[Etiology, pathophysiology and management of post-traumatic pneumomediastinum: our experience].

The Authors reported the cases of posttraumatic pneumomediastinum came to their observation over the past 8 years. The etiology, pathophysiology, diagnosis, treatment and blunt injures eventually associated are discussed. Conclude that in the absence of associated injuries the treatment and the course of post-traumatic pneumomediastinum are the same that spontaneous pneumomediastinum.

[Thoracic trauma: incidence, social and economic costs, educational opportunities. Experience on the last eight years of Thoracic Surgical Unit of Messina University].

The Authors, after extensive introduction on the incidence, etiology, classification, pathophysiology, possible complications, diagnosis and treatment of thoracic trauma, relate their experience on the last eight years, stressing the diagnostic and therapeutic strategy in management of trauma simple and complicated and assessing finally serious social impact of these pathologies and the educational opportunities provided.

Mast cells in invasive ductal breast cancer: different behavior in high and minimum hormone-receptive cancers.

Background: Studies on the role of mast cells (MC) in cancer have given contrasting results. In order to contribute to the clarification of their role, research on breast cancer was carried out, because some aspects of its carcinogenesis, such as the diversity of the hormonal component, differ greatly.

Materials And Methods: This study included 50 cases of invasive ductal breast cancer not otherwise specified (NOS): 25 of them were high hormone-receptive (HHR) cancers with estrogen and progesterone receptor values not lower than 50%, 25 were minimum hormone-receptive (MHR) cancers (< 5%).

[Ferguson hemorrhoidectomy, modified by using the Ligasure radiofrequency coagulator].

The aim of the study was the evaluation of results of modified Ferguson hemorrhoidectomy, with use of the Ligasure radiofrequency coagulator, compared to the Milligan-Morgan and Longo techniques. From January 1988 to December 2005, 3011 patients underwent Ferguson hemorrhoidectomy (1849 F, 1162 M; age range: 18 to 84 years). One thousand three hundred patients had previously been treated by medical therapy with poor results and in 225 patients (7.

["Intentionally" limited pulmonary resection versus lobectomy for the treatment of peripheral stage IA non-small cell lung cancers].

Background: The purpose of this study is to assess, through the retrospective analysis of our experience and the literature review, whether the limited pulmonary resection is comparable to lobectomy for treatment of the peripheral stage IA (T1N0M0) non-small cell lung cancers (NSCLC), in terms of oncologic radicality, survival and rate of local, regional and systemic recurrences. Moreover it has been considered the impact of the limited resections in comparison with the lobar resections on the postoperative pulmonary function.

Patients And Methods: We have analyzed a consecutive series of 36 patients, 28 men and 8 women, of inclusive age among the 61 to 81 years (average 73 years), who underwent surgical resection from January 2000 to December 2003 for T1N0M0 peripheral NSCLC; 11 limited resections and 25 lobectomies have been performed.

Spontaneous pneumomediastinum: experience in 18 adult patients.

Spontaneous pneumomediastinum (SPM) is defined as the presence of air in the mediastinum, developing in the absence of traumatic, iatrogenic, or preceding pulmonary pathologies (emphysema, chronic bronchitis, and lung cancer). The aim of this study was to review our experiences with SPM, underlining its symptomatology, diagnosis, treatment, and followup, and defining a reasonable course of assessment and management. A retrospective case series was conducted to identify adult patients with SPM who were diagnosed and treated in our institution between 1998 and 2005.

[Post-operative analgesia in thoracic surgery: physiopathological features, therapeutic framework and methodologies].

Pain after surgery is a major handicap for patients as it bounds and decreases ability for spontaneous movement, cough and deep breathing, aiding the onset of complications and invalidating the recovery capabilities of operated patients. In thoracic surgery, the need to compile and employ guidelines for post-surgical pain management has become a pressing requirement in recent years. Currently available protocols include several options of treatment that are frequently a subject in the most recent scientific papers and play a key role, as they constitute the framework upon which building with changes and fixes that take account of incidental circumstances, in relation to both patients and surgery, again for both the organizational and structural features of the surgical environment.

