The potential risk of contralateral non-sentinel groin node metastasis in women with early primary vulvar cancer following unilateral sentinel node metastasis: a single center evaluation in University Hospital of Düsseldorf

Background!#!Since the introduction of sentinel node biopsy (SLNB) in unifocal vulvar cancer (diameter of < 4 cm) and unsuspicious groin lymph nodes, the morbidity rate of patients has significantly decreased globally. In contrast to SLNB, bilateral inguinofemoral lymphadenectomy (IFL) has been associated with increased risk of common morbidities. Current guidelines (NCCN, ESGO, RCOG, and German) recommend that in cases of unilaterally positive sentinel lymph node (SLN), bilateral IFL should be performed. However, two recent publications by Woelber et al. and Nica et al. contradict the current guideline, since a significant rate of positive non sentinel lymph nodes in IFL contralaterally was not observed [Woelber et al. 0% (p = 0/28) and Nica et al. 5.3% (p = 1/19)].!##!Methods!#!A retrospective single-center analysis conducted in the University Hospital of Dusseldorf, evaluating vulvar cancer patients treated with SLNB from 2002 to 2018.!##!Results!#!22.2% of women (n = 4/18) were found to have contralateral IFL groin metastasis after an initial diagnosis of unilateral SLN metastasis. The depth of tumor infiltrating cells correlated significantly and positively with the rate of incidence of groin metastasis (p = 0.0038).!##!Conclusion!#!Current guideline for bilateral IFL should remain as the standard management. Therefore, this depth may be taken into account as an indication for bilateral IFL. The management of VC and SLNB should be performed in a high volume center with an experienced team in marking SLN and performing the adequate surgical procedure. Well conducted counseling of the patients outlining advantages but also potential oncological risks of this technique especially concerning rate of groin recurrence is critical

Gas-solid flow in a ring-baffled CFB riser: numerical and experimental analysis

Circulating fluidized beds (CFBs) are used in a variety of industrial applications in which the homogeneous distribution of the solid phase is desirable. The core-annulus concentration profile is a characteristic of the flow profile in these devices and it leads to solids concentration near the wall. The use of airfoil-shaped ring-type baffles is an alternative to improve the solids distribution in the cross section of CFB risers. In this study, the solids velocity and volume fraction profiles were obtained by PDA measurements and used to validate a computational fluid dynamics (CFD) model. Improvements in the solids distribution are evaluated using a statistical coefficient of variation. The results demonstrate that the ring baffles increase the solids velocity near the wall and redirect the particles to the riser center. The more homogeneous distribution of the particles in the radial direction, shown by both the experimental and numerical solids volume fraction coefficients of variation, improves the gas-solids contact and consequently could increase the yield and selectivity of products of the chemical reactions. In addition, it was found that the insertion of the ring baffles caused a pressure drop reduction in the riser flow. This study enables the investigation of the solids distribution in CFB risers in large scale.345521531CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPES308714/2016-4Sem informaçã

Immaginari migranti

L'intersezione di culture che gli autori translingue naturalmente racchiudono in sé, comporta – dopo il primo periodo di rottura, strappo, rifiuto, morte interiore – una sorta di rinascita identitaria, una ricomposizione armonica che. Le differenze delle due culture si limano o si integrano, in certi casi si sovrappongono e in altri si rifiutano, ma comunque si riconoscono come ricchezza e come parte integrante dell’identità (un sostantivo che, a questo punto, dovrebbe potersi declinare al plurale). Non, dunque, alterità irriducibile, estraneità, confine rigido che si esplica in un aut/aut perentorio, ma la molteplice e rizomatica integrazione inclusiva, che potrebbe inaugurare un nuovo «tempo di sanare» piuttosto che di «uccidere» (Lombardi-Diop). Una «planetarietà», che è cosa ben diversa dalla globalizzazione inglobante e uniformata – come ben ricorda Gayatri Chakravorty Spivak

Peripheral markers of apoptosis in parkinson’s disease: the effect of dopaminergic drugs

