Diego Sinagra

Past, Present, and Future of Fluorescence

It is important to define fluorescence. There are several ways to describe this term: (1) the emission of electromagnetic radiation, especially of visible light, stimulated in a substance by the absorption of incident radiation and persisting only as long as the stimulating radiation is continued. (2) Emitting light during exposure to radiation from an external source. (3) Luminescence that is caused by the absorption of radiation at one wavelength followed by nearly immediate reradiation usually at a different wavelength and that ceases almost at once when the incident radiation stops. The common denominators for this term are a source of radiation, the absorption of this radiation, and the emission of a modified radiation that ends immediately as the source stops emitting radiation. Chemically speaking, fluorescence is brought about by absorption of photons in the singlet ground state promoted to a singlet excited state. The spin of the electron is still paired with the ground state electron. As the excited molecule returns to ground state, it involves the emission of a photon of lower energy, which corresponds to a longer wavelength, than the absorbed photon and therefore lower energy, than the absorbed radiation.

Laparoscopic approach in the treatment of malignant adrenal tumours

Abstract Introduction Malignant primary or secondary adrenal tumours are uncommon. For most of them early surgery with adrenalectomy is the only means of cure. Although controversy exists on this issue, the increasing experience in laparoscopic surgery extends the indication for laparoscopic adrenalectomy to potentially malignant and to metastatic adrenal tumours. Our aim was to evaluate the technical feasibility of laparoscopic adrenalectomy for malignant neoplasias, describing the results of our consecutive series of patients. Material and methods We retrospectively analysed 13 patients who underwent laparoscopic adrenalectomy for malignant neoplasia between March 1999 and June 2009 at the Hospital de Clinicas at the University of Buenos Aires and at the Hospital Aleman in Buenos Aires. A transperitoneal laparoscopic approach was used in all patients. The mean follow-up time was 37.9 months (2–84). Results Thirteen laparoscopic adrenalectomies were performed due to malignant neoplasia. Mean age was 55.2±12 years. The male to female ratio was 10:3. Five patients had an adrenal carcinoma, one patient a malignant phaeochromocytoma, and 7 patients had metastatic tumours. Three patients required conversion to laparotomy. Average operation time was 146.4 min. There were two perioperative complications and no mortalities. Average length of hospital stay was 4.6 days (1–35). The survival at 3 years was 46%. The cause of death was the underlying disease in all cases. Conclusion Laparoscopic adrenalectomy is a reasonable technique for malignant adrenal tumours, when the open oncological resection can be reproduced by the laparoscopic approach.