A case of visceral leishmaniasis and pulmonary tuberculosis in a post-partum woman

AbstractVisceral leishmaniasis due to Leishmania infantum is a vector-borne zoonotic disease transmitted by sand fly bites endemic in rural or periurban areas of the Mediterranean basin. Pregnancy is accompanied by changes in immune response, mainly a decrease in cellular immunity and a proportional increase in humoral immunity. These physiological events result in increased risk of infection by pathogens whose immunity is based on a T-helper 1 predominant response. We describe a case of visceral leishmaniasis and pulmonary tuberculosis diagnosed in a post-partum woman four days after delivery. The diagnosis of leishmaniasis should be considered in pregnant women with fever and haematologic…

Uniportal thoracoscopy combined with laparoscopy as minimally invasive treatment of esophageal cancer

A 67-year-old man was referred to our attention for management of esophageal adenocarcinoma, localized at the level of the esophagogastric junction and obstructed the 1/3 of the esophageal lumen. Due to the extension of the disease (T3N1M0-Stage IIIA), the patient underwent neo-adjuvant chemo-radiation therapy and he was then scheduled for a minimally invasive surgical procedure including laparoscopic gastroplasty, uniportal thoracoscopic esophageal dissection and intrathoracic end-to-end esophago-gastric anastomosis. No intraoperative and post-operative complications were seen. The patient was discharged in post-operative day 9. Pathological study confirmed the diagnosis of adenocarcinoma …

Anatomical variations of the internal jugular vein: The role of ultrasonography

Purpose: In many places, especially in emergency department, central venous catheter is still inserted using anatomical landmark guidance with a success rate up to 97.6% and complications up to 15%. This study was aimed to determine by the support of ultrasono-graphy (US) the anatomical variations of the internal jugular vein (IJV) in relation with other structures of the neck, such as the common carotid artery (CCA). Material and Methods: 830 patients requiring central vein catheterization (CVC) were in-cluded in the analysis. The position of the IJV in relation to the other structures of the neck was demonstrated by portable ultrasonography. Results: The mean diameter of IJV was 10.3 mm i…

Un raro caso di sindrome ipoglicemica ipoinsulinemica: S. di Doege-Potter (SDP)

Trattamento simultaneo di metastasi epatiche e spleniche da carcinoma colo-rettale

Synchronous colorectal carcinoma

Weekly docetaxel (wDOC) for the treatment of metastatic breast cancer (MBC): A literature based meta-analysis

Clinical anatomy of central cenous catheterization guided

Contrast-enhanced versus baseline ultrasonography in the characterization of benign focal hepatic lesions

Low cell proliferation marker and low thymidylate synthase levels in the highly aggressive signet ring cell variant histotype of colorectal carcinoma

Puntura percutanea eco-guidata e puntura TC-guidata di neoformazioni endotoraciche

Puntura percutanea eco-guidata e puntura TC-guidata di neoformazioni endotoraciche Data: 2004 Dettaglio tipologia d'Ateneo: 3a - Articoli su riviste ISI (anche on line)

Syncronous colorectal carcinoma.

Tiroidectomia in urgenza per linfoma primitivo della tiroide: report di un caso ed indicazioni diagnostico-terapeutiche

Analysis of the Thymidylate Synthase Gene Structure in Colorectal Cancer Patients and lts Possible Relation with the S-Fluorouracil Drug Response

Thymidylate synthase (TS) catalyzes methylation of dUMP to dTMP and it is the target for the 5-Fluorouracil (5-FU) activity*. Barbour et al. showed that variant structural forms of TS in tumour cell lines confer resistance to fluoropyrimidines. We planned to perform the whole TS gene structure by means of sequencing techniques in human colorectal cancer (CRC) san-rples to try to identify the presence of any possible TS variant form that could be responsible of fluoropyrimidines drug resistance and of the worse prognosis. We performed the TS-DNA gene sequence in 68 CRC from patients of A, B, and C Dukes' stages and different histological grade, but we did not find any mutation in the TS-DNA …

Il drenaggio pleurico

Per definizione, il drenaggio è un presidio atto ad eliminare liquidi generalmente patologici da cavità naturali o neoformate. Il drenaggio di raccolte addominali non presenta particolari difficoltà poiché è sufficiente che il tubo di drenaggio sia ben posizionato, pervio, declive e di calibro proporzionato alla quantità e alla qualità del materiale da drenare. La sua assenza, anche se potrà ritardare o complicare notevolmente il processo di guarigione di una malattia, difficilmente comprometterà la vita del soggetto in maniera acuta e drammatica. Assai diverso è il drenaggio di raccolte intratoraciche, non soltanto per la assoluta necessità del suo impiego, ma anche per le modalità tecnich…

Trattamento endoscopico dei polipi del colon-retto

4843delC of the BRCA1 gene is a possible founder mutation in Southern Italy (Sicily).

