[Reconstruction of the inguinal ligament in recurrent inguinal hernia using the "three-sheet" technique].

Destruction of the groin ligament is an unusual occurrence, often of traumatic or surgical origin. In the event of recurrent inguinal hernia with a destroyed inguinal ligament, the reconstruction of the wall with the surgical techniques currently available yields prognostically unfavourable results with frequent recurrence in only a short space of time. The aim of this report was to present a hernioplasty technique using the "three-sheet" implant involving reduction of the hernia sac and the affixing of two reinforcement nets in Prolene in an attempt to reconstruct the destroyed groin ligament.

A simple device for high-precision head image registration: preliminary performance and accuracy tests.

The purpose of this paper is to present a new device for multimodal head study registration and to examine its performance in preliminary tests. The device consists of a system of eight markers fixed to mobile carbon pipes and bars which can be easily mounted on the patient's head using the ear canals and the nasal bridge. Four graduated scales fixed to the rigid support allow examiners to find the same device position on the patient's head during different acquisitions.

[Chemokines: possible therapeutic targets and useful clinical parameters in renal transplantation].

Chemokines are a family of small, structurally related cytokines that regulate trafficking of different subsets of leukocytes, thus critically regulating inflammation. The chemokine system influences allograft biology at 3 main levels: 1) the process of ischemia-reperfusion injury, 2) the induction of transplant tolerance, and 3) the pathogenesis of acute rejection and chronic allograft nephropathy. Accordingly, following ischemia/reperfusion in a rat model, CXCR2 produced at the graft level attracts and activates granulocytes, which in turn promotes graft damage.

Balance between endoscopic and genetic information in the choice of ileorectal anastomosis for familial adenomatous polyposis.

Background And Objectives: The number of rectal polyps and the site of mutations in the APC (Adenomatous polyposis coli) gene have been used to guide the surgical management in patients with familial adenomatous polyposis (FAP). The aim of this study is to assess the utility of the APC mutation screening compared to the degree of the rectal polyposis in surgical decision making.

Methods: The post-surgical courses of 25 patients submitted to subtotal colectomy with ileorectal anastomosis (IRA) were reviewed.

Pretreatment verification of IMRT absolute dose distributions using a commercial a-Si EPID.

A commercial amorphous silicon electronic portal imaging device (EPID) has been studied to investigate its potential in the field of pretreatment verifications of step and shoot, intensity modulated radiation therapy (IMRT), 6 MV photon beams. The EPID was calibrated to measure absolute exit dose in a water-equivalent phantom at patient level, following an experimental approach, which does not require sophisticated calculation algorithms. The procedure presented was specifically intended to replace the time-consuming in-phantom film dosimetry.

Use of motion tracking in stereotactic body radiotherapy: Evaluation of uncertainty in off-target dose distribution and optimization strategies.

Spatial accuracy in extracranial radiosurgery is affected by organ motion. Motion tracking systems may be able to avoid PTV enlargement while preserving treatment times, however special attention is needed when fiducial markers are used to identify the target can move with respect to organs at risk (OARs). Ten patients treated by means of the Synchrony system were taken into account.

Risk-benefit analysis of X-ray exposure associated with lung cancer screening in the Italung-CT trial.

Objective: Prior analyses of X-ray exposures in lung cancer screening with CT considered the basic acquisition technique in single-detector scanners and the effects of a lifetime screening regimen, whereas the potential benefit in terms of lives saved was not addressed.

Materials And Methods: We determined the total-body effective dose of different acquisition techniques for one single-detector and one MDCT scanner and made projections about the cumulative radiation exposure to smokers undergoing four annual CT examinations on the same scanners in the Italung-CT Trial. Combining these data with estimates of radiation-induced fatal cancer and of the benefit of screening, we calculated the risk-benefit ratio for participants in the trial, ex-smokers, and never-smokers.

Magnetic resonance diffusion-weighted imaging: extraneurological applications.

Diffusion-weighted (Dw) imaging has for a number of years been a diagnostic tool in the field of neuroradiology, yet only since the end of the 1990s, with the introduction of echoplanar imaging (EPI) and the use of sequences capable of performing diffusion studies during a single breath hold, has it found diagnostic applications at the level of the abdomen. The inherent sensitivity to motion and the magnetic susceptibility of Dw sequences nonetheless still create problems in the study of the abdomen due to artefacts caused by the heartbeat and intestinal peristalsis, as well as the presence of various parenchymal-gas interfaces. With regard to focal liver lesions, a review of the literature reveals that Dw imaging is able to differentiate lesions with high water content (cysts and angiomas) from solid lesions.

3-Aza-6,8-dioxabicyclo[3.2.1]octanes as new enantiopure heteroatom-rich tropane-like ligands of human dopamine transporter.

CNS diseases such as Parkinson, schizophrenia, and attention deficit hyperactivity disorder (ADHD) are characterized by a significant alteration of dopamine transporter (DAT) density. Thus, the development of compounds that are able to selectively interact with DAT is of great interest. Herein we describe the design and synthesis of a new set of 3-aza-6,8-dioxabicyclo[3.

[High serum levels of Transforming Growth Factor-beta1, Interleukin-10 and Vascular Endothelial Growth Factor in pancreatic adenocarcinoma patients].

Background: Pancreatic adenocarcinomas are among the most aggressive types of cancer with an extremely poor diagnosis. Since this type of cancer is not well amenable to chemo- and radiotherapy or immunotherapy, surgical resection remains the only feasible treatment to date. Transforming Growth Factor (TGF)-beta and Interleukin (IL)-10 are potent immunomodulators that have been shown to suppress several aspects of the immune response.

[Esophageal motility disorders].

