Alternative Applications of Trans-Oral Robotic Surgery (TORS): A Systematic Review

The role of robotic surgery in the field of oncology has been widely described, in particular for the tumours of the oropharynx and larynx, but its efficacy for benign pathology is inconsistent

Global Gene Expression Profiling Of Human Pleural Mesotheliomas: Identification of Matrix Metalloproteinase 14 (MMP-14) as Potential Tumour Target

BACKGROUND:The goal of our study was to molecularly dissect mesothelioma tumour pathways by mean of microarray technologies in order to identify new tumour biomarkers that could be used as early diagnostic markers and possibly as specific molecular therapeutic targets. METHODOLOGY:We performed Affymetrix HGU133A plus 2.0 microarray analysis, containing probes for about 39,000 human transcripts, comparing 9 human pleural mesotheliomas with 4 normal pleural specimens. Stringent statistical feature selection detected a set of differentially expressed genes that have been further evaluated to identify potential biomarkers to be used in early diagnostics. Selected genes were confirmed by RT-PCR. As reported by other mesothelioma profiling studies, most of genes are involved in G2/M transition. Our list contains several genes previously described as prognostic classifier. Furthermore, we found novel genes, never associated before to mesotheliom that could be involved in tumour progression. Notable is the identification of MMP-14, a member of matrix metalloproteinase family. In a cohort of 70 mesothelioma patients, we found by a multivariate Cox regression analysis, that the only parameter influencing overall survival was expression of MMP14. The calculated relative risk of death in MM patients with low MMP14 expression was significantly lower than patients with high MMp14 expression (P = 0.002). CONCLUSIONS:Based on the results provided, this molecule could be viewed as a new and effective therapeutic target to test for the cure of mesothelioma

A proposito della psiconevrosi cardiaca in tema di medicina assicurativa (rilievi clinici e medico-legali).

Gli AA. Ricordano la poliedricità dei disturbi soggettivi della psiconevrosi cardiaca che contrasta a volte con la contenuta entità dei corrispondenti segni fisici e strumentali. Dopo averne brevemente richiamate alcune notizie di origine etiopatogenetico, prospettano un protocollo per l’accertamento medico-legale della sindrome. A verifica dell’attendibilità dei metodi di diagnosi medico-legale confrontano la casistica ambulatoriale dell’Istituto di Patologia Medica della II Facoltà di Medicina e Chirurgia di Napoli con quella dell’Istituto di Medicina e Legale e delle Assicurazioni della medesima Facoltà. Dell’analisi comparativa delle due casistiche si ha dimostrazione che ai fini pratici è possibile pervenire ugualmente ad una certezza medico-legale nella diagnosi dell’affezione anche se non si possono impiegare tutti i mezzi strumentali disponibili nella pratica clinica

Minimizing contagion risks of COVID-19 during Trans Oral Robotic Surgery

In this communication we would like to share our experience in managing TORS patients during COVID-19 pandemia

Sulla diagnosi di insufficienza coronarica (I.C.) da sforzo nell’ambito della medicina pubblica

Alla luce delle nuove esigenze diagnostiche e valutative nell’ambito della Medicina Pubblica, si riportano i risultati di uno studio su 102 soggetti con elettrocardiogramma da sforzo computerizzato e miocardio-scintigrafia da sforzo per la diagnosi di insufficienza coronarica. Sotto l’aspetto metodologico si perviene alla conclusione che in Medicina Pubblica in un numero rilevante di casi l’elettrocardiografia da sforzo computerizzata può essere ritenuta una affidabile indagine, con un buon rapporto costo-beneficio, di facile esecuzione e pertanto preferibile alle metodiche radioisotopiche

Hybrid Exoscopic and Robotic Transoral Removal of a Bilateral Hilar Submandibular Stone: Technical Note and Review of the Literature