Role of artificial nutrition in patients undergoing surgery for esophageal cancer.

Malnourished cancer patients undergoing major surgical treatments are at a high risk of morbidity and mortality. As compared to patients affected by other tumors, the highest rate of malnutrition (78.9%) was found in those with esophageal cancer due to postoperative complications.

Histamine and selenium in lung cancer.

The relationship between allergies and cancer incidence and the role played by histamine on the immune system and on inhibiting tumor growth have been the subject of study in our group. The influence of histamine dosage on free radicals was investigated in both lung cancer and healthy subjects. Plasmatic selenium levels in the same patients were assayed in order to highlight the role played by free radicals in lung cancer.

[Treatment of the esophageal cancer: the impact of peri-operative parenteral nutrition].

The malnourished cancer patients are at a higher risk of morbidity and mortality, when undergoing major surgical treatments. In comparison with patients affected with other cancers, the highest occurrence of malnutrition (78.9%) was found in those with esophageal cancer and is related with post-operative complications.

[Preputioplasty in the treatment of phimosis in pediatric age. Indications and results].

Aim: Phimosis is a common condition in the pediatric age. Circumcision has been the technique of choice for the surgical correction of this condition. As an alternative to circumcision different techniques of preputioplasty have been described in the last years.

[Thromboembolic risk and prevention of deep venous thrombosis in open and laparoscopic surgery].

Deep Vein Thrombosis (DVT) and pulmonary embolism are the dangerous and serious complications in patients undergoing surgery. It is known that prognosis is strictly linked to timely recognition of the pathogenetic-clinical phase of the thromboembolic disease and that prevention, therefore, plays the leading role in patients at risk. The most recent series show that, in absence of prophylaxis, the frequency of DVT, diagnosed by objective tests, is still significant in abdominal surgery.

[Malignant pleural mesothelioma: early diagnosis and multimodality management].

Malignant pleural mesothelioma (MPM) is a cancer with a poor prognosis, and its incidence increase, mainly as a result of exposure to asbestos. Universally acknowledged therapeutic approaches still don't exist at the moment, because of its refractory behaviour to all standard therapies; treatment protocols inclusive of either surgery, radiotherapy or chemotherapy have been largely employed, but usually with little impact on survival. For potentially operable pleural mesotheliomas new treatments tend to combine surgery both with new chemotherapy drugs and radiotherapy, in order to improve remarkably survival rates in selected cases.

[Safety and effectiveness of lung volume reduction surgery for treatment of chronic obstructive pulmonary disease].

Lung volume reduction surgery (LVRS) has been proposed and performed in order to decrease dyspnea and improve wordly life without major impairments in oxygen-dependent patients affected by serious chronic obstructive pulmonary disease (COPD) and severe dyspnea that doesn't suffer drastic alterations notwithstanding rehabilitation procedures tailored for the specific case. The purpose of LVRS is to optmize thoraco-pulmonary dynamics, considerably compromised in these patients, relaxing the serious expiratory restraint to airflow and improving the muscular respiratory functionality. In this work the authors bring forth the physio-pathological foundations that justify the use of LVRS, also analyzing data brought by the international literature about surgery guidelines, short-term morbidity and mortality, clinical-functional effects and long-term survival.

In vitro evaluation of oxidative damage from organic solvent vapours on human skin.

Aim of this study is to focus on the cutaneous effects of occupational exposure to the vapours of common organic solvents. Higher incidence of cancer is suspected in subjects exposed to organic solvents characterized by reactive metabolic intermediates, which are assumed to induce oxidative damage on liver, kidney and haematopoietic system. To our knowledge there are no relevant data about the oxidative effect of the organic solvents on skin after exposure to their vapours.

[Evaluation of direct occupational ocular trauma using electrophysiological techniques].