Various studies have been published in Italy regarding the different BRCA1 mutations, but only the BRCA1-5083del19 mutation is recurrent and specific to individuals of Italian descent with a founder effect on the Calabrian population. In our previous study, BRCA1-5083del19 mutation carriers were found in four index cases of 106 Sicilian patients selected for familial and/or hereditary breast/ovarian cancers. The high frequency rate of this mutation identified in the Sicilian population led us to perform haplotype analysis in all family carriers. Five highly polymorphic microsatellite markers were used (D17S1320, D17S932, D17S1323, D17S1326, D17S1325) to establish whether or not all these fa…

Barrett's esophagus incidence in a sicilian population of refluxing patients undergoing EGDS

A case of splenic rupture: A rare event after laparoscopic cholecystectomy

Background Laparoscopic cholecystectomy (LC) is generally safe and well-accepted. In rare cases, it is associated with complications (intra- e postoperative bleeding, visceral injury and surgical site infection). Splenic lesion has been reported only after direct trauma. We report an unusual case of splenic rupture presenting after “uncomplicated” LC. Case presentation A 77-year-old woman presented with distended abdomen, tenderness in the left upper quadrant and severe anemia 12 hours after LC. Clinical examination revealed hypovolemic shock. Abdominal computed tomography confirmed the diagnosis of splenic rupture, and the patient required an urgent splenectomy through midline incision. Th…

Polipi neoplastici del colon –retto. Indicazioni e risultati preliminari della Polipectomia endoscopica.

Functional characterization of a novel 3D model of the epithelial-mesenchymal trophic unit

Background/Aim: Epithelial-mesenchymal communication plays a key role in tissue homeostasis and abnormal signaling contributes to chronic airways disease such as COPD. Most in vitro models are limited in complexity and poorly represent this epithelial-mesenchymal trophic unit. We postulated that cellular outgrowth from bronchial tissue would enable development of a mucosal structure that recapitulates better in vivo tissue architecture. Materials and Methods: Bronchial tissue was embedded in Matrigel and outgrowth cultures monitored using time-lapse microscopy, electrical resistance, light and electron microscopy. Cultures were challenged repetitively with cigarette smoke extract (CSE). Res…

Ultrasound guided central venous catheterization of internal jugular vein on over 65-year-od patients versus blind technique

BACKGROUND AND OBJECTIVES: Performing a central venous catheterization (CVC) on older patients for long-term central intravenous therapy could be a very important procedure. It could be associated with a high incidence of related complications, especially on over 65-year-old, high risk, selected patients. METHODS: The authors analyzed the results of 72 central venous CVC of internal jugular vein performed on over 65-year-old patients with ultrasound (US) guide from January 1998 to April 2003. RESULTS: The average performing time was 4 min, with 98.7% of success, 0% of major complications, and 4.1% of minor complications (one mild vagal hypotension and two catheter dislocation). CONCLUSIONS:…

Virtual bronchoscopy and preoperative assessment of airways stenosis

Fournier's gangrene: case report and review of recent literature

BENIGN GASTRIC POLYPS AND HELICOBACTER PYLORI INFECTION.

Comparison of central venous catheterization with and without ultrasound guide

Purpose: To compare the effectiveness, safety and time needed to perform central venous catheterization (CVC) in the presence or absence of an ultrasound (US) guide. Methods: Between January 1999 and February 2002 we performed CVCs in 196 patients: 105 patients received US guided CVC (group I) and 91 patients had CVC without US guide (group II). Results: The average time to perform CVC was shorter with US guide (4 vs 7min). The utilization of the US guide was also associated with improved success (98.09% vs 91.2%, p < 0.025) and lack of major complications (0% vs 9.8%, p < 0.001). Conclusions: US-guided CVC affords an easier, safer and more rapid cannulation of a central vein. It is especia…

HSP60 and HASP10 overexpression in metastatic colon cancer

La gestione post-operatoria in chirurgia toracica

La colecistectomia laparoscopica nel paziente uremico

Herpes Simplex Esophagitis in Immunocompetent Host: A Case Report

Introduction. Herpes simplex esophagitis is well recognized in immunosuppressed subjects, but it is infrequent in immunocompetent patients. We present a case of HSE in a 53-year-old healthy man. Materials and Methods. The patient was admitted with dysphagia, odynophagia, and retrosternal chest pain. An esophagogastroduodenoscopy revealed minute erosive area in distal esophagus and biopsies confirmed esophagitis and findings characteristic of Herpes Simplex Virus infection. Results. The patients was treated with high dose of protonpump inhibitor, sucralfate, and acyclovir, orally, with rapid resolution of symptoms. Discussion. HSV type I is the second most common cause of infectious esophagi…

Linfangioma cistico addominale: un'origine dibattuta

Lobo azygos: variante anatomica spesso misconosciuta

Synchronous liver metastases from colorectal carcinoma

Immunophenotypical characterization of a case of pulmonary metastatic biphasic synovial sarcoma: anatomoclinical aspects and short review of literature

La tracheostomia in urgenza

“Weekly regimen of cisplatin, epirubicin, 5-Fluorouracil and folinic acid with G-CSF is active in advanced gastroesophageal (GE) and gastric (G) cancer: a phase II study”

Hsp60 and Hsp10 overexpression in metastatic colon cancer.

