Inflammatory markers as prognostic factors of survival in patients affected by hepatocellular carcinoma undergoing transarterial chemoembolization

Transarterial chemoembolization (TACE) is a good choice for hepatocellular carcinoma (HCC) treatment when surgery and liver transplantation are not feasible. Few studies reported the value of prognostic factors influencing survival after chemoembolization. In this study, we evaluated whether preoperative inflammatory factors such as neutrophil to lymphocyte ratio and platelet to lymphocyte ratio affected our patient survival when affected by hepatocellular carcinoma. Methods. We retrospectively evaluated a total of 72 patients with hepatocellular carcinoma that underwent TACE. We enrolled patients with different etiopathogeneses of hepatitis and histologically proven HCC not suitable for surgery. The overall study population was dichotomized in two groups according to the median NLR value and was analyzed also according to other prognostic factors. Results. The global median overall survival (OS) was 28 months. The OS in patients with high NLR was statistically significantly shorter than that in patients with low NLR. The following pretreatment variables were significantly associated with the OS in univariate analyses: age, Child-Pugh score, BCLC stage, INR, and NLR. Pretreated high NLR was an independently unfavorable factor for OS. Conclusion. NLR could be considered a good prognostic factor of survival useful to stratify patients that could benefit from TACE treatment

Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma.

In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children

Prophylactic arterial catheterization in the management of high risk patients for obstetric haemorrhage

OBJECTIVES: Post-partum haemorrhage still remains one of the major causes of maternal morbidity and mortality. In case of abnormal placentation it is possible to carry out preventive and therapeutic actions. To maintain fertility in reproductive-aged women and to avoid a more radical surgery, embolization has been introduced in patients at high risk for haemorrhage. To describe a new option in the management of patients with abnormal placentation by an elective, preventive arterial catheterization and selective embolization of pelvic arteries. PATIENTS AND METHODS: A retrospective study including thirty six patients with abnormal placental invasion. All patients were prepared in the angiographic room and preventive arterial catheterization was performed before elective caesarean delivery. Materials for interventional angiography were transferred to the operating room. During surgery, selective embolization of pelvic arteries was realized in case of uncontrolled bleeding. RESULTS: Thirty-six elective arterial catheterizations were performed: 4 cases (11.1%) required embolization, haemorrhage was stopped in 2 patients. Hysterectomy was performed in two cases (5.5%). No death was reported. Two humeral thrombosis (5.5%) were registered. CONCLUSIONS: Prophylactic arterial catheterization appears to be safe. The main advantage is the reduction of the interval between the onset of bleeding and the embolization. This new option of management may contribute to reduce the risk of hysterectomy and maternal death

MOKA3D: An innovative approach to 3D gas kinematic modelling. I. Application to AGN ionized outflows

Studying the feedback process of Active Galactic Nuclei (AGN) requires characterising multiple kinematical components, such as rotating gas and stellar disks, outflows, inflows, and jets. To compare the observed properties with theoretical predictions of galaxy evolution and feedback models and to assess the mutual interaction and energy injection rate into the interstellar medium (ISM), one usually relies on simplified kinematic models. These models have several limitations, as they often do not take into account projection effects, beam smearing and the surface brightness distribution of the emitting medium. Here, we present MOKA3D, an innovative approach to model the 3D gas kinematics from integral field spectroscopy observations. In this first paper, we discuss its application to the case of AGN ionised outflows, whose observed clumpy emission and apparently irregular kinematics are only marginally accounted for by existing kinematical models. Unlike previous works, our model does not assume the surface brightness distribution of the gas, but exploits a novel procedure to derive it from the observations by reconstructing the 3D distribution of emitting clouds and providing accurate estimates of the spatially resolved outflow physical properties (e.g. mass rate, kinetic energy). As an example, we demonstrate the capabilities of our method by applying it to three nearby Seyfert-II galaxies observed with MUSE at the VLT and selected from the MAGNUM survey, showing that the complex kinematic features observed can be described by a conical outflow with a constant radial velocity field and a clumpy distribution of clouds.Comment: 17 pages, 14 figure