The most recent data from National Institute Insurance Work Accident (INAIL) confirm the high incidence of ocular injury as accident work. In this work the authors analyse the most common clinical form of occupational ocular trauma with the purpose to evaluate the use of electrophysiological tests in the diagnosis and in the follow up of these accidents. Authors admit the importance of more recent techniques as TC and MR in the diagnosis of these injuries; however, they conclude that electrophysiological tests can be considered as a first choice for the evaluation of the evolution and sequelae of ocular traumatism, for their low cost and easy application.

A modified weekly docetaxel schedule as first-line chemotherapy in elderly metastatic breast cancer: a safety study.

Standard dose docetaxel is burdened by severe toxicity. Weekly schedules have been shown to be active as standard scheme with reduced side effects. In 20-30% of elderly patients (pts) the classic 6-week schedule induces grade 3/4 fatigue and other cumulative toxicities.

Chest wall reconstruction after resection in lung cancer: personal experience.

Chest wall reconstruction after resection, for locally advanced lung cancer but also for some selected secondary tumors, is a demanding challenge to surgeons, anesthetists and experts in respiratory function rehabilitation who must guarantee a regular natural ventilation, adequate protection of intrathoracic organs and acceptable cosmetic outcome. To this aim, many procedures using autologous, heterologous, or prosthetic materials, are available. A study conducted on 13 lung cancer patients who after resection underwent reconstruction with heterologous prosthetic material is presented.

[Haemothorax and chylothorax: surgical approach].

Diseases causing blood accumulation in the pleural space (or haemothorax) are usually very demanding for diagnosis and require a multidisciplinar therapeutical approach in emergency. So, their treatment should always be immediate and should aim to restore the optimal patient's haemodynamic conditions and to find the site of bleeding. Chylothorax, a lymphatic effusion in the pleural space, is also a very important pathology, as it effects the nutritional and immunological state of the patient causing pleural involvement and respiratory insufficiency.

[Surgical treatment of hydatid cysts].

Hydatidosis represents a form of helminthic zoonosis with a stronger medical, social and economic impact. It is endemic in some areas of the world including Mediterranean countries, and therefore Italy. The disease is often diagnosed in an advanced phase, due to the poor symptomatology in the early stages.

[Surgical treatment of celomic cysts].

Celomic cysts (pericardiopleural or serous cysts) are rare, as they account for about 30% of all the homoplastic disembryogenetic lesions of the mediastinum. There is not usually a characteristic symptomatology associated with this anomaly, which is, however, easily diagnosed by means of the most common radiologic techniques. The TC together with the MRI provides all the necessary data for an appropriate management of the patient.

Recombinant human erythropoietin stimulates angiogenesis and wound healing in the genetically diabetic mouse.

The effects of recombinant human erythropoietin (rHuEPO) in diabetes-related healing defects were investigated by using an incisional skin-wound model produced on the back of female diabetic C57BL/KsJ-m(+/+)Lept(db) mice (db(+)/db(+)) and their normoglycemic littermates (db(+/+)m). Animals were treated with rHuEPO (400 units/kg in 100 microl s.c.

[Combined video-thoracoscopic, surgical and endovascular treatment in a case of ascites and recurrent bilateral pleural effusion].

Among recurrent pleural effusions a role of remarkable importance is held by those combined with ascitis due to the difficulty of their treatment, even using widely tested techniques. The incidence of such pathology varies from 4% to 6% of patients suffering from cirrhotic pathology, reaching 10% in cases with advanced illnesses. Pleural effusions involve the right emithorax more frequently than the left one, but it can show up bilaterally too.

[Bronchial arteries: anatomical and clinical studies and strategies in surgical approach].

One of the most important and controversial aspects of thoracic surgery is due to the topographical and surgical anatomy of the vascular structures involving the mediastinum. The knowledge of the so-called "vascular time", in fact, allows to face more complicated surgical situations, typical of the most specialistic thoracic surgery. The bronchial arteries represent a paradigm of what we have just stated.