Post-pneumonectomy broncho-pleural fistula successfully closed by open-window thoracostomy associated with V.A.C. therapy

Broncho-pleural fistula (BPF), is a dramatic complication that may occur after lung resection. The treatment is challenging due to its high rate of morbidity and mortality. Herein, a case of BPF associated with empyema, occurred in an elderly patient who had undergone to left pneumonectomy for non-small cell lung cancer (NSCLC), is reported. After various treatments including chest drainage and endoscopic procedures, BPF was successfully closed by open-window thoracotomy associated with vacuum assisted closure (V.A.C.) device therapy. The authors conclude that V.A.C. is a convenient and safe measure in the management of empyema with BPF. Moreover, in similar clinical contexts, V.A.C. may be the only option available that may assure the survival of the patient and the avoiding any later-phases of residual cavity

Age as a risk factor in the occurrence of pneumothorax after transthoracic fine needle biopsy: Our experience

Transthoracic needle biopsy (TTNB) of the lung is a well-established technique for diagnosing many thoracic lesions, and is an important alternative to more invasive surgical procedures. Complications of TTNB include pneumothorax, hemoptysis, hemothorax, infection, and air embolism, with the most common complication as pneumothorax. From June 2011 to June 2014 we performed a prospective study of 188 patients who underwent TTNB with CT guidance at University Hospital of Salerno, Italy. Pneumothorax occurred in 14 of 188 biopsies (7.45%). With the respect of age of patients pneumothorax occurred more frequently in patients aged 60-70 years, while it was less frequent in younger (70 years). In conclusion, data of our prospective study documented that CT-guided TTNB is a safe and reliable procedure in elderly patients with suspected chest malignancy and is well tolerated

Flood hazard of the Somma-Vesuvius region based on historical (19-20th century) and geomorphological data

This paper presents a preliminary susceptibility map of the flood hazard for the Somma-Vesuvius volcanic district, worked out by means of multidisciplinary historical, geological, geomorphological and rainfall data processing. It is well known that the Somma-Vesuvius volcano, due to its explosive volcanism and the dense urbanization of the surrounding area, with a population exceeding 650,000 is one of the most dangerous active volcanoes of the world. Although this area has been extensively studied from the volcanological point of view with regards to its volcanic hazard, there are currently not many detailed studies about its flood hazard factors, despite the fact that, in the last century, many intense rainfall events in this area have produced several floods that invaded the surrounding plains affecting towns and roads, and causing much damages and loss of lives. Accordingly, in this paper high-resolution DEM (5×5 m pixel) and detailed geomorphological maps of the whole area have been analyzed and processed in GIS environment, carrying out a comparative study of the present-day morphology and the morphology of the 1900’s volcanic edifice, including changes of infrastructures and buildings throughout the last century. These results, together with historical chronicles data and the rainfall accurate data for all flood events, have been processed in this paper for highlighting the drainage basins areas of Somma-Vesuvius where the flood phenomena could be more probable in the future, working out a preliminary zoning map, also suggesting in which sectors interventions useful for mitigation of flood risk should be implemented

Painting the Palace of Apries I: ancient binding media and coatings of the reliefs from the Palace of Apries, Lower Egypt

This study gives an account of the organic components (binders and coatings) found in the polychromy of some fragmented architectural reliefs from the Palace of Apries in Memphis, Egypt (26th Dynasty, ca. 589-568 BCE). A column capital and five relief fragments from the collections of the Ny Carlsberg Glyptotek in Copenhagen were chosen for examination, selected because of their well-preserved polychromy. Samples from the fragments were first investigated using Fourier transform infrared (FTIR) spectroscopy to screen for the presence of organic materials and to identify the chemical family to which these materials belong (proteinaceous, polysaccharides or lipid). Only the samples showing the potential presence of organic binder residues were further investigated using gas chromatography with mass spectrometry detection (GC-MS) targeting the analysis towards the detection and identification of compounds belonging to the chemical families identified by FTIR. The detection of polysaccharides in the paint layers on the capital and on two of the fragments indicates the use of plant gums as binding media. The interpretation of the sugar profiles was not straightforward so botanical classification was only possible for one fragment where the results of analysis seem to point to gum arabic. The sample from the same fragment was found to contain animal glue and a second protein material (possibly egg). While the presence of animal glue is probably ascribable to the binder used for the ground layer, the second protein indicates that either the paint layer was bound in a mixture of different binding materials or that the paint layer, bound in a plant gum, was then coated with a proteinaceous material. The surface of two of the investigated samples was partially covered by translucent waxy materials that were identified as a synthetic wax (applied during old conservation treatments) and as beeswax, respectively. It is possible that the beeswax is of ancient origin, selectively applied on yellow areas in order to create a certain glossiness or highlight specific elements