In this study, we measured the lymphocyte levels of proteins involved in apoptosis regulation, such as Bcl-2, the peripheral benzodiazepine receptor (PBR), caspase-3, and Cu/Zn superoxide dismutase (Cu/Zn SOD), in patients with Parkinson's disease (PD), either untreated or under therapy with dopaminergic agents (L-Dopa alone or L-dopa + dopamine agonists) and in healthy volunteers. All PD groups showed increased activity of caspase-3, compared to controls, particularly those under treatment only with L-Dopa. In this latter group, the increase in caspase-3 activity was also paralleled by an increase in the concentration of Cu/Zn SOD. In addition, patients taking L-Dopa + dopamine agonists showed marked decrease in Bcl-2 levels and increased PBR expression, which seems in keeping with the hypothesis that PBR may be functionally related to Bcl-2. In conclusion, we found clear modifications in the levels of proteins involved in the control of apoptosis in lymphocytes of PD patients. These changes were disease related but also modulated by the pharmacological treatment, which confirms the potential role of apoptosis in PD pathogenesis and the modulatory influence of dopaminergic agents

Modifications of apoptosis-related protein levels in lymphocytes of patients with Parkinson\u2019s disease. The effect of dopaminergic treatment

In this study, we investigated whether changes in the regulatory mechanisms of apoptosis and oxidative stress may be detected, peripherally, in patients with Parkinsons disease (PD). For this purpose, we measured caspase-3 activity, Bcl-2 concentrations, peripheral benzodiazepine receptor (PBR) expression and Cu/Zn superoxide dismutase (SOD) concentrations in lymphocytes of untreated PD patients, patients treated only with L-Dopa or with L-Dopa and dopamine agonists and healthy volunteers. Caspase-3 activity was significantly increased in all PD patient groups. Patients treated with L-Dopa and dopamine agonists showed the lowest values of Bcl-2, coupled with the highest density of PBRs, while increased levels of Cu/Zn SOD were found in the group under monotherapy with L-Dopa. We also found, in PD patients, clear, negative correlations between Bcl-2 levels and both duration and severity of the disease. Our findings point to the existence of changes in the regulatory mechanisms of apoptosis in PD patients \u2013 observable outside the central nervous system \u2013 which seem to be modulated by the pharmacological treatment with dopaminergic agents

Evaluation of Integrated HPV DNA as Individualized Biomarkers for the Detection of Recurrent CIN2/3 during Post-Treatment Surveillance

Purpose: Post-treatment follow-up in women with cervical pre-cancers (CIN3) is mandatory due to relapse in up to 10% of patients. Standard follow-up based on hrHPV-DNA/cytology co-testing has high sensitivity but limited specificity. The aim of our prospective, multicenter, observational study was to test the hypothesis that an individualized viral-cellular-junction test (vcj-PCR) combined with cytology has a lower false positive rate for the prediction of recurrence compared to standard co-testing. Methods: Pre-surgical cervical swabs served for the identification of HPV16/18 DNA integration sites by next-generation-sequencing (NGS). Samples taken at 6, 12 and 24 months post-surgery were evaluated by cytology, hrHPV-DNA and the patients’ individual HPV-integration sites (vcj-PCR on the basis of NGS). Results: Integration sites were detected in 48 of 445 patients (10.8%), 39 of them had valid follow-up data. The false positive rate was 18.2% (95% CI 8.6–34.4%) for standard hrHPV/cytology at six months compared to 12.1% (95% CI 4.8–27.3%) for vcj-PCR/cytology, respectively (McNemar p = 0.50). Six patients developed recurrences (1 CIN2, 5 CIN3) during follow-up. Standard co-testing detected all, whereas vcj-PCR/cytology detected only five patients with recurrences. Data of 269 patients without evidence of HPV16/18 integration were subject to post-hoc analyses. Standard co-testing revealed a false positive rate of 15.7% (95% CI 11.7–20.7%) and predicted ten of fourteen recurrences at six months. Conclusions: Although highly specific on its own vcj-PCR could not detect all recurrent CIN2/3. Possible reasons for this unexpected result may be multifocal lesions, intratumoral heterogeneity with respect to HPV integration and/or incident CIN