MUSE AO spectroscopy confirms five dual AGNs and two strongly lensed QSOs at sub-arcsec separation

The novel Gaia Multi Peak (GMP) technique has proven to be able to successfully select dual and lensed AGN candidates at sub-arcsec separations. Both populations are important because dual AGNs represent one of the central, still largely untested, predictions of lamdaCDM cosmology, and compact lensed quasars allow to probe the central regions of the lensing galaxies. In this work, we present high spatial resolution spectroscopy of twelve GMP-selected systems. We use the the adaptive-optics assisted integral-field spectrograph MUSE at VLT to resolve each system and study the nature of each component. All the targets reveal the presence of two components confirming the GMP selection. We classify five targets as dual AGNs, two as lensed systems, and five as a chance alignment of a star and and AGN. Having separations between 0.30" and 0.86", these dual and lensed systems are, to date, among the most compact ever discovered at z >0.3. This is the largest sample of distant dual AGNs with sub-arcsec separations ever presented in a single paper.Comment: 11 pages, 9 figure

Castel di Sangro-Scontrone field camp – structural and applied geomorphology

The Geomorphological Field Camp 2014 in the Castel di Sangro-Scontrone area is the result of geological and geomorphological teaching field work activities carried out in Central Italy by a group of 23 students attending the Structural Geomorphology and Applied Geomorphology courses (Master's Degree in Geological Science and Technology of the Università degli Studi ‘G. d'Annunzio’ Chieti-Pescara, Italy, Department of Engineering and Geology). The Field Camp 2014 was organized in May 2014, following regular classes held during the fall term. General activities for the field camp were developed over four main stages: (1) preliminary analysis of the regional geological and geomorphological setting of the area; (2) preliminary activities for the analysis of the local area (orography, hydrography and photogeology investigations, and geographical information system processing); (3) field work, focused on the analysis of a specific issue concerning structural geomorphology or applied geomorphology (e.g. landscape evolution, river channel change, landslide distribution, and flood hazard); and (4) post-field work production of the map. Finally, the fundamental role of field work in the analysis of landscape and in land management was outlined: indeed, the overall field camp enhanced the crucial role of field-based learning for young geomorphologists in order to acquire a strong sensitivity to geomorphological processes and landscape evolution

A new model for the characterization of infection risk in gunshot injuries:Technology, principal consideration and clinical implementation

<p>Abstract</p> <p>Introduction</p> <p>The extent of wound contamination in gunshot injuries is still a topic of controversial debate. The purpose of the present study is to develop a model that illustrates the contamination of wounds with exogenous particles along the bullet path.</p> <p>Material and methods</p> <p>To simulate bacteria, radio-opaque barium titanate (3-6 μm in diameter) was atomized in a dust chamber. Full metal jacket or soft point bullets caliber .222 (n = 12, v₀= 1096 m/s) were fired through the chamber into a gelatin block directly behind it. After that, the gelatin block underwent multi-slice CT in order to analyze the permanent and temporary wound cavity.</p> <p>Results</p> <p>The permanent cavity caused by both types of projectiles showed deposits of barium titanate distributed over the entire bullet path. Full metal jacket bullets left only few traces of barium titanate in the temporary cavity. In contrast, the soft point bullets disintegrated completely, and barium titanate covered the entire wound cavity.</p> <p>Discussion</p> <p>Deep penetration of potential exogenous bacteria can be simulated easily and reproducibly with barium titanate particles shot into a gelatin block. Additionally, this procedure permits conclusions to be drawn about the distribution of possible contaminants and thus can yield essential findings in terms of necessary therapeutic procedures.</p

GMP-selected dual and lensed AGNs: selection function and classification based on near-IR colors and resolved spectra from VLT/ERIS, KECK/OSIRIS, and LBT/LUCI