Pleural epithelioid angiosarcoma with lymphatic differentiation arisen after radiometabolic therapy for thyroid carcinoma: immunohistochemical findings and review of the literature

Abstract Background Pleural angiosarcoma is a rare tumor that causes diffuse pleural thickening and effusion, mimicking mesothelioma. Immunohistochemistry is needed to highlight endothelial differentiation. We describe the first case of pleural angiosarcoma with lymphatic differentiation following radiometabolic therapy for thyroid carcinoma. Case presentation A 50-year-old man showed diffuse pleural thickening and effusion. Nine years earlier, he underwent thyroidectomy and radiometabolic therapy for thyroid carcinoma with lymph node metastases. Histologically, the tumor consisted of a solid proliferation of atypical epithelioid cells and anastomosed vascular spaces, lacking of red blood c…

A rare cause of acute cholecystitis

Trattamento dei versamenti pleurici secondari a neoplasia maligna: nostra esperienza

Obbietivi:Il versamento pleurico di natura maligna ( VPM) è indice di malattia neoplastica avanzata associato a bassa aspettativa di vita.A [UTF-8?]tutt’oggi il trattamento mira essenzialmente a migliorare la qualità di vita. Metodi: dal Gennaio 2000 al Settembre 2004, sono stati trattati 90 pazienti affetti da VPM ( età media 55 anni).La neoplasia primitiva nel 40% dei casi era di origine polmonare, nel 25% mammaria e nel 35% di altra sede. Ventisei pazienti sono stati sottoposti solamente a toracentesi evacuativa a causa delle scadenti condizioni fisiche ( pazienti con indice di Karnovski < 30%), mentre i restanti 64 pazienti sono stati sottoposti a toracentesi e pleurodesi chimica con …

REATMENT OF GASTROINTESTINAL STROMAL TUMOR (GIST). REVIEW OF THE LITERATURE AND A CASE REPORT

Secondary Carina and Lobar Bronchi Stenting in Patients with Advanced Lung Cancer: Is It Worth the Effort? A Clinical Experience

Background: The lobar airway stenting remains an endoscopic procedure not well standardized in patients with locally advanced lung cancer disease. The goal of this study was to evaluate technical feasibility, clinical outcome, and complications of different stents in patients with malignant lesions involving lobar bronchi, primary and secondary carina. Methods: Between November 2008 and October 2013, we retrospectively analyzed 146 patients with benign and malignant tracheobronchial stenosis who underwent airway stent insertion below main carina and main bronchi. Results: In all, 170 airway stenting procedures were performed on 146 patients. In all, 51 of them with malignant peripheral airw…

Current role of computed tomography-guided transthoracic needle biopsy of metastatic lung lesions.

ABSTRACT  Aim: As part of the Catania symposium on lung metastasectomy we reviewed our practice of computed tomography (CT)-guided percutaneous transthoracic needle biopsy of pulmonary metastatic lesions with particular emphasis on diagnostic accuracy and nature of complications lesions. Materials &amp; methods: 25 patients with metastatic lesions of the lung have been evaluated between May 2010 and February 2014. Inclusion criteria consisted of patients with histologically confirmed, metastatic disease of the lung, those receiving a CT-guided needle biopsy, were at least 18 years of age; and with adequate hepatic, renal and hematological function. We recorded also the size of the sampled …

Barrett's Oesophagus incidence in a sicilian population of refluxing patients undergoing EGDS

LOW CELL PROLIFERATION AND LOW THYMIDYLATE SYNTHASE LEVELS IN THE HIGLY AGGRESSIVE SIGNET RING CELL VARIANT HISTOTYPE OF COLORECTAL CARCINOMA

Synchronous adenomatous polyps and colorectal carcinoma

An uncommon case of pneumothorax

Vantaggi degli ultrasuoni nel posizionamento di un agocannula nella vena giugulare interna (nuove note di tecnica)

The authors analized the result of 175 central venous ca he- terization CVC. of internal jugular vein performed with the ultrasound guide (US) from January 1998 to October 2002. The average performing time was 45 minutes. 98.2% of success and 4% of complications (one pagal hypotension, one artery puncture, four catheter dislocation, one haeiuatoinai). The US guide CVC is a safe procedure with short performing time, low rate of failures and complications and high rate of success: it is helpful in all patients with vascular anatomical variations, with not visualized or Land marks and with coagulation disorders.

