30 research outputs found
Charcoal Suspension Tattoo: A New Technique for Intraoperative Detection of Small Tumors of the Parotid Gland
No full textAbstract
OBJECTIVE:
The current surgical trend in the treatment of pleomorphic adenomas of the parotid gland is to limit the extent of resection. This raises the need to correctly identify the mass within the normal parenchyma so as to avoid dissecting the entire superficial lobe of the gland. We describe ultrasound-guided tattooing as a technique to facilitate identification and excision of parotid pleomorphic adenomas.
METHODS:
We reviewed 23 consecutive patients with pleomorphic adenoma of the parotid gland. All patients underwent ultrasound-guided tattooing of the lesions with a charcoal suspension. Baseline tumor and patients' characteristics, major and minor complications, and subjective tolerance to the procedure were recorded. We assessed the number of intralesionally marked masses and the percentage of intraoperatively detected marked lesions.
RESULTS:
The injection was well tolerated. No major complications were recorded. In 2 cases (9%), a transient increase in lesion size was observed. No other minor complications were encountered. Charcoal was found inside the tumor in 19 cases (83%). In 4 cases (17%), it was found in the tissues above the lesion. Twenty-three lesions were intraoperatively detected (100%) and dissected.
CONCLUSION:
Charcoal suspension tattooing is safe and well tolerated for the detection of small pleomorphic adenomas during parotid surgery
Surgical treatment of neglected hip fracture in children with cerebral palsy: Case report and review of the literature
No full textCase. A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed. Conclusion. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients.Case. A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed.Conclusion. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients
Pituitary dysfunction and its association with quality of life in traumatic brain injury
No full textBACKGROUND:
Traumatic brain injury (TBI) is a major cause of death and disability and may cause transient or persistent, isolated or multiple hypopituitarism in a variable percentage of cases.
OBJECTIVES:
The primary aim of this study was to determine the incidence of isolated and multiple anterior pituitary hormone deficiency in subjects with TBI in a single institution. The secondary aim was to determine a correlation between pituitary deficiency and quality of life (QOL) after TBI.
METHODS:
Thirty-five patients, aged between 18 and 63 years, were evaluated 6months to 5 years after TBI. We evaluated the QOL by SF-12(®) questionnaire and measured serum basal GH, IGF1, LH, FSH, testosterone (in males), 17-β-estradiol (in women), PRL, fT4 and TSH. In patients with low IGF1, a GHRH + Arginine test was performed.
RESULTS:
Single or multiple pituitary failure was found in 13 patients (37%). Low testosterone was found in 7 males, low FSH and/or LH in 4, low IGF1 in 7 patients. Hypogonadotropic hypogonadism and GH insufficiency assessed by GHRH + Arginine test were found respectively in 3 and 2 patients. One patient displayed a concomitant GH insufficiency and low TSH level. Twenty six patients showed a reduction in QOL. A correlations between altered QOL and hormonal deficiency was not observed.
