Primary melanoma of the bladder: Case report and review of the literature.

Skin melanoma represents one of the most common and lethal solid tumor. It usually develops on the skin but it can occur in any tissues with melanine- containing-cells (extracutaneous malignant melanoma). Only 4-5% of malignant melanomas originate in extracutaneous tissues, and they have an extremely lethal behavior (1). These non-skin malignant melanomas are rare but extremely aggressive. Primary melanoma of the genitourinary tract accounts for less than 0.2% of all melanomas. To date only 28 cases of primary bladder melanoma (PMM) are described. We report a rare case of PMM of the bladder in a 72 years old man treated with radical cystectomy and immunotherapy with Nivolumab.

Therapeutic ureteral occlusion with Ifabond cyanoacrylate glue: an interesting solution.

OBJECTIVE: The aim of this study was to present a novel approach for complete and permanent ureteral occlusion using a percutaneous injection of Ifabond cyanoacrylate glue. METHODS: We describe in detail all the steps of our surgery, performed on a 79-year-old patient with urinary leakage from ureteral stump following radical cystectomy. N-hexyl-cyanoacrylate glue (Ifabond) was used to occlude the distal ureter and solve the leakage. RESULTS: Our approach was successful, sparing our already frail patient further surgical procedures. Six months pyelography confirmed the complete ureteral blockage with absence of extravasation. CONCLUSIONS: In complicated scenarios with urinary leakages and frail patients, synthetic glues such as Ifabond might represent an interesting therapeutic option to solve the fistulas, leading to durable success with a minimally invasive approach.

An Organizational Perspective to the Creation of the Research Field.

The aim of the paper is to contribute to the definition and analysis of the "access to the field" (Feldman et al. 2003) through an inter-organizational perspective. The paper discusses a case study on the access of a researcher to a hospital department where both organizations and actors are shown as actively constructing the research site. Both researcher and participants are described in terms of work organizations originally engaged in parallel systems of activity. Dynamics of negotiation "tied" the different actors' activities in a new activity system where researcher and participants concur to the effectiveness of both organizations (i.e., the research and the hospital ward). An Activity Theory perspective (Leont'ev 1978) is used with the aim of focusing the analysis on the activities in charge to the different actors. The approach adopted introduces the idea that, from the outset, research is made possible by a process of co-construction that works through the development of a completely new and shared work space arising around the encounter between researchers and participants. It is the balance between improvised actions and the co-creation of "boundary objects" (Star and Griesemer 1989), which makes interlacement possible between the two activity systems. The concept of "knotworking" (Engeström 2007a) is adopted to interpret specific actions by both organizations and actors intended to build a knot of activities whereby the new research system takes place.

[Use of frozen sections to assess surgical margins during radical prostatectomy]. / Impiego dell'esame estemporaneo al congelatore per la valutazione dei margini chirurgici in corso di prostatectomia radicale

INTRODUCTION: At present there is no consensus on the use of frozen sections (FS) during radical prostatectomy. Several groups have proposed the benefit of FS although the studies differ widely in sampling methods and sites where FS were taken. This study aims to evaluate the usefulness and reliability of standard assessment of FS in multiple sites during radical prostatectomy. METHODS: During open radical prostatectomy in all patients we sampled tissue from the urethral stump, the neurovascular bundles, the Denonvillier fascia and the bladder neck after removing the prostate. Where FS showed positive margins, further periprostatic tissue was resected from the prostatic bed until negative margins were achieved. The results of FS were compared with margin status of final pathology. RESULTS: From 1998 to 2004 we performed FS during 250 consecutive open radical prostatectomies (104 nerve sparing procedures). 66 patients had positive FS (26.4%) and 53 patients had positive surgical margins at final pathology (21.2%). All patients with positive FS had negative margins when further tissue was resected in the prostatic bed. During nerve sparing procedures positive FS were found in 14 patients. In these cases the procedure was converted into standard prostatectomy by resecting the neurovascular bundles. Sensibility and specificity were both 90%. Positive and negative predictive values were respectively 72% and 97%. CONCLUSIONS: Standard assessment of FS in multiple sites during radical prostatectomy achieved sensibility and specificity as high as 90%. Although the resection of urethral stump and tissue close to the neurovascular bundles could compromise functional results, standard assessment of FS in multiple sites could help the surgeon to reduce the positive surgical margins, to monitor the oncological safety of a nerve sparing procedure and to improve the pathological staging.

ASTEF: a simple tool for examining fixations.

In human factors and ergonomics research, the analysis of eye movements has gained popularity as a method for obtaining information concerning the operator's cognitive strategies and for drawing inferences about the cognitive state of an individual. For example, recent studies have shown that the distribution of eye fixations is sensitive to variations in mental workload---dispersed when workload is high, and clustered when workload is low. Spatial statistics algorithms can be used to obtain information about the type of distribution and can be applied over fixations recorded during small epochs of time to assess online changes in the level of mental load experienced by the individuals. In order to ease the computation of the statistical index and to encourage research on the spatial properties of visual scanning, A Simple Tool for Examining Fixations has been developed. The software application implements functions for fixation visualization, management, and analysis, and includes a tool for fixation identification from raw gaze point data. Updated information can be obtained online at www.astef.info, where the installation package is freely downloadable.