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A gastrointestinal stromal tumor (GIST) masquerading as an ovarian mass
Giorgio Carlomagno, Pasquale Beneduce
World Journal of Surgical Oncology , 2004, DOI: 10.1186/1477-7819-2-15
Abstract: We report a case of myxoid variant of GIST in a 42 years old woman presenting as an epigastric mass associated to an ovarian cyst and elevated CA-125. Histologically, the lesions was composed of a proliferation of spindle cells in an abundant myxoid stroma, without evidence of atypia or anaplasia. Immunohistochemical stains showed strong positive staining with muscle actin, positive staining with CD34 and weak positive staining with CD117, while showed negative for S-100.At surgery every effort should be made to identify the origin of the tumor. A complete surgical removal of the tumor should be obtained, as this is the only established treatment that offers long term survival.Gastrointestinal stromal tumors (GIST) are rare tumors that may arise anywhere in the tubular gastrointestinal tract, but stomach is the most common site of localization. Surgery is the main stay of treatment and complete resection is achieved in most of cases [1]. The 5 year overall survival ranges from 21% to 88% in different series, depending from risk grading and completeness of surgical resection [1-4]. In light of the tendency of these tumors to pursue an indolent clinical course with a significant risk of late relapse, a brisk follow-up is advocated for all patients [5]. Imatinib mesylate is proposed as therapy for high risk GISTs after surgery [6]. A distinctive morphologic variant of gastrointestinal stromal tumor has been described, characterized by a prominent myxoid stromal background reminiscent of a neural neoplasm but lacking the immunohistochemical or ultrastructural features of peripheral nerve sheath or ganglionic differentiation. This variant is more frequent in women and mostly occurs in the stomach. These lesions are described grossly as well circumscribed, unencapsulated, with a prominently myxoid and often cystic cut surface [7]. We report a case of myxoid variant GIST, occurring in a 42 year old woman.A 42-year-old woman presented with pelvic pain, palpable pelvic mass
Constituindo realidades: sobre A for a do direito de Pierre Bourdieu
Márcio Cunha Carlomagno
Revista da Faculdade de Letras : Sociologia , 2011,
Factores de riesgo asociados a preeclampsia en el Hospital Nacional Daniel Alcides Carrión. Callao. Abril a junio de 2010.
Carlomagno Morales Ruiz
Revista Peruana de Epidemiologia , 2011,
Abstract: Objetivos:Calcular la incidencia de preeclampsia e identificar los factores de riesgo asociados al diagnóstico de preeclampsia. Métodos: Estudio de Casos y Controles realizado entre abril y junio de 2010 en el Hospital Nacional Daniel Alcides Carrión (HNDAC). Se incluyeron todos los casos de preeclampsia diagnosticados y cuya participación informada fue voluntaria con firma de consentimiento informado. El grupo casos contó con 132 participantes. El grupocasos estuvo pareado uno a uno según edad materna y edad gestacional. Resultados: La incidencia de preeclampsia fue de10.8%. Los factores de riesgo identificados fueron: antecedente de violencia física (OR: 1.32; IC: 1.19-4.8; <0.05), no planificación del embarazo (OR: 1.23; IC95%: 1.12-10.56; <0.05), primigravidad (OR: 1.54; IC95%: 1.3-8.72; <0.01), antecedente previo de preeclampsia (OR: 3.16; IC95%: 1.1-7.4; <0.01) eIMCalto (OR: 3.2; IC95%: 2.25-7.35; <0.01). Conclusiones: La preeclampsia es un fenómeno frecuente en el HNDAC y cuya naturaleza muestra una clara asociación con fenómenos de naturaleza psicosocial. Nuestros resultados en relación a los factores de riesgo condicen con lorevelado por la evidencia publicada. Se sugiere la creación de un programa de atención y de investigación para los casos de preeclampsia en el HNDAC.
Digital Ischemia in Patients with Solid Tumors: a Case Report and Review of the Literature  [PDF]
Lucia Raimondo, Chiara Alessandra Cella, Roberto Moretto, Elide Matano, Chiara Carlomagno
Journal of Cancer Therapy (JCT) , 2011, DOI: 10.4236/jct.2011.22036
Abstract: Digital ischemia is a rare paraneoplastic phenomenon associated with various malignancies, especially adenocarcinomas. We reported a case of digital ischemia onset during treatment with capecitabine + oxaliplatin, letrozole and epoetinbeta in a 75-year old woman with colon and breast cancer and a secondary hepatic lesion. A literature review disclosed 68 cases of solid neoplasms associated with digital ischemia. The proposed mechanisms of such clinical manifestations are various: vasospasm due to sympathetic hyperactivity, arteritis induced by tumour antigen-antibody complexes deposition or as consequence of immune deregulation, blood hyperviscosity, hypercoagulability or peripheral thrombosis. In the present case, clinical and laboratory evaluations failed to reveal evidence of thrombosis, arteritis, inherited or acquired hypercoagulable state and we postulated the peripheral vasospasm and the sympathetic activity (possibly due to chemotherapy drugs) as potential causes of the digital ischemia.
