[Show abstract][Hide abstract] ABSTRACT: Background/Aim: Matrix metalloproteinases (MMPs) are involved in cancer biology. Expression of MMP7 (matrilysin) in colorectal cancer is associated with metastatic disease even though it is expressed in most tumour states. In the present study, our purpose was to analyze MMP7 in bowel and lymph nodes of different tumour stages and to evaluate its expression as a cancer biomarker.
28 patients surgically-treated for benign and malignant colorectal tumours were recruited and analyzed for MMP7 in tumoural tissue, lymph nodes and serum by histology, immunohistochemistry, ELISA and western blotting.
Immunohistochemistry showed prevalent expression of MMP7 in advanced cancer. A significant increase (p<0.001) was evident in serum of stage III/IV cancers compared to both adenomas and non-metastatic disease. MMP7 was increased in cancer tissues with prevalence in stage I/II. Lymph nodes presented a significant increase of MMP7 (p<0.05 adenoma vs. stage I/II and p<0.001 vs. stage III/IV).
MMP7 increases with dysplasia and cancer disease stage in tumour tissue as well as in the regional lymph nodes. It may be used as a complement in investigating suspected locally advanced cancer.
In vivo (Athens, Greece) 07/2014; 28(1):105-10. · 0.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The goal of this study was to describe and review the results of a technique in which reconstruction of the common and profunda femoral arteries is combined with a femoro-femoral crossover graft using the same synthetic graft. A synthetic bifurcated graft (such as the ones used for aortobifemoral reconstruction), in which one limb is cut off, is used, leaving an enlarging patch at the end where the proximal anastomosis will be fashioned.
From January 1972 to January 2000, 6 patients underwent this reconstruction for severe limb ischemia. Patients were followed up in the outpatient clinic every 6 months.
No postoperative mortality and no major complications were seen. One patient had a superficial wound infection, which resolved with conservative treatment. Five patients had a patent graft at an average follow-up of 39 months.
Using the same synthetic graft allows angioplasty of the common and profunda femoral arteries of the donor side and revascularization of the opposite lower limb, with good short- and long-term results.
Annals of Vascular Surgery 07/2013; 27(5):687-8. DOI:10.1016/j.avsg.2012.10.014 · 1.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
The aim of this study was to determine the hemodynamic and clinical changes after occlusion of polytetrafluoroethylene (PTFE) femorotibial grafts.
Twenty-seven patients were randomly selected from all patients who underwent femorotibial bypass grafting in our department. In 10 patients, the reversed autologous saphenous vein was used as graft, and in 17 patients a PTFE prosthesis was used. Out of the latter 17 patients, 10 began long-term aspirin therapy and 7 began oral anticoagulation with warfarin.
Nine out of the 10 patients with occluded PTFE grafts and who received only aspirin therapy had a critical ischemia after occlusion of the graft, and 4 underwent major amputation. Among the 10 patients with occluded autologous vein bypass, critical ischemia was present in only 4 patients, and only 2 required some form of surgical therapy with no case of major amputation.
After occlusion of a PTFE femorotibial graft, there is a condition of critical ischemia that is less common after occlusion of a vein graft. Oral anticoagulation seems to prevent these negative changes.
Annals of Vascular Surgery 01/2013; 27(5). DOI:10.1016/j.avsg.2012.05.030 · 1.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Lumbar hernia is a rare form of abdominal hernia, which has been recognized later along the early development of the modern surgery. it has been, on many occasions, the object of heavy debate regarding its anatomical background and as well its etiology. The authors reports the historical aspects of this rare pathology, focusing on the earliest descriptions of hernia arising in lumbar regions, on the first reports of surgical repair, and on the anatomical description of the lumbar weakness areas, that are currently named Petit's triangle and Grynfeltt and Lesshaft's triangle.
Annali italiani di chirurgia 10/2011; 83(5):451-4. · 0.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Matériel
Un total de 10 patients aléatoirement choisis parmi ceux ayant eu un pontage fémoro-poplité en veine saphène inversée dans notre établissement et qui ont eu une angiographie postopératoire étaient inclus dans l'étude.
