Solid-pseudopapillary tumor of the pancreas: A single center experience

open6noAim of this study was to review the institutional experience of solid-pseudopapillary tumors of the pancreas with particular attention to the problems of preoperative diagnosis and treatment. From 1997 to 2013, SPT was diagnosed in 18 patients among 451 pancreatic cystic neoplasms (3.7%). All patients underwent preoperative abdominal ultrasound, computed assisted tomography, and tumor markers (CEA and CA 19-9) determinations. In some instances, magnetic resonance, positron emission tomography, and endoscopic ultrasound with aspiration cytology were performed. There were two males and 16 females. Serum CA 19-9 was slightly elevated in one case. Preoperative diagnosis was neuroendocrine tumor (n = 2), mucinous tumor (n = 2), and SPT (n = 14). Two patients underwent previous operation before referral to our department: one explorative laparotomy and one enucleation of SPT resulting in surgical margins involvement. All patients underwent pancreatic resection associated with portal vein resection (n = 1) or liver metastases (n = 1). One patient died of metastatic disease, 77 months after operation, and 17 are alive and free with a median survival time of 81.5 months (range 36-228 months). Most of SPT can be diagnosed by CT or MRI, and the role of other diagnostic tools is very limited. We lack sufficient information regarding clinicopathologic features predicting prognosis. Caution is needed when performing limited resection, and long and careful follow-up is required for all patients after surgery.openBeltrame, Valentina; Pozza, Gioia; Dalla Bona, Enrico; Fantin, Alberto; Valmasoni, Michele; Sperti, CosimoBeltrame, Valentina; Pozza, Gioia; DALLA BONA, Enrico; Fantin, Alberto; Valmasoni, Michele; Sperti, Cosim

Environmental Life-Cycle based methods to support the transition towards Circular Economy in the Agri-food sector

The holistic approach of Life Cycle Thinking can support the transition towards sustainable production and consumption patterns, in a circular economy approach. The objective of this dissertation thesis is to critically analyse some peculiar aspects of the application of environmental life-cycle based methods to the agri-food sector and to identify its opportunities and obstacles through the testing of some methods and tools. The main critical methodological problems of the application of Life Cycle Assessment (LCA) to agri-food sector were described. In particular, the analysis was focused on the necessity of using dispersion models for the calculation of on-field emissions. To test how this kind of models work and which data are required, PestLCI 2.0 was applied to an experimental farm in Northern Italy, and a comprehensive set of pesticide emissions in the different compartments, which is a relevant input for the inventory phase, was obtained. However, further research efforts are needed to develop characterisation factors for groundwater emissions, in order to exploit the potential of PestLCI 2.0. Moreover, the use of LCA for communication purposes was evaluated through the testing of the Product Environmental Footprint method in an Italian Taleggio cheese production chain, with the aim to evaluate if it fulfils the harmonisation needs for the calculation and communication of food products environmental performance. The application resulted to be resource-intensive: this aspect could make it difficult to spread the method, especially if the goal is to involve European Small and Medium Enterprises. Finally, the Water Footprint Network method was tested in an Italian tomato cultivar production with the aim to evaluate strengths and weaknesses. Results highlighted that site-specific data are needed to increase the results robustness and that the effect of the yield may penalize extensive cultivations. However, this method can support a sustainable water management and green marketing strategies

Application of PestLCI model to site-specific soil and climate conditions: the case of maize production in Northern Italy

The calculation of emissions from the use of pesticides is a critical issue in LCA studies of agrifood products and only occasionally discussed in details in literature studies. The objective of this study is to assess the results of the application of PestLCI 2.0 model to the production of maize in Northern Italy using site-specific soil and climate data, which were added for this purpose in PestLCI database. In this way, the application of the tool and its database were tailored to that area. Moreover, the results were compared with those obtained assuming maize cultivation on other soil typologies in the surrounding areas. Results show that soil variation scarcely affects the emissions to air and surface water are whereas it affects significantly the emissions to groundwater. Finally, some features of PestLCI were highlighted and comments for a further improvement of the model were provided

Environmental assessment of antimicrobial coatings for packaged fresh milk

Antimicrobial coatings are being increasingly used as a means to extend the shelf life of food products. This extension helps consumers cut down on the food waste generated at household level, while at the same time reducing the impact, which these products' life cycle has on the environment. The aim of this Life Cycle Assessment study is thus to assess the consequences on the environment arising from the application of an antimicrobial coating onto the packaging of a fresh milk product, while also taking into account the reduction in milk waste. The antimicrobial coating considered is a synthetic derivative of lauric acid. The application of the coating involves additional environmental impacts caused by all the inputs and outputs which occur during its life cycle. At the same time, however, the use of this coating allows to extend the fresh milk's shelf life with a consequent reduction in food waste. The data related to the production and application of the coating were provided by the packaging laboratory of the Institute of Agrochemistry and Food Technology (Valencia) and by manufacturing companies. The data related to food waste, milk processing, refrigeration transports, storage, and end of life of both product and packaging were obtained from previous studies, institutional reports and Ecoinvent database v2.2. The Midpoint Impact 2002 method was used to assess impacts. The results show how the reduction in milk waste achievable by using the coating generates higher environmental benefits than the impacts caused by the coating's life cycle due to milk saving. Furthermore this study demonstrates the importance of including food waste in Life Cycle Assessment studies of packaging systems. The connection between packaging design and food waste is a decisive aspect in the evaluation of actual environmental sustainability and should thus be considered in all assessments of packaging solutions. (C) 2015 Elsevier Ltd. All rights reserved.Manfredi, M.; Fantin, V.; Vignali, G.; Gavara Clemente, R. (2015). Environmental assessment of antimicrobial coatings for packaged fresh milk. Journal of Cleaner Production. 95:291-300. doi:10.1016/j.jclepro.2015.02.0482913009

Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Aim of this study was to review the institutional experience of solid-pseudopapillary tumors of the pancreas with particular attention to the problems of preoperative diagnosis and treatment. From 1997 to 2013, SPT was diagnosed in 18 patients among 451 pancreatic cystic neoplasms (3.7%). All patients underwent preoperative abdominal ultrasound, computed assisted tomography, and tumor markers determinations. In some instances, magnetic resonance, positron emission tomography, and endoscopic ultrasound with aspiration cytology were performed. There were two males and 16 females. Serum CA 19-9 was slightly elevated in one case. Preoperative diagnosis was neuroendocrine tumor ( = 2), mucinous tumor ( = 2), and SPT ( = 14). Two patients underwent previous operation before referral to our department: one explorative laparotomy and one enucleation of SPT resulting in surgical margins involvement. All patients underwent pancreatic resection associated with portal vein resection ( = 1) or liver metastases ( = 1). One patient died of metastatic disease, 77 months after operation, and 17 are alive and free with a median survival time of 81.5 months (range 36-228 months). Most of SPT can be diagnosed by CT or MRI, and the role of other diagnostic tools is very limited. We lack sufficient information regarding clinicopathologic features predicting prognosis. Caution is needed when performing limited resection, and long and careful follow-up is required for all patients after surgery

VEGF165-induced vascular permeability requires NRP1 for ABL-mediated SRC family kinase activation.

The vascular endothelial growth factor (VEGF) isoform VEGF165 stimulates vascular growth and hyperpermeability. Whereas blood vessel growth is essential to sustain organ health, chronic hyperpermeability causes damaging tissue edema. By combining in vivo and tissue culture models, we show here that VEGF165-induced vascular leakage requires both VEGFR2 and NRP1, including the VEGF164-binding site of NRP1 and the NRP1 cytoplasmic domain (NCD), but not the known NCD interactor GIPC1. In the VEGF165-bound receptor complex, the NCD promotes ABL kinase activation, which in turn is required to activate VEGFR2-recruited SRC family kinases (SFKs). These results elucidate the receptor complex and signaling hierarchy of downstream kinases that transduce the permeability response to VEGF165. In a mouse model with choroidal neovascularisation akin to age-related macular degeneration, NCD loss attenuated vessel leakage without affecting neovascularisation. These findings raise the possibility that targeting NRP1 or its NCD interactors may be a useful therapeutic strategy in neovascular disease to reduce VEGF165-induced edema without compromising vessel growth

Downregulation of nuclear-encoded genes of oxidative metabolism in dialyzed chronic kidney disease patients.

BACKGROUND:Mitochondria, essential eukaryotic cells organelles defined as the "powerhouse of the cell" because of their ability to produce the vast majority of energy necessary for cellular metabolism, may have a primary role in the oxidative stress-related intracellular machinery associated to chronic kidney disease (CKD).METHODS:To better assess this research assumption, we decided to study the key factors regulating mitochondrial oxidative metabolism in CKD patients in peritoneal dialysis (PD, n\u200a=\u200a15) using several bio-molecular methodologies.RESULTS:RT-PCR experiments demonstrate that the expression level of peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1\u3b1) and nuclear respiratory factor-1 (NRF-1), two genes primarily involved in mitochondrial biogenesis and functions, were significantly hypo-expressed in peripheral blood mononuclear cells of PD patients compared to healthy subjects (HS, n\u200a=\u200a15). Additionally, mRNA levels of several PGC1-\u3b1 downstream target genes (TFAM, COX6C,COX7C, UQCRH and MCAD) were profoundly down-regulated in PD cells. TFAM protein analysis confirmed gene-expression results. High plasmatic concentration of Malondialdehyde found in PD patients, confirmed the contribution of the oxidative stress to these biological effects. Finally, Nuclear factor erythroid-derived 2-like 2 (NRF2 or NFE2L2), a transcription factor for numerous antioxidant/detoxifying enzymes and one of its target genes, superoxide dismutase-2 mitochondrial (SOD2) were up-regulated in PD compared to HS.CONCLUSIONS:Our results revealed, for the first time, that CKD-PD patients' PBMC, through a complex intracellular biochemical machinery, are able to modulate their mitochondrial functions probably in the attempt to reduce oxidative metabolic damage and to turn on a valuable defense cellular strategy against oxidative stress

SEMA6A drives GnRH neuron-dependent puberty onset by tuning median eminence vascular permeability

Innervation of the hypothalamic median eminence by Gonadotropin-Releasing Hormone (GnRH) neurons is vital to ensure puberty onset and successful reproduction. However, the molecular and cellular mechanisms underlying median eminence development and pubertal timing are incompletely understood. Here we show that Semaphorin-6A is strongly expressed by median eminence-resident oligodendrocytes positioned adjacent to GnRH neuron projections and fenestrated capillaries, and that Semaphorin-6A is required for GnRH neuron innervation and puberty onset. In vitro and in vivo experiments reveal an unexpected function for Semaphorin-6A, via its receptor Plexin-A2, in the control of median eminence vascular permeability to maintain neuroendocrine homeostasis. To support the significance of these findings in humans, we identify patients with delayed puberty carrying a novel pathogenic variant of SEMA6A. In all, our data reveal a role for Semaphorin-6A in regulating GnRH neuron patterning by tuning the median eminence vascular barrier and thereby controlling puberty onset

Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE