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De Simoni M, Baroni G, Battistoni G, Bisogni M, Cerello P, Ciocca M, Donetti M, Dong Y, Embriaco A, Ferrero V, Fiorina E, Fischetti M, Franciosini G, Giacchi G, Kraan A, Luongo C, Maggi M, Mancini Terracciano C, Marafini M, Malekzadeh E, Mattei I, Mazzoni E, Mirandola A, Morrocchi M, Muraro S, Patera V, Pennazio F, Schiavi A, Solfaroli-Camillucci E, Sportelli G, Tampellini S, Toppi M, Traini G, Trigilio A, Vischioni B, Vitolo V, Carlotti D, De Gregorio A, Sarti A. PD-0897 In vivo verification by detection of charged fragments in carbon ion therapy treatments at CNAO. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02976-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fischetti M, Baroni G, Battistoni G, Bisogni G, Cerello P, Ciocca M, De Maria P, De Simoni M, Di Lullo B, Donetti M, Dong Y, Embriaco A, Ferrero V, Fiorina E, Franciosini G, Galante F, Kraan A, Luongo C, Magi M, Mancini-Terracciano C, Marafini M, Malekzadeh E, Mattei I, Mazzoni E, Mirabelli R, Mirandola A, Morrocchi M, Muraro S, Patera V, Pennazio F, Schiavi A, Sciubba A, Solfaroli Camillocci E, Sportelli G, Tampellini S, Toppi M, Traini G, Valle SM, Vischioni B, Vitolo V, Sarti A. Inter-fractional monitoring of [Formula: see text]C ions treatments: results from a clinical trial at the CNAO facility. Sci Rep 2020; 10:20735. [PMID: 33244102 PMCID: PMC7693236 DOI: 10.1038/s41598-020-77843-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 11/13/2020] [Indexed: 12/26/2022] Open
Abstract
The high dose conformity and healthy tissue sparing achievable in Particle Therapy when using C ions calls for safety factors in treatment planning, to prevent the tumor under-dosage related to the possible occurrence of inter-fractional morphological changes during a treatment. This limitation could be overcome by a range monitor, still missing in clinical routine, capable of providing on-line feedback. The Dose Profiler (DP) is a detector developed within the INnovative Solution for In-beam Dosimetry in hadronthErapy (INSIDE) collaboration for the monitoring of carbon ion treatments at the CNAO facility (Centro Nazionale di Adroterapia Oncologica) exploiting the detection of charged secondary fragments that escape from the patient. The DP capability to detect inter-fractional changes is demonstrated by comparing the obtained fragment emission maps in different fractions of the treatments enrolled in the first ever clinical trial of such a monitoring system, performed at CNAO. The case of a CNAO patient that underwent a significant morphological change is presented in detail, focusing on the implications that can be drawn for the achievable inter-fractional monitoring DP sensitivity in real clinical conditions. The results have been cross-checked against a simulation study.
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Affiliation(s)
- M. Fischetti
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
| | - G. Baroni
- Dipartimento di Elettronica Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | | | - G. Bisogni
- INFN Sezione di Pisa, Pisa, Italy
- Dipartimento di Fisica “E. Fermi”, Università di Pisa, Pisa, Italy
| | | | - M. Ciocca
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - P. De Maria
- Scuola di Specializzazione di Fisica Medica, Sapienza Università di Roma, Rome, Italy
| | - M. De Simoni
- Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
| | - B. Di Lullo
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
| | - M. Donetti
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - Y. Dong
- INFN Sezione di Milano, Milan, Italy
- Dipartimento di Fisica, Università degli Studi di Milano, Milan, Italy
| | | | | | - E. Fiorina
- INFN Sezione di Torino, Turin, Italy
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - G. Franciosini
- Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
| | - F. Galante
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
| | - A. Kraan
- INFN Sezione di Pisa, Pisa, Italy
| | - C. Luongo
- INFN Sezione di Pisa, Pisa, Italy
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa, Italy
| | - M. Magi
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
| | - C. Mancini-Terracciano
- Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
| | - M. Marafini
- INFN Sezione di Roma I, Rome, Italy
- Museo Storico della Fisica e Centro Studi e Ricerche “E. Fermi”, Rome, Italy
| | - E. Malekzadeh
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - I. Mattei
- INFN Sezione di Milano, Milan, Italy
| | | | - R. Mirabelli
- Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
- Museo Storico della Fisica e Centro Studi e Ricerche “E. Fermi”, Rome, Italy
| | - A. Mirandola
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - M. Morrocchi
- INFN Sezione di Pisa, Pisa, Italy
- Dipartimento di Fisica “E. Fermi”, Università di Pisa, Pisa, Italy
| | - S. Muraro
- INFN Sezione di Milano, Milan, Italy
| | - V. Patera
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
- Museo Storico della Fisica e Centro Studi e Ricerche “E. Fermi”, Rome, Italy
| | | | - A. Schiavi
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
| | - A. Sciubba
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
- INFN Sezione dei Laboratori di Frascati, Rome, Italy
- Museo Storico della Fisica e Centro Studi e Ricerche “E. Fermi”, Rome, Italy
| | - E. Solfaroli Camillocci
- Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
- Scuola di Specializzazione in Fisica Medica, Sapienza Università di Roma, Rome, Italy
| | - G. Sportelli
- INFN Sezione di Pisa, Pisa, Italy
- Dipartimento di Fisica “E. Fermi”, Università di Pisa, Pisa, Italy
| | - S. Tampellini
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - M. Toppi
