The ultrasonographic diagnosis of lymph node varicose veins in the groin - an overlooked missing link in chronic venous disease?

Aim: Chronic venous disease is a common pathology characterized by valvular incompetence and venous hypertension. The venous network of the lymph nodes at the Scarpa triangle connects the superficial and the deep venous systems. This study aimed to describe infrainguinal intranodal venous dilatations and to evaluate the connection with peripheral venous disease.

Intraoperative Right Colic Graft Ischemia, Followed by Delayed Oesophagoplasty Including an Ileo-Transverse Anastomosis and the Cervical Revascularisation of the Ileum: Case Report.

The ischemic complications during the isolation of the substituting oesophageal graft placement and after its placement may lead to graft necrosis and to the need to find a different reconstructive procedure. The most frequent reports of graft necroses occur in the days following the reconstruction. We are presenting the case of a 27-y.

Genetic and epigenetic mechanisms involved in bariatric surgery.

Morbid obesity (BMI>40 kg/m2) is a challenging health condition with an increasing incidence in the last decades. Conventional therapy which consists in diet and lifestyle interventions, along with pharmaceutical therapy, has a limited effect on morbidly obese patients. In this context, bariatric surgery is the most effective approach, leading to significant weight loss, along with other beneficial effects like type 2 diabetes resolution or improvement of cardiovascular status.

Biological and Histological Assessment of the Hepatoportoenterostomy Role in Biliary Atresia as a Stand-Alone Procedure or as a Bridge toward Liver Transplantation.

: In patients with biliary atresia (BA), hepatoportoenterostomy (HPE) is still a valuable therapeutic tool for prolonged survival or a safer transition to liver transplantation. The main focus today is towards efficient screening programs, a faster diagnostic, and prompt treatment. However, the limited information on BA pathophysiology makes valuable any experience in disease management.

Hepatoportoenterostomy in Selective Obstructive Cholestasis - An New Experimental Model in the Rat.

Biliary atresia is the most frequent cause for neonatal obstructive cholestasis. Hepatoportoenterostomy (HPE) is the only method allowing survival until liver transplantation. For a maximum rate of success, the HPE procedure has to be performed within the 60 days of life.

New inductive proximity sensor platform for precise localization of small colorectal tumors.

Location of small gastric or colorectal tumors during a laparoscopic procedure is often imprecise and can be misleading. There is a real need for a compatible and straightforward tool that can be used intraoperatively to help the surgeon in this regard. We emphasize in the present work on the fabrication of a new and innovative inductive proximity switch architecture, fully compatible with laparoscopic surgery and with direct application in precise localisation of bowel tumors.

An experimental protocol for colorectal liver metastases ablation by radiofrequency toward a standard procedure.

Background: Radiofrequency ablation (RF) is already a viable alternative to surgical resection for focal liver tumors treatment. The use of RF ablation in combination with surgery or chemotherapy and the large panel of RF tools need new experimental models to develop new opportunities for this kind of therapy.

Purpose: The purpose of this study was to identify the optimal RF parameters that will allow in situ colic cancer liver metastases destruction with minimal secondary effects.

The Value of Staging Laparoscopy for Optimal Multidisciplinary Treatment in Patients with Gastric Cancer.

Despite improvements in the conventional preoperative tools used for staging of gastric cancer, their accuracy still needs to be improved. Laparoscopy has the potential to visualize and characterize the tumor, the peritoneal cavity and the lymph nodes and thus to better select patients for the optimal treatment strategy. Material and Method: Patients with gastric cancer staged initially with contrast enhanced computer tomography and endoscopic ultrasound were also evaluated by laparoscopy and laparoscopic ultrasound in a distinct preoperative staging procedure.

Ultrasonographic and Imaging Appearance of Peripheral Intraneural Vascular Anomalies: Report of Two Cases and Review of the Literature.

The purpose of the paper is to present the ultrasonographic and imaging appearance of two cases of peripheral nerve intraneural vascular anomalies and provide a comprehensive review of the publications on this subject.The clinical presentation, ultrasonographic appearance, corresponding imaging and outcome of a case of ulnar nerve venous malformation and a case of median nerve arteriovenous malformation are presented.Literature search revealed 35 papers presenting 52 cases of vascular anomalies involving the peripheral nerves.

Cervical Exenteration - Guidelines and Surgical Technique Principles.

Unlabelled: Neoplastic invasion of the structures of the cervical region originating from a malignant tumour developed in one of the viscera of the throat may benefit from cervical exenteration. Defined as resection of the hypopharynx, cervical oesophagus, larynx and cervical trachea, exenteration has limited indications and is mandatorily accompanied by digestive tube reconstruction. The aim of this article is to highlight the indication, surgical strategy and important surgical stages illustrated by images from personal professional experience.

Saphenous nerve block as a diagnosis tool for chronic postsurgical pain of the left medial calf.

Ultrasound-guided saphenous nerve block above the knee may be a valuable diagnosis tool in patient presenting chronic pain of the calf.

Extension of Hepatic Resection Ameliorates Survival in Patients with Type IIIa or IIIb Klatskin Tumors Despite Surgical Complications.

Major hepatectomies for hilar cholangiocarcinoma (HC) are associated with high rates of morbidity and mortality. We aimed to evaluate how and if surgical complications related to extended hepatectomies for HC type III and IV according to Bismuth-Corlette classification influence patients long-term survival. The files of all patients with major hepatectomy for HC and postoperative complications were retrospectively reviewed.

