[Infection of the vascular prosthesis. The diagnostic, preventive and treatment protocols: preliminary results]. / L'infezione di protesi vascolare. Protocollo diagnostico, di prevenzione e di trattamento: risultati preliminari.

A number of strategies for the management of vascular graft infections are described in literature. Nevertheless, this serious compliance is still burdened with high rates of morbidity and mortality. At the present the principal efforts are therefore directed towards prevention and early diagnosis. In this view, the authors propose their protocol of study, on the basis of the encouraging results till now obtained.

[Posttraumatic pseudoaneurysms of the anterior tibial artery: a review of the literature and a clinical case report]. / Pseudoaneurismi post-traumatici dell'arteria tibiale anteriore: revisione della letteratura e presentazione di un caso clinico.

The authors after a review of the literature report a case of anterior tibial artery false aneurysm in a seventeen year old male, due to traumatic sprained ankle during a basketball match. Surgical techniques used in repairing the lesion as well as microsurgical technique for the direct suture of the artery, which allowed to resolve the problem, are discussed.

[Juvenile vascular pathology due to homocystinuria. A clinical case report]. / Patologia vascolare giovanile da omocistinuria. Presentazione di un caso clinico.

The authors report a case of juvenile vasculopathy in a homocystinuria patient. They point out that thromboembolism may be the only symptomatic expression of this genetically determined metabolic disease. Diagnostic approach and surgical therapy of the vascular lesions as well as medical therapy to prevent further complications are analysed. The opportunity to perform clinical tests for the diagnosis of homocystinuria in all those young patients presenting vascular lesions without other risk factors is finally stressed.

[Revascularization of distal arteries of the leg: critical considerations on more than 2000 cases reported in the literature]. / Le rivascolarizzazioni delle arterie distali della gamba: considerazioni critiche su oltre 2000 casi raccolti in letteratura.

The Authors review the results of more than 2000 cases of lower extremity revascularization, treated from 1969 to 1991 and reported in the literature. They evaluate indications, contraindications and results at 12 and 24 months from operation performed with saphenous vein "in situ" and reversed. Finally they stress the greater reliability of by-passes performed with "in situ" saphenous vein graft.

[Formation of calculi on a double J catheter]. / Formazione di calcoli su catetere a doppio J.

A case of lithiasis due to indwelling double J ureteral stent is described. Pathogenesis and possibilities of prevention are discussed.

[Adjuvant chemotherapy in carcinoma of the bladder: current results and prospects]. / La chemioterapia adiuvante nel carcinoma della vescica: risultati attuali e prospettive.

Adjuvant chemotherapy is one of the latest and more promising modality of cancer treatment within the multidisciplinary approach to neoplasms. This paper illustrates the biological rationale as well as preliminary evaluation of its effectiveness for bladder carcinoma.

[Thyroid cancer and its incidence in nodular thyroid diseases: our experience]. / Il cancro della tiroide e la sua incidenza nelle tireopatie nodulari: nostra esperienza.

The authors report their experience with 453 cases of thyroid nodules observed over a period of 5 years. The intention was to determine the incidence of malignant lesions. A female prevalence of the nodular pathology was clearly evident (7.2%), with a maximum incidence between the 3rd and 6th decade. Among malignant tumors (14.2%) the following histologic types were most frequently found: papillary adenocarcinoma (5.7%), follicular adenocarcinoma (2.7%), occult cancer (2.7%), anaplastic cancer (2.3%). Up to the 4th decade female prevalence was clearly evident (Max in the 3rd decade; F/M ratio = 6.5); then an increased male incidence was registered bringing to a reduction of the F/M ratio (1.5 in the 5th and 6th decade) and to its inversion in the 7th decade (M/F = 1.25).

[Treatment of stenosis of the posterior urethra using Sachse's urethrotome]. / Trattamento delle stenosi dell'uretra posteriore con l'uretrotomo di Sachse.

The authors suggest to treat the stenosis of the posterior urethra with a technique able to prevent relapses as much as possible. For this reason they recommend the improved technique of Sachse as the more suitable, avoiding, though, irritative stimuli (resections and indwelling catheters).

[Risk factors and multicentricity of vascular atherosclerotic disease. Our experience]. / Fattori di rischio e polidistrettualità nella malattia vascolare aterosclerotica. Nostra esperienza.

The objective of this study is the identification of the most important risk factors of atherosclerosis and the determination of its multicentricity, the goal being an efficient primary and secondary prevention of this disease. Over the course of eight years, at the Department of Diagnosis and Surgical Physiopathology of Peripheral Vascular Diseases, 829 subjects with atherosclerosis were examined, of whom 513 males and 316 females between 18 and 85 years old, as well as to 200 healthy control subjects. The risk factors in consideration were: age, sex, hypertension, diabetes, lipoidoproteinosis, smoking, alcohol and coffee intake. From the data obtained it was revealed that smoking represents the most important risk factor for atherosclerosis (65% of the cases, 40% of the controls), followed in decreasing order by hypertension (31% of the cases, 6% of the controls), diabetes (26% of the cases, 2% of the controls), lipoidoproteinosis (15% of the cases, 6% of the controls). Furthermore 21% of the subjects drank coffee and 28% ingested alcoholic beverages, compared with, respectively 19% and 24% of the controls. In 70% of the cases the presence of atherosclerotic lesions were found in more than one vascular region. Atherosclerosis has a multifactorial etiology as there exists a correlation between the predisposition of the patient to acquire the disease and environmental factors. It is difficult to distinguish the determining effects of a single risk factor, because often many risk factors are tightly interrelated in the same individual; a nearly direct relationship clearly exists between the number and entity of the risk factors and the clinical picture of the patient examined.(ABSTRACT TRUNCATED AT 250 WORDS)