Congenital scoliosis associated with agenesis of the uterine cervix. Case report
Giorgio Carlomagno, Arturo Di Blasi, Matteo Monica
BMC Women's Health , 2004, DOI: 10.1186/1472-6874-4-4
Abstract: A 46 years old woman presenting cyphoscoliosis and very low stature (120 cm – 3,93 feet), came to our observation for acute pelvic pain; she also reported primary amenorrhoea associated with cyclic pelvic pain. Clinical and imaging evaluation, evidenced a blind vaginal duct of normal length, left cystic adnexal mass, and enlarged uterus with hematometra. FSH, LH, 17β estradiol and CA-125, karyotype and radiographic study of limbs and vertebral column were also evaluated.At laparotomy, a left ovarian cyst was found. Uterus ended at the isthmus; under this level a thin fibrous tissue band was found, joining the uterus to the vagina. Uterine cervix was replaced by fibrous tissue containing some dilated glands lined with müllerian epithelium. Karyotype resulted 46, XX. The described skeletal deformity, were consistent with Klippel-Feil syndrome.We report a case of congenital scoliosis associated with müllerian agenesis limited to uterine cervix, association thus far seen only among patients with Mayer-Rokitansky-Kuster-Hauser syndrome (utero-vaginal agenesis). This case report supports the necessity to evaluate, for accompanying müllerian anomalies, all cases of congenital structural scoliosis in view of the possibility for many müllerian development abnormalities, if timely diagnosed, to be surgically corrected.The müllerian tract is the embryologic structure that develops into the internal female genitalia. Bilateral müllerian ducts grow medially and caudally to contact and fuse then abuts with the urogenital sinus. Alterations in the normal sequence of development leads to the wide spectrum of reproductive tract abnormalities classified as lack of development or lateral or vertical fusion defects. The complete agenesis of uterus and vagina is known as Mayer-Rokitansky-Kuster-Hauser syndrome. A rare form of lack of development, regarding only a tract of the müllerian ducts, leads to the isolated uterine cervix agenesis [1,2]. Patients affected by this rare, "non commu
Evaluación docente. mecanismo equitativo y confiable o proceso viciado que no cumple con su objetivo?
Araya Alpízar, Carlomagno,Vargas Barrantes, élida
Revista Electrónica Actualidades Investigativas en Educación , 2013,
Abstract: Resumen: Este artículo es producto de la evaluación que estudiantes realizaron al cuerpo docente que labora en la Sede de Occidente, Universidad de Costa Rica. Se muestran los resultados de la evaluación docente que hacen un total de 4817 estudiantes, distribuidos en 348 grupos, en el primer ciclo de 2011. Doscientos cuatro docentes (119 varones y 85 mujeres) fueron evaluados por medio de un cuestionario. Se encontró que existe una correlación positiva lineal entre dos variables cuantitativas: la nota promedio que obtienen los estudiantes en los cursos y la calificación promedio que reciben los docentes. Esto significa que existe la probabilidad de que conforme se incrementa la nota promedio por grupo, la evaluación docente mejora y viceversa. Para el Departamento de Ciencias Naturales, los estudiantes obtienen las notas promedio más bajas en los cursos (7,1 ± 1,69) y de igual forma los docentes reciben en promedio las calificaciones más bajas (8,5 ± 1,25). En el otro extremo, se ubican los Departamentos de Educación y Filosofía, Artes y Letras en donde estudiantes y docentes reciben las mejores calificaciones (9,1 y 9,2 respectivamente). Una calificación intermedia corresponde a los docentes que laboran en el Departamento de Ciencias Sociales y en el Sistema de Educación General (8,7 y 8,8 respectivamente). Los autores recomiendan una forma de evaluación más integral; de estímulo y mejora en el proceso ense anza-aprendizaje, que considere otros ámbitos del espacio de trabajo y de la labor docente. Abstract: This article is the result of the student evaluation conducted to the faculty professors who work at the San Ramón branch of the University of Costa Rica. The results of 4817 student evaluations, distributed in 348 groups, are shown during the first cycle of 2011. Two hundred and four faculty professors (119 males and 85 females) were assessed by using a questionnaire. The study found that there is a positive linear correlation between two quantitative variables: the average grade earned by students in the courses and the average score received by teachers. This means that there is a probability that as the average grade per group increases, the faculty evaluation improves, and vice versa. In the Department of Natural Sciences, students earn the lowest average grades in the courses (7.1 ± 1.69); similarly, faculty professors obtain averaged lower scores (8.5 ± 1.25). At the other end, there are other departments like the Departments of Philosophy, Arts and Letters, and the Department of Education where students and faculty members get the best score
