Peritoneal washing cytology in gastric cancer. How, when and who will get a benefit? A review.

The most frequent cause of treatment failure following surgery for gastric cancer is peritoneal metastasis. The ability to predict the likelihood of peritoneal recurrence should improve the therapeutic approach to gastric cancer. Cytological analysis of peritoneal washings is thought to be useful for direct detection of free cancer cells in the peritoneal cavity. Intraperitoneal free cancer cells (IFCC) isolated during peritoneal washing in patients with gastric cancer, have been demonstrated to be significantly and independently related to the prognosis, influencing both early recurrence and poor survival, so that since 1998 the Japanese Classification of Gastric Carcinoma (JCGC) recommend peritoneal wash cytology (PWC) for the local staging. In Western countries PWC is not uniform practice, because of several controversies regarding the low sensitivity rate of conventional cytology, the correct application of molecular diagnosis (immunostaining and RT_PCR) and the exact role of PWC in the clinical practice. The authors examine the current apply of peritoneal washing in gastric cancer, emphasizing the clinical implication of peritoneal cytology by analyzing the different modality and techniques to perform it (conventional cytology, immunocytochemistry, RT-PCR), when to achieve it during the diagnostic or clinical work-up (at the staging or during the surgical treatment), and who will get a benefit (all patients or selected patients).

Paranasal sinuses anatomic variants: 64-slice CT evaluation.

AIM: The aim of the paper was to perform a 64-slice CT evaluation of the main anatomic variants of paranasal sinuses. METHODS: From April 2005 to January 2006, 100 patients were chosen among all those that had undergone a paranasal sinuses CT examination. They were 45 women and 55 men, all aged between 18 and 70 years, mean age 46 years; they were all caucasian. This research has been conducted using a 64-slice Siemens Somatom Volume-Zoom multidetector Spiral CT. Para-nasal sinuses CT examination has been performed through a thin axial acquisition; the patient was lying on his back and the images were processed with multiplanar reconstruction (MPR). The anatomic variants considered in this study are: concha bullosa, Haller cells, uncinate process abnormalities, agger nasi cells, ethmoidal bulla, Onodi cell, middle turbinate curvature abnormalities. RESULTS: In this research it has been noticed that 29% of patients are affected by concha bullosa, 5% by Haller cells and again 5% by uncinate process abnormalities; 52% are affected by agger nasi cells, 15% by ethmoidal bulla, 9% by Onodi cell and 11% by middle turbinate curvature abnormalities. CONCLUSION: By using a 64-slice CT you can get a better quality of images in terms of spatial and temporal resolution. Osteomeatal complex structures are often featured by many anatomic variants. The most of the time, percentages are the same as recent researches have shown.

[Appendiceal lithiasis: case report and review of literature]. / Calcolosi dell'appendice: caso clinico e revisione della letteratura.

Appendiceal calculi are found in a limited percentage of patients. They are in association to an elevated prevalence of necrotic appendicitis and perforation of the appendix. The Authors report a case of acute appendicitis associated to appendiceal lithiasis with perforation of the organ. They emphasize the possibility to perform a preventive appendectomy in case of incidental appendiceal lithiasis. Besides they consider the differential diagnosis of the calcified images located in the lower abdominal quadrants with the aid of the various imaging methods available today, particularity sonography and computerized tomography.

L-dopa effects on preprogramming and control activity in a skilled motor act in Parkinson's disease.

OBJECTIVES: The authors investigated whether preprogramming (Bereitschaftspotential, BP) and control activity (skilled performance positivity, SPP) in a bimanual, sequential skilled performance task (SPT) is sensitive to L-dopa administration in non-demented Parkinson's disease (PD) patients. METHODS: Movement related potentials (MRPs) were recorded in 12 non-demented parkinsonian patients before and after acute L-dopa administration, and in 17 control subjects, all of whom were performing SPT for the first time. BP, SPP and correct performances were evaluated both as a grand average and in sequential blocks in order to verify the learning effect. RESULTS: After L-dopa administration the PD patients scored a significantly higher percentage of correct performances (P<0.05), linked to a decreased BP amplitude (P<0.001) and an increased SPP amplitude (P<0.005), than before therapy. Dynamic evaluation through the block analysis did not show any learning effect in off-therapy patients but showed that L-dopa intake improved learning, linked to a BP amplitude decrease (P<0.005) and a SPP amplitude increase (P<0.05). Furthermore, L-dopa minimized differences in the learning trend between off-therapy PD patients and controls. CONCLUSIONS: Our findings suggest that skilled motor learning is impaired in non-demented untreated PD patients. Dopaminergic drug administration seems to restore the ability of PD patients to use more automatic motor strategies, as demonstrated by the electrophysiological and behavioural pattern, which became more similar to that of normal subjects.

Psychophysiological approach in Parkinson's disease: L-dopa effects on preprogramming and control activity.

To investigate whether preprogramming (Bereitschaftspotential, BP) and control activity (skilled performance positivity, SPP) in a complex task are sensitive to L-dopa, movement related potentials (MRPs) were recorded in 12 non-demented Parkinson's disease (PD) patients before and after acute L-dopa administration, and in 17 control subjects. After L-dopa administration, the PD patients scored a significantly higher percentage of correct performances ( p<0.05), linked to a decreased BP amplitude ( p<0.001) and an increased SPP amplitude ( p<0.005), than before therapy. Our findings suggest that preprogramming activity is impaired in untreated PD patients. Dopaminergic drug administration seems to restore their ability to use more automatic motor strategies which become more similar to that of normal subjects.