Institutional review of patients presenting with suspected appendicitis.

Background: Appendicitis is a common gastrointestinal surgical emergency. Treatment balances the risks of negative appendicectomy (NA) against potential complicated appendicitis in determining clinical priority. This study reviewed the population characteristics, results of the diagnostic modalities and Alvarado score (AlvS) of patients with suspected appendicitis.

An audit of operative notes: facts and ways to improve.

Background: Accurate operation record keeping is an important element of risk management. Handwritten surgical notes are often produced as evidence in medico-legal malpractice cases and incomplete and illegible notes may be a source of weakness in a surgeon's defence. Therefore, we audited the surgical notes in a teaching hospital surgical department.

Transcriptional silencing of ETS-1 efficiently suppresses angiogenesis of pancreatic cancer.

In this study, we addressed the hypothesis that transcriptional suppression of erythroblastosis virus E26 oncogene homolog 1 (ETS-1) is an efficient therapeutic approach to pancreatic adenocarcinoma by investigating the effect of ETS-1 suppression in human pancreatic cancer cells. We accomplished this by using an adenoviral vector encoding only the DNA-binding domain of wild-type ETS-1 (ETS-1 dominant negative, ETS-1-DN). ETS-1-DN decreases ETS-1-binding by competing for its binding to DNA.

[The impact of patient and tumor related prognostic factors on survival in non-medullary differentiated thyroid cancer. A study of 125 cases].

Unlabelled: The aim of the study was to assess the impact of patient--(age) and tumor--related factors (size, extrathyroidal invasion, distant metastasis, multicentricity and lymphatic metastasis) on survival of patients with differentiated thyroid cancer (DTC).

Material And Method: A clinical retrospective study was carried out on a series of 125 patients operated for non medullary DTC in the IIIrd Surgical Unit, in the period 1990-2005. The disease specific survival (DS) was calculated using the Kaplan Meyer method and Cox regression univariate and multivariate analysis was used to assess the impact of prognostic factors on DS.

The PMAIP1 gene on chromosome 18 is a candidate tumor suppressor gene in human pancreatic cancer.

Frequent loss of heterozygosity on the long arm of chromosome 18 is observed in pancreatic cancer. Previous studies suggested the existence of one or more tumor-suppressor genes other than SMAD4 on chromosome 18. To identify the candidate tumor-suppressor gene(s), we compared gene expression by cDNA microarray analyses using a pancreatic cancer cell line Panc-1 and its hybrid cell lines showing suppressed cell growth after introduction of one normal copy of chromosome 18.

[Rare caecal pseudotumours].

Among the rarely caecal pseudotumours are those caused by a coagulation disorder. The clinical course of caecal pseudotumours is highly variable. Most patients are diagnosed with acute appendicitis, but the real diagnosis is confirmed after laboratory investigation and histopathologic exam.

[Surgical treatment of esophageal strictures secondary to gastroesophageal reflux disease].

The end point in gastro-oesophageal reflux disease (GERD) evolution is oesophageal stenosis. The aim of this study is merely to establish the absolute requisite of treating simultaneously the oesophageal stenosis and the causal disorder, GERD. This article analyses the diversity of surgical treatment in relationship with the location and length of the oesophageal stenosis using a group of 35 patients with GERD over a period of 25 years.

Features of pathological assessment in rectal cancer.

Rectal cancer diagnosis is established by collaboration between oncological surgeons, oncologists, pathologists and imaging specialists. By examining the macroscopic and microscopic aspect of the surgical specimen, the pathologist could provide the surgeon with information regarding the surgical procedure. Staging represents the clinical or pathological assessment of the extent of tumour spread.

[Malignant peritoneal mesothelioma].

Mesothelioma is a neoplasm originating from the mesothelial surface lining cells of the serous human cavities. It may involve the pleura, less frequently the peritoneum rarely, the pericardium, the tunica vaginalis testis and ovarian epithelium. Asbestos has been widely used in industry.

Safety and efficacy of conservative management in acute severe pancreatitis.

Acute severe pancreatitis represents a disease with multiple complications and a high mortality rate. The clinical evolution is related to the acute systemic inflammatory response syndrome, due mainly to inflammatory mediators and pancreatic enzymes and to the infectious complications representing a peak in the incidence of death. This study aims to retrospectively analyse the outcome of patients diagnosed with acute severe pancreatitis, conservatively treated versus those surgically managed.

Diagnostic features of benign pancreatic insulinomas. An analysis of three cases.

Insulinoma is a neuroendocrine tumour deriving mainly from the pancreatic islet cells that produces excessive amounts of insulin. Accurate preoperative detection and localization of insulinoma is essential for the selection of appropriate candidates for surgery. We present the case reports of three patients with benign pancreatic insulinoma.

[Metachronous primary cancers of the colon and stomach].

We report herein a case of 69 years old woman who, in the course of 11 years, developed two cancers: carcinoma of the colon fistulization in duodenum and adenocarcinoma of the stomach. No polyposis has been found. This patient successfully underwent a right hemicolectomy with pancreaticoduodenectomy (Traverso-Longmire procedure).

[Current strategy in colorectal cancer screening].

Screening programs should begin by classifying the individual patient's level of risk based on personal, family, and medical history, which will determine the appropriate approach for each subject. The individual's risk status determines when screening should be initiated and what tests and frequency are appropriate. To achieve these aims, care systems should establish standards and operating procedures.

