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Russo Luca,Avesani Giacomo,Gui Benedetta,Trombadori Charlotte Marguerite Lucille,Salutari Vanda,Perri Maria Teresa,Di Paola Valerio,Rodolfino Elena,Scambia Giovanni,Manfredi Riccardo 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.8
Immunotherapy is an effective treatment option for gynecological malignancies. Radiologists dealing with gynecological patients undergoing treatment with immune checkpoint inhibitors should be aware of unconventional immune-related imaging features for the evaluation of tumor response and immune-related adverse events. In this paper, immune checkpoint inhibitors used for gynecological malignancies and their mechanisms of action are briefly presented. In the second part, patterns of pseudoprogression are illustrated, and different forms of immune-related adverse events are discussed.
Santander Lucas,Machado Nicolle Rakanidis,Fagundes Beatriz Oliveira,Victor Jefferson Russo 대한백신학회 2024 Clinical and Experimental Vaccine Research Vol.13 No.1
Since the 1950s decade, it has been suggested that a naturally produced or induced repertoire of immunoglobulin G (IgG) idiotypes may exert some immunoregulatory functions. In the last decades, some more advanced theories have suggested that the repertoire of IgG idiotypes may influence the development or control of some atopic diseases. In atopic dermatitis (AD), some evidence indicated that the IgG repertoire obtained from these patients could effectively mediate regulatory functions on thymic and peripheral CD4+ and CD8+ T cells. Furthermore, some recent clinical trials have corroborated the hypothesis that IgG from AD patients can exert regulatory functions in vivo. Here, we revised some historical aspects that yield current approaches developed in vitro and in vivo to elucidate a recently proposed theory termed “hooks without bait” that can strengthen the broad spectrum of research about evaluating different sets of IgG idiotypes and determine their immunological effects.
Robotic Spine Surgery and Augmented Reality Systems: A State of the Art
Gianluca Vadalà,Sergio De Salvatore,Luca Ambrosio,Fabrizio Russo,Rocco Papalia,Vincenzo Denaro 대한척추신경외과학회 2020 Neurospine Vol.17 No.1
Instrumented spine procedures have been performed for decades to treat a wide variety of spinal disorders. New technologies have been employed to obtain a high degree of precision, to minimize risks of damage to neurovascular structures and to diminish harmful exposure of patients and the operative team to ionizing radiations. Robotic spine surgery comprehends 3 major categories: telesurgical robotic systems, robotic-assisted navigation (RAN) and virtual augmented reality (AR) systems, including AR and virtual reality. Telesurgical systems encompass devices that can be operated from a remote command station, allowing to perform surgery via instruments being manipulated by the robot. On the other hand, RAN technologies are characterized by the robotic guidance of surgeon-operated instruments based on real-time imaging. Virtual AR systems are able to show images directly on special visors and screens allowing the surgeon to visualize information about the patient and the procedure (i.e., anatomical landmarks, screw direction and inclination, distance from neurological and vascular structures etc.). The aim of this review is to focus on the current state of the art of robotics and AR in spine surgery and perspectives of these emerging technologies that hold promises for future applications.
Gianluca Vadalà,Giuseppe Francesco Papalia,Fabrizio Russo,Paolo Brigato,Luca Ambrosio,Rocco Papalia,Vincenzo Denaro 대한척추신경외과학회 2024 Neurospine Vol.21 No.1
Objective: Several studies have advocated for the higher accuracy of transpedicular screw placement under cone-beam computed tomography (CBCT) compared to conventional 2-dimensional (2D) fluoroscopy. The superiority of navigation systems in perioperative and postoperative outcomes remains a topic of debate. This study aimed to compare operative time, screw placement time and accuracy, total radiation dose, perioperative and postoperative outcomes in patients who underwent transpedicular screw fixation for degenerative lumbar spondylolisthesis (DLS) using intraoperative CBCT navigation versus 2D fluoroscopy. Methods: A retrospective analysis was conducted on patients affected by single-level DLS who underwent posterior lumbar instrumentation with transpedicular screw fixation using surgical CBCT navigation (NV group) or 2D fluoroscopy-assisted freehand technique (FH group). Demographics, screw placement time and accuracy, operative time, total radiation dose, intraoperative blood loss, screw revision rate, complications, and length of stay (LOS) were assessed. Results: The study included a total of 30 patients (NV group: n = 15; FH group: n = 15). The mean screw placement time, operative time, and LOS were significantly reduced in the NV group compared to the FH group (p < 0.05). The total radiation dose was significantly higher in the NV group (p < 0.0001). No significant difference was found in terms of blood loss and postoperative complications. Conclusion: This study suggests that intraoperative CBCT-navigated single-level lumbar transpedicular screw fixation is superior in terms of mean screw placement time, operative time, and LOS compared to 2D fluoroscopy, despite a higher intraoperative radiation exposure.
Sergio De Salvatore,Gianluca Vadalà,Leonardo Oggiano,Fabrizio Russo,Luca Ambrosio,Pier Francesco Costici 대한척추신경외과학회 2021 Neurospine Vol.18 No.1
Objective: Preoperative planning in spine surgery is a fundamental step of the surgical workup and is often assisted by direct visualization of anatomical 2-dimensional images. This process is time-consuming and may excessively approximate the 3-dimensional (3D) nature of spinal anatomy. Virtual reality (VR) is an emerging technology capable of reconstructing an interactive 3D anatomical model that can be freely explored and manipulated. Methods: Sixty patients with adolescent idiopathic scoliosis underwent correction of the scoliotic curve by posterior arthrodesis after preoperative planning using traditional on-screen visualization of computed tomography scans (control group, n=30) or exploration of a 3D anatomical model in VR using Google Cardboard (Google Inc.) (VR group, n=30). Mean operative time, blood loss, length of hospital stay, and surgeon’s satisfaction were assessed after surgery. Results: The use of VR led to a significant decrease in operative time and bleeding while increasing the surgeon’s satisfaction compared to the control group. Conclusion: Preoperative planning with VR turned out to be effective in terms of operative time and blood loss reduction. Moreover, such technology proved to be reproducible, cost-effective, and more satisfactory compared to conventional planning.