Coagulation and fibrosis: A potential non-negligible target of statins in chronic hepatitis

n/

Gastric adenocarcinoma cutaneous metastasis arising at a previous surgical drain site: a case report

<p>Abstract</p> <p>Introduction</p> <p>Skin metastasis from internal carcinoma rarely occurs. It has an incidence of 0.7 to 9% and it may be the first sign of an unknown malignancy. However, it can also occur during follow-up.</p> <p>Case presentation</p> <p>A 90-year-old female patient was admitted to our surgical division with a diagnosis of anemia from a bleeding gastric adenocarcinoma. She underwent a gastric resection and Billroth II retrocolic Hofmeister/Finsterer reconstruction. She developed an enteric fistula, which needed a permanent abdominal drain until the 60^thpostoperative day. After 12 months she was readmitted to our division with subacute small bowel obstruction and an erythematous swelling on the right side of the abdomen. Biopsies characterized it as a cutaneous metastasis from the gastric adenocarcinoma. No surgical therapy was performed given her poor clinical condition.</p> <p>Conclusion</p> <p>Skin metastasis from carcinomas of the upper gastrointestinal tract is very rare. Persisting erythematous nodules must be biopsied in order to diagnose cutaneous metastases and to recognize them early and start prompt therapy with anti-tumour agents before the occurrence of massive visceral metastases.</p

Occurrence of immune thrombocytopenic purpura in a patient with essential thrombocythemia: How the immune system can overcome a neoplastic clone

n/

Extended narrow-line region in Seyfert galaxies

We present our recent results about the extended narrow-line region (ENLR) of two nearby Seyfert 2 galaxies (IC 5063 and NGC 7212) obtained by modelling the observed line profiles and spectra with composite models (photoionization+shocks) in the different regions surrounding the AGN. Then, we compare the Seyfert 2 ENLRs with the very extended one recently discovered in the narrow-line Seyfert 1 (NLS1) galaxy Mrk 783. We have found several evidences of interaction between the ISM of the galaxies and their radio jets, such as a) the contribution of shocks in ionizing the high velocity gas, b) the complex kinematics showed by the profile of the emission lines, c) the high fragmentation of matter, etc. The results suggest that the ENLR of IC 5063 have a hollow bi-conical shape, with one edge aligned to the galaxy disk, which may cause some kind of dependence on velocity of the ionization parameter. Regarding the Mrk 783 properties, it is found that the extension of the optical emission is almost twice the size of the radio one and it seems due to the AGN activity, although there is contamination by star formation around 12 arcsec from the nucleus. Diagnostic diagrams excluded the contribution of star formation in IC 5063 and NGC 7212, while the shock contribution was used to explain the spectra emitted by their high velocity gas.Comment: 9 pages, 2 figures, proceeding of the conference "Quasars at all cosmic epochs", accepted for publication in Front. Astron. Space Sci. - Milky Way and Galaxie

Very high energy sky monitoring with the Southern Widefield Gamma-ray Observatory

The Southern Wide-field Gamma-ray Observatory (SWGO) is the proposal for a new ground-based γ-ray instrument in the Southern Hemisphere, which will use an array of water-Cherenkov particle detectors to provide continuous monitoring of a large portion of the sky at the very- and ultra-high-energies (VHE and UHE, respectively). At the low energy side, SWGO aims to push the observational range of wide-field ground-based γ-ray facilities down to a few hundred GeV, thus bridging the gap between space and ground-based facilities in the monitoring of the VHE sky. In the high energy domain, on the contrary, it will benefit from the optimal coverage of the Galactic Plane to map the distribution of UHE sources in the inner parts of the Galactic disk and close to the Galactic Center, leading to an extraordinary improvement in our ability to identify their most likely counterparts. In this contribution, we describe the concept of SWGO and its potential to constrain the physics of VHE emission and particle acceleration in γ-ray sources powered by relativistic jets and energetic shocks. We finally discuss its role within the global network of multi-messenger facilities

Feasibility of laparoscopy for small bowel obstruction

<p>Abstract</p> <p>Background</p> <p>Adherential pathology is the most common cause of small bowel obstruction. Laparoscopy in small bowel obstruction does not have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere with abdominal wall integrity.</p> <p>Methods</p> <p>We performed a review without any language restrictions considering international literature indexed from 1980 to 2007 in Medline, Embase and Cochrane Library. We analyzed the reference lists of the key manuscripts. We also added a review based on international non-indexed sources.</p> <p>Results</p> <p>The feasibility of diagnostic laparoscopy is high (60–100%), while that of therapeutic laparoscopy is low (40–88%). The frequency of laparotomic conversions is variable ranging from 0 to 52%, depending on patient selection and surgical skill. The first cause of laparotomic conversion is a difficult exposition and treatment of band adhesions. The incidence of laparotomic conversions is major in patients with anterior peritoneal band adhesions. Other main causes for laparotomic conversion are the presence of bowel necrosis and accidental enterotomies. The predictive factors for successful laparoscopic adhesiolysis are: number of previous laparotomies ≤ 2, non-median previous laparotomy, appendectomy as previous surgical treatment causing adherences, unique band adhesion as phatogenetic mechanism of small bowel obstruction, early laparoscopic management within 24 hours from the onset of symptoms, no signs of peritonitis on physical examination, experience of the surgeon.</p> <p>Conclusion</p> <p>Laparoscopic adhesiolysis in small bowel obstruction is feasible but can be convenient only if performed by skilled surgeons in selected patients. The laparoscopic adhesiolysis for small bowel obstruction is satisfactorily carried out when early indicated in patients with a low number of laparotomies resulting in a short hospital stay and a lower postoperative morbidity. Although a higher small bowel obstruction recurrence remains the major postoperative risk of the laparoscopic management of these patients.</p

Virtual colonoscopy in stenosing colorectal cancer

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

A severe case of hemobilia and biliary fistula following an open urgent cholecystectomy

<p>Abstract</p> <p>Background</p> <p>Cholecystectomy has been the treatment of choice for symptomatic gallstones, but remains the greatest source of post-operative biliary injuries. Laparoscopic approach has been recently preferred because of short hospitalisation and low morbidity but has an higher incidence of biliary leakages and bile duct injuries than open one due to a technical error or misinterpretation of the anatomy. Even open cholecystectomy presents a small number of complications especially if it was performed in urgency. Hemobilia is one of the most common cause of upper gastrointestinal bleeding from the biliary ducts into the gastrointestinal tract due to trauma, advent of invasive procedures such as percutaneous liver biopsy, transhepatic cholangiography, and biliary drainage.</p> <p>Methods</p> <p>We report here a case of massive hemobilia in a 60-year-old man who underwent an urgent open cholecystectomy and a subsequent placement of a transhepatic biliary drainage.</p> <p>Conclusion</p> <p>The management of these complications enclose endoscopic, percutaneous and surgical therapies. After a diagnosis of biliary fistula, it's most important to assess the adequacy of bile drainage to determine a controlled fistula and to avoid bile collection and peritonitis. Transarterial embolization is the first line of intervention to stop hemobilia while surgical intervention should be considered if embolization fails or is contraindicated.</p