Open and / or laparoscopic surgical treatment of liver hydatic cysts

Hydatid disease is a severe parasitic disease with a widely ranging distribution. In the human being the liver is the most frequent organ affected. 1 The treatment should be individualized to the morphology, size, number and location of the cysts, that is why a variety of surgical operations have been advocated from complete resection like total pericystectomy or partial hepatectomy to laparoscopy to a minimally invasive procedures like percutaneous aspiration of cysts to conservative drug therapy. 3-4 This study compares laparoscopic versus open management of the hydatid cyst of liver the surgical approach to liver echinococcosis is still a controversial issue and shows our results of surgical treatment of liver hydatid cysts during a 3-years period

Data analysis with ordinal and interval dependent variables: examples from a study of real estate salespeople

This paper re-examines the problems of estimating the parameters of an underlying linear model using survey response data in which the dependent variables are in discrete categories of ascending order (ordinal, as distinct from numerical) or, where they are observed to fall into certain groups on a continuous scale (interval), where the actual values remain unobserved. An ordered probit model is discussed as an appropriate framework for statistical analysis for ordinal dependent variables. Next, a maximum likelihood estimator (MLE) derived from grouped data regression for interval dependent variable is discussed. Using LIMDEP, a packaged statistical program, survey data from an earlier manuscript are analyzed and the findings presented.

Pancreas divisum. Correlation between anatomical abnormalities and bile precipitation in the gallbladder in seven patients

Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported. There is an association between PD and higher concentration of bile in the gallbladder. Cholecystectomy can be considered curative in patients with PD in the absence of indications for major surgery

Antioxidant Supplementation in the Treatment of Aging-Associated Diseases

Oxidative stress is generally considered as the consequence of an imbalance between pro- and antioxidants species, which often results into indiscriminate and global damage at the organismal level. Elderly people are more susceptible to oxidative stress and this depends, almost in part, from a decreased performance of their endogenous antioxidant system. As many studies reported an inverse correlation between systemic levels of antioxidants and several diseases, primarily cardiovascular diseases, but also diabetes and neurological disorders, antioxidant supplementation has been foreseen as an effective preventive and therapeutic intervention for aging-associated pathologies. However, the expectations of this therapeutic approach have often been partially disappointed by clinical trials. The interplay of both endogenous and exogenous antioxidants with the systemic redox system is very complex and represents an issue that is still under debate. In this review a selection of recent clinical studies concerning antioxidants supplementation and the evaluation of their influence in aging-related diseases is analyzed. The controversial outcomes of antioxidants supplementation therapies, which might partially depend from an underestimation of the patient specific metabolic demand and genetic background, are presented

JCV-specific T-cells producing IFN-gamma are differently associated with PmL occurrence in HIV patients and liver transplant recipients

Aim of this work was to investigate a possible correlation between the frequency of JCV-specific T-cells and PML occurrence in HIV-infected subjects and in liver transplant recipients. A significant decrease of JCV-specific T-cells was observed in HIV-PML subjects, highlighting a close relation between JCV-specific T-cell immune impairment and PML occurrence in HIV-subjects. Interestingly, liver-transplant recipients (LTR) showed a low frequency of JCV-specific T-cells, similar to HIV-PML subjects. Nevertheless, none of the enrolled LTR developed PML, suggesting the existence of different immunological mechanisms involved in the maintenance of a protective immune response in LT

Relationships between constructional and visuospatial abilities in normal subjects and in focal brain-damaged patients.

We tested 125 normal subjects and 24 right and 22 left focal brain-damaged patients (RBD and LBD) on the Rey figure copying test and on a battery of perceptual and representational visuospatial tasks, in search of relationships between constructional and visuospatial abilities. Selected RBD and LBD were not affected by severe aphasia, unilateral spatial neglect or general intellectual defects. Both RBD and LBD showed defective performances on the constructional task with respect to normal subjects. As regards visuospatial tasks, both patient groups scored lower than normal subjects in judging angle width and mentally assembling geometrical figures; moreover, RBD, but not LBD, achieved scores significantly lower than healthy controls in judging line orientation and analyzing geometrical figures. Post-hoc comparisons did not reveal any significant differences between RBD and LBD. Multiple regression analysis showed that visuospatial abilities correlate with accuracy in copying geometrical drawings in normal subjects and in RBD, but not in LBD. From a theoretical perspective, these findings support the idea that visual perceptual and representational abilities do play a role in constructional skills