TTF-1/p63-Positive Poorly Differentiated NSCLC: A Histogenetic Hypothesis from the Basal Reserve Cell of the Terminal Respiratory Unit

TTF-1 is expressed in the alveolar epithelium and in the basal cells of distal terminal bronchioles. It is considered the most sensitive and specific marker to define the adenocarcinoma arising from the terminal respiratory unit (TRU). TTF-1, CK7, CK5/6, p63 and p40 are useful for typifying the majority of non-small-cell lung cancers, with TTF and CK7 being typically expressed in adenocarcinomas and the latter three being expressed in squamous cell carcinoma. As tumors with coexpression of both TTF-1 and p63 in the same cells are rare, we describe different cases that coexpress them, suggesting a histogenetic hypothesis of their origin. We report 10 cases of poorly differentiated non-small-…

Nm-23-H1 expression does not predict clinical survival in colorectal cancer patients

The gene Nm23, which encodes for a nucleoside diphosphate kinase, has been defined as a metastasis-suppressor gene because of the inverse correlation between its expression and the metastatic capacity of the tumor cells. For colorectal cancer, however, the findings are equivocal. The aim of our study was to assess, in 160 patients undergoing surgery for colorectal cancer (CRC), the expression of the Nm23-H1 protein and to evaluate its possible associations with traditional clinicopathologic variables, with DNA-ploidy and proliferative activity (S-phase fraction, SPF), and with disease-free and overall survival of patients. Nm23-H1 expressions were evaluated on paraffin-embedded tissue by im…

CD1A expression in Barrett’s oesophagus: new role for an old molecule against the metaplastic progression

CD1A expression in Barrett's oesophagus: new role for an old molecule against metaplastic progression

BENIGN GASTRIC POLYPS AND HELICOBACTER PYLORI

Linfangioma cistico addominale; un’origine dibattuta

Resection of esophageal diverticulum through uniportal video-assisted thoracoscopic surgery

Open surgery remains the standard strategy for management of esophageal diverticulum in symptomatic patients. However, in the last years an increasing number of minimally invasive approaches have been proposed for this issue in order to reduce the surgical trauma and favor a fast return to daily activity. Herein, we describe a novel technique as uniportal video-assisted thoracoscopic surgery (VATS) for performing resection of esophageal diverticulum. This procedure was successfully carried out in three consecutive patients with giant mid-esophageal diverticulum (mean size: 6.5±0.5 cm). The mean post-operative time was 121±10 minutes. The chest drain was removed 48 hours later in all cases a…

Il carcinoide bronchiale: revisione della letteratura recente

Objective: Yo evaluate methods of diagnosis and treatment, and the long term survival of patients treated for bronchial carcinoid tumor by the review of recent literature. Methods: The Authors conducted a retrospective study on internet-based-evidence of patients treated for bronchial car-cinoid tumor since 1993 to 2004. Symptoms, diagnosis, operative approach and survival were assessed. Conclusions: On the basis of the review of the international literature, the Authors affirm that the 5 and 10-year probability of survival are closely linked to the histological type of carcinoid, to the presence of nodal and distant metastasis. Owing to the potential malignancy of these tumours, preference…

Analysis of the Thymidylate Synthase Gene Structure in Colorectal Cancer Patients and Its Possible Relation with the 5-Fluorouracil Drug Response

Thymidylate synthase (TS) catalyzes methylation of dUMP to dTMP and it is the target for the 5-Fluorouracil (5-FU) activity. Barbour et al. showed that variant structural forms of TS in tumour cell lines confer resistance to fluoropyrimidines. We planned to perform the whole TS gene structure by means of sequencing techniques in human colorectal cancer (CRC) samples to try to identify the presence of any possible TS variant form that could be responsible of fluoropyrimidines drug resistance and of the worse prognosis. We performed the TS-DNA gene sequence in 68 CRC from patients of A, B, and C Dukes' stages and different histological grade, but we did not find any mutation in the TS-DNA str…

I tumori della mammella e/o dell’ovaio di tipo eredofamiliare: strategie di prevenzione nelle donne ad alto rischio

Numerosi fattori sono stati coinvolti nell’insorgenza del carcinoma mammario e dell’ovaio tra cui l’età, fattori ormonali e riproduttivi come l’età e il numero di gravidanze e l’utilizzo di contraccettivi orali e, in minor misura, fattori ambientali e stili di vita. Le possibilità per la gestione clinica delle pazienti considerate ad alto rischio di sviluppare carcinoma della mammella e/o dell’ovaio includono chirurgia profilattica (es. mastectomia bilaterale profilattica o ovarosalpingectomia bilaterale), chemioprevenzione (principalmente tamoxifene e raloxifene ma anche, più recentemente, inibitori dell’aromatasi nelle donne ad alto rischio in postmenopausa), cambiamenti nelle abitudini d…

HSP60 and HSP10 overexpression in metastastic colon cancer

Terminal ligature of inferior thyroid arterhy branches during total thyroidectomy for multinodular goiter is associated with higher postoperative calcium and PTH levels

Purpose: To evaluate the impact of truncal versus terminal branch ligature of the inferior thyroid artery (ITA) on postoperative calcium and PTH plasma levels in patients undergoing total thyroidectomy for multinodular goiter. Methods: A prospective randomized study was performed comparing a group of patients that underwent either truncal ligature of the ITA (group 1) or terminal ligature of ITA branches (group 2). Results: A series of 126 consecutive patients with non-toxic euthyroid multinodular goiter underwent total thyroidectomy. Truncal ligature of the ITA was performed in 63 patients (group 1) and terminal branch ITA ligature in 63 patients (group 2). Postoperative ionized serum calc…

Role of videoassisted thoracoscopy procedure in the diagnosis and treatment of malignant pleural mesothelioma

Contrast-enhanced versus baseline ultrasonography in the characterization of benign focal lesions.

