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1. Endoscopic endonasal approach for resection of a recurrent spheno-orbital meningioma resulting in complete resolution of visual symptoms: A case report and review of literature

Author

Kim, Won, Ghodrati, Farinaz, Mozaffari, Khashayar, Samarage, H Milan, Zhang, Ashley B, Pradhan, Anjali, Lee, Jivianne T, Goldberg, Robert A, and Yang, Isaac

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Ophthalmology and Optometry, Rare Diseases, Brain Disorders, Neurosciences, Cancer, Eye Disease and Disorders of Vision, Patient Safety, Clinical Research, Brain Cancer, Humans, Female, Adult, Middle Aged, Aged, Aged, 80 and over, Male, Meningioma, Sphenoid Bone, Orbital Neoplasms, Neurosurgical Procedures, Treatment Outcome, Neoplasm Recurrence, Local, Meningeal Neoplasms, Retrospective Studies, Spheno-orbital meningioma, Endonasal, Endoscopic approach, Neurosurgery, Optic tract, Vision loss, Oncology and Carcinogenesis, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

PurposeSpheno-orbital meningiomas are rare tumors, accounting for up to 9% of all intracranial meningiomas. Patients commonly present with proptosis, and visual deficits. These slow growing tumors are hard to resect due to extension into several anatomical compartments, resulting in recurrence rates as high as 35-50%. Although open surgical approaches have been historically used for resection, a handful of endoscopic approaches have been reported in recent years. We aimed to review the literature and describe a case of spheno-orbital meningioma with severe vision loss which was resected with an endoscopic endonasal approach achieving complete resolution of visual symptoms.MethodsA systematic review of literature was conducted in accordance with the PRISMA guidelines. PubMed, Cochrane, and Web of Science databases were queried for spheno-orbital meningiomas resected via an endoscopic endonasal approach. Furthermore, the presentation, surgical management, and post-operative outcomes of a 53-year-old female with a recurrent spheno-orbital meningioma are described.ResultsThe search yielded 26 articles, of which 8 were included, yielding 19 cases. Average age at presentation was 60.5 years (range: 44-82), and 68.4% of patients were female. More than half of the cases achieved subtotal resection. Common complications associated with endoscopic endonasal surgery included CN V2 or CN V2/V3 hypoesthesia. Following surgical intervention, visual acuity and visual field remained stable or improved in the majority of the patients.ConclusionEndoscopic approaches are slowly gaining momentum for treatment of spheno-orbital meningiomas. Further studies on the clinical benefits of this approach on patient outcomes and post-operative complications is warranted.

Published
2022

4. Endoscopic endonasal approach for resection of a recurrent spheno-orbital meningioma resulting in complete resolution of visual symptoms: A case report and review of literature

Author

Won Kim, Farinaz Ghodrati, Khashayar Mozaffari, H. Milan Samarage, Ashley B. Zhang, Anjali Pradhan, Jivianne T. Lee, Robert A. Goldberg, and Isaac Yang

Subjects
Adult, Male, Cancer Research, Oncology and Carcinogenesis, Neurosurgery, Neurosurgical Procedures, Rare Diseases, Vision loss, Clinical Research, Sphenoid Bone, Meningeal Neoplasms, 80 and over, Humans, Oncology & Carcinogenesis, Eye Disease and Disorders of Vision, Retrospective Studies, Aged, Cancer, Neurosciences, Middle Aged, Brain Disorders, Brain Cancer, Neoplasm Recurrence, Treatment Outcome, Local, Spheno-orbital meningioma, Neurology, Oncology, Endonasal, Orbital Neoplasms, Female, Endoscopic approach, Patient Safety, Neurology (clinical), Meningioma, Optic tract
Abstract

Purpose Spheno-orbital meningiomas are rare tumors, accounting for up to 9% of all intracranial meningiomas. Patients commonly present with proptosis, and visual deficits. These slow growing tumors are hard to resect due to extension into several anatomical compartments, resulting in recurrence rates as high as 35–50%. Although open surgical approaches have been historically used for resection, a handful of endoscopic approaches have been reported in recent years. We aimed to review the literature and describe a case of spheno-orbital meningioma with severe vision loss which was resected with an endoscopic endonasal approach achieving complete resolution of visual symptoms. Methods A systematic review of literature was conducted in accordance with the PRISMA guidelines. PubMed, Cochrane, and Web of Science databases were queried for spheno-orbital meningiomas resected via an endoscopic endonasal approach. Furthermore, the presentation, surgical management, and post-operative outcomes of a 53-year-old female with a recurrent spheno-orbital meningioma are described. Results The search yielded 26 articles, of which 8 were included, yielding 19 cases. Average age at presentation was 60.5 years (range: 44–82), and 68.4% of patients were female. More than half of the cases achieved subtotal resection. Common complications associated with endoscopic endonasal surgery included CN V2 or CN V2/V3 hypoesthesia. Following surgical intervention, visual acuity and visual field remained stable or improved in the majority of the patients. Conclusion Endoscopic approaches are slowly gaining momentum for treatment of spheno-orbital meningiomas. Further studies on the clinical benefits of this approach on patient outcomes and post-operative complications is warranted.

Published
2022

5. Contributors

Author

Aarabi, Bizhan, Abbott, Rick, Abd-El-Barr, Muhammad M., Abel, Taylor J., Abou-Al-Shaar, Hussam, Acar, Feridun, Achey, Rebecca L., Ackerman, Laurie L., Adappa, Nithin D., Adelson, P. David, Agarwal, Nitin, Aguirre-Padilla, David H., Ahluwalia, Manmeet S., Ahmad, Shahjehan, Ahmed, A. Karim, Ahmed, Raheel, Aisiku, Imoigele P., Akbar, Muhammad A., Akram, Harith, Alaraj, Ali, Albrecht, Jennifer S., Albuquerque, Felipe C., Alexander, Michael J., Alexandrov, Andrei V., Alexopoulos, Andreas V., Ali, Zarina S., Al-Khalili, Kenan, Al-Mefty, Ossama, Al-Mefty, Rami O., Alnahhas, Iyad, Alrobaian, Malek, Al-Saiegh, Fadi, Alterman, Ron L., Altshuler, David B., Amenta, Peter S., Ames, Christopher P., Amin-Hanjani, Sepideh, Ammirati, Mario, Andaluz, Norberto, Anderson, Richard C.E., Andrade, Pablo, Ares, William J., Arle, Jeffrey E., Arnaout, Omar, Arnold, Paul M., Assina, Rachid, Aszmann, Oskar C., Attenello, Frank J., III, Attia, Albert, Avellino, Anthony M., Awad, Issam A., Ayantayo, Temitayo O., Bader, Edward R., Badhiwala, Jetan H., Baehring, Joachim M., Bagic´, Anto I., Bagley, Stephen J., Bai, Michael Y., Bailes, Julian E., Bain, Mark, Baker, Turner, Ball, Perry A., Ballester, Leomar Y., Balu, Ramani, Ban, Vin Shen, Barak, Tanyeri, Baranoski, Jacob F., Barbaro, Nicholas M., Barber, Sean M., Barker, Frederick G., II, Barnett, Gene H., Barone, Constance M., Barrow, Daniel Louis, Basma, Jaafar, Batchelor, Tracy T., Batjer, H. Hunt, Beattie, Michael S., Beaumont, Andrew, Beaumont, Thomas L., Bederson, Joshua B., Belani, Puneet, Belzberg, Allan J., Benet, Arnau, Ben-Haim, Sharona, Berenstein, Alejandro, Berga, Sarah L., Berger, Mitchel S., Bergsneider, Marvin, Bernstock, Joshua D., Bhatia, Sanjay, Bi, Wenya Linda, Bigder, Mark G., Bijlenga, Philippe, Bingaman, William, Birk, Harjus S., Bishop, Allen T., Blakeley, Jaishri O., Blomstedt, Patric, Blue, Rachel, Blumenthal, Scott, Boaro, Alessandro, Boddu, James V., Bohnen, Angela, Bok, Arnold P., Boone, Myles D., Boop, Frederick A., Boszczyk, Bronek M., Bowyer, Susan M., Brahimaj, Bledi C., Brem, Henry, Brem, Steven, Bresnahan, Jacqueline C., Brinjikji, Waleed, Brinkmann, Benjamin H., Brînzeu, Andrei, Britz, Gavin W., Brockmeyer, Douglas L., Brown, Desmond A., Brown, Justin M., Brown, Matthew T., Brown, Robert D., Jr., Bruce, Jeffrey N., Bruckman, Karl C., Bruhat, Alexis, Brunstrom-Hernandez, Janice E., Brunswick, Andrew, Bruzek, Amy K., Buchanan, Ian A., Budohoski, Karol P., Buell, Thomas J., Büki, András, Bunevicius, Adomas, Burchiel, Kim J., Bydon, Mohamad, Byrne, Richard W., Cabrejo, Raysa, Cabrilo, Ivan, Cahill, Daniel P., Caplan, Justin M., Carlson, Andrew P., Carrión-Penagos, Julián, Carroll, Benjamin W., Cascino, Gregory D., Castaneyra-Ruiz, Leandro, Castinetti, Frederic, Cavalcanti, Daniel D., Cawley, C. Michael, Cernak, Ibolja, Cetas, Justin S., Chan, Michael D., Ka-Ying Chan, Vivien, Chang, Chih-Chang, Chang, Louis, Chang, Steven D., Charbel, Fady T., Charest-Morin, Raphaële, Chari, Aswin, Chaudhary, Navjot, Chauvel, Patrick, Chen, Kevin S., Chen, Liang, Cheng, Joseph, Cherian, Jacob, Cheung, Kenneth M.C., Cheyuo, Cletus, Chiang, Veronica L., Chiarelli, Peter A., Chiocca, E. Antonio, Chitale, Rohan V., Cho, Catherine, Choi, Heejung, Chou, Dean, Christian, Cindy W., Christiansen, Peter A., Church, Ephraim W., Clarke, Jennifer L., Cleary, Daniel R., Clune, James E., Cohen, Justin D., Cohen-Inbar, Or, Colasanti, Roberto, Collins, John M., Comair, Youssef G., Conner, Andrew K.P., Connolly, E. Sander, Jr., Cooper, Jared B., Corcos, Daniel Montie, Coric, Domagoj, Costa, Anthony B., Couldwell, William T., Crino, Peter B., Crofton, Andrew R., Cullen, D. Kacy, Curt, Armin, Dacey, Ralph G., Jr., Daci, Rrita, Dailey, Andrew T., D’Alessandris, Quintino Giorgio, Damisah, Eyiyemisi C., Daniels, David J., Das, Sunit, Davanzo, Justin R., David, Carlos A., David, David J., Davidson, Benjamin, Davis, Gavin A., Day, Arthur L., Dea, Nicolas, De Donato, Giuseppe, Deiner, Stacie, De la Garza, Carlos, Delavari, Nader, Del Brutto, Oscar H., Delman, Bradley N., DeLong, Mahlon R., DeMonte, Franco, de Oliveira, Evandro, Derman, Peter B., Desai, Arati, Deshpande, Krutika, Diaz, Michele, Diaz-Arrastia, Ramon R., DiGiorgio, Anthony M., DiLuna, Michael L., DiMeco, Francesco, Dlouhy, Brian J., Doğruel, Yücel, Donahue, Joseph H., Donoho, Daniel A., Doshi, Amish H., Dreier, Jens P., Driver, Joseph, Drofa, Alexander, Ducruet, Andrew F., Duffau, Hugues, Duhaime, Ann-Christine, Dumont, Aaron S., Duncan, John S., Dunn, Gavin P., Dunn, Ian F., Eberwine, James H., Eckardt, Gerald W., Edem, Idara J., Edwards, Michael S.B., Egemen, Emrah, Eisenbarth, Rachel, Eisenberg, Howard, Elder, J. Bradley, Elhammady, Mohamed Samy, Elias, W. Jeffrey, Ellingson, Benjamin M., Ellis, Jason A., Elswick, Clay M., Emch, Todd M., Emerson, Samuel, Ene, Chibawanye I., Englot, Dario J., Erdman, John H., III, Eskandari, Ramin, Essayed, Walid Ibn, Everson, Richard G., Fadul, Camilo E., Fan, Yi, Farina, Dario, Farrell, Christopher J., Feghali, James, Fehlings, Michael G., Fehnel, Katie Pricola, Feigin, Valery L., Feldman, Eva L., Feldman, Michael J., Feldstein, Neil, Fenno, Lief E., Ferguson, Adam R., Feroze, Abdullah H., Fessler, Richard G., Filler, Aaron G., Findlay, J. Max, Finn, Michael A., Finnell, Richard H., Fisher, Charles G., Flamm, Eugene S., Flanders, Tracy M., Flemming, Kelly D., Flores-Sarnat, Laura, Follett, Kenneth A., Fontes, Ricardo B.V., Ford, Paul J., Foreman, Brandon