Peritoneal carcinomatosis (PC), which has been regarded as a lethal condition, may now be treated, achieving a long-term disease-free survival with cytoreductive surgery by treating macroscopic tumor ...seeding and hyperthermic intraperitoneal chemotherapy (HIPEC) by treating residual microscopic disease. The purpose of this study was to analyse the morbidity and mortality of this procedure.
A total of 39 consecutive patients were included in this retrospective study. After complete resection of the PC, HIPEC was performed via the coliseum technique. The chemotherapeutic agents used depended on the tumors' histology.
Postoperative mortality and morbidity rates were 5.1%% (2/39) and 43.5% (17/39), respectively. The most frequent complications were pulmonary complications (31%), gastrointestinal fistulas (20%), hematologic toxicity (16%) and postoperative bleeding (11%). Statistical correlations were evidenced between morbidity and PC index (p<0.004), duration of surgery (p<0.001) and blood loss (p<0.001).
This approach has resulted in a relatively high but acceptable percent of adverse events considering the expected advantage for survival.
Introduction
The incidence of lymphoma in patients with HIV infection is higher than in the general population.
Case report
Here, we present the case of a 41-year-old Greek male with recurrent ...episodes of fever for one year, who presented with the symptoms and signs of acute abdomen, right pelvic pain, anorexia and nausea starting 8 hours prior to admission. Laparotomy revealed complete obstruction of the terminal ileum and cecum due to a ruptured mass. A right colectomy with a latero-lateral ileotransverse anastomosis was performed. On histology, the mass proved to be an extranodal localization of diffuse large B-cell lymphoma (DLBCL) of the ileum. Based on the history and histopathological findings, HIV infection was suspected and testing proved positive. We hypothesize that although this patient had been suffering from intermittent fever for a year, he was never investigated thoroughly, and delay in the diagnosis and treatment of the HIV infection favored the development of lymphoma.
In conclusion
All patients with lymphoma should be investigated for underlying immunosuppression, especially in the case of extranodal localization of the disease.
The presence of an inflamed or non-inflamed appendix in an inguinal hernial sac is called Amyand’s hernia and it is a rare condition. The case is presented here of a 76-year-old Greek male with a ...known right reducible inguinal hernia, who presented at the hospital emergency department with the symptoms and signs of incarceration of the hernia. Intraoperatively, an inflamed appendix was revealed trapped in the hernial sac. To our knowledge this is the first case of Amyand’s hernia reported in a patient in Southwestern Greece.
Dirofilariasis is a rare human parasitic disease.
Dirofilaria repens
most commonly causes subcutaneous and ocular infections. The case is presented of a 24-year-old Greek male with a painless ...swelling in the right groin of one month’s duration. Exploratory incision of the lesion revealed a whitish living worm of approximately 7 cm in length. The worm was removed and identified by its morphology as D. repens. This is the first case of dirofilariasis of the groin to be reported in Southwestern Greece.
Sarcoidosis is a granulomatous disorder of unknown etiology. The term of immunoangiostasis has been addressed by various studies as potentially involved in the disease pathogenesis. The aim of the ...study was to investigate the expression of the master regulator of angiogenesis hypoxia inducible factor (HIF)-1a - vascular endothelial growth factor (VEGF)- inhibitor of growth factor 4-(ING4) - axis within sarcoid granuloma.
A total of 37 patients with sarcoidosis stages II-III were recruited in our study. Tissue microarray technology coupled with immunohistochemistry analysis were applied to video-assisted thoracoscopic surgery (VATS) lung biopsy samples collected from 37 sarcoidosis patients and 24 controls underwent surgery for benign lesions of the lung. Computerized image analysis was used to quantify immunohistochemistry results. qRT-PCR was used to assess HIF-1a and ING4 expression in 10 sarcoidosis mediastinal lymph node and 10 control lung samples.
HIF-1a and VEGF-ING4 expression, both in protein and mRNA level, was found to be downregulated and upregulated, respectively, in sarcoidosis samples compared to controls. Immunohistochemistry coupled with computerized image analysis revealed minimal expression of HIF-1a within sarcoid granulomas whereas an abundant staining of ING4 and VEGF in epithelioid cells was also visualized.
Our data suggest an impairment of the HIF-1a - VEGF axis, potentialy arising by ING4 overexpression and ultimately resulting in angiostasis and monocyte recruitment within granulomas. The concept of immunoangiostasis as a possible protection mechanism against antigens of infectious origin needs further research to be verified.
The common sites of abscess formation complicating perforated acute appendicitis are well known. However, localization of these abscesses to the psoas muscle is rare.
In our case, a 36-year-old black ...male refugee attended the emergency department of our hospital complaining of abdominal pain after falling from a truck. His history revealed two former operations on the lower abdomen performed in Sudan. Computerized tomography of the abdomen that followed displayed the formation of a psoas abscess. As a result, the patient underwent exploratory laparotomy which identified perforation of the appendix retroperitoneally. A culture of the abscess specimen disclosed the presence of Klebsiella pneumoniae and Proteus mirabilis.
In addition to describing this case, we also briefly review the literature for retroperitoneal psoas abscesses.
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The present study aimed to fabricate a hollow microneedle device consisting of an array and a reservoir by means of 3D printing technology for transdermal peptide delivery. Hollow ...microneedles (HMNs) were fabricated using a biocompatible resin material, while PLA filament was used for the reservoirs. The fabricated microdevice was characterized by means of optical microscopy, scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), contact angle measurements and leakage inspection studies to ensure the passageway of liquid formulations. Mechanical failure and penetration tests were carried out and supported by Finite Element Analysis (FEA). The cytocompatibility of the microneedle arrays was assessed to human keratinocytes (HaCaT). Finally, the transport of the model peptide octreotide acetate across artificial membranes was assessed in Franz cells using the aforementioned HMN design.
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