Il trattamento medico e chirurgico nei pazienti affetti da iperparatiroidismo secondario e terziario. Revisione della letteratura

Introduzione: L’iperparatiroidismo è un’alterazione fisiopatologica della secrezione di paratormone dovuta o da un rilascio autonomo e anomalo (iperparatiroidismo primario o terziario) da parte delle paratiroidi o da un’alterazione dell’omeostasi del calcio che stimola l’eccessiva produzione di paratormone (iperparatiroidismo secondario). Obiettivi: Il trattamento clinico dell’iperparatiroidismo secondario o terziario non è univoco. Sorge pertanto la necessità di una revisione delle attuali metodiche diagnostico-terapeutiche. Discussione: Nell’iperparatiroidismo secondario (2HPT) si ha una progressiva iperplasia delle paratiroidi e un incremento della produzione di paratormone. Tra le cause…

Virtual broncoscopy in the preoperative assessment of airways stenosis

La chirurgia laparoscopica nel paziente uremico

Il trattamento dei tumori stromali gastrici (GIST). Revisione della letteratura e descrizione di un caso

background: Gastrointestinal stromal tumors (GIST) are rare mesenchimal tumors that are characterized by constitutive overexpression of the tyrosin-kinase receptor KIT (CD 117). The authors analyse the basis of the treatment of gastric GIS, starting form the study of a recent observed case. Experimental design: Report of one case treated with endoscopic resection. Evaluation of treatment and 2-years follow- results: The treatment of gastric GIS I must be modulated on prognostic, genetic and molecular factors. These factors are the basis of the formation and growth of GIST. conclusions: Complete surgical extirpation without rupture remains the only curative treatment of localized favourable …

Thoracoscopy in pleural effusion –two techniques: awake single-access video-assisted thoracic surgery versus 2-ports video-assisted thoracic surgery under general anesthesia

Awake single access video-assisted thoracic surgery with local anesthesia improves procedure tolerance, reduces postoperative stay and costs. Materials & methods: Local anesthesia was made with lidocaine and ropivacaine. We realize one 20 mm incision for the 'single-access', and two incisions for the '2-trocars technique'. Results: Mortality rate was 0% in both groups. Postoperative stay: 3dd ± 4 versus 4dd ± 5, mean operative time: 39 min versus 37 min (p < 0.05). Chest tube duration: 2dd ± 5 versus 3dd ± 6. Complications: 11/95 versus 10/79. Conclusion: Awake technique reduce postoperative hospital stay and chest drainage duration, similar complications and recurrence rate. The authors ca…

MULTIDISCIPLINARY APPROACH TO PALLIATIVE MANAGEMENT OF PANCREATOBILIARY TRACT CARCINOMAS

Ultrasound (US) guided central venous catheterization of internal jugular vein on over 65-year-old patients versus blind technique.

Background and Objectives Performing a central venous catheterization (CVC) on older patients for long-term central intravenous therapy could be a very important procedure. It could be associated with a high incidence of related complications, especially on over 65-year-old, high risk, selected patients. Methods The authors analyzed the results of 72 central venous CVC of internal jugular vein performed on over 65-year-old patients with ultrasound (US) guide from January 1998 to April 2003. Results The average performing time was 4 min, with 98.7% of success, 0% of major complications, and 4.1% of minor complications (one mild vagal hypotension and two catheter dislocation). Conclusions The…

Cystic mucinous adenocarcinoma of the lung: a case report.

Abstract Mucinous cystic tumors of the lung are uncommon, the preoperative pathologic diagnosis is difficult and their biological behavior is still controversial. We report the case of a patient with a clinically benign cystic lesion that post-operatively showed to be consistent with an invasive adenocarcinoma arising in a mucinous cystadenoma of the lung, We underline the difficulty of the clinical pre-operative diagnosis of this cystic neoplasia radiologically mimicking a hydatid cyst, and we report the negative TTF1 immunostaining potentially misleading in the differential diagnosis with metastatic mucinous carcinomas. Finallly, we evidence the presence of a pre-existing mucinous benign …

Malattia di Fournier: caso clinico e revisione della letteratura

OBJECTIVE: The authors report their experience in diagnosis and treatment of one case of Fournier's gangrene; recent international literature review. EXPERIMENTAL DESIGN: Complete clinical report. Diagnostic, clinical and prognostic indication, evaluation of effectiveness of surgical treatment (debridement and necrosectomy) and follow-up; comparison between indications and multidisciplinary approach proposed by international literature. SETTING: Operative Unit of General and Thoracic Surgery. University "Paolo Giaccone" of Palermo. INTERVENTION: Repeated surgical treatment previous multimodal approach, according to international guide-lines. RESULTS: Complete recovery with "restitutio ad in…

