Difficult diagnosis of angiomatoid fibrous histiocytoma of the leg mimicking a benign condition

Angiomatoid fibrous histiocytoma is a rarely metastasizing soft-tissue tumor of low-grade malignancy. Here we report a case of angiomatoid fibrous histiocytoma located in the leg of a 15-year-old female. This case is of particular interest due to its radiological features that led to raise two questions concerning the nature of the disease (is it reactive or tumoral?) and its site of origin (within soft tissues or the tibial periosteum?). Here we describe ultrasound, magnetic resonance imaging, computed tomography scan and positron emission tomography findings that helped answer these questions, understand the real nature of the disease and its appropriate treatment. This case shows that a single type of imaging technique may not be sufficient to understand the real nature of a musculoskeletal lesion and that it is necessary to combine all information derived from various imaging techniques in order to correctly diagnose and treat the disease

Embolisation for Vascular Injuries Complicating Elective Orthopaedic Surgery

AbstractObjectivesThe study aims to present the indications and emphasise the role of embolisation for vascular injuries in orthopaedic surgery.MethodsThirty-one patients with vascular injuries complicating elective orthopaedic surgery had embolisation from 2003 to 2010. N-2-butyl cyano-acrylate (NBCA) was used as embolic agent in 28 patients, gelatin sponge in three and coil embolisation in addition to NBCA or gelatin sponge in two patients. The mean follow-up period was 37 months (range, 4–96 months).ResultsThe most common orthopaedic operations associated with vascular injuries amenable to embolisation were hip-joint procedures; and the most common injuries were arterial tears of branch vessels or non-critical axial vessels, most commonly of the superior glutaeal artery. In all cases, angiography showed the bleeding point, and a single embolisation session effectively stopped bleeding. Embolisation-related complications were not observed.ConclusionsEmbolisation should be considered the treatment of choice for vascular injuries of branch vessels or non-critical axial vessels following elective orthopaedic surgery because of the advantages of minimally invasive therapy and the lack of complications

Activation of PKC-ε counteracts maturation and apoptosis of HL-60 myeloid leukemic cells in response to TNF family members

Protein kinase C (PKC)-ε, a component of the serine/threo-nine PKC family, has been shown to influence the survival and differentiation pathways of normal hematopoietic cells. Here, we have modulated the activity of PKC-ε with specific small molecule activator or inhibitor peptides. PKC-ε inhibitor and activator peptides showed modest effects on HL-60 maturation when added alone, but PKC-ε activator peptide significantly counteracted the pro-maturative activity of tumor necrosis factor (TNF)-α towards the monocytic/macrophagic lineage, as evaluated in terms of CD14 surface expression and morphological analyses. Moreover, while PKC-ε inhibitor peptide showed a reproducible increase of TNF-related apoptosis inducing ligand (TRAIL)-induced apoptosis, PKC-ε activator peptide potently counteracted the pro-apoptotic activity of TRAIL. Taken together, the anti-maturative and anti-apoptotic activities of PKC-ε envision a potentially important proleukemic role of this PKC family member

Auditive direct in utero observation (Audio): A randomized controlled trial for a prenatal demonstration of fetal hearing

Introduction: The objective of this randomized controlled study was to demonstrate whether acoustic stimulation in utero is associated with fetal reactivity which is documentable by car-diotocography. Materials and methods: A monocentric randomized controlled trial was performed at a single university tertiary hospital between September 2016 and July 2017. This study was registered as a randomized clinical trial on clinicaltrail.gov (registration number NCT04622059). Unselected pregnancies at term of gestation were consecutively recruited for the purpose of this study. After 10 min of normal cardiotocography without accelerations (non-stress-test with a basal frequency between 110 and 150 beats/min, normal variability between 6 and 15 b/min, no accelerations, and no fetal movements), fetuses were randomized at a 1:1 ratio to either of the two groups. Fetuses in group A (n = 105) received acoustic stimulation after 10 min from the beginning of the CTG, whereas fetuses in group B received no stimulation (n = 105). The outcome variables investigated were the lapse of time between the beginning of the CTG and the occurrence of the first accelera-tion, and the lapse of time between the beginning of the CTG and the first fetal movement noticed. Results: The lapse of time between the beginning of the CTG and the occurrence of the first acceleration was significantly shorter in the group with acoustic stimulation compared to the other group (14.87 ± 5.01 vs. 21.90 ± 6.94 min, p-value < 0.001 log-rank test). Similarly, the lapse of time between the beginning of the CTG and the occurrence of the first fetal movement was significantly shorter in group A compared to group B (17.77 ± 7.62 vs. 23.28 ± 7.61 min, p-value < 0.001, log-rank test). Fetal cardiac acceleration and the occurrence of a fetal movement during the first 20 min of the CTG were more frequently recorded in group A compared to group B (respectively, 15% vs. 5% and 20% vs. 8%). Conclusion: This RCT showed an early fetal reaction following auditive stimulus, documentable by cardiotocography. Further research is needed to investigate a possible role of acoustic stimulation in utero for the prenatal diagnosis of congenital hypoacusis

TRAIL, OPG, and TWEAK in kidney disease: biomarkers or therapeutic targets?

