Development and flight test of an avionics LIDAR for helicopter and UAV low-level flight

In recent years, laser radar (LIDAR) has become a promising technology for navigation and obstacle avoidance in helicopters and UAV, mainly because of its good wire detection performance on a wide range of incidence angles, and also due to its outstanding range and accuracy. In this paper we describe the activities carried out for the design, integration and test of the Laser Obstacle Avoidance System 'Marconi' (LOAM) on helicopter and UAV platforms. After a brief description of the system architecture and sensor characteristics, emphasis is given to the performance models and processing algorithms required for obstacle detection/classification and calculation of alternative flight paths, as well as to the ground and flight test activities performed on various platforms

Tracheal sleeve pneumonectomy for bronchogenic carcinoma

For a long time, primary tumors arising less than 2 cm distal to the carina have presented a contraindication to surgical excision. Tracheal sleeve pneumonectomy technique allows carinal resection and reconstruction but still carries considerable postoperative complications. From 1983 to 1992 we performed 27 right tracheal sleeve pneumonectomies and one left. Fourteen patients had N0 nodes, nine had N1, and five had N2. No anastomotic complications, either fistula or stenosis, were observed. Successful outcome depends on meticulous attention to surgical details and careful anaesthetic management with a new ventilation tube. One patient died on the twenty- second postoperative day from myocardial infarction. Complications included pneumonia (one), vocal cord paresis (two), and pleural empyema without bronchial fistula (one). Conservative treatment allowed complete recovery from all complications. There are seven patients alive at 4 years after operation and one at 5 years. Six patients have been disease-free for between 1 and 32 months. Two patients died free of disease at 13 and 42 months. Two patients died of mediastinal recurrence and 10 of distant metastases within 6 and 54 months

Impact of routine videothoracoscopy as the first step of the planned resectiona for lung cancer. Experience of 1306 cases

We have analyzed our experience of 1306 patients with NSCLC, submitted from November 1991 to December 2007 to routine videothoracoscopy exploration, as the first step of the planned procedure, in order to evaluate its validity in obtaining precise assessment of tumor extension, verifying thoracoscopic resectability and in decreasing the rate of unnecessary thoracotomies. Thoracoscopy revealed inoperability in 58 patients (4.4%) mostly due to pleural dissemination (2.4%) or mediastinal infiltration (1.7%). Of the remaining 1248 (95.6%), 449 (34.4%) had thoracoscopic resection (230 lobectomies, 6 pneumonectomies, 230 wedge resections), 767 (58.7%) underwent open resection (592 lobectomies, 175 pneumonectomies), and 32 (2.4%) had an exploratory thoracotomy (ET). Among the 32 ETs, thoracoscopy had suspected unresectability in 7 (0.5%), had been incompletely carried out in 4 early cases (0.3%) and had been unfeasible in 21 (1.6%). In our previous series from 1980 to 1991 the E.T. rate had been 11.6%. In the present series, after the introduction of routine thoracoscopy, the E.T. rate is 2.4% and the global rate of patients correctly staged, by thoracoscopy is 73.3%, significantly better than by CT. Video exploration resulted highly reliable in excluding conditions of unresectability with a negative predictive value (NPV) of 0.97. We conclude that preliminary thoracoscopy is useful in obtaining correct staging, reliably evaluates resectability of the lesion and helps in decreasing unnecessary thoracotomies

The i148m Pnpla3 polymorphism influences serum adiponectin in patients with fatty liver and healthy controls

