68 research outputs found

    Robotic-assisted laparoscopic extended pelvic lymph node dissection for prostate cancer: surgical technique and experience with the first 99 cases

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    BACKGROUND: To date, there is still a paucity of data in the literature on robotic-assisted laparoscopic extended pelvic lymph node dissection (RALEPLND) in patients with prostate cancer. OBJECTIVE: To assess the technical feasibility of RALEPLND and to present our surgical technique. DESIGN, SETTING, AND PARTICIPANTS: From April 2006 to March 2008, we performed RALEPLND in 99 patients prior to robotic-assisted laparoscopic radical prostatectomy. Indications for RALEPLND were a prostate-specific antigen (PSA) >/=10 ng/ml or a preoperative Gleason score >/=7. The data were evaluated retrospectively. SURGICAL PROCEDURE: The transperitoneal approach was used in all cases. In order to gain optimal access to the common iliac bifurcation, the five trocars were placed in a more cephalad position than in patients undergoing radical prostatectomy without RALEPLND. After identification of important landmarks, the lymphatics covering the external iliac vein, the obturator lymphatic packet, and the lymphatics overlying the internal iliac artery were removed on both sides. MEASUREMENTS: The total lymph node yield, the frequency of lymph node metastases, and the complication rate. RESULTS AND LIMITATIONS: The median patient age was 64 yr (range: 45-78). The median preoperative PSA level was 7.7 ng/ml (range: 1.5-84.6). The median number of lymph nodes harvested was 19 (range: 8-53). In 16 patients (16%), we found lymph node metastasis. Complications occurred in seven patients (7%). CONCLUSIONS: RALEPLND is feasible, and its lymph node yield is well in the range of open series. The robotic-assisted laparoscopic approach in itself does not seem to limit a surgeon's ability to perform a complete extended pelvic lymph node dissection

    Differentiation in prefrontal cortex recruitment during childhood:Evidence from cognitive control demands and social contexts

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    Emerging cognitive control during childhood is largely supported by the development of distributed neural networks in which the prefrontal cortex (PFC) is central. The present study used fNIRS to examine how PFC is recruited to support cognitive control in 5–6 and 8-9-year-old children, by (a) progressively increasing cognitive control demands within the same task, and (b) manipulating the social context in which the task was performed (neutral, cooperative, or competitive), a factor that has been shown to influence cognitive control. Activation increased more in left than right PFC with cognitive control demands, a pattern which was more pronounced in older than younger children. In addition, activation was higher in left PFC in competitive than cooperative contexts, and higher in right PFC in cooperative and neutral than competitive contexts. These findings suggest that increasingly efficient cognitive control during childhood is supported by more differentiated recruitment of PFC as a function of cognitive control demands with age. Keywords: Prefrontal cortex, Cognitive control, Cooperation, Competition, Children, Functional near-infrared spectroscopy (fNIRS

    Information and digital literacies; a review of concepts

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    A detailed literature reviewing, analysing the multiple and confusing concepts around the ideas of information literacy and digital literacy at the start of the millennium. The article was well-received, and is my most highly-cited work, with over 1100 citations

    Necrotizing meningoencephalitis associated with cortical hippocampal hamartia in a Pekingese dog

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    A 4-year-old male Pekingese dog was referred to the clinic with a history of recurrent seizures and progressive abnormal gait and behavior, which did not respond to treatment. At necropsy, a large cortical defect in the right temporo-parietal cortex, malacia of subcortical white matter, right basal nuclei, and capsula interna, as well as abnormalities of the right hippocampus were observed. Histological examination of the brain revealed moderate to severe nonsuppurative meningoencephalitis in the left cerebral hemisphere and extensive infarction-like lesions with milder inflammation in the right hemisphere. In the right hippocampus, the pyramidal cells were arranged in a gyrus-like pattern and intermingled with gemistocytic and fibrillary astrocytes. The histopathological features of the inflammatory lesions were consistent with necrotizing meningoencephalitis and resembled those described in so-called Pug dog encephalitis. The hippocarnpal changes were interpreted as dysplasia (monolateral hippocarnpal cortical hamartia), unrelated to clinical signs and necrotizing inflammatory lesions

    HYDROCEPHALUS WITH PERIVENTRICULAR ENCEPHALITIS IN THE DOG

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    A 3-month-old female Dalmatian dog and a 2.5-month-old Poodle dog were referred with a sudden onset of neurological syndrome consistent with hydrocephalus. Clinical signs included depression, severe ataxia, eye abnormalities and skull enlargment in one case. Postmorten examination revealed severe internal hydrocephalus with cavitation of the cerebral white matter associated with necrotizing and inflammatory lesions of the periventricular nervous tissue. Although no bacteria were isolated from cerebrospinal fluid and no infectious agents were detected in the brains, an infectious etiology was postulated

    Un caso di encefalite del Carlino

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