Intraoperatively malpositioned stent as a complication of common bile duct injury during laparoscopic cholecystectomy

Injuries occurring during laparoscopic bile duct exploration in the course of laparoscopic cholecystectomy may represent threatening complications and lead to inappropriate management. We present a case of patient with biliary colic who underwent laparoscopic cholecystectomy. During the procedure, a common bile duct injury occurred, compelling conversion to open approach, and the patient was treated using a manually inserted biliary stent. She was referred with severe right upper quadrant pain six weeks after the surgery. Investigation with endoscopic retrograde cholangiopancreatography showed a malpositioned biliary stent with completely extra-biliary trajectory. This is thought to be the first description of a malpositioned common bile duct stent through the common biliary duct as a complication of the commonly performed surgical procedure of bile duct exploration

From deceased to bioengineered graft: New frontiers in liver transplantation

none6siopenCesaretti M.; Zarzavajian Le Bian A.; Moccia S.; Iannelli A.; Schiavo L.; Diaspro A.Cesaretti, M.; Zarzavajian Le Bian, A.; Moccia, S.; Iannelli, A.; Schiavo, L.; Diaspro, A

Diagnostic Value of Prenatal MR Imaging in the Detection of Brain Malformations in Fetuses before the 26th Week of Gestational Age

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Decreasing incidence of gastric MALT lymphomas in the era of anti-Helicobacter pylori interventions: results from a population-based study on extranodal marginal zone lymphomas

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Giant Sigmoid Diverticulum: A Rare Presentation of a Common Pathology

Although colonic diverticulum is a common disease, affecting about 35% of patients above the age of 60, giant sigmoid diverticulum is an uncommon variant of which only relatively few cases have been described in the literature. We report on our experience with a patient affected by giant sigmoid diverticulum who was treated with diverticulectomy. Resection of the diverticulum is a safe surgical procedure, provided that the colon section close to the lesion presents no sign of flogosis or diverticula; in addition, recurrences are not reported after 6-year follow-up

Variability of Forebrain Commissures in Callosal Agenesis: A Prenatal MR Imaging Study

BACKGROUND AND PURPOSE: Agenesis of the corpus callosum, even when isolated, may be characterized by anatomic variability. The aim of this study was to describe the types of other forebrain commissures in a large cohort of randomly enrolled fetuses with apparently isolated agenesis of the corpus callosum at prenatal MR imaging. MATERIALS AND METHODS: All fetuses with apparent isolated agenesis of the corpus callosum undergoing prenatal MR imaging from 2004 to 2014, were evaluated for the presence of the anterior or a vestigial hippocampal commissure assessed in consensus by 2 pediatric neuroradiologists. RESULTS: Overall, 62 cases of agenesis of the corpus callosum were retrieved from our data base. In 3/62 fetuses (4.8%), no forebrain commissure was visible at prenatal MR imaging, 23/62 fetuses (37.1%) presented with only the anterior commissure, and 20/62 fetuses (32.3%) showed both the anterior commissure and a residual vestigial hippocampal commissure, whereas in the remaining 16/62 fetuses (25.8%), a hybrid structure merging a residual vestigial hippocampal commissure and a rudiment of the corpus callosum body was detectable. Postnatal MR imaging, when available, confirmed prenatal forebrain commissure findings. CONCLUSIONS: Most fetuses with apparent isolated agenesis of the corpus callosum showed at least 1 forebrain commissure at prenatal MR imaging, and approximately half of fetuses also had a second commissure: a vestigial hippocampal commissure or a hybrid made of a hippocampal commissure and a rudimentary corpus callosum body. Whether such variability is the result of different genotypes and whether it may have any impact on the long-term neurodevelopmental outcome remains to be assessed. AC : anterior commissure ACC : agenesis of the corpus callosum CC : corpus callosum GA : gestational age HC : hippocampal commissure HS : hybrid structur

Contributo alla quantificazione della fitomassa epigea di alcuni pascoli dell’Appennino umbro-marchigiano (Italia centrale)

Il presente studio rappresenta un primo approccio alla descrizione, in termini quantitativi, della risorsa foraggera ovvero della produttività che caratterizza alcune tipologie di pascolo nell’Appennino Umbro-Marchigiano. Seppur ancora perfettibili i risultati ottenuti sono coerenti con l’ipotesi di base e cioè con la constatazione che la produttività aumenta passando dalle comunità xeriche a quelle semimesofile ed ai prati-pascolo. La produttività dipende infatti, da diverse variabili quali: disponibilità di risorse ambientali, intensità con cui le diverse componenti delle piante vengono consumate dagli erbivori (GRIME, 2001), composizione floristica del pascolo (le specie vegetali influenzano la fisionomia e la struttura architettonica del manto erboso e quindi la produzione), caratteristiche geomorfologiche, pedologiche e climatiche del sito di studio, ecc