La survenue de changements dégénératifs à l'angiographie de contrôle était corrélée avec la qualité du lit d’aval vu à l'angiographie préopératoire et avec le niveau de l'index de résistance périphérique, calculé comme différence entre la pression à la partie supérieure du mollet et celle à la cheville, divisée par la pression au bras.
Trois patients ont eu les changements dégénératifs qui étaient plus fréquents en cas de lit d’aval pauvre et d'index de résistance distale élevé.
Les changements dégénératifs des greffons de veine saphène inversée sont plus communs en cas de lit d’aval pauvre et de résistance distale élevée. Ces facteurs devraient être ajoutés aux nombreux facteurs de risque qui ont été analysés précédemment.
Annales de Chirurgie Vasculaire 08/2011; 25(6):818–821. DOI:10.1016/j.acvfr.2012.09.012
[Show abstract][Hide abstract] ABSTRACT: A total of 10 patients randomly selected from those who had reversed saphenous vein femoropopliteal bypass at our Institution and who had a postoperative angiogram were included into the study.
The occurrence of degenerative changes at the control angiography was correlated to the quality of the distal runoff as seen at the preoperative angiography and to the level of the index of distal resistances, calculated as the difference between the upper calf pressure and that at the ankle, divided by the arm pressure.
Three patients had degenerative changes which were more common in case of poor distal runoff and high index of distal resistances.
Degenerative changes in reversed saphenous vein grafts are more common in case of poor distal runoff and high distal resistance. These factors should be added to the many risk factors that have been analyzed previously.
Annals of Vascular Surgery 04/2011; 25(6):766-9. DOI:10.1016/j.avsg.2011.01.006 · 1.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Endovascular techniques are often applied, but they have occasionally been reported in the treatment of popliteal vascular entrapment (PVE). A case of bilateral PVE is presented with an acute occlusion of the right popliteal artery. This was twice unsuccessfully treated with arterial recanalization and stenting at another Institution. The patient required an arterial reconstruction with his reversed saphenous vein, in addition to resection of the medial gastrocnemius muscle laterally inserted on his right limb. The left limb was treated with a simple myotomy. Recanalization and stenting is not recommended for PVE treatment.
Annals of Vascular Surgery 11/2010; 24(8):1135.e1-3. DOI:10.1016/j.avsg.2010.03.010 · 1.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction: The incidence of pheochromocytomas is about 1–2/100000 in the adult population. Nearly 10% have an extra-adrenal location or multiple locations and are defined as paragangliomas. They might be catecholamine-secreting as ordinary pheochromocytomas or clinically asymptomatic with compression symptoms.
Patients and Methods: Three cases of abdominal paraganglioma with different clinical onset are reported.
Discussion: Incidentally diagnosed asymptomatic retroperitoneal tumors with secondary hypertension suggest paraganglioma. Increased levels of catecholamine and extra-adrenal lesions identified at CT or MR imaging with positive MIBG scintigraphy support the diagnosis. Optimal care requires a multidisciplinary approach, accurate preoperative exact localization and adequate preoperative medical treatment to reduce perioperative cardiovascular complications.
The Endocrinologist 02/2010; 20(2):63-65. · 0.12 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Primary hyperparathyroidism (pHPT) is caused by a single monoclonal adenoma in more than 80% of patients. Biomolecular mechanisms causing pHPT are still not completely known, even if a great amount of studies have been developed recently, mainly regarding angiogenesis and growth factors. Among the latter, insulin-like growth factor 1 (IGF-1), basic fibroblastic growth factor (bFGF), vascular endothelial growth factor (VEGF), and transforming growth factor beta 1 (TGF-beta1) and their effects have been extensively evaluated in different kinds of endocrine disease.