P., Foreman, Paul M., Fornoff, Linden E., Fouda, Mohammed A., Foyouzi, Nastaran, Franco, Daniel, Franzini, Andrea, Fridley, Jared S., Friedlander, Robert M., Frisoli, Fabio A., Fry, Donald E., Gregory Fu, Kai-Ming, Fujita, Naohide, Fulbright, Robert K., Fulkerson, Daniel H., Fuller, Gregory N., Fusco, Matthew R., Galanopoulou, Aristea S., Gallagher, Gary W., Galvan, Adriana, Gander, Phillip E., Gandhi, Chirag D., Gao, Guoyi, Garcia, Hector H., García, Paul S., Gardner, Paul A., Gardner, Raquel C., Garzon-Muvdi, Tomas, Gavin, Cormac G., Gea-Banacloche, Juan C., George, Timothy M., Georgoulis, George D., Gerard, Carter S., Gerety, Patrick A., Gerszten, Kristina, Gerszten, Peter C., Ghaith, Abdul Karim, Ghatan, Saadi, Ghobrial, George M., Ghogawala, Zoher, Ghosh, Chaitali, Giacino, Joseph T., Giacobbe, Peter, Gianaris, Thomas J., Giannotta, Steven L., Giglio, Pierre, Gilad, Ronit, Gill, Brian J.A., Gillick, John L., Gilmer, Holly S., Gjedde, Albert H., Glenn, Chad A., Godil, Saniya S., Goel, Atul, Gokaslan, Ziya L., Goldberg, Jacob L., Goldstein, Hannah E., Golub, Danielle, Gonzalez, Glenn A., Gonzalez-Martinez, Jorge Á., Goodden, John R., Goodman, J. Clay, Goodrich, James Tait, Goodwin, C. Rory, Gordon, David S., Gottfried, Oren N., Goumnerova, Liliana C., Goyal, Anshit, Grady, M. Sean, Graffeo, Christopher S., Grafman, Jordan H., Gragnaniello, Cristian, Grande, Andrew W., Grant, Gerald A., Grebenciucova, Elena, Greenfield, Jeffrey, Grimaudo, Heather C., Groff, Michael W., Gross, Robert E., Grossman, Rachel, Groves, Mari L., Gstoettner, Clemens, Guenette, Jeffrey P., Günel, Murat, Gupta, Nalin, Gutman, Matthew J., Guyer, Richard D., Hachem, Laureen D., Haddad, Georges F., Hadjipanayis, Constantinos G., Hafez, Daniel M., Hagan, John P., Haglund, Michael M., Haines, Stephen J., Haldeman, Clayton L., Halvorson, Kyle G., Hamberger, Marla J., Hamdi, Hussein, Hamilton, D. Kojo, Hamilton, Kimberly M., Hamilton, Mark G., Hankinson, Todd C., Haq, Ihtsham ul, Harbaugh, Robert E., Hardesty, Douglas A., Hardigan, Trevor, Hariz, Marwan, Harrigan, Mark R., Harrop, James S., Hartings, Jed A., Härtl, Roger, Harward, Stephen C., II, Hasbun, Rodrigo, Hawryluk, Gregory W.J., Hayman, Erik, Hayward, Richard D., He, Lucy, Healy, Andrew T., Heary, Robert F., Heiden, Petra, Heinricher, Mary M., Heller, Robert S., Retel Helmrich, Isabel R.A., Helmy, Adel, Heman-Ackah, Sabrina M., Hendricks, Benjamin K., Herendeen, John S., Heros, Roberto C., Herrup, Karl, Hervey-Jumper, Shawn L., Heuer, Gregory G., Heyer, Eric J., Higuchi, Yoshinori, Hillary, Frank G., Ho, Winson S., Hoang, Nguyen, Hoang, Stanley, Hoelscher, Christian, Hoffer, S. Alan, Hofstetter, Christoph, Holland, Eric C., Holland, Ryan M., Holste, Katherine, Hongo, Kazuhiro, Horisawa, Shiro, Horner, Philip J., Howard, Matthew A., III, Hsueh, Brian, Huang, Judy, Huang, Kevin T., Huang, Michael C., Huang, Raymond Y., Hudgins, Eric, Huguenard, Anna, Hunt, Matthew A., Hurlbert, R. John, Hussein, Ahmed E., Hutchinson, Peter J., Huttner, Anita, Huys, Daniel, Hwang, Steven W., Iaccarino, Mary A., Ibrahim, Mohab, Iliff, Jeffrey J., Ilyas, Adeel, Ingram, Susan L., Isaacs, Albert M., Isaias, Ioannis U., Iskandar, Bermans J., Iyer, Aditya K., Jabbour, Pascal, Jackson, Christopher M., Jadhav, Ashutosh P., Jakobs, Martin, Jallo, George I., Jane, John A., Jr., Janigro, Damir, Jankowitz, Brian T., Jea, Andrew, Jehi, Lara, Jellinger, Kurt A., Jenson, Amanda V., Jho, Diana, Jiang, Bowen, Jiang, Fan, Jimenez, David F., Jimenez, Lincoln, Jin, Haiyan, Jo, Jasmin T., Johanson, Conrad E., Johnson, Luke A., Johnson, Mark D., Johnson, Nathaniel, Jones, Adrian C., Jones, Kristen E., Jones, Tuckerman, Joseph, Jacob R., Joshi, Krishna C., Joshi, Rushikesh S., Jovin, Tudor G., Julian, Alex, Juraschka, Kyle, Abdo do Seixo Kadri, Paulo, Kalani, M. Yashar S., Kalanithi, Paul S.A., Kalfas, Iain H., Kalnins, Aleksandrs Uldis, Kamath, Ashwin A., Kanev, Paul M., Kang, Daniel G., Kang, James D., Kanter, Adam S., Kaplitt, Michael G., Kappel, Ari D., Karikari, Isaac, Karsy, Michael, Kasliwal, Manish K., Kaufmann, Anthony M., Kawasaki, Hiroto, Kellner, Christopher P., Kelly, Alexander P., Kemeny, Andras A., Kestle, John R.W., Khalsa, Siri S., Khan, Imad S., Khan, Nadia, Khan, Tariq, Khanna, Omaditya, Khanna, Ryan, Kigerl, Kristina A., Kim, Dong H., Kim, Louis J., Kim, Paul K., Kim, Thomas A., Kim, Won, Kirnaz, Sertaç, Kirsch, Wolff, Kitchen, Neil D., Klein, Joshua P., Kliot, Michel, Knightly, John J., Knisely, Jonathan, Knopman, Jared, Ko, Andrew L., Kobayashi, Katsuya, Kobets, Andrew J., Koch, Matthew J., Kocharian, Gary, Koerner, John D., Kohara, Kotaro, Kohn, Max, Kolias, Angelos G., Koo, Clara S., Kosztowski, Thomas, Kotecha, Rupesh R., Kovach, Christopher K., Kraemer, Mark R., Krauss, Joachim K., Krieg, Sandro M., Krieger, Mark D., Krishnaney, Ajit A., Ksendzovsky, Alexander, Kulkarni, Abhaya V., Vijay Kumar, Gomatam R., Kumar, Sachin A., Kung, David K., Kuo, Jeffrey V., Kvint, Svetlana, Kwan, Kenny, Issa Laack, Nadia N., Ladner, Travis R., Lafage, Renaud, Lafage, Virginie, Lam, Arthur M., Lamm, Adam G., Landazuri, Patrick, Lanzino, Giuseppe, Larson, Paul, Lau, Catherine Y., Lau, Darryl, Lavine, Sean D., Lawler, Sean E., Laws, Edward R., Jr., Lawton, Michael T., Laxpati, Nealen G., Lebed, Brett D., Lee, Cheng-Chia, Lee, Jonathan J., Lee, Ryan P., Lee, Sangmi, Lehman, Ronald A., Jr., Lenke, Lawrence G., Le Roux, Peter D., Leuthardt, Eric C., Levin, Emily, Levy, Elad I., Lewis, Evan