587 research outputs found
Therapeutic potential of high mobility group box-1 in ischemic injury and tissue regeneration.
No full textHigh-mobility group box-1 (HMGB1) is a nuclear protein that acts as a cytokine when released into the extracellular milieu by necrotic and inflammatory cells, and is involved in inflammatory responses and tissue repair. This protein is released passively during cellular necrosis by almost all cells that have a nucleus, but is also actively secreted by immune cells such as macrophages and monocytes. This cytokine plays a key role in mediating the local and systemic responses to several stimuli and might have therapeutic relevance. Indeed, vessel-associated stem cells, injected into the general circulation of dystrophic mice, migrate to sites of tissue damage in response to the HMGB1 signal, by a nuclear factor-κB dependent mechanism. Moreover, endogenous HMGB1 enhances angiogenesis and restores cardiac function in a murine model of myocardial infarction, and the exogenous administration of HMGB1 after myocardial infarction leads to the recovery of left ventricular function through the regeneration of cardiomyocytes. Finally, recent findings show that endogenous HMGB1 is crucial for ischemia-induced angiogenesis in diabetic mice and that HMGB1 protein administration enhances collateral blood flow in the ischemic hind limbs of diabetic mice through a VEGF-dependent manner. The mechanisms of action of this protein are complex and are not well known or defined. The objective of this review is to evaluate the data regarding the tissue regeneration effects of HMGB1, with the aim of providing practical considerations about this topic for the management of subjects affected by ischemic and degenerative diseases
New therapeutic effects of cilostazol in patients with ischemic disorders.
No full textCilostazol (CIL) is effective for the treatment of patients with peripheral arterial disease (PAD). CIL is an orally administered drug with multiple effects, including anti-platelets aggregation, favorable functions on plasmatic lipids and vasodilator ones, but how these effects might be related to improvement in patients walking affected by PAD is not fully understood. The latest data demonstrate that nitric oxide (NO) is induced by CIL through endothelial nitric oxide synthase (eNOS) activation via a cyclic-AMP (cAMP)/ protein kinase A (PKA)- and PI3K/Akt- dependent mechanism. This mechanism is also responsible for the vasodilatation dependent on endothelium which characterized patients receiving CIL. Other investigators have found that CIL notably reduces the exercise-induced host-inflammatory response in PAD patients, and consequently it improves lipid hydroperoxides and cell-adhesion molecule levels. We recently reported that CIL is able to cause neoangiogenesis in vivo by stimulating the production of proangiogenic proteins, such as vascular endothelial growth factor (VEGF), that increase levels of Endothelial progenitor cells (EPCs) and the formation of new blood vessels. The mechanisms of action of this drug are several and are not clear and established. The objective of the present review is to analyze the existing data about the therapeutic effects of CIL, with the purpose of providing practical indications about this topic for the management of subjects affected by ischemic disorders
Response to comment on: Biscetti et al. (2010) High-mobility group box-1 protein promotes angiogenesis after peripheral ischemia in diabetic mice through a VEGF-dependent mechanism. Diabetes;59:1496-1505
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GNPy experimental validation on flex-grid, flex-rate WDM optical transport scenarios
No full textWe demonstrate accurate GSNR predictions for a flex-grid and flex-rate experimental transmission using an enhanced implementation of the open-source GNPy library for a 1600 km OLS, involving QPSK, 8-QAM and 16-QAM modulation formats
Transoral robotic surgery for bilateral parenchymal submandibular stones: the Flex Robotic System
No full textTraditional management of the submandibular gland stones is based on transcervical sialadenectomy. Recently, conservative treatments emerged. In particular, transoral robotic surgery (TORS) has been used for the removal of submandibular sialoliths. Previous case series of TORS reported the use of the Da Vinci system with a high success rate. We describe an uncommon case of bilateral hilo-parenchymal submandibular stone removed via transoral approach with the Flex Robotic System. We report the step-by-step procedure for the transoral robotic approach to hilo-parenchymal submandibular sialoliths through the oral floor. The procedure was successful without complications. The total procedure time was 130 minutes, including 20 minutes for the robotic setting. The Flex Robotic System appeared to be a safe conservative surgical tool for hilo-parenchymal submandibular sialoliths by simultaneously preserving submandibular glands and avoiding severe complications on anatomical structures of the oral floor
The Role of the Stem Cells Therapy in the Peripheral Artery Disease.
No full textVascular complications of diabetes mellitus are an important issue for all clinicians involved in the management of this complex pathology. Although many therapeutic advances have been reached, peripheral arterial disease is still an unsolved problem that each year compromises the quality of life and life span of affected patients. Oftentimes, patients, after ineffective attempts of revascularization, undergo greater amputations. At the moment, there is no effective and definitive treatment available. In this scenario, the therapeutic use of stem cells could be an interesting option. The aim of the present review is to gather all the best available evidence in this regard and to define a new role of the stem cells therapy in this field, from biomarker to possible therapeutic target
Flex-PAM modulation formats for future optical transmission system
No full textWe propose four strategies to establish the operation of the transmitter of flexible modulation formats based on different PAM constellations on the in-phase and quadrature axes of the two polarizations exploited for optical fiber transmission (Flex-PAM). We verify that the strategy based on forcing all the four PAMs to operate at the same bit error rate (BER) - the "same-BER" strategy - besides being the easiest to be implemented enables back-to-back performances only slightly sub-optimal with respect to the strategy that minimizes the overall Flex-PAM signal-to-noise ratio, given the target BER. We also show how nonlinear propagation performances of a WDM comb of Flex-PAM channels can be optimized operating on the power ratio between the four PAM constellation
Outcomes of Lower Extremity Endovascular Revascularization: Potential Predictors and Prevention Strategies
No full textPeripheral artery disease (PAD) is a manifestation of atherosclerosis, which may affect arteries of the lower extremities. The most dangerous PAD complication is chronic limb-threatening ischemia (CLTI). Without revascularization, CLTI often causes limb loss. However, neither open surgical revascularization nor endovascular treatment (EVT) ensure long-term success and freedom from restenosis and revascularization failure. In recent years, EVT has gained growing acceptance among all vascular specialties, becoming the primary approach of revascularization in patients with CLTI. In clinical practice, different clinical outcomes after EVT in patients with similar comorbidities undergoing the same procedure (in terms of revascularization technique and localization of the disease) cause unsolved issues that need to be addressed. Nowadays, risk management of revascularization failure is one of the major challenges in the vascular field. The aim of this literature review is to identify potential predictors for lower extremity endovascular revascularization outcomes and possible prevention strategies
Quantitative digital subtraction angiography to localize intercostal arteries during thoracic endovascular aortic repair
No full textThe accurate identification and preservation of critical intercostal arteries are important technical issues during thoracic endovascular aortic repair (TEVAR) to reduce the risk of postoperative paraparesis.
The localization of intercostal arteries by digital subtraction angiography (DSA) before deployment of a stent graft is often difficult because of their small caliber and posterior orientation. Parametric color coding is an imaging software that measures flow dynamics in a DSA series and provides quantitative information without the additional cost of an X ray dose and contrast medium. In a single image, quantitative DSA (Q-DSA; syngo iFlow software; Siemens, Forchheim, Germany) provides information on the transit of contrast medium through vessels
We describe the use of Q-DSA to localize and preserve the intercostal arteries in the distal descending aorta during TEVAR
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