The effects of robotic assistance on upper limb spatial muscle synergies in healthy people during planar upper-limb training.

Background: Robotic rehabilitation is a commonly adopted technique used to restore motor functionality of neurological patients. However, despite promising results were achieved, the effects of human-robot interaction on human motor control and the recovery mechanisms induced with robot assistance can be further investigated even on healthy subjects before translating to clinical practice. In this study, we adopt a standard paradigm for upper-limb rehabilitation (a planar device with assistive control) with linear and challenging curvilinear trajectories to investigate the effect of the assistance in human-robot interaction in healthy people.

[Multidetector CT urography: diagnostic role in the evaluation of patients with non-traumatic hematuria].

Blood in the urine (hematuria) can originate from any site along the urinary tract and may be the only sign of renal or vesical malignancy. Therefore, literature recommends for the evaluation of any case of macroscopic or microscopic hematuria. Our aim was to define the diagnostic role of multidetector CT urography (MDCTu) in the evaluation of this symptom through the analysis of 181 consecutive patients from January 2003 to March 2006.

Papillary carcinoma of the thyroid: low expression of NCAM (CD56) is associated with downregulation of VEGF-D production by tumour cells.

The expression of NCAM was investigated in tissue sections of 61 cases of papillary carcinoma and in 14 lymph node metastases using immunohistochemistry. Tumour cells of 18 primary tumours were not stained, whereas in the remaining 43 cases, NCAM was expressed in less than 5% tumour cells. Similar results were obtained when NCAM expression was evaluated at the RNA level.

[The actual role of bilateral neck exploration in the treatment of primary hyperparathyroidism].

Surgery is the only curative treatment for primary hyperparathyroidism (pHPT). Surgical exploration is recommended for all patients with biochemically documented pHPT and signs or symptoms of the disease. Some patients are asymptomatic, others have subtle symptoms that disappear after parathyroid surgery.

[Intraoperative quick parathyroid hormone assay in thyroid surgery: preliminary experience on 36 cases].

Through the analysis of our preliminary experience on 36 consecutive cases of thyroid surgery, we assessed the feasibility of the rapid intraoperative assay of the intact parathyroid hormone (iPTH) as predictive risk factor of hypocalcemia versus seric calcium level on the first post-operative day to select the patients eligible to an early discharge. Furthermore, we managed to determine if iPTH level during thyroid surgery could point out the cases in which parathyroid autotransplantation is necessary, as the macroscopic evaluation of the parathyroid gland's viability is inadequate.

[Renal giant angiomyolipoma in tuberous sclerosis complex: case report and literature review].

The aim of this paper is to describe a typical clinical case of tuberous sclerosis complex (Bourneville disease) and discuss controversial issues about the management of this rare condition, with a short revision of the literature. Particularly, we define which is the role of the surgeon in the treatment of this very rare condition, that should be primary approached conservatively.

Hepatocyte growth factor (HGF) downregulates thrombospondin 1 (TSP-1) expression in thyroid papillary carcinoma cells.

This study investigates the expression of thrombospondin-1 in papillary carcinoma of the thyroid and the role of Met-HGF interaction in TSP-1 regulation. In tissue sections, immunostaining for TSP-1 was associated with the fibrous tumour stroma, and showed areas of marked intensity adjacent to the basal membrane of tumour cells. Investigation of TSP-1 RNA expression showed that, in 10 of 14 cases, TSP-1 mRNA levels were significantly lower in tumour tissue (20-100% reduction; mean = 55% +/- 20; p = 0.

[The Bochdalek hernia in the adult: case report and review of the literature].

The Bochdalek hernia, the most common diaphragmatic hernia, except the hiatus hernia, is located on the posterolateral side of this muscle. This pathology is generally diagnosed in children; in fact only 105 such cases occurring in adults have been described in the literature. In these cases, surgical intervention is made necessary by the severity of potential complications.

[Benign cicatricial stenosis of colorectal anastomosis: considerations on 2 cases].

During the surgical treatment of two patients with benign anastomotic colorectal stenosis, the Authors registered the presence of concomitant tenacious adherence of the anastomotic line to the sacral bone. Such event, according to the Authors, could represent one of the causes of failure and greater risk of perforation during the treatment with the different endoscopic therapies that, nevertheless, ought to be considered the gold standard in the therapy of benign structures. The Authors developed their hypothesis physiopathologic on the basis of personal experience and of the search a diagnostic procedure able to highlight the presence of a tenacious adherence with solid structures during the operative evaluation.

[Inflammatory tumors of the cecum in emergencies: surgical considerations and case report].

A cecal mass of uncertain etiology encountered during surgery for presumed appendicitis is a dilemma for the surgeon. The differential diagnosis of an unsuspected ileocecal mass must include neoplasm, diverticular disease, inflammatory bowel disease and severe appendicitis involving the ileocecal region. Right hemicolectomy is the gold standard for the treatment of the unsuspected ileocecal mass.

Incidentally detected giant oncocytoma arising in retroperitoneal heterotopic adrenal tissue.

A nonfunctional retroperitoneal oncocytoma incidentally discovered in a 40-year-old woman is described. The tumor, which was 17 cm in largest dimension, was completely separated from the kidneys and adrenal glands and consisted of nests of polygonal cells with large, granular, eosinophilic cytoplasm. Significant nuclear atypia, necrosis, and mitosis were absent.

[Principles of surgical technique of the anterior access to the thoraco-lumbar spine].

General surgeons are more and more frequently requested to prepare an operative exposure of the spine, in order to perform anterior maneuvers of removal and stabilization of the vertebral bodies. Since 1989 to date, in collaboration with the neurosurgical équipe of Prof. G.

