with diffuse thoracic pain. Hypermetabolic pulmonary nodules were discovered at the positron emission tomographic scan. Necrotizing granulomatous vasculitis was demonstrated at lung biopsy. In this paper, we describe the association between pulmonary nodules and ulcerative colitis and we discuss the possibility of an overlap syndrome between ulcerative colitis and Wegener granulomatosis.
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Affiliation(s)
- A Ouazzani
- Services de Chirurgie Thoracique, Hôpital Erasme, Bruxelles.
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16
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Abstract
We report a case of a 42-year-old man with a right pleural mesothelioma. This neoplasm has 3 rare features. Firstly, it was a localized form: suspected by imaging, visualized by video-assisted thoracoscopy, at the time of the curative-thoracotomy and confirmed by the pathological analysis. The second characteristic is its histological type: "malignant lymphohistiocytoid mesothelioma". This rare subtype has been reported in only 4 papers. Third, after pleuro-pneumonectomy, our patient is alive after 6 years and 5 months postoperatively without any sign of recurrence. Only one case with a long follow-up has been reported but with recurrence at 5 years postoperatively.
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Affiliation(s)
- A. Ouazzanil
- Departments of Thoracic Surgery, Brussels, Belgium
| | - B. Rondeletl
- Departments of Thoracic Surgery, Brussels, Belgium
| | - Y. Sokolow
- Departments of Thoracic Surgery, Brussels, Belgium
| | | | - M. Remmelink
- Departments of Thoracic Surgery, Brussels, Belgium
| | - M. Cappello
- Departments of Surgical Pathology, Erasme University Hospital, Brussels, Belgium
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Dondji B, Sun T, Bungiro RD, Vermeire JJ, Harrison LM, Bifulco C, Cappello M. CD4 T cells mediate mucosal and systemic immune responses to experimental hookworm infection. Parasite Immunol 2010; 32:406-13. [PMID: 20500671 DOI: 10.1111/j.1365-3024.2010.01204.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Hookworm infection is associated with anaemia and malnutrition in many resource-limited countries. Ancylostoma hookworms have previously been shown to modulate host cellular immune responses through multiple mechanisms, including reduced mitogen-mediated lymphocyte proliferation, impaired antigen presentation/processing, and relative reductions in CD4(+) T cells in the spleen and mesenteric lymph nodes. Syrian hamsters were depleted of CD4(+) for up to 9 days following intraperitoneal injection (200 microg) of a murine anti-mouse CD4 monoclonal IgG (clone GK1.5). CD4(+) T-cell-depleted hamsters infected with the hookworm Ancylostoma ceylanicum exhibited a threefold higher mean intestinal worm burden and more severe anaemia than animals that received isotype control IgG. In addition, depletion of CD4(+) T cells was associated with impaired cellular and humoral (serum and mucosal) immune responses to hookworm antigens. These data demonstrate an effector role for CD4(+) T cells in hookworm immunity and disease pathogenesis. Ultimately, these studies may yield important insights into the relationship between intestinal nematode infections and diseases that are associated with CD4(+) T-cell depletion, including HIV.
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Affiliation(s)
- B Dondji
- Program in International Child Health, Department of Pediatrics, Yale University School of Medicine, New Haven CT, USA
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Licata A, Calvaruso V, Cappello M, Craxì A, Almasio PL. Clinical course and outcomes of drug-induced liver injury: nimesulide as the first implicated medication. Dig Liver Dis 2010; 42:143-8. [PMID: 19625223 DOI: 10.1016/j.dld.2009.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Revised: 06/03/2009] [Accepted: 06/10/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Drug-induced liver injury (DILI) is the most common cause of death from acute liver failure, and accounts for approximately 13% of cases of acute liver failure in the United States. The clinical presentation of DILI covers a wide spectrum, from asymptomatic liver test abnormalities to symptomatic acute liver disease, prolonged jaundice and disability, or overt acute or subacute liver failure. The aim of our study was to evaluate the number of DILI cases admitted to our Unit and to identify the drugs responsible. Thus, we reviewed all clinical records of patients with DILI admitted to our Unit from 1996 to 2006. PATIENTS AND METHODS A database was constructed, reporting demographic, clinical features at onset, laboratory results, suspected drugs and follow-up. Liver damage was defined as hepatocellular, cholestatic or mixed, according to clinical and laboratory data. RESULTS Forty-six patients were admitted with a diagnosis of DILI. Presentation was jaundice in 22 patients and hepatic failure in 3 (all attributed to nimesulide). Liver damage was of a cytolytic pattern in 19 cases (41%), cholestatic in 15 (33%) and mixed in 12 (26%). Jaundice was found to be higher in nimesulide-induced liver damage compared to other drugs (p=0.007). Three out of 14 patients with nimesulide-induced DILI developed encephalopathy and/or ascites. Time of recovery in the nimesulide group was significantly lower than DILI from other drugs (p<0.001). CONCLUSION Non-steroidal anti-inflammatory drugs, psychotropic drugs and antimicrobials are the most common causes of DILI. Nimesulide-induced DILI is usually reversible upon discontinuation of the drug, but occasionally progresses to liver failure.
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Affiliation(s)
- A Licata
- Gastroenterology & Hepatology Unit, Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
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19
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Abstract
A 51-year-old woman with a giant pulmonary artery aneurysm was referred to our department for surgical opinion. Imaging study confirmed a large aneurysmal dilatation of the left pulmonary artery starting in the pulmonary trunk. There was no underlying pathology except for a pulmonary commissurotomy 20 years previously for a significant valvular pulmonary stenosis. The role of surgery in this entity is not well defined. We report the management of one case.
