Complications of tracheal sleeve pneumonectomy: personal experience and overview of the literature.

Objectives: Tracheal sleeve pneumonectomy, although technically demanding, is considered the choice for tracheobronchial angle cancers. Complications in our 49 tracheal sleeve pneumonectomies are reviewed. Results, complications, and technical aspects are critically discussed.

[Biology and needs of the aged].

The elderly age group is growing rapidly as a proportion of the total population of Italy. By the year 2020 the population aged 65 and over is expected to increase from 17% to 23%. The biological process of aging leads to a loss of functional reserves, and so elderly people are frail and affected by multiple diseases.

Atherogenic lipid profile in elderly patients with ischaemic cerebrovascular disease.

The significance of the link between plasma cholesterol concentrations and risk of cerebrovascular disease (CVD) in the elderly is still debated. In a case-control study we found that elderly patients with ischaemic CVD have an atherogenic lipid profile, despite having low or normal total cholesterol concentrations.

Age-dependent expression of fibrosis-related genes and collagen deposition in rat kidney cortex.

Because progressive fibrosis is a histological hallmark of the aging kidney, we sought to characterize the course of some fibrosis-related genes [pro-alpha2(I)collagen (COL-I), pro-alpha1(III)collagen (COL-III), and transforming growth factors beta1 and beta3 (TGF-beta1 and TGF-beta3)] of interstitial collagen accumulation [COL-I and COL-III proteins, hydroxyproline (PRO-OH), histology] and its degradation (matrix metalloproteinase MMP-1 and -2) during maturation and early aging in rats. During the lifespan considered we observed no changes in the mRNA, except that COL-I mRNA tended to be up-regulated from 2 to 19 months of age. However, progressive fibrosis was histologically detectable, with COL-I accumulation (p < .

Videothoracoscopic approach to primary mediastinal pathology.

Study Objectives: Personal results and validity of videothoracoscopic (VTS) approach to primary mediastinal diseases are analyzed.

Design: Retrospective review of personal experience.

Setting: Department of Surgery, San Giuseppe Hospital, University of Milano, Italy.

Left ventricular response to beta-adrenergic stimulation in aging rats.

The incidence of heart failure in the population increases steeply among older people. Overactivation of the sympathetic nervous system is associated to and responsible for worsening of heart failure. This study describes the influence of aging on short-term left ventricular (LV) adaptation to b-adrenergic stimulation in Wistar rats.

Neuropsychological assessment of the severely impaired elderly patient: validation of the Italian short version of the Severe Impairment Battery (SIB). Gruppo di Studio sull'Invecchiamento Cerebrale della Società Italiana di Gerontologia e Geriatria.

One hundred and sixty-nine severely demented patients were tested in a multicenter study with the short version of the Severe Impairment Battery which was translated into Italian with the purpose of adapting and validating it for an Italian population. Patients were enrolled in Italian geriatric centers participating in the Study Group on Aging Brain of the Italian Society of Gerontology and Geriatrics. Following thorough clinical and instrumental examinations, they were evaluated with the Mini Mental State Examination, the Clinical Dementia Rating, the Severe Impairment Battery (SIB), the Gottfries-Bråne-Steen Rating Scale for Dementia, the Activity of Daily Living index, and the Bedford Alzheimer Nursing Severity scale (BANS.

Hepatitis C infection in an Italian population not selected for risk factors.

Aims/background: This study estimated the prevalence of HCV infection and relationship with viremia in a general population. The inhabitants of Albavilla town were personally invited to participate.

Methods: Out of 3997 inhabitants falling within the age range 18-85 years, 2403 (participation rate 60.

False radiographic appearance of a right bronchial stump following extended right pneumonectomy.

The authors describe three cases in which postoperative frontal chest radiographs following extended right pneumonectomy showed a right hilar lucency producing the false appearance of a residual main bronchus that is shown by additional studies to represent a dilated esophagus.

BsmI polymorphism of the vitamin D receptor gene in hyperparathyroid or hypoparathyroid dialysis patients.

Since bone mineral density may be influenced by the polymorphisms of the vitamin D receptor (VDR) gene, we studied whether VDR genotypes might drive the progression toward hyperparathyroidism or hypoparathyroidism in patients with end-stage renal disease. On the basis of their parathyroid hormone (PTH) levels, we divided 99 patients undergoing dialysis into 2 groups: 56 patients with hypoparathyroidism (PTH < 104 pg/mL [< 11 pmol/L]) and 43 with hyperparathyroidism (PTH > 261 pg/mL [> 27.5 pmol/L]).

Tensile bond strengths of hard chairside reline resins as influenced by water storage.

Due to gradual resorption of the edentulous ridge bone, removable prostheses often require denture base relines to improve fit and stability. This research evaluated the bond strength between one heat-cured acrylic resin (Lucitone 550(R)) and two hard chairside reline resins, after two different periods of storage in water (50 h and 30 days). The bond strength was evaluated using a tensile test.

Techniques of pneumonectomy. Video-assisted thoracic surgery pneumonectomy.