Porosity Distribution in Composite Structures with Infrared Thermography
Cinzia Toscano,Carosena Meola,Giovanni Maria Carlomagno
Journal of Composites , 2013, DOI: 10.1155/2013/140127
Abstract: Composite structures are increasingly used in the transport industry especially in the aeronautical sector thanks to their favorable strength-to-weight ratio with respect to metals. However, this is true if the final part is defects free and complies with quality requirements. A main weakness in composites is porosity, which is likely to be introduced during manufacturing processes and which may knock down the material characteristics affecting its performance in service. Porosity plays a key role in sandwich structures, which involve novel metal foams as core, since the foam performance strongly depends on size and distribution of pores. The determination of porosity is mostly attained by destructive methods, which supply only a general indication linked to the production part number. Conversely, composites may entail local significant variation of porosity, which may be discovered only with effective nondestructive techniques. The attention of the present work is focused on the possibility to use infrared thermography to get information about the amount and distribution of porosity. In particular, two techniques: flash thermography and lock-in thermography are used to comply with requirements of both monolithic composites and metal foams. 1. Introduction Composite structures are increasingly used in the transport industry especially in the construction of aircraft [1] thanks to their favorable strength-to-weight ratio with respect to metals. Adversely, one of the main problems is related to their intrinsic inhomogeneous structure and to defects that can be inadvertently induced during their manufacture. The mostly used composites include a polymeric matrix reinforced with either carbon, or glass fibers, which are generally referred to as fiber reinforced polymers (FRPs). Generally, plies of fibers impregnated with resin are overlaid owing to a fixed stacking sequence and cured in autoclave. The autoclave cycle involves the combined effects of temperature and pressure. Temperature is needed to activate and to control the chemical reactions in the resin, while pressure may squeeze off the resin in excess to consolidate the stacked plies and to minimize the amount of entrapped gas between the plies and within the resin [2]. In particular, setting up the vacuum pressure and maintaining it for a fixed interval have been individuated as critical parameters to be carefully monitored [3, 4] to avoid undesired formation of voids in the laminate. In fact, the presence of porosity can reduce the interlaminar shear strength causing delamination (interlamina
Risk of Second Solid Malignancy among 1000 Kidney Transplanted Patients: A Single Center Study  [PDF]
Michele L. Santangelo, Sergio Spiezia, Nicola Carlomagno, Concetta Dodaro, Cristina La Tessa, Davide De Rosa, Maria Pina Piantadosi, Andrea Renda
Open Journal of Organ Transplant Surgery (OJOTS) , 2012, DOI: 10.4236/ojots.2012.24011
Abstract: In this study we focus on kidney-transplanted patients in order to investigate the correlation between immunodeficiency (ID) induced by immunosuppressive treatments and the incidence of solid multiple primary malignancies (MPM). Material of study: From 1980 to 2010 we followed up 1000 kidney-transplanted patients (637M, 363F). This group was homogeneous for age, immunology (e.g. miss-match index), number of rejection events and for immunosuppressive therapy. Results: Out of 1000 kidney-transplanted patients we observed 70 patients (53M, 17F) with cancer disease and in 22 of them a multiple cancer has been found. Most of multiple cancer were synchronous and the association between cancer and rejection episodes were not significant. Discussion: In general population 1 out of 9 patients with a cancer would develop a second neoplasia during the course of his life, so, it would be logical to conclude that, from a merely theoretical and statistical point of view, long term transplanted patients potentially have a higher risk to develop MPM. But our series and literature review did not confirm it, probably because these patients die before the appearance of a second primary malignancy. Conclusions: Despite many observations regarding different types of tumors/pre-cancerous lesions and their increased incidence in ID patients and despite the fact that immune suppression is a predisposing factor for the multicancer syndrome, at least theoretically, nowadays there are no significant statistical data favouring a correlation between ID and MPM in kidney transplanted patients.
