Genetic causes can be directly responsible for various clinical conditions of male infertility and spermatogenic impairment. With the increased use of assisted reproduction technologies our ...understanding of genetic basis of male infertility has large implications not only for understanding the causes of infertility but also in determining the prognosis and management of such couples. For these reasons, the genetic investigations represent today an essential and useful tool in the treatment of male infertility. Several evidences are available for the clinical practice regarding the diagnosis; however, there are less information relative to the treatment of the genetic causes of male infertility. Focus of this review is to discuss the main and more common genetic causes of male infertility to better direct the genetics investigation in the treatment of spermatogenic impairment.
To examine the diagnostic and therapeutic role of fiber-optic and rigid bronchoscopy in pediatric patients with foreign body inhalations.
From January 1986 to December 2004, we observed 128 young ...patients with suspicion of foreign body aspiration. Patients were divided into 3 groups: group I, patients with negative chest X-ray; group II, patients with radiological direct signs; group III, patients with radiological indirect signs.
Removal of the foreign body was effected in 105 patients by rigid bronchoscopy and in 13 patients by fiber-optic bronchoscopy. In 3 group II patients a thoracotomy with a bronchotomy was necessary.
Fiber-optic bronchoscopy showed a diagnostic accuracy rate of 100 % but played a poor therapeutic role with a case resolution of 10.7 %. Rigid bronchoscopy was the main technique, permitting the removal of the tracheobronchial foreign body in 97.2 % of patients.
Brooker's merocyanine and its derivatives are well-studied molecules due to their very interesting optical properties. Merocyanine dyes exhibit different colors in solution depending on the solvent's ...polarity, pH, aggregation and intermolecular interactions. The synthesis of 1-methyl-4-(oxocyclohexadienylidene)ethylidene-1,4-dihydropyridine (MOED) dye yielded a particularly interesting solid state structure where in one crystal lattice, MOED and its protonated form are bound by hydrogen bonding interactions.
Aim of the study was to establish a noninvasive method for the preoperative characterisation of a pulmonary nodule when biopsy of the small mass is impossible.
From 1 January 2006 to 31 December ...2008, we observed 124 asymptomatic patients with a noncalcified single lung nodule highlighted by computerised tomography (CT) of the thorax. Patients were divided into 2 groups: Group A consisted of 57 patients with lesion diameters between 0.5 cm and 0.99 cm; Group B consisted of 67 patients with lesion diameters between 1.0 cm and 1.5 cm. Fibreoptic bronchoscopy was negative for endobronchial neoformation in all patients. The topographic distribution of the lesions advised against CT-guided transthoracic needle biopsy or video-assisted thoracoscopy. All patients had preoperative 18-fluorine fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) associated with CT of the thorax, which was compared with CT for evaluation of the mass.
Postoperative histological diagnosis revealed 54 primary lung cancers, 47 lung metastases and 23 benign lesions. In Group A the sensitivity of 18F-FDG PET/CT and CT was 95 % and 73 % and the specificity was 72 % and 64 %, respectively ( P = 0.000001 for 18F-FDG PET/CT; P = 0.000177 for CT). In Group B the sensitivity of 18F-FDG PET/CT and CT was 95 % and 97 %, and the specificity was 80 % and 87 %, respectively ( P = 0.000001).
Our study shows that 18F-FDG PET/CT improves the identification and characterisation of potentially malignant pulmonary nodules with a diameter < 1 cm. This technique could be a valid alternative to a surgical approach, currently the main method to investigate indeterminate lung nodules.
To report our experience with bronchial carcinoids.
From January 1990 to March 2003 we treated 42 such patients, 30 females and 12 males. All patients underwent preoperative total body computed ...tomography (CT), total body In-111 octreotide scintigraphy, and SPECT of the thorax, with evaluation of serum levels of CEA, CgA, NSE, and urinary 5-HIAA. Diagnosis was obtained in 28 patients with fibre-optic bronchoscopy and in 14 patients with CT-guided trans-thoracic needle biopsy.
There were 26 typical and 16 atypical carcinoids. 30 lobectomies, 5 bilobectomies, 6 wedge resections, and 1 pneumonectomy were carried out. The 3-year and the 5-year survival rates in the typical and atypical carcinoid groups were 100 % and 96 % vs. 81 % and 68 %, respectively (p < 0.001).
Long-term survival is based on histological completeness of surgical treatment. Octreotide scintigraphy and SPECT document N (1) and N (2) precisely.
OBJECTIVES
Impaired cardiopulmonary reserve is the main cause of inoperability in non-small-cell lung cancer (NSCLC). This study aims to evaluate the role of a preoperative pulmonary rehabilitation ...(PPR) programme in the improvement of functional parameters, which can enable an increase in the number of patients eligible for surgery.
METHODS
From January 2008 to June 2011, we observed a uniform group of 27 patients with NSCLC and chronic obstructive pulmonary disease (COPD). It showed: (i) a body mass index of 21.5 ± 2 kg/m²; (ii) forced expiratory volume in 1 s (FEV1) of 1.14 ± 0.7 l; (iii) maximal peak of oxygen consumption (VO2max) of 12.9 ± 1.8 ml/kg/min; (iv) carbon monoxide diffusing capacity (DLCO) of 72 ± 3% predicted; (v) stage IB of lung cancer. All patients underwent a 4-week PPR programme, 6 days a week and were re-evaluated before inclusion for surgery.
RESULTS
The rehabilitation programme was completed by all patients and extended by 2 weeks in nine patients, in order to obtain a further functional improvement. A statistically significant increase has been in the values of PaO2 (60 ± 10 vs 82 ± 12 mmHg), of VO2max (12.9 ± 1.8 vs 19.2 ± 2.1 ml/kg/min, P = 0.00001) and of FEV1 (1.14 ± 0.7 vs 1.65 ± 0.8 l, P = 0.02). All patients underwent a lobectomy, with a postoperative morbidity of 15%.
CONCLUSIONS
A 4 to 6-week PPR programme prepares the NSCLC and COPD patients properly for the surgical approach, reducing the functional limitations of inoperability.
We report 5 cases of Boerhaave's syndrome with necrotizing mediastinitis and pleural empyema. We chose a surgical treatment characterized by manual suture and heterologous tissue to repair esophagus ...rupture. This option allows a better result in terms of morbidity and mortality.
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