Personnel real time dosimetry in interventional radiology.

Interventional radiology and hemodynamic procedures have rapidly grown in number in the past decade, increasing the importance of personnel dosimetry not only for patients but also for medical staff. The optimization of the absorbed dose during operations is one of the goals that fostered the development of real-time dosimetric systems. Indeed, introducing proper procedure optimization, like correlating dose rate measurements with medical staff position inside the operating room, the absorbed dose could be reduced. Real-time dose measurements would greatly facilitate this task through real-time monitoring and automatic data recording. Besides real-time dose monitoring could allow automatic data recording. In this work, we will describe the calibration and validation of a wireless real-time prototype dosimeter based on a new sensor device (CMOS imager). The validation measurement campaign in clinical conditions has demonstrated the prototype capability of measuring dose-rates with a frequency in the range of few Hz, and an uncertainty smaller than 10%.

Double PPH technique for hemorrhoidal prolapse: a multicentric, prospective, and nonrandomized trial.

INTRODUCTION: Longo's technique (or PPH technique) is well known worldwide. Meta-analysis suggests that the failure due to persistence or recurrence is close to 7.7%. One of the reasons for the recurrence is the treatment of the advanced hemorrhoidal prolapse with a single stapling device, which is not enough to resect the appropriate amount of prolapse. MATERIALS AND METHODS: We describe the application of "Double PPH Technique" (D-PPH) to treat large hemorrhoidal prolapses. We performed a multicentric, prospective, and nonrandomized trial from July 2008 to July 2009, wherein 2 groups of patients with prolapse and hemorrhoids were treated with a single PPH or a D-PPH. Results were compared. The primary outcome was evaluation of safety and efficacy of the D-PPH procedure in selected patients with large hemorrhoidal prolapse. RESULTS: In all, 281 consecutive patients suffering from hemorrhoidal prolapse underwent surgery, of whom 74 were assigned intraoperatively to D-PPH, whereas 207 underwent single PPH. Postoperative complications were 5% in both groups (P = .32), in particular: postoperative major bleeding 3.0% in PPH versus 4.1% D-PPH (P = .59); pain 37.9 % PPH versus 27.3% D-PPH (mean visual analog scale [VAS] = 2.5 vs 2.9, respectively; P = .72); and fecal urgency 2.1% PPH versus 5.7% D-PPH (P = .8). Persistence of hemorrhoidal prolapse at 12-month follow-up was 3.7% in the PPH group versus 5.9% in the D-PPH group (P = .5). CONCLUSIONS: Our data support the hypothesis that an accurate intraoperative patient selection for single (PPH) or double (D-PPH) stapled technique will lower in a significant way the incidence of recurrence after Longo's procedure for hemorrhoidal prolapse.

[6 cases of small intestine lymphoma]. / Sei casi di linfoma dell'intestino tenue.

The Authors report six cases of primitive and secondary intestinal lymphomas. Surgical radicality was achieved only in three of them. In the other cases surgical resection carried out in emergency and late histological diagnosis did not allow a correct surgical treatment. Peri-operative mortality was 16%. Five patients underwent adequate radiation and chemo-therapy programme. Recurrences, secondary localizations, or other neoplasms elsewhere, require a prolonged follow up period for these patients.

Characterization of stroma from Fuchs' endothelial dystrophy corneas.

Fuchs' endothelial dystrophy is commonly regarded as an endothelial cell disorder. In the present study we compared glycoconjugates of Fuchs' and normal corneas using FITC conjugated lectins [peanut agglutinin (PNA), castor bean agglutinin (RCA120), soybean agglutinin (SBA), and wheat germ agglutinin (WGA)]. Our results showed increased staining with RCA120 and PNA in the posterior region of the Fuchs' corneas, indicating an accumulation of terminal beta-galactose and B-D-galactose (1-3)-D-N-acetylgalactosamine residues. The stromal and epithelial regions of normal and Fuchs' corneas exhibited similar staining patterns with all lectins tested. Our collagen studies showed an increased extractability and abnormal amino acid analyses of collagen from Fuchs' corneas as compared with normals. The purified collagens did have similar banding patterns by sodium dodecyl sulfate gels. However, further characterization by 125(1) two-dimensional peptide mapping revealed that Fuchs' alpha 1-sized chains contained fingerprints that were distinctly different from normal cornea stromal collagen. These data suggest that in addition to abnormal accumulation of RCA120- and PNA-specific glycoconjugates in the posterior cornea, Fuchs' corneas contained stromal collagens with altered biochemical properties. We postulate that the characteristic deterioration of endothelial function in Fuchs' dystrophy may compromise the microenvironment of the stroma and its keratocytes, and thereby lead to an altered collagenous extracellular matrix.

Keratoconus: I. Biochemical studies.

The present study analyses collagenous and non-collagenous components from age-matched normal and keratoconus corneas. Intact keratoconus corneas showed decreased collagen, total protein, and hydroxylysine levels, with normal reducible collagen cross-linking. Non-collagenous fractions were isolated from corneas with a 4 M guanidine procedure. As demonstrated by PAGE-silver stain, the keratoconus cornea guanidine extracts had a 75 kDa band that was absent in normal cornea guanidine extracts. In addition, there was a markedly increased level of protein, uronic acid and neutral hexose in keratoconus extracts as compared with controls. Our Western blot studies showed increased affinity for the castor-bean agglutinin (RCA120, specific for terminal galactose) in the keratoconus extracts as compared with normals. These data suggest the presence of an abnormal noncollagenous component in keratoconus corneas.

[Diagnostic value of 5'nucleotidase in primary and secondary neoplasms of the liver]. / Valore diagnostico della 5'nucleotidasi nelle neoplasie primitive e secondarie del fegato.

64 patients with various malignant neoplasms (6 primary and 18 secondary liver cancers, 40 tumors without evidence of hepatic involvement) entered a comparative study measuring serum levels of 5'nucleotidase, AFP, TPA, CEA, CA 19-9. In primary liver cancer, 5'nucleotidase true positive rate was 100% (vs 67% of AFP, TPA, CA 19-9 and 33% of CEA); in secondary liver tumors it was 67% (vs 11% of AFP, 44% of CEA, 55% of CA 19-9 100% of TPA). Diagnostic sensitivity was 75% and specificity 90.5%.

Modulation of lens-induced uveitis by superoxide dismutase.

Recent studies on reactive oxygen metabolites have suggested that these products may be important mediators in the early tissue damage that develops from immunopathologic inflammations. The superoxide anion appears to be the principal product of the respiratory burst. In order to determine the effects of removing superoxide with superoxide dismutase on modulating the inflammation in experimental phacoanaphylactic endophthalmitis, the animals with this experimental disorder were treated with superoxide dismutase. The treatment resulted in significant reduction of choroidal inflammation, retinal edema and vasculitis, suggesting phlogogenic role of superoxide in the ocular immune-complex disease.

Adherence of Candida to corneal surface.

In the pathogenesis of mycotic infections, adherence of the microbes to surface structures prior to invasion appears to be the initial and essential step in a susceptible host. Adherence and inhibition of adherence of Candida albicans to rabbit corneal surface was investigated in vitro by light and scanning electron microscopic examinations. The results indicate that blastospores of Candida albicans rarely bind to intact corneal epithelium, but consistently adhere to stroma denuded of epithelium. Such adherence was inhibited by concanavalin A. With its strong affinity for the yeast cell wall carbohydrate mannan, concanavalin A may block the site of attachment of yeast cells to the corneal surface.