Ultrastructural changes of the pulmonary parenchyma after experimentally induced endotoxic shock in dogs with and without drug protection.

The authors describe the ultrastructural alterations of the pulmonary parenchyma produced in dogs by endotoxic shock, and they examine the effects that a 'secretolytic' drug (bromexine) has in modifying those changes. In the animals under shock there is a complete breakdown of the normal structure of the pulmonary parenchyma. According to the authors, these lesions are caused by the damage of the lining layer and of the cells which produce the constituents of the surfactant system. In dogs under shock and treated with bromexine the authors have seen a better organization of the pulmonary parenchyma: the cellular limits of the pneumocytes of types I and II were more clearly defined and the osmiophilic bodies were increased both in number and volume. The authors conclude that the damage of the lining layer and of the pneumocytes of type II plays an important role in the development of the ARDS and they say that bromexine can improve clinical and morphological aspects of that syndrome.

Immunologic alterations and active aspecific immunotherapy in lung cancer patients.

An immunologic study was undertaken on 89 lung cancer patients and on the basis of results obtained so far, a protocol of active, aspecific immunotherapy by living bacterial vaccines (BCG) and/or synthetic immunopotentiator (methisoprinol) was carried out. First results obtained in patients undergoing immunostimulation are reported together with the observation that while positive humoral effects seem present in stage I and II patients, in cases of spread of the disease results are substantially negative.

[Obstruction of the principal bile duct caused by Fasciola hepatica. First case in Sicily]. / Ostruzione della via biliare principale da fasciola epatica. Prima osservazione in Sicilia.

The first case of human liver infestation due to liver fluke in Sicily is reported. After a clinical review of parasitosis, the autochthonous nature of the case is mentioned to highlight its epidemiological and prophylactic importance, especially in those regions where climatic conditions and living and working habits favour infestation. Finally, attention is called to diagnostic difficulties, treatment and appropriate hygiene and dietetic measures.

Considerations on the origin and ultrastructural aspects of type II pneumocytes under normal conditions and endotoxic shock experimentally induced in dogs.

On the basis of the morphological aspects found during a series of experimental investigations on the ultrastructural aspects of the lung under shock in the dog, the authors deny that type II pneumocytes belong to the group of alveolar macrophages and maintain that they are of an epithelial nature. This is confirmed by the presence of desmosomal junctions with the type I pneumocytes. In the "shock lung" induced by Escherichia Coli endotoxin, the type II pneumocytes appear to be severely damaged with particular involvement of the osmiophilic inclusions, sites of synthesis and/or heaping up of the principal phospholipidic constituents of the surfactant system.

[Immunological monitoring of patients with carcinoma of the lung. Study method and preliminary research]. / Il monitoraggio immunologico di pazienti con carcinoma del polmone. Metodo di studio e ricerche preliminari.

It is by now an established fact that the status of the immune system stands in some relationship with the onset and evolution of malignancy. To clarify this relationship the authors investigated the immune system of patients with pulmonary carcinoma, with special regard to the functions of the T and B lymphocyte lines. After suitable explanation of their experimental protocol, which involved immunological monitoring and the study of relationships between immunological changes and the extent and histological type of malignancy, and also the effects of any treatments being administered, the authors describe the results obtained in 18 preoperative patients. The study revealed an overall diminution of cell-mediated immune activity: less strongly positive DNCB skin tests, reduced capacity for making E rosettes, reduced blast transformation with PHA. With B lymphocytes the EA rosette test was often depressed, whereas antibody titers were normal or even above normal, and the pokeweed blast test was invariable above normal values. These preliminary results show that at the time of diagnosing malignancy, the greater aggressiveness characteristic of the less differentiated cellular types, or of stages of diffuse malignancy, is associated with overpowering of cell defenses and (within certain limits) enhancement of the humoral response.

[Irrigation of colostomized patients]. / L'irrigazione dei colostomizzati.

After a brief recall of the main problems of post-colostomy patients, the authors describe the method of colonic irrigation, which affords the complete discharge of fecal matter and continence over the ensuing 24 hours. The authors give an account of the results obtained with this methodology at the Stoma Center of Catania; and they conclude that the method in question, applied correctly and appropriate cases, seems to represent the treatment of first choice for the postoperative management of colostomy cases.

[Intrathoracic goiters]. / I gozzi endotoracici.

Reference is made to the nosographical classification of intrathoracic goitre and the difficulties associated with its diagnosis. Particular attention is devoted to the correct surgical technique required. Surgery is mandatory in mediastinal cases on account of the slow and gradual progression of the swelling and exacerbation of the symptoms, and also because complications may supervene (cancer, intraparenchymal haemorrhage, etc.). The approach routes are discussed, along with the conditions requiring resort to a complementary route--usually median sternotomy--in addition to cervicotomy.

[Diverticula of the duodenum. Clinico-diagnostic and therapeutic considerations]. / I diverticoli del duodeno. Considerazioni clinico-diagnostiche e terapeutiche.

On the basis of a study of the most recent clinico-statistical contributions on diverticula of the duodenum and personal experience, based on observation of 72 cases, the Authors set out a modern review of the subject. After emphasizing that diverticula of the duodenum are responsible for clinically evident and uncharacteristics sympatoms in only about 10-20% of cases, the Authors discuss the most modern procedures for diagnosis of diverticula of the duodenum. Lastly there is a full discussion of the indications for operation and the different surgical possibilities for treatment of the disease.