196,170 research outputs found
Ablation of pulmonary neoplasms: review of literature and future perspectives
No full textThermal ablation is a minimally invasive technology used to treat many types of tumors, including lung cancer. Specifically, lung ablation has been increasingly performed for unsurgical fit patients with both early-stage primi- tive lung cancer and pulmonary metastases. Image-guided available techniques include radiofrequency ablation, microwave ablation, cryoablation, laser ablation and irreversible electroporation. Aim of this review is to illustrate the major thermal ablation modalities, their indications and contraindications, complications, outcomes and notably the possible future challenges
Effectiveness and safety in radiofrequency ablation of pulmonary metastases from HCC: a five years study
No full textHepatocellular carcinoma (HCC) is a frequent tumor that may be treated with radiofrequency thermal ablation (RFA). RFA has been used with success also in treatment of pulmonary metastases from a wide range of primitive tumors, especially colorectal. Previous studies have shown that RFA con be used in treating HCC pulmonary metastases. Purpose of our study was a retrospective evaluation of overall survival and complication rates of percutaneous CT-guided radiofrequency ablation of pulmonary metastases from hepatocellular carcinoma (HCC). Data were collected from 40 CT-guided ablation sessions performed on 42 lesions in 26 patients (16 M and 10 F; mean age 62.5 years) with pulmonary metastases from HCC (size range 0.3–4 cm, mean diameter 1.4 ± 0.98 cm) from February 2012 to December 2017. All patients, as in advanced stage of illness (stage C), were treated according to Barcelona Clinic Liver Cancer (BCLC) criteria, with Sorafenib. They had no active HCC foci in the liver and no more than three metastases in the lung. Patients did not discontinue medical therapy with Sorafenib and pulmonary relapses were treated up to three times. In two patients two lesions were treated during the same procedure. Each lesion was ablated under CT guidance. Follow-up contrast-enhanced CT at 1, 3, 6, 12-month and every 6 months after treatment were reviewed. A total of 42 metastatic lung lesions from HCC in 26 patients (57% male, 43% female) were treated with CT-guided radiofrequency thermal ablation procedures. Immediate radiofrequency ablation-related complications (subtle pneumothorax) were observed in 9 of 40 procedures (22.5%). Only one patient developed a pneumothorax requiring drainage tube insertion (2.5%). No other major complications occurred. Moreover, no significant worsening of pulmonary function was observed. In all patients the overall survival rates were 88.5% at 1 year, 69.8% at 3 years and 26.2% at 5 years. Our retrospective assessment confirmed that percutaneous CT-guided radiofrequency thermal ablation in 23 patients with pulmonary metastases from HCC represents an effective and safe alternative treatment option in patients not considerable as potential candidates to surgery
RFA of primary and metastatic lung tumors: long-term results
No full textThe aim of our study is a retrospective evaluation of effectiveness and safety of Computed Tomography (CT)-guided radiofrequency ablation (RFA) therapy of primary and metastatic lung lesions in patients that cannot be considered surgical candidates. From February 2007 to September 2017, we performed 264 CT-guided ablation sessions on 264 lesions in 174 patients (112 M and 62 F; mean age, 68 years; range 36–83 years) affected by primary and metastatic lung lesions. The 45% of patients was affected by primary lung cancer, with size range lesion of 10–50 mm, and the 55% by metastatic lung lesions with size range of 5–49 mm. All patients had no more than three metastases in the lung and pulmonary relapses were treated up to three times. Overall Survival (OS), Progression-Free Survival (PFS), Local Progression-Free Survival (LPFS) and Cancer-specific survival (CSS) at 1, 3 and 5 years were calculated both in primary lung tumors and in metastatic patients. Immediate and late RFA-related complications were reported. Pulmonary function tests were evaluated after the procedures. The effectiveness of RFA treatment was evaluated by contrast-enhanced CT. In patients affected by primary lung lesions, the OS rates were 66.73% at 1 year, 23.13% at 3 years and 16.19% at 5 years. In patients affected by metastatic lung lesions, the OS rates were 85.11%, 48.86% and 43.33%, respectively, at 1, 3 and 5 years. PFS at 1, 3 and 5 years were 79.8%, 60.42%, 15.4% in primary lung tumors and 78.59%, 51.8% and 6.07% in metastatic patients. LPFS at 1, 3 and 5 years were 79.8%, 64.69%, 18.87% in primary