Prognostic significance of primary-tumor extension, stage and grade of nuclear differentiation in patients with renal cell carcinoma

Surgery remains the preferred therapy for renal cell carcinoma. The various adjunctive or complementary therapies currently yield disappointing results. Identifying reliable prognostic factors could help in selecting patients most likely to benefit from postoperative adjuvant therapies. We reviewed the surgical records of 78 patients who had undergone radical nephrectomy with lymphadenectomy for renal cell carcinoma, matched for type of operation and histology. According to staging (TNM), 5.1% of the patients were classified as stage I, 51.3% as stage II, 29.5% as stage III and 14.5% as stage IV. Of the 78 patients 40 were T2N0 and 21 T3aN0. Tumor grading showed that 39.7% of the patients had well-differentiated tumors(G1), 41.1% moderately-differentiated (G2), and 19.2% poorly-differentiated tumors (G3). Overall actuarial survival at 5 and 10 years was 100% for stage 1; 91.3% at 5 years and 83.1% at 10 years for stage II; 45.5% and 34.1% for stage III; and 29.1% and nil for stage IV (stage II vs stage III p = 0.0001). Patients with tumors confined to the kidney (pT2N0) had better 5- and 10-year survival rates than patients with tumors infiltrating the perirenal fat (pT3aN0) (p = 0.000006). Survival differed according to nuclear grading (G1 vs G3 ; p = 0.000005; G2 vs G3; p = 0.0009). In conclusion our review identified tumor stage, primary-tumor extension, and the grade of nuclear differentiation as reliable prognostic factors in patients with renal cell carcinomas

A Free-Form Lensing Grid Solution for A1689 with New Mutiple Images

Hubble Space Telescope imaging of the galaxy cluster Abell 1689 has revealed an exceptional number of strongly lensed multiply-imaged galaxies, including high-redshift candidates. Previous studies have used this data to obtain the most detailed dark matter reconstructions of any galaxy cluster to date, resolving substructures ~25 kpc across. We examine Abell 1689 (hereafter, A1689) non-parametrically, combining strongly lensed images and weak distortions from wider field Subaru imaging, and we incorporate member galaxies to improve the lens solution. Strongly lensed galaxies are often locally affected by member galaxies, however, these perturbations cannot be recovered in grid based reconstructions because the lensing information is too sparse to resolve member galaxies. By adding luminosity-scaled member galaxy deflections to our smooth grid we can derive meaningful solutions with sufficient accuracy to permit the identification of our own strongly lensed images, so our model becomes self consistent. We identify 11 new multiply lensed system candidates and clarify previously ambiguous cases, in the deepest optical and NIR data to date from Hubble and Subaru. Our improved spatial resolution brings up new features not seen when the weak and strong lensing effects are used separately, including clumps and filamentary dark matter around the main halo. Our treatment means we can obtain an objective mass ratio between the cluster and galaxy components, for examining the extent of tidal stripping of the luminous member galaxies. We find a typical mass-to-light ratios of M/L_B = 21 inside the r<1 arcminute region that drops to M/L_B = 17 inside the r<40 arcsecond region. Our model independence means we can objectively evaluate the competitiveness of stacking cluster lenses for defining the geometric lensing-distance-redshift relation in a model independent way.Comment: 23 pages with 25 figures Replced with MNRAS submitted version. Some figures have been corrected and minor text edit

On the thermal and double episode emissions in GRB 970828

Following the recent theoretical interpretation of GRB 090618 and GRB 101023, we here interpret GRB 970828 in terms of a double episode emission: the first episode, observed in the first 40 s of the emission, is interpreted as the proto-black-hole emission; the second episode, observed after t$_0$+50 s, as a canonical gamma ray burst. The transition between the two episodes marks the black hole formation. The characteristics of the real GRB, in the second episode, are an energy of $E_{tot}^{e^+e^-} = 1.60 \times 10^{53}$ erg, a baryon load of $B = 7 \times 10^{-3}$ and a bulk Lorentz factor at transparency of $\Gamma = 142.5$. The clear analogy with GRB 090618 would require also in GRB 970828 the presence of a possible supernova. We also infer that the GRB exploded in an environment with a large average particle density $\, \approx 10^3$ part/cm$^3$ and dense clouds characterized by typical dimensions of $(4 - 8) \times 10^{14}$ cm and $\delta n/n \propto 10$. Such an environment is in line with the observed large column density absorption, which might have darkened both the supernova emission and the GRB optical afterglow.Comment: 7 pages, 10 figures, submitted to Ap