Locally vascularized pelvic accessory spleen

Il polisplenismo e la milza accessoria sono anomalie congenite generalmente asintomatiche. Riportiamo un raro caso di polisplenismo con milza pelvica ectopica in una donna bianca di 67 anni. Nella pelvi di sinistra all’ecografia transvaginale è stata ritrovata una massa soffice, ben definita, omogenea e vascolarizzata. La paziente è stata quindi sottoposta a valutazione con RM e TC addominale con contrasto: sono state ottenute immagini con aspetto parenchimale simile alla milza. E’ stata eseguita una scintigrafia addominale con albumina umana colloidale radiomarcata con tecnezio sulla regione pelvica con scansioni planari e SPECT. I risultati hanno mostrato la presenza di un’area di captazione del radiofarmaco nella pelvi, mentre la milza è stata normalmente visualizzata. Questi ritrovamenti hanno confermato la presenza di una milza accessoria con una arteria originante dall’aorta ed una vena che si anastomizzava con la vena mesenterica superiore. Alla nostra conoscenza, nella letteratura, esiste solo un caso di vera milza ectopica localmente vascolarizzata nella pelvi.Polysplenism and accessory spleen are congenital, usually asymptomatic anomalies. A rare case of polysplenism with ectopic spleen in pelvis of a 67-year-old, Caucasian female is reported here. A transvaginal ultrasound found a soft well-defined homogeneous and vascularized mass in the left pelvis. Patient underwent MRI evaluation and contrast-CT abdominal scan: images with parenchymal aspect, similar to spleen were obtained. Abdominal scintigraphy with 99mTc-albumin nanocolloid was performed and pelvic region was studied with planar scans and SPECT. The results showed the presence of an uptake area of the radiopharmaceutical in the pelvis, while the spleen was normally visualized. These findings confirmed the presence of an accessory spleen with an artery originated from the aorta and a vein that joined with the superior mesenteric vein. To our knowledge, in the literature, there is just only one case of a true ectopic, locally vascularized spleen in the pelvis

Weyl-Gauge Symmetry of Graphene

The conformal invariance of the low energy limit theory governing the electronic properties of graphene is explored. In particular, it is noted that the massless Dirac theory in point enjoys local Weyl symmetry, a very large symmetry. Exploiting this symmetry in the two spatial dimensions and in the associated three dimensional spacetime, we find the geometric constraints that correspond to specific shapes of the graphene sheet for which the electronic density of states is the same as that for planar graphene, provided the measurements are made in accordance to the inner reference frame of the electronic system. These results rely on the (surprising) general relativistic-like behavior of the graphene system arising from the combination of its well known special relativistic-like behavior with the less explored Weyl symmetry. Mathematical structures, such as the Virasoro algebra and the Liouville equation, naturally arise in this three-dimensional context and can be related to specific profiles of the graphene sheet. Speculations on possible applications of three-dimensional gravity are also proposed.Comment: 22 pages, 3 figures - two new references and few typos fixed, matches published version by Annals of Physic

Automatic discovery of drug mode of action and drug repositioning from gene expression data

2009 - 2010The identification of the molecular pathway that is targeted by a compound, combined with the dissection of the following reactions in the cellular environment, i.e. the drug mode of action, is a key challenge in biomedicine. Elucidation of drug mode of action has been attempted, in the past, with different approaches. Methods based only on transcriptional responses are those requiring the least amount of information and can be quickly applied to new compounds. On the other hand, they have met with limited success and, at the present, a general, robust and efficient gene-expression based method to study drugs in mammalian systems is still missing. We developed an efficient analysis framework to investigate the mode of action of drugs by using gene expression data only. Particularly, by using a large compendium of gene expression profiles following treatments with more than 1,000 compounds on different human cell lines, we were able to extract a synthetic consensual transcriptional response for each of the tested compounds. This was obtained by developing an original rank merging procedure. Then, we designed a novel similarity measure among the transcriptional responses to each drug, endingending up with a “drug similarity network”, where each drug is a node and edges represent significant similarities between drugs. By means of a novel hierarchical clustering algorithm, we then provided this network with a modular topology, contanining groups of highly interconnected nodes (i.e. network communities) whose exemplars form secondlevel modules (i.e. network rich-clubs), and so on. We showed that these topological modules are enriched for a given mode of action and that the hierarchy of the resulting final network reflects the different levels of similarities among the composing compound mode of actions. Most importantly, by integrating a novel drug X into this network (which can be done very quickly) the unknown mode of action can be inferred by studying the topology of the subnetwork surrounding X. Moreover, novel potential therapeutic applications can be assigned to safe and approved drugs, that are already present in the network, by studying their neighborhood (i.e. drug repositioning), hence in a very cheap, easy and fast way, without the need of additional experiments. By using this approach, we were able to correctly classify novel anti-cancer compounds; to predict and experimentally validate an unexpected similarity in the mode of action of CDK2 inhibitors and TopoIsomerase inhibitors and to predict that Fasudil, a known and FDA-approved cardiotonic agent, could be repositioned as novel enhancer of cellular autophagy. Due to the extremely safe profile of this drug and its potential ability to traverse the blood-brain barrier, this could have strong implications in the treatment of several human neurodegenerative disorders, such as Huntington and Parkinson diseases. [edited by author]IX n.s

Chirurgia della valvulopatia mitralica mediante Port Access. Esperienza di due centri.

