1,720,971 research outputs found
VEGF-D e caratteri anatomo patologici tumori gastrointestinali
No full textLa diffusione metastatica è il principale fattore prognostico negativo nelle patologie neoplastiche ed il sistema linfatico risulta essere tra le prime vie di diffusione a distanza delle cellule neoplastiche.[1]
Le glicoproteine VEGF-C e VEGF-D sono membri della famiglia del Vascular Endothelial Growth Factor (VEGF) riconosciuta come regolatore della proliferazione del sistema linfatico durante l’embriogenesi e nei processi patologici come gli stati infiammatori, i disordini del sistema linfatico e la diffusione metastatica dei tumori maligni. [1-3] [2-5]
Le neoplasie solide in grado di esprimere VEGF risultano favorite nella crescita in quanto l’aumentato metabolismo delle cellule tumorali necessita di un maggiore apporto energetico e dunque di una maggiore vascolarizzazione. Ne consegue un aumento del potenziale metastatico.[6]
Secondo i più recenti studi la famiglia VEGF è composta da 5 citochine nei mammiferi: VEGF, PIGF (platelet induced growth factor), VEGF-B, VEGF-C, VEGF-D.[4-8] (Tab. Ia, Ib).[7-11]
I sottotipi VEGF-C e VEGF-D sono stati identificati come ligandi del recettore linfatico endoteliale VEGFR3 così come per il recettore dell’endotelio vascolare VEGFR2. [13-15] [12-15]
Sia il VEGF-C che il VEGF-D sono capaci di indurre la proliferazione e la migrazione di cellule linfatiche endoteliali in vitro. [16] [16]
Studi sperimentali e clinico patologici hanno correlato l’asse VEGF-C, VEGF-D/VEGFR3 alla diffusione linfatica cosi come alla prognosi di diversi tumori solidi nell’uomo. [17]
E’ stato inoltre dimostrato come il VEGF del sottotipo “D” sia responsabile della aumentata linfoangiogenesi.[9-12] [18-21]
La maggior parte di questi dati sono stati raccolti tramite lo studio dei campioni anatomopatologici post resezione con intento curativo.[6;17]
Nel tentativo di ottenere le medesime informazioni prima dell’eventuale trattamento sia per prognosi che per indirizzare verso la giusta terapia, è stato sviluppato un metodo immunoistochimico per le neoplasie solide dell’apparato gastrointestinale (stomaco-esofago-colonretto). [22-23]
Infatti lo studio quantitativo del VEGF-C e VEGF-D in campioni di sangue periferico risultano utili come possibile applicazione del come biomarker preoperatorio in merito alla diffusione metastatica linfonodale e contribuire allo staging preoperatorio delle suddette neoplasie solide del tratto gastrointestinale.
La correlazione tra l’asse VEGFC, VEGFD ed il VEGFR3 è dimostrata da diversi studi in molti tumori solidi. [17-19] [24-26]
La maggior parte dei studi ha confermato la correlazione positiva tra la maggior espressione del growth factor e fattori oncologici sfavorevoli. [20-23] [27-30]
Scopo della ricerca è individuare una correlazione tra l’espressione del VEGF-D ed alcuni parametri anatomo-patologici caratteristici delle neoplasie in studio
Solitary small bowel metastasis after resection of bile duct carcinoma
No full textSmall bowel solitary metastases are a very rare occurrence and are more frequently recognized only in the presence of a severe complication, such as intestinal hemorrhage or occlusion. We report the case of a 75 year-old man who was admitted with a recent history of mechanical ileus developed one year after the surgical removal of an endoscopically intubated carcinoma of the extrahepatic biliary tree (pT3 pN0 Mx). A solitary metastasis of the small bowel, 30 cm from the ileo-cecal valve, was excised during the emergency laparotomy and a side-to-side anastomosis was performed to reconstruct the intestinal continuity. Patient was, thereafter, discharged in the 9th postoperative day. Local recurrence and intrabdominal dissemination are often observed in patients treated for bilio-pancreatic carcinoma. Preoperative invasive (ERCP, FNA, PTBD, etc.) diagnostic procedures and surgical tumor manipulation are associated with a greater risk of metastasis implantation and intraabdominal dissemination. In accordance to the literature, the authors propose, in cases with resectable bilio-pancreatic neoplasms, the use of standard external low dose radiotherapy prior to any invasive diagnostic procedure and/or surgical removal
Un raro caso di ernia di Amyand. Caso clinico e revisione della letteratura [A rare case of Amyand’s hernia: case report and review of the literature]
No full textAmyand's hernia is defined as an inguinal hernia within the hernial sac containing the appendix. It is a rare disease, reported in 1% of cases of inguinal hernia repair. The appendix can be complicated by acute appendicitis in 0.13% of cases. This disease is often very difficult to diagnose, and most of the time it can be confused with an incarcerated or strangulated inguinal hernia. Often, it requires an emergent surgical treatment. This article describes the case of a 82-year-old female who was admitted for an intestinal obstruction and a bulge in the right inguinal region. An abdominal computed tomography scan showed dilated small bowel loops with multiple air/liquid levels and one loop herniating into the right inguinal canal. The patient underwent a laparotomy that showed the presence of an acute appendicitis and a necrotized ileal loop protruding into the right inguinal canal. The patient underwent an appendectomy and small bowel resection and she was discharged on postoperative day 10. Amyand's hernia can be a challenge for the surgeon. Its treatment depends on the grade of inflammation of the appendix. In fact, it can range from the simple repair of the abdominal defect with a prosthetic mesh, to appendectomy, small bowel resection and repair of the abdominal wall defect without a mesh
COMPLICANZE DELLA CIRROSI EPATICA NEL CORSO DI 20 ANNI IN UN SOLO PAZIENTE. SUCCESSO DI TUTTI I TRATTAMENTI
No full textGoing Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Risk factors for anastomotic leakage after resection for colorectal cancer and inflammatory bowel disease.
No full textCiliated hepatic foregut cysts: a case report
No full textThe ciliated hepatic foregut cysts (CHFC) are uncommon benign lesions with columnar ciliated epithelium covering a connective lapse tissue. They are solitary uniloculate cysts localized in the left lobe of the liver. The diagnosis is made occasionally during autopsy or imaging studies for not related symptoms. The Authors report a case of CHFC with a review of the literature that allowed them to find only 60 cases
Multidisciplinary treatment in Budd-Chiari syndrome: clinical case
No full textBudd-Chiari Syndrome (BCS) is characterized by obstruction of hepatic venous outflow. When obstruction is limited to the suprahepatic veins, portocaval shunting provides an immediate relief of symptoms. If the obstacle results also from narrowing of the inferior vena cava (IVC), multimodality treatments seem to offer safer and easier alternative. In the patient herein reported, combination of side-to-side portocaval anastomosis with a cavo-atrial shunt through an expandible metallic stent provided immediate relief of symptoms. The patient is doing well after 85 months from combined treatment. In conclusion infracaval stenting combined to side-to-side portocaval shunting should represent the treatment of choice in acute or subacute forms of BCS
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