Clinical outcome of latissimus dorsi tendon transfer and partial cuff repair in irreparable postero-superior rotator cuff tear

Background and purpose Irreparable rotator cuff tears are a common cause of pain in adult population, requiring in many cases a surgical treatment. Possible alternatives are debridement, partial repair, muscle transfers and joint replacement. We evaluated two groups of patients with irreparable rotator cuff tear treated surgically: one group received an arthroscopic-assisted latissimus dorsi tendon transfer (LDTT), and the other an arthroscopic rotator cuff partial repair. Aim of our study was to compare clinical results and quality of life in two groups of patients with massive irreparable rotator cuff tear: one receiving an arthroscopic LDTT and the other receiving an arthroscopic rotator cuff partial repair. Methods Forty patients were assigned to two groups: 20 patients to group TT treated with LDTT and 20 patients to group PR treated with a partial repair. The average follow-up duration was 2.8 years (1\u20135, SD 3). Pre- and postoperative modified UCLA shoulder score, ROM, measurement of the strength and the rotator cuff quality of life (RC-QOL) were used to asses the outcome. Results LDTT showed significative improvements when compared to partial repair in UCLA score results, strength and RC-QOL questionnaire. No differences were found between the groups in pain relief. Conclusion Both techniques are effective in reducing patients\u2019 symptoms. We believe that in younger, high-demanding patients with no or mild osteoarthritis, the LDTT represents a valid treatment option with better modified UCLA score improvement and strength at our follow-up

PET/MRI in prostate cancer: a systematic review and meta-analysis

Aim: In recent years, the clinical availability of scanners for integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) has enabled the practical potential of multimodal, combined metabolic-receptor, anatomical, and functional imaging to be explored. The present systematic review and meta-analysis summarize the diagnostic information provided by PET/MRI in patients with prostate cancer (PCa). Materials and methods: A literature search was conducted in three different databases. The terms used were \u201ccholine\u201d or \u201cprostate-specific membrane antigen - PSMA\u201d AND \u201cprostate cancer\u201d or \u201cprostate\u201d AND \u201cPET/MRI\u201d or \u201cPET MRI\u201d or \u201cPET-MRI\u201d or \u201cpositron emission tomography/magnetic resonance imaging.\u201d All relevant records identified were combined, and the full texts were retrieved. Reports were excluded if (1) they did not consider hybrid PET/MRI; or (2) the sample size was < 10 patients; or (3) the raw data were not enough to enable the completion of a 2 7 2 contingency table. Results: Fifty articles were eligible for systematic review, and 23 for meta-analysis. The pooled data concerned 2104 patients. Initial disease staging was the main indication for PET/MRI in 24 studies. Radiolabeled PSMA was the tracer most frequently used. In primary tumors, the pooled sensitivity for the patient-based analysis was 94.9%. At restaging, the pooled detection rate was 80.9% and was higher for radiolabeled PSMA than for choline (81.8% and 77.3%, respectively). Conclusions: PET/MRI proved highly sensitive in detecting primary PCa, with a high detection rate for recurrent disease, particularly when radiolabeled PSMA was used

Variación de las realizaciones de /θs/ en el sociolecto bajo de la ciudad de Sevilla: datos de PRESEEA-SE

En la ciudad de Sevilla conviven en la actualidad dos subsistemas consonánticos en los que se combinan la reducción fonológica en /θs/, resultado dialectal originario, de carácter innovador, y la oposición /s/:/θ/, característica de las variedades septentrionales. En este trabajo nos centramos en las realizaciones de /θs/ en hablantes sevillanos con grado de instrucción bajo, utilizando para ello los materiales de PRESEEA-SE. Las variantes localizadas fueron, en orden de frecuencia decreciente: [s] (patrón de seseo), [θ] (patrón de ceceo) y [h] (patrón de jejeo). Su análisis, en contraste con los resultados conservadores de /s/→[s] : /θ/→[θ] y teniendo en cuenta las variables de edad y sexo, nos ha llevado a las siguientes conclusiones: 1) el seseo, modelo de prestigio en el andaluz occidental, es la pauta preferida en este grupo poblacional, especialmente entre los hombres de menor edad; 2) el ceceo es una patrón minoritario y poco prestigioso, sin resultados en el sociolecto alto y con mayor pervivencia en los sujetos del tercer grupo etario; 3) el jejeo, que obtuvo índices de frecuencia bajos, está especialmente asociado a palabras específicas y al habla de los varones.Nowadays there are two consonant subsystems coexisting in Seville city that combine phonological reduction in /θs/, original dialectal result, as an innovative feature; and the opposition /s/:/θ/, characteristic of the northern varieties. This paper focuses on the phonetic realization of /θs/ among a sample of twenty-four Sevillian low-level speakers, taken from PRESEEASE corpus. For this purpose, we considered the variables of age and gender. Three variants were identified, in descending order of frequency: [s] (seseo pattern), [θ] (ceceo pattern) and [h] (jejeo pattern). The analysis of these trends, as opposed to the conservative realizations of /s/→[s]: /θ/→[θ], shows that: 1) seseo, a prestigious parameter in Western Andalusia, was preferred by this population segment, especially younger men; 2) ceceo, a minority and less prestigious pattern, and with no results among the high-level people, was produced by the third age group subjects; 3) jejeo, which obtained low-frequency indices, was mainly related to specific words and male speakers

Sexual Dimorphism in Cellular and Molecular Features in Human ACTH-Secreting Pituitary Adenomas.

