Cutaneous Metastases from Malignant Melanoma: Clinical Features and New Therapeutic Perspectives

In this chapter, cutaneous metastases from malignant melanoma will be analyzed from a clinical and a prognostic point of view. This non rare condition is often distressing for the patient, as cutaneous lesions increase progressively in number and size and are frequently worsened by ulceration, bleeding and pain. After a general introduction about the incidence of cutaneous involvement in melanoma natural history, clinical classification of skin metastases will be provided. Then, the impact of cutaneous localizations on prognosis will be evaluated. In the last paragraph, the different therapeutic options for the management of patients with loco-regional or diffused cutaneous metastases will be reviewe

After Surgery: Follow-Up Guidelines of Melanoma Patients

There are several main reasons to begin a follow-up schedule after surgical treatment of the primary cutaneous lesion in patients affected by melanoma. The main goal is the early detection of disease recurrence, even if the impact of a prompt treatment on prognosis is still debated (Barth et al 1995, Atkins et al 2008, Garbe et al 2008). Several authors believe that early detection of asymptomatic metastases does not affect overall survival (Barth et al 1995, Atkins et al 2008). Others (Garbe et al 2008) showed a clear survival benefit for an early with respect to late metastases detection, with a 3-year survival rate of 76%, compared to the 38% of patients with late diagnosis. The early relapse recognition might lead to a more complete and less invasive surgical treatment, with potential benefits for the patient

Vanillin production using metabolically engineered Escherichia coli under non-growing conditions

BACKGROUND: Vanillin is one of the most important aromatic flavour compounds used in the food and cosmetic industries. Natural vanillin is extracted from vanilla beans and is relatively expensive. Moreover, the consumer demand for natural vanillin highly exceeds the amount of vanillin extracted by plant sources. This has led to the investigation of other routes to obtain this flavour such as the biotechnological production from ferulic acid. Studies concerning the use of engineered recombinant Escherichia coli cells as biocatalysts for vanillin production are described in the literature, but yield optimization and biotransformation conditions have not been investigated in details. RESULTS: Effect of plasmid copy number in metabolic engineering of E. coli for the synthesis of vanillin has been evaluated by the use of genes encoding feruloyl-CoA synthetase and feruloyl hydratase/aldolase from Pseudomonas fluorescens BF13. The higher vanillin production yield was obtained using resting cells of E. coli strain JM109 harbouring a low-copy number vector and a promoter exhibiting a low activity to drive the expression of the catabolic genes. Optimization of the bioconversion of ferulic acid to vanillin was accomplished by a response surface methodology. The experimental conditions that allowed us to obtain high values for response functions were 3.3 mM ferulic acid and 4.5 g/L of biomass, with a yield of 70.6% and specific productivity of 5.9 μmoles/g × min after 3 hours of incubation. The final concentration of vanillin in the medium was increased up to 3.5 mM after a 6-hour incubation by sequential spiking of 1.1 mM ferulic acid. The resting cells could be reused up to four times maintaining the production yield levels over 50%, thus increasing three times the vanillin obtained per gram of biomass. CONCLUSION: Ferulic acid can be efficiently converted to vanillin, without accumulation of undesirable vanillin reduction/oxidation products, using E. coli JM109 cells expressing genes from the ferulic acid-degrader Pseudomonas fluorescens BF13. Optimization of culture conditions and bioconversion parameters, together with the reuse of the biomass, leaded to a final production of 2.52 g of vanillin per liter of culture, which is the highest found in the literature for recombinant strains and the highest achieved so far applying such strains under resting cells conditions

Inflammatory Cutaneous Diseases in Renal Transplant Recipients.

Kidney transplant recipients frequently suffer from skin infections and malignancies, possibly due to the effects of long-term immunosuppressive therapy. While the relationships between immunosuppression and these pathological conditions have been widely investigated, little is known about the relative incidence and characteristics of inflammatory skin diseases in this type of patient. In this study, we analyze the incidence of a number of inflammatory cutaneous diseases in a cohort of patients who underwent kidney transplantation. Although our study shows a relatively low incidence of these pathologies in transplanted patients-in agreement with the general action of immunosuppressant therapies in reducing inflammation-we scored a different efficacy of the various immunosuppressive regimens on inflammatory and autoimmune skin diseases. This information can be key for designing immunosuppressive regimens and devising accurate follow-up protocols

The Lie derivative of spinor fields: theory and applications

Starting from the general concept of a Lie derivative of an arbitrary differentiable map, we develop a systematic theory of Lie differentiation in the framework of reductive G-structures P on a principal bundle Q. It is shown that these structures admit a canonical decomposition of the pull-back vector bundle i_P^*(TQ) = P\times_Q TQ over P. For classical G-structures, i.e. reductive G-subbundles of the linear frame bundle, such a decomposition defines an infinitesimal canonical lift. This lift extends to a prolongation Gamma-structure on P. In this general geometric framework the concept of a Lie derivative of spinor fields is reviewed. On specializing to the case of the Kosmann lift, we recover Kosmann's original definition. We also show that in the case of a reductive G-structure one can introduce a "reductive Lie derivative" with respect to a certain class of generalized infinitesimal automorphisms, and, as an interesting by-product, prove a result due to Bourguignon and Gauduchon in a more general manner. Next, we give a new characterization as well as a generalization of the Killing equation, and propose a geometric reinterpretation of Penrose's Lie derivative of "spinor fields". Finally, we present an important application of the theory of the Lie derivative of spinor fields to the calculus of variations.Comment: 28 pages, 1 figur

1054 Noninvasive Qp/Qs ratio measurement with phase-contrast cine MRI in patients with atrial septal defect: comparison with heart catheterization

The correlation analysis showed a good overlap between measurements (Qp: r = 0.65, p = 0.0004; Qs: r = 0.64, p = 0.0005; Qp/Qs ratio: r = 0.68, p = 0.0002), also confirmed by regression analysis (R2 = 0.42, p < 0.001 for Qp; R2 = 0.41, p = 0.001 for QS; R2 = 0.46, p < 0.001 for Qp/Qs ratio), and by the Bland-Altman statistical analysis for method comparison (see Figure 1). The interobserver variability was low

Extensive "halo naevi" phenomenon and regression of melanin during nivolumab treatment in metastatic melanoma: A predictor of a better outcome?

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