Tiroidectomia in urgenza per linfoma primitivo della tiroide

Objective: A case of acute wheezing causing primitive thyroid lymphoma observed ay the Operative Unit of General and Thoracic Surgery of the University "P. Giaccone" of Palermo, Italy, is reported. Experimen tal design: Diagnostic, clinical and prognostic indication, evaluation of effectveness of radical surgical treatment and follow-up. Intervention: Emergency radical surgical treatment (debulking) and surgical tracheostomy (tracheal infiltration) Results: Complete recovery with "restitutio ad integrum". No relapse were recorded ad short follow-up. Conclusions: Total thyroidectomy in front of uncertain cytology with the suspect of Hashimoto's treatment or acute wheezing nr localized neopla…

HSP60 and HSP10 overespression in metastatic colon cancer

EGFR genomic alterations in cancer: prognostic and predictive values.

The role of EGFR in cancer development and progression has been recognized for long time in a variety of human malignancies including lung, head and neck, colon, breast, ovary and glioma. Recently its role as a target of antineoplastic agents has also been identified and a variety of EGFR-targeted drugs is already being used in a clinical setting and others are at present under investigation. Many data involving EGFR protein expression are now available for the choice of anti-EGFR monoclonal antibodies in colorectal cancer and with regard to EGFR gene mutations for the choice of tyrosine kinase inhibitors in lung cancer. Other EGFR-related molecular factors, including the EGFR gene copy num…

SINGLE ACCESS THORACOSCOPY IN BENIGN AND MALIGN PLEURIC PATHOLOGY

(OBJECTIVE) Jacobeus and Bethune performed thoracoscopy under local anaesthesia, already on early 1900. A single access associated with local anaesthesia aims to improve procedure tolerance, shorten recovery and reduce costs. (METHODS) Premedication consists of atropine 0.01 mg/kg and midazolam (0,02-0.04 mg/kg). Pain control and sedation was obtained by remifentanile (0.05-0.1 mcg/kg/min). Local anaesthesia was made with lidocaine and ropivacaine. An incision of 20 mm is realised at 6° intercostal space for the “single-access-technique”, and two incisions for the “2-trocars-technique” (15 mm at 5°space - 10 mm at 6°/7°space). The 5 mm 0° camera is preferred for single-access technique. The…

An uncommon cause of pneumothorax

Causa rara di ostruzione delle vie aeree: linfoma tiroideo

Virtual broncoscopy in the preoperative assessment of peripheral airways stenosis

L’utilità del drenaggio biliare transepatico percutaneo ecoguidato negli itteri ostruttivi

3D CT scan for perioperative identification of anatomical variations of lungs.

Aim: The aim of this study is to investigate anatomical lung variations and vascular patterns using volumetric 3D computed tomography (CT) representations. Methods &amp; results: We considered 24 major thoracic surgery performed in our ward. In these, we discovered some interesting anatomical variations of the main pulmonary fissures. These findings were not visible on the plain x-ray or during routine examination of a preoperative CT scan. After re-examination of 3D CT scan reconstruction the anatomical variations were detected. Discussion: General thoracic surgeons must familiarize themselves with anatomical variations in lungs. 3D images may aid the general thoracic surgeon in performin…

Wider implications of video-assisted thoracic surgery versus open approach for lung metastasectomy

ABSTRACT  Lung metastasectomy is considered a safe and potentially curative procedure despite there is not a strong evidence that metastasectomy prolongs long-term survival in patients with lung metastases. Moreover, the debate is open regarding the best approach for lung metastasectomy, video-assisted thoracic surgery versus open approach. A systematic review of literature to clarify what is the best approach to prolong survival in patients with lung metastases was performed. Our study confirms that overall survival is equivalent for video-assisted thoracic surgery and thoracotomy, therefore the ‘gold standard’ surgical treatment for lung metastases remains a point of debate. The choice o…

Aberrant methylation within RUNX3 CpG island associated with the nuclear and mitochondrial microsatellite instability in sporadic gastric cancers. Results of a GOIM (Gruppo Oncologico dell'Italia Meridionale) prospective study.

Background: Gastric cancer (GC) development is a multistep process, during which numerous alterations accumulate in nuclear and mitochondrial DNA. A deficiency of repair machinery brings about an accumulation of errors introduced within simple repetitive microsatellite sequences during replication of DNA. Aberrant methylation is related to microsatellite instability (MSI) by the silencing of the hMLH1 gene. The aim of this study is to investigate a possible relationship between the RUNX3 promoter methylation, nuclear microsatellite instability (nMSI) and mitochondrial microsatellite instability (mtMSI), in order to clarify its biological role in GC. Patients and methods: nMSI and mtMSI were…

Syncronous adenomatous polyps and colorectal carcinoma

Polipi neoplastici del colon-retto. Indicazioni e risultato preliminari della polipectomia endoscopica

MULTIDISCIPLIBILIARY TRACT CARCINOMASNARY APPROACH TO PALLIATIVE MANAGEMENT OF PANCREATICO

F3 the advantage of ultrasound-guided FNA of pleura in the diagnosis of the malignant pleural effusion

Role of intraoperative ultrasound in the screening of liver metastases from colorectal carcinoma: initial experiences.

