Risoluzione chirurgica di un granuloma periferico a cellule giganti del mascellare superiore mediante laser a diodi

ObjectivesThe Peripheral Giant Cell Granuloma (PGCG) is a gingival hyperplasia that rises from the mucoperiostium or the periodontal ligament and may occur at gingival edges or alveolar ridges of the oral mucosa. In this paper a case of PGCG treated by a diode laser 808 nm is described.Materials and methodsA case of a 65 years old female patient, in good health, with a PGCG located at the anterior portion of edentulous maxilla, is described. The mass was surgically excised using an 808 nm diode laser (KDL-10, Kavo, Germany) with parameters of 2 W continuous wave and a 320 nm optic fiber.ResultsSurgery was performed with no intra- nor post-operative complications. Follow-up at 7 and 21 days showed an increasing secondary intention healing. Histological examination confirmed the clinical diagnosis of peripheral giant cell granuloma.ConclusionsLaser surgery of PGCG offers many intraoperative advantages and reduces postoperative complications, also increasing patient's compliance. For that reason, as well as in light of recent literature studies, it may be considered as the gold standard.     

Repair of long-term venous catheters

The insertion of long-term Silastic catheters into the vena cava for home parenteral nutrition, antibiotic administration, and chemotherapy is increasing; however, one of the often described complications of these catheters is breakage of the external segment of the catheter. A new device as well as a new method for repair of the catheter has been described. Clinical testing of the catheters repaired with this device by our nutritional support service has demonstrated no leakage or occlusion at the catheter repair site. We believe the catheter repair kit described is simpler to use than the repair kit currently on the market.     

Spontaneous rupture of the right sinus of valsalva mimicking an ascending aortic intramural hematoma

Spontaneous ruptures of the ascending aorta are extremely rare and require emergent surgical intervention. We report a case of a delayed diagnosis of a spontaneous, localized periostial rupture of a nondilated right sinus of Valsalva, which mimicked an intramural hematoma of the ascending aorta. The diagnosis and surgical management of this unusual pathology is the subject of this case report.     

Incidence,survival, pathology,and genetics of adult Latino Americans with glioblastoma

Latino Americans are a rapidly growing ethnic group in the United States but studies of glioblastoma in this population are limited. We have evaluated characteristics of 21,184 glioblastoma patients from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. This SEER data from 2001 to 2011 draws from 28% of the U.S. population. Latinos have a lower incidence of GBM and present slightly younger than non-Latino Whites. Cubans present at an older age than other Latino sub-populations. Latinos have a higher incidence of giant cell glioblastoma than non-Latino Whites while the incidence of gliosarcoma is similar. Despite lower rates of radiation therapy and greater rates of sub-total resection than non-Latino Whites, Latinos have better 1 and 5 year survival rates. SEER does not record chemotherapy data. Survivals of Latino sub-populations are similar with each other. Age, extent of resection, and the use of radiation therapy are associated with improved survival but none of these variables are sufficient in a multivariate analysis to explain the improved survival of Latinos relative to non-Latino Whites. As molecular data is not available in SEER records, we studied the MGMT and IDH status of 571 patients from a UCLA database. MGMT methylation and IDH1 mutation rates are not statistically significantly different between non-Latino Whites and Latinos. For UCLA patients with available information, chemotherapy and radiation rates are similar for non-Latino White and Latino patients, but the latter have lower rates of gross total resection and present at a younger age.     

TUDCA prevents cholestasis and canalicular damage induced by ischemia-reperfusion injury in the rat, modulating PKCalpha-ezrin pathway.

Cholestasis, induced by liver ischemia-reperfusion injury (IRI), is characterized by dilatation of bile canaliculi and loss of microvilli. Tauroursodeoxycholic acid (TUDCA) is an anti-cholestatic agent, modulating protein kinase C (PKC) alpha pathway. PKC reduces ischemic damage in several organs, its isoform alpha modulates ezrin, a key protein in the maintenance of cell lamellipoidal extensions. We evaluated the effects of TUDCA on cholestasis, canalicular changes and PKCalpha-ezrin expression in a rat model of liver IRI. Livers flushed and stored with Belzer solution or Belzer + 10 mm TUDCA (4 degrees C for 6 h) were reperfused (37 degrees C with O(2)) with Krebs-Ringer bicarbonate + 2.5 micromol/min of Taurocholate or TUDCA. Bile was harvested for bile flow assessment. Liver tissue was employed for Electron Microscopy (EM) and for PKCalpha and ezrin immunoblot and immunofluorescence. The same experiments were conducted with the PKCalpha inhibitor Go-6976. TUDCA-treated livers showed increased bile flow (0.25+/-0.17 vs. 0.042+/-0.02 microl/min/g liver, P<0.05) and better preservation of microvilli and bile canalicular area at EM. These effects were associated with increased PKCalpha and ezrin expression (P=0.03 and P=0.04 vs. control respectively), as also confirmed by immunofluorescence data. PKCalpha inhibition abolished these TUDCA effects. TUDCA administration during IRI reduces cholestasis and canalicular damage in the liver modulating PKCalpha-ezrin pathway.