1,720,967 research outputs found
IRREVERSIBLE ELECTROPORATION FIRST STEPS TOWARDS CELLULAR SURGERY
No full textLa permeabilità della membrana cellulare può essere modificata da una serie di impulsi elettrici brevi ma intensi, in un processo chiamato elettroporazione.
L’elettroporazione irreversibile è una tecnica di ablazione tissutale in cui gli impulsi elettrici scaricati sul tessuto da trattare determinano una permeabilizzazione di membrana irreversibile, che conduce all’apoptosi delle cellule coinvolte con conseguente necrosi tissutale.
Questa tecnica è stata recentemente introdotta come tecnica di ablazione non termica minimamente invasiva.
Le opzioni terapeutiche dei pazienti affetti da carcinoma pancreatico localmente avanzato sono limitate e pregne di complicanze e nonostante i continui progressi nelle terapie antitumorali multimodali, la sopravvivenza e la qualità di vita di questi pazienti rimangono comunque molto scarse.
Abbiamo arruolato nel nostro studio dieci pazienti affetti da neoplasia pancreatica non metastatica, non resecabile e li abbiamo sottoposti all’applicazione dell’elettroporazione irreversibile utilizzando il sistema Nanoknife durante una re-laparotomia.
Lo scopo del nostro studio era di valutare la sicurezza e la fattibilità dell’applicazione dell’elettroporazione irreversibile nel trattamento del carcinoma pancreatico localmente avanzato.
L’applicazione dell’elettroporazione irreversibile è stata ben tollerata in tutti e dieci i pazienti in assenza di complicanze procedurali o nell’immediato postoperatorio; l’evento avverso più frequente è stata la comparsa di dolore addominale dopo la procedura.
Il tempo medio trascorso tra l’applicazione dell’elettroporazione e il decesso è stato di 7.6 mesi, con un tempo medio dalla diagnosi di 16.8 mesi; la sopravvivenza globale dei nostri pazienti si è dimostrata superiore sia a quella di un gruppo di controllo costituito da pazienti nello stesso stadio di malattia che però avevano ricevuto solo chirurgia palliativa e chemioterapia, sia a quella descritta in letteratura per pazienti nello stesso stadio di malattia trattati solo con protocolli di chemio o chemioradioterapiaThe permeability of the cell membrane could be increased by intense but short electrical fields in a process called electroporation. Irreversible electroporation (IRE) is a tissue ablation technique in which electrical pulses are delivered to undesirable tissue to produce cell necrosis through irreversible cell membrane permeabilization that leads to cell apoptosis and has recently begun to emerge as an important minimally invasive non-thermal ablation technique.
Treatment options for locally advanced pancreatic cancer are limited and plenty of complications and survival and quality of life of these patients still remains really poor despite advances in cancer multimodal therapies.
Ten patients with unresectable non metastatic pancreatic cancer non responsive to chemo or chemoradiotherapy were enrolled: they underwent IRE application using Nanoknife System during laparotomy.
The purpose of this study was to evaluate the safety and feasibility of the IRE to treat locally advanced pancreatic cancer.
The IRE application was well-tolerated in all patients and there were no procedural or immediate post-procedural complications; the most frequent adverse event was abdominal pain after procedure.
Mean time from treatment to death was 7.6 months and mean time from diagnosis to death was 16.8 months; overall survival of our patients was longer compared with a group of patients who received palliative surgery and chemotherapy and with overall survival in literature of patients in the same stage treated with chemo/chemoradiotherapy protocols alone
TRAITEMENT DES ANEURISMES DU TRONC CŒLIAQUE :EXPERIENCE PERSONNELLE ET REVISION DE LA LITTERATURE
No full textINTRODUCTION: Celiac trunk aneurysms represent 4% of all splanchnic artery aneurysms. These lesions are thus extremely rare but yet have a significant clinical importance. Mortality, mainly related to site characteristics, is a significant risk (14%) in the event of rupture.
PATIENTS AND METHODS: We put forward our experience in both diagnosis and treatment in three patients, two women and one man (average age 55.3 years, range 35-74), presenting aneurysms involving the celiac trunk. The preoperative diagnosis was established successively with ultrasonography, CT scan and angiography. Two patients were treated via an open surgical approach while endovascular percutaneous treatment was performed for the third patient.
