Evaluation of diaphragmatic mobility following intra-abdominal sub-diaphragmatic fixation of a double-layered mesh in rats.

Purpose: To evaluate the tissue integration of a double-sided mesh after fixation in diaphragm and to study the diaphragmatic mobility by ultrasound.

Methods: Twenty male Wistar rats were used. The animals were assigned into two equal groups according to the day of euthanasia.

Fibroblast activation protein and its prognostic significance in correlation with vascular endothelial growth factor in pancreatic adenocarcinoma.

Fibroblast activation protein (FAP), a selective protein for tumor stromal fibroblasts, is expressed in >90% of human epithelial carcinomas. A characteristic feature of pancreatic cancer is an extensive fibrotic or desmoplastic reaction surrounding the primary tumor. The present study aimed to evaluate the expression levels of FAP and vascular endothelial growth factor (VEGF) and determine their correlation in pancreatic adenocarcinoma.

DNA methylation profile of genes involved in inflammation and autoimmunity in inflammatory bowel disease.

The contribution of epigenetic alterations to disease pathogenesis is emerging as a research priority. In this study, we aimed to seek DNA methylation changes in peripheral blood and tissue biopsies from patients with inflammatory bowel disease. The promoter methylation status of genes involved in inflammation and autoimmunity was profiled using the Human Inflammatory Response and Autoimmunity EpiTect Methyl II Signature PCR Array profiles.

Repair of gastric defects with an equine pericardial patch.

Purposes: The objective of this study was to test the efficacy of an equine pericardial patch for repairing full-thickness defects of the stomach wall.

Methods: Circular defects, 1.5 cm in diameter, were created on the anterior wall of the stomach of 12 female New Zealand rabbits.

DNA methylation changes in inflammatory bowel disease.

The cause of inflammatory bowel disease, encompassing Crohn's disease and ulcerative colitis, remains a mystery but evidence is accumulating that complex interactions between the genetic background and the gut microbiota of the host and environmental factors associated with rapid industrialization and westernized life styles may underlie its pathogenesis. Recent epigenetic studies have suggested that interactions between environment and host DNA may play a leading role in the phenotypical expression of both diseases, explaining amongst others the differences in disease expression in monozygotic twins. DNA methylation is the most studied epigenetic modification and during the last decade its correlation to IBD pathogenesis has been well established.

Controversies and challenging therapeutic modalities in gastric cancer.

Gastric cancer is still the fourth common neoplasm worldwide. Gastric ulcers, adenomatous polyps, and intestinal metaplasia have been associated with an increased relative risk. Tissue diagnosis and anatomic localization of the primary tumor are best obtained by upper gastrointestinal endoscopy.

Combined side-to-end anastomosis with temporary end colostomy for the management of selected left-sided colonic emergencies.

Management of surgical emergencies of the left colon commonly requires excision of the colonic segment bearing the lesion, creation of an end colostomy, and closure of the rectosigmoid stump. Closure of the end stoma may be technically challenging. During this study, we used a new surgical technique involving the creation of an end-to-side anastomosis of the rectosigmoid stump to the base of the proximal colonic segment in association with an end colostomy.

Carcinoid tumors of the duodenum and the ampulla of Vater: current diagnostic and therapeutic approach in a series of 8 patients. Case series.

Aim: To describe the specific characteristics of duodenal/perivaterian carcinoids and to analyze the diagnostic/therapeutic approach.

Material And Methods: Eight patients were included in our study. Symptoms on admission included dyspepsia, upper gastrointestinal (GI) bleeding and anemia.

Recapitulation of ras oncogene mutations in breast cancer.

Several human breast cancer cell lines have been shown to contain mutational activation of Ras oncogenes. The goal of this review is to clarify the physiology and biochemical pathways of Ras family oncogenes in order to understand thoroughly the mechanisms behind Ras gene mutations. Ras genes are involved in the early stages of mammary oncogenesis through augmented expression of the normal p21 protein.

Retained surgical sponges: what the practicing clinician should know.

Retained surgical sponges (RSS) are an avoidable complication following surgical operations. RSS can elicit either an early exudative-type reaction or a late aseptic fibrous tissue reaction. They may remain asymptomatic for long time; when present, symptomatology varies substantially and includes septic complications (abscess formation, peritonitis) or fibrous reaction resulting in adhesion formation or fistulation into adjacent hollow organs or externally.

