X-ray structure of a lectin-bound DNA duplex containing an unnatural phenanthrenyl pair.

DNA duplexes containing unnatural base-pair surrogates are attractive biomolecular nanomaterials with potentially beneficial photophysical or electronic properties. Herein we report the first X-ray structure of a duplex containing a phen-pair in the center of the double helix in a zipper like stacking arrangement.

[Identification of an objective reference parameter for the reconstruction of a large incisional hernia following physiological principles]. / Identificazione di un parametro obiettivo di riferimento per la ricostruzione secondo criteri fisiologici del grande laparocele.

Repairing a parietal defect of a large incisional hernia should not be limited to the closure of the breach by means of the modern biocompatible prosthetic sheets, but must also be able to restore a correct intra abdominal pressure, otherwise the derangement from the normal respiratory dynamics and the circulatory stasis in the abdominal veins and in those of the lower limbs remain unaltered. Over-correcting the parietal abdominal tension on the contrary can cause a dangerous compartmental syndrome. The attempts of an intraoperative measurement of the correct intra abdominal pressure restoration has been generally hampered from the condition of curarization of the patient during the operation. Using the automatic mechanical ventilator fixed at volume and not at pressure priority, as usual, can offer the possibility to calibrate, following objective parameters, the propriety of the surgical repair still during the final phases of the reparative operation. The simplicity and ingenuity of the here proposed method and the normal availability in every operative theatre of the necessary means for this measurements described, requires attention among the surgeons and a large diffusions of its simple use.

[Experimental study of the effect of the Argon Beam Coagulator on organic tissues from the viewpoint of surgical utilization]. / Studio sperimentale dell'effetto dell'Argon Beam Coagulator su tessuti organici in vista dell'impiego in chirurgia.

The Argon Beam Coagulator has gained his space in surgery thanks to its operative characteristics, that are very useful in sealing the bleeding parenchymal tissue with minimal injury to the surroundings. The aim of the present study is that of evaluate the physical properties of the instrument in its coagulation action. The experimental study with the Birtcher 6000 Argon Beam Coagulator has been designed to measure the top temperature that develops right where the Argon beam meets the tissue, while operating. Using a laser guided telethermometer, the searching of that temperature was uneasy right on the operatory field because of the unwilling movements of the operator hand and those of the patient himself. Therefore a similar protocol was made on a piece of meat coming from the butcher. At the longest application of the beam coagulation on the same point the developed temperature was never higher than 100 degrees C whilst a complete coagulation effects. The advantage of the Argon Beam coagulation are therefore to seal the diffuse bleeding without injury to this adjacent tissues, never exposed to a temperature higher than that of boiling water. The advantages are also evident in comparison with the more usual spray electrosurgery that is instead characterized by a wide carbonisation also with this spray option.

[Critical update on the no-touch technique in colonic cancer using the grasping tie]. / Aggiornamento critico della tecnica del "no-touch" per il cancro del colon con l'uso del "Grasping tie".

The time honoured strategy of "no-touch" in the surgery of colon cancer does not stand an anatomical and patho-physiological criticism, also on the basis of some results of the literature. The personal experience of the problem leads to the proposal of an alternative realization of the procedure, that is an up-to-date of the classic method, and is really worth and easy to be overall adopted. The suggestion is to seal bipolarly the colon tract with the tumour by mean of the original grasping tie from the very beginning of the operation, and then to temporarily clamp the mesocolon close to the gut, before going on with the surgical dissection, lymphectomy and exeresis as usual. This procedure is able to completely isolate from the first steps of the operation the affected tract of the colon, so opposing the possible spreading of tumour cells in the portal and in the systemic venous stream during the following surgical manipulations. The rationale of the proposal is that of a more efficacy of the "no-touch" strategy based on strict anatomical and patho-physiological considerations.

[The radical treatment of hepatic hydatidosis with deep and multiple locations. The role of new technologies particularly in the case of multiple locations]. / Sul trattamento radicale dell'idatidosi epatica a localizzazione profonda e multipla. Ruolo delle nuove tecnologie, specie in caso di localizzazioni multiple.

