Conservative Treatment

No abstract available.Image:  Cardarelli Hospital. Naples, Italy

Intraoperative stenting of the internal carotid artery after unsuccessful eversion endarterectomy

AbstractStenting Of The Internal Carotid Artery (ICA) Has Been Shown To Be Feasible In Atherosclerotic Lesions, In Restenosis After Carotid Endarterectomy, And In Spontaneous Carotid Dissections. To Correct An Intimal Flap That Detached Distal Occlusion Of The Ica After Eversion Carotid Endarterectomy, As Shown With Intraoperative Completion Angiography, We Successfully Used Stenting Of The Ica With A Self-EXPANDABLE Stainless Steel Stent Placed During Surgery Through The Common Carotid Artery. (J Vasc Surg 1999;30:355-6.

Inconsistency of the capital asset pricing model in a multi-currency environment

The capital asset pricing model (CAPM) is a widely adopted model in asset pricing theory and portfolio construction because of its intuitive nature. One of its main conclusions is that there exists a global market portfolio that each rational investor should hold in proportion with the risk-free asset. In this paper we demonstrate theoretically and through an example that the CAPM cannot hold in a multi-currency environment. This is because it produces different market risk premia depending on the investor’s base currency unless each exchange rate is uncorrelated with the asset prices in the portfolio. This finding has significant implications, including questioning the starting point of the Black & Litterman (1992) model, which is widely used in asset allocation and assumes that the CAPM equilibrium provides a neutral starting point for estimating expected risk premia. However, this assumption may not hold in a multi-currency environment, potentially rendering the model less effective

Expression of Matrix Metalloproteinases and Their Tissue Inhibitors in Chronic Rhinosinusitis With Nasal Polyps: Etiopathogenesis and Recurrence:

Chronic rhinosinusitis with nasal polyps is a multifactorial disease of the nasal and paranasal sinus mucosa and it includes, as comorbidities, anatomic and morphologic alterations, allergic rhinitis, and immunologic diseases. We investigated matrix metalloproteinases (MMP-2, MMP-7, and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2) concentration in different etiopathogenetical groups of patients with nasal polyposis (NP) in relation to recurrence after sinonasal surgery. The study group consisted of 45 patients with NP (those with allergic rhinitis, nonallergic rhinitis and asthma or nonallergic rhinitis, and obstruction of osteomeatal complex [OMC]) who underwent endonasal sinus surgery. We also collected 10 patients who underwent septoplasty as control. Immunohistochemistry of nasal mucosa fragments, Western blotting, and polymerase chain reaction analysis showed increased MMPs levels (MMP-9 more than MMP-2 and MMP-7) and decreased tissue inhibitors of MMPs levels (TIMP-1 less than TIMP-2), in patients with chronic rhinosinusitis with nasal polyps compared with control group, in particular in patients with nonallergic rhinitis and asthma compared to those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC. We observed a higher risk of recurrence in patients with nonallergic rhinitis and asthma than in those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC after 36 months from surgery. In this research, we evaluated pathogenesis of NP related to MMPs and their inhibitors concentrations in polypoid tissue

Ballistic differences in professional soccer players with and without visual impairment

Vision is considered the most important sensory input modality for sport performance (1). Recent studies have shown the existence of developmental delays in motor and sport skills in individuals with visual impairment (2). The purpose of the current study is to examine the kinematic and ballistic differences during football match between professional players with visual impairment and players without visual impairment. During athletic preseason, all soccer players of Delfino Pescara 1936 were evaluated on the basis of visual and orthotic parameters. The sample was composed of 18 professional players including 8 with visual impairment (age -yrs- 23.5 ± 2,50 SD; height -cm- 181.75 ± 9.08 SD ; mass -kg- 78 ± 8.58 SD)and 10 with no visual impairment (age -yrs- 26.6 ± 5.29 SD; height -cm- 177.1 ± 5.95 SD; mass -kg-74.3 ± 6.78 SD). All players were subjected to Natural and Corrected Visual Acuity, Refractive Examination during Miosis and Cycloplegia, Intraocular Pressure (IOP), Extrinsic Ocular Motility, Examination of Convergence and Cover Tests. During all regular season (September 2015/ May 2016, 42 matches, 3780 minutes) for each player it was reported the number of passing under 10 meters, errors of passing under 10 meters (expressed in centimeters), number of passing over 10 meters, errors of passing over 10 meters (expressed in centimeters) and shots in the target and out the target. The results suggest that the players with visually impairment miss passing with a higher percentage than in the control group in both conditions (under the 10 meters and over 10 meters). No significance emerged on the parameter shots on target in both groups. Results showed that the vision is a fundamental proprioceptive channel for the performance in elite soccer players but the small samples analyzed and the lack of prior research studies on the topic subject suggest that further studies will be needed

Segmental hypoplasia of the basilar artery: a case report and review of literature