CONCLUSIONS:
Isolated or multiple hypopituitarism resulting from TBI are frequent. Alterations in QOL and pituitary function resulting from TBI are not associated
Charcoal suspension tattoo: new tool for the localization of malignant laterocervical lymph nodes
No full textWe present a retrospective study to evaluate safety and effectiveness of ultrasound (US)-guided tattooing with charcoal of suspicious laterocervical lymph nodes. When an open biopsy of a laterocervical lymph node is needed, the choice of the lymph node to excise and examine is fundamental to avoid rebiopsy. Surgeons tend to choose the most surgical approachable enlarged lymph node that does not always correspond to the one with worst echographic aspect. We present 16 cases of patients with laterocervical adenopathy with inconclusive or non-adequate results at fine needle aspiration cytology addressed to open biopsy. Those patients underwent US-guided preoperative injection of a charcoal suspension inside the lymph node to excise to mark it, and then excisional biopsy was performed. Sixteen marked lesions (100 %) were detected intraoperatively and dissected. The injected charcoal was detected intraoperatively in all cases. In 14 patients (87, 5 %) it was inside the lesion; in two cases (12, 5 %), the charcoal suspension was found in the tissues above the lesion. The procedure was well tolerated in all cases. No major procedure-related complications were encountered. US-guided charcoal tattooing is a new, safe, well-tolerated, and easy-to-perform technique for the marking of US suspicious laterocervical lymph nodes. This preliminary study shows a high technical success rate (76 %) and high percentage of intraoperative detection of marked lesions (100 %) with a low rate of complications
Accuracy of the Anatomage Table in detecting extranodal extension in head and neck cancer: a pilot study
No full textPurpose: To assess whether the three-dimensional reconstructions of preoperative computed tomography (CT) scans are helpful for establishing extranodal extension (ENE) in head and neck carcinoma. Approach: Patients with a histological diagnosis of ENE ( pENE + ) were considered "cases" and patients with negative histological examination for ENE ( pENE - ) were considered "controls." Cases and controls were divided into two groups: a major nodes (MaN) group (lymph nodes on CT > 15 mm ) and a minor nodes (MiN) group (lymph nodes on CT ≤ 15 mm ). The preoperative CT scans were uploaded to the Anatomage Table and were randomly and blindly provided to the radiologist for assessment. The findings at the Anatomage Table were compared with those of CT and magnetic resonance imaging (MRI) scans. Results: Analysis of data from the MaN group showed that the Anatomage Table had a higher percentage of concordance with histopathological examination (90%) than the CT and MRI scans. The Anatomage Table had 100% sensitivity in identifying all pENE + patients, associated with a lower specificity. The negative predictive value of 100% allowed identification of pENE - patients. In the MiN group, on the other hand, sensitivity was lower, related to a high number of false-negative results. Conclusions: The Anatomage Table could represent a useful tool for preoperatively establishing the extranodal extension of cervical lymph node metastasis
Prognostic role of the MRI-based involvement of superior pharyngeal constrictor muscle in oropharyngeal squamous cell carcinoma
No full textObjectives: The aim of this study was to determine the impact of the involvement of the superior pharyngeal constrictor muscle (SPCM) evaluated by magnetic resonance imaging (MRI) on outcome in oropharyngeal squamous cell carcinomas (OPSCCs). Methods: A retrospective study including consecutive patients with OPSCC treated with curative intent. Results: A total of 82 consecutive patients with OPSCC met inclusion criteria. At multivariate analysis, patients with SPCM infiltration were at significantly higher risk of death (HR: 3.37, CI: 1.21-9.38) and progression (HR: 3.39, CI: 1.38-8.32). In a multivariate model conditioned on HPV status, a significantly higher risk of death and progression was observed by combining both SPCM and HPV status with patients harboring an HPV-negative OPSCC with SPCM infiltration showing the poorest outcome. Conclusion: MRI evidence of SPCM involvement significantly and independently increases the risk of death and progression in subjects with OPSCC. Considering both MRI-assessed SPCM infiltration and HPV status significantly improved risk stratification in these malignancies
Il linguaggio della satira a Modena Materiali per una storia dell’illustrazione umoristica tra Otto e Novecento