Parathyroid cell cultures were prepared from six human adenomatous parathyroid glands that were surgically removed. After 7 days of culture, the cells were refed with DMEM supplemented with 2% FCS alone (control group), or containing hrTGFbeta1, or hrIGF-I, or hrbFGF, or hrVEGF. Then, after 48-hour incubation, cell count was performed by a particle count and size analyzer, and prevalence of cell cycle was analyzed by using a flow cytometer.
Cell count (x10000) in the control group was 3.73 +/- 0.32. Low-dose TGF-beta1 stimulation resulted in 5.25 +/- 0.38 cells, and high-dose TGF-beta1 stimulation resulted in 2.35 +/- 0.37 cells. IGF-1 stimulation resulted in 5.4 +/- 0.65 cells, bFGF stimulation in 5.68 +/- 0.86 cells, and VEGF stimulation resulted in 6.03 +/- 1.03 cells. Statistical analysis revealed significant differences in the control group compared with the growth factor-stimulated groups. Cytometry showed different results in the percentage of cells in S-phase, in particular 22.65 +/- 4.98% of IGF-1-stimulated cells were found in S-phase compared with 7.55 +/- 3.2% of control group cells (p < 0.0001).
Growth factors seem to play an important role in parathyroid adenoma cell proliferation; IGF-1, bFGF, VEGF, and low-dose TGF-beta1 promote cell proliferation, whereas high-dose TGF-beta1 inhibits these phenomena.
World Journal of Surgery 01/2010; 34(1):48-54. DOI:10.1007/s00268-009-0294-x · 2.64 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Lumbar hernias, which are rare hernias of the posterolateral abdominal wall, can be divided into two groups: primary lumbar hernias, often the expression of a congenital defect, which typically arise in two areas of weakness, the superior triangle and inferior triangle and acquired (or diffuse) lumbar hernias which are usually due to previous lumbar trauma or surgery. Clinical examination may be adjuvated by ultrasound or CT scan, which can reveal the abdominal wall defect with the hernia content (viscera or extraperitoneal tissue). Surgical repair of lumbar hernias, both primary and acquired, has rapidly developed through recent years, similarly to the treatment of more frequent kinds of hernia (groin, epigastric), evolving from direct repair to mini-invasive techniques, even if, since the rarity of these hernias, precise knowledge of this complex anatomic region is required. Nowadays there are two valid alternatives: open tension-free repair (with use of mesh), and mini-invasive repair. Both are safe and effective, even if smaller hernias can be treated by open approach, with loco-regional anesthesia and good cosmetic effect. Larger hernias, or hernias with suspected viscera involvement, should require larger incisions and viscera exploration. For this reason laparoscopic access would be preferable.
The American surgeon 12/2009; 75(12):1238-41. · 0.82 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The selective blockage of platelet-derived growth factor BB (PDGF-BB), basic fibroblast growth factor (bFGF), and transforming growth factor beta1 (TGF-beta1) by specific antibodies coated into expanded polytetrafluoroethylene (ePTFE) grafts may diminish neointimal hyperplasia. Sixty pigs were divided into two groups (n = 30 each) and then further divided into five subgroups. Group 1 had a bilateral iliac artery ePTFE interposition graft precoated with Matrigel. Three subgroups (A, B, and C) received a specific monoclonal antibody against PDGF-BB, bFGF, or TGF-beta1. One (D) received all antibodies, and one served as control (nonimmune immunoglobulin G [IgG] isotypes) (E). Group 2 had a bilateral iliac artery endothelial cell (EC)-seeded ePTFE interposition graft precoated with Matrigel. Three subgroups (A, B, and C) received a specific antibody against PDGF-BB, bFGF, or TGF-beta1. One (D) received all antibodies, and one served as control (nonimmune IgG isotypes) (E). Light microscopy and immunohistochemical stain showed that neointimal hyperplasia formation was significantly reduced in subgroups D compared to the others (p < 0.05). In subgroups D, the different precoating influenced neointimal hyperplasia formation. It was more pronounced in the prosthesis precoated with EC and Matrigel (p < 0.05). In organ culture, the amount of PDGF-BB, bFGF, and TGF-beta1 release was reduced in subgroup D animals compared to the others (p < 0.05). In subgroups D, the release of PDGF-BB, bFGF, and TGF-beta1 depended on ePTFE seeding. A higher amount of these growth factors was released in the prostheses precoated with EC and Matrigel (p < 0.05), and the bromodeoxyuridine labeling index confirmed higher incorporation in this subgroup (p < 0.001). The combined use of locally administered anti-PDGF-BB, bFGF, and TGF-beta1 monoclonal antibodies reduces neointimal hyperplasia formation.