BACKGROUND: Reduced adiponectin is implicated in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH), and the I148M Patatin-like phospholipase domain-containing 3 (PNPLA3) polymorphism predisposes to NAFLD and liver damage progression in NASH and chronic hepatitis C (CHC) by still undefined mechanisms, possibly involving regulation of adipose tissue function. Aim of this study was to evaluate whether the I148M PNPLA3 polymorphism influences serum adiponectin in liver diseases and healthy controls. METHODS: To this end, we considered 144 consecutive Italian patients with NAFLD, 261 with CHC, 35 severely obese subjects, and 257 healthy controls with very low probability of steatosis, all with complete clinical and genetic characterization, including adiponectin (ADIPOQ) genotype. PNPLA3 rs738409 (I148M) and ADIPOQ genotypes were evaluated by Taqman assays, serum adiponectin by ELISA. Adiponectin mRNA levels were evaluated by quantitative real-time PCR in the visceral adipose tissue (VAT) of 35 obese subjects undergoing bariatric surgery. RESULTS: Adiponectin levels were independently associated with the risk of NAFLD and with the histological severity of the disease. Adiponectin levels decreased with the number of 148\u2009M PNPLA3 alleles at risk of NASH both in patients with NAFLD (p\u2009=\u20090.03), and in healthy subjects (p\u2009=\u20090.04). At multivariate analysis, PNPLA3 148\u2009M alleles were associated with low adiponectin levels (<6\u2009mg/ml, median value) independently of NAFLD diagnosis, age, gender, BMI, and ADIPOQ genotype (OR 1.67, 95% c.i. 1.07-2.1 for each 148\u2009M allele). The p.148\u2009M PNPLA3 variant was associated with decreased adiponectin mRNA levels in the VAT of obese patients (p\u2009<\u20090.05) even in the absence of NASH. In contrast, in CHC, characterized by adiponectin resistance, low adiponectin was associated with male gender and steatosis, but not with PNPLA3 and ADIPOQ genotypes and viral features. CONCLUSIONS: The I148M PNPLA3 variant is associated with adiponectin levels in patients with NAFLD and in healthy subjects, but in the presence of adiponectin resistance not in CHC patients. The I148M PNPLA3 genotype may represent a genetic determinant of serum adiponectin levels. Modulation of serum adiponectin might be involved in mediating the susceptibility to steatosis, NASH, and hepatocellular carcinoma in carriers of the 148\u2009M PNPLA3 variant without CHC, with potential therapeutic implications

Do genetic factors protect for early onset lung cancer? A case control study before the age of 50 years

<p>Abstract</p> <p>Background</p> <p>Early onset lung cancer shows some familial aggregation, pointing to a genetic predisposition. This study was set up to investigate the role of candidate genes in the susceptibility to lung cancer patients younger than 51 years at diagnosis.</p> <p>Methods</p> <p>246 patients with a primary, histologically or cytologically confirmed neoplasm, recruited from 2000 to 2003 in major lung clinics across Germany, were matched to 223 unrelated healthy controls. 11 single nucleotide polymorphisms of genes with reported associations to lung cancer have been genotyped.</p> <p>Results</p> <p>Genetic associations or gene-smoking interactions was found for <it>GPX1(Pro200Leu) </it>and <it>EPHX1(His113Tyr)</it>. Carriers of the Leu-allele of <it>GPX1(Pro200Leu) </it>showed a significant risk reduction of OR = 0.6 (95% CI: 0.4–0.8, p = 0.002) in general and of OR = 0.3 (95% CI:0.1–0.8, p = 0.012) within heavy smokers. We could also find a risk decreasing genetic effect for His-carriers of <it>EPHX1(His113Tyr) </it>for moderate smokers (OR = 0.2, 95% CI:0.1–0.7, p = 0.012). Considered both variants together, a monotone decrease of the OR was found for smokers (OR of 0.20; 95% CI: 0.07–0.60) for each protective allele.</p> <p>Conclusion</p> <p>Smoking is the most important risk factor for young lung cancer patients. However, this study provides some support for the T-Allel of <it>GPX1(Pro200Leu) </it>and the C-Allele of <it>EPHX1(His113Tyr) </it>to play a protective role in early onset lung cancer susceptibility.</p

Chirurgia post-bariatrica : il ruolo del chirurgo plastico nella chirurgia dell&#8217; obesit&#224;