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
- INFN Sezione dei Laboratori di Frascati, Rome, Italy
| | - G. Traini
- INFN Sezione di Roma I, Rome, Italy
- Museo Storico della Fisica e Centro Studi e Ricerche “E. Fermi”, Rome, Italy
| | | | - B. Vischioni
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - V. Vitolo
- CNAO Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - A. Sarti
- Dipartimento di Scienze di Base e Applicate per l’Ingegneria, Sapienza Università di Roma, Rome, Italy
- INFN Sezione di Roma I, Rome, Italy
- Museo Storico della Fisica e Centro Studi e Ricerche “E. Fermi”, Rome, Italy
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Mattei I, Alexandrov A, Alunni Solestizi L, Ambrosi G, Argiro S, Bartosik N, Battistoni G, Belcari N, Biondi S, Bisogni MG, Bruni G, Camarlinghi N, Carra P, Catanzani E, Ciarrocchi E, Cerello P, Clozza A, Colombi S, De Lellis G, Del Guerra A, De Simoni M, Di Crescenzo A, Donetti M, Dong Y, Durante M, Embriaco A, Emde M, Faccini R, Ferrero V, Ferroni F, Fiandrini E, Finck C, Fiorina E, Fischetti M, Francesconi M, Franchini M, Galli L, Gentile V, Hetzel R, Hild S, Iarocci E, Ionica M, Kanxheri K, Kraan AC, Lante V, Lauria A, La Tessa C, Lopez Torres E, Massimi C, Marafini M, Mengarelli A, Mirabelli R, Montesi MC, Morone MC, Morrocchi M, Muraro S, Narici L, Pastore A, Pastrone N, Patera V, Pennazio F, Placidi P, Pullia M, Ramello L, Ridolfi R, Rosso V, Rovituso M, Sanelli C, Sartorelli G, Sato O, Savazzi S, Scavarda L, Schiavi A, Schuy C, Scifoni E, Sciubba A, Secher A, Selvi M, Servoli L, Silvestre G, Sitta M, Spighi R, Spiriti E, Sportelli G, Stahl A, Tomassini S, Tommasino F, Traini G, Toppi M, Valeri T, Valle SM, Vanstalle M, Villa M, Weber U, Zoccoli A, Sarti A. Measurement of 12C Fragmentation Cross Sections on C, O, and H in the Energy Range of Interest for Particle Therapy Applications. IEEE Trans Radiat Plasma Med Sci 2020. [DOI: 10.1109/trpms.2020.2972197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Carra P, Bertazzoni M, Bisogni MG, Cela Ruiz JM, Del Guerra A, Gascon D, Gomez S, Morrocchi M, Pazzi G, Sanchez D, Sarasola Martin I, Sportelli G, Belcari N. Auto-Calibrating TDC for an SoC-FPGA Data Acquisition System. IEEE Trans Radiat Plasma Med Sci 2019. [DOI: 10.1109/trpms.2018.2882709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kostara E, Sportelli G, Belcari N, Camarlinghi N, Cerello P, Del Guerra A, Ferrero V, Fiorina E, Giraudo G, Morrocchi M, Pennazio F, Pullia M, Rivetti A, Rolo MD, Rosso V, Wheadon R, Bisogni MG. Particle beam microstructure reconstruction and coincidence discrimination in PET monitoring for hadron therapy. Phys Med Biol 2019; 64:035001. [PMID: 30572320 DOI: 10.1088/1361-6560/aafa28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Positron emission tomography is one of the most mature techniques for monitoring the particles range in hadron therapy, aiming to reduce treatment uncertainties and therefore the extent of safety margins in the treatment plan. In-beam PET monitoring has been already performed using inter-spill and post-irradiation data, i.e. while the particle beam is off or paused. The full beam acquisition procedure is commonly discarded because the particle spills abruptly increase the random coincidence rates and therefore the image noise. This is because random coincidences cannot be separated by annihilation photons originating from radioactive decays and cannot be corrected with standard random coincidence techniques due to the time correlation of the beam-induced background with the ion beam microstructure. The aim of this paper is to provide a new method to recover in-spill data to improve the images obtained with full-beam PET acquisitions. This is done by estimating the temporal microstructure of the beam and thus selecting input PET events that are less likely to be random ones. The PET detector we used was the one developed within the INSIDE project and tested at the CNAO synchrotron-based facility. The data were taken on a PMMA phantom irradiated with 72 MeV proton pencil beams. The obtained results confirm the possibility of improving the acquired PET data without any external signal coming from the synchrotron or ad hoc detectors.
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Affiliation(s)
- E Kostara
- Istituto Nazionale di Fisica Nucleare (INFN), Pisa, Italy. Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy
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Fiorina E, Ferrero V, Pennazio F, Baroni G, Battistoni G, Belcari N, Cerello P, Camarlinghi N, Ciocca M, Del Guerra A, Donetti M, Ferrari A, Giordanengo S, Giraudo G, Mairani A, Morrocchi M, Peroni C, Rivetti A, Da Rocha Rolo M, Rossi S, Rosso V, Sala P, Sportelli G, Tampellini S, Valvo F, Wheadon R, Bisogni M. Monte Carlo simulation tool for online treatment monitoring in hadrontherapy with in-beam PET: A patient study. Phys Med 2018; 51:71-80. [DOI: 10.1016/j.ejmp.2018.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/29/2018] [Accepted: 05/02/2018] [Indexed: 10/17/2022] Open
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Spagnoli LG, Dell'Isola C, Sportelli G, Mauriello A, Rizzo F, Casciani CU. Primary Malignant Fibrous Histiocytoma of Storiform-Pleomorphic Type: A Case Report of an Ano-Rectal Localization. Tumori 2018; 70:567-70. [PMID: 6099619 DOI: 10.1177/030089168407000616] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Among the various localizations of primary malignant histiocytoma, the ano-rectal one is exceedingly rare. In this paper we report a case characterized by a storiform-pleomorphic pattern of the tumor and a rapid fatal course of the disease with metastasis in the lungs. The prognostic value of the histologic features is briefly discussed.
