Acute motor conduction block neuropathy Another Guillain-Barré syndrome variant.

OBJECTIVE: To report two patients with an acute exclusively motor neuropathy with conduction blocks. METHODS: Serial electrophysiologic studies were carried out. RESULTS: Two patients developed symmetric proximal and distal weakness without sensory abnormalities after enteritis. Tendon reflexes were normal in one patient and brisk in the other. One patient had high titer immunoglobulin G to GD1a and GM1, and the other to GD1b, GD1a, and GM1 and a recent Campylobacter jejuni infection. Electrophysiology showed early partial motor conduction block in intermediate and distal nerve segments, normal sensory conductions even across the sites of conduction block, and normal somatosensory evoked potentials. Conduction blocks resolved in 2 to 5 weeks without excessive temporal dispersion of proximal motor responses. CONCLUSIONS: Acute motor neuropathy with normal or brisk tendon reflexes, conduction block, and fast recovery appears to be a variant of Guillain-Barré syndrome. Conduction block may result from immune-mediated conduction failure at the nodes of Ranvier without demyelination.

A rare chromosome 5 heterochromatic variant derived from insertion of 9qh satellite 3 sequences.

A rare chromosome 5 heterochromatic variant not linked to any clinical sign was identified in a three-generation family. After performing conventional cytogenetics characterization, fluorescence in situ hybridization of D9Z1 indicated that the unusually large qh region of chromosome 5 originated from 9qh, whereas the centromere of the variant chromosome was 5-specific as demonstrated by primed in situ DNA labelling. FISH of probes targeting satellite 3 and beta-satellite sequences of 9qh showed that only satellite 3 sequences were present in the variant 5qh region.

[Appendicular mucocele. A report of a case diagnosed preoperatively]. / Mucocele appendicolare. Presentazione di un caso diagnosticato preoperatoriamente.

Mucocele of the appendix is an unusual clinical entity. Despite a recognized constellation of findings, the diagnosis is not usually made prior to surgical exploration. A 35 year old man is reported in whom clinical evaluation, including US and CT scans, resulted in the correct preoperative diagnosis confirmed at surgery and leading to appropriate operative decisions.

[Rare colonic occlusions: volvulus of the splenic flexure]. / Occlusioni coliche rare: il volvolo della flessura splenica.

Authors report a case of perforated splenic flexure volvulus, treated with resection, end colostomy and closure of the distal stump. From the revision of literature it comes out the case reported is the 30th recorded till now, the 6th with ischemic complications, and the only one with perforation. Actual pathogenetic trends and various therapeutic options are reported.

[Laparoscopic cholecystectomy: considerations on the technique]. / La colecistectomia laparoscopica: riflessioni sulla tecnica.

The Authors analyze the single steps of laparoscopic cholecystectomy and describe the technique usually preferred. On the basis of the experience acquired, advantages and disadvantages of each manoeuver and instrument available are pointed out.

Review of norfloxacin in lower urinary tract infections.

A review of worldwide clinical trials with norfloxacin in the treatment of uncomplicated urinary tract infections (UTIs), as well as our personal experience with 215 assessable patients, is presented. Almost all patients received 400 mg b.i.d. for 3-15 days. Bacteriological eradication (10(4) CFU/ml of urine or less) was achieved in more than 90% of patients. Short-term therapy (3 days) with norfloxacin proved to be as effective and tolerable as a 10- to 14-day conventional therapeutic schedule in the treatment of lower uncomplicated UTIs. Overall incidence of drug-related adverse experiences was 2.3%.

[Aneurysms of the gluteal artery (description of a clinical case and review of the literature)]. / Gli aneurismi dell'arteria glutea (Descrizione di un caso clinico e revisione della letteratura).

The authors show a case of superior gluteal artery aneurysm they operated successfully. Starting from this case the Authors review the literature about the etiology, the clinical characteristics, the diagnosis and the various methods of treatment of this lesion.

[Primary gastric lymphoma: our experience (clinical contribution)]. / Il linfoma gastrico primitivo: nostra esperienza (contributo clinico).

The authors analyze a personal study population (11 cases) of primary gastric lymphoma. Whenever possible, more radical surgery was carried out even in severely debilitated patients. Polychemotherapeutic treatment was given after discharge. The mean postoperative survival was 35 months, and the 5-year survival rate was 27.2%.

[Biliary pathology in chronic pancreatitis]. / La patologia biliare nella pancreatite cronica.

The authors expose in a very accurate discussion the biliary pathology during chronic pancreatitis. They divide the biliary lesions into associated with pancreatitis and secondary to chronic pancreatitis. They emphasize the necessity to practise a detailed study of the biliary tract in all patients affected by chronic pancreatitis and the good results showed by a very simple surgical act.

[Carcinoma of the gallbladder. Clinico-statistical considerations]. / Il carcinoma della colecisti. Considerazioni clinico-statistiche.

The Authors shortly describe some essential aspects of the gall-bladder primitive cancer, and state their experience about 19 cases of malignant neoplasms observed out of 2280 operations on biliary duct. They confirm the extremely severe prognosis of such disease due to diagnostic delay. As a conclusion, they affirm the simple cholecystectomy is the choice operation in the precocious forms, and suggest the preventive cholecystectomy in the risk patients for such pathology.

Contemporaneous administration of digitalis and dilazep to subjects with heart failure of ischemic etiology.

The objective of this trial was to determine whether the digitalis-dilazep combination interferes with the inotropic effects of digitalis or produces significant cardiovascular modifications. Twenty patients suffering from heart failure of ischemic or ischemic plus valvular etiologies, undergoing digitalis treatment for at least 3 weeks, were administered dilazep (300 mg/day). Systolic, diastolic blood pressures and heart rate, supine and standing, QS2I, LVETI, PEPI, PEP/LVET, triple product, and percentage diastole were recorded. The controls were undertaken at entry, after the digitalis + dilazep association, and after 1 month of digitalis alone when dilazep was ceased. None of the parameters assessed were modified as a result of dilazep treatment. Since systolic time intervals and the PEP/LVET ratio remained unaltered and equal to the values recorded during digitalis alone, it is concluded that dilazep does not interfere with the inotropic action of digitalis.

[Fenquizone in the medium term treatment of essential hypertension. Double-blind comparison with chlorthalidone and placebo]. / I fenquizone nel trattamento a medio termine dell'ipertensione arteriosa essenziale. Confronto in doppio cieco con clortalidone e placebo.

In a double blind study, tolerability and antihypertensive effect of fenquizone were compared with those of chlorthalidone and placebo. In both mild and moderately severe essential hypertension, fenquizone and chlortalidone showed a significant antihypertensive effect; moreover, fenquizone lowered the clinostatic arterial diastolic pressure in a more gradual and continuous way. Differently from chlortalidone, fenquizone had no effects on blood levels of potassium and cholesterol.