lung tumors and 86.29%, 69.15% and 44.45% in metastatic patients. CSS at 1, 3 and 5 years was 95.56%, 71.84%, 56.72% in primary lung tumors and 94.07%, 71% and 71% in metastatic patients. Immediate RFA-related complications (pneumothorax, pleural effusion and subcutaneous emphysema) were observed, respectively, in 42, 53 and 13 of 264 procedures (15.9%, 20% and 5%). There also occurred one major complication (lung abscess, 0.36%). No significant worsening of pulmonary function was noted. Our retrospective evaluation showed long-term effectiveness, safety and imaging features of CT-guided RFA in patients affected by primary and metastatic lung cancer as an alternative therapy in non-surgical candidates
3D MODELLING AND MEDIEVAL LIGHTING RECONSTRUCTION FOR RUPESTRIAN CHURCHES
No full textThe aim of this research is to define a method, able to analyse the systems of illumination in the medieval period, through a 3D virtual model reconstruction. It specifically needs to deepen the interactions between natural and artificial illumination in confined spaces. The study describes and examines the best survey technique to obtain a 3D model reconstruction, according to the achievement of such lighting scenarios, and the most suitable tools for lighting analysis. Thus, it is possible to carry out accurate interpretations of the past starting from historical sources and scientific data about lighting. This method was validated on a case study of a rupestrian church in Matera. The rupestrian contexts are less investigated in relation to mediaeval artificial lighting even if there are recognitions and comparative studies of widespread contexts, not only in Puglia and Basilicata, but also in Mediterranean area (e.g. in Cappadocia and Cyprus) which allow identifying evidences related to artificial lighting systems. The architectural signs (hole, niches, etc.) for ancient luminaries can be studied in 3D and lighting prospective. Lastly, the virtual model of the rupestrian church was imported into an opensource visualisation software (3D Heritage Online Presenter) to be appreciable on line and to promote historical heritage knowledge
Detection of Fibroadipose Tissue Infiltration with Cardiac Computed Tomography: A Case of Arrhythmogenic Cardiomyopathy
No full text: In the evaluation of cardiomyopathies, cardiac computed tomography (CCT) is predominantly used for assessing congenital or acquired coronary artery diseases as a potential etiology underlying the observed myocardial abnormalities. However, its utility is expected to expand. We present a case of an asymptomatic patient with claustrophobia who sought medical attention due to frequent ventricular beats. The resting electrocardiogram revealed repolarization abnormalities characterized by flattened T-waves in the lateral leads and low QRS voltages in the peripheral leads, whereas transthoracic echocardiography was normal. CCT accurately identified hypodense areas indicative of fibrofatty infiltration within the inferolateral and anterior walls of the left ventricle. Furthermore, late iodine contrast-phase imaging revealed subepicardial late enhancement striae in the same regions. These imaging findings were pivotal in establishing a diagnosis of left-dominant arrhythmogenic cardiomyopathy. This clinical vignette underscores the potential of CCT in tissue characterization, particularly when cardiac magnetic resonance imaging is contraindicated or unavailable
Thermal and seismic capacity improvements for masonry building heritage: A unified retrofitting system
No full textToday, the attention in the retrofitting of building is quickly growing. In this field, the re-use of waste materials and the innovation in the retrofitting techniques are among the crucial topics. Generally, thermal capacity and seismic resistance are two aspects very felt by the building owners. Commonly, independent approaches are assessed in order to cover the energy and mechanical lacks of a building. In such a way, the intervention may result time‐ and cost‐consuming or, sometimes, poorly effective. The present paper aimed to propose and validate a new retrofitting system based on the partial use of waste materials, such as fly ash and expanded glass (acting as a matrix), and a fiber open grid reinforcement. The proposal is suitable for the plastering of building with the double scope of thermal insulation and seismic strengthening throughout a unique application. An experimental investigation was carried out considering small‐scaled masonry panels with double-side retrofitting. The studied parameters were thermal transmittance and shear strength. The results evidenced the effectiveness of the proposed technique, able to significantly improve the un-retrofitted masonry, from both the thermal and mechanical point of view
