Hepatocellular carcinoma treatment over sorafenib: epigenetics, microRNAs and microenvironment. Is there a light at the end of the tunnel?

Introduction: Sorafenib is currently the only approved therapy in hepatocellular carcinoma (HCC). Alternative first- and second-line treatments are a significant unmet medical need, and several biologic agents have been tested in recent years, with poor results. Therefore, angiogenic pathways and the cytokine cascade remain possible targets in HCC.

A modified technique of pancreaticojejunostomy after pancreatoduodenectomy: a preliminary experience.

Pancreatoduodenectomy currently represents the treatment of choice for resectable pancreatic and periampullary malignant tumours, symptomatic chronic pancreatitis, duodenal cystic dystrophy, large adenomas, diverticula and benign periampullary tumours. Pancreato-jejunostomy failure remains the main complication following pancreatoduodenectomy, even leading to death. To improve the safety of this anastomosis, a modified technique of pancreato-jejunal anastomosis with posterior double-layer suture and Wirsung duct evagination is proposed.

Effects of olive oil polyphenols on fatty acid synthase gene expression and activity in human colorectal cancer cells.

Oleuropein (OL) and hydroxytyrosol (HT), the main olive oil polyphenols, possess anti-proliferative effects in vitro. Fatty acid synthase, a key anabolic enzyme of biosynthesis of fatty acids, plays an important role in colon carcinoma development. Our aim was to investigate whether gene expression of FAS, as well as its enzymatic activity, is regulated by HT and OL in two human colon cancer cell lines, as HT-29 and SW620.

Mucinous cystic neoplasm of the pancreas: a case report.

Cystic neoplasms of the pancreas account for only a small percentage of pancreatic tumours. They include mucinous cystic tumours, which have a higher incidence in females in their forties or fifties. Cystic neoplasms of the pancreas can present in a benign, borderline or malignant form.

Endoscopic management of large colorectal polyps.

Objectives: The optimal treatment for large colorectal polyps (LCPs) is still a controversial issue. The aim of this study was to evaluate the safety and effectiveness of endoscopic polypectomy (EP) of colorectal polyps >or=2 cm in size.

Patients And Methods: One hundred fifty-one EP LCPs were performed over a period of 7 years.

Basiliximab versus steroids in double therapy immunosuppression in liver transplantation: a prospective randomized clinical trial.

Background: : Basiliximab (B), an anti-CD25 monoclonal antibody, may represent an alternative to steroids (S) in immunosuppression after liver transplantation (LTx). The aim of this prospective randomized clinical trial was to compare B with S in a cyclosporin A (CsA)-based immunosuppression regimen in primary LTx.

Methods: : Forty-seven adult recipients of LTx were randomly assigned to receive B or S.

Intragastric balloon and binge eating.

Background: In recent years, particular attention has been paid to the effect that eating disturbances and especially binge eating can have on the outcome of surgical treatments for obesity. Endoscopic positioning of the Bioenterics intragastric balloon (BIB) is mainly used in the work-up for surgical treatment of morbid obesity. Available data show that the BIB is a valid tool for reducing weight and co-morbidity, even if only a temporary treatment in morbidly obese patients.

Comparison of hemodynamic and respiratory effects of propofol and sevoflurane during carbon dioxide pneumoperitoneum in a swine model.

The aim of this study was to compare intraoperative hemodynamic and respiratory parameters using propofol and sevoflurane during laparoscopic surgery in a porcine model. After induction of general anaesthesia in 16 pigs with fentanyl (0.005 mg kg(-1)) followed by propofol (6 mg Kg(-1)), it was maintained with fentanyl (0.

Long-term functional assessment of antegrade colonic enema for combined incontinence and constipation using a modified Marsh and Kiff technique.

Purpose: Constipation and fecal incontinence can severely affect quality of life for patients, particularly when simultaneously present. Malone antegrade colonic enema enables periodic colonic emptying, thus preventing uncontrolled passage of feces and constipation.

Methods: Eleven patients with fecal incontinence and severe constipation or perineal colostomy after Miles' operation underwent a modified Marsh and Kiff ileostomy for antegrade colonic enema.

The Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) A retrospective review of 379 patients undergoing laparoscopic splenectomy.

In December 2000, the Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) was formally launched under the auspices of the Italian Society for Endoscopic Surgery and New Technologies (SICE). The aim of this multicentre study was to analyse various aspects of the treatment that are still under discussion, such as the extension of the laparoscopic indications in cases of malignancy, independently of the associated splenomegaly, patient selection and operative techniques. A retrospective review of 379 patients undergoing laparoscopic splenectomy for haematological diseases from February 1, 1993, to September 15, 2005, was conducted.

Solid papillary neoplasm of the pancreas: a case report.