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Abstract
OBJECTIVES Hemorrhoids are a very common condition. The treatment depends upon persistence and severity of symptoms. For hemorrhoids of II and III grade the rubber band ligation may be therapeutic. Our aim is to report the outcomes of rubber band ligation of hemorrhoids, with a follow up of 6 months. MATERIALS AND METHODS A total of 50 patients underwent rubber band ligation for symptomatic hemorrhoids (grade II and III) without prolapse, between June 2012 and June 2014. All patients underwent plug test to rule out presence of rectal mucosal prolapse and were classified according to PATE classification (1). Each hemorrhoid was ligated with one rubber band through a ligator. All patients were evaluated immediately at the end of the procedure, after ten days and six months after the treatment. Patient's demographic and operative data were collected and analyzed. RESULTS The mean patients age was 47.6±12.3 years (range 24-72). All procedures were performed without complications. Before rubber band ligation, 42 patients had rectal bleeding, 38 had perineal discomfort and 27 had itching. Ten days after the treatment, 12 patients presented self-limited rectal bleeding, but 10 of these had more hemorrhoids and underwent a second rubber band ligation. No patients complained perineal discomfort, and 8 patients had itching; 78% and 16% of patients respectively, experienced feeling of a foreign body inside the canal anal and anal pain. After 6 months, only 13 patients were occasionally symptomatic: 4 patients had rectal bleeding, 2 had perineal discomfort and 4 had itching. Three more patients presented both perineal discomfort and hitching. None had the feeling of a foreign body in anal canal or anal pain. CONCLUSIONS Rubber band ligation is an efficacious, cost-effective and simple treatment for the second and third degree hemorrhoids without rectal mucosal prolapsed. In our hands, no severe complications developed and minor complications could be handled with ease.
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Affiliation(s)
- F Gaj
- Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini - Ospedale Israelitico, Roma, Italia
| | - I Biviano
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italia
| | - G Sportelli
- Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini
| | - L Candeloro
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italia
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Piliero MA, Pennazio F, Bisogni MG, Camarlinghi N, Cerello PG, Del Guerra A, Ferrero V, Fiorina E, Giraudo G, Morrocchi M, Peroni C, Pirrone G, Sportelli G, Wheadon R. Full-beam performances of a PET detector with synchrotron therapeutic proton beams. Phys Med Biol 2016; 61:N650-N666. [PMID: 27819254 DOI: 10.1088/0031-9155/61/23/n650] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Treatment quality assessment is a crucial feature for both present and next-generation ion therapy facilities. Several approaches are being explored, based on prompt radiation emission or on PET signals by [Formula: see text]-decaying isotopes generated by beam interactions with the body. In-beam PET monitoring at synchrotron-based ion therapy facilities has already been performed, either based on inter-spill data only, to avoid the influence of the prompt radiation, or including both in-spill and inter-spill data. However, the PET images either suffer of poor statistics (inter-spill) or are more influenced by the background induced by prompt radiation (in-spill). Both those problems are expected to worsen for accelerators with improved duty cycle where the inter-spill interval is reduced to shorten the treatment time. With the aim of assessing the detector performance and developing techniques for background reduction, a test of an in-beam PET detector prototype was performed at the CNAO synchrotron-based ion therapy facility in full-beam acquisition modality. Data taken with proton beams impinging on PMMA phantoms showed the system acquisition capability and the resulting activity distribution, separately reconstructed for the in-spill and the inter-spill data. The coincidence time resolution for in-spill and inter-spill data shows a good agreement, with a slight deterioration during the spill. The data selection technique allows the identification and rejection of most of the background originated during the beam delivery. The activity range difference between two different proton beam energies (68 and 72 MeV) was measured and found to be in sub-millimeter agreement with the expected result. However, a slightly longer (2 mm) absolute profile length is obtained for in-spill data when compared to inter-spill data.