La chirurgia mininvasiva della mitrale mediante Port Access, risulta una delle maggiori innovazioni in cardiochirurgia in grado di migliorare gli outcome a breve medio e lungo termine se paragonata alla chirurgia convenzionale. In questo studio sono sono prese in esame le esperienze di due centri di eccellenza che hanno condotto tali interventi mediante approcci tecnici intraoperatori diversi per il clampaggio aortico: l'Endoclamp ed il clampaggio aortico transtoracico. Vengono altresì discussi i risultati di tali metodiche affidabili e sicure con particolare attenzione alla riproducibilità, all'efficacia, agli outcome ed in ultima analisi ai costi

Machine Learning Applications for Jet Tagging in the CMS Experiment

The fundamental physics research at the frontier accessible by today's particle accelerators such as the CERN Large Hadron Collider pose unique challenges in terms of complexity and abundance of data to analyse. In this context, it is of paramount importance to develop algorithms capable of dealing with multivariate problems to enhance humans' ability to interpret data and ultimately increase the discovery potential of the experiments. Machine learning techniques therefore assume an increasingly important role in the experiments at the LHC. In this work, we give an overview of the latest developments in this field, with a particular focus on the algorithms developed and used within the CMS Collaboration. The review follows this structure: (1) Introduction presents the CMS Experiment at LHC and the most common methods used in particle physics; (2) Jet Flavour Tagging briefly describes the main algorithms used to reconstruct heavy-flavour jets; (3) Jet Substructure and Deep Tagging focuses on the identification of heavy-particle decay in boosted jets; (4) Analysis Applications gives examples of applying the algorithm in physics analyses; and (5) Conclusions summarises the state-of-the-art and gives indications for future studies

A prospective evaluation on external jugular vein cut-down approach for TIVAD implantation

BACKGROUND: Totally implantable venous access devices can be implanted both by percutaneous approaches and by surgical approaches with cephalic vein or external jugular vein cut-down techniques that are related to low intraoperative complication rates. The authors report a prospective evaluation of 83 consecutive external jugular vein cut-down approaches for totally implantable venous access devices implantation. METHODS: Eighty three consecutive patients (28 M, 55 F, mean age 54.2) suffering from solid tumors (58) or hematologic diseases (25) were consecutively submitted to totally implantable venous access devices insertion through external jugular vein cut-down approach (75 on right side, 8 on left side). RESULTS: All devices were surgically implanted; no instances of intraoperative complications were detected. After a minimum follow-up of 150 days, only one case of wound hematoma and one case of device malfunction due to incorrect catheter angulation were noted. Postoperative patient satisfaction was evaluated by the use of specific questionnaire that demonstrated a good satisfaction and compliance (92.8 %) of patients with implanted devices. CONCLUSIONS: Despite the lack of controlled studies comparing external jugular vein cut-down approach vs other approaches, this approach should be considered as a tool for long-term central vein catheters positioning, both as an alternative and for primary approach

Diagnostic Workup for Disorders of Bone and Mineral Metabolism in Patients with Chronic Kidney Disease in the Era of KDIGO Guidelines

KDIGO (Kidney Disease: Improving Global Outcomes) is an international nonprofit organization devoted to “improve the care and outcomes of kidney disease patients worldwide through promoting coordination, collaboration, and integration of initiatives to develop and implement clinical practice guidelines.” The mineral and bone disorder (MBD) in patients with chronic kidney disease (CKD) has been the first area of interest of KDIGO international initiative. KDIGO guidelines on CKD-MBD were published in 2009 with the intent to modify the previous KDOQI guidelines that had failed to consistently change the global outcome of CKD patients. After the publication of KDOQI guidelines for bone metabolism and disease in 2003, a large number of observational data emerged in literature linking disordered mineral metabolism with adverse clinical outcomes. Notwithstanding this large body of observational data, a paucity of evidence from high-quality clinical trials was available for the development of KDIGO guidelines. Herein, a summary will be provided of the most important findings of KDIGO guidelines regarding the diagnostic workup and clinical monitoring of CKD-MBD patients