Extended distal pancreatectomy with thoracic wall resection after neoadjuvant FOLFIRINOX: Is there a limit of resection for pancreatic cancer after downstaging?

Tommaso Giuliani,Maria Lopez Rubio,Eva Montalva Oron,Javier Maupoey Ibanez,Andrea Bosca Robledo,Cecilia Lopez Valdivia,Judith Perez Rojas,Rafael Lopez Andujar 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.1

Indications and outcomes of extended pancreatectomies have been recently appraised by the International Study Group for Pancreatic Surgery. However, no definitive conclusions have been drawn, particularly in the setting of neoadjuvant treatments. We present here a case of 53-year-old man diagnosed with a bulky adenocarcinoma of the tail of the pancreas and infiltrating the adjacent organs and the thoracic wall. The patient was sent to neoadjuvant chemotherapy and he underwent 12 cycles of FOLFIRINOX. Since a significant radiological response was observed after chemotherapy, the patient was scheduled for extended distal pancreatectomy with en bloc resection of the thoracic wall, in order to achieve a radical resection. The surgery is herein described with all technical details. The patient was discharged after an uneventful early post-operative course and subsequently readmitted for a late grade B post-operative pancreatic fistula, which was ultimately treated successfully. Pathology showed complete response. When performed in centers with ample experience in pancreatic surgery, extended pancreatic resections represent a viable curative option with acceptable surgical outcomes. In this setting, challenging tailored resections should be considered to achieve negative margins, particularly following maximized effective downstaging strategies.

Micro-computed tomography for assessing the internal and external voids of bulk-fill composite restorations: A technical report

Tosco Vincenzo,Monterubbianesi Riccardo,Furlani Michele,Giuliani Alessandra,Putignano Angelo,Orsini Giovanna 대한영상치의학회 2022 Imaging Science in Dentistry Vol.52 No.3

Purpose: This technical report aims to describe and detail the use of micro-computed tomography for a reliable evaluation of the bulk-fill composite/tooth interface. Materials and Methods: Bulk-fill composite restorations in tooth cavities were scanned using micro-computed tomography to obtain qualitatively and quantitatively valuable information. Two-dimensional information was processed using specific algorithms, and ultimately a 3-dimensional (3D) specimen reconstruction was generated. The 3D rendering allowed the visualization of voids inside bulk-fill composite materials and provided quantitative measurements. The 3D analysis software VG Studio MAX was used to perform image analysis and assess gap formation within the tooth-restoration interface. In particular, to evaluate internal adaptation, the Defect Analysis addon module of VG Studio Max was used. Results: The data, obtained with the processing software, highlighted the presence and the shape of gaps in different colours, representing the volume of porosity within a chromatic scale in which each colour quantitatively represents a well-defined volume. Conclusion: Micro-computed tomography makes it possible to obtain several quantitative parameters, providing fundamental information on defect shape and complexity. However, this technique has the limit of not discriminating materials without radiopacity and with low or no filler content, such as dental adhesives, and hence, they are difficult to visualise through software reconstruction.

Iodide Suppression of Major Histocompatibility Class I Gene Expression in Thyroid Cells Involves Enhancer A and the Transcription Factor NF-kB

Taniguchi, Shin-Ichi,Shong, Minho,Giuliani, Cesidio,Napolitano, Giorgio,Saji, Motoyasu,Montani, Valeria,Suzuki, Koichi,Singer, Dinah S.,Kohn, Leonard D. 충남대학교 생물공학연구소 1999 생물공학연구지 Vol.7 No.-

Increased MHC class I expression on thyrodytes is evident in ATD (4, 21) and has been suggested to be an important causal factor in the development or perpetuation of disease expression (3). The hypothesis has been offered that the elevations result in abnormal presentation of thyroid antigens to immune cells, thereby breaking tolerance, and that this elicits the clonal expansion of autoreactive T cells associated with disease expression (3).

Micro-computed tomography for assessing the internal and external voids of bulk-fill composite restorations: A technical report

Tosco, Vincenzo,Monterubbianesi, Riccardo,Furlani, Michele,Giuliani, Alessandra,Putignano, Angelo,Orsini, Giovanna Korean Academy of Oral and Maxillofacial Radiology 2022 Imaging Science in Dentistry Vol.52 No.-

Purpose: This technical report aims to describe and detail the use of micro-computed tomography for a reliable evaluation of the bulk-fill composite/tooth interface. Materials and Methods: Bulk-fill composite restorations in tooth cavities were scanned using micro-computed tomography to obtain qualitatively and quantitatively valuable information. Two-dimensional information was processed using specific algorithms, and ultimately a 3-dimensional (3D) specimen reconstruction was generated. The 3D rendering allowed the visualization of voids inside bulk-fill composite materials and provided quantitative measurements. The 3D analysis software VG Studio MAX was used to perform image analysis and assess gap formation within the tooth-restoration interface. In particular, to evaluate internal adaptation, the Defect Analysis addon module of VG Studio Max was used. Results: The data, obtained with the processing software, highlighted the presence and the shape of gaps in different colours, representing the volume of porosity within a chromatic scale in which each colour quantitatively represents a well-defined volume. Conclusion: Micro-computed tomography makes it possible to obtain several quantitative parameters, providing fundamental information on defect shape and complexity. However, this technique has the limit of not discriminating materials without radiopacity and with low or no filler content, such as dental adhesives, and hence, they are difficult to visualise through software reconstruction.

