[A rare case of Meckel's diverticulum perforation]. / Un raro caso di perforazione del diverticolo di Meckel.

Meckel's diverticulum is a pathology not rarely found everyday clinical medicine especially when it present with one of its complications. The specific diagnosis is a bit difficult to put because of the low sensibility and specificity of symptoms of diagnostic and instrumental techniques used. The reported case shows a rare type of complication constituted by the phlogosis of Meckel's diverticulum, itself due to an extraneous thing ingested by the patient. The authors discuss the entity of the manifestations of this pathology and highlight every aspects.

[Branchial carcinoma]. / II carcinoma branchiale.

The Authors report three cases of epidermoidal carcinoma arising from a congenital cyst of the anterolateral region of the neck. This type of tumor, rarely found in daily practice, arises from a degenerate branchial tissue and differential diagnosis often includes nodal involvement from systemic neoplasias. However, diagnostic criteria of such diseases are well defined; furthermore the rarity of branchial carcinoma is opposed to the high frequency of metastatic lymph nodes deriving from tumors with similar histological aspects located in other sites which could alter the real percentage of branchial tumor manifestation.

[Laparovideocholecystectomy]. / La laparovideocolecistectomia.

The authors present the guidelines which have been followed to introduce into their own Surgical Division an alternative method to cholelithiasis treatment: laparovideocholecystectomy (l.v.c.). They point out how the directions for use of the new surgical method, in place of the traditional laparectomic technique, must be limited to non-complicated cholelithiasis cases, especially in the initial learning stages. That sets the global "morbility" of the above said l.v.c. beneath the cholecystectomy performed with traditional technique. In addition, they point out the sure economic advantages at social and contributions level arriving at the conclusion that l.v.c. is the best treatment for Gallstones.

[Internal hernias. Description of 2 cases]. / Le ernie interne. Descrizione di due casi.

The authors describe two cases of recent observed internal-hernia, regarding in the first case the right para-duodenal dimple, and in the second a mesenteric breach. They report the clinic presentation and the diagnostic and therapeutic approach compared with the data deriving from the international literature. A complete clinical classification of the internal-hernia is illustrated showing the different clinical signs. The respective symptomatology that in the initial phases of this pathology is not too evident, shows that the internal hernia should always be held in due consideration at the moment of diagnosis because the consequent mortality due to complications such as intestinal-gangrene is rather high.

[Cancer of the gastric stump. Our experience]. / Il cancro del moncone gastrico. Nostra esperienza.

The authors discuss their experience of six cases of cancer of the gastric stump observed by them in the period from 1988 to 1992 inclusive. All the patients were operated; five total gastrectomies and a gastric re-resection were effected. In association also the spleen was removed in four patients, in one of them a hepatic metastasectomy and a distal pancreasectomy were effected. In the discussion the problems concerning the diagnostic and therapeutic implications with some references to the more likely etiopathogenetic theories were dealt with.

[Atypical metastases from gastric carcinoma. A primary and isolated case localized in the abdominal wall]. / In tema di metastasi atipiche da carcinoma gastrico. Su un caso primitivo ed isolato localizzato alla parete addominale.

The authors report a rare case of gastric carcinoma metastasis localised in the anterior abdominal wall which was an isolated and primary sign of disease. After having underlined the rarity of the case, there is a brief discussion of aspects related to the spread of primary tumours in relation to other cases reported over the past decade; the most important reports of atypical secondary localisations are listed.

[Carcinoma of the cecum: is early diagnosis possible?]. / Il carcinoma del cieco: è possibile una diagnosi precoce?

Between 1982 and 1989, a consecutive series of 34 patients with cancer of the cecum were operated in our hospital. Overall, at 5 years the survival was 50%. We did not notice any correlation among symptom duration and survival. Patients admitted in the asymptomatic phase had the best survival rate (66.6%). Our study suggest that only neoplasm diagnosed in asymptomatic patients and treated promptly are related to a good survival rate. We, therefore, emphasize the importance and the necessity to investigate all patients with a suspected cecum cancer by means of colonoscopy.

[An unusual case of hydatid cyst with adrenal localization]. / Su un caso eccezionale di cisti idatidea a localizzazione surrenalica.

The paper reports a case of hydatid cyst with a primary adrenal location. Having underlined the rarity of this finding and reviewed the literature on the topic, the Authors discuss the epidemiological, pathogenetic and clinico-diagnostic aspects. In conclusion they underline the difficulty of arriving at a precise diagnosis prior to surgery in spite of the fact that new imaging diagnostic methods enable diagnostic hypotheses regarding this pathology to be advanced.