Tutti gli interventi chirurgici per la terapia dell`obesit\ue0 determinano un importante calo di peso che comporta quasi sempre un rilassamento dei tessuti cutanei. La chirurgia plastica post bariatrica mira ad eliminare i problemi relativi alle infezioni micotiche e batteriche delle pliche cutanee abnormi rimaste al termine del programma di dimagrimento quando il paziente ha raggiunto un peso verosimilmente stabile e a ridurre in modo incisivo le difficolt\ue0 posturali meccaniche e gli impedimenti ai movimenti e alla deambulazione, perci\uf2 \ue8 una chirurgia di tipo riabilitativo. Dall`ACCORDO Stato-Regioni del 11/2001 gli interventi di chirurgia plastica funzionale sono coperti dal Sistema Sanitario Nazionale. Essi constano nell`asportazione di masse cutaneo-adipose superficiali, eseguita per lo pi\uf9 in anestesia generale e prevedono una degenza di pochi giorni in regime di Ricovero Ordinario. Le complicanze postoperatorie sono generiche ma le condizioni generali dei pazienti possono discriminare una ripresa ottimale. Talora, per migliorare il rimodellamento sono necessari dei piccoli ritocchi, attuati dopo il recupero definitivo dal precedente intervento. Nella nostra UO sono stati effettuati 134 primi interventi (11% degli interventi bariatrici eseguiti) su 115 femmine e 19 maschi con et\ue0 di 44 \ub1 12 anni; Peso all`intervento bariatrico 117 \ub1 23.6 Kg; BMI 44.1 \ub1 6.9 Kg/m2; EW 60.1 \ub1 19.8 Kg e Peso all`intervento plastico 79.6 \ub1 14.6 Kg; BMI 29.9 \ub1 5.1 Kg/m2; EW 22.6 \ub1 13.5 Kg. 37 pazienti hanno avuto la necessit\ue0 di un secondo intervento e 10 ne hanno subito un terzo per un totale di 108 addominoplastiche, 29 lifting delle cosce, 6 torsoplastiche, 17 lifting delle braccia, 17 mastoplastiche riduttive e 4 revisioni. Le complicanze sono state il 3.7%. Le femmine sono l`85.8% dei pazienti operati. L`intervento pi\uf9 frequente \ue8 l`addominoplastica (80.5%) poi il lifting delle cosce (21.6%), la brachioplastica e la mastoplastica riduttiva (12.6%). Possono esserne causa le caratteristiche di composizione corporea e conformazione fisica, lo stile di vita, la pi\uf9 attenta valutazione dell`immagine corporea e la pi\uf9 frequente conquista dell`obiettivo bariatrico da parte delle femmine. La chirurgia plastica favorisce il conseguimento di vantaggi funzionali ma anche di positivi cambiamenti estetici contribuendo ad incoraggianti mutamenti psichici, perci\uf2, per un efficace approccio multidisciplinare al paziente obeso, il ruolo del chirurgo plastico \ue8 fondamentale per sostenere il recupero di abilit\ue0 essenziali ed ottenere risultati soddisfacenti e duratur

Injection Port and Connecting Tube Complications after Laparoscopic Adjustable Gastric Banding

Background: Port-site and connecting tube complications are usually considered minor problems in the follow-up of obese patients submitted to laparoscopic adjustable gastric banding (LAGB), but the incidence reported in literature ranges from 4.3% to 24%. These complications are mainly because of the mechanical stress of the port and the tube; therefore, their incidence might be time dependent and probably increase during the follow-up. Methods: We evaluated retrospectively 489 obese patients submitted to LAGB from February 1998 to December 2005, considering all the complications of the connecting tube and port. Their clinical signs, imaging exams, operative reports, and hospitalization files were evaluated. Results: The meam follow-up of the patients was 41 months. Seventy-one patients (14.5%) presented port and connecting tube complications that required 82 revisional operations. Fifty-four patients had system leaks, 3 had infection problems, and 14 mechanical problems, always requiring surgical revision. In five patients, the system leak was observed twice and required a second surgical repair, while one patient presented three times a leakage of the connecting tube and needed three surgical revisions. All cases of system leakage were to significant weight regain. In one case of recurrent port infection, we had to remove the band. Conclusion: Port-site and connecting tube problems are the most common complications after LAGB. Although they are considered marginal complications, they usually cause weight regain; their correction often requires surgical revision and sometimes removal of the band