Background. Cushing\u2019s disease presents gender disparities in prevalence and clinical course. Little is known, however, about sexual dimorphism at the level of the corticotrope adenoma itself. The aim of the present study was to evaluate molecular features of ACTH-secreting pituitary adenomas collected from female and male patients with Cushing\u2019s disease. (2) Methods. We analyzed 153 ACTH-secreting adenomas collected from 31 men and 122 women. Adenomas were established in culture and ACTH synthesis and secretion assessed in basal conditions as well as during incubation with CRH or dexamethasone. Concurrently, microarray analysis was performed on formalin-fixed specimens and differences in the expression profiles between specimens from male and female patients identified. (3) Results. ACTH medium concentrations in adenomas obtained from male patients were significantly lower than those observed in adenomas from female patients. This could be observed for baseline as well as modulated secretion. Analysis of corticotrope transcriptomes revealed considerable similarities with few, selected differences in functional annotations. Differentially expressed genes comprised genes with known sexual dimorphism, genes involved in tumour development and genes relevant to pituitary pathophysiology. (4) Conclusions. Our study shows for the first time that human corticotrope adenomas present sexual dimorphism and underlines the need for a gender-dependent analysis of these tumours. Differentially expressed genes may represent the basis for gender-tailored target therapy

An incidental pancreatic finding at 18F-choline PET/CT: Chronic mass-forming pancreatitis

We present a case of a chronic mass-forming pancreatitis (CMFP) detected by 18F-choline (FCH) PET/CT in a male affected by prostate cancer. FCH PET/CT scan showed a focal uptake in the uncinate process of the pancreas, later diagnosed as a CMFP at biopsy. Although the physiological distribution of FCH in the pancreas, a careful interpretation of the images in this area is warranted

Role of the ubiquitin/proteasome system on ACTH turnover in rat corticotropes

Purpose: A large number of studies has investigated proopiomelanocortin processing in anterior pituitary corticotropes but little is known on proopiomelanocortin/ACTH degradation within these cells. The ubiquitin-proteasome system is an intracellular protein degradation pathway which has garnered considerable interest in recent times, given its role in maintenance of protein homeostasis. Aim of the present study was to evaluate the role of the ubiquitin-proteasome system in proopiomelanocortin/ACTH turnover in pituitary corticotropes. Methods: Rat anterior pituitary primary cultures were treated with 0.01\u2013100 nM MG132, a proteasome inhibitor, or 0.1\u2013100 nM K48R, an inhibitor of polyubiquitylation, for 4 and 24 h and ACTH concentrations in medium and cell lysates estimated by immunometric assay. Co-immunoprecipitation for ubiquitin and ACTH was carried out to establish ubiquitin-tagged protein products. Results: Inhibition of proteasome-mediated degradation with MG132 lead to an increase in ACTH concentrations, both as regards secretion and cell content. Likewise, inhibition of polyubiquitylation was associated with increased ACTH secretion and cell content. Ubiquitin/ACTH co-immunoprecipitation revealed that proopiomelanocortin was a target of ubiquitylation. Conclusions: We provide the first evidence that the ubiquitin-proteasome system is involved in proopiomelanocortin/ACTH degradation in corticotropes. Indeed, proopiomelanocortin is a target of ubiquitylation and modulation of ubiquitin-proteasome system affects ACTH turnover. This study shows that regulation of ACTH proteolytic degradation may represent a means to control ACTH secretion

Gene expression profiling in human corticotrope tumors reveals distinct, neuroendocrine profiles

ACTH-secreting pituitary adenomas give rise to a severe endocrinological disorder, i.e., Cushing's disease, with multifaceted clinical presentation and treatment outcomes. Experimental studies suggested that disease variability is inherent to the pituitary tumor, thus pointing to the need for further studies into tumor biology. Aim of the present study was to evaluate transcriptome expression pattern in a large series of ACTH-secreting pituitary adenoma specimens, in order to identify molecular signatures of these tumors. Gene expression profiling of formalin-fixed paraffin-embedded specimens from 40 human ACTH-secreting pituitary adenomas revealed significant expression of genes involved in protein biosynthesis and ribosomal function, in keeping with neuroendocrine cell profile. Unsupervised cluster analysis identified three distinct gene profile clusters and several genes were uniquely overexpressed in a given cluster, accounting for different molecular signatures. Of note, gene expression profiles were associated with clinical features such as age and size of the tumor. Altogether, our study shows that corticotrope tumors are characterized by neuroendocrine gene expression profile and present subgroup-specific molecular features