Esophageal motility abnormalities are usually diagnosed when esophageal manometry is performed in patients with unexplained non-cardiac chest pain, non obstructive dysphagia or as a part of the preoperative evaluation for surgery of gastroesophageal reflux. Classification of these abnormalities has been a subject of controversy. These esophageal contraction abnormalities can be separated manometrically from the motor pattern seen in normal subjects, however, their clinical relevance is still unclear and debated.

Molecular mechanisms of alcohol-induced liver injury. An Update.

Alcoholic liver disease has a known etiology but a complex pathogenesis. The understanding of how alcohol damages the liver has expanded substantially over the last decade. In particular the genesis of fatty liver, the effect of the metabolites of ethanol oxidation, the interaction between endotoxin and kupffer cells, and the genetic predisposition to develop severe liver disease have been the focus of a great deal of research.

[Role of salvage surgery in the recurrence of mouth and oropharynx tumors].

Educational objectives at the conclusion of this presentation, the participant should be able to identify the different criteria that lead to the surgical approach rather than to the medical treatment (radiation therapy -RT--and/or chemotherapy--CT). Introduction. When we have to deal with medium or big recurrence of an oral or oropharingeal cancer is very difficult to make the right choice between the surgical or medical therapy: what we have to ask to ourselves is whether is legitimate to reoperate considering the sequences due to surgery and the results expected.

Anal carcinoma occurring in Crohn's disease patients with chronic anal fistula.

This paper reports six patients with perianal Crohn's disease (CD), who developed anal cancer in chronic anal fistulas. Tumors have been often diagnosed at an advanced stage and had a worse prognosis than cancers arising in the general population as tumor symptoms may mimic symptoms of CD, resulting in delay in diagnosis. Patients with perianal CD should undergo a careful surveillance program for ano-rectal carcinoma, including routine biopsy of any suspected lesion.

Hemolymphangiomatosis of the spleen: imaging features.

Hemolymphangiomatosis is an extremely rare entity that has never been described in the diffuse form. Its main pathologic feature is proliferation of lymphatic and vascular cells inducing interstitial and hematic lakes and then splenomegaly. We report a complete imaging study, including magnetic resonance (MR) imaging, after administration of a superparamagnetic contrast agent.

Magnetic resonance imaging and Orbscan assessment of the anterior chamber.

Purpose: To evaluate the correlation between white-to-white (WTW) distance as assessed by Orbscan II (Bausch & Lomb) and high-resolution magnetic resonance imaging (MRI) sulcus-sulcus (S-S) measures and to analyze the correlation between age and anterior chamber parameters.

Setting: Istituto per la Ricerca e la Cura del Cancro, Candiolo, Torino, Italy.

Methods: Eighty-eight patients had MRI with a 1.

Inferior approach for the isolation of the left-middle hepatic veins in liver resections: a safe way.

Background: Control of blood outflow from the liver has become mandatory to reduce back-bleeding and prevent air emboli in difficult liver resections when dealing with the hepatic veins. Selective control of the major hepatic veins rather than unselective vena cava clamping is preferable in most of these cases. Extrahepatic isolation of the left-middle hepatic veins has been considered for a long time to be a hazardous maneuver, and there is no general agreement about the technique that should be used.

[Relationship between insulin secretion, and thyroid and ovary function in patients suffering from polycystic ovary].

Aim: The present paper investigates the relationship between polycystic ovary syndrome, hypothyroidism and insulin-resistance and how, by submitting patients to a specific therapy for any one of the three pathologies, we also obtain an improvement in the other associated pathologies.

Methods: We selected 45 patients aged between 16 and 25 with problems of polycystic ovary syndrome, hypothyroidism and insulin-resistance and divided them into 3 groups. The 15 Group A patients followed a dietetic therapy.

[Biological aspects of pancreatic cancer].

Pancreatic ductal carcinoma still is an aggressive disease with a fatal prognosis due to late diagnosis and resistance to pharmacological and surgical treatments. Molecular investigations of pancreatic cancer are complicated by the restricted accessibility of the organ for biopsies. However, recent studies have indicated that pancreatic cancer is a multi-stage process resulting from the accumulation of genetic changes in the somatic DNA of normal cells.

Cyclotorsional eye movements during a simulated PRK procedure.

Purpose: Eye alignment is a serious concern when performing corneal surface ablation. Although several excimer lasers monitor horizontal and vertical movements, little is known about the potential impact of cyclotorsional movements. Dynamic cyclotorsions have been measured on 10 emmetropic subjects during a simulated PRK treatment.

5alpha-Reductase activity in Lycopersicon esculentum: cloning and functional characterization of LeDET2 and evidence of the presence of two isoenzymes.

The full-length cDNA (LeDET2) encoding a 257 amino acid protein homolog of Arabidopsis DET2 (AtDET2) was isolated in tomato (Lycopersicon esculentum). LeDET2 has 76% similarity with AtDET2 and structural characteristics conserved among plant and mammalian steroid 5alpha-reductases (5alphaRs). LeDET2 is ubiquitously expressed in tomato tissues with higher levels in leaf than in stem, root, seed and callus.

Noncardiac chest pain of esophageal origin in patients with and without coronary artery disease.

Background/aims: Non-cardiac chest pain is a frequent finding in patients admitted to emergency departments, and it has been shown that many of these patients may have an esophageal cause for their pain. However, little data are available on patients primarily referred to the cardiology unit, and especially those with coronary artery disease. The purpose of this study was to assess the role of esophageal dysfunction in chest pain patients with and without coronary artery disease.

[The choice of surgical therapy in adenocarcinoma of the cardia].

Aim: From 1996 the adenocarcinoma of the esophago-gastric junction (AEG) is divided into 3 types according to Siewert's classification. For AEG type I and III the surgical treatment is codified, while for type II is still controversial. The aim of our study is to understand what is the better surgical treatment for AEG type II.