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Affiliation(s)
- M A Piliero
- Department of Physics, University of Pisa, Pisa, Italy. INFN, Pisa, Italy
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Rosso V, Battistoni G, Belcari N, Camarlinghi N, Cirrone G, Collini F, Cuttone G, Ciocca M, Del Guerra A, Ferrari A, Ferretti S, Kraan A, Mairani A, Pullia M, Molinelli S, Romano F, Sala P, Sportelli G, Zaccaro E. DoPET: an in-treatment monitoring system for particle therapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30188-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cerello P, Battistoni G, Belcari N, Bisogni M, Camarlinghi N, Cicirello F, Cirrone G, Coli S, Corsi F, Cuttone G, De Lucia E, Del Guerra A, Delogu P, Faccini R, Ferretti S, Fiorina E, Giraudo G, Kraan A, Licciulli F, Liu B, Marino N, Marzocca C, Mataresse G, Morone C, Morrocchi M, Muraro S, Nicoloni R, Pennazio F, Peroni C, Piersanti L, Piliero M, Pirrone G, Rivetti A, Romano F, Rosso V, Sal P, Sarti A, Sciubba A, Sportelli G, Wheadon R. 44: Simulation of Hadrontherapy In-beam monitoring at CNAO with the INSIDE detector. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34065-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Patera V, Battistoni G, Belcari N, Bisogni M, Camarlinghi N, Cerello P, Ciciriello F, Cirrone G, Coli S, Corsi F, Cuttone G, De Lucia E, Del Guerra A, Delogu P, Faccini R, Ferretti S, Fiorina E, Giraudo G, Kraan A, Licciulli F, Liu B, Marino N, Marzocca C, Matarrese G, Morone C, Morrocchi M, Muraro S, Nicolini R, Peroni C, Piersanti L, Piliero M, Pirrone G, Rivetti A, Romano F, Rosso V, Sala P, Sarti A, Sciubba A, Sportelli G, Wheadon R. 152: An integrated monitoring system for the on-line assessment of particle therapy treatment accuracy. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sportelli G, Belcari N, Camarlinghi N, Cirrone GAP, Cuttone G, Ferretti S, Kraan A, Ortuño JE, Romano F, Santos A, Straub K, Tramontana A, Guerra AD, Rosso V. First full-beam PET acquisitions in proton therapy with a modular dual-head dedicated system. Phys Med Biol 2013; 59:43-60. [DOI: 10.1088/0031-9155/59/1/43] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Sportelli G, Ortuño JE, Vaquero JJ, Desco M, Santos A. Massively parallelizable list-mode reconstruction using a Monte Carlo-based elliptical Gaussian model. Med Phys 2012; 40:012504. [DOI: 10.1118/1.4771936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gaj F, Andreuccetti J, Sportelli G, Bottari S. [Mucoprolassectomy with circular stapler: early results with a new device]. Clin Ter 2012; 163:e53-e55. [PMID: 22555834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIMS Stapled transanal mucosectomy is widely used by a lot of surgeon and in RCT, when compared to other haemorrhoidectomy techniques, it didn't show a real primacy. We describe results obtained with a new device, the EEA™ 33-mm Hemorrhoid and Prolapse Stapler Set con DST Series™ (Covidien™), used on 65 patients. PATIENTS AND METHODS Sixty-five patients underwent a stapled transanal mucosectomy for grade III (n° 20), IV (n° 15) haemorrhois and rectal prolapse (n° 30). The operation were performed by two surgeons. Results. Resected tissue had a mean width of 4.2 cm (3.3-6.1 cm) and a mean weight of 11 g (8-21 g). Surgical time were 22 min (15-35 min). Bleeding of the suture line were observed in 5 cases (7.7%) and they required a mean of 2 haemostatic stitch (1-5) in adsorbable suture 2/0. Mucoprolapsectomy was considered excellent in 55 patients (84.7%), good in 8 patients (12.3%), bad in 2 patients (3%) by surgeons. There were no early and late complications like bleeding, abscesses, anastomotic dehiscence. We report two case of perianal haematoma that don't need any treatment and one case of anal stenosis treated with dilatation therapy. Post-operative pain, estimated with VAS, emphasized an excellent response to NSAIDs in first postoperative day, in 10 cases (15.4%) we prolonged analgesic therapy for 3 days, in one case (1.5%) for one week. After 6 month all patients were revaluated with physical examination and anoscopy. Only one patient (1.5%) had an asymptomatic recurrence of rectal prolapse. CONCLUSION We conclude that the new device makes easy and standardized surgery. The new device reduce a lot of difficult in patients with tight pelvis and a small distance between ischiatic tubers.
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Affiliation(s)
- F Gaj
- Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini, Universita' Sapienza di Roma, Unita' di Chirurgia Generale, Villa Tiberia, Casa di Cura Privata Convenzionata, Roma, Italia.
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Batori M, Straniero A, Pipino R, Chatelou E, Sportelli G. Stapled hemorrhoidopexy in the treatment of hemorrhoid disease. Our eight-year experience. MINERVA CHIR 2010; 65:21-25. [PMID: 20212414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Stapled hemorrohoidopexy using Longo technique (PPH) is accompanied by good postoperative outcomes. The aim of this study was to report the data regarding our experience with stapled hemorrhoidopexy, the results of the operations and the complications rate in comparison with those published in the literature. METHODS In our Department 127 patients with symptomatic hemorrhoids have been selected between November 2000 and December 2008 for PPH. This retrospective study included patients with a rectal prolapse from second to fourth degree. RESULTS Two patients had an anal bleeding on the day of surgery. All of them were returned to the operating theatre. A third patient had an anal bleeding that did not require a second surgical intervention. In one case a postoperative stenosis occurred that required a reoperation three days after the dismission from hospital. In one case an urgency occurred, with transitional fecal incontinence, spontaneously regressed two weeks after the intervention. No urinary retention occurred in our caseload. Pain was referred by 37 patients and was controlled by standard analgesia in all cases. No cases of chronic pain were detected. There were no cases of anal stenosis, permanent incontinence or deaths in this series. CONCLUSION Among the cases examined important complications occurred in five (3.9%), but reintervention was necessary only for three patients (2.4%). This study confirms that PPH, used on patients with a rectal prolapse from second to fourth degree, is feasible and safe.