Nuovi dati sui Gastrotrichi marini della Sicilia

I gastrotrichi marini popolano quasi esclusivamente le sabbie costiere, soprattutto dell’infralitorale superiore. Le specie conosciute sono circa 520, delle quali 163 rinvenute anche in Italia. Per la Sicilia sono segnalate una quarantina di specie, molte raccolte negli anni ‘90. Nel settembre 2022 abbiamo intrapreso nuove indagini, focalizzandoci sulla costa del canale di Sicilia e sul golfo di Mondello. Sono state investigate dieci località prelevando in ciascuna 1-2 litri di sedimento. L’analisi tassonomica è stata condotta nel laboratorio da campo creato a Sciacca. Gli animali sono stati estratti mediante narcotizzazione/decantazione e i gastrotrichi rinvenuti montati su vetrino e studiati a fresco utilizzando microscopia Nomarski. Nel complesso sono state rinvenute oltre 40 specie con una media di 11 ± 6,8 specie per località. La gastrotricofauna, divisa più o meno equamente tra l’ordine Macrodasyida e Chaetonotida, è stata documentata con oltre 2500 fotografie. La Località Le Solette (Menfi, AG) è risultata la più ricca con ben 22 specie, seguita da Mondello (PA) con 19. Valori di ricchezza specifica che figurano tra i più elevanti in assoluto, e che sono da mettere in relazione con il tipo di substrato di queste località: sabbia pulita a granulometria media-fine, la più idonea alla vita di questi micrometazoi. Complessivamente, la fauna documentata nel 2022 risulta costituita per la maggior parte da specie già note per la Sicilia, ma non mancano le novità, sia a livello regionale (e.g., Mesodasys littoralis Remane, 1951, Tetranchyroderma antenniphora Hummon & Todaro, 2010, T. polyprobolostomum Hummon, Todaro, Balsamo & Tongiorgi, 1996, Halichaetonotus margaretae Hummon, Balsamo & Todaro, 1992, Heteroxenotrichula subterranea (Remane, 1934), Xenotrichula punctata Wilke, 1954) sia in senso assoluto. Gli esemplari dei generi Dolychodasys Gagne, 1977 e Lepidodasys Remane, 1926 da noi rinvenuti apparterrebbero infatti a specie nuove per la scienza. La conferma verrà dalle analisi molecolari ancora in corso. I risultati ottenuti indicano che le conoscenze sulla fauna a gastrotrichi della Sicilia non sono complete e invogliano a proseguire le indagini lungo altri tratti costieri

Computer-assisted liver graft steatosis assessment via learning-based texture analysis

Purpose: Fast and accurate graft hepatic steatosis (HS) assessment is of primary importance for lowering liver dysfunction risks after transplantation. Histopathological analysis of biopsied liver is the gold standard for assessing HS, despite being invasive and time consuming. Due to the short time availability between liver procurement and transplantation, surgeons perform HS assessment through clinical evaluation (medical history, blood tests) and liver texture visual analysis. Despite visual analysis being recognized as challenging in the clinical literature, few efforts have been invested to develop computer-assisted solutions for HS assessment. The objective of this paper is to investigate the automatic analysis of liver texture with machine learning algorithms to automate the HS assessment process and offer support for the surgeon decision process. Methods: Forty RGB images of forty different donors were analyzed. The images were captured with an RGB smartphone camera in the operating room (OR). Twenty images refer to livers that were accepted and 20 to discarded livers. Fifteen randomly selected liver patches were extracted from each image. Patch size was 100 × 100. This way, a balanced dataset of 600 patches was obtained. Intensity-based features (INT), histogram of local binary pattern (HLBPriu2), and gray-level co-occurrence matrix (FGLCM) were investigated. Blood-sample features (Blo) were included in the analysis, too. Supervised and semisupervised learning approaches were investigated for feature classification. The leave-one-patient-out cross-validation was performed to estimate the classification performance. Results: With the best-performing feature set (HLBPriu2+INT+Blo) and semisupervised learning, the achieved classification sensitivity, specificity, and accuracy were 95, 81, and 88%, respectively. Conclusions: This research represents the first attempt to use machine learning and automatic texture analysis of RGB images from ubiquitous smartphone cameras for the task of graft HS assessment. The results suggest that is a promising strategy to develop a fully automatic solution to assist surgeons in HS assessment inside the OR