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20
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Kohn A, Daperno M, Armuzzi A, Cappello M, Biancone L, Orlando A, Viscido A, Annese V, Riegler G, Meucci G, Marrollo M, Sostegni R, Gasbarrini A, Peralta S, Prantera C. Infliximab in severe ulcerative colitis: short-term results of different infusion regimens and long-term follow-up. Aliment Pharmacol Ther 2007; 26:747-56. [PMID: 17697208 DOI: 10.1111/j.1365-2036.2007.03415.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Severe ulcerative colitis is a life-threatening disorder, despite i.v. glucocorticoids treatment. Infliximab has been proposed as a safe rescue therapy. AIM To evaluate short- and long-term effectiveness and safety of infliximab in severe refractory ulcerative colitis. METHODS Eighty-three patients with severe ulcerative colitis (i.v. glucocorticoids treatment-refractory) were treated with infliximab in 10 Italian Gastroenterology Units. Patients underwent one or more infusions according to the choice of treating physicians. Short-term outcome was colectomy/death 2 months after the first infusion. Long-term outcome was survival free from colectomy. Safety data were recorded. RESULTS Twelve patients (15%) underwent colectomy within 2 months. One died of Legionella pneumophila infection 12 days after infliximab. Early colectomy rates were higher in patients receiving one infusion (9/26), compared with those receiving two/more infusions (3/57, P = 0.001, OR = 9.53). Seventy patients who survived colectomy and did not experience any fatal complications were followed-up for a median time of 23 months; 58 patients avoided colectomy during the follow-up. Forty-two patients were maintained on immunosuppressive drugs. No clinical features were associated with outcomes. CONCLUSIONS Infliximab is an effective and relatively safe therapy to avoid colectomy and maintain long-term remission for patients with severe refractory ulcerative colitis. In the short term, two or more infusions seem to be more effective than one single infusion.
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Affiliation(s)
- A Kohn
- Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.
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21
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Holland MP, Skelly DK, Kashgarian M, Bolden SR, Harrison LM, Cappello M. Echinostome infection in green frogs (Rana clamitans) is stage and age dependent. J Zool (1987) 2006. [DOI: 10.1111/j.1469-7998.2006.00229.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
In 1997, a large portion of the femur of a four-year-old child affected by a Ewing's sarcoma was reconstructed with an innovative technique that used a massive bone allograft, in conjunction with a vascularised fibula autograft that was directly articulated within the acetabulum. The aim of the present study was to assess the kinematic behaviour of the reconstructed hip during flexion, once the acute remodelling process observed after the operation had ceased. A few additional CT slices of the hip joint region, in a flexed position, were taken at month 33 of the follow-up. The helical axes relative to the neutral-flexion motor action were estimated: their relative positions, with respect to the anatomical femoral heads, were compared, and the translation of the anatomical head centres was estimated. The angles spanned by the two femurs were almost equal, as were the translations along the respective helical axis. The main difference between the two femurs was the distance between the estimated femoral head centres and the relative helical axes. This resulted in a non-negligible translation of 2.9 mm of the fibula head inside the acetabulum during flexion, significantly higher than the 0.5 mm found for the intact contralateral femur. The results showed that, although the transplanted fibula grew and remodelled during the follow up, the action of the reconstructed hip joint still cannot be described as a ball-and-socket.
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Affiliation(s)
- F Taddei
- Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy.
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23
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Vereecken P, Awada A, Devriendt D, Laporte M, Heenen M, Salès F, Cappello M. [Re: innovative therapeutic approaches in melanoma]. Rev Med Brux 2004; 25:S 542. [PMID: 15688894] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- P Vereecken
- Service de Dermatologie, Hôpital Erasme, U.L.B
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Jiang X, Bailly MA, Panetti TS, Cappello M, Konigsberg WH, Bromberg ME. Formation of tissue factor-factor VIIa-factor Xa complex promotes cellular signaling and migration of human breast cancer cells. J Thromb Haemost 2004; 2:93-101. [PMID: 14717972 DOI: 10.1111/j.1538-7836.2004.00545.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Tissue factor (TF) is a transmembrane glycoprotein that initiates blood coagulation when complexed with factor (F)VIIa. Recently, TF has been shown to promote cellular signaling, tumor growth, angiogenesis, and metastasis. In the present study, we examined the pathway by which TF-FVIIa complex induces cellular signaling in human breast cancer cells using the Adr-MCF-7 cell line. This cell line has high endogenous TF expression as measured by flow cytometry and expression of protease-activated receptors 1 and 2 (PAR1 and PAR2) as determined by reverse transcriptase-polymerase chain reaction analysis. Both PAR1 and PAR2 are functionally active as determined by induction of p44/42 mitogen-activated protein kinase (MAPK) phosphorylation using specific agonist peptides. We found that MAPK phosphorylation in this cell line was strongly induced by the combination of FVIIa and factor (F)X, but not by FVIIa alone at a concentration of FVIIa that approaches physiological levels. Induction of MAPK phosphorylation involved the formation of TF-FVIIa-FXa complex and occurred by a pathway that did not require thrombin formation, indicating a critical role for FXa generation. In addition, induction of MAPK phosphorylation was found to be independent of PAR1 activation. We then examined whether TF-FVIIa complex formation could promote tumor cell migration using a modified Boyden chamber chemotaxis assay. The combination of FVIIa and FX, but not FVIIa alone, strongly induced migration of tumor cells by a pathway that probably involves PAR2, but not PAR1 activation. MAPK phosphorylation was found to be required for the induction of cell migration by the combination of FVIIa and FX. These data suggest that TF-FVIIa-mediated signaling in human breast cancer cells occurs most efficiently by formation of the TF-FVIIa-FXa complex. One of the physiological consequences of this signaling pathway is enhanced cell migration that is probably mediated by PAR2, but not PAR1 activation.