M., Lhatoo, Samden, Li, Dianyou, Li, Yingda, Ching Ng, Angela Li, Liau, Linda M., Liebenow, Brittany, Lieberman, Isador H., Limbrick, David D., Jr., Lin, Emily, Lin, Kant Y., Lin, Zhengyu, Lingsma, Hester F., Linskey, Mark E., Lipsman, Nir, Litvack, Zachary N., Liu, James K.C., Liu, Kenneth C., Liu, Wei, Lober, Robert M., Lohkamp, Laura-Nanna, Lonser, Russell R., Louvi, Angeliki, Lozano, Andres M., Lu, Victor M., Luciano, Mark G., Lukas, Rimas V., Luo, Lan, Ma, Lijun, Maas, Andrew I.R., Macdonald, R. Loch, Mack, William J., Mackey, Kimberly A., Macki, Mohamed, MacLachlan, Lara S., Madarash, Holly Oemke, Madsen, Peter J., Maegele, Marc, Magistretti, Pierre J., Mahan, Mark A., Maher, Cormac O., Mahtabfar, Aria, Majeed, Kashif, Makarenko, Serge, Makley, Amy T., Malessy, Martijn J.A., Malik, Athar N., Mallucci, Conor, Mambelli, Dorian D., Mammi, Marco, Mangano, Francesco T., Maniker, Allen H., Manley, Geoffrey T., Manolidis, Spiros, Maroon, Joseph C., Martin, Alastair, Martin, Neil A., Martirosian, Vahan, Martirosyan, Nikolay L., Maslink, Colin, Massie, Lara, Mathur, Amit M., Matias, Caio M., Mauer, Kimberly M., Maulucci, Christopher M., Maurer, Robert K., Mazur, Marcus D., Mazwi, Nicole, McAllister, James P., II, McClain, Craig D., McCormack, Ryan M., McCrea, Michael A., McCutcheon, Ian E., McDermott, Michael W., McDougall, Cameron G., McDougall, Cameron M., McEvoy, Andrew W., McGrath, Hari, McGrath, Lynn, Jr., McKhann, Guy M., McMahon, J. Tanner, McPheeters, Matthew J., Meaney, David F., Medel, Ricky, Medress, Zachary, Mehta, Minesh P., Menacho, Sarah T., Menezes, Arnold H., Menon, David K., Mergeche, Joanna L., Meyer, Fredric B., Meyer, Jenna, Meyer, Scott A., Meyers, Philip M., Midha, Rajiv, Miller, Charles A., Miller, Jonathan P., Miller, Neil R., Mirza, Farhan A., Mirzadeh, Zaman, Miserocchi, Anna, Misra, Basant K., Missios, Symeon, Miyagishima, Danielle F., Miyashiro, Kevin Y., Mizuno, Junichi, Mizuno, Shuichi, Mocco, J., Mohyeldin, Ahmed, Mokin, Maxim, Molinaro, Annette M., Moliterno, Jennifer, Monteith, Stephen J., Montenegro, Thiago S., Mooney, Michael A., Moosa, Shayan, Morales, Diego M., Morgan, Clinton D., Morgan, Isabella, Morgan, Michael Kerin, Mortimer, Vance R., Moss, Nelson, Moss, S. David, Mukherjee, Pratik, Mummaneni, Praveen V., Munich, Stephan A., Muraszko, Karin, Murthy, Saikiran G., Mushlin, Harry, Mussi, Antônio C.M., Nagel, Sean J., Nagy, Gábor, Nair, Dileep R., Najm, Imad M., Nakaji, Peter, Nakajima, Takeshi, Nasser, Rani, Nater, Anick, Navarro, Jovany Cruz, Nayak, Lakshmi, Neira, Justin A., Nelson, Lindsay D., Neman, Josh, Newell, David W., Nguyen, James H., Ngwenya, Laura Benjamin, Nicolato, Antonio, Nimjee, Shahid M., Nishimura, Sayoko, Niu, Tianyi, Norris, Scott A., Noureldine, Mohammad Hassan A., Nurmikko, Turo J., Nuwer, Marc R., Oberheim-Bush, Nancy Ann, Ochiai, Taku, Oh, Nathan, Oh, Taemin, Okonkwo, David O., Okun, Michael S., Oldfield, Edward H., Brigid O’Leary, Joanna Shawn, Olivi, Alessandro, O’Neill, Francis, Oppenlander, Mark E., Osbun, Joshua W., O’Toole, John E., Özduman, Koray, Ozpinar, Alp, Pain, Margaret, Palacios, Eva M., Palmer, James N., Pamir, M. Necmettin, Pamoukian, Vicken, Panesar, Sandip S., Panov, Fedor E., Paramasivam, Srinivasan, Park, Christine, Park, Jon, Park, Paul, Park, T.S., Parker, Whitney E., Parsa, Andrew T., Partington, Michael D., Patel, Aman B., Patel, Bhuvic, Patel, Smruti K., Patel, Vaibhav M., Patil, Parag G., Payne, Russell, Peeters, Sophie M., Pekmezci, Melike, Pendharkar, Arjun V., Penn, Richard Deren, Pennicooke, Brenton H., Pennington, Zach, Della Pepa, Giuseppe Maria, Perin, Alessandro, Perlmutter, Joel S., Persing, J. Scott, Persing, John A., Persing, Sarah M., Peters, Matthew E., Petersen, Erika A., Petrov, Dmitriy, Pham, Martin, Picht, Thomas, Piepmeier, Joseph M., Pikis, Stylianos, Pilcher, Webster H., Pinckard-Dover, Heather N., Pineda, José A., Pinter, Joseph D., Pisculli, Mary L., Pittman, Thomas, Plesnila, Nikolaus, Pollack, Ian F., Pollock, Bruce E., Polly, David W., Jr., Polster, Sean P., Popovich, Phillip G., Post, Kalmon D., Potts, Matthew B., Pouratian, Nader, Powers, Alexander K., Prager, Briana C., Prashant, Giyarpuram N., Prestigiacomo, Charles J., Prevedello, Daniel M., Proctor, Mark R., Prolo, Laura M., Prost, Robert W., Puduvalli, Vinay K., Purger, David A., Qualmann, Krista J., Quiñones-Hinojosa, Alfredo, Raffa, Scott J., Raghavan, Prashant, Rahal, Jason Pierce, Rajappa, Prajwal, Ram, Zvi, Ranjan, Manish, Rao, Ganesh, M.S. Raper, Daniel, Rapoport, Benjamin I., Raskin, Jeffrey S., Raslan, Ahmed M., Rasmussen, Peter, Rasouli, Jonathan J., Ravindra, Vijay M., Ray, Dibyendu K., Ray, Wilson Z., Raz, Eytan, Raza, Shaan M., Régis, Jean, Reilly, Peter L., Reith, Florence C.M., Rennert, Robert C., Resnick, Daniel K., Reynolds, Renée, Rezai, Ali R., Rhines, Laurence D., Rhoton, Albert L., Jr., Ribalta, Teresa, Richardson, R. Mark, Riggins, Gregory J., Riina, Howard A., Rinaldo, Lorenzo, Rincon-Torroella, Jordina, Ringer, Andrew J., Riva-Cambrin, Jay, Rizk, Elias, Robert, Stephanie M., Robertson, Claudia, Robertson, Jon H., Robinson, Leslie C., Robinson, Michael W., Robinson, Shenandoah, Roche, Aidan D., Roche, Pierre-Hugues, Rogg, Jeffrey M., Roguski, Marie, Roland, Jarod L., Rolston, John D., Rosenberg, William S., Rosenow, Joshua M., Rosenthal, Guy, Rosenwasser, Robert H., Roser, Florian, Rosner, Michael K., Rosseau, Gail, Rossi, Vincent J., Rovner, Eric S., Rubiano, Andres M., Rubio, Roberto Rodriguez, Rucker, Janet