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Affiliation(s)
- M Batori
- Department of Surgery Francesco Durante, La Sapienza University, Rome, Italy.
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17
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Gaj F, Sportelli G, Veltri S, Crispino P. [Proctological surgery: use of a salsobromoiodic gel solution in the post-operative period]. Clin Ter 2009; 160:111-113. [PMID: 19452098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND This study was aimed to demonstrate the advantages and the efficacy of a salsobromoiodic gel solution sponge to use in coloproctology after surgery for the most frequent pathologies of anal canal and of perineal region. MATERIALS AND METHODS The Authors have tested the salsobromoiodic gel solution (Fertomcidina U) in a consecutive series of patients referred to 5 coloproctological centers where they have been submitted to surgery for pathologies of anal canal and of perineal region. A total of 30 patients, 15 with clinico-instrumental diagnosis of III-IV degree haemorrhoids and 15 with diagnosis of chronic anal fissure entered in a clinical follow-up after an out-patient setting or surgery for the respective pathologies. The gel formulation is realized as a salsobromoiodic solution containing salicylic acid and magnesium biphosphate making a strong bactericide and fungicide action applicable on human skin for tissues reparation and their re-epithelization. The experimental treatment was performed on the duration of at least 10 days, with two topic applications. RESULT In 100% of the treated patients, the used gel has determined the prevention of infective complications, favouring a normal re-epithelization of tissue submitted to surgery or affected by previous anal mucosal lesions. The use of gel has not caused irritation and skin damage. No symptom and sign of toxicity were observed. CONCLUSIONS The use of salsobromoiodic gel solution has been useful to prevent infections and to contribute to the cicatrisation, healing and re-epithelization of anal mucosal lesions after surgery on a normal outpatients setting. The use of gel formulation resulted easy and satisfactory for the patients affected by the most frequent proctological pathologies which require a surgical treatment.
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Affiliation(s)
- F Gaj
- Dipartimenti di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini, Università degli Studi di Roma, Rome, Italy.
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18
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Fiocca E, Ceci V, Donatelli G, Moretta MG, Santagati A, Sportelli G. Palliative treatment of upper gastrointestinal obstruction using self-expansible metal stents. Eur Rev Med Pharmacol Sci 2006; 10:179-82. [PMID: 16910347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Gastric outlet obstruction is either a late event in the natural history of bilio-pancreatic tumors or the result of recurrent gastric or pancreatic tumors. Self-expansible metal stents, inserted under endoscopic and fluoroscopic control, can be used for palliative treatment. The present study was aimed at evaluating both the feasibility and the results of stenting in patients with malignant gastric outlet obstruction; in addition, some technical suggestions are presented. A total of 33 patients, who had a metal stent positioned, were retrospectively evaluated; 20 of them were women and 13 were men, aged from 45 to 94 years, with a mean age of 75 years. Twenty-seven patients had a pancreatic adenocarcinoma, 4 had a stricture of a gastrojejunal anastomosis due to recurrent pancreatic tumor, 2 had a stricture of a gastrojejunal anastomosis secondary to gastric cancer surgery. No postoperatory complications were observed. Improvement in the quality of life was obtained in all patients. Following the stenting procedure, the median duration of hospitalization was 8 days (range: 6-20 days), and the mean survival rate was 12 weeks (range: 2-66 weeks). Endoscopic stenting for the palliation of malignant gastric outlet obstruction is feasible and is well tolerated by most patients. In some cases a period of enteral nutrition had to be necessarily carried out; nonetheless, the insertion of the stent improved the quality of life.
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Affiliation(s)
- E Fiocca
- Department of Surgical Endoscopy, P Stefanini Department of General Surgery, La Sapienza University, Umberto I General Hospital, Rome, Italy.
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19
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Batori M, Chatelou E, Mariotta G, Sportelli G, Straniero A, Casella G, Casella MC. Giant mesenteric fibromatosis. Eur Rev Med Pharmacol Sci 2005; 9:223-5. [PMID: 16128042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Mesenteric fibromatosis is a proliferative fibroblastic neoplasia of the small intestine mesentery which may occur as a unique or multiple formation. Mesenteric fibromatosis represents the 8% of all desmoid neoplasm. Giant mesenteric fibromatosis is uncommon by itself (2-4 case/milion/year). Since the rarity of this tumor and the difficulties in diagnostic and therapeutic ambit, we believe it justified to describe a case of giant mesenteric fibromatosis which came to our observation.
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Affiliation(s)
- M Batori
- Department of Surgical Sciences and Applied Medical Technologies, La Sapienza University--Rome, Italy
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20
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Santagati A, Ceci V, Donatelli G, Pasqualini MJ, Silvestri F, Pitasi F, Sportelli G, Fiocca F. Palliative treatment for malignant jaundice: endoscopic vs surgical approach. Eur Rev Med Pharmacol Sci 2003; 7:175-80. [PMID: 15206487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
In this retrospective, comparative study a total of 107 patients, presenting with malignant inoperable strictures of common bile duct, due to a pancreatico-biliary malignancy, underwent palliative treatments. In a group, consisting of 82 patients (76.64%), endoscopic stenting procedures were performed; polyethylene stents or self-expanding metal stents were applied in 37 and 45 patients, respectively. The prerequisites for a successful endoscopic stenting were a) accuracy of diagnosis and b) exclusion of patients presenting with tumors potentially treatable by a curative resection. In the other group, consisting of 25 patients (23.36%), biliary-enteric bypass procedures were performed. Endoscopic treatment was successful in 97.5% of the cases (80/82); complication rate was 7.3% (6 patients on 82), and mortality rate was 3.6% (3 patients on 82). Median hospital stay was 13.4 and 7.3 days in patients treated with plastic stents and metallic stents, respectively. Bypass surgery was successful in 99% of the cases (24/25); complication rate was 24% (6 patients on 25), and mortality rate was 16% (4 patients on 25). Median hospital stay was 26 days. For the patients in whom a curative resection could not be performed, both the above mentioned methods resulted in a high rate of immediate technical and therapeutic success. However, the surgical approach showed a significantly higher rate in procedure-related mortality and morbidity; in addition, the hospital stay lasted longer in surgically treated patients. The patients who are definitely unsuitable for curative resection are better managed by positioning a stent. The use of metal stents should be preferred in those less serious patients who may supposedly survive longer.