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Affiliation(s)
- X Jiang
- Temple University School of Medicine, Sol Sherry Thrombosis Research Center, Philadelphia, PA 19140, USA
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25
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Narasimhan S, Koski RA, Beaulieu B, Anderson JF, Ramamoorthi N, Kantor F, Cappello M, Fikrig E. A novel family of anticoagulants from the saliva of Ixodes scapularis. Insect Mol Biol 2002; 11:641-650. [PMID: 12421422 DOI: 10.1046/j.1365-2583.2002.00375.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Using biochemical and molecular approaches, we have identified a 9.8 kDa protein in the saliva of Ixodes scapularis that inhibits the intrinsic pathway of coagulation. The 9.8 kDa anticoagulant protein was purified by reverse-phase HPLC and its N-terminal amino acid sequence determined. The N-terminal sequence showed homology with Salp14, an immuno-dominant antigen present in the saliva of engorging I. scapularis nymphs. Recombinant Salp14 expressed in Escherichia coli prolonged the activated partial thromboplastin time (APTT) of human plasma in a dose-dependent manner and was a specific inhibitor of factor Xa. A cDNA encoding a 9.3 kDa protein, Salp9Pac, was subsequently isolated from an I. scapularis salivary gland cDNA library. Salp9Pac showed 93% identity to the N-terminal sequence of the anticoagulant purified by HPLC. These data indicate that the anticoagulant protein purified by HPLC, Salp9Pac and Salp14 are members of a family of novel coagulation protease inhibitors present in tick saliva. While recombinant Salp9Pac did not show biological activity in the assays tested currently, it is likely to be mechanistically different from its paralogues. This raises the possibility that ticks may enhance their adaptive ability to cope with a wide spectrum of proteases, by transcribing such structurally related anticoagulant proteins with different functions.
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Affiliation(s)
- S Narasimhan
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8031, USA
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26
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Di Marco V, Ferraro D, Almasio P, Vaccaro A, Parisi P, Cappello M, Cino N, Di Stefano R, Craxì A. Early viral clearance and sustained response in chronic hepatitis C: a controlled trial of interferon and ribavirin after high-dose interferon induction. J Viral Hepat 2002; 9:354-9. [PMID: 12225330 DOI: 10.1046/j.1365-2893.2002.00370.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
High-dose induction with alpha-interferon induces early viral clearance of hepatitis C and combined with ribavirin enhances sustained response. We assess whether adding ribavirin after viral clearance obtained by alpha-interferon induction increased the rate of viral eradication.Forty-one naïve patients with chronic hepatitis C were randomised to receive, after 4 weeks of 10 mU daily of alpha-interferon (induction), 3 mU daily for 22 weeks and 3 mU thrice weekly for 26 weeks of either interferon alone (monotherapy) or interferon plus 1000-1200 mg daily of ribavirin (combination therapy). At the end of the induction phase, 23 (56%) subjects had cleared HCV-RNA. During therapy, breakthrough was observed in four patients on monotherapy, but never in patients on combination therapy. The rate of clearance of HCV-RNA was different between monotherapy and combination therapy at the end of treatment (40% vs. 76.1%, P=0.02) and at the end of follow-up (5% vs. 57.1%, P=0.001). Twelve of the 23 patients who cleared HCV-RNA during induction, but only one of the 18 still HCV-RNA-positive after 4 weeks of therapy, had a sustained response (52.2% vs. 5.6%, P=0.001). Clearance of HCV-RNA at 1 week had a high positive predictive value for sustained response in combination therapy (PPV=0.75), but not in monotherapy (PPV=0.33). Induction with high daily doses of alpha-interferon obtains suppression of hepatitis C in more than half of patients, but ribavirin is needed to maintain a sustained response. The rate of sustained response is a function of the time to HCV-RNA clearance. In patients not responding to induction therapy addition of ribavirin does not obtain a sustained virological response.
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Affiliation(s)
- V Di Marco
- Cattedra di Gastroenterologia, Clinica Medica, University of Palermo, Palermo, Italy.
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Cappello M, de Francquen P. [The thoracic surgery department]. Rev Med Brux 2002; 23 Suppl 2:41-2. [PMID: 12584909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
The Department of Thoracic Surgery has been developed since 40 years, and particularly since 23 years at the Hôpital Erasme. The high rate of lung cancers did induce an important activity in surgical oncology, inside multidisciplinary teams. After a first attempt in 1969, lung transplantation is now successful. Infectious diseases, traumas and functional respiratory defects impose heavy daily charge. Research has been developed in lung transplantation, thyroid metabolism, respiratory mechanics and clinical trial in oncology.
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Harrison LM, Córdova JL, Cappello M. Ancylostoma caninum anticoagulant peptide-5: immunolocalization and in vitro neutralization of a major hookworm anti-thrombotic. Mol Biochem Parasitol 2001; 115:101-7. [PMID: 11377744 DOI: 10.1016/s0166-6851(01)00276-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hookworm infection is a major cause of gastrointestinal blood loss and iron deficiency anemia in the developing world. Recently two major anticoagulant serine protease inhibitors have been identified and cloned from adult Ancylostoma caninum hookworms. One of these, A. caninum anticoagulant peptide 5 (AcAP5), is a potent and specific inhibitor of human coagulation factor Xa. A polyclonal IgG has been purified from rabbits immunized with recombinant AcAP5 using affinity chromatography. Using immunohistochemistry, the polyclonal alpha-rAcAP5 IgG localized to the cephalic or amphidial glands, confirming previous biochemical studies that had identified this secretory gland as the primary source of anticoagulant activity in the adult worm. This polyclonal IgG also neutralized the inhibitory activity of recombinant and native AcAP using a single stage chromogenic assay of coagulation factor Xa activity. In addition, the polyclonal IgG also neutralized the anticoagulant activity of native and recombinant AcAP5 as measured by the activated partial thromboplastin time clotting assay. Importantly, this neutralizing activity is species specific, as the polyclonal IgG failed to neutralize the anticoagulant activity of A. ceylanicum. Taken together, these data suggest that the hookworm anticoagulant AcAP5 represents a viable target for future immunization strategies aimed at inhibiting the ability of the adult hookworm to feed on blood in vivo.