C., Rui, Yanning, Russin, Jonathan J., Rutka, James T., Saadeh, Yamaan S., Saatian, Behnaz, Sack, Kenneth D., Sader, Nicholas, Safaee, Michael M., Safain, Mina G., Sagher, Oren, Sahgal, Arjun, Saigal, Rajiv, Saito, Nobuhito, Saleh, Mohamed, Salinas, Ryan D., Salminger, Stefan, Samarage, H. Milan, Samdani, Amer F., Sand, Lauren A., Sani, Sepehr, Sankaran, Sujatha, Sansur, Charles A., Santarius, Thomas, Santiago, Paul, Santiago-Dieppa, David R., Santiago-Sim, Teresa, Sarkiss, Christopher A., Sarnat, Harvey B., Sarris, Christina E., Sather, Michael, Savastano, Luis E., Sawaya, Raymond, Schaller, Karl, Schiff, Nicholas D., Schipmann, Stephanie, Schlachter, Leslie, Schlesinger, David J., Schmidt, Franziska A., Schmidt, Meic H., Schneider, Lonnie, Schramm, Johannes, Schuele, Stephan U., Schulder, Michael, Schupper, Alexander J., Schwab, Frank J., Schwartz, Theodore H., Sciubba, Daniel M., Scott, R. Michael, Scullen, Tyler A., Selden, Nathan R., Sellin, Jonathan N., Selman, Warren R., Sen, Chandranath, Serizawa, Toru, Serrone, Joseph C., Sgubin, Donatella, Shaffrey, Christopher I., Shah, Kushal J., Shah, Lubdha M., Shah, Manish N., Shahlaie, Kiarash, Shapiro, Maksim, Sharan, Ashwini, Sharma, Deepak, Sharma, Mohan R., Sheehan, Jason P., Sheehan, Jonas M., Sheikhi, Lila, Shiflett, James M., Shigamatsu, Tomoyoshi, Shilpakar, Sushil Krishna, Shils, Jay L., Shimony, Nir, Shin, Alexander Y., Siddiqui, Adnan H., Sidhu, Meneka K., Silveira, Luke A., Silver, Jerry, Sindou, Marc, Singh, Jeffrey M., Singh, Manish K., Sizdahkhani, Saman, Skirboll, Stephen, Slavin, Justin, Smith, Brandon W., Smith, Edward R., Smith, Justin S., Smith, Kris A., Smith, Luke G.F., Smith, Timothy R., Smith, Yoland, Solomon, David A., Solomon, Robert A., Soltys, Scott G., Somji, Mohamed, Sorenson, Jeffrey M., Soriano, Sulpicio G., Sorscher, Michelle, Souweidane, Mark M., Spencer, Dennis D., Spetzler, Robert F., Spinazzi, Eleonora F., Spinner, Robert J., Sribnick, Eric A., Srinivasan, Visish M., Stabingas, Kristen, Stapleton, Christopher J., Starke, Robert M., Starr, Philip, St. Clair, Eric G., Stedelin, Brittany, Stefko, S. Tonya, Steinberg, Gary K., Stern, Matthew A., Steyerberg, Ewout W., Stieg, Philip E., Stone, Scellig S.D., Stoodley, Marcus, Strahle, Jennifer M., Stricsek, Geoffrey, Strong, Anthony, Strowd, Roy E., III, Stummer, Walter, Su, YouRong S., Sughrue, Michael E., Suh, John H., Sulaiman, Wale A.R., Sun, Bomin, Sun, Matthew Z., Sun, Xiaonan Richard, Sundaram, Vikram K., Sweid, Ahmad, Syed, Hasan R., Tagliati, Michele, Taira, Takaomi, Tajsic, Tamara, Takagi, Yasushi, Takeoka, Yoshiki, Tamargo, Rafael J., Tanaka, Shota, Tandon, Nitin, Tang, Daniel D., Tanweer, Omar, Tate, Matthew C., Tatsui, Claudio E., Taylor, Jennie W., Taylor, Jesse A., Taylor, Michael D., Templer, Jessica W., Teo, Charles, Tessier, Jeffrey M., Theadom, Alice, Theodore, Nicholas, Thinwa, Josephine W., Thompson, B. Gregory, Jr., Thompson, Eric M., Thompson, Stephen A., Thon, Niklas, Thurtell, Matthew J., Tilton, Ann H., Timmons, Shelly D., Tonn, Jörg-Christian, Toth, Gabor, Toussaint, Charles P., Tran, Minh H., Trapp, Bruce D., Traylor, Jeffrey I., Trifiletti, Daniel M., Tse, Kai-Hei, Tubbs, R. Shane, Tuleasca, Constantin, Tunkel, Allan R., Türe, Ugur, Umansky, Daniel, Unda, Santiago R., Ung, Timothy H., Upadhyayula, Pavan S., Uribe, Juan S., Uy, Benjamin R., Vaccaro, Alexander R., Vakharia, Kunal, Vakharia, Vejay N., Valvassori, Luca, van den Bent, Martin J., Van Gompel, Jamie J., Vasquez, Carlos M., Vasudeva, Viren S., Vasudevan, Kumar, Vellimana, Ananth K., Verlicchi, Angela, Vervoordt, Samantha M., Viapiano, Mariano S., Vide, Sérgio, Villa, Genaro R., Virk, Michael S., Visser-Vandewalle, Veerle, Vitek, Jerrold L., Vivas-Buitrago, Tito, Vo, Chau D., Vogelbaum, Michael A., Vollmer, Dennis G., Wackym, P. Ashley, Wainwright, Mark S., Wali, Arvin R., Walker, Corey T., Walters, Beverly C., Wang, Anthony C., Wang, Arthur, Wang, Huan, Wang, Joshua L., Wang, Kevin K.W., Wang, Michael Y., Wang, Minghao, Wang, Shelly, Wang, Tao, Wang, Tony R., Wang, Vincent Y., Waqas, Muhammad, Warf, Benjamin C., Weiner, Howard L., Weingart, Jon D., Weinstein, Lawrence, Weiss, Martin H., Weiss, Nirit, Welch, Babu G., Wellons, John C., III, Wen, Hung Tzu, Wen, Patrick Y., West, G. Alexander, Wewel, Joshua T., Whitehead, William E., Whiting, Alexander C., Whiting, Donald M., Wichmann, Thomas, Wilkinson, D. Andrew, Williams, Michael A., Williams-Medina, Alberto R., Williamson, Theresa, Wilson, Lindsay, Winer, Jesse L., Winfree, Christopher J., Winkler, Ethan A., Winn, H. Richard, Wintermark, Max, Wipplinger, Christoph, Witiw, Christopher D., Wolfla, Christopher E., Wolinsky, Jean-Paul, Wong, Eric T., Worrell, Gregory A., Wrensch, Margaret R., Wright, Christina H., Wu, Jau-Ching, Wu, Jenny, Wu, Kyle C., Wu, Pang Hung, Xu, David S., Xu, Linda Wei, Xu, Yifan, Xu, Zhen, Xu, Zhiyuan, Yaeger, Kurt A., Yahanda, Alexander T., Yan, Rachel E., Yan, Yuanqing, Yang, George L., Yasuno, Katsuhito, Yen, Chun-Po, Yokota, Kazuya, Yolcu, Yagiz Ugur, Young, Timothy P., Yu, Jennifer S., Yue, John K., Yuh, Esther L., Zabramski, Joseph M., Zacest, Andrew, Zacko, J. Christopher, Zada, Gabriel, Zafonte, Ross D., Zager, Eric L., Zakare-Fagbamila, Rasheedat T., Zakeri, Amanda, Zanotti, Bruno, Zawar, Ifrah, Zeineddine, Hussein A., Zellner, Elizabeth G., Zhan, Shikun, Zhang, Chencheng, Zhang, Michael, Zhang, Yingying, Zibly, Zion, Zigler, Jack E., Zipfel, Gregory J., Zipser, Carl Moritz, Zrinzo, Ludvic, and Zumofen, Daniel W.

