30 research outputs found

    The histopathological correlate of peri-vascular adipose tissue attenuation on computed tomography in surgical ascending aorta aneurysms: Is this a measure of tissue inflammation?

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    On computed tomography (CT) imaging, a peri-vascular adipose tissue attenuation (pVAT) measure has been proposed as a non-invasive correlate of inflammation in the coronary artery vessels, and a single research group provided histopathological demonstration of this radiologi-cal/pathological correspondence. Our group has shown that patients with surgical-grade ascending aorta (AA) aneurysm display higher pVAT compared with patients with smaller aneurysms or normal AA. Based on histopathological studies on coronary arteries, we speculated that this correlation may be related to a non-otherwise specified aortic inflammatory process. However, since adipose tissue around the AA is often scant, and there are no histopathological studies confirming such hypothesized association between higher pVAT and inflammation around the AA, we cannot exclude that this pVAT change is secondary to different mechanisms, unrelated to the actual presence of peri-vascular inflammation. We performed a retrospective clinical/radiological/pathological study in 78 patients who underwent AA surgery with the aim to correlate pre-operatory pVAT on CT with histopathological findings from the surgical specimens. Histopathological review and immunohisto-chemistry were performed on the surgical aortic samples. The AA adventitial/periadventitial adipose tissue had higher pVAT by an increasing collagen fiber deposition, which progressively makes the fat hypotrophic and, in the late stages of this process, it replaces the normal soft tissue composition in this location. In the ascending aorta, pVAT on CT imaging is probably not a proxy for the presence of current vascular inflammation, although it may track changes involving the progressive substitution of perivascular adipose cells by higher-pVAT tissues, mainly fibrotic replacement

    Innate immune signaling in hearts and buccal mucosa cells of patients with arrhythmogenic cardiomyopathy

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    Background: Nuclear factor κB (NF-κB) signaling in cardiac myocytes causes disease in a mouse model of arrhythmogenic cardiomyopathy (ACM) by mobilizing CCR2-expressing macrophages that promote myocardial injury and arrhythmias. Buccal mucosa cells exhibit pathologic features similar to those seen in cardiac myocytes in patients with ACM. Objectives: We sought to determine if persistent innate immune signaling via NF-κB occurs in cardiac myocytes in patients with ACM and if this is associated with myocardial infiltration of proinflammatory cells expressing CCR2. We also determined if buccal mucosa cells from young subjects with inherited disease alleles exhibit NF-κB signaling. Methods: We analyzed myocardium from ACM patients who died suddenly or required cardiac transplantation. We also analyzed buccal mucosa cells from young subjects with inherited disease alleles. The presence of immunoreactive signal for RelA/p65 in nuclei of cardiac myocytes and buccal cells was used as a reliable indicator of active NF-κB signaling. We also counted myocardial CCR2-expressing cells. Results: RelA/p65 signal was seen in numerous cardiac myocyte nuclei in 34 of 36 cases of ACM but not in 19 age-matched control individuals. Cells expressing CCR2 were increased in patient hearts in numbers directly correlated with the number of cardiac myocytes showing NF-κB signaling. NF-κB signaling was observed in buccal cells in young subjects with active disease. Conclusions: Patients with clinically active ACM exhibit persistent innate immune responses in cardiac myocytes and buccal mucosa cells, reflecting a local and systemic inflammatory process. Such individuals may benefit from anti-inflammatory therapy

    DualSPHysics: from fluid dynamics to multiphysics problems

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    DualSPHysics is a weakly compressible smoothed particle hydrodynamics (SPH) Navier–Stokes solver initially conceived to deal with coastal engineering problems, especially those related to wave impact with coastal structures. Since the first release back in 2011, DualSPHysics has shown to be robust and accurate for simulating extreme wave events along with a continuous improvement in efficiency thanks to the exploitation of hardware such as graphics processing units for scientific computing or the coupling with wave propagating models such as SWASH and OceanWave3D. Numerous additional functionalities have also been included in the DualSPHysics package over the last few years which allow the simulation of fluid-driven objects. The use of the discrete element method has allowed the solver to simulate the interaction among different bodies (sliding rocks, for example), which provides a unique tool to analyse debris flows. In addition, the recent coupling with other solvers like Project Chrono or MoorDyn has been a milestone in the development of the solver. Project Chrono allows the simulation of articulated structures with joints, hinges, sliders and springs and MoorDyn allows simulating moored structures. Both functionalities make DualSPHysics especially suited for the simulation of offshore energy harvesting devices. Lately, the present state of maturity of the solver goes beyond single-phase simulations, allowing multi-phase simulations with gas–liquid and a combination of Newtonian and non-Newtonian models expanding further the capabilities and range of applications for the DualSPHysics solver. These advances and functionalities make DualSPHysics an advanced meshless solver with emphasis on free-surface flow modelling

    Ebv-driven lymphoproliferative disorders and lymphomas of the gastrointestinal tract: A spectrum of entities with a common denominator (part 3)