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Affiliation(s)
- L M Harrison
- Infectious Diseases Section, Departments of Pediatrics and Epidemiology and Public Health, Child Health Research Center, Yale University School of Medicine, 06520-8081, New Haven, CT, USA
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Bungiro RD, Greene J, Kruglov E, Cappello M. Mitigation of hookworm disease by immunization with soluble extracts of Ancylostoma ceylanicum. J Infect Dis 2001; 183:1380-7. [PMID: 11294670 DOI: 10.1086/319867] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2000] [Revised: 02/05/2001] [Indexed: 11/03/2022] Open
Abstract
Hookworms are a leading cause of anemia in developing countries, and a strategy aimed at reducing pathology caused by blood-feeding adult parasites would be a valuable addition to global control efforts. This article describes experiments designed to induce resistance to the major clinical sequelae (weight loss and anemia) of Ancylostoma ceylanicum hookworm infection in Syrian golden hamsters of the outbred LVG strain. Previously infected animals acquired long-lived resistance to weight loss and anemia caused by a secondary hookworm infection. Furthermore, transfer of pooled serum from twice-infected hamsters to animals undergoing a primary infection was associated with partial resistance to growth delay and anemia. Active vaccination of hamsters with soluble adult hookworm antigens emulsified in alum led to partial protection from hookworm-associated pathology in the absence of reductions in adult worm burden. This intriguing result may have important implications for human vaccine development.
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Affiliation(s)
- R D Bungiro
- Department of Pediatrics, Infectious Diseases Section, Yale Child Health Research Center, Yale University School of Medicine, New Haven, CT 06520-8081, USA
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30
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Cassart M, Hamacher J, Verbandt Y, Wildermuth S, Ritscher D, Russi EW, de Francquen P, Cappello M, Weder W, Estenne M. Effects of lung volume reduction surgery for emphysema on diaphragm dimensions and configuration. Am J Respir Crit Care Med 2001; 163:1171-5. [PMID: 11316655 DOI: 10.1164/ajrccm.163.5.2006055] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Part of the functional benefit provided by lung volume reduction surgery (LVRS) may be related to improvement in respiratory muscle function resulting from changes in diaphragm dimension and configuration. To study these changes, we obtained 3D reconstructions of the muscle using spiral computed tomography in 11 patients with severe emphysema before and 3 mo after surgery, and in 11 normal subjects matched for sex, age, height, and weight. Bilateral LVRS was performed by thoracoscopy in eight patients and by sternotomy in three patients. Acquisitions were made in the supine posture at relaxed FRC, midinspiratory capacity, and TLC. On average, LVRS produced a 51 +/- 11% increase in FEV(1) and a 30 +/- 4% decrease in FRC. The total surface area of the diaphragm (A(di)) and of the zone of apposition (A(ap)) at FRC increased by 17 +/- 4% and 43 +/- 8%, respectively, but the surface area of the dome did not change. Compared with the values recorded in the normal subjects, postoperative values of A(di) and A(ap) at FRC were reduced by 11% (p < 0.05) and 24% (p < 0.005), respectively. The curvature of the dome increased at TLC in the left sagittal plane, but was otherwise unaffected by the procedure. We conclude that LVRS substantially increases A(di) and A(ap), but does not significantly improve diaphragm configuration at FRC.
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Affiliation(s)
- M Cassart
- Department of Radiology, University Hospital, Zürich, Switzerland
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31
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Milstone AM, Harrison LM, Bungiro RD, Kuzmic P, Cappello M. A broad spectrum Kunitz type serine protease inhibitor secreted by the hookworm Ancylostoma ceylanicum. J Biol Chem 2000; 275:29391-9. [PMID: 10893410 DOI: 10.1074/jbc.m002715200] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although blood-feeding hookworms infect over a billion people worldwide, little is known about the molecular mechanisms through which these parasitic nematodes cause gastrointestinal hemorrhage and iron deficiency anemia. A cDNA corresponding to a secreted Kunitz type serine protease inhibitor has been cloned from adult Ancylostoma ceylanicum hookworm RNA. The translated sequence of the A. ceylanicum Kunitz type inhibitor 1 (AceKI-1) cDNA predicts a 16-amino acid secretory signal sequence, followed by a 68-amino acid mature protein with a molecular mass of 7889 daltons. Recombinant protein (rAceKI-1) was purified from induced lysates of Escherichia coli transformed with the rAceKI-1/pET 28a plasmid, and in vitro studies demonstrate that rAceKI-1 is a tight binding inhibitor of the serine proteases chymotrypsin, pancreatic elastase, neutrophil elastase, and trypsin. AceKI-1 inhibitory activity is present in soluble protein extracts and excretory/secretory products of adult hookworms but not the infective third stage larvae. The native AceKI-1 inhibitor has been purified to homogeneity from soluble extracts of adult A. ceylanicum using size exclusion and reverse-phase high pressure liquid chromatography. As a potent inhibitor of mammalian intestinal proteases, AceKI-1 may play a role in parasite survival and the pathogenesis of hookworm anemia.
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Affiliation(s)
- A M Milstone
- Infectious Diseases Section, Yale Child Health Research Center, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8081, USA
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Abstract
Surgical treatment of lung metastases from melanoma is highly controversial as the expected outcome is much poorer than for other primary tumours and a reliable system for selecting patients is lacking. This study evaluated the long-term results of lung metastasectomy for melanoma, with the aim of defining a subset of patients with better prognosis. By reviewing the data of the International Registry of Lung Metastases (IRLM), we identified 328 patients who underwent lung metastasectomy for melanoma in the period 1945-1995. Survival was calculated by Kaplan-Meier estimate, using log-rank test and Cox regression model for statistical analysis. After complete pulmonary metastasectomy (282 patients) the 5- and 10-year survival was 22% and 16%, respectively. In this group of patients, a time to pulmonary metastases (TPM) shorter than 36 months or the presence of multiple metastases were independent unfavourable prognostic factors. There were no long-term survivors after incomplete resection (46 patients, P< 0.01). Using the IRLM grouping system, patients without risk factors (TPM > 36 months and single lesion) experienced the best survival (29% at 5 years), followed by those with one risk factor only (20% at 5 years). On the other hand, those with two risk factors or incomplete resection showed a significantly poorer survival (7% and 0% at 5 years). Surgery plays an important role in carefully selected cases of pulmonary metastatic melanoma. The prognostic grouping system proposed by the International Registry of Lung Metastases provides a simple and effective method for improving the selection of surgical candidates.
