Overexpression of NDP kinase nm23 associated with ploidy image analysis in colorectal cancer.

The nm23 gene was originally identified by differential hybridization between two murine melanoma cell sublines with low and high metastatic potential. Nm23 is localized on chromosome 17q21.3-22. Allelic deletions of chromosome 17 have been related to the progression of colorectal carcinomas. We have evaluated and compared the expression of nm23 NPD kinase protein using an immunohistochemical method and DNA ploidy evaluation with image analysis. This study was performed on 20 patients, who underwent surgery for colorectal carcinoma. Patients were followed up during the period from 1992 to 1994. Results have shown an association between the parameters obtained for the nm23 NPD kinase protein expression, and aneuploid DNA and neoplastic progression. The expression of nucleoside diphosphate (NDP) kinase mm23 has been reported to be inversely related to the metastatic potential of experimental cells in human breast cancer. A relationship between the positivity in protein expression of gene product in the allele nm23 H1 and the state of the lymph nodes has also been found.

Carcinoid to cecal bowel localization: a case report and literature review.

The authors report a case of cecal malignant carcinoid, diagnosticated in a 68 years old male patient. Carcinoid tumours are rare neoplasm and their behaviour seems to change with the localization. Cecal carcinoid represents only 2-3% of gastrointestinal carcinoid. Some times it is discovered incidentally at autopsy, surgery or endoscopy. The aim of this paper has been to review, in literature, the frequency, treatment and prognosis of this neoplasm.

Prognostic factors in rehabilitation of above knee amputees for vascular diseases.

PURPOSE: This study was undertaken to predict rehabilitation potential and prognostic factors of patients undergoing above knee amputation for vascular diseases. METHOD: In a prospective study on 144 patients consecutively admitted to our rehabilitation unit for above knee amputation, multiple regression analyses were used to assess the relationship between nine independent variables and a battery of outcome measures: the Rivermead Mobility Index (RMI) and Barthel Index (BI) effectiveness on discharge, length of hospital stay. Two multiple logistic regressions were performed, using as dependent variable the occurrence of good or partial autonomy in mobility, quantified as RMI scores. RESULTS: Advanced age was the most powerful prognostic factor influencing effectiveness expressed as both mobility (RMI) and BI. Patients aged < 65 years had a greater probability (odds ratio 2.92) of good autonomy in mobility than older patients. The absence of vascular impairment of the residual limb and timely admission to the rehabilitation hospital correlated positively with effectiveness of mobility. CONCLUSIONS: These findings indicate that relevant prognostic factors can be identified at the beginning of rehabilitation treatment.

[Anastomotic dehiscence in colorectal surgery and the total parenteral nutrition. A clinical study]. / Deiscenze anastomotiche in chirurgia colo-rettale e NPT. Studio clinico.

After analysing previous investigations into the incidence of anastomotic dehiscence in colorectal surgery, the paper reports experience with a group of 27 patients treated by a "routine"-TPN after major surgery. In addition, a second group of 67 patients, treated by TPN alone after a postoperative complication, was included in this study. The results show the utility of TPN in the prevention or faster healing of anastomotic dehiscences.

[Lipoma of the colon. Apropos of a case report]. / Il lipoma del colon. A proposito di un'osservazione.

Lipoma of the large intestine is a rare, benign tumor. The clinical findings and the diagnostic studies are analysed and a case of giant submucosal colonic lipoma removed by colonoscopy is reported. Colonoscopic removal of submucosal lipomas is recommended, while the necessity of a surgical treatment in presence of intussusception or subserosal lipomas is confirmed.

Primary intra-abdominal malignant fibrous histiocytoma. Case report and literature review.

Malignant fibrous histiocytoma is a pleomorphic soft tissues sarcoma usually found in the extremity and in the retroperitoneum. The primary intra-abdominal localization of this tumour is very rare and only thirty-five previous reports are present in the world medical literature. The Authors report a case of giant malignant fibrous histiocytoma of the mesentery, which is treated by surgical removal plus adjuvant chemotherapy.

[Local anesthesia in the surgery of inguinal hernia. Technical notes]. / L'anestesia locale nella chirurgia dell'ernia inguinale. Note di tecnica.

Routine use of local anaesthesia associated with tension-free hernioplasty in surgical treatment of inguinal hernia allows an immediate patient walking and prompt discharge from the hospital unit: with this technique 89 cases in two years were operated. The anaesthesia-related discomforts and complications are minimal. The addition of an intravenous sedative (propofol) premis to extend this approach to anxious patients too.

[Bilateral retroperitoneal lymphadenectomy in tumors of the testis: anatomo-clinical considerations]. / La linfadenectomia retroperitoneale bilaterale nei tumori del testicolo: considerazioni anatomo-cliniche.

Bilateral retroperitoneal lymphadenectomy is usually indicated for non-seminomatous testis tumour at stage IIA and IIB. For seminoma is generally used radiotherapy, although some Authors prefer the surgical approach. Radical retroperitoneal lymphadenectomy must be bilateral, because metastatic cell can often spread to the contralateral lymph nodes. Lymphadenectomy is used not only for therapy, but also for staging: thus clinical evaluation and other diagnostic techniques are not always correct (30% of understaging). Permanent sexual disfunction can follow radical surgery, due to extensive retroperitoneal dissection and exeresis of lumbar sympathetic nerves; so it is proposed, for stage I tumors, a monolateral or limited retroperitoneal lymphadenectomy. Eight patients with non-seminomatous testicular tumours are reported by the authors; 2 (stage I) were treated with monolateral, 4 (stage IIA and IIB) with bilateral retroperitoneal lymphadenectomy; in 2 patients (stage IIC and IID) chemotherapy was followed by debulking surgery. Relapses were observed between 3 and 19 months. Sexual dysfunctions after surgery were present in 5 patients (69%); in all of these a bilateral retroperitoneal lymphadenectomy was performed.

[Use of the eutectic ointment EMLA (Eutectic Mixture of Local Anesthetics) in the surgical treatment of inguinal hernia under local anesthesia]. / L'uso della crema eutettica EMLA nel trattamento chirurgico dell'ernia inguinale in anestesia locale.

The use of EMLA eutectic cream is very effective and well tolerated in superficial anaesthesia. It is particularly indicated in surgical treatment of inguinal hernia by local anaesthesia, to achieve the analgesia of superficial layers. This allows to reduce the total dose of anaesthetics administrated by infiltration, reducing the risk of overdose, eliminating the pain due to injection, and is very agreeable for the patients.

[Surgery of inguinal hernias in the geriatric patient]. / La chirurgia dell'ernia inguinale nel paziente geriatrico.

The Authors report a series of 73 elderly patients undergone to Lichtenstein hernioplasty with local anaesthesia. Treatment of inguinal hernia in emergency involves a high mortality; on the contrary, the lack of complications and a very good patient compliance shows that elective repair of inguinal hernia should be preferred and performed in the elderly.

[Carcinoid of the thymus]. / Il carcinoide del timo.

Thymic carcinoid is a rare lesion. Two cases are reported and diagnostic as well as therapeutic problems are discussed.

Roux-en-Y gastric bypass patients hospitalized for substance use disorders achieve successful weight loss despite poor psychosocial outcomes.

An emerging body of literature indicates that Roux-en-Y gastric bypass (RYGB) patients may be at a heightened risk for substance use disorders (SUDs) after surgery. Little is known about how weight loss and psychosocial outcomes of RYGB patients who develop SUD differ from those who do not. The present study compared weight loss and psychosocial outcomes of 26 post-RYGB patients in inpatient SUD treatment with those of 26 RYGB patients who did not evidence problematic substance use in the post-operative period. SUD and control cases were matched on age, sex and time lapse since surgery. No significant differences in % total weight loss or % excess weight loss (EWL) were found between groups. Those in SUD treatment were significantly less likely to meet the surgical failure criteria of <50% EWL but evidenced greater symptoms of depression, higher rates of probable major depressive disorder and poorer quality of life. Our findings indicate that RYGB patients hospitalized for SUDs achieve successful weight loss despite having poor psychosocial outcomes.