Solitary fibrous tumor of the pleura: surgery and clinical course in 18 cases

Solitary fibrous tumors of the pleura are very rare neoplasms that can sometimes present with malignant features. Between 1984 and 2007, 18 cases were treated in our institution. There were 7 men and 11 women, with a median age of 56 years (range, 33-77 years). All patients underwent surgical treatment. Except for one case with hemangiopericytic features, all tumors were histologically the fibrous type of pleural mesothelioma. Resections were radical and there were no recurrences. There was no perioperative mortality. The outcome was excellent, and all patients have been followed up continuously. Survival rates at 3, 5, and 10 years were calculated as 86.7%, 75%, and 66.7%. One patient died after 18 months (malignant type of solitary fibrous tumor), and 2 died of unrelated disease after 24 and 53 months. Surgery is the treatment of choice, and careful long-term clinical follow-up is required

Composite of elastin-based matrix and electrospun poly(L-lactic acid) fibers: A potential smart drug delivery system

Stimuli-responsive hydrogel matrices are inspiring manifold applications in controlled delivery of bioactive compounds. Elastin-derived polypeptides form hydrogel matrices that may release bioactive moieties as a function of local increase of active elastases, as it would occur in several processes like inflammation. In view of the development of a patch for healing wounds, recombinant elastin-based polypeptides were combined with a proteolysis-resistant scaffold, made of electrospun poly-L-lactic acid (PLLA) fibers. The results of this study demonstrated the compatibility of these two components. An efficient procedure to obtain a composite material retaining the main features of each component was established. The release of the elastin moiety was monitored by means of a simple protocol. Our data showed that electrospun PLLA can form a composite with fusion proteins bound to elastin-derived polypeptides. Therefore, our approach allows designing a therapeutic agent delivery platform to realize devices capable of responding and interacting with biological systems at the molecular level

Typical and atypical pulmonary carcinoids: our institutional experience

Pulmonary carcinoids are rare malignant neoplasms, accounting for 2-5% of all lung tumors, with an approximate annual incidence of 2.3-2.8 cases per million of the population. We relate our experience of 54 patients (21 male, 33 female, mean age 53+/-15 years) treated between July 1986 and April 2006. All the patients underwent preoperative fibrobronchoscopy: preoperative diagnosis was made in 28 patients (52%). Surgical treatment consisted of: 31 standard lobectomies, 6 pneumonectomies, 5 bilobectomies, 2 sleeve lobectomies, 2 anatomic segmentectomies, 6 wedge resections; two patients were managed with sleeve bronchial procedure of the left main bronchus without lung resection. Fifty-four patients were followed with a mean time of observation of 67 months: 6 (11%) deaths occurred, at a mean period of 49 months after surgery; there were no postoperative deaths. Overall, 5-year survival was 91%, 10 years 83%: 5-year survival was 91% for typical carcoinoids (TC) vs. 88% for atypical (AC), 10 years 91% for TC and 44% for AC (significant value, P=0.0487). Carcinoid tumors are a distinct group of neuroendocrine tumors with a good prognosis in most cases. Surgery currently represents the best treatment with good results at mid- and long-term survival, according to an acceptable risk

Use of coagulant spray glue (Glubran 2) for aerostatic purposes in pulmonary parenchyma resections in pigs: a preliminary study

BACKGROUND: The aim of our study was to test the aerostatic validity of a cyan-acrylic glue (Glubran 2), applied by means of a spray catheter, on an experimental pig model. MATERIALS AND METHODS: 15 young pigs were divided into three study groups of 5 based on surgical techniques: (1) atypical pulmonary resection with mechanical suturing and reinforcement with continuous suturing; (2) resection of the pulmonary parenchyma with a cold scalpel, followed by local application of Glubran 2; (3) atypical pulmonary resection with mechanical suturing followed by application of Glubran 2. RESULTS: The mean aerostasis time was calculated at 3.5 +/- 1.26 s. The histopathological analysis did not show any particular differences when comparing the effects of the treatments carried out with Glubran 2 spray glue and the standard treatments. No statistically significant differences were recorded in the short- and medium-term survival of pigs treated with Glubran 2 compared with the respective control groups. CONCLUSIONS: The application of Glubran 2 spray on wounds caused by pulmonary resections in pigs proved to have a rapid and effective influence for the purposes of aerostasis without significant differences in air losses and survivals

Ultra-small octahedral PtNP-labeled antibodies as an ultrasensitive nanozyme probe for chemiluminescence detection in bioanalytics