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Affiliation(s)
- F Leo
- Department of Thoracic Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
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Abstract
The interactions between the different rib cage inspiratory muscles in the generation of pleural pressure remain largely unknown. In the present study, we have assessed in dogs the interactions between the parasternal intercostals and the interosseous intercostals situated on the right and left sides of the sternum. For each set of muscles, the changes in airway opening pressure (DeltaPao) obtained during separate right and left activation were added, and the calculated values (predicted DeltaPao) were then compared with the DeltaPao values obtained during symmetric, bilateral activation (measured DeltaPao). When the parasternal intercostals in one or two interspaces were activated, the measured DeltaPao was commonly greater than the predicted value. The difference, however, was only 10%. When the interosseous intercostals were activated, the measured DeltaPao was nearly equal to the predicted value. These observations strengthen our previous conclusion that the pressure changes produced by the rib cage inspiratory muscles are essentially additive. As a corollary, the rib cage can be considered as a linear elastic structure over a wide range of distortion.
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Affiliation(s)
- M Cappello
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, and Chest Service, Erasme University Hospital, 1070 Brussels, Belgium
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34
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Cappello M. Voices in the outer room. J Lesbian Stud 2000; 4:41-58. [PMID: 24802682 DOI: 10.1300/j155v04n04_04] [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] [Indexed: 06/03/2023]
Abstract
SUMMARY An argument (in the form of a demonstration) for the development of a queer aesthetic, the essay asks whether it is our charge as lesbian writers to hold a mirror up to our experience, to "self-disclose" (so often such narratives change nothing but succeed in flattening our lives), or to find the form that will answer to queer habits of being, radical sensibilities and ideologies. The essay takes three different liminal spaces as its ground-a sickroom, a conversation on an airplane, and a Catholic confessional-to explore my own aesthetic process, the role played by randomness and interruption in that process, the complex presence of external and internalized (dis)embodied voices in my self-writing, and the desire through my work to create what I call "disruptive beauty."
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Bromberg ME, Cappello M. Cancer and blood coagulation: molecular aspects. Cancer J Sci Am 1999; 5:132-8. [PMID: 10367166] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- M E Bromberg
- Department of Internal Medicine, Yale University, School of Medicine, New Haven, Connecticut 06520, USA
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36
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Chadderdon RC, Cappello M. The hookworm platelet inhibitor: functional blockade of integrins GPIIb/IIIa (alphaIIbbeta3) and GPIa/IIa (alpha2beta1) inhibits platelet aggregation and adhesion in vitro. J Infect Dis 1999; 179:1235-41. [PMID: 10191228 DOI: 10.1086/314724] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Hookworms, aggressive, blood-feeding, intestinal nematodes, are currently a leading cause of iron deficiency anemia in the developing world. An inhibitor of platelet aggregation and adhesion has been partially purified and characterized from soluble protein extracts of adult Ancylostoma caninum hookworms. This protein, named the hookworm platelet inhibitor, has an estimated molecular mass of 15 kDa as determined by size-exclusion chromatography. In addition to blocking platelet aggregation in response to a variety of agonists, the partially purified inhibitor also prevents adhesion of resting platelets to immobilized fibrinogen and collagen. Inhibitory monoclonal antibodies were used to identify specific blockade of cell surface integrins GPIIb/IIIa (alphaIIbbeta3) and GPIa/IIa (alpha2beta1), the platelet receptors for fibrinogen and collagen, respectively. This broad-spectrum anti-platelet activity is also present in excretory and secretory products of adult worms, suggesting a biologic role for the hookworm platelet inhibitor in vivo.
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37
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Abstract
We have previously developed a canine model of isolated flail chest to assess the effects of this condition on the mechanics of breathing, and these studies have led to the conclusion that the respiratory displacement of the fractured ribs is primarily determined by the fall in pleural pressure (Delta Ppl) and the action of the parasternal intercostal muscles. The present studies were designed to test the validity of this conclusion. A flail was induced in six supine anesthetized animals by fracturing both dorsally and ventrally the second to fifth ribs on the right side of the chest, after which the phrenic nerve roots were bilaterally sectioned in the neck. Sectioning the phrenic nerves caused a 34% decrease in Delta Ppl, associated with a 39% increase in parasternal intercostal inspiratory EMG activity (p < 0.05), and resulted in a marked reduction in the inspiratory inward displacement of the ribs. In three animals, the inward rib displacement was even reversed into a small outward displacement. When the airway was then occluded at end-expiration to increase Delta Ppl during the subsequent inspiration, all animals again showed a clear-cut inward rib displacement. These observations therefore confirm that in dogs with flail chest, the inspiratory displacement of the fractured ribs is set by the balance between the force related to pleural pressure and that generated by the parasternal intercostals. These observations also point to the critical importance of the pattern of inspiratory muscle activation in determining the magnitude of rib cage paradox in such patients.
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Affiliation(s)
- M Cappello
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, and Departments of Chest Medicine and Surgery, Erasme University Hospital, Brussels, Belgium
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38
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Byl B, Jacobs F, Roucloux I, de Franquen P, Cappello M, Thys JP. Penetration of meropenem in lung, bronchial mucosa, and pleural tissues. Antimicrob Agents Chemother 1999; 43:681-2. [PMID: 10049288 PMCID: PMC89181 DOI: 10.1128/aac.43.3.681] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Lung, bronchial mucosa, and pleural tissue samples were obtained from 14 patients undergoing lung surgery 1 to 5 h after administration of 1 g of meropenem. The mean (range) peak concentrations of meropenem were 3.9 (0.2 to 8.2), 6.6 (3.0 to 13.3), and 2.8 (0.6 to 7.8) mg/kg of tissue, respectively, exceeding the MICs at which 90% of isolates are inhibited for most respiratory pathogens.