[Extra-ocular sebaceous carcinoma: report of a case]. / Il carcinoma sebaceo extra-oculare: a proposito di un caso.

The Authors streamed the rarity of this pathological entity for which the histologic diagnosis is even very difficult. Treatment is based on a wide surgical excision; the value of postoperative irradiation and chemotherapy is discussed. The prognosis is poor.

[Leiomyosarcoma of the jejunum associated with severe enterorrhagia. Clinical case]. / Leiomiosarcoma del digiuno associato a grave enterorragia. Caso clinico.

The paper describes a cases of jejunal leiomyosarcoma associated with severe enterorrhagia. The rarity of this lesion and its difficult diagnosis are underlined. Having discussed the different anatomo-pathological aspects, the most appropriate diagnostic methods for a early diagnosis are examined. Moreover, the utility of carrying out a regular clinical and diagnostic follow-up of patients who have undergone surgery is stressed so that possible relapses or metastases, which are fatal in the majority of subjects affected by this form of neoplasia, can be treated as quickly as possible.

Short and long term prognostic significance of neurological anomalies of the first year in very low birthweight infants.

The short and long term, prognostic significance of early neuromotor anomalies was assessed in infants with birthweight under 1500 g (VLBW infants), who have a high risk of developing cerebral palsy (CP) but who also have transient neurological anomalies. The series comprises 35 VLBW infants born between 1 January 1978 and 31 March 1980 with regular neurological follow-up until the second year of life: 10 with CP of varying severity and 25 without CP. The latter were examined in the first year of school by means of an age-specific method designed to elicit minor neurological dysfunctions (MND). Analysis of neuromotor development in the first year of life identified important grounds for clinical suspicion in the first semester of corrected age, especially on the basis of a global neurological assessment including optimal neurological items score at presumed term age and the combination of two or more major neurological signs in the first semester. The diagnosis of CP cannot be established until the 2nd semester of life, in 70% of cases by the end of the 3rd trimester. It rests on the following criteria: persistence of two or more major neurological signs (abnormalities of limb tone, axial tone and of movement), specific pathological pattern of limb tone, always associated with retarded postural control. Neurological examination at school age revealed a significantly higher frequency of MND in the VLBW children than in a group of normal controls. The quantity of MND correlated significantly with the severity and duration of the first year neurological anomalies but not with the obstetric and postnatal neurological risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

[Early gastric cancer: considerations on 22 cases]. / Early gastric cancer: considerazioni su 22 casi.

Twenty two cases of early gastric cancer were observed in an overall group of 171 patients with gastric cancer. Clinic, radiological and endoscopic elements for diagnosis were discussed, as well as isto-pathological identification and treatment methods. Late prognosis, as related to degree of local and nodes involvement and to surgery applied, was considered.

[Surgical treatment in acute occlusion of the large intestine caused by carcinoma]. / Il trattamento chirurgico nell'occlusione acuta da carcinoma del grosso intestino.

Fifty four cases of acute large bowel obstruction were observed in an overall groups of 266 patients with colonic carcinoma. Pre-operative elements which seems to contra-indicate a primary radical surgery and advantages of the same procedure are considered. In the experience of the Authors, primary and delayed staged resection of the cancer seems to give the same survival rate at short and long term. Choice of surgery of obstructive large bowel carcinoma should be based pratically on general patient's conditions.

Determination of isoxsuprine in human plasma by gas chromatography with electron capture detection.

A rapid and sensitive gas chromatographic method for the determination of the beta-adrenergic agent isoxsuprine in human plasma has been developed. The procedure involves the extraction of the drug with ether and an internal standard (propranolol) from plasma at alkaline pH, solvent evaporation, and the formation of a tri-trifluoroacetyl derivative by reaction with trifluoroacetic anhydride in ethyl acetate. Analyses were carried out by gas-liquid chromatography on a 3% OV-17 column using an electron capture detector. The minimum detectable amount of isoxsuprine was 0.5 ng/ml of plasma and the electron capture detector response was tested to be linear (r2 greater than 0.999) between 0.5 and 20 ng/ml. No interferences from endogenous substances were found. Precision of the method was found to be 9.9, and 6.1% coefficient of variation at 1 ng/ml and 10 ng/ml of plasma, respectively. Determination of isoxsuprine at the nanogram level in cord plasma samples from newborns at the time of the delivery was possible using the described procedure.