[Abdominal approach to the treatment of the vestigial retrorectal tumors: our experience].

Although the vestigial retrorectal cysts are still rare, the number of the observed ones is destined to increase, as methods by imaging become routinely used in the clinical practice. Once diagnosed, the removal of retrorectal lesions should be mandatory. Therefore, by reporting three clinical cases, the Authors propose notes of technique above the abdominal approach used for the surgical treatment of these retrorectal congenital neoformations.

The management of retrorectal congenital tumors.

Although retrorectal congenital tumors are still rare, the number of the observed ones is destined to increase, as methods by imaging become routinely used in the clinical practice. By presenting three clinical cases the authors describe the surgical technique of the anterior route they performed for the management of such formations. The abdominal approach had no postoperative complications, short hospital stay, no neurological consequences and good long-term results.

Total removal of an intramedullary cavernous angioma by transthoracic approach.

Intramedullary cavernous angiomas are rare vascular malformations; all published cases have been surgically approached posteriorly by standard laminectomy. We describe the case of a 63-year-old man with an intramedullary cavernous angioma, anteriorly located in the thoracic spinal cord. The angioma was operated on by transthoracic approach and totally removed.

[Diaphragmatic eventration in the adult: repair with Gore-Tex surgical mesh].

The Authors report the case of a fifty-nine-year-old patient, affected by complete eventration of the left diaphragm and cranial stomach dislocation with axial volvulus, associated with an upward movement of part of the left colon and some jejunal loops. The subclinical condition had been occasionally discovered during a routine chest X-ray at the age of eighteen and the patient remained without symptoms up to five years ago, when he began to show significant digestive and cardiorespiratory symptoms. The patient has been successfully treated via thoracotomy with phrenic alloplastic using Gore-Tex patch and has obtained an immediate remission of the symptoms.

[Blind-ending branch of bifid ureter: apropos of a case].

The Authors report on a case of blind-ending ureter. A young woman (29 years old) underwent surgery because of recurrent urinary tract infections and left loin pain. The operation consisted in a radical resection of the blind branch together with Coen's operation for the coexistence of vesicoureteral reflux.

[Postoperative sacrocele: prevention and surgical considerations].

In the Authors experience with surgical management of sacral chordomas, an unusual complication represented by posterior herniation of the rectum was observed. Weakness of the posterior pelvic floor is at the basis of this complication, which the Authors defined "sacrocele". Posterior herniation of the rectum highly impairs the patient quality of life and may contraindicate radiation therapy.

[Endoscopic palliative treatment of a neoplastic esophageal fistula: report of a case].

Oesophago-respiratory neoplastic fistulas present serious problems of management, because of the severe status of the patient. Therefore, a palliative treatment, to allow for a gradual respiratory and digestive function recovery with clinical improvements is needed. Surgical palliation has a mortality rate of 40% and a long post-operative hospitalization.

Ureteral anastomosis in the orthotopic ileal neobladder: comparison of 2 techniques.

Purpose: The functional results and complications of 2 different ureteroileal anastomoses were evaluated in patients with bladder cancer undergoing radical cystectomy and orthotopic ileal bladder substitution.

Materials And Methods: Between 1989 and 1995, 102 patients underwent creation of a low pressure neobladder. In the first 50 cases the ureteroileal anastomosis was created with a split-cuff nipple technique as an additional antireflux mechanism.

[Orthotopic replacement of the bladder in the female].

Orthotopic substitution of the bladder in females is a procedure which is increasing worldwide. Patients with tumours of the bladder neck or the trigon, or with multifocal tumours, expanded carcinomas in situ or massive pelvic adenopathies are not eligible for the procedure. The main consideration should be the risk of urinary incontinence or hypercontinence.

Lower urinary tract reconstruction following cystectomy: experience and results in 96 patients using the orthotopic ileal bladder substitution of Studer et al.

Between 1989 and 1993 96 patients (89 males and 7 females) affected with invasive neoplasms of the bladder underwent surgery consisting of the creation of an orthotopic ileal neobladder according to Studer et al., after radical cystectomy. Patient selection and details of the surgical procedure are described.

Neoadjuvant M-VAC (methotrexate, vinblastine, adriamycin, and cisplatin) chemotherapy and bladder preservation for muscle-infiltrating transitional cell carcinoma of the bladder.

A group of 66 patients with locally advanced T2-T4 NOMO TCC of the bladder were treated with three cycles of neo-adjuvant M-VAC chemotherapy. Of 65 evaluable patients, 18 (28%) were T2, 22 (34%) were T3a, 21 (33%) were T3b, and 4 (6%) were T4a. Patients were restaged clinically by repeat CT scan and TURB and were to undergo pathologic staging.

Orthotopic ileal neobladder in female patients after radical cystectomy: 2-year experience.

We describe a surgical technique to conserve urinary continence in 7 women who underwent radical cystectomy with construction of an orthotopic ileal neobladder for infiltrating bladder carcinoma. The selection of the patients and the surgical procedure to preserve the anatomical and functional integrity of the female urethra are described. Followup ranged from 7 to 28 months.

Local immunotherapy of superficial bladder cancer by intravesical instillation of recombinant interleukin-2.

Local immunotherapy of superficial bladder cancer by endovesical administration of recombinant interleukin-2 (rIL-2) was investigated in a phase I-II study. Twenty-five patients with Ta-T1, N0, M0, G1-G2 transitional cell carcinoma of the bladder received an induction course of rIL-2 (10 daily instillations) with the tumor in place using an interpatient dose escalation scheme from 3 to 18 x 10(6) IU/day. Seven to fourteen days after the end of the induction course, the objective clinical response was evaluated and transurethral resection of the bladder tumor was carried out.