Fine-needle cytology in the follow-up of breast carcinoma

The postoperative follow-up strategies for breast carcinoma (BC) utilize different procedures; the aim of this study was to investigate the role of fine-needle cytology (FNC) in the follow-up of BC patients. Two hundred sixty-six FNC samples from 190 BC patients have been reviewed. The target anatomical sites were 190 breast including 155 ipsilateral and 145 contralateral breast lesions and 76 extra-mammary nodules. Extra-mammary lesions included lymph nodes, thyroidal nodules, soft tissue lesions, (subcutaneous and sub-scars), salivary glands and deep located masses. Diagnostic distribution of the breast lesions was as follows: 51 positive, 15 indeterminate/suspicious, 119 negative and 5 inadequate. Positive cases included 43 ipsilateral and 8 contralateral BC, 9 BC in different quadrants from those of onset of the first BC. Sensitivity, specificity and accuracy have been 90, 91 and 90&, respectively. FNC, in a correct setting, is a reliable and effective method for the follow-up management of BC patients

High-resolution tracking in a GEM-Emulsion detector

SHiP (Search for Hidden Particles) is a beam dump experiment proposed at the CERN SPS aiming at the observation of long lived particles very weakly coupled with ordinary matter mostly produced in the decay of charmed hadrons. The beam dump facility of SHiP is also a copious factory of neutrinos of all three kinds and therefore a dedicated neutrino detector is foreseen in the SHiP apparatus. The neutrino detector exploits the Emulsion Cloud Chamber technique with a modular structure, alternating walls of target units and planes of electronic detectors providing the time stamp to the event. GEM detectors are one of the possible choices for this task. This paper reports the results of the first exposure to a muon beam at CERN of a new hybrid chamber, obtained by coupling a GEM chamber and an emulsion detector. Thanks to the micrometric accuracy of the emulsion detector, the position resolution of the GEM chamber as a function of the particle inclination was evaluated in two configurations, with and without the magnetic fiel

On random flights with non-uniformly distributed directions

This paper deals with a new class of random flights $\underline{\bf X}_d(t),t>0,$ defined in the real space $\mathbb{R}^d, d\geq 2,$ characterized by non-uniform probability distributions on the multidimensional sphere. These random motions differ from similar models appeared in literature which take directions according to the uniform law. The family of angular probability distributions introduced in this paper depends on a parameter $\nu\geq 0$ which gives the level of drift of the motion. Furthermore, we assume that the number of changes of direction performed by the random flight is fixed. The time lengths between two consecutive changes of orientation have joint probability distribution given by a Dirichlet density function. The analysis of $\underline{\bf X}_d(t),t>0,$ is not an easy task, because it involves the calculation of integrals which are not always solvable. Therefore, we analyze the random flight $\underline{\bf X}_m^d(t),t>0,$ obtained as projection onto the lower spaces $\mathbb{R}^m,m<d,$ of the original random motion in $\mathbb{R}^d$. Then we get the probability distribution of $\underline{\bf X}_m^d(t),t>0.$ Although, in its general framework, the analysis of $\underline{\bf X}_d(t),t>0,$ is very complicated, for some values of $\nu$, we can provide some results on the process. Indeed, for $\nu=1$, we obtain the characteristic function of the random flight moving in $\mathbb{R}^d$. Furthermore, by inverting the characteristic function, we are able to give the analytic form (up to some constants) of the probability distribution of $\underline{\bf X}_d(t),t>0.$Comment: 28 pages, 3 figure