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Affiliation(s)
- A Santagati
- Surgery Department "P. Stefanini", University of Rome "La Sapienza", Rome, Italy
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21
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Abstract
We describe the case of an elderly woman with rapid destruction of the right hip followed by the same involvement of her left hip 10 months later. The clinical history, the physical examination and radiographic images suggested the diagnosis of rapidly destructive hip disease. This disease is a distinct entity, unilateral in 80%-90% of cases, which requires extensive investigation and special efforts for its identification. Essential elements for the differential diagnosis are discussed.
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Affiliation(s)
- C Trevisan
- Orthopedics Clinic, San Gerardo Hospital, Bicocca University of Milan, Via Donizetti 106, I-20052 Monza (MI), Italy Tel.: +39-039-2332322 Fax: +39-039-2302905 E-mail: , Italy
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22
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Fiocca F, Santagati A, Ceci V, Donatelli G, Pasqualini MJ, Moretti MG, Speranza V, Di Giuli M, Minervini S, Sportelli G, Giri S. ERCP and acute pancreatitis. Eur Rev Med Pharmacol Sci 2002; 6:13-7. [PMID: 12608652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Acute biliary pancreatitis (ABP) is a serious complication of biliary stones disease and is associated with significant morbidity and mortality. The role of ERCP in the management of ABP has been the focus of discussion in recent years. In this report, we evaluated a protocol of emergency Endoscopic retrograde Cholangiopancreatography (ERCP) (within 24 hours) and early ERCP (within 72 hours). From July 1997 to July 2000, were observed 45 patients (19 man and 26 women) with acute biliary pancreatitis. Mean age of patients was 63.4 years (range 21-87 years). Diagnosis of ABP was based on anamnesis and clinical assessment and was confirmed by specific laboratory data (hyperamylasemia, hyperlipasemia, total and fractionated bilirubinemia, gamma-GT, transaminase, alkaline phosphatase, hypocalcemia, hyperglycemia, leukocytosis). Ultrasound scanning within 24 h of admission was performed in 45 patients (100%) and it revealed gallbladder stones and muddy bile in 39 patients (87%). Computed tomography (CT) performed in all patients, showed a severe acute pancreatitis in the second or subsequent week following admission. The severity of acute pancreatitis was established by Glasgow's criteria and by clinical details of patients. ERCP and Endoscopic Sphinterotomy (ES) was performed in all 45 patients with acute biliary pancreatitis. Twenty-six patients (57%) were classified as having a severe attack (> 4) 19 as having a mild attack by Glasgow's criteria. ERCP associated with ES was performed within 24 hours in 22 patients (49%), 11 (50%) showed a severe attack and 11 (50%) showed a mild attack. A total of 2 complications (4%) occurred and the mortality was of 2 patients (4%). In 23 patients (51%) ERCP and ES was performed within 72 hours after conservative therapy, 8 (35%) showed a mild attack and 15 (65%) showed a severe attack. A total of 5 complications (9%) occurred and the mortality was of 3 patients (6%). Our study showed that ERCP with endoscopic sphincterotomy can be performed safely by skilled endoscopist, without adverse consequences soon after the onset of acute biliary pancreatitis even within the first 24 hours and it showed that is better than ERCP within 72 hours after conservative therapy.
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Affiliation(s)
- F Fiocca
- Department of General Surgery P. Stefanini, University La Sapienza, Rome, Italy
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23
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Lazzaro M, Giri S, Lippolis M, Gallina S, Carrara A, Pitasi F, Annessi M, Batori M, Prece V, Sportelli G. Sentinel node role in breast cancer surgery. Eur Rev Med Pharmacol Sci 2001; 5:181-4. [PMID: 12201669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Radical surgery of breast cancer includes lymphadenectomy of axilla as well as the dissection of the neoplastic tissue. However recently many works have raised doubts on the opportunity of performing routinary axillary dissection, which elevates morbidity risk, in absence of axillary metastases. However, unfortunately, information on axillary lymph node pathology, is not available with any other technique excluding complete dissection and istopathological examination. Sentinel node technique is a new methodology that consents evaluation of lymph node status in the operating theatre. It allows the surgeon to judge on the opportunity of carrying out the lymphadenectomy or not.