Stapled cholecystojejunostomy for palliative treatment of the malignant jaundice; an effective and feasible alternative to hand-sewn method.

Unresectable periampullary cancer is commonly characterized by painless jaundice and has a rapid evolution with dismal prognosis. Biliary drainage can be achieved by various techniques and approaches, with the endoscopic drainage being the preferred method. However, when open surgery is performed with the intent to resect a tumor which is finally found to be unresectable, open drainage of the biliary tree is indicated.

Facing the challenge of treating gallbladder carcinoma. Review of the literature.

Gallbladder carcinoma (GBC) remains the most common biliary tract malignancy and is characterized as an aggressive and highly lethal disease. There is also a wide discrepancy among sources regarding the epidemiology of the tumor. Despite recent research on the therapeutic strategies against gallbladder neoplastic disorders, surgical resection appears the only potentially curative approach.

Walled-off pancreatic necrosis.

Walled-off pancreatic necrosis (WOPN), formerly known as pancreatic abscess is a late complication of acute pancreatitis. It can be lethal, even though it is rare. This critical review provides an overview of the continually expanding knowledge about WOPN, by review of current data from references identified in Medline and PubMed, to September 2009, using key words, such as WOPN, infected pseudocyst, severe pancreatitis, pancreatic abscess, acute necrotizing pancreatitis (ANP), pancreas, inflammation and alcoholism.

Sentinel lymph node biopsy in breast cancer: a systematic review.

Lymphatic mapping and sentinel lymphadenectomy have become an important tool for axillary lymph node staging in women with early-stage breast cancer. Many issues such as indications, usefulness, or best method of performing a sentinel node biopsy need to be addressed. Multiple studies now confirm that sentinel lymphadenectomy accurately stages the axilla and is associated with less morbidity than axillary dissection.

Facing the challenge of managing linitis plastica--review of the literature.

Linitis Plastica (LP) denotes a diffuse, intra-murally infiltrating, anaplastic carcinoma in a hollow structure resulting in a shrunken organ with thickened walls. The neoplasm is encountered in every segment of gastrointestinal tract with the gastric localization being the most frequent and simultaneous or successive affection of different digestive sites rarely reported. Symptoms often associated with LP of the stomach include pain and lump in the epigastrium, weight loss, anorexia, dysphagia, nausea and vomiting.

Current trends in the management of infected necrotizing pancreatitis.

Severe acute pancreatitis is a potentially life-threatening disease. Pancreatic necrosis is associated with an aggravated prognosis, while superimposed infection is almost always lethal without surgery. Bacterial translocation mainly from the gut is the most widely accepted mechanism in the pathogenesis of infected pancreatic necrosis.

Small (<10 mm) thyroid nodules; how aggressively should they be managed?

Most commonly, an aggressive management (including surgery) is recommended for thyroid nodules measuring >10 mm. The aim of this review is to present currently available data regarding indications for aggressive treatment of small (<10 mm) thyroid nodules. Clinical factors (history of neck irradiation; extremes of age, i.

A case of signet ring carcinoma of the appendix: dilemmas in differential diagnosis and management.

Purpose: Signet ring carcinoma (SRC) of the appendix consists one of the most biologically virulent cancers. We present the case of a patient with primary SRC complicated by the development of acute inflammation of the appendix.

Case Report: A 78-year-old man was admitted due to a 5-day history of increasing colicky abdominal pain and vomiting.

Preoperative detection of cervical lymph node metastases in papillary thyroid cancer: a surgical perspective.

Despite its relatively benign biological behavior, papillary thyroid cancer is frequently associated with cervical lymph node metastases at the time of diagnosis. These metastases have a limited impact on overall survival, but are recognized as a significant risk factor for locoregional recurrence of the disease. This may significantly alter quality of life, and may require further therapeutic interventions which may be associated with increased morbidity.

Ultrasound-guided catheterization of the internal jugular vein in oncologic patients; comparison with the classical anatomic landmark technique: a prospective study.

Aim: To compare the traditional anatomic landmark technique with the ultrasound-guided method for central venous catheterization.

Material And Methods: During three years, 551 patients underwent internal jugular vein catheterization; in 347 patients, the ultrasound-guided technique was used, while in the other 204 patients the catheter was introduced by using the classical anatomic landmark method. Operating time, complications (pneumothorax, puncture of carotid artery with or without hematoma formation), and number of attempts to achieve central venous catheterization were recorded.