Solid pseudopapillary neoplasm of the pancreas, solid and cystic, is a rare disease compared to ductal adenocarcinoma. The tumor most often affects women of African race aged in their twenties or thirties. We report the case of a 48-year-old man affected by solid pseudopapillary neoplasm of the pancreas treated by distal splenopancreasectomy.

Red blood cell (RBC) surface acetylcholinesterase showing a hemorheological pattern during glaucoma treatment.

Background: Glaucoma is currently attributed to two different possible pathogenetic mechanisms: mechanical (the ocular damage is induced by physical injury), and vascular (the ocular damage is sustained by ischemia of the optic nerve head).

Aim: We considered the possibility that several anti-glaucoma drugs (beta-blockers, carbonic anhydrase inhibitors and prostaglandins) could have an influence on optic nerve head hemorheology and oxygen supply.

Materials And Method: We studied 4 groups of 10 subjects each: a control group, and 3 primary open angle glaucoma (POAG) groups, treated with topical beta-blockers, (10 patients), carbonic anhydrase inhibitors (CAI), and prostaglandin analogs (PG), respectively.

Cholecystectomy in situs viscerum inversus totalis. Does laparoscopy increase the pitalls?

Situs viscerum inversus is a rare condition in which the organs are transposed, totally or partially, to the opposite side of the body. Normally, there are no organ dysfunctions. Clinically, symptoms of cholelithiasis may be clear but confused by the location of the gallbladder on the opposite side.

Insulin signaling in human visceral and subcutaneous adipose tissue in vivo.

In this study, we evaluated the activation of various insulin signaling molecules in human fat in vivo and compared signaling reactions in visceral and subcutaneous fat depots. Paired abdominal omental and subcutaneous fat biopsies were obtained from nonobese subjects with normal insulin sensitivity under basal conditions and 6 and 30 min following administration of intravenous insulin. Insulin receptor phosphorylation was more intense and rapid and insulin receptor protein content was greater in omental than in subcutaneous adipose tissue (P < 0.

Retrobulbar metastasis from gallbladder carcinoma after laparoscopic cholecystectomy. A case report.

Extra-abdominal metastases from gallbladder cancer are very rare; the sites outside the abdomen most frequently affected are the skin, bone and central nervous system. In the literature, only one case of orbital metastasis from gallbladder cancer has been reported, in a patient previously treated by open cholecystectomy. We report the case of a 53-year-old woman who underwent a laparoscopic cholecystectomy for symptomatic gallbladder stones.

Stop Flow in abdominal and pelvic cancer relapses.

To determinate MTD, DLT and safe doses for phase II study, a dose finding study with Mitomycin and Adriamycin Stop-Flow administration was carried out. A phase II study focused on resectability of pelvic colorectal relapses is in progress. From November 1995, 84 pts, 52 male and 32 female (94 treatments), with advanced not resectable abdominal (14 pts) or pelvic (70 pts) relapses, and resistant to previous systemic chemotherapy, were enrolled in the study.

[Italian translation and prospective validation of fecal incontinence quality of life (FIQL) index].

The evaluation of any functional disease affecting quality of life requires a purpose-designed quality-of-life index for clinical trials as well as for evaluating the outcomes of treatments. The fecal incontinence quality of life index (FIQL) was developed at Minnesota University (USA) for patients with faecal incontinence but could not be used for Italian patients without appropriate cultural and linguistic adaptation. Therefore this index was translated into italian and prospectively validated on a new series of 73 incontinent patients and 8 healthy controls in order to provide Italian coloproctologists with a useful tool for clinical research.

Reliability of electrophysiologic anal tests in predicting the outcome of sacral nerve modulation for fecal incontinence.

Introduction: Sacral nerve modulation has been demonstrated to be a new efficacious treatment for fecal incontinence. The effectiveness of the procedure is preliminarily tested by means of a peripheral nerve evaluation. Integrity of the sacral neural pathway is generally believed to be a necessary condition for a good response, but no data are available to confirm whether electrophysiologic anal tests are predictive of the clinical outcome of the peripheral nerve evaluation.

Permanent sacral nerve modulation for fecal incontinence and associated urinary disturbances.

Background And Aims: Sacral nerve modulation (SNM) using an implantable pulse generator is gaining increasing acceptance in the treatment of several functional disturbances of the urinary and intestinal tract. This new therapeutic approach offers new possibilities in the treatment of fecal incontinence (FI) by means of its possible effects on anorectal physiology.

Patients And Methods: Fourteen patients with FI, six of whom had associated urinary disturbances, underwent permanent SNM after successful peripheral nerve evaluation tests.

[State of lucid delirium after orthotopic liver transplantation. Clinical case].

Neuropsychiatric complications after liver transplantation are common and have an incidence ranging from 0.5% to 47% in several international reports. They are due to different causes (coagulation, haemodynamic or electrolyte disorders, infections, immunosuppressive drugs).