Thoracoscopic major pulmonary resections such as lobectomies or pneumonectomies are the most difficult operations that can be attempted thoracoscopically, and still have limited routine application in thoracic surgical practice. The precise indications for thoracoscopic pneumonectomy are very rare and have not yet been defined precisely; we limited the procedure only to double tumors, small tumors infiltrating the fissure, and small tumors at the secondary carina not amenable to a bronchoplasty procedure. Although the technique still has very limited applications, the advantages include reduced surgical trauma and consequent minimal postoperative pain, a shortened hospital stay, and a rapid resumption of normal activities which ultimately reduces costs.

Hepatitis G virus infection in the elderly.

Background And Aims: At least 10% of post-transfusion and community-acquired hepatitis cases are not accounted for by the A to E viruses. Hepatitis G virus (HGV), a novel agent belonging to the Flaviviridae and distantly related to HCV has recently been identified. The epidemiology and clinical significance of this infection in the geriatric setting is still little known.

Fibroblasts from Alzheimer's disease donors do not differ from controls in response to heat shock.

We investigated HSPs mRNA expression in cultured fibroblasts from control and AD patients. Northern blot analysis using probes for HSP70 and HSC73 revealed that HS induced a several fold increase in both mRNA. Under these condition the extent of mRNA increase was similar in controls and AD.

Video-assisted thoracoscopic surgery (VATS) major pulmonary resections: the Italian experience.

Videoendoscopic lobectomies or pneumonectomies are infrequently performed, mostly because of technical difficulties, concern for intraoperative accidents, and radicality in case of malignancy. The work diffusely describes technical details and a personal experience of videothoracoscopic major pulmonary resections (MPRs). All patients are first explored thoracoscopically.

Water sorption, solubility, and bond strength of two autopolymerizing acrylic resins and one heat-polymerizing acrylic resin.

Statement Of Problem: Because water sorption of autopolymerizing acrylic reline resins is accompanied by volumetric change, it is a physical property of importance. As residual monomer leaches into the oral fluids and causes tissue irritation, low solubility of these resins is desired. Another requirement is a satisfactory bond between the autopolymerizing acrylic resins and the denture base acrylic resin.

Age-associated differences in neutrophil oxidative burst (chemiluminescence).

Phagocytic defensive functions consist of a sequence of events, including migration, phagocytosis, secretion, and the release of reactive oxygen species (ROS). The last of these (also called "oxidative burst") has not received due attention in the elderly, even though it can be considered the most important event in the process of killing an invading microorganism. The aim of the present study was to investigate the oxidative burst activity of polymorphonuclear neutrophil leukocytes (PMNs) in relation to age, using a technique that specifically identifies ROS production: luminol-amplified chemiluminescence (LACL).

Remodelling of cardiac extracellular matrix during beta-adrenergic stimulation: upregulation of SPARC in the myocardium of adult rats.

Our objectives were (i) to evaluate the expression of several genes involved in the remodelling of cardiac extracellular matrix (ECM), with a special interest on SPARC (secreted protein acidic and rich in cysteine) a glycoprotein with anti-adhesive properties, and (ii) to characterise structural changes in the left (LV) and right (RV) ventricles of rats subjected to continuous beta-adrenergic stimulation. The rats were infused for 3 or 7 days with isoproterenol (ISO, 4 mg/kg/day) or vehicle. Hybridisation analysis was done for SPARC, atrial natriuretic peptide (ANP),alpha2 (I) [COL-I] and alpha1 (III) [COL-III] procollagens, TGF-beta1 and TGF-beta3 mRNA content.

A neurological dissociation between preserved visual and impaired spatial processing in mental imagery.

Studies on primates have shown that visual and spatial perceptual analysis depends on two separate neural pathways, associated with the processing of "what" and "where" an object is (visual characteristics and spatial coordinates, respectively). Similar dichotomies have been proposed by cognitive psychologists (e.g.

Videothoracoscopic treatment of oesophageal leiomyoma.

Background: Oesophageal leiomyomas are usually so easily removed that thoracotomy seems out of proportion and thoracoscopic removal is therefore highly desirable.

Methods: Out of a total of 1003 thoracoscopic operations undertaken between July 1991 and December 1996, seven patients underwent thoracoscopic removal of oesophageal leiomyoma. All of them had been preoperatively studied by oesophagogastroscopy and computed tomographic scanning of the chest which had confirmed the presence of a lesion with benign features.

Age-dependent expression of fibrosis-related genes and collagen deposition in the rat myocardium.

Objectives: We sought to characterize the evolution, during maturational growth and early ageing, of the messenger abundance of four genes involved in cardiac fibrosis regulation (procollagens alpha2(I) and alpha1(III), transforming growth factors beta1, and beta3) and corroborate it with the alterations in collagen deposition in cardiac interstitium and around coronary arteries.

Methods: Messenger RNA was quantified in LV and RV of 2-, 6-, 12- and 19-month-old male Sprague-Dawley rats (n = 5 per group) with Northern blot analysis. Collagen deposition was quantified with a semi-automated image analyser on Sirius red-stained sections of LV tissue.

Endoscopic treatment of bronchopleural fistulas.

Background: Bronchial fistula is one of the most serious complications of pulmonary resection.

Methods: We present an endoscopic treatment that consists of multiple submucosal injections of polidocanol-hydroxypoliethoxidodecane (Aethoxysklerol Kreussler) on the margins of the fistula using an endoscopic needle inserted through a flexible bronchoscope.

Results: From 1984 to 1995, 35 consecutive nonselected patients with a postresectional bronchopleural fistula were treated.