RESULTS: Mortality was null at 13 days on average from admission for the surgical patients and 4 days for the patient treated endovascularly. Postoperative complications were modest: pulmonary thickening with pleural effusion for the two surgical patients (spontaneous resolution), while for the third patient treated with an endovascular method, the stent migrated to a splanchnic arterial branch, with no consequence for the spleen. The average follow-up was 19 months (range 14-24). Full exclusion of the aneurysm was maintained at four months for the aneurysm treated percutaneously. A patent celiac was also maintained for the patients treated surgically.
CONCLUSIONS: Considering the largely unforeseeable outcome and the high risk of rupture, we suggest that all the patients presenting this type of aneurysmal lesion should be treated. This attitude is widely advocated in the literature. Moreover, we noted null mortality in our small series, with only one percutaneous "re-do" case; resolutive at last control. With the present improvement in stent technology, endovascular treatment should be preferred. Patients should be treated surgically only if a percutaneous procedure would be risky or technically unfeasible due to the size of the aneurysm or its anatomic features
The role of splenectomy in myelofibrosis with myeloid metaplasia
No full textAim. In this paper we retrospectively analyzed prospectively-collected data on our myelofibrosis with myeloid metaplasia (MMM) patients who underwent splenectomy. The aim was to ascertain the hematological response and any resolution of symptoms existing prior to splenectomy; redefining timing and role of splenectomy in the treatment of MMM.
Methods. This prospective study considered 31 patients with MMM who underwent splenectomy for transfusion-dependent anemia, thrombocytopenia, abdominal swelling and pain. Postoperative work-up consisting in laboratory tests and clinical evaluation performing a quality of life (QoL) test based on EORTC QLQ-C30 questionnaire. Follow-up data were collected for one year after surgery. Statistical analysis used Student's t-test, the Mann-Whitney rank sum, Fisher's exact test, the Friedman test and the Wilcoxon test.
Results. Mortality was 3.2%. Respiratory symptomatic complications occurred in 35.4%. In all patients the need for blood transfusions was significantly reduced (P=0.005). An improvement in the painful symptoms was reported and a significant improve of postoperative quality of life was observed at one year after surgery.
Conclusion. In our experience splenectomy is associated with limited perioperative mortality and morbidity. Acute complications are almost exclusively limited to respiratory tract. The removal of spleen seems can be recommended to increase the QoL and to palliate hematological disorders in patients no more responder to chemotherapy
[Internal carotid artery aneurisms: two cases].
No full textTwo cases of Internal Carotid Artery Aneurysm
Imaging of biliary and vascular complications
No full textWith the aid of numerous high-quality illustrations, this volume explains the strengths and limitations of the different techniques employed in the imaging of pancreatitis. Ultrasound, computed tomography, magnetic resonance imaging and interventional imaging are each considered separately in the settings of acute and chronic pancreatitis. A further section is devoted to imaging of the complications of these conditions. Throughout, care has been taken to ensure that the reader will achieve a sound understanding of how the imaging findings derive from the pathophysiology of the disease processes. The significance of the imaging findings for clinical and therapeutic decision making is clearly explained, and protocols are provided that will assist in obtaining the best possible images
Differences between main-duct and branch-duct intraductal papillary mucinous neoplasms of the pancreas
No full textIn the last decade, intraductal papillary mucinous neoplasms (IPMNs) have become commonly diagnosed. From a morphological standpoint, they are classified in main-duct IPMNs (MD-IPMNs) and branch-duct IPMNs (BD-IPMNs), depending on the type of involvement of the pancreatic ductal system by the neoplasm. Despite the fact that our understanding of their natural history is still incomplete, recent data indicate that MD-IPMNs and BD-IPMNs show significant differences in terms of biological behaviour with MD-IPMNs at higher risk of malignant degeneration. In the present paper, clinical and epidemiological characteristics, rates of malignancy and the natural history of MD-IPMNs and BD-IPMNs are analyzed. The profile of IPMNs involving both the main pancreatic duct and its side branches (combined-IPMNs) are also discussed. Finally, general recommendations for management based on these differences are given
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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