The aim of this study was to assess the utility of intraoperative ultrasound (IOUS) in the diagnosis and management of liver metastases from colorectal carcinoma. IOUS was performed on a consecutive series of 70 patients undergoing surgery for colorectal carcinoma, with follow-up ranging from 6 to 24 months. In ten cases (14.3%), 13 metastatic tumours were diagnosed; only six of these had been found by preoperative workup and/or surgical inspection. Seven (53.9%) small metastatic liver lesions were identified only by IOUS. None of the lesions diagnosed by IOUS was palpable, and they were all extremely small--ranging from 4 x 6 to 12 x 16 mm. Seventy-three locations were examined in order to…

Nodular histiocytic/mesothelial hyperplasia as consequence of chronic mesothelium irritation by sub-phrenic abscess.

Nodular histiocytic/mesothelial hyperplasia (NHMH) is a benign localized alteration, first described in 1975 by Rosai in the hernia sac [1]. Few pulmonary cases have been reported in literature [2–6]. Sometimes it has been reported in the pericardium [7,8] or presenting as an inguinal mass [9]. The ‘mesothelial/monocytic incidental cardiac excrescence’, first described by Weinot et al. in 1994 [10] is now considered a similar lesion to NHMH [11]. It consists of a reactive proliferation of histiocytes and mesothelium secondary to chronic irritation and it has been observed in pleura-damaging processes, such as pneumothorax [5], or as consequence of cardiac catheterization, inflammation, mech…

LOW CELL PROLIFERATION AND LOW THYMIDYLATE SYNTHASE LEVELS IN THE HIGHLY AGGRESSIVE SIGNET RING CELL VARIANT HISTOTYPE OF COLORECTAL CARCINOMA

Pleural fluid collection and ultrasound guided percutaneous drainage

La ligature terminale des branches de l’artère thyroïdienne inférieure diminue la morbidité parathyroïdienne après thyroïdectomie totale pour goitre

Resume But de l’etude Le but de cette etude etait d’evaluer l’impact de la ligature proximale de l’artere thyroidienne inferieure sur le taux postoperatoire de calcium et de parathormone chez les patients operes d’une thyroidectomie totale pour goitre. Patients et methodes Une etude randomisee a compare un groupe de patients operes par ligature proximale tronculaire de l’artere thyroidienne inferieure (groupe 1) a un deuxieme groupe de patients operes par ligature distale des branches de l’artere thyroidienne inferieure au contact de la capsule thyroidienne. Cent vingt-six patients consecutifs operes d’une thyroidectomie totale pour goitre multiheteronodulaire euthyroidien ont ete inclus. S…

Mediastinal syndrome from plasmablastic lymphoma in human immunodeficiency virus and human herpes virus 8 negative patient with polycythemia vera: a case report

Background: Plasmoblastic lymphoma is a rare and aggressive subtype of diffuse large B cell lymphoma, which occurs usually in the jaw of immunocompromised subjects. Case presentation: We describe the occurrence of plasmoblastic lymphoma in the mediastinum and chest wall skin of an human immunodeficiency virus-negative 63-year-old Caucasian man who had had polycytemia vera 7 years before. At admission, the patient showed a superior vena cava syndrome, with persistent dyspnoea, cough, and distension of the jugular veins. Imaging findings showed a 9.7 × 8 × 5.7 cm mediastinal mass. A chest wall neoformation biopsy and ultrasound-guided fine-needle aspiration biopsy of the mediastinal mass allo…

Incidence of venous thromboembolism in patients undergoing thoracotomy for lung cancer

Limited information exists on the incidence of symptomatic venous thromboembolism (vTE) in patients undergoing chest surgery for lung cancer. Several factors increase the thromboembolic risk in patients undergoing surgery for lung cancer: the intrinsic procoagulant effect of cancer,extensive surgical intervention, dependent limb position in the operating room, and vessel injury consequent to the operation. Furthermore,these patients might be especially vulnerable to pulmonary embolism (PE) because of the loss of lung tissue and the presence of chronic obstructive pulmonary disease and cardiovascular diseases caused by smoking.t Older studies found a very high incidence of thromboembolic eve…

What can platinum offer yet in the treatment of PS2 NSCLC patients? A systematic review and meta-analysis

Abstract: Background: Randomized phase III trials showed interesting, but conflicting results, regarding the treatment of NSCLC, PS2 population. This meta-analysis aims to review all randomized trials comparing platinum-based doublets and single-agents in NSCLC PS2 patients. Materials and methods: Data from all published randomized trials, comparing efficacy and safety of platinum-based doublets to single agents in untreated NSCLC, PS2 patients, were collected. Pooled ORs were calculated for the 1-year Survival-Rate (ly-SR), Overall Response Rate (ORR), and grade 3-4 (G3-4) hematologic toxicities. Results: Six eligible trials (741 patients) were selected. Pooled analysis showed a significan…

