Splenic and concomitant liver abscess after laparoscopic sleeve gastrectomy

Introduction: Laparoscopic sleeve gastrectomy (LSG) is a safe and effective procedure for losing weight and gaining control of obesity-related comorbidities. However, it is associated with postoperative complications such as bleeding, leak, and midgastric stenosis. Splenic and hepatic abscesses have been reported as unusual and rare complications after primary LSG. We report a case of splenic and concomitant hepatic abscesses after primary LSG, successful minimally invasive management, and midterm follow-up. Case Description: We report a complex case of splenic abscess with satellite hepatic abscess plus splenic thrombosis (0.1%) diagnosed 67 days after LSG. This unusual complication was managed by a minimally invasive approach (spleen sparing) with complete resolution after 35 days. After 18 months of follow-up, the patient showed complete resolution of the splenic and liver abscesses and progressive loss of excess weight. Conclusion: In high-volume centers, rare and life-threatening complications such as splenic and hepatic abscesses may be observed. The minimally invasive approach could represent an effective option of avoiding splenectomy in selected case

Physico-chemical and thermochemical studies of the hydrolytic conversion of amorphous tricalcium phosphate into apatite

The conversion of amorphous tricalcium phosphate with different hydration ratio into apatite in water at 25 °C has been studied by microcalorimetry and several physical–chemical methods. The hydrolytic transformation was dominated by two strong exothermic events. A fast, relatively weak, wetting process and a very slow but strong heat release assigned to a slow internal rehydration and the crystallization of the amorphous phase into an apatite. The exothermic phenomenon related to the rehydration exceeded the crystalline transformation enthalpy. Rehydration occurred before the conversion of the amorphous phase into apatite and determined the advancement of the hydrolytic reaction. The apatitic phases formed evolved slightly with time after their formation. The crystallinity increased whereas the amount of HPO4 2− ion decreased. These data allow a better understanding of the behavior of biomaterials involving amorphous phases such as hydroxyapatite plasma-sprayed coating

Primi casi di naturalizzazione del noce nero (Juglans nigra L.) (Juglandaceae) in Sicilia

Il presente studio riporta i primi casi di naturalizzazione del noce nero in Sicilia. Il possibile ruolo giocato dagli animali disseminatori e dalle condizioni climatiche locali sono stati discussi

Proteomic identification of salivary biomarkers in 20 patients with Oral Squamous Cell Carcinoma

Objectives. Saliva has been proposed as a potential diagnostic fluid combined with proteomic analysis. The aim of this study is to assess the proteomic salivary profile using SELDI-TOF-MS technology in patients with Oral Squamous Cell Carcinoma (OSCC), grouped in relation to the TNM staging and compared with healthy subjects. Methods. In this secondary hospital based case-control study, patients with confirmed histopathological diagnosis of primary untreated OSCC as “cases” and healthy age- and sex-matched subjects as “controls” were consecutively enrolled, after informed consent. Saliva (5 mL) was collected by spitting directly into a clean 15 mL conical tube, aliquoted and stored at -80°C until use. SELDI-TOF Q10 ProteinChip system was used to screen for differentially expressed proteins in the saliva samples according to the manufacturer’s instructions (BioRad Inc). Univariate statistics and Roc plot were used for data analysis. Results. Twenty cases (6 M, 14 F, middle age 66.8 yy) and 20 controls (8 M, 12 F, middle age 61.9 yy) were included. In cases, seven were early-EsOSCC (3 stage I and 4 stage II) and 13 were late-LsOSCC (7 stage III and 6 stage IV). Proteomic analysis showed significant statistical differences in peptide profile in control vs OSCC and in EsOSCC vs LsOSCC samples (p<0.05). The differentiated pattern between overall OSCC and controls consisted of one peptide peak (8940-ROC:1), between EsOSCC and controls of four peptide peaks (7096-ROC 0.93; 12712–ROC:0.89; 8086 – ROC: 0.93 and 11002 – ROC:0.93) and between LsOSCC and EsOSCC of one peptide peak (6026-ROC 0.80). Conclusions. Although with limitation of the small sample size, this first study suggests that saliva contains proteomic signatures that could serve as biomarkers for OSCC at different stages. Once validated on a large clinical cohort, oral fluid proteomic based on SELDI-TOF-MS technology may be extensively used as a promising new non-invasive tool for early diagnosis in oral cancer patients