Major Histocompatibility Class Ⅱ HLA-DRα Gene Expression in Thyrocytes : Counter Regulation by the Class Ⅱ Transactivator and the Thyroid Y Box Protein

MONTANI, VALERIA,TANIGUCHI, SHIN-ICHI,SHONG, MINHO,SUZUKI, KOICHI,OHMORI, MASAYUKI,GIULIANI, CESIDIO,NAPOLITANO, GIORGIO,SAJI, MOTOYASU,FIORENTINO, BRUNO,REIMOLD, ANDREAS M.,TING, JENNY P.-Y,KOHN, LEO 충남대학교 생물공학연구소 1999 생물공학연구지 Vol.7 No.-

Aberrant expression of major histocompatibility complex(MHC) classⅡ proteins on thyrocytes, which is associated with autoimmune thyroid disease, is mimicked by γ-interferon (γ-IFN). To define elements and factors that regulate classⅡ gene expression in thyrocytes and that might be involved in aberrant expression, we have studied γ-IFN-induced HLA-DRα gene expression in rat FRTL-5 thyroid cells. The present report shows that classⅡ expression in FRTL-5 thyrocytes is positively regulated by the classⅡ transactivator (CIITA), and that CIITA mimics the action of γ-IFN. Thus as is the case for γ-IFN, several distinct and highly conserved elements on the 5'-flanking region of the HLA-DRα gene, the S, X_1, X_2, and Y boxes between -137 to -65 bp, are required for classⅡ gene expression induced by pCIITA transfection in FRTL-5 thyroid cells. CIITA and γ-IFN do not cause additive increases in HLA-DRα gene expression in FRTL-5 cells, consistent with the possibility that CIITA is an intermediate factor in the γ-IFN pathway to increased classⅡ gene expression. Additionally, γ-IFN treatment of FRTL-5 cells induces an endogenous CIITA transcript; pCIITA transfection mimics the ability of γ-IFN treatment of FRTL-5 thyroid cells to increase the formation of a specific and novel protein/DNA complex containing CBP, a coactivator of CRE binding proteins important for cAMP-induced gene expression; and the action of both γ-IFN and CIITA to increase classⅡ gene expression and increase complex formation is reduced by cotransfection of a thyroid Y box protein, which suppresses MHC classⅠ gene expression in FRTL-5 thyroid cells and is a homolog of human YB-1, which suppresses MHC classⅡ expression in human glioma cells. we conclude that CIITA and TSH receptor suppressor element binding protein-1 are components of the γ-IFN-regulated transduction system which, respectively, increase or decrease classⅡ gene expression in thyrocytes and may, therefore, be involved in aberrant classⅡ expression associated with autoimmune thyroid disease. (Endocrinology 139: 280-289, 1998)

Statistical Analysis of Gene Expression in Innate Immune Responses: Dynamic Interactions between MicroRNA and Signaling Molecules

Piras, Vincent,Selvarajoo, Kumar,Fujikawa, Naoki,Choi, Sang-Dun,Tomita, Masaru,Giuliani, Alessandro,Tsuchiya, Masa Korea Genome Organization 2007 Genomics & informatics Vol.5 No.3

MicroRNAs (miRNAs) are known to negatively control protein-coding genes by binding to messenger RNA (mRNA) in the cytoplasm. In innate immunity, the role of miRNA gene silencing is largely unknown. In this study, we performed microarray-based experiments using lipopolysaccharide (LPS)-stimulated macrophages derived from wild-type, MyD88 knockout (KO), TRIF KO, and MyD88/TRIF double KO mice. We employed a statistical approach to determine the importance of the commonality and specificity of miRNA binding sites among groups of temporally co-regulated genes. We demonstrate that both commonality and specificity are irrelevant to define a priori groups of co-down regulated genes. In addition, analyzing the various experimental conditions, we suggest that miRNA regulation may not only be a late-phase process (after transcription) but can also occur even early (1h) after stimulation in knockout conditions. This further indicates the existence of dynamic interactions between miRNA and signaling molecules/transcription factor regulation; this is another proof for the need of shifting from a 'hard-wired' paradigm of gene regulation to a dynamical one in which the gene co-regulation is established on a case-by-case basis.

