Abstract Cholangiocarcinoma (CC) is the second most common type of primary liver cancer after hepatocellular carcinoma. Surgical resection is considered the only curative treatment for CC. In ...general, laparoscopic liver surgery (LLS) is associated with improved short-term outcomes without compromising the long-term oncological outcome. However, the role of LLS in the treatment of CC is not yet well established. In addition, CC may arise in any tract of the biliary tree, thus requiring different types of treatment, including pancreatectomies and extrahepatic bile duct resections. This review presents and discusses the state of the art in the laparoscopic and robotic surgical treatment of all types of CC. An electronic search was performed to identify all studies dealing with laparoscopic or robotic surgery and cholangiocarcinoma. Laparoscopic resection in patients with intrahepatic CC (ICC) is feasible and safe. Regarding oncologic adequacy, as R0 resections, depth of margins, and long-term overall and disease-free survival, laparoscopy is comparable to open procedures for ICC. An adequate patient selection is required to obtain optimal results. Use of laparoscopy in perihilar CC (PHC) has not gained popularity. Further studies are still needed to confirm the benefit of this approach over conventional surgery for PHC. Laparoscopic pancreaticoduodenectomy for distal CC (DCC) represents one of the most advanced abdominal operations owing to the necessity of a complex dissection and reconstruction and has also had small widespread so far. Minimally invasive surgery seems feasible and safe especially for ICC. Laparoscopy for PHC is technically challenging notably for the caudate lobectomy. Not least as for the LLR, the robotic approach for DCC appears technically achievable in selected patients.
Telomeres are protein-bound tandemly repeated simple DNA sequences placed at the chromosome ends, their role being essential for maintaining genome integrity. Severe telomere damage can trigger ...potential carcinogenic events such as chromosome fusions, whilst telomere shortening results (at least in mammals) in a protective mechanism known as 'replicative senescence'. In most Metazoa, telomere shortening is avoided by the ribonucleoprotein telomerase. In this brief overview, we focused on the evolutionary conservation of telomeres and telomerase in basal Metazoa (Ctenophora, Porifera, Placozoa, Cnidaria). In all these taxa, telomerase seems to be active and telomeres show the canonical TTAGGG sequence. Presence of telomerase activity and absence of telomere shortening is in accordance with the lack of senescence seen in basal Metazoa, although a clear correspondence between the “demographic senescence” and “replicative senescence” remains to be elucidated. Nonetheless, basal Metazoa can be useful as model organisms in studies on the evolution of telomere biology, Evo-Devo investigations on the control of telomerase activity, the emergence of senescence, as well as telomere-independent effects of telomerase.
Current evidence suggests that integrating diverse warning systems at different biological levels may not only increase the probability of detecting threats but also mitigate their impact. Here, we ...propose the use of both molecular and morphological descriptors at different biological levels in sessile bivalves (a suitable biological model in monitoring programs) to collect information on the ecosystem health of coastal marine habitats. In this context, studies may be implemented on biomarkers to exploit some population features, with the aim to propose an actual monitoring program that predictively would provide possible scenarios on the species fitness and ecosystem changes. Thus, the use of quality biotic elements may provide an objective environmental monitoring method and facilitate the development of sanitary, economic, and social strategies related to sustainable exploitation.
Abstract Background Clinical practice requires an accurate psychological assessment of subjects with clinical history of alcohol abuse and/or substance abuse (abuse history AH) for therapeutic ...choice. This study aims to identify significant correlations between the Minnesota Multiphasic Personality Inventory (MMPI)-2 scales in patients awaiting liver transplantation. Methods We evaluated a personality questionnaire containing MMPI-2 scales in the sample of 308 patients (81.8% males and 18.2% females) awaiting liver transplantation. The AH group composed 44.49% of patients and in the abuse free (AF) group, 55.51%. Scales were compared using Shapiro-Wilk test and Mann-Whitney U test. Interrelationships were examined using Spearman's correlation. Results This analysis found 27 scales of the MMPI-2 that were statistically different between 2 groups (AF and AH). In the AH group, we found a significant correlation between the following pairs of scales: Schizophrenia Scale (Sc) with the Addictions Potential Scale, Social Introversion scale (Si) with the Psychopathic Deviate scale (Pd), and Social Discomfort scale with Pd; the ES scale was negatively correlated with the Sc and Si scales. This interim study showed that the understanding of these indicators is crucial both for the assessment accuracy and for a prediction of the degree of therapy compliance after the transplantation. Conclusions The scales of the MMPI-2 indicated a marked tendency to emotional rigidity, a lack of self-esteem and susceptibility judgment. Social introversion and social discomfort trends lead to impulsive behavior and deviant actions that combine poorly with good compliance with treatment.
Abstract Inferior vena cava (IVC) preservation during orthotopic liver transplantation (OLT) is known as the “piggyback” technique. The end-to-side anastomosis is constructed between the graft's IVC ...and recipient's hepatic veins using a Satinsky side clamp applied in a transverse position. To stabilize the large Satinsky clamp and preserve a sufficient vascular stump after hepatectomy and before graft implantation, we propose a technical innovation consisting of hanging the septa between the left and middle hepatic vein and between the middle and right hepatic vein using 2 tapes. This technique showed some advantages when performing the caval outflow anastomosis, representing a further technical refinement of the piggyback end-to-side technique for the implantation on the 3 hepatic veins. From November 2001 to September 2012, we performed 272 consecutive OLT at our institution with the piggyback technique using the hanging of the hepatic veins septa in all cases. In conclusion, the hanging of the 3 hepatic veins septa presented in this study represents a simple, safe and reproducible technique for the outflow anastomosis using the piggyback technique.
Nitric oxide in invertebrates Colasanti, M; Venturini, G
Molecular neurobiology,
1998, Letnik:
17, Številka:
1-3
Journal Article
Recenzirano
Nitric oxide (NO) is considered an important signaling molecule implied in different physiological processes, including nervous transmission, vascular regulation, immune defense, and in the ...pathogenesis of several diseases. The presence of NO is well demonstrated in all vertebrates. The recent data on the presence and roles of NO in the main invertebrate groups are reviewed here, showing the widespread diffusion of this signaling molecule throughout the animal kingdom, from higher invertebrates down to coelenterates and even to prokaryotic cells. In invertebrates, the main functional roles described for mammals have been demonstrated, whereas experimental evidence suggests the presence of new NOS isoforms different from those known for higher organisms. Noteworthy is the early appearance of NO throughout evolution and striking is the role played by the nitrergic pathway in the sensorial functions, from coelenterates up to mammals, mainly in olfactory-like systems. All literature data here reported suggest that future research on the biological roles of early signaling molecules in lower living forms could be important for the understanding of the nervous-system evolution.
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