Endoscopic treatment of colonic polyps into digestive endoscopy ambulatory

Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review

Introduction. Acrylic cement pulmonary embolism is a potentially serious complication following vertebroplasty. Case Report. A 70-year-old male patient was treated with percutaneous vertebroplasty for osteoporotic nontraumatic vertebral collapse of L5-S1. Asymptomatic pulmonary cement embolism was detected on routine postoperative chest radiogram and the patient was treated with enoxaparin, amoxicillin, and dexamethasone. At the followup CT scan no further migration of any cement material was reported; and the course was uneventful. Discussion. The frequency of local leakage of bone cement is relatively high (about 80–90%), moreover, the rate of cement leakage into the perivertebral veins (…

La tracheostomia in urgenza nel trattamento delle ostruzioni delle vie respiratorie

Clinical Anatomy of Central Venous Catheterization Ultrasound-Guided

A Strange Case of Left Bowel Ischemia after Right Hernioplasty

We report the first observed case of a young man who suffered of large and unsuspected left bowel ischemia following an elective right open hernioplasty. A 54-year-old man had a 2-year history of right inguinal reducible mass and was admitted to hospital for an elective day case open inguinal hernioplasty for a direct right inguinal hernia. Apart from mild hypertension controlled with ACE inhibitor, he was medically fit and well. The patient was submitted to open tension-free mesh repair with polypropylene preshaped mesh with local infiltration anesthesia and additive sedation with midazolam. The local anesthesia and surgery were uneventful and he was discharged home on the same day as per …

Benign gastric polyps and Helicobacter pilori infection

Comparasion of central venous catheterization with and without ultrasound guide

PURPOSE: To compare the effectiveness, safety and time needed to perform central venous catheterization (CVC) in the presence or absence of an ultrasound (US) guide. METHODS: Between January 1999 and February 2002 we performed CVCs in 196 patients: 105 patients received US guided CVC (group I) and 91 patients had CVC without US guide (group II). RESULTS: The average time to perform CVC was shorter with US guide (4 vs 7 min). The utilization of the US guide was also associated with improved success (98.09% vs 91.2%, p<0.025) and lack of major complications (0% vs 9.8%, p<0.001). CONCLUSIONS: US-guided CVC affords an easier, safer and more rapid cannulation of a central vein. It is especially…

Flow cytometric DNA analysis of hepatic tumours on ultrasound-guided fine-needle aspirates

A study was performed on a nonconsecutive series of 51 patients in order to assess the feasibility, reliability, and usefulness of flow cytometric (FCM) DNA analysis of samples obtained from benign and malignant hepatic tumours by means of ultrasound-guided fine-needle aspiration (UG-FNA). Cytological and often histological confirmation of the nature of the lesion was obtained in all cases from an expert pathologist. For FCM DNA analysis in 32 cases, it was also possible to use samples obtained at surgery from the actual tumours. There were no post UG-FNA complications, either early or late. It was possible to perform FCM DNA analysis on 6/7 (85.7%) of the benign tumour aspirates and all 44…

Cisti broncogena diaframmatica associata ad ernia di Bochdalek

“Weekly docetaxel and gemcitabine as first line treatment for metastatic breast cancer: results of a multicenter phase II study”

&lt;i&gt;Objectives:&lt;/i&gt; We conducted a multicenter phase II study to evaluate the clinical efficacy, toxicity, and dose intensity of a new weekly schedule of docetaxel and gemcitabine as first-line treatment of metastatic breast cancer patients. &lt;i&gt;Methods:&lt;/i&gt; We enrolled 58 patients, 52% of whom had received a previous anthracycline-containing chemotherapy. The treatment schedule was: docetaxel 35 mg/m&lt;sup&gt;2&lt;/sup&gt; and gemcitabine 800 mg/m&lt;sup&gt;2&lt;/sup&gt; i.v. on days 1, 8, 15 every 28 days. &lt;i&gt;Results:&lt;/i&gt; All patients were assessable for toxicity and 56 for efficacy. Overall response rate was 64.3% with 16.1% of complete responses and 48…

Functional characterization of a novel 3D model of the epithelial-mesenchymal trophic unit

Background/Aim: Epithelial-mesenchymal communication plays a key role in tissue homeostasis and abnormal signaling contributes to chronic airways disease such as COPD. Most in vitro models are limited in complexity and poorly represent this epithelial-mesenchymal trophic unit. We postulated that cellular outgrowth from bronchial tissue would enable development of a mucosal structure that recapitulates better in vivo tissue architecture. Materials and Methods: Bronchial tissue was embedded in Matrigel and outgrowth cultures monitored using time-lapse microscopy, electrical resistance, light and electron microscopy. Cultures were challenged repetitively with cigarette smoke extract (CSE). Res…

Post-transplant renal lymphocele treated by percutaneous ultrasono graphy guide aspiration and instillation of povidone-iodine

Analysis of coding and non-coding regions of thymidylate syntetase gene in colorectal cancer patients and its possible relationship with 5-fluorouracil drug response