Modulation of glucose-related metabolic pathways controls glucose level in airway surface liquid and fight oxidative stress in cystic fibrosis cells
No full textDirect and indirect evidences show that elevated glucose concentrations in airway surface liquid (ASL) promote lung infection by pathogens, playing a role in the progression of the Cystic Fibrosis (CF) disease. The joint action of transporter/s for glucose and of the cellular enzymes is essential in order to try to lower ASL glucose level. Inside the cell, the glycolysis and the pentose phosphate pathway (PPP) compete for the utilization of glucose-6-phosphate (G6P), the product in which glucose, after entry within the cell and phosphorylation, is trapped. The study aims to clarify whether, modulating the activity of enzymatic proteins and/or the level of metabolites/cofactors, involved in intracellular glucose utilization, a lowering of the extracellular glucose level in CF occurs. Biochemical approaches have enabled us to understand i) how G6P is shunted between glycolysis and PPP and ii) that mitochondria, more than enzymes/cofactors participating to the two cell glucose utilization pathways, are protagonists of the scene in counteracting the high ASL glucose level as well as oxidative stress in CF
A new Fabric Reinforced Geopolymer Mortar (FRGM) with mechanical and energy benefits
No full textA large part of the European building Heritage is dated back over centuries. Consequently, its structural and thermal performances are often inadequate. Commonly, different interventions are proposed for solving these issues separately. However, reasonable drawbacks arise when the structural retrofitting requires a direct contact with the target-member while the insulation layer is potentially interposed in between. In this scenario, the present research proposes a novel and unique system able to guarantee both the energetic and the structural retrofitting. Inorganic Matrix Composites (IMCs) are a promising solution in this sense. Among them, the Fabric Reinforced Cementitous Matrix (FRCM) is one of the most used; or rather a composite made of a fabric (open grid or mesh) within an inorganic matrix (lime or cement based). Even if the inorganic matrix has a relevant thickness (if compared with the one of the fabric), its thermal resistance is insufficient. The novelty of this work consists in assessing a new geo-polymeric FRCM-system by combining fly-ash binder (reused material) and expanded glass aggregate (recycled material). Direct tensile tests, for measuring the tensile strength, ultimate strain and elastic modulus, were performed in addition to thermal conductivity tests. The results were compared with those of traditional FRCM (commercially available). The potentiality of the proposal for structural and energy retrofitting is discussed and examples of its possible application are also reported
Mechanisms of bone impairment in sickle bone disease
No full textSickle bone disease (SBD) is a chronic and invalidating complication of Sickle cell disease (SCD), a multisystem autosomal recessive genetic disorder affecting millions of people worldwide. Mechanisms involved in SBD are not completely known, especially in pediatric age. Among the hypothesized pathogenetic mechanisms underlying SBD are bone marrow compensatory hyperplasia and bone ischemic damage, both secondary to vaso-occlusive crisis (VOC), which leads to cell sickling, thus worsening local hypoxia with a negative impact on osteoblast recruitment. Furthermore, the hypoxia is a strong activator of erythropoietin, which in turn stimulates osteoclast precursors and induces bone loss. Hemolysis and iron overload due to a chronic transfusion regimen could also contribute to the onset of bone complications. Vitamin D deficiency, which is frequently seen in SCD subjects, may worsen SBD by increasing the resorptive state that is responsible for low bone mineral density, acute/chronic bone pain, and high fracture risk. An imbalance between osteoblasts and osteoclasts, with a relative decrease of osteoblast recruitment and activity, is a further possible mechanism responsible for the impairment of bone health in SCD. Moreover, delayed pubertal growth spurt and low peak bone mass may explain the high incidence of fracture in SCD adolescents. The aim of this review was to focus on the pathogenesis of SBD, updating the studies on biochemical, instrumental, and biological markers of bone metabolism. We also evaluated the growth development and endocrine complications in subjects affected with SCD
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