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    EBV is the first known oncogenic virus involved in the development of several tumors. The majority of the global population are infected with the virus early in life and the virus persists throughout life, in a latent stage, and usually within B lymphocytes. Despite the worldwide diffusion of EBV infection, EBV-associated diseases develop in only in a small subset of individuals often when conditions of immunosuppression disrupt the balance between the infection and host immune system. EBV-driven lymphoid proliferations are either of B-cell or T/NK-cell origin, and range from disorders with an indolent behavior to aggressive lymphomas. In this review, which is divided in three parts, we provide an update of EBV-associated lymphoid disorders developing in the gastrointestinal tract, often representing a challenging diagnostic and therapeutic issue. Our aim is to provide a practical diagnostic approach to clinicians and pathologists who face this complex spectrum of disorders in their daily practice. In this part of the review, the chronic active EBV infection of T-cell and NK-cell type, its systemic form; extranodal NK/T-cell lymphoma, nasal type and post-transplant lymphoproliferative disorders are discussed

    What do we have to know about pd-l1 expression in prostate cancer? A systematic literature review. part 1: Focus on immunohistochemical results with discussion of pre-analytical and interpretation variables

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    Immunotherapy targeting the PD-1–PD-L1 axis yielded good results in treating different immunologically ‘‘hot’’ tumors. A phase II study revealed good therapeutic activity of pembroli-zumab in selected prostatic carcinoma (PC)-patients. We performed a systematic literature review (PRISMA guidelines), which analyzes the immunohistochemical expression of PD-L1 in human PC samples and highlights the pre-analytical and interpretation variables. Interestingly, 29% acinar PCs, 7% ductal PCs, and 46% neuroendocrine carcinomas/tumors were PD-L1+ on immunohisto-chemistry. Different scoring methods or cut-off criteria were applied on variable specimen-types, evaluating tumors showing different clinic-pathologic features. The positivity rate of different PD-L1 antibody clones in tumor cells ranged from 3% (SP142) to 50% (ABM4E54), excluding the single case tested for RM-320. The most tested clone was E1L3N, followed by 22C3 (most used for pem-brolizumab eligibility), SP263, SP142, and 28-8, which gave the positivity rates of 35%, 11–41% (de-pending on different scoring systems), 6%, 3%, and 15%, respectively. Other clones were tested in <200 cases. The PD-L1 positivity rate was usually higher in tumors than benign tissues. It was higher in non-tissue microarray specimens (41–50% vs. 15%), as PC cells frequently showed heterogenous or focal PD-L1-staining. PD-L1 was expressed by immune or stromal cells in 12% and 69% cases, respectively. Tumor heterogeneity, inter-institutional preanalytics, and inter-observer interpretation variability may account for result biases

    Unsteady stokes flow for a vibrating cantilever under a free-surface

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    Vibration of a thin, rectangular-cross-section beam submerged in a viscous, quiescent fluid undergoing small amplitude oscillations is studied using a Boundary Element (BE) approach in which the free-surface is modeled through a stress-free boundary condition. The Stokes approximation is used where nonlinear convective terms are negligible and the problem is formulated in Fourier and Laplace transform space when appropriate. Results are expressed in terms of nondimensional hydrodynamic force and its components, namely added mass and damping coefficients. Several parametric studies are conducted to evaluate the effects of depth of submergence, frequency and the amplitude of oscillations on the hydrodynamic functions. The results are compared with the classical solution for a vibrating lamina in an infinite fluid as the limit case and with a recent study using Smoothed Particle Hydrodynamics (SPH) analysis in the presence of a freesurface

    Smoothed Particle Hydrodynamics vs Lattice Boltzmann for the solution of steady and unsteady fluid flows

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    Numerical simulations of steady and unsteady viscous flows are presented by adopting two different numerical methodologies: the Smoothed Particle Hydrodynamics formulation implemented in the open-source code DualSPHysics and an in-house lattice Boltzmann code based on a concise central-moments scheme. Both methods employ a weakly compressible assumption to simulate incompressible flow, which means the fluid is assumed barotropic and the density and pressure are related through an equation of state. The accuracy of the two approaches is evaluated against well-defined and consolidated benchmark tests. Advantages and disadvantages of the two methodologies are discussed and substantiated by quantitative comparisons that focus on accuracy and efficacy of the two methodologies against other well-established computational methods. Overall, both formulations proposed herein are able to capture the relevant flow physics with a good level of accuracy when compared to other more affirmed techniques. Remarkably, this is observed in spite of the proposed two methods lacking key strategies commonly used in grid-based methods, such as adaptive mesh refinement

    La valutazione dell'esperienza di tirocinio : una ricerca preliminare nel Corso di Laurea in Fisioterapia

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    Lo scopo di questo studio \ue8 quello di analizzare i risultati ottenuti mediante l\u2019analisi dei dati di un questionario compilato dallo studente rispetto all\u2019esperienza di tirocinio vissuta, con il preciso obiettivo di osservare i dati ottenuti al fine di migliorare sia il processo di programmazione e pianificazione sia di verificare l\u2019adeguatezza delle sedi accreditate per l\u2019esperienza clinica, nel rispetto e in coerenza con gli accordi stipulati in fase di convenzione. Parole chiave: tirocinio professionalizzante, modelli di valutazione e di autovalutazione. Summary The purpose of this study is to examine student\u2019s clinical perceptions of training experiences by the evaluation of a questionnaire, in order to improve the clinical process and the planning of clinical teaching programme and quality. Key words: professional training, evaluation and self-evaluation model
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