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Affiliation(s)
- B Byl
- Infectious Diseases Clinic, Erasme Hospital, Université Libre de Bruxelles, Belgium.
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39
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Cappello M, Li S, Chen X, Li CB, Harrison L, Narashimhan S, Beard CB, Aksoy S. Tsetse thrombin inhibitor: bloodmeal-induced expression of an anticoagulant in salivary glands and gut tissue of Glossina morsitans morsitans. Proc Natl Acad Sci U S A 1998; 95:14290-5. [PMID: 9826693 PMCID: PMC24366 DOI: 10.1073/pnas.95.24.14290] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The tsetse thrombin inhibitor, a potent and specific low molecular mass (3,530 Da) anticoagulant peptide, was purified previously from salivary gland extracts of Glossina morsitans morsitans (Diptera: Glossinidae). A 303-bp coding sequence corresponding to the inhibitor has now been isolated from a tsetse salivary gland cDNA library by using degenerate oligonucleotide probes. The full-length cDNA contains a 26-bp untranslated segment at its 5' end, followed by a 63-bp sequence corresponding to a putative secretory signal peptide. A 96-bp segment codes for the mature tsetse thrombin inhibitor, whose predicted molecular weight matches that of the purified native protein. Based on its lack of homology to any previously described family of molecules, the tsetse thrombin inhibitor appears to represent a unique class of naturally occurring protease inhibitors. Recombinant tsetse thrombin inhibitor expressed in Escherichia coli and the chemically synthesized peptide are both substantially less active than the purified native protein, suggesting that posttranslational modification(s) may be necessary for optimal inhibitory activity. The tsetse thrombin inhibitor gene, which is present as a single copy in the tsetse genome, is expressed at high levels in salivary glands and midguts of adult tsetse flies, suggesting a possible role for the anticoagulant in both feeding and processing of the bloodmeal.
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Affiliation(s)
- M Cappello
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510, USA
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40
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Donnelly KM, Bromberg ME, Milstone A, Madison McNiff JM, Terwilliger G, Konigsberg WH, Cappello M. Ancylostoma caninum anticoagulant peptide blocks metastasis in vivo and inhibits factor Xa binding to melanoma cells in vitro. Thromb Haemost 1998; 79:1041-7. [PMID: 9609244] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We evaluated the in vivo anti-metastatic activity of recombinant Ancylostoma caninum Anticoagulant Peptide (rAcAP), a potent (Ki = 265 pM) and specific active site inhibitor of human coagulation factor Xa originally isolated from bloodfeeding hookworms. Subcutaneous injection of SCID mice with rAcAP (0.01-0.2 mg/mouse) prior to tail vein injection of LOX human melanoma cells resulted in a dose dependent reduction in pulmonary metastases. In order to elucidate potential mechanisms of rAcAP's anti-metastatic activity, experiments were carried out to identify specific interactions between factor Xa and LOX. Binding of biotinylated factor Xa to LOX monolayers was both specific and saturable (Kd = 15 nM). Competition experiments using antibodies to previously identified factor Xa binding proteins, including factor V/Va, effector cell protease receptor-1, and tissue factor pathway inhibitor failed to implicate any of these molecules as significant binding sites for Factor Xa. Functional prothrombinase activity was also supported by LOX, with a half maximal rate of thrombin generation detected at a factor Xa concentration of 2.4 nM. Additional competition experiments using an excess of either rAcAP or active site blocked factor Xa (EGR-Xa) revealed that most of the total factor Xa binding to LOX is mediated via interaction with the enzyme's active site, predicting that the vast majority of cell-associated factor Xa does not participate directly in thrombin generation. In addition to establishing two distinct mechanisms of factor Xa binding to melanoma, these data raise the possibility that rAcAP's antimetastatic effect in vivo might involve novel non-coagulant pathways, perhaps via inhibition of active-site mediated interactions between factor Xa and tumor cells.
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Affiliation(s)
- K M Donnelly
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
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41
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Bardoczky GI, d'Hollander AA, Cappello M, Yernault JC. Interrupted expiratory flow on automatically constructed flow-volume curves may determine the presence of intrinsic positive end-expiratory pressure during one-lung ventilation. Anesth Analg 1998; 86:880-4. [PMID: 9539619 DOI: 10.1097/00000539-199804000-00037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
UNLABELLED We studied patients undergoing elective pulmonary surgery to establish whether observing interrupted expiratory flow (IEF) on the flow-volume curves constructed by the Ultima SV respiratory monitor is a reliable way to identify patients with dynamic pulmonary hyperinflation and intrinsic positive end-expiratory pressure (PEEPi). Patients' tracheas were intubated with a double-lumen endotracheal tube and ventilated with a Siemens 900C constant flow ventilator. In 30 patients, PEEPi was determined by the end-expiratory occlusion (EEO) method during the periods of two-lung and one-lung ventilation in the lateral position. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of the IEF method were calculated. From the 122 measurement pairs, PEEPi was identified with the EEO method in 65 occasions. The mean level of PEEPi was 4.4 cm H2O. During one-lung ventilation, the level of PEEPi and the number of true-positive findings was significantly higher (PEEPi = 4.7 cm H2O and 32 episodes) than during two-lung ventilation (2.9 cm H2O and 19 episodes). When the level of PEEPi was higher than 5 cm H2O, the predictive value of IEF was 100%. The overall sensitivity of the IEF method was 0.78, its specificity was 0.91, and its predictive value was 0.92. In conclusion, examination of the flow-volume curves displayed on the respiratory monitor may identify patients with dynamic hyperinflation and PEEPi during anesthesia for thoracic surgery. IMPLICATIONS To identify patients with intrinsic positive end-expiratory pressure during anesthesia without the need to interrupt mechanical ventilation, the flow-volume curves of an online respiratory monitor may be examined. The presence of an interrupted expiratory flow may suggest the presence of intrinsic positive end-expiratory pressure with a reasonable accuracy.