Annals of Vascular Surgery 05/2009; 23(3):398-409. DOI:10.1016/j.avsg.2008.11.012 · 1.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Le blocage sélectif du facteur de croissance de dérivé plaquettaire (PDGF-BB), du facteur de croissance basique de fibroblaste (bFGF), et du facteur de croissance transformant β1 (TGF-β1) par des anticorps spécifiques enduits dans des greffes de polytétrafluoroéthylène expansé (ePTFE) peut diminuer l'hyperplasie néointimale. Soixante porcs ont été divisés en deux groupes (n = 30), puis divisés en cinq sous-groupes. Le groupe 1 avait subi une interposition iliaque bilatérale d'ePTFE enduit de Matrigel™. Trois sous-groupes (A, B, et C) ont reçu un anticorps monoclonal spécifique contre PDGF-BB, bFGF, ou TGF-β1. Un groupe (D) a reçu tous les anticorps, et un autre groupe (E) a servis de contrôle (isotypes non immunes d'immunoglobulines G [IgG]). Le groupe 2 avait subi une interposition iliaque bilatérale d'ePTFE couvert de cellules endothéliales (CE) dans la Matrigel. Trois sous-groupes (A, B, et C) ont reçu un anticorps spécifique contre PDGF-BB, bFGF, ou TGF-β1. Un groupe (D) a reçu tous les anticorps, et un autre groupe (E) a servis de contrôle (isotypes non immunes d'immunoglobulines G [IgG]). La microscopie photonique et l'immunohistomarquage ont prouvé que la formation d'hyperplasie néointimale était sensiblement réduite dans les sous-groupes D comparés aux autres (p < 0,05). Dans les sous-groupes D, le prérevêtement différent a influencé la formation d'hyperplasie néointimale. Elle était davantage prononcée dans la prothèse couverte de CE dans la Matrigel (p < 0.05). Dans la culture d'organe, les quantités de PDGF-BB, de bFGF, et de TGF-β1 relarguées était réduites chez des animaux du sous-groupe D comparés aux autres (p < 0,05). Dans les sous-groupes D, la sécrétion de PDGF-BB, de bFGF, et de TGF-β1 dépendait de l'ensemencement de l'ePTFE. Une quantité plus élevée de ces facteurs de croissance était libérée dans les prothèses enduites de CE dans la Matrigel (p < 0,05), et l'index de marquage au bromodéoxyuridine a confirmé une incorporation plus élevée dans ce sous-groupe (p < 0,001). L'utilisation combinée des anticorps monoclonaux anti-PDGF-BB, bFGF, TGF-β1 administrés localement réduit la formation d'hyperplasie néointimale.
Annales de Chirurgie Vasculaire 05/2009; 23(3):428-440. DOI:10.1016/j.acvfr.2009.09.013
[Show abstract][Hide abstract] ABSTRACT: S-adenosylmethionine is a metabolite regulating many biological processes; S-adenosylmethionine effect on ubiquitin-proteasome system (UPS) has not been studied yet. We investigated S-adenosylmethionine effects on UPS activity both in vitro, by inhibitor screening assay, and in rat vascular smooth muscle cells, by Western Blot of proteasomal targets. We found that S-adenosylmethionine inhibited UPS activity.
Protein and Peptide Letters 02/2008; 15(1):58-62. DOI:10.2174/092986608783330396 · 1.07 Impact Factor