42 research outputs found
POORLY DIFFERENTIATED FOLLICULAR THYROID CARCINOMA: PROGNOSTIC FACTORS AND RELEVANCE OF HISTOLOGICAL CLASSIFICATION
No full textBackground. Poorly differentiated follicular carcinomas (PDFC) of the thyroid represent an heterogeneous but distinct group of tumors, clinically and histopathogenetically intermediate between follicular-derived well-differentiated and anaplastic carcinomas. The existence of this group of tumors was first proposed independently by Sakamoto et al. in 1983 and Carcangiu et al. in 1984 according to substantially different diagnostic criteria. Indeed, although the number of articles written on the subject of PD carcinoma has grown exponentially during the last decade, at the present the diagnostic criteria differ between various authors. Moreover, there is no clear definition of the histological, immunohistochemical and genetic characteristics of PDFC. Furthermore, although the majority of studies show the aggressiveness of PDFC with a high propensity for local recurrence and distant metastasis, there is no consensus regarding the prognostic indicators for these tumors.
Objective: The work performed during my Doctorate thesis in France contributes to clarify the histological definition and to identify clinical, histological, immunohistochemical characteristics of PDFC. For this purpose, parallel clinical, histological and immunohistochemical investigations have been performed.
Methods: Forty patients affected by PDFC were identified on the basis of a trabecular, insular, or solid (TIS) growth pattern, and their clinical outcome was correlated with histological architecture, cytological characteristics and expression of various markers of cell proliferation and differentiation such as cyclin A, B1, D1 and E, Ki67, TPO, galectin 3, Duox, VEGF, EGFR, P53.
Results: The mean survival was 5.2 5 years. At 5 years,the survival rate was 63% and the metastasis-free survival rate was 57%. An older age at the time of diagnosis and a larger tumor size were associated with an increased risk of distant metastases and of cancer related death whereas a high expression of Duox was associated with a reduced risk of death. In these patients with PDFC, no histological features or marker expression was prognostic. Conclusion: this study confirmed that PDFC has a more aggressive behavior than well differentiated carcinoma (WDC); prognosis is related to indicators that are relevant in patients with WDC, advanced age and larger tumor size
“Ruolo della PET (tomografia ad emissione di positroni) con 2-(18F)Fluoro-2-Desossiglucosio (FDG) nel carcinoma differenziato della tiroide”
No full textA rare case of infant sepsis due to the emm-89 genotype of Group A Streptococcus within a community-acquired cluster
No full textInvasive Group A Streptococcus disease is a severe and sometimes life-threatening infection with only few cases reported in literature. We describe the case of a 49-day-old male infant with invasive Group A Streptococcus infection characterized by acute otitis media and development of septicemia within a probably community-acquired cluster. The causative agent resulted to be a rare emm-89 genotype of Streptococcus pyogenes. Group A Streptococcus must be considered responsible for sepsis in newborns and young infants
Follow-up of differentiated thyroid carcinoma.
No full textThyroid cancer is the most common endocrine malignancy. More than 90% of primary thyroid cancers are differentiated papillary or follicular types. The treatment of differentiated thyroid carcinoma (DTC) consists of total thyroidectomy and radioactive iodine ablation therapy, followed by L-thyroxine therapy. The extent of initial surgery, the indication for radioiodine ablation therapy and the degree of TSH-suppression are all issues that are still being debated cancers are in relation to the risk of recurrence. Total thyroidectomy reduces the risk of recurrence and facilitates (131)I ablation of thyroid remnants. The aim of radioiodine ablation is to destroy any normal or neoplastic residuals of thyroid tissue. These procedures also improve the sensitivity of thyroglobulin (Tg) as a marker of disease, and increase the sensitivity of (131)I total body scan (TBS) for the detection of persistent or recurrent disease. The aim of TSH-suppressive therapy is to restore euthyroidism and to decrease serum TSH levels, in order to reduce the growth and progression of thyroid cancer. After initial treatment, the objectives of the follow-up of DTC is to maintain adequate thyroxine therapy and to detect persistent or recurrent disease through the combined use of neck ultrasound (US) and serum Tg and (131)I TBS after TSH stimulation. The follow-up protocol should be adapted to the risk of recurrence. Recent advances in the follow-up of DTC are related to the use of recombinant human TSH (rhTSH) in order to stimulate Tg production and the ultrasensitive methods for Tg measurement. Undetectable serum Tg during TSH suppressive therapy with L-T4 does not exclude persistent disease, therefore serum Tg should be measured after TSH stimulation. The results of rhTSH administration and L-thyroxine therapy withdrawal are equivalent in detecting recurrent thyroid cancer, but the use of rhTSH helps to avoid the onset of hypothyroid symptoms and the negative effects of acute hypothyroidism on cardiovascular, hepatic, renal and neurological function. In low-risk DTC patients serum Tg after TSH stimulation, together with ultrasound of the neck, should be used to monitor persistent disease, avoiding diagnostic TBS which has a poor sensitivity. These recommendations do not apply when Tg antibodies are present in the serum, in patients with persistent or recurrent disease or limited thyroid surgery. Low-risk patients may be considered to be in remission when undetectable Tg after TSH stimulation and negative US evaluation of the neck are present. On the contrary, detectable Tg after TSH stimulation is an indicator in selecting patients who are candidates for further diagnostic procedure