Published
2023
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6. Evaluation des besoins en information des patients suivis en radiothérapie: étude effectuée sur la base du livret de la radiothérapie

Author

Pascale Romestaing, M. Pace, C. Raison, C. Compagnon, V. Bonnet, D. Noël, H. Milan, P. Pigeon, F. Mornex, C. Couvreur, P. Demachy, F. Kimmel, and Jean-Pierre Gerard

Subjects
Oncology, Radiology, Nuclear Medicine and imaging
Abstract

Resume La Societe francaise de radiotherapie oncologie (SFRO) et le Syndicat national des radiotherapeutes oncologues (SNRO) ont elabore et edite un livret d'information sur la radiotherapie au debut de 1999. L'etude presente a pour objectif d'evaluer la pertinence de ce livret, sur la forme et le fond, apres presque un an d'utilisation. Huit centres francais ont participe a cette recherche qui a concerne 1 62 personnes malades, en debut de traitement en radiotherapie. Les conclusions de cette etude demontrent la volonte affirmee des patients d'etre clairement informes sur leur maladie, sur leur traitement, ainsi que sur les effets secondaires du traitement. Il est important de souligner que 97 % d'entre eux estiment qu'un livret d'information est une reelle necessite et que celui presente par la SFRO repond a la majorite de leurs questions. Acquerir des connaissances techniques et pratiques sur ce qui leur arrive a permis a 62 % d'entre eux de se sentir rassures, et pour 55 % d'etre mieux prepares au traitement a venir. Le chiffre le plus revelateur: ils sont 87 % a demander un discours-verite et que le cancer soit appele par son nom et non remplace par des termes plus evasifs. Cependant, les patients souhaitent (dans 72 % des cas) plus d'informations encore sur leur cancer, les choix de traitement, leur qualite de vie, dans une tentative de s'approprier psychiquement leur ≪ guerison ≫ par rapport a une maladie dont ils n'ont pas pu controler l'emergence et dont le developpement leur a echappe. Les patients ne veulent plus etre passifs, ne plus subir mais reclament le droit de devenir les ≪ partenaires ≫ de leurs medecins, de leurs soins, de leur guerison.

Published
2000
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7. [Evaluating radiotherapy patients' need for information: a study using a patient information booklet]

Author

V, Bonnet, C, Couvreur, P, Demachy, F, Kimmel, H, Milan, D, Noël, M, Pace, C, Raison, C, Compagnon, P, Romestaing, J P, Gérard, P, Pigeon, and F, Mornex

Subjects
Patient Education as Topic, Radiotherapy, Patient Satisfaction, Data Collection, Neoplasms, Radiation Oncology, Humans, Pamphlets
Abstract

The French Radiotherapy-Oncology Society (SFRO) and the National Trade of Radiotherapists-Oncologists (SNRO) elaborated and published a patient information booklet on radiotherapy, in 1999. This present study appraises the pertinence of the form and substance of this booklet one year after its release. Eight radiotherapy centers participated in this research which evaluated 162 patients at treatment initiation. The conclusions of this study demonstrated the importance of clearly informing patients of their disease, treatment, and the secondary effects of treatment. It is essential to emphasize that 97% of the patients declared that an information booklet is a real necessity, and that the one provided by the SFRO responds to the majority of their concerns. Obtaining technical and practical knowledge resulted in a reassurance about their treatment. The most revealing result is that 87% requested direct communication about their illness, and that cancer be named by this word and not other, evasive terms. Seventy-two percent of the patients requested more information about their cancer, different treatment options, and quality of life issues in an attempt to psychologically prepare themselves to face an illness for which they have little control. Patients refuse to be passive, and claim the right to become 'partners' of the medical teams, concerning their treatment and recovery.

Published
2000

8. Economic impact and clinical benefits of pharmacist involvement on surgical wards

Author

R E, Ariano, R H, Demianczuk, R G, Danzinger, A, Richard, H, Milan, and B, Jamieson

Subjects
Patient Care Team, Canada, Cost Savings, Workforce, Pilot Projects, Hospital Bed Capacity, 500 and over, Hospitals, Teaching, Pharmacy Service, Hospital, Drug Prescriptions, Referral and Consultation, Surgery Department, Hospital, Drug Costs
Abstract

A one-year pilot project was performed to assess the economic and clinical benefit of pharmacist involvement on the surgical wards of a 600-bed tertiary care, teaching hospital. A total of 405 recommendations were collected with a physician acceptance rate of 90%. From these recommendations, 1416 patient follow-ups were performed to document outcome. The total documented cost avoidance of the pharmacists' activities was $33,265.58. The total annual drug expenditure for the department of surgery declined by $59,662 representing a 9% decrease over the previous year with the greatest decline involving antimicrobials which decreased by $52,587 compared with the previous year. Most of the cost-avoidance in this area was attributable to antimicrobial selection and dosing adjustment in renal impairment. Pharmacist-directed pharmacokinetic monitoring of aminoglycosides resulted in a clinical success rate of 93.8% for treatment regimens and a 6.2% incidence of nephrotoxicity. Housestaff education aimed at improving prescribing practices were identified and provided for select agents including midazolam, ketorolac, vancomycin and aminoglycosides. As well, select recommendations were documented which illustrated the benefit to patient care of pharmacist involvement. Pharmacist involvement on the surgery services produced both financial and clinical benefits.

Published
1995

12. Validation of a simple and inexpensive method for the quantitation of infarct in the rat brain

Author

C.L.R. Schilichting, K.C.M. Lima, L.A. Cestari Junior, J.Y. Sekiyama, F.M. Silva, and H. Milani

Subjects
Focal cerebral ischemia, Infarct size, Rats, Triphenyltetrazolium chloride stain, Weighing method, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

A gravimetric method was evaluated as a simple, sensitive, reproducible, low-cost alternative to quantify the extent of brain infarct after occlusion of the medial cerebral artery in rats. In ether-anesthetized rats, the left medial cerebral artery was occluded for 1, 1.5 or 2 h by inserting a 4-0 nylon monofilament suture into the internal carotid artery. Twenty-four hours later, the brains were processed for histochemical triphenyltetrazolium chloride (TTC) staining and quantitation of the schemic infarct. In each TTC-stained brain section, the ischemic tissue was dissected with a scalpel and fixed in 10% formalin at 0ºC until its total mass could be estimated. The mass (mg) of the ischemic tissue was weighed on an analytical balance and compared to its volume (mm³), estimated either by plethysmometry using platinum electrodes or by computer-assisted image analysis. Infarct size as measured by the weighing method (mg), and reported as a percent (%) of the affected (left) hemisphere, correlated closely with volume (mm³, also reported as %) estimated by computerized image analysis (r = 0.88; P < 0.001; N = 10) or by plethysmography (r = 0.97-0.98; P < 0.0001; N = 41). This degree of correlation was maintained between different experimenters. The method was also sensitive for detecting the effect of different ischemia durations on infarct size (P < 0.005; N = 23), and the effect of drug treatments in reducing the extent of brain damage (P < 0.005; N = 24). The data suggest that, in addition to being simple and low cost, the weighing method is a reliable alternative for quantifying brain infarct in animal models of stroke.