Submandibular gland sialolithiasis can be addressed by gland removal or by stone removal. Intraoral stone removal has now become the go-to technique to minimize aesthetic and functional sequelae (e.g., marginalis mandibulae injury, visible surgery scar) and, although traditional techniques were first experimented with (intraoral ducotomy), newer techniques drew the interest of the scientific community: sialoendoscopy, TORS-S (TransOral Robotic Surgery Assisted–Sialolithotomy) and VITOM-guided sialolithotomy. In this article, we compare the two newest transoral techniques for transoral sialolithotomy, TORS-S and 3D-4K VITOM-guided sialolithotomy, used to treat bilateral hilar submandibular gland sialolithiasis in the same patient, one technique for each side. Using these techniques, a faster recovery is achievable with almost no anatomical and/or functional sequelae, since they both allow better visualization and manipulation of soft tissues and noble structures (e.g., lingual nerve and Wharton’s duct) and make surgery easier and safer. Moreover, OR staff can better perceive surgical steps and be involved in the procedure, thus showing the high educational and training potential of these technologies

Targeting the autosomal Ceratitis capitata transformer gene using Cas9 or dCas9 to masculinize XX individuals without inducing mutations

Background: Females of the Mediterranean fruit fly Ceratitis capitata (Medfly) are major agricultural pests, as they lay eggs into the fruit crops of hundreds of plant species. In Medfly, female sex determination is based on the activation of Cctransformer (Cctra). A maternal contribution of Cctra is required to activate Cctra itself in the XX embryos and to start and epigenetically maintain a Cctra positive feedback loop, by female-specific alternative splicing, leading to female development. In XY embryos, the male determining Maleness-on-the-Y gene (MoY) blocks this activation and Cctra produces male-specific transcripts encoding truncated CcTRA isoforms and male differentiation occurs. Results: With the aim of inducing frameshift mutations in the first coding exon to disrupt both female-specific and shorter male-specific CcTRA open reading frames (ORF), we injected Cas9 ribonucleoproteins (Cas9 and single guide RNA, sgRNA) in embryos. As this approach leads to mostly monoallelic mutations, masculinization was expected only in G1 XX individuals carrying biallelic mutations, following crosses of G0 injected individuals. Surprisingly, these injections into XX-only embryos led to G0 adults that included not only XX females but also 50% of reverted fertile XX males. The G0 XX males expressed male-specific Cctra transcripts, suggesting full masculinization. Interestingly, out of six G0 XX males, four displayed the Cctra wild type sequence. This finding suggests that masculinization by Cas9-sgRNA injections was independent from its mutagenic activity. In line with this observation, embryonic targeting of Cctra in XX embryos by a dead Cas9 (enzymatically inactive, dCas9) also favoured a male-specific splicing of Cctra, in both embryos and adults. Conclusions: Our data suggest that the establishment of Cctra female-specific autoregulation during the early embryogenesis has been repressed in XX embryos by the transient binding of the Cas9-sgRNA on the first exon of the Cctra gene. This hypothesis is supported by the observation that the shift of Cctra splicing from female to male mode is induced also by dCas9. Collectively, the present findings corroborate the idea that a transient embryonic inactivation of Cctra is sufficient for male sex determination

Targeted somatic mutagenesis through CRISPR/Cas9 ribonucleoprotein complexes in the olive fruit fly, Bactrocera oleae

The olive fruit fly, Bactrocera oleae (Diptera: Tephritidae), is the most destructive insect pest of olive cultivation, causing significant economic and production losses. Here, we present the establishment of the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 methodology for gene disruption in this species. We performed targeted mutagenesis of the autosomal gene white (Bo-we), by injecting into early embryos in vitro preassembled and solubilized Cas9 ribonucleoprotein complexes loaded with two gene-specific single-guide RNAs. Gene disruption of Bo-we led to somatic mosaicism of the adult eye color. Large eye patches or even an entire eye lost the iridescent reddish color, indicating the successful biallelic mutagenesis in somatic cells. Cas9 induced either indels in each of the two simultaneously targeted Bo-we sites or a large deletion of the intervening region. This study demonstrates the first efficient implementation of the CRISPR/Cas9 technology in the olive fly, providing new opportunities towards the development of novel genetic tools for its control

Correlation analysis (Pearson coefficient) between our predicted warfarin dosage by Jackknife and that predicted by www.warfarindosing.org (panel A, p<0.001, R² = 0.805) and www.pharmgkb.org (panel B, p<0.001, R² = 0.773).

<p>The solid line represent a good correlation between the two doses. Open circles represent individuals for whom no variants in CYP2C9 and VKORC1 -1639 G>A were detected. Gray circles represent individuals with only one polymorphic gene (either VKORC1 -1639 G>A or CYP2C9* 2 or *3). Black circles represent individuals with at least two polymorphic genes.</p