Ligands and receptors of the tumor necrosis factor (TNF) superfamily regulate immune responses and homeostatic functions with potential diagnostic and therapeutic implications. Kidney disease represents a global public health problem, whose prevalence is rising worldwide, due to the aging of the population and the increasing prevalence of diabetes, hypertension, obesity, and immune disorders. In addition, chronic kidney disease is an independent risk factor for the development of cardiovascular disease, which further increases kidney-related morbidity and mortality. Recently, it has been shown that some TNF superfamily members are actively implicated in renal pathophysiology. These members include TNF-related apoptosis-inducing ligand (TRAIL), its decoy receptor osteoprotegerin (OPG), and TNF-like weaker inducer of apoptosis (TWEAK). All of them have shown the ability to activate crucial pathways involved in kidney disease development and progression (e.g. canonical and non-canonical pathways of the transcription factor nuclear factor-kappa B), as well as the ability to regulate cell proliferation, differentiation, apoptosis, necrosis, inflammation, angiogenesis, and fibrosis with double-edged effects depending on the type and stage of kidney injury. Here we will review the actions of TRAIL, OPG, and TWEAK on diabetic and non-diabetic kidney disease, in order to provide insights into their full clinical potential as biomarkers and/or therapeutic options against kidney disease

La disclosure volontaria del modello di business nel prospetto informativo di quotazione: un’analisi comparative

How do companies to be listed actually deal with voluntary disclosure of their business model? Is it true that firms with greater knowledge-based resources and technological innovation endowments have a lower propensity to adopt fully open communication behaviors? This paper aims to identify the voluntary disclosure policies adopted by three Italian companies in their Initial Public Offering (IPO) prospectuses in order to investigate whether any differences may depend on the type of innovation underlying each business model. A series of interviews conducted with the top management made it possible to understand more deeply the business model of each company. Further, a content analysis has been developed to compute a measure of disclosure and to point out the strategic concepts and their relevance. We provide evidence that companies with a business model based on technology-push innovation have a lower propensity to the full disclosure of their intangible components, particularly of those mainly based on knowledge as these are also invisible. Our study adds to the literature of business and financial reporting by focusing on a new object of inquiry, that is the business model. The business model plays an important role in allowing external actors to understand a company’s value, thus companies’ strategic communication should be shaped accordingly. The results suggest the need to address the issue of voluntary disclosure of the business model by first distinguishing “visible” intangible resources from those that are “invisible” (both to financial and competitive markets). The study aims to make a contribution to the ongoing debate on business and financial reporting practice

Charged-Particle Multiplicity in Proton-Proton Collisions

This article summarizes and critically reviews measurements of charged-particle multiplicity distributions and pseudorapidity densities in p+p(pbar) collisions between sqrt(s) = 23.6 GeV and sqrt(s) = 1.8 TeV. Related theoretical concepts are briefly introduced. Moments of multiplicity distributions are presented as a function of sqrt(s). Feynman scaling, KNO scaling, as well as the description of multiplicity distributions with a single negative binomial distribution and with combinations of two or more negative binomial distributions are discussed. Moreover, similarities between the energy dependence of charged-particle multiplicities in p+p(pbar) and e+e- collisions are studied. Finally, various predictions for pseudorapidity densities, average multiplicities in full phase space, and multiplicity distributions of charged particles in p+p(pbar) collisions at the LHC energies of sqrt(s) = 7 TeV, 10 TeV, and 14 TeV are summarized and compared.Comment: Invited review for Journal of Physics G -- version 2: version after referee's comment

Validation of techniques to mitigate copper surface contamination in CUORE

In this article we describe the background challenges for the CUORE experiment posed by surface contamination of inert detector materials such as copper, and present three techniques explored to mitigate these backgrounds. Using data from a dedicated test apparatus constructed to validate and compare these techniques we demonstrate that copper surface contamination levels better than 10E-07 - 10E-08 Bq/cm2 are achieved for 238U and 232Th. If these levels are reproduced in the final CUORE apparatus the projected 90% C.L. upper limit on the number of background counts in the region of interest is 0.02-0.03 counts/keV/kg/y depending on the adopted mitigation technique.Comment: 10 pages, 6 figures, 6 table