Published
2004
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13. Tacrolimus (FK506) reduces ischemia-induced hippocampal damage in rats: a 7- and 30-day study

Author

F. Giordani, A. Benetolli, L.A. Favero-Filho, K.C.M. Lima, L. Cestari Junior, and H. Milani

Subjects
Cerebral ischemia, Hippocampal cell death, FK506, Sustained neuroprotection, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

The neuroprotective effect of the immunosuppressant agent FK506 was evaluated in rats after brain ischemia induced for 15 min in the 4-vessel occlusion model. In the first experimental series, single doses of 1.0, 3.0 or 6.0 mg FK506/kg were given intravenously (iv) immediately after ischemia. In the second series, FK506 (1.0 mg/kg) was given iv at the beginning of reperfusion, followed by doses applied intraperitoneally (ip) 6, 24, 48, and 72 h post-ischemia. The same protocol was used in the third series except that all 5 doses were given iv. Damage to the hippocampal field CA1 was assessed 7 or 30 days post-ischemia on three different stereotaxic planes along the septotemporal axis of the hippocampus. Ischemia caused marked neurodegeneration on all planes (P

Published
2003
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14. Magnesium chloride alone or in combination with diazepam fails to prevent hippocampal damage following transient forebrain ischemia

Author

H. Milani, E.R. Lepri, F. Giordani, and L.A. Favero-Filho

Subjects
cerebral ischemia, hippocampal lesion, CA1 cell loss, magnesium chloride, diazepam, neuroprotection, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

In the central nervous system, magnesium ion (Mg2+) acts as an endogenous modulator of N-methyl-D-aspartate (NMDA)-coupled calcium channels, and may play a major role in the pathomechanisms of ischemic brain damage. In the present study, we investigated the effects of magnesium chloride (MgCl2, 2.5, 5.0 or 7.5 mmol/kg), either alone or in combination with diazepam (DZ), on ischemia-induced hippocampal cell death. Male Wistar rats (250-300 g) were subjected to transient forebrain ischemia for 15 min using the 4-vessel occlusion model. MgCl2 was applied systemically (sc) in single (1x, 2 h post-ischemia) or multiple doses (4x, 1, 2, 24 and 48 h post-ischemia). DZ was always given twice, at 1 and 2 h post-ischemia. Thus, ischemia-subjected rats were assigned to one of the following treatments: vehicle (0.1 ml/kg, N = 34), DZ (10 mg/kg, N = 24), MgCl2 (2.5 mmol/kg, N = 10), MgCl2 (5.0 mmol/kg, N = 17), MgCl2 (7.5 mmol/kg, N = 9) or MgCl2 (5 mmol/kg) + DZ (10 mg/kg, N = 14). Seven days after ischemia the brains were analyzed histologically. Fifteen minutes of ischemia caused massive pyramidal cell loss in the subiculum (90.3%) and CA1 (88.4%) sectors of the hippocampus (P0.05). Both DZ alone and DZ + MgCl2 reduced rectal temperature significantly (P

Published
1999
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15. 3D model of laser treatment by a moving heat source with general distribution of energy in the beam.

Author

Zdeněk V, Milan H, and Jiří M

Abstract

A three-dimensional model of direct heat treatment of a sample surface with a moving laser has been established utilizing the finite element method. Attention is devoted to the preparation of complex boundary conditions of a moving heat source. Boundary conditions of material heat treatment are defined in the form of the heat transfer coefficient with consideration of several effects. Those include general distribution of energy in the laser beam, laser motion velocity, laser axis position outside the sample, and utilization of multiple laser motion tracks over the sample. Various arrangements of sample heat treatment are proposed and computer simulated. Different velocities of laser motion, multiple motion over the same track, and simple motion over a number of tracks are investigated. The temperature distribution in the sample and the depths of material heat treatment are evaluated. The simulation model can be used for temperature prediction during laser surface treatment of materials.

Published
2016
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17. Artificial neural networks are able to recognize gastro-oesophageal reflux disease patients solely on the basis of clinical data.

Author

Pace F, Buscema M, Dominici P, Intraligi M, Baldi F, Cestari R, Passaretti S, Bianchi Porro G, and Grossi E

Subjects
Adult, Esophagoscopy, Esophagus metabolism, Female, Health Status Indicators, Humans, Hydrogen-Ion Concentration, Life Style, Male, Middle Aged, Monitoring, Physiologic methods, Reproducibility of Results, Severity of Illness Index, Diagnosis, Computer-Assisted methods, Gastroesophageal Reflux diagnosis, Neural Networks, Computer
Abstract

Background: Artificial neural networks (ANN) are modelling mechanisms that are highly flexible and adaptive to solve the non-linearity inherent in the relationship between symptoms and underlying pathology., Objectives: To assess the efficacy of ANN in achieving a diagnosis of gastro-oesophageal reflux disease (GORD) using oesophagoscopy or pH-metry as a diagnostic gold standard and discriminant analysis as a statistical comparator technique in a group of patients with typical GORD symptoms and with or without GORD objective findings (e.g. a positive oesophagoscopy or a pathological oesophageal pH-metry)., Methods: The sample of 159 cases (88 men, 71 women) presenting with typical symptoms of GORD, were subdivided on the basis of endoscopy and pH-metry results into two groups: GORD patients with or without oesophagitis, group 1 (N=103), and pH and endoscopy-negative patients in whom both examinations were negative, group 2 (N=56). A total of 101 different independent variables were collected: demographic information, medical history, generic health state and lifestyle, intensity and frequency of typical and atypical symptoms based on the Italian version of the Gastroesophageal Reflux Questionnaire (Mayo Clinic). The diagnosis was used as a dependent variable. Different ANN models were assessed., Results: Specific evolutionary algorithms selected 45 independent variables, concerning clinical and demographic features, as predictors of the diagnosis. The highest predictive performance was achieved by a 'back propagation' ANN, which was consistently 100% accurate in identifying the correct diagnosis compared with 78% obtained by traditional discriminant analysis., Conclusion: On the basis of this preliminary work, the use of ANN seems to be a promising approach for predicting diagnosis without the need for invasive diagnostic methods in patients suffering from GORD symptoms.

Published
2005
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18. Msx2 and necdin combined activities are required for smooth muscle differentiation in mesoangioblast stem cells.