Oral amelanotic melanoma: a case report

Objectives. Primary oral melanoma is a very rare malignancy, representing about 0.5% of all melanomas, characterized by a wide clinical-histological variability and a very aggressive behavior. Aim of the present study is to describe a case of oral amelanotic melanoma, an infrequent variant with a poorer prognosis than that of pigmented melanomas for a more aggressive biological behavior and frequent delays for the correct diagnosis and for starting the treatment. Case report. A 53-year-old white man referred at the Department Surgical, Oncological and Oral Sciences for a macular, scarsely pigmented lesion with irregular margins, located on anterior region of hard palate. The lesion, completely asymptomatic and without any history of trauma or injury, was observed by his dentist some months ago. The patient was a smoker (about 20 cigarettes a day for 30 years) and his anamnesis was negative for any systemic diseases and drug assumption. Histological examination, following the incisional biopsy, showed the hyperplasia of the junctional melanocytes with occasionally dendritic appearance and light atypia; on the recommendation of pathologist, a second incisional biopsy was performed, and a definitive diagnosis of “amelanotic melanoma in situ” was confirmed. After diagnosis, the patient was referred to the unit of Head and Neck Surgery for staging and surgical approach of the lesion. Conclusions. This case report underlines the importance to perform biopsy of all lesions of the oral cavity to rule out malignancy, even when slightly colored, asymptomatic and with a clinically harmless presentation. Besides benign diseases (e.g melanotic macules, nevi, extravasation of blood pigments, amalgam tattoos and deposition of other exogenous/endogenous pigments), rare variant of non-pigmented melanoma should be considered in order to avoid a dangerous diagnostic and therapeutic delay

Oral HPV Infection: Current Strategies for Prevention and Therapy

Infection with High Risk (HR) Human Papillomaviruses (HPVs) is the main aetiological agent of Cervical Squamous Cell Carcinoma (CSCC) and also associated in a subgroup of other neoplasms, including Oropharyngeal Squamous cell Carcinoma (OPSCC). HPV infection, in genital as in oral mucosa can also be subclinical or associated with benign proliferative lesions (common warts, condylomas, papillomas) caused mostly by infection with Low Risk (LR)-HPVs. In the last decades, extensive research has resulted in growing knowledge on HPV biology and specifically viral life cycle, biochemical properties of viral proteins and their interaction with the host proteins leading to potential new targets of prophylactic or therapeutic vaccines and therapies for HPV infection. In addition, notable progresses have been made in the field of diagnostics to detect HPV DNA or RNA. The recent epidemiological data suggest the significant changes in HPV endemic, due to the changes in sexual habits especially among young generations (i.e. early sexual debuts, multiple sexual partners, oral and anal sex); this scenario has urged on the need of adequate campaigns of primary (sexual education, vaccination programs) and secondary prevention (diagnostics of HPV-related diseases). Due to the growing interest on HPV infection and HPV related cancers, the authors made a narrative review of the literature on oral HPV infection and oral-genital transmission. After this, in view of the controversies about the strategies of therapy and prevention of HPV infection, the present review focuses on the current state of art about the available tools for the therapeutic and, if any, preventive management of oral HPV infection

PRIMARY ORAL MUCOSA MELANOMA: A REPORT OF AN UNUSUAL CLINICOPATHOLOGICAL CASE

Primary oral melanoma is a rare malignancy with an aggressive behaviour. Up to date, the wide clinicalhistological variability of this oncological entity does not clarify the etiopathogenetic characteristics of these cancers and limit the therapeutic strategies. We report a case of a 64-year-old white female referred to the Dept. of Surgical, Oncological and Oral Sciences for a pigmented lesion of the mandibular gingiva, already arising 20 years ago but dimensionally increased in the last three months. Clinically, a black plaque-like pigmentation of the vestibular alveolar mucosa of the mandible (from 3.6 to 3.3) was observed. This lesions was still painless. CT dentalscan and ecography of the head and neck lymph nodes have showed no signs of bone and lymph nodes involvement. An incisional biopsy of the lesion was performed under local anaesthesia. Histopathologic examination showed a nodular proliferation of atypical melanocytic elements with epithelioid aspect and nuclear alterations; numerous abnormal mitotic figures were evident and the malignant melanocytes were characterized by marked intra/extracellular pigmentation. Immunohistochemical staining showed strong and diffuse positivity for Melan A and HMB45, 40% positive for Ki67 and positive/negative result for p16. These histopathologic features were suggestive for animal-type invasive melanoma. After diagnosis, the patient was referred to the Dept. of Head and Neck Surgery for staging and chirurgical approach of the lesion. At the best of our knowledge, only a very small number of animal-type melanomas have been reported in the oral cavity and usually with a more indolent behavior than conventional melanoma and a better prognosis. However, future reports are necessary to characterize the features of this cancer and to determine any factors that may correlate with outcome