The Gaia-Multi-Peak (GMP) technique can be used to identify large numbers of dual or lensed AGN candidates at sub-arcsec separation, allowing us to study both multiple SMBHs in the same galaxy and rare, compact lensed systems. The observed samples can be used to test the predictions of the models of SMBH merging once 1) the selection function of the GMP technique is known, and 2) each system has been classified as dual AGN, lensed AGN, or AGN/star alignment. Here we show that the GMP selection is very efficient for separations above 0.15'' when the secondary (fainter) object has magnitude G<20.5. We present the spectroscopic classification of five GMP candidates using VLT/ERIS and Keck/OSIRIS, and compare them with the classifications obtained from: a) the near-IR colors of 7 systems obtained with LBT/LUCI, and b) the analysis of the total, spatially-unresolved spectra. We conclude that colors and integrated spectra can already provide reliable classifications of many systems. Finally, we summarize the confirmed dual AGNs at z>0.5 selected by the GMP technique, and compare this sample with other such systems from the literature, concluding that GMP can provide a large number of confirmed dual AGNs at separations below 7 kpc.Comment: 14 pages,A&A, in pres

Rescue of HIV-1 Release by Targeting Widely Divergent NEDD4-Type Ubiquitin Ligases and Isolated Catalytic HECT Domains to Gag

Retroviruses engage the ESCRT pathway through late assembly (L) domains in Gag to promote virus release. HIV-1 uses a PTAP motif as its primary L domain, which interacts with the ESCRT-I component Tsg101. In contrast, certain other retroviruses primarily use PPxY-type L domains, which constitute ligands for NEDD4-type ubiquitin ligases. Surprisingly, although HIV-1 Gag lacks PPxY motifs, the release of HIV-1 L domain mutants is potently enhanced by ectopic NEDD4-2s, a native isoform with a naturally truncated C2 domain that appears to account for the residual titer of L domain-defective HIV-1. The reason for the unique potency of the NEDD4-2s isoform has remained unclear. We now show that the naturally truncated C2 domain of NEDD4-2s functions as an autonomous Gag-targeting module that can be functionally replaced by the unrelated Gag-binding protein cyclophilin A (CypA). The residual C2 domain of NEDD4-2s was sufficient to transfer the ability to stimulate HIV-1 budding to other NEDD4 family members, including the yeast homologue Rsp5, and even to isolated catalytic HECT domains. The isolated catalytic domain of NEDD4-2s also efficiently promoted HIV-1 budding when targeted to Gag via CypA. We conclude that the regions typically required for substrate recognition by HECT ubiquitin ligases are all dispensable to stimulate HIV-1 release, implying that the relevant target for ubiquitination is Gag itself or can be recognized by divergent isolated HECT domains. However, the mere ability to ubiquitinate Gag was not sufficient to stimulate HIV-1 budding. Rather, our results indicate that the synthesis of K63-linked ubiquitin chains is critical for ubiquitin ligase-mediated virus release

Switches, Excitable Responses and Oscillations in the Ring1B/Bmi1 Ubiquitination System

In an active, self-ubiquitinated state, the Ring1B ligase monoubiquitinates histone H2A playing a critical role in Polycomb-mediated gene silencing. Following ubiquitination by external ligases, Ring1B is targeted for proteosomal degradation. Using biochemical data and computational modeling, we show that the Ring1B ligase can exhibit abrupt switches, overshoot transitions and self-perpetuating oscillations between its distinct ubiquitination and activity states. These different Ring1B states display canonical or multiply branched, atypical polyubiquitin chains and involve association with the Polycomb-group protein Bmi1. Bistable switches and oscillations may lead to all-or-none histone H2A monoubiquitination rates and result in discrete periods of gene (in)activity. Switches, overshoots and oscillations in Ring1B catalytic activity and proteosomal degradation are controlled by the abundances of Bmi1 and Ring1B, and the activities and abundances of external ligases and deubiquitinases, such as E6-AP and USP7