Hereditary transthyretin amyloidosis (ATTRv) is a genetic, autosomal dominant, severe disease characterized by progressive sensory-motor polyneuropathy, cardiomyopathy, dysautonomia, renal and eyes ...involvement, provoked by the deposition of the mutated and unstable transthyretin protein. In past decades, liver transplant, avoiding the synthesis of the pathologic protein, has been a good, even if not resolutive, treatment. In this report we describe two siblings affected with ATTRv, who developed first symptoms of disease at a young age and underwent a liver transplant with prompt resolution of clinical manifestations. After several years, central nervous system and eyes symptoms relapsed despite treatment, considering that the synthesis of mutated protein continues in choroid plexus, a locum where current therapies are unable to act. In our opinion, these cases represent a long-term prognostic model for the novel gene-silencers approved for ATTRv, because they share a similar therapeutic effect with liver transplant: the block of mutated protein synthesis limited only in the main transthyretin (TTR) production organ is able to prevent the progression of disease only for some years, but not to avoid long-term clinical worsening due to extra-hepatic production of TTR. Novel future therapeutic strategies are demanded to guarantee a better long-term stabilization of symptomatology.
Purpose
The authors evaluated the usefulness of three-dimensional rotational angiography (3DRA) in surgical planning and postoperative evaluation of cerebral aneurysms.
Materials and methods
A total ...of 111 consecutive aneurysms in 100 patients (32 emergency referrals due to haemorrhage) were evaluated with 3DRA over a period of 3 years. The rotational study was always performed with a single injection of 20 cc of contrast agent in the afferent vessel after diagnostic cerebral angiography in the two orthogonal projections. Three-dimensional reconstructions were obtained for the pre- and postoperative assessment.
Results
Three-dimensional RA provides a virtual view of the surgical field with the same orientation required for the surgical approach and, compared with surgical findings, reliably defined location, orientation, morphology and relationship with parent vessels of the aneurysm in all cases. Postoperatively, it allowed better assessment of any residual lesion and of the relationship between surgical clips and parent vessels, compared with standard 2D angiography.
Conclusions
3DRA is a reliable method for preliminary assessment of cerebral aneurysms undergoing surgery. It provides multiple projections with a preview of the surgical field and study of lesion characteristics, which can help achieve faster and safer surgery. Compared with 2D angiography, the 3D model, with its multiple views, allows better assessment of postoperative outcomes. The method also significantly reduces the number of angiographic projections and therefore radiation and contrast-medium dose to the patient.
Hemimegalencephaly (HME) is a rare congenital malformation of the brain, grossly characterized by enlargement and overdevelopment of one cerebral hemisphere. We describe a 16-month-old patient with ...facial asymmetry caused by congenital infiltrating lipomatosis of the face (CILF) associated with ipsilateral HME. Although HME has been described as part of different syndromic diseases, the association of HME with CILF has been rarely reported. Our case and literature review suggest that when the diagnosis of CILF is suspected or established, the possible presence of associated HME has to be considered and a magnetic resonance imaging (MRI) must be performed even in absence of neurological features, not always present in early stages. MRI also demonstrates the involvement of intracranial structures outside the affected cerebral hemisphere, such as brain stem, cerebellum, cranial nerves, and blood vessels. In our patient, computed tomography of the brain provided detailed information on osseous hypertrophy and skull-base foramina enlargement.
Motivated by the hierarchical micro and nanoscale features in terms of porosity of diatomite, the production of ceramic-graded porous foams with tailored porosity, obtained by using it as raw ...material, has been proposed. The main challenge during the foam-production process has been the preservation of diatomite nanometric porosity and the addition of other levels of hierarchical porosity. The coupled use of two techniques of direct foaming (chemical and mechanical), combined with the use of 3D printing inverse replica method, assured the achievement of porosity of, respectively, microscopic and macroscopic dimensions. Optical and scanning electron microscopies have been performed for an in-depth characterization of the final microstructure. XRD analysis has been carried out to check the influence of sacrificial templates on the matrix mineralogical composition. The porosity of the diatomite-based foams has been investigated by means of nitrogen-adsorption analysis and mercury-intrusion porosimetry. The experimental tests confirmed the presence of different porous architectures ranging over several orders of magnitudes, giving rise to complex systems, characterized by hierarchical levels of porosity. The presence of porosity of graded dimensions affects the final mechanical performances of the macroporous diatomite-based foams, while their mineralogical composition does not result to be affected by the addition of templates.
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In the last decade, a great deal of research has been devoted to the design and development of graphene-based polymer nanocomposites characterized by a prescribed arrangement of the ...graphene-based nanosheets into spatially segregated 3D architectures. The formation of a continuous filler network obtained by confining the nanosheets into a constrained volume of the polymeric matrix is particularly attractive from a technological point of view. The preparation of segregated 3D graphene-based architectures facilitates the proper tailoring of the overall performance of the resulting polymer nanocomposites, providing significant improvements in terms of structural (i.e., mechanical properties) and functional (electrical properties, sensing ability, and adsorption/absorption capacity) features. This review focuses on polymer-based nanocomposites in two categories, namely bulk and porous (foam and aerogels) systems. These all share the common distinctive feature that relies on the peculiar arrangement of the graphene-based nanosheets in the form of a segregated yet continuous 3D assembly. For each class of materials, the main preparation strategies are presented and the resulting structure-property correlations are highlighted and discussed, together with the technological implications, and possible future directions.
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