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Affiliation(s)
- G I Bardoczky
- Department of Anesthesiology, Erasme University Hospital, Free University of Brussels, Belgium
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42
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Affiliation(s)
- M Cappello
- Yale University School of Medicine, New Haven, CT, USA
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43
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Canepari M, Bove M, Maeda E, Cappello M, Kawana A. Experimental analysis of neuronal dynamics in cultured cortical networks and transitions between different patterns of activity. Biol Cybern 1997; 77:153-162. [PMID: 9323864 DOI: 10.1007/s004220050376] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Experimental investigation of the dynamics of biological networks is a fundamental step towards understanding how the nervous system works. Spontaneous activity in cultured networks of cortical neurons has been investigated by using a multisite recording technique with planar electrode arrays. In these networks, the spatiotemporal firing patterns were studied in the presence of different extracellular solutions. Transitions from asynchronous firing dynamics to synchronous firing dynamics were observed when the extracellular Ca2+ concentration was increased from 0.1 mM to 1 mM. Addition of extracellular Mg2+ reduced the spontaneous activity at any Ca2+ concentration, and an increase in the extracellular K+ concentration enhanced the frequency of periodical synchronous bursts. N-methyl-D-aspartate (NMDA) and non-NMDA glutamate receptor antagonists inhibited synchronous activity. A spatiotemporal analysis of the data has been performed, and the properties of the network such as the synchronization and the periodicity have been quantified in order to clarify how variations of intrinsic parameters of the network can induce structural transitions in the neural dynamics. This experimental study is a possible approach to investigate the computational properties of a neuronal network.
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Affiliation(s)
- M Canepari
- Biophysics Laboratory, International School for Advanced Studies, Trieste, Italy.
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44
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Abstract
We have previously shown in dogs that the ribs in flail chest move paradoxically inward during inspiration but continue to move cranially. We have also shown that flail elicits, probably via an increased activation of the muscle spindles, a threefold to fourfold increase in external intercostal inspiratory EMG activity without inducing any changes in parasternal intercostal activity. Therefore, the present studies were undertaken to test the hypothesis that the persistent cranial motion of the fractured ribs resulted primarily from the action of the external intercostals. A flail was induced in seven supine anesthetized animals by fracturing both dorsally and ventrally ribs 3 to 6 on the right side of the chest, after which the external intercostal muscles in interspaces 1 to 7 were severed. Severing the external intercostals caused a small increase in the inspiratory inward displacement of the fractured ribs, from 2.76 +/- 0.31 to 3.25 +/- 0.38 mm (p < 0.05), but it did not affect the parasternal intercostal EMG activity or the cranial rib displacement (before, 3.61 +/- 1.03 mm; after, 3.22 +/- 1.43 mm; NS). However, when the parasternal intercostals in interspaces 1 to 7 were also denervated, the inspiratory inward displacement of the ribs increased markedly to 5.95 +/- 0.48 mm (p < 0.01), and their inspiratory cranial displacement was reversed into a 1.05 +/- 0.58 mm inspiratory caudal displacement (p < 0.01). We conclude, therefore, that in dogs with flail chest the respiratory displacements of the ribs are still primarily determined, besides pleural pressure, by the action of the parasternal intercostals. These observations also suggest that in anesthetized dogs, spindle-induced excitation of the external intercostals has little impact on the mechanical behavior of the ribs.
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Affiliation(s)
- M Cappello
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, Belgium
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45
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Abstract
Anthelminthic drug chemotherapy has failed as an acceptable approach to hookworm control in the less developed countries of the tropics. The development of a genetically engineered vaccine against hookworm infection would be a major advance in our efforts to control this parasitic disease. We have produced several lead recombinant hookworm vaccine antigens. Their development is based on scientific principles that were generated almost 70 years ago when investigators first began to attenuate living infective hookworm larvae. Those early studies on attenuated live vaccines highlighted the importance of secreted larval antigens for eliciting protective immunity in dogs challenged with Ancylostoma caninum. The two major secreted larval antigens have been recently identified as Ancylostoma secreted protein-1 (ASP-1) and ASP-2. The predicted amino acid sequences of the ASP cDNAs together with experimental immunogenicty data using the expressed recombinant protein suggest that the ASPs are promising vaccine antigens. Preliminary hookworm challenge data in mice immunized with recombinant ASP-1 helps to validate this assumption. Alternative vaccines based on either genetic immunization (DNA vaccines) or immunization with recombinant molecules expressed from adult hookworm cDNAs are also under evaluation. Optimization of vaccine route, delivery system, and adjuvant formulations will be required before future planned phase I testing in humans. Vaccine development for a target population living in rural areas of less developed countries will require innovative solutions to financing and manufacture.
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Affiliation(s)
- P J Hotez
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520, USA
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46
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Affiliation(s)
- J M Dumonceau
- Department of Gastroenterology and Hepatopancreatology, Erasme University Hospital, Bruxelles, Belgium
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47
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Cappello M, Hawdon JM, Jones BF, Kennedy WP, Hotez PJ. Ancylostoma caninum anticoagulant peptide: cloning by PCR and expression of soluble, active protein in E. coli. Mol Biochem Parasitol 1996; 80:113-7. [PMID: 8885227 DOI: 10.1016/0166-6851(96)02658-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Ancylostoma caninum Anticoagulant Peptide (AcAP) is the major anticoagulant activity present in extracts of adult Ancylostoma caninum hookworms. This 8.7 kDa protein is a potent and specific inhibitor of human coagulation factor Xa. Using PCR, we have isolated a cDNA encoding for AcAP from an adult A. caninum cDNA library. The 5' end of the AcAP cDNA was identified by reverse transcription PCR (RT-PCR) using A. caninum cDNA and a 5' primer corresponding to a nematode spliced leader sequence. The AcAP cDNA was expressed in E. coli using a prokaryotic expression vector, and the recombinant fusion protein (rAcAP) was purified to homogeneity using nickel resin affinity chromatography and reverse phase HPLC. Purified rAcAP is comparable to the native protein in inhibitor activity, with an apparent equilibrium inhibitory dissociation constant (Ki*) for the inhibition of factor Xa of 265 +/- 71 pM. The purified protein also prolongs the prothrombin and partial thromboplastic times of human plasma in a dose dependent manner.