Ubiquitin-Specific Protease 8 Mutant Corticotrope Adenomas Present Unique Secretory and Molecular Features and Shed Light on the Role of Ubiquitylation on ACTH Processing

Background: Somatic mutations in the ubiquitin-specific protease 8 (USP8) gene have recently been shown to occur in ACTH-secreting pituitary adenomas, thus calling attention to the ubiquitin system in corticotrope adenomas. Objectives: Assess the consequences of USP8 mutations and establish the role of ubiquitin on ACTH turnover in human ACTH-secreting pituitary adenomas. Methods: USP8 mutation status was established in 126 ACTH-secreting adenomas. Differences in ACTH secretion and POMC expression from adenoma primary cultures and in microarray gene expression profiles from archival specimens were sought according to USP8 sequence. Ubiquitin/ACTH coimmunoprecipitation and incubation with MG132, a proteasome inhibitor, were performed in order to establish whether ubiquitin plays a role in POMC/ACTH degradation in corticotrope adenomas. Results: USP8 mutations were identified in 29 adenomas (23%). Adenomas presenting USP8 mutations secreted greater amounts of ACTH and expressed POMC at higher levels compared to USP wild-type specimens. USP8 mutant adenomas were also more sensitive to modulation by CRH and dexamethasone in vitro. At microarray analysis, genes associated with endosomal protein degradation and membrane components were downregulated in USP8 mutant adenomas as were AVPR1B, IL11RA, and PITX2. Inhibition of the ubiquitin-proteasome pathway increased ACTH secretion and POMC itself proved a target of ubiquitylation, independently of USP8 sequence status. Conclusions: Our study has shown that USP8 mutant ACTH-secreting adenomas present a more "typical" corticotrope phenotype and reduced expression of several genes associated with protein degradation. Further, ubiquitylation is directly involved in intracellular ACTH turnover, suggesting that the ubiquitin-proteasome system may represent a target for treatment of human ACTH-secreting adenomas

The potential use of service-oriented infrastructure framework to enable transparent vertical scalability of cloud computing infrastructure

Cloud computing technology has become familiar to most Internet users. Subsequently, there has been an increased growth in the use of cloud computing, including Infrastructure as a Service (IaaS). To ensure that IaaS can easily meet the growing demand, IaaS providers usually increase the capacity of their facilities in a vertical IaaS increase capability and the capacity for local IaaS amenities such as increasing the number of servers, storage and network bandwidth. However, at the same time, horizontal scalability is sometimes not enough and requires additional strategies to ensure that the large number of IaaS service requests can be met. Therefore, strategies requiring horizontal scalability are more complex than the vertical scalability strategies because they involve the interaction of more than one facility at different service centers. To reduce the complexity of the implementation of the horizontal scalability of the IaaS infrastructures, the use of a technology service oriented infrastructure is recommended to ensure that the interaction between two or more different service centers can be done more simply and easily even though it is likely to involve a wide range of communication technologies and different cloud computing management. This is because the service oriented infrastructure acts as a middle man that translates and processes interactions and protocols of different cloud computing infrastructures without the modification of the complex to ensure horizontal scalability can be run easily and smoothly. This paper presents the potential of using a service-oriented infrastructure framework to enable transparent vertical scalability of cloud computing infrastructures by adapting three projects in this research: SLA@SOI consortium, Open Cloud Computing Interface (OCCI), and OpenStack

Activity of the olm (Proteus anguinus) in surface habitats: ecological and evolutionary insights

The olm is considered as a classic example of troglobiont organism. However, in the past different observations of individuals of the typical troglomorphic populations have been reported for springs of Venetia Giulia. The aim of this work is to point out the non-random active use of surface habitats by the olm, providing a comparison with the occurrence observed in caves and performing an assessment of factors favouring ecotone habitats exploitation. Since 2020 we started multiple day and night surveys of olms in both springs and caves. Each spring and cave habitat monitored has been characterised by respect to abiotic and biotic features, including planktonic and benthic prey availability. We detected the olm at least once in 10 springs, with a maximum of 9 individuals occurring together. Detection probability in springs and caves was similar. Spring habitats provided higher density of potential prey available. Olms seems to prefer springs without predator fish and temporary hydroperiod. We recorded in one spring a larva of 3.5 cm which could be the smallest ever recorded in the field. We suggest that epigean habitats and borders with surface may have an underestimated importance for animals adapted to subterranean environments, including the olm. Our results stimulate for testing if exploitation of ecotones between surface and groundwater can lead to differentiation in populations/subpopulations of stygobiont animals