The anomalies of the basilar artery are rare when compared with those ones pertaining to the circle of Willis vessels. Partial duplication or fenestration is rather common (0.6% to 1.8% in the angiographic descriptions); on the other hand, other anomalies, including complete duplication, hypoplasia and aplasia are exceptional. A rare case of segmental hypoplasia of the basilar artery in a 49-year-old man with transient vertebrobasilar (VB) ischemia, explored by magnetic resonance imaging (MRI) and digital angiography (DA), is reported. The embryology, the clinical relevance and the magnetic resonance findings of this arterial anomaly are discussed, with a review of other six reported cases. The appearance of a segmental aplasia was suggested in our case by MRI, and successively confirmed not only by time-of-flight MR-angiography (TOF-MRA) but also by DA. Only ultrathin-slice T2-weighted (w) images revealed the real finding of basilar artery (BA) hypoplasia; this sequence, not employed in previously reported cases, is mandatory to allowing a clear differential diagnosis between BA aplasia and hypoplasia. In conclusion, segmental hypo-aplasia of the BA is an exceptional embryological anomaly. This anomaly may be of clinical importance, and it should be considered among the potential causes of vertebrobasilar insufficiency in young adults. These cases should be investigated by MR and MRA; we stress the importance of ultrathin slice T2-weighted sequences in order to discriminate between aplasia and hypoplasia

Phenotypic and functional characterization of endothelial progenitor cells isolated from peripheral blood of renal cell carcinoma patients

Endothelial progenitor cells (EPCs) are mobilized from either bone marrow or arterial walls to restore blood perfusion to ischemic organs and establish the vascular network within growing tumors [1]. The Ca2+ machinery plays a key role in EPC activation and might serve a molecular target for novel therapies of highly angiogenic tumors, such as renal cell carcinoma (RCC) [1]. The Ca2+ toolkit is remodelled in EPCs isolated from RCC patients (RCC-EPCs) as respect to healthy donors [2]. The present study was undertaken to evaluate for the first time the functional properties of EPCs isolated from tumor patients by focusing on RCC-EPCs. We extended our analysis at microscopic level by monitoring the sub-cellular structure of RCC-EPCs relative to their Ca2+ signalling fingerprint. Our results showed a striking functional and ultrastructural difference between RCC-EPCs and their normal counterparts, which might be the basis for designing novel, more specific anti-angiogenic treatments

TIMPs and MMPs expression in nasal polyps

Nasal polyposis is a chronic inflammatory disease characterized by inflammatory invasion of nasal mucosa, changes in cells differentiation, thickness reduction and remodelling of basal membrane, hyperplasia of mucous glands, extracellular matrix deposition. MMPs shown a proteolytic activities towards several components of extracellular matrix, play an important role in connective tissue remodeling. MMPs are a proteins family including 25 isoforms of Ca2+ and Zn 2+ dependant endopeptidases. MMPs are inactive and can be activated by proteases removing some amino acids. Tissue inhibitors of matrix metalloproteinases (TIMPs) are natural inhibitors of MMPs. TIMPs inhibiting MMPs activation by MMPs/TIMPs complexes: TIMP-1 and TIMP-2 are soluble protein, inhibiting mainly MMP-9 and 2, TIMP-3 is mainly associated to ECM. The balance between MMP/TIMP is very critical in matrix remodeling and various physiological processes. Imbalances between these enzymes and inhibitors may cause pathological processes such as chronic inflammation, degenerative disease and tumour invasion. In our study we aimed at demonstrating MMP/TIMP imbalance in nasal polyposis, similar to other pathological processes. The complex structure of polyp formation is still unknown. In this research nasal polyp specimens were obtained from 96 patients with nasal polyposis during endoscopic sinus surgery. Bullous middle turbinates with normal appearing mucosa of fifteen non-smoker patients free of any allergic or infectious diseases of nose or sinuses were used as controls. Patients were divided in three groups: patients of group A have morphostructural polyps; patients of group B have syndromic polyps; patients of group C have allergic polyps. We investigate MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1, TIMP-2, TIMP-3 expression in our specimens using immunoistochemistry, Western Blot Analysis and RT-PCR methods. Our results shown a interesting relashionship between MMPs/TIMPs imbalance and nasal polyps formation

An ontology-based approach supporting holistic structural design with the consideration of safety, environmental impact and cost

Early stage decision-making for structural design critically influences the overall cost and environmental performance of buildings and infrastructure. However, the current approach often fails to consider the multi-perspectives of structural design, such as safety, environmental issues and cost in a comprehensive way. This paper presents a holistic approach based on knowledge processing (ontology) to facilitate a smarter decision-making process for early design stage by informing designers of the environmental impact and cost along with safety considerations. The approach can give a reasoning based quantitative understanding of how the design alternatives using different concrete materials can affect the ultimate overall performance. Embodied CO2 and cost are both considered along with safety criteria as indicative multi-perspectives to demonstrate the novelty of the approach. A case study of a concrete structural frame is used to explain how the proposed method can be used by structural designers when taking multi performance criteria into account. The major contribution of the paper lies on the creation of a holistic knowledge base which links through different knowledge across sectors to enable the structural engineer to come up with much more comprehensive decisions instead of individual single objective targeted delivery