Regulation of Major Histocompatibility Class Ⅱ Gene Expressino in FRTL-5 Thyrocytes : Opposite Effects of Interferon and Methimazole

MONTANI, VALERIA,SHONG, MINHO,TANIGUCHI, SHIN-ICHI,SUZUKI, KOICHI,GIULIANI, CESIDIO,NAPOLITANO, GIORGIO,SAITO, JUN,SAJI, MOTOYASU,FIORENTINO, BRUNO,REIMOLD, ANDREAS M.,SINGER, DINAH S.,KOHN, LEONARD D 충남대학교 생물공학연구소 1999 생물공학연구지 Vol.7 No.-

Aberrant expression of major histocompatibility complex (MHC) classⅡ antigens is associated with autoimmune thyroid disease; aberrant expression duplicating the autoimmune state can be induced by interferon-γ (IFNγ). We have studied IFNγ-induced human leukocyte antigen (HLA)-DRα gene expression in rat FRTL-5 thyroid cells to identify the elements and factors important for aberrant expression. Using an HLA-DRα 5'-flanking region construct from-176 to +45 bp coupled to the chloramphenicol acetyltransferase reporter gene, we show that there is no basal classⅡ gene expression in FRTL-5 thyroid cells, that IFNγ can induce expression, and, as is the case for antigen-presenting cells from the immune system, that IFNγ-induced expression requires several highly conserved elements on the 5'-flanking region, which, from 5' to 3', are the S, X_1, X_2, and Y boxes. Methimazole (MMI), a drug used to treat patients with Graves' disease and experimental thyroiditis in rats or mice, can suppress the IFNγ-induced increase in HLA-DRα gene expression as a function of time and concentration; MMI simultaneously decreases IFNγ-induced endogenous antigen presentation by the cell. Using gel shift assays and the HLA-DRα 5'-flanking region from -176 or -137 to +45 bp as radiolabeled probes, we observed the formation of a major protein-DNA complex with extracts from FRTL-5 cells untreated with IFNγ, termed the basal or constitutive complex, and formation of an additional complex with a slightly faster mobility in extracts from cells treated with IFNγ. MMI treatment of cells prevents IFNγ from increasing the formation of this faster migrating complex. Formation of both complexes is specific, as evidenced in competition studies with unlabeled fragments between -137 and -38 bp from the start of transcription; nevertheless, they can be distinguished in such studies. Thus, high concentrations of double stranded oligonucleotides containing the sequence of the Y box, but not S, X_1, or X_2 box sequences, can prevent formation of the IFNγ-increased faster migrating complex, but not the basal complex. Both complexes involve multiple proteins and can be distinguished by differences in their protein composition. Thus, using specific antisera, we show that two cAMP response element-binding proteins, activating transcription factor-1 and/or -2, are dominant proteins in the upper or basal complex. The upper or basal complex also includes c-Fos, Fra-2, Ets-2, and Oct-1. A dominant protein that distinguishes the IFNγ-increased lower complex is CREB-binding protein (CBP), a coactivator of cAMP response element-binding proteins. We, therefore, show that aberrant expression of MHC classⅡ in thyrocytes, induced by IFNγ, is associated with the induction or increased formation of a novel portein-DNA complex and that its formation as well as aberrant classⅡ expression are suppressed by MMI, a drug used to treat human and experimental autoimmune thyroid disease. Its component proteins differ from those in a major, basal, or constitutive protein-DNA complex formed with the classⅡ 5'-flanking region in cells that are not treated with IFNγ and that do not express the classⅡ gene. (Endocrinology 139: 290-302, 1998)

Atlantic forcing of Pacific decadal variability

Kucharski, F.,Ikram, F.,Molteni, F.,Farneti, R.,Kang, I. S.,No, H. H.,King, M. P.,Giuliani, G.,Mogensen, K. Springer Science + Business Media 2016 Climate dynamics Vol.46 No.7

<P>This paper investigates the Atlantic Ocean influence on equatorial Pacific decadal variability. Using an ensemble of simulations, where the ICTPAGCM ('SPEEDY') is coupled to the NEMO/OPA ocean model in the Indo-Pacific region and forced by observed sea surface temperatures in the Atlantic region, it is shown that the Atlantic Multidecadal Oscillation (AMO) has had a substantial influence on the equatorial Pacific decadal variability. According to AMO phases we have identified three periods with strong Atlantic forcing of equatorial Pacific changes, namely (1) 1931-1950 minus 1910-1929, (2) 1970-1989 minus 1931-1950 and (3) 1994-2013 minus 1970-1989. Both observations and the model show easterly surface wind anomalies in the central Pacific, cooling in the central-eastern Pacific and warming in the western Pacific/Indian Ocean region in events (1) and (3) and the opposite signals in event (2). The physical mechanism for these responses is related to a modification of the Walker circulation because a positive (negative) AMO leads to an overall warmer (cooler) tropical Atlantic. The warmer (cooler) tropical Atlantic modifies the Walker circulation, leading to rising (sinking) and upper-level divergence (convergence) motion in the Atlantic region and sinking (rising) motion and upper-level convergence (divergence) in the central Pacific region.</P>