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Affiliation(s)
- M Lazzaro
- Istituto di II Clinica Chirurgica, University La Sapienza, Rome, Italy
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24
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Sportelli G, Crovaro M, Mercuri M, Carrara A, Giri S, Fiocca F. Conservative approach in the treatment of the biliary tract's iatrogenic lesions. Eur Rev Med Pharmacol Sci 2000; 4:123-6. [PMID: 11710509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Iatrogenic lesions of the biliary tract have always represented a problem of real actuality in the abdominal surgery. The incidence of post-cholecystectomy complications is from 0.1% to 0.25% and it's increased to 0.3-0.6% for laparoscopic surgery. Potential predisposing factors to iatrogenic biliary lesions are anatomic anomalies, acute and chronic phlogosis and technical mistakes. Anatomic anomalies are present in 6-25% of all cases according to different statistics; an incomplete knowledge of the biliary tract can predispose to a mistake legating or dissecting a wrong branch. This paper present a caseload of 27 patients admitted to our Service of Digestive Endoscopy owing to post laparoscopic cholecystectomy complications. Patients have been recruited in a period from two days to six months to the intervention. Detected complicances have been divided in "major", which comprehended biliary lesions (7 cases) and biliary stenosis (8 cases), and in "minor" which included biliary leakages (12 cases). CPRE, PTC, Ultrasound, CT and cholangio-MR were used to diagnose the biliary damage. Conservative approach has been resolutive in all patients with minor biliary lesions and in three cases of major lesions; in seven cases of biliary stenosis endoscopic-radiologic combined treatment has been successfully performed, in the other patients surgical operation was obliged choice. Comparing our results with literature we can affirm that conservative treatment represents the first choice in case of minor lesions (100% of successes), whereas in case of major biliary lesions it constitutes a valid alternative to the reparative surgery; when surgical option results impossible to defer, it can help the surgeon identifying the damage and draining the biliary tract.
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Affiliation(s)
- G Sportelli
- Department of Surgery Paride Stefanini, La Sapienza University, Rome, Italy
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25
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Mercuri M, Distefano M, Crovaro M, Giri S, Sportelli G, Carrara A, Butti A, Marin AW. Central venous catheter disruption and embolization: percutaneous retrieval. A case report. Eur Rev Med Pharmacol Sci 2000; 4:133-8. [PMID: 11710511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Disruption followed by intravasal embolization is a rare (0.5%) however possible complication secondary to the insertion of a central venous catheter. The carriers of these implantable systems are patients who, for their cure and at times even for their survival, require the chronic intravenous infusion of drugs and solutions. Therefore materials that can allow long-term insertion with a minimum of complications are the most suitable. There are several causes of disruption and embolization of cannulae. The most common are represented by the pinch-off syndrome and catheter disconnection from reservoir. The literature on the subject is illustrated and a personal case treated with intravascular retrieval is reported.
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Affiliation(s)
- M Mercuri
- Department of Surgery Paride Stefanini, La Sapienza University, Rome, Italy
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26
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Sportelli G, Loffredo L, Lupi M, Lonardo MT, Prece V, Lazzaro M, Gallina S, Mancini B, Mugnaini L, Mugnaini L. A multidisciplinary approach to the treatment of small-cell lung cancer: the role played by surgery. Eur Rev Med Pharmacol Sci 1999; 3:261-3. [PMID: 11261737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The authors report their data on 344 cases of small-cell lung cancer treated according to indications with combined chemoradiotherapy and in selected cases with surgical intervention. In patients with limited disease, the results of pharmacologic therapy significantly improve the prognosis only in association with surgery. The role of surgery has been reappraised in the treatment of small-cell lung cancer which appears, nowadays, multidisciplinary.
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Affiliation(s)
- G Sportelli
- 2nd Department of Surgery, University La Sapienza, Rome
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27
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Batori M, Lazzaro M, Lonardo MT, Lupi M, Annessi M, Loffredo L, Mugnaini L, Sportelli G. A rare case of pulmonary neurofibroma: clinical and diagnostic evaluation and surgical treatment. Eur Rev Med Pharmacol Sci 1999; 3:155-7. [PMID: 11073121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The authors report a rare case of a pulmonary neurofibroma treated by surgical excision. The case report is accompanied by a review of the literature and the discussion of the diagnostic problems posed by neurogenic tumors of the thorax.
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Affiliation(s)
- M Batori
- IInd Department of Surgery, University La Sapienza, Rome, Italy
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28
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Amoroso A, Garzia P, Pasquarelli C, Sportelli G, Afeltra A. Hashimoto's thyroiditis associated with urticaria and angio-oedema: disappearance of cutaneous and mucosal manifestations after thyroidectomy. J Clin Pathol 1997; 50:254-6. [PMID: 9155680 PMCID: PMC499824 DOI: 10.1136/jcp.50.3.254] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 60 year old woman affected by Hashimoto's thyroiditis presented with a history of recurring episodes of urticaria and angio-oedema. Clinical and laboratory evaluation of the patient excluded allergy to external agents, hereditary angio-oedema, and occult infections. A pathogenic relation between Hashimoto's thyroiditis and chronic urticaria/angio-oedema was suspected. However, treatment with L-thyroxine had no influence on the frequency and severity of the cutaneous and mucosal manifestations, which occurred almost daily and required repeated administration of steroids. The patient therefore underwent total thyroidectomy. Cytometric analysis of intrathyroidal lymphocyte subsets showed unusual abnormalities. Urticaria and angio-oedema completely remitted after surgery; 18 months postoperatively the patient was still asymptomatic.