Porosity and Inclusion Detection in CFRP by Infrared Thermography
C. Toscano,C. Meola,M. C. Iorio,G. M. Carlomagno
Advances in Optical Technologies , 2012, DOI: 10.1155/2012/765953
Abstract: The ever wide use of composite materials in the aeronautical industry has evidenced the need for development of ever more effective nondestructive evaluation methodologies in order to reduce rejected parts and to optimize production costs. Infrared thermography has been recently enclosed amongst the standardized non destructive testing techniques, but its usefulness needs still complete assessment since it can be employed in several different arrangements and for many purposes. In this work, the possibility to detect slag inclusions and porosity is analyzed with both lock-in themography and pulse thermography in the transmission mode. To this end, carbon-fiber-peinforced polymers different specimens are specifically fabricated of several different stacking sequences and with embedded slag inclusions and porosity percentages. As main results, both of the techniques are found definitely able to reveal the presence of the defects above mentioned. Moreover, these techniques could be considered complementary in order to better characterize the nature of the detected defects. 1. Introduction In the last thirty years a huge employment of carbon-fiber-reinforced polymers (CFRPs) has characterized the production of components in the aerospace industry [1]. Indeed, since their introduction in the civil aviation in the eighties, CFRPs have gained a progressive interest due to their versatility (e.g., perfectly matching the design requirements) as well appreciable low weight and high stiffness with costs saving. However, due to the many parameters involved in the CFRP manufacturing process, special care must be devoted to production control [2], in order to reduce rejected parts, and to detect, at the onset stage, buried defects, which may, unpredictably, grow once the structure is under load. Moreover, the intrinsic nonhomogeneities of the components and their properties, which are strictly dependent on the fiber quantity and orientation, make them susceptible to damage if impacted, also at low energy. This is why strong efforts have been paid by the industries to develop ever more effective non destructive testing and evaluation techniques [3]. Great attention was devoted, in the last twenty years, to the use of infrared thermography, (IRT) for non destructive evaluation (NDE) of materials and, recently, it was included amongst the standardized NDE techniques in the aeronautical field [4]. The main advantages of IRT are related to its contactless character and fast rate of inspection of large components. It can be used as complement to, or substitute, of the most
Monitoring Composites under Bending Tests with Infrared Thermography
Carosena Meola,Giovanni Maria Carlomagno,Carmela Bonavolontà,Massimo Valentino
Advances in Optical Technologies , 2012, DOI: 10.1155/2012/720813
Abstract: The attention of the present paper is focused on the use of an infrared imaging device to monitor the thermal response of composite materials under cyclic bending. Three types of composites are considered including an epoxy matrix reinforced with either carbon fibres (CFRP) or glass fibres (GFRP) and a hybrid composite involving glass fibres and aluminium layers (FRML). The specimen surface, under bending, displays temperature variations pursuing the load variations with cooling down under tension and warming up under compression; such temperature variations are in agreement with the bending moment. It has been observed that the amplitude of temperature variations over the specimen surface depends on the material characteristics. In particular, the presence of a defect inside the material affects the temperature distribution with deviation from the usual bending moment trend. 1. Introduction Infrared thermography (IRT) has proved helpfulness in many industrial and research fields as stated by the proceedings of the four main international symposia [1–4]. Amongst its many applications, an infrared imaging device is helpful for thermoelastic stress analysis (TSA) purposes [5, 6] and to monitor the surface temperature change (thermoelastic effect) which is experienced by a body when subjected to stress variations under load [7]. The thermoelastic effect was first conceived by Lord Kelvin (Thomson) in 1978 [8]. Many years later, in 1956 [9], Biot performed a thermodynamic analysis and formulated the classical thermoelastic equation, which expresses the change in temperature of a solid in terms of the change in the sum of the principal stresses . The temperature variation, under reversible and adiabatic conditions (i.e., in the elastic regime and neglecting heat transfer within the body and to the environment), for isotropic materials can be written as where is the absolute body temperature, is the mean stress amplitude, and is the material thermoelastic constant. Equation (1) relates the temperature local variations to the stress variations. In particular, under adiabatic conditions, positive dilatation (tension) entails cooling of the material and vice versa. In metals, the thermoelastic limit is generally assumed [10] as an indication for the yielding point. In orthotropic materials as fibre-reinforced polymers (FRP) (1) is modified as with and being the thermal expansion coefficients along the principal material directions and the mean volumetric heat capacity. For complex composite materials a direct relationship between the mean stress and TSA data is
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