Chemiluminescence (CL)-based probes are one of the most sensitive detection principles in nanodiagnostics. A widely used system is the CL substrate for peroxidase (HRP) employed to label a variety of molecules ranging from small steroids to protein. The CL cocktail for HRP is based on luminol or its analogues, hydrogen peroxide, and an enhancer, allowing the detection of submolar concentrations of the enzyme-labeled analyte. The catalyst of the CL reaction, namely HRP, can be replaced by other more practical and highly stable nano-catalysts/nanozymes; among them, recent studies have demonstrated the superior performance of Pt nanomaterials [1]. In this work, we propose the use of ultra-small (3 nm) citrate-coated octahedral Pt nanocrystals prepared by a new wet chemical reduction method in aqueous environment and conjugated to a secondary human IgG antibody, as an ultrasensitive probe for luminol/hydrogen peroxide CL detection. Conjugates with different nanocrystal-to-antibody molar ratios were first fully characterized and purified by Field-Flow Fractionation (FFF) [2]. FFF confirms the homogeneous size of the conjugated which represents a fundamental parameter for their efficiency. The FFF-selected purified conjugates are homogeneous in size and highly concentrated, and readily available for downstream CL tests, an important requirement for the use of FFF as semi-prep step. First results demonstrate the applicability of Pt nanocrystals as probes for CL detection. Indeed the Pt nanocrystals-antibodies CL signal has been measured for the different nanoparticles-IgG molar ratios, showing an increasing signal as a function of nanoparticles concentration with the possibility to detect IgG down to 10-12 M, value close to that obtained using HRP [3]. In addition, the light signal reaches a steady state value for more than 30 minutes, thus facilitating the assay handling. These results paves the way to the use of Pt nanomaterials, highly monodisperse in size and shape and with easy-to-remove coating, for the production of highly efficient catalysts/nanozymes for CL applications and the development of simple and rapid new tests

Spray-congealed Solid Lipid Microparticles as a new tool for the controlled release of Bisphosphonates from a Calcium Phosphate Bone cement

The aim of this work was to develop an innovative drug delivery system potentially useful for the local delivery of Bisphosphonates to bone tissue. We propose the use of Solid Lipid Microparticles (MPs), up to now mainly used for oral and topical drug delivery, as carrier for bisphosphonates due to the favourable biocompatibility and lower toxicity of the lipids compared with many polymers. The delivery platform consisted of a biomimetic \u3b1-tricalcium phosphate-gelatin cement (CPC) enriched with alendronate loaded MPs (MPs-AL) produced by the spray congealing technology. Alendronate direct addition to cement composition is limited since Alendronate is able to sequester calcium from calcium phosphates, thus preventing the setting of the cements. At variance, this approach permitted to load a relatively high amount of the drug on the CPC and allowed the controlled release of the highly water soluble alendronate. A Design of Experiment (DoE) was employed for the screening of the effects of the formulation variables related to the presence of unloaded microparticle (MPs) on the cement most important mechanical properties. Then, MPs loaded with 10 % w/w of alendronate were produced using five different carriers (Stearic Acid, Stearilic Alcohol, Cutina HR, Tristearin and Precirol ATO5). All MPs-AL exhibited a spherical shape, encapsulation efficiency higher than 90% and prevalent particle size ranging from 100-150 micron. Solid state characterization (DSC, HSM and X-ray powder diffraction) demonstrated that encapsulation of alendronate into MPs did not alter its crystal structure. MPs-AL addition to the cement provoked a modest lengthening of the setting times and of the hardening reaction leading to the complete transformation of \u3b1-tricalcium phosphate into calcium-deficient hydroxyapatite, without significantly affect the cement mechanical properties. Moreover, the results of in vitro AL release study performed on cements enriched with MPs-AL showed that the system allows a controlled release of the drug over time

Adjuvant Chemotherapy With Sequential or Concurrent Anthracycline and Docetaxel: Breast International Group 02-98 Randomized Trial

Background Docetaxel is more effective than doxorubicin for patients with advanced breast cancer. The Breast International Group 02-98 randomized trial tested the effect of incorporating docetaxel into anthracycline-based adjuvant chemotherapy and compared sequential vs concurrent administration of doxorubicin and docetaxel. Methods Patients with lymph node-positive breast cancer (n = 2887) were randomly assigned to one of four treatments: 1) sequential control (four cycles of doxorubicin at 75 mg/m2, followed by three cycles of cyclophosphamide, methotrexate, and 5-fluorouracil [CMF]); 2) concurrent control (four cycles of doxorubicin at 60 mg/m2 plus cyclophosphamide at 600 mg/m2, followed by three cycles of CMF); 3) sequential docetaxel (three cycles of doxorubicin at 75 mg/m2, followed by three cycles of docetaxel at 100 mg/m2, followed by three cycles of CMF); 4) concurrent docetaxel (four cycles of doxorubicin at 50 mg/m2 plus docetaxel at 75 mg/m2, followed by three cycles of CMF). The primary comparison evaluated the efficacy of including docetaxel regardless of schedule and was planned after 1215 disease-free survival (DFS) events (ie, relapse, second primary cancer, or death from any cause). Docetaxel and control treatment groups were compared by log-rank tests, and hazard ratios (HR) of DFS events were calculated by Cox modeling. All statistical tests were two-sided. Results Due to a lower-than-anticipated rate of relapse, this analysis was performed after 5 years with 732 events. Patients in control arms had a 5-year DFS of 73% (95% confidence interval [CI] = 70% to 75%). Docetaxel treatment resulted in an improvement in DFS of borderline statistical significance compared with control treatment (HR = 0.86, 95% CI = 0.74 to 1.00; P = .05). However, DFS in the sequential docetaxel arm was better than that in the concurrent docetaxel arm (HR = 0.83, 95% CI = 0.69 to 1.00) and in the sequential control arm (HR = 0.79, 95% CI = 0.64 to 0.98). Conclusions Incorporating docetaxel into anthracycline-based therapy resulted in an improvement in DFS that was of borderline statistical significance. However, important differences may be related to doxorubicin and docetaxel scheduling, with sequential but not concurrent administration, appearing to produce better DFS than anthracycline-based chemotherap