[Differentiated thyroid cancer--peculiar morphological and clinical forms].

The most common clinical presentation of differentiated thyroid cancer (DTC), consisting of papillary and follicular adenocarcinoma (with their histological variants), is the solitary thyroid nodule. A review of the literature is performed in order to describe particular forms of DTC, in terms of incidence, diagnosis and treatment: occult carcinoma, carcinoma on aberrant thyroid tissue, "functional" thyroid carcinoma and familial non-medullary carcinoma. A particular interest is shown to the coexistence of malignancy with benign thyroid diseases, such as goiter, hyperthyroidism and Hashimoto's thyroiditis, as well as parathyroid adenoma.

[Evidence-based colorectal cancer screening].

Colorectal cancer has been identified as an appropriate candidate for early detection and treatment of both asymptomatic individuals and those at risk of the disease. The lifetime incidence of colorectal cancer among persons at average risk is sufficiently high to justify screening the general population. This review presents the latest strategies employed in early detection of the colorectal cancer.

[Use of polypropylene mesh for incisional hernia repair].

Incisional hernia is an important complication of abdominal surgery. Procedures for the repair of these hernias with sutures and with mesh have been reported, but there is no consensus about which type of procedure is best. We have performed a retrospective analysis on 1014 patients operated on in our unit between 1994 and 2003 for simple or recurrent incisional hernias.

[Anterior resection of the rectum for rectal cancer--options, limits, immediate complications].

A number of factors have recently led to a more conservative approach for middle or low rectal cancers, making possible sphincter preservation and reducing the number of abdomino perineal excisions of the rectum. We have performed a retrospective analysis on 510 patients operated on in our unit between 1994 and 2003 for rectal cancer. There were a number of 118 anterior resection of rectum; in 20 cases the TME has been performed and in 6 cases a very low anterior resection of rectum was done.

Screening for functional tumor suppressor activity in pancreatic cancer.

Pancreatic cancer has a well-known reputation as one of the leading causes of cancer deaths worldwide. Thus, acquisition of efficient approaches and markers for accurate detection at the earlier stages of the disease should be prioritized. We have been focusing on tumor suppressor genes (TSGs) activity in pancreatic cancer to find effective methods for its genetic diagnosis and/or treatment.

Chromosome 12, frequently deleted in human pancreatic cancer, may encode a tumor-suppressor gene that suppresses angiogenesis.

Several lines of evidence have suggested that the long arm of chromosome 12 may carry a tumor-suppressor gene(s) that plays a role in pancreatic ductal carcinogenesis. We have previously found a significant association between loss of heterozygosity of the 12q arm and a poor prognosis in pancreatic cancer patients. In this study, we introduced a normal copy of chromosome 12 into some pancreatic ductal carcinoma cells.

Functional analysis of chromosome 18 in pancreatic cancer: strong evidence for new tumour suppressor genes.

Background: In a previous work, we demonstrated that loss of heterozygosity of 18q is a frequent event significantly associated with poor prognosis in pancreatic cancer. We hypothesized that restoration of heterozygosity of chromosome 18 in pancreatic cancer cells would reduce their tumorigenicity. This study was intended to provide functional evidence for the existence of new tumour suppressor gene(s) located on chromosome 18.

The role of chromosome 18 abnormalities in the progression of pancreatic adenocarcinoma.

To date, the events that mediate tumor progression in pancreatic cancer are still poorly understood. Cytogenetic, allelotype, and somatic cell hybrid studies in human pancreatic adenocarcinoma have suggested that chromosome 18 may carry tumor suppressor genes (TSGs), including SMAD4. We previously identified that LOH of 18q at the SMAD4 locus, along with LOHs on 17p and 12q, positively associated with poor prognoses of pancreatic cancer patients.

Inserting chromosome 18 into pancreatic cancer cells switches them to a dormant metastatic phenotype.

We demonstrated previously that restoration of chromosome 18 suppressed growth of pancreatic cancer cells in vitro, as well as that of tumors inoculated into nude mice. We also demonstrated that loss of 18q was associated with poor prognosis. Hence there is the possibility that the 18q arm harbors a gene(s) implicated in tumor progression and/or metastasis.

Restoration of SMAD4 by gene therapy reverses the invasive phenotype in pancreatic adenocarcinoma cells.

SMAD4 is a critical cofactor in signal transduction pathways activated in response to transforming growth factor-beta (TGF-beta)-related ligands, regulating cell growth and differentiation. The roles played by SMAD4 inactivation in tumours highlighted it as a tumour-suppressor gene. However, restoration of the TGF-beta antiproliferative pathway following SMAD4 gene transfer in null-tumour cell lines is controversial.

Suppression of the tumorigenic phenotype by chromosome 18 transfer into pancreatic cancer cell lines.

A number of lines of evidence have suggested that the long arm of chromosome 18 apart from SMAD4 may carry a tumor-suppressor gene(s) that plays a role in the early stage of pancreatic ductal carcinogenesis. Thus, adenovirus-mediated introduction of SMAD4 does not suppress in vitro growth in cells with completely inactivated SMAD4, and frequent loss of 18q at the SMAD4 locus is observed in pancreatic cancers but no abnormalities of the normal SMAD4 homolog have been detected. In this study, we introduced a normal copy of chromosome 18 into some pancreatic ductal carcinoma cells with and without a complete inactivation of SMAD4.