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Affiliation(s)
- A Amoroso
- Department of Clinical Medicine, University of Rome, La Sapienza, Italy
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29
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Amoroso A, Cossu MF, Mariotti A, Guido F, Ferri GM, De Rosa FG, Sportelli G. [Increased plasma levels of endothelin in patints with essential arterial hypertension]. Riv Eur Sci Med Farmacol 1996; 18:33-7. [PMID: 8766780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Endothelin-1 (ET-1) is an endothelium-derived vasoconstrictive peptide. In this study the Authors measured in 25 subjects (15 with essential hypertension and 10 normal) plasma levels of endothelin-1. Patients with hypertension had significantly higher plasma ET-1 concentration than normal subjects (2.18 +/- 1.07 vs. 1.36 +/- 0.40 pg/ml, p < 0.02). Plasma arginine vasopressin, renin activity and aldosterone concentration did not show significant differences between hypertensive and normotensive subjects. These data suggest that ET-1 may be involved in the development or maintenance of hypertension.
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Affiliation(s)
- A Amoroso
- Dipartimento di Medicina Clinica, Università degli Studi La Sapienza, Roma
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30
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Dell'Isola C, Pacella A, Stroppa I, Sportelli G. [Anatomo-surgical notes on transhiatal access in esophagectomy]. G Chir 1990; 11:551-6. [PMID: 2288843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Authors through an anatomic study on 20 cadavers specify the surgical procedure for transhiatal esophagectomy and describe the anatomical structures involved. The proper manoeuvres and artifices to avoid intraoperative accidents are suggested. Finally, the indications for this peculiar operation are discussed.
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Affiliation(s)
- C Dell'Isola
- Patologia Speciale Chirurgica e Propedeutica Clinica, II Università degli Studi Tor Vergata, Roma
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31
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Dell'Isola C, Tucci G, Sportelli G, Stroppa I. [Anatomo-surgical findings on structure and function of the esophageal hiatus]. G Chir 1989; 10:549-52. [PMID: 2518291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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32
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Dell'Isola C, Tucci GF, Sportelli G, Tarallo M. [Transdiaphragmatic access to the thoracic aorta. Anatomo-surgical findings]. G Chir 1988; 9:895-9. [PMID: 3152904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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33
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Sgalambro A, Marras A, Lombardi F, Guasconi C, Schiavone G, Sportelli G, Del Giudice S, Marinoni C. [Non-invasive evaluation with continuous Doppler of the systolic pressure of the right ventricle in patients with tricuspid insufficiency]. G Ital Cardiol 1987; 17:667-72. [PMID: 3692071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Tricuspid regurgitation (TR) is detected by Doppler echocardiography in a high proportion of patients with right ventricle pressure or volume overload. Continuous wave Doppler (CW) provides a noninvasive estimation of the transtricuspid systolic pressure gradient, applying the modified Bernoulli formula to the maximum velocity of the TR jet. The purpose of this study was to test the accuracy of the CW prediction of systolic right ventricular pressure (RVPs), obtained adding a clinical estimate of the mean right atrial pressure (RAPm) to the Doppler derived pressure gradient. The study population consisted of 22 adult patients with Doppler proved TR, undergoing right heart catheterization (cath) for mitral valve disease (12 pts), atrial septal defect (8 pts), dilated cardiomyopathy (1 pt) or pulmonary hypertension (1 pt). Two studies were duplicated after nifedipine administration. TR was graded by pulsed Doppler flow mapping as mild in 7, moderate in 11, severe in 4 pts. RAPm was estimated clinically from the inspection of neck veins pulsatility (mmHg = pulsatility cm+5/1.3). At CATH RVPs ranged from 27 to 80 (46 +/- 17) mmHg, RAPm from 0 to 13 (6 +/- 3) mmHg. RVPs Doppler prediction showed a close correlation with CATH (r .97, SEE 4.2 mmHg), with a slight mean underestimation (-2 +/- 4 mmHg) (Fig. 3, Tab. I). The discrepancies between CW and CATH ranged from -9 to +10 mmHg, almost entirely due to inaccuracy of the RAPm clinical estimate (r .48, see 3.8 mmHg) (Fig. 4, Tab. I).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Sgalambro
- Servizio di Cardiologia, Ospedale Civico, Codogno, Milano
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34
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Dell'Isola C, Bonanome M, Laganà A, Sportelli G, Correnti S. [Problems and controversies in the management of the perineal cavity after amputation of the rectum by the Miles abdomino-perineal method for carcinoma]. MINERVA CHIR 1987; 42:465-7. [PMID: 3614696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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35
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Rizzo F, Dell'Isola C, Laganà A, Sportelli G, Casciani CU. [Carcinoma of the extrahepatic bile ducts. Diagnosis and treatment]. MINERVA CHIR 1985; 40:339-41. [PMID: 4000507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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36
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Marinoni C, Lombardi F, Guasconi C, Sportelli G. [Controlled clinical investigation of sotalol and alphamethyldopa in hypertensive patients]. Cardiologia 1984; 29:405-13. [PMID: 6391519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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37
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Rizzo F, Dell'Isola C, Sportelli G, Laganà A, Casciani CU. [Controversies and current attitudes in the surgical therapy of neoplasms of the head of the pancreas]. MINERVA CHIR 1984; 39:741-4. [PMID: 6472682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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38
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Rizzo F, Dell'Isola C, Laganà A, Sportelli G, Casciani CU. [Role of cephalic duodenopancreatectomy in benign and malignant diseases of the head of the pancreas. Indications and notes of technic]. MINERVA CHIR 1984; 39:745-50. [PMID: 6472683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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