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Affiliation(s)
- M Cappello
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA
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Bardoczky GI, Yernault JC, Engelman EE, Velghe CE, Cappello M, Hollander AA. Intrinsic positive end-expiratory pressure during one-lung ventilation for thoracic surgery. The influence of preoperative pulmonary function. Chest 1996; 110:180-4. [PMID: 8681625 DOI: 10.1378/chest.110.1.180] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To detect and to quantify intrinsic positive end-expiratory pressure (PEEPi) during thoracic surgery in the dependent lung of patients intubated with a double-lumen endotracheal tube (DLT) in the lateral position. METHODS Twenty consecutive patients undergoing elective pulmonary resection were anesthetized, paralyzed, and intubated with a DLT. Their lungs were ventilated (Siemens Servo 900 C ventilator; Siemens Elevna; Solna, Sweden) with constant inspiratory flow. Fraction of inspired oxygen, tidal volume (10 mL/kg), frequency (10/min), and inspiratory time/total time (0.33) were kept constant during the study. PEEPi and ventilatory data were measured in the dependent lung in the supine then in the lateral position with a closed hemithorax. The obtained data were analyzed according to the presence (group PH) or absence (group N) of pulmonary hyperinflation determined from the preoperative pulmonary function data as higher than 120% of predicted value of functional residual capacity (FRC) and residual volume (RV). DATA ANALYSIS In the dependent lung of patients in group PH (n = 11), PEEPi was present in the supine (n = 8) and in the lateral (n = 11) positions in the range of 1 to 10 cm H2O. In group N (n = 9), PEEPi was detected in one patient and only in the supine position. In the whole group of 20 patients, the preoperative value of FRC (% predicted) and RV (% predicted) was statistically significantly correlated to the presence of PEEPi, whereas the preoperative FEV1 (% predicted) was poorly related to PEEPi in both positions. There was no significant correlation between the value of PaCO2 and PEEPi during one-lung ventilation (OLV) but patients in group PH had a significantly higher PaCO2 during OLV than group N (p = 0.012). CONCLUSIONS In patients with chronic obstructive lung disease and pulmonary hyperinflation, PEEPi occurs commonly during the period of OLV and only occasionally in patients with normal lungs. As the ventilatory pattern, the size of DLT, and the side of surgery were similar in the two groups of patients, we conclude that the occurrence of PEEPi in our patients was influenced mainly by the preexisting pulmonary hyperinflation and airflow obstruction.
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Affiliation(s)
- G I Bardoczky
- Department of Anesthesiology, Erasme University Hospital, Free University of Brussels, Belgium
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Abstract
We have previously shown that flail chest in the dog causes an inspiratory inward displacement of the ribs and an increased inspiratory activity in the external intercostal muscles, and we have speculated that this increased activity is due to an increased spindle afferent activity. The present studies were designed to test this hypothesis. Twenty-nine supine anesthetized dogs were studied, and flail was produced surgically by fracturing ventrally and dorsally two to four contiguous ribs on the right side of the chest. Although flail elicited an increased inspiratory activity in the external intercostal and levator costae muscles in the disconnected segment of the rib cage, it did not alter the inspiratory activity in the diaphragm and parasternal intercostals. Expiratory activity in the triangularis sterni, internal intercostals, and transversus abdominis remained unchanged also, as did the inspiratory activity in the external intercostals on the left side of the chest. After flail, the normal inspiratory shortening of the external intercostal muscles in the disconnected segment was also reversed into an inspiratory muscle lengthening. However, when the fractured ribs were connected to the adjacent ribs so that the external intercostals were prevented from lengthening during inspiration, external intercostal and levator costae inspiratory activity was unaltered. These observations support the hypothesis that the increased external intercostal muscle activity seen in flail chest results primarily from an increased activation of the muscle spindles.
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Affiliation(s)
- M Cappello
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, Belgium
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Cappello M, Bergum PW, Vlasuk GP, Furmidge BA, Pritchard DI, Aksoy S. Isolation and characterization of the tsetse thrombin inhibitor: a potent antithrombotic peptide from the saliva of Glossina morsitans morsitans. Am J Trop Med Hyg 1996; 54:475-80. [PMID: 8644901 DOI: 10.4269/ajtmh.1996.54.475] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A potent and specific inhibitor of the human coagulation protease thrombin was identified in salivary gland extracts of the tsetse fly, Glossina morsitans morsitans, an important vector of African trypanosomiasis. This low molecular weight peptide (MW = 3,530 Da as determined by laser desorption mass spectrometry) was purified using a combination of size-exclusion chromatography and reverse-phase, high-performance liquid chromatography, respectively. Amino terminal sequencing of the purified protein reveals no homology to any previously identified serine protease inhibitor or naturally occurring anticoagulant. The tsetse thrombin inhibitor (TTI) is a stoichiometric inhibitor of thrombin, with an apparent equilibrium dissociation inhibitory constant (Ki*) [corrected] of 584 x 10(-15)M. In addition, it is also a potent inhibitor of thrombin-induced platelet aggregation. Like other hematophagous arthropods, tsetse flies appear to have evolved a novel protease inhibitor capable of antagonizing host hemostasis and facilitating blood feeding.
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Affiliation(s)
- M Cappello
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
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