Can APACHE II, SOFA, ISS, and RTS Severity Scores be used to Predict Septic Complications in Multiple Trauma Patients?

Background: Physiological composite scores are used to predict mortality in multiple trauma patients. Sepsis is the leading cause of late mortality in trauma victims brought about by immune suppression due to homeostasis dysregulation.

Objective: To determine whether APACHE II, SOFA, ISS and RTS scores can predict the occurrence of sepsis in multiple trauma patients.

Mangled lower extremity: can we trust the amputation scores?

Background: Limb injuries represent a constant and severe problem. Several lower limb injuries are more frequent than upper limb injuries. Over time, in an attempt to quantify the severity of traumas and to establish guidelines for the decision whether to save or amputate a mangled extremity, several scoring systems have been reported.

Gastrointestinal stromal tumor (GIST) associated with synchronous colon adenocarcinoma - a case report.

Gastrointestinal stromal tumors (GIST) are rare mesenchymal neoplasms of the gastrointestinal tract with a malignant potential and unpredictable behavior. In the literature a few cases of synchronous development of a GIST and another neoplasia with different incidence, etiology, evolution and prognostic have been described. We report a case of a 61 year old male with a simultaneous occurrence of a GIST and a colon adenocarcinoma.

The prognostic role of apoptosis mediators in rectal adenocarcinoma.

Background/aims: Genes included in apoptosis may be involved in tumor biology and identify specific groups of patients with individual therapy. The aim of this study was to evaluate the prognostic value of some apoptosis markers in conjunction with pathological factors in operable rectal cancer patients.

Methodology: Tumor samples from 87 patients with rectal adenocarcinoma were analyzed retrospectively.

Anomalies of thoracic outlet in human fetuses: anatomical study.

Background: Thoracic outlet syndrome (TOS) identifies the clinical condition determined by the mechanical compression and entrapment of the subclavian vessels and the brachial plexus cords within the space delineated by the scalene muscles, the clavicle, and the first rib. To date, there are no concluding explanations concerning the real causes of the appearance of TOS in children. This is the first study to investigate the existence, frequency, and type of thoracic outlet anomalies in the prenatal stage (human fetuses).

Clinical and ultrasound approach to achalasia in a child. Case report.

Achalasia is a primary esophageal motor disorder of unknown etiology characterized by insufficient lower esophageal sphincter (LES) relaxation in response to deglution. We present the case of a child diagnosed with asthma, with no response to asthma treatment. On account of associating dysphagia, regurgitation of food and weight loss he was given an abdominal ultrasound that revealed a massive dilated and narrowing of its distal segment esophagus.

Electricity and fishing - a dangerous mix.

Background: The advent of fishing rods made of carbon fiber and graphite rods has greatly increased the risks of electrical injuries associated with fishing. The braided fishing lines and metal hooks put the fishermen at risk for electrical injuries.

Purpose: We review our burn center's experience with electrical injuries related to fishing activities during the last four years.

Clinical aspects and cytokine response in severe H1N1 influenza A virus infection.

Introduction: The immune responses in patients with novel A(H1N1) virus infection (nvA(H1N1)) are incompletely characterized. We investigated the profile of Th1 and Th17 mediators and interferon-inducible protein-10 (IP-10) in groups with severe and mild nvA(H1N1) disease and correlated them with clinical aspects.

Methods: Thirty-two patients hospitalized with confirmed nvA(H1N1) infection were enrolled in the study: 21 patients with nvA(H1N1)-acute respiratory distress syndrome (ARDS) and 11 patients with mild disease.

Feasibility of a high intrathoracic esophagogastric anastomosis without thoracic access after laparoscopic-assisted transhiatal esophagectomy: a pilot experimental study.

Introduction: The aim of the present study was to evaluate the feasibility of a technique that uses solely the transhiatal approach to create a high intrathoracic esophagogastric anastomosis after laparoscopic transhiatal resection of the distal esophagus.

Method: Using a laparoscopic approach, the esophagi of 10 midsized pigs were dissected and transected as high as possible in the thorax, and the anvil of a circular stapler was introduced perorally into the esophageal stump. Through a midline short laparotomy, the circular stapler was inserted into the gastric tube and advanced through the hiatus to be connected with the anvil and create the anastomosis.

Inferior mesentericocaval shunt--an efficient therapeutical alternative in Budd Chiari syndrome associated with portal and splenic vein thrombosis in a teenager.

The authors present the case of a 17 year old girl admitted to hospital for poor general state, mild scleral jaundice, deficient nutritional state, oliguria and massive ascites. She was diagnosed with Budd-Chiari syndrome: thrombosis of the left suprahepatic vein and nonocclusive thrombosis of the inferior vena cava at the level of the 12th thoracal and the lumbar vertebrae. The specific feature of the case was the association of portal and splenic vein thrombosis.

Omental free-tissue transfer: indications and results from personal experience.

Between 1987-2002, omental free-tissue transfer was used in 11 patients, aged 6-65 years (mean age, 37.6). The omentum was used for the treatment of brachial plexus injury pain (3 cases), Romberg's disease (1 case), defects of the extremities occurring with chronic obstructive arterial disease (2 cases), posttraumatic lesions (3 cases), and following oncological resections (2 cases).