Music affects functional brain connectivity and is effective in the treatment of neurological disorders
No full textIn a million years, under the pressure of natural selection, hominins have acquired the abilities for vocal learning, music, and language. Music is a relevant human activity, highly effective in enhancing sociality, is a universal experience common to all known human cultures, although it varies in rhythmic and melodic complexity. It has been part of human life since the beginning of our history, or almost, and it strengthens the mother-baby relation even within the mother's womb. Music engages multiple cognitive functions, and promotes attention, concentration, imagination, creativity, elicits memories and emotions, and stimulates imagination, and harmony of movement. It changes the chemistry of the brain, by inducing the release of neurotransmitters and hormones (dopamine, serotonin, and oxytocin) and activates the reward and prosocial systems. In addition, music is also used to develop new therapies necessary to alleviate severe illness, especially neurological disorders, and brain injuries
Utilizzo del TSH ricombinante nella diagnostica del carcinoma differenziato della tiroide:trials multicentrici di validazione
No full textCombined DiI and Antibody Labeling Reveals Complex Dysgenesis of Hippocampal Dendritic Spines in a Mouse Model of Fragile X Syndrome
No full textStructural, functional, and molecular alterations in excitatory spines are a common hallmark of many neurodevelopmental disorders including intellectual disability and autism. Here, we describe an optimized methodology, based on combined use of DiI and immunofluorescence, for rapid and sensitive characterization of the structure and composition of spines in native brain tissue. We successfully demonstrate the applicability of this approach by examining the properties of hippocampal spines in juvenile Fmr1 KO mice, a mouse model of Fragile X Syndrome. We find that mutant mice display pervasive dysgenesis of spines evidenced by an overabundance of both abnormally elongated thin spines and cup-shaped spines, in combination with reduced density of mushroom spines. We further find that mushroom spines expressing the actin-binding protein Synaptopodin—a marker for spine apparatus—are more prevalent in mutant mice. Previous work identified spines with Synaptopodin/spine apparatus as the locus of mGluR-LTD, which is abnormally elevated in Fmr1 KO mice. Altogether, our data suggest this enhancement may be linked to the preponderance of this subset of spines in the mutant. Overall, these findings demonstrate the sensitivity and versatility of the optimized methodology by uncovering a novel facet of spine dysgenesis in Fmr1 KO mice
TRASCRIPTION FACTORS COOPERATE TO PROMOTE DOPAMINERGIC DIFFERENTIATION
No full textMesencephalic dopaminergic (mesDA) neurons are mainly located in ventral midbrain (substantia nigra and ventral tegmental area) and control voluntary movement, reward, attention and other cognitive processes. Their degeneration is related to Parkinson?s disease (PD), Attention Deficit Hyperactivity Disorder (ADHD) and other pathological conditions.
During dopaminergic differentiation and maturation a great numbers of molecules (morphogens and trascription factors) are tightly regulated. Among these the transcription factor Nurr1 has a pivotal role in embryonic differention and maintenance in the adulthood of mesDA neurons. It regulates the expression of tyrosine hydroxylase (TH) and is essential for survival of the dopaminergic neurons. Lmx1a, another trascription factor, is expressed mainly in the early phases of dopaminergic differentiation even if recent works suggest its roles in late phases of development by regulating the expression of vescicular monoamine transporter 2 (VMAT2) and the dopamine transporter (DAT) both markers of mature mesDA neurons.
In this work we reveal that Nurr1 and Lmx1a, act in a cooperative way to promote DA differentiation both in mouse mesencephalic primary cultures and in mesencephalic immortalized cell line (mes-c-myc-A1). Co-expression of Nurr1 with Lmx1a boosts the DA phenotype by increasing the levels of TH, VMAT2 and DAT. Interestingly by performing Luciferase reporter assays with Lmx1a and truncated constructs of Nurr-1 we observed that the C-terminal part of Nurr-1 is essential for this synergic activity.
Taken togheter our results can help to clarify the mechanism of action of Nurr1 and provide new research avenues aimed to dissect the essential players in DA differentiation
