Remotely-pumped network-embedded self-tuning transmitter for 80-Gb/s conventional hybrid TDM/WDM PON with 256-split.

We present a colorless network-embedded self-tuning transmitter assisted by a remotely pumped erbium-doped double-pass amplifier located at the remote node for a conventional hybrid stacked-WDM/TDM-PON. The scheme provides up to 256-split PON with 80-Gb/s aggregate upstream capacity obtained with RSOA direct modulation at 2.5 Gb/s.

Reflux oesophagitis in children; the role of endoscopy. A multicentric Italian survey.

BACKGROUND: The decision whether to perform endoscopy in children with suspected reflux oesophagitis is not a straightforward one. Few symptoms are specific for oesophagitis and the diagnosis is not always correlated even to visual findings on endoscopy. AIM: The aim of this study was to define the role of endoscopy and especially of histology in the diagnosis of reflux oesophagitis and to examine the correlations between symptoms, endoscopic findings and histology in children with suspected gastroesophageal reflux disease. PATIENTS AND METHODS: One hundred and thirty-six patients with a clinical diagnosis of reflux oesophagitis, aged 1-18 years (mean 8.43; standard deviation +/-4.4), were enrolled from 12 Italian Paediatrics Gastroenterology Centres; symptom score, endoscopic and histologic oesophagitis scores were observed before and after therapy with proton pump inhibitors. RESULTS: Before therapy, a high correlation between the prevailing symptom score and endoscopic score was demonstrated, but not with histologic score: there was a significant tendency for histologic grade to exceed visual findings. After therapy, endoscopic score and histologic score were significantly improved. CONCLUSIONS: Oesophageal biopsies increase the diagnostic accuracy of upper endoscopy. Histologic grading is often much more important than the endoscopic appearance, so that endoscopic oesophageal biopsies are very important aids in the diagnosis of oesophagitis. Appropriate clinical evaluation of symptoms must occur before endoscopic examination.

[Eosinophilic gastroenteritis. A report of a clinical case]. / Gastroenterite da eosinofili. Descrizione di un caso clinico.

Eosinophilic gastroenteritis is an inflammatory pathology with an unknown etiology characterised by the presence of an eosinophil infiltrate on the intestinal wall. The symptoms (bleeding, occlusion, fistulae, etc.) may lead to surgery even if the best treatment is medical. Endoscopic examination with specific multiple biopsies is indispensable for the diagnosis of the pathology. The authors report the case of a 2-month-old baby suffering from intermittent pyloric obstruction secondary to eosinophilic gastroenteritis which was wrongly interpreted as hypertrophic stenosis of the pylorus.

[Prenatal detection of a cyst in the liver hilum. Interpretation for an adequate treatment]. / Diagnosi ecografica prenatale di una immagine cistica a carico dell'ilo epatico. Interpretazione per un adeguato trattamento.

The diagnosis assigned to a cystic collection of liver hilum (CCLH) detected by means of prenatal ultrasonography is usually that of choledochal cyst (CC) thus carrying a good prognosis. The aim of this work is to state more precisely the significance of such CCLH, from a review of our experience. Files of children treated in our institution for either CC or biliary atresia (BA) with bile duct cysts have been screened for prenatal detection of CCLH. From 1985 to 1994, seven children have been referred to our institution, all after birth, all after prenatal detection of CCLH between 22 and 38 weeks of pregnancy (median = 33 weeks). Postnatal diagnosis, established by means of percutaneous cholangiography, was CC in 5 children without any evidence of cholestasis, and BA in 2 children with alcoholic stools and hepatomegaly. The 5 CC patients have been submitted to successful surgery at age 16 days to 10 months. The 2 BA patients have been operated at age 23 and 111 days, the latter unfortunately with gross cirrhosis and portal hypertension. An accurate prenatal diagnosis had been done by previous investigators only in 3 of the 7 cases, all 3 being CC cases. A review of the literature confirms that prenatal detection of a CCLH occurs mostly during the 3rd trimester of pregnancy and that of the postnatal diagnosis is almost always CC. Nevertheless the diagnosis of BA, requiring an early surgical procedure is also possible. We recommend that prenatal detection of a CCLH should result at least in referring the baby soon after birth to a team skilled in hepatobiliary pathology.

[Conservative treatment of post-traumatic hepatic hematoma. Case reports]. / Trattamento conservativo dell'ematoma epatico post-traumatico. Casistica clinica.

Post-traumatic hepatic haematomas may need surgical or conservative treatment. TC allows exact stadiation of hepatic lesions, detecting those mandatory for surgical approach. Haemodinamic unsteadiness and/or necessity of > 40 ml/kg blood transfusion suggest serious uncontrollable bleeding, that is surgical emergency. Three cases of post-traumatic heapatic haematomas recovered after conservative treatment (clinical, haematological and radiological survey) are described.

[Recto-cutaneous penile fistula. A description of a clinical case and review of the literature]. / Fistola retto-cutanea peniena. Descrizione di un caso clinico e revisione della letteratura.

This describes a newborn with an imperforate anus associated to a fistulous track extending along the scrotal raphe and opening at the penis top. This variant appears to be a low anomaly. The surgical treatment of this pathology is discussed.

[Surgical treatment of anal fistula]. / Il trattamento chirurgico delle fistole anali.

The surgical problems posed by a fistula are closely related to the morphology of the channel and its relationship with the sphincter, especially with the striated sphincter. Fistulas are characterised by an extremely variable course and often demand an individual approach. For superior trans-sphincter and supra-sphincter fistulas the channel section method with seton offers the best guarantees of respecting sphincter function by means of slower healing.

[Emergency surgical treatment of acute perforation of the colon]. / Il trattamento chirurgico in urgenza delle perforazioni acute del colon.

Thirty cases of perforated colon observed in the past 10 years in the General Surgery Division of Novara are reported. The therapeutic approach and results obtained are reviewed. Postoperative complications and mortality with the various types of intervention are assessed in the light of personal experience and reported data.

[Neoplasms of the duodenum. A description of 2 clinical cases]. / Neoplasie del duodeno. Descrizione di due casi clinici.

Duodenal tumours are a rare pathology, hard to diagnose early because of the unsubstantial symptomatology even though, in recent years, with the advent of improved techniques, a larger number have found their way into the literature. Two cases of duodenal cancer, one an adenocarcinoma localised in the first portion of the duodenum and one a subpapillary leiomyosarcoma are reported. 2 and 5 years respectively after the operation, both patients are in good health and do not present signs of disease.