No full textThe node’s specific test of Modena’s illustrated comics, in the late nineteenth century and the first two decades of the twentieth century, made it possible to add new tiles of knowledge in an already existing historiography on the subject, drawing a historical framework in which the Modena’s illustration developed itself, both in reference to an urban context and beyond this. The complete photographic campaign has offered the opportunity to enhance documents with the result of new assignments. This led to the reorganization of the acquired data, as well as the deepening of the individual personality, highlighting aspects so far remained in the shadows. By the analysis performed, signs of major innovations emerged from the "Marchese Colombi" of 1893 and "La Sciarpa d’Iride" in 1897, so that they can be considered essential in Modena’s publishing publications in the specific field of illustrated comics. The first new feature is the collaboration of Umberto Tirelli to "Marchese Colombi" which, starting from 1895, brings the cartoon image to become the central node of the journal despite the text, this prerogative recognized by most critics as the the exclusive "Duca Borso" since 1900. In the assignment test has been recognized Umberto Tirelli as the author of cartoons traced in several sheets appeared between 1900 and 1903; in some cases, these partnerships were simply reordered, in others, we can talk of new assignments. Furthermore, from the analysis of fifteen years of "Duca Borso," it was possible to reconsider the common opinion of the critics, on the basis that the most prosperous period and lush of the magazine coincides with the direction of Umberto Tirelli. Between 1908 and 1912, in fact, on "Duca Borso" interesting illustrations of artists no less valid Tirelli are alternated, and yet, in the last two years of life, very young designers collaborate and such practice will herald them painting experience. It is found in these pages the figure of sixteen years old Mario Vellani Marchi identified under the pseudonym of Marius, in which has been tried to reconstruct a biographical profile as update as possible. Special attention has also been devoted to the Unique Numbers and to periodicals discontinuously issued, among which we remember "Il Navicello” on 8 May 1910, whose illustrations were attributed to the illustrator Aguini, who stole them from Umberto Tirelli. The catalog of Aguini has been enriched also by illustrations of other Unique Numbers appeared in Modena until 1913. After the break imposed by the war, the humorous illustration will be entrusted in its results in particular to Mario Vellani Marchi which, in 1921, along with Casimiro Jodi will establish "Il Gatto Bigio." Mario Vellani Marchi is the first artist that contributed to the developments of Modena’s illustrated comics during the twenties
Telomere shortening in mucosa surrounding the tumor: Biosensor of field cancerization and prognostic marker of mucosal failure in head and neck squamous cell carcinoma.
No full textOBJECTIVES: The aim of the present study was to investigate the pattern of telomere length and telomerase expression in cancer tissues and the surrounding mucosa (SM), as markers of field cancerization and clinical outcome in patients successfully treated for with head and neck squamous cell carcinoma (HNSCC).
MATERIALS AND METHODS: This investigation was a prospective cohort study. Telomere length and levels of telomerase reverse transcriptase (TERT) transcripts were quantified by real-time PCR in cancer tissues and SM from 139 and 90 patients with HNSCC, respectively.
RESULTS: No correlation was found between age and telomere length in SM. Patients with short telomeres in SM had a higher risk of mucosal failure (adjusted HR=4.29). Patients with high TERT levels in cancer tissues had a higher risk of regional failure (HR=2.88), distant failure (HR=7.27), worse disease-specific survival (HR for related death=2.62) but not mucosal failure. High-risk patients having both short telomeres in SM and high levels of TERT in cancer showed a significantly lower overall survival (HR=2.46).
CONCLUSIONS: Overall these findings suggest that telomere shortening in SM is a marker of field cancerization and may precede reactivation of TERT. Short telomeres in SM are strongly prognostic of mucosal failure, whereas TERT levels in cancer tissues increase with the aggressiveness of the disease and are prognostic of tumor spread
Symplectic resolutions for multiplicative quiver varieties and character varieties for punctured surfaces
No full textWe study the algebraic symplectic geometry of multiplicative quivervarieties, which are moduli spaces of representations of certain quiveralgebras, introduced by Crawley-Boevey and Shaw, called multiplicativepreprojective algebras. They are multiplicative analogues of Nakajima quivervarieties. They include character varieties of (open) Riemann surfaces fixingconjugacy class closures of the monodromies around punctures, when the quiveris "crab-shaped". We prove that, under suitable hypotheses on the dimensionvector of the representations, or the conjugacy classes of monodromies in thecharacter variety case, the normalisations of such moduli spaces are symplecticsingularities and that the existence of a symplectic resolution depends on acombinatorial condition on the quiver and the dimension vector. These resultsare analogous to those obtained by Bellamy and the first author in the ordinaryquiver variety case, and for character varieties of closed Riemann surfaces. Atthe end of the paper, we outline some conjectural generalisations to modulispaces of objects in 2-Calabi--Yau categories.<br