Author

Brunelli S, Tagliafico E, De Angelis FG, Tonlorenzi R, Baesso S, Ferrari S, Niinobe M, Yoshikawa K, Schwartz RJ, Bozzoni I, Ferrari S, and Cossu G

Subjects
Animals, Aorta cytology, Aorta embryology, Cell Differentiation genetics, Cells, Cultured, Coculture Techniques, DNA-Binding Proteins genetics, Gene Expression Profiling, Homeodomain Proteins, Mesenchymal Stem Cells metabolism, Mice, Mice, Inbred C57BL, Muscle Proteins genetics, Muscle, Smooth, Vascular, Myocytes, Cardiac cytology, Myocytes, Smooth Muscle metabolism, Nerve Tissue Proteins genetics, Nuclear Proteins genetics, Oligonucleotide Array Sequence Analysis, RNA Interference, RNA, Small Interfering genetics, Rats, Recombinant Fusion Proteins physiology, Transcriptional Activation, Transfection, DNA-Binding Proteins physiology, Gene Expression Regulation, Developmental, Mesenchymal Stem Cells cytology, Muscle Proteins biosynthesis, Myocytes, Smooth Muscle cytology, Nerve Tissue Proteins physiology, Nuclear Proteins physiology
Abstract

Little is known about the molecular mechanism underlying specification and differentiation of smooth muscle (SM), and this is, at least in part, because of the few cellular systems available to study the acquisition of a SM phenotype in vitro. Mesoangioblasts are vessel-derived stem cells that can be induced to differentiate into different cell types of the mesoderm, including SM. We performed a DNA microarray analysis of a mesoangioblast clone that spontaneously expresses an immature SM phenotype and compared it with a sister clone mainly composed of undifferentiated progenitor cells. This study allowed us to define a gene expression profile for "stem" cells versus smooth muscle cells (SMCs) in the absence of differentiation inducers such as transforming growth factor beta. Two transcription factors, msx2 and necdin, are expressed at least 100 times more in SMCs than in stem cells, are coexpressed in all SMCs and tissues, are induced by transforming growth factor beta, and, when coexpressed, induce a number of SM markers in mesoangioblast, fibroblast, and endothelial cell lines. Conversely, their downregulation through RNA interference results in a decreased expression of SM markers. These data support the hypothesis that Msx2 and necdin act as master genes regulating SM differentiation in at least a subset of SMCs.

Published
2004
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19. Low frequency of severe hepatotoxicity and association with HCV coinfection in HIV-positive patients treated with HAART.

Author

Monforte Ade A, Bugarini R, Pezzotti P, De Luca A, Antinori A, Mussini C, Vigevani GM, Tirelli U, Bruno R, Gritti F, Piazza M, Chigiotti S, Chirianni A, De Stefano C, Pizzigallo E, Perrella O, and Moroni M

Subjects
Alanine Transaminase blood, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, Cohort Studies, Disease Progression, Female, HIV Seropositivity complications, HIV-1 isolation & purification, Hepatitis B Surface Antigens analysis, Humans, Male, Proportional Hazards Models, Stavudine, Zidovudine therapeutic use, Hepatitis C complications
Abstract

Background: Highly active antiretroviral therapy (HAART) is strongly effective in reducing morbidity and mortality in HIV-1-positive individuals. Its main drawback is the potential toxicity. Data on the frequency and determinants of severe hepatotoxicity in a clinical setting are still sparse., Methods: This is a prospective study of HIV-1-positive individuals with known HBsAg and HCV-Ab serology. The study end point was progression to alanine aminotransferase (ALT) levels > or =200 IU/L after HAART initiation. Cumulative probability of progression to this end point was estimated by the Kaplan-Meier method. Crude and adjusted hazard ratios (HR) were estimated by proportional hazards regression model., Results: One thousand two hundred fifty-five patients were included. HBsAg was found in 91 (7.2%), HCV-Ab in 578 (46.5%) patients; almost all injection drug users (451 of 482; 93.6%) were HCV-Ab positive. Sixty-one individuals progressed to the end point with a probability of 7.9% (95% confidence interval [CI], 5.6-10.0) of progression at 24 months from starting. Independent factors predicting progression to the end point were baseline ALT levels (HR, 5.29; 95% CI, 3.24-8.65; every 10 IU/L higher), HCV-Ab positivity (HR, 4.01; 95% CI, 1.48-10.85) or both HBsAg and HCV Ab positivity (HR, 3.85, 95% CI, 1.01-14.61), and previous non-HAART therapy (HR, 1.84, 95% CI, 1.04-3.42). Patients receiving stavudine-containing regimens had a lower risk than those receiving zidovudine-containing regimens (HR, 0.30, 95% CI, 0.12-0.71)., Conclusions: There was a low risk of ALT > or =200 IU/L in our cohort. Hepatitis C coinfection and elevated ALT levels at HAART initiation are important predictors of progression to ALT > or =200 IU/L; stavudine-containing regimens were associated with a lower risk compared with zidovudine-containing regimens.

Published
2001
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20. [Evaluating radiotherapy patients' need for information: a study using a patient information booklet] .

Author

Bonnet V, Couvreur C, Demachy P, Kimmel F, Milan H, Noël D, Pace M, Raison C, Compagnon C, Romestaing P, Gérard JP, Pigeon P, and Mornex F

Subjects
Data Collection, Humans, Neoplasms radiotherapy, Patient Satisfaction, Pamphlets, Patient Education as Topic, Radiation Oncology, Radiotherapy psychology
Abstract

The French Radiotherapy-Oncology Society (SFRO) and the National Trade of Radiotherapists-Oncologists (SNRO) elaborated and published a patient information booklet on radiotherapy, in 1999. This present study appraises the pertinence of the form and substance of this booklet one year after its release. Eight radiotherapy centers participated in this research which evaluated 162 patients at treatment initiation. The conclusions of this study demonstrated the importance of clearly informing patients of their disease, treatment, and the secondary effects of treatment. It is essential to emphasize that 97% of the patients declared that an information booklet is a real necessity, and that the one provided by the SFRO responds to the majority of their concerns. Obtaining technical and practical knowledge resulted in a reassurance about their treatment. The most revealing result is that 87% requested direct communication about their illness, and that cancer be named by this word and not other, evasive terms. Seventy-two percent of the patients requested more information about their cancer, different treatment options, and quality of life issues in an attempt to psychologically prepare themselves to face an illness for which they have little control. Patients refuse to be passive, and claim the right to become 'partners' of the medical teams, concerning their treatment and recovery.

Published
2000
Full Text
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21. Economic impact and clinical benefits of pharmacist involvement on surgical wards.

Author

Ariano RE, Demianczuk RH, Danzinger RG, Richard A, Milan H, and Jamieson B

Subjects
Canada, Cost Savings, Drug Prescriptions economics, Drug Prescriptions statistics & numerical data, Hospital Bed Capacity, 500 and over, Hospitals, Teaching, Pilot Projects, Referral and Consultation, Workforce, Drug Costs trends, Patient Care Team economics, Patient Care Team standards, Pharmacy Service, Hospital, Surgery Department, Hospital economics
Abstract

A one-year pilot project was performed to assess the economic and clinical benefit of pharmacist involvement on the surgical wards of a 600-bed tertiary care, teaching hospital. A total of 405 recommendations were collected with a physician acceptance rate of 90%. From these recommendations, 1416 patient follow-ups were performed to document outcome. The total documented cost avoidance of the pharmacists' activities was $33,265.58. The total annual drug expenditure for the department of surgery declined by $59,662 representing a 9% decrease over the previous year with the greatest decline involving antimicrobials which decreased by $52,587 compared with the previous year. Most of the cost-avoidance in this area was attributable to antimicrobial selection and dosing adjustment in renal impairment. Pharmacist-directed pharmacokinetic monitoring of aminoglycosides resulted in a clinical success rate of 93.8% for treatment regimens and a 6.2% incidence of nephrotoxicity. Housestaff education aimed at improving prescribing practices were identified and provided for select agents including midazolam, ketorolac, vancomycin and aminoglycosides. As well, select recommendations were documented which illustrated the benefit to patient care of pharmacist involvement. Pharmacist involvement on the surgery services produced both financial and clinical benefits.

Published
1995

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