Advanced technologies (intraoperative ultrasonography, CT scan, argon coagulator ...) have changed the surgical approach of liver hydatid disease, allowing even multiple or deeply located cysts to be detected and treated successfully. Authors report a series of 4 patients with single (3) or multiple (1) unilocular hepatic cysts; and 1 patient with thoraco-pulmonary hydatid recurrent disease. Treatments of choice and surgical techniques are described. No infective compliances occurred. The mean period of hospitalization was 19 days (ranging between 10 days and 4 weeks). The longest hospitalization was observed in a patient with a post-operative biliary fistula at low out put. Total cysto-pericystectomy is emphasized as the gold standard procedure in the treatment of non complicated unilocular hydatid cysts of the liver. Modern means of investigation and technical equipment make it feasible and safe even in unfavorable localizations, allowing radical removal of the cysts preserving in the meantime all the surrounding liver parenchyma.

[Oncologic "second-look" today]. / Il "second look" oncologico oggi.

The Wangensteen's proposal of the SLL is far from us, not only chronologically but, what is more meaningful, technologically. Radiology, with its digestive tract barium meal or enema, was at his time the only mean entrusted for the instrumental study of the patient, and the medical oncology was at its very dawn. The Wangensteen's purpose was to discover with a SLL the recurrence (metastasis or relapse) of the neoplastic disease after a first demolitive surgical approach, not waiting its late clinical evidence. And this on the conviction that also the recurrent neoplastic disease can be again successfully treated by surgery when early detected. Many facts have happened since the 50's, and if it is by now demonstrated true that also the neoplastic recurrence can be successfully treated by surgery--naturally for particular neoplasms and in particular localization--it is equally true that diagnostic possibilities have widely evolved permitting the non invasive detection and localization of neoplastic recurrences with remarkable accuracy. Thence the renewed possibility of a reinterventional surgery.

[Renal angiomyolipoma causing an acute abdomen]. / L'angiomiolipoma del rene quale causa di addome acuto vascolare.

Herewith referred a case of renal angiomyolipoma relieved on a patient of 62. The new involvement has been found following an evidence of a keen syntomathology related by a steep abdominal ache centred above all on the right hypocondrium followed by a general light ache. The ecography and the "TAC" on the bely have showed a new enlarged involvement, centred on the hypocondrium and on the right oval side of a diameter of nearly 35 cm, that moved anteriorly the right renal, with an involvement of a perirenal hematoma. The surgery has ended with a nephrectomy with the drop of the involvement on the renal tissue and the emorragical enlargement which has allowed a local nephrectomy and therefore to resume the organon as a new growth not dangerous. The histological diagnosis separated on the renal carcinoma han been possible with certainty only examining cruently the area after a tumorectomia, but the general clinical course and the evidence of the angioTAC had been realized towards the exact diagnosis.

Dynamic test with recombinant interferon-alpha-2b: effect on 90K and other tumour-associated antigens in cancer patients without evidence of disease.

We have previously shown that a short course of recombinant interferon-alpha-2b (rIFN-alpha-2b) (3 million units day for 5 days) for patients with primary gynaecologic malignancies was able to increase the circulating levels of a newly discovered tumour associated antigen, termed 90K. In this study, we have investigated the effects of the same modality of administration of rIFN-alpha-2b in 62 patients with breast and colorectal cancer whose primary tumour was surgically removed 1 month before and who were without evidence of disease (NED) at the time of the study. A significant increase of 90K serum concentration was already observed 24 h after the first r-IFN-alpha-2b injection and persisted throughout the investigational period. The increase was more pronounced in patients with a basal 90K-negative than a 90K-positive assay. Of 54 patients who started the test with a 90K negative assay, 17 (31%) shifted to a positive assay after rIFN-alpha-2b. Twenty-eight of 62 (45%) patients exhibited a 90K value above the mean increment of the whole population. The serum levels of CEA, CA-15-3, CA 19-9, and alpha-fetoprotein measured in the same serum samples were not modified. After 2 years of follow-up, ten patients relapsed. Six of them showed a 90K increase above the mean increment of the whole population. As with ovarian cancer, the increase of 90K following r-IFN-alpha-2b administration might be of importance for the early detection of disease recurrence in clinically NED breast and colon cancer patients.

[Totally implantable systems for long-term chemotherapeutic treatment]. / Sistemi totalmente impiantabili per trattamento chemioterapico a lungo termine.

The authors report their own experience with completely implantable systems for the long-term chemotherapeutic treatment, compared with a review of modern literature. The experience even if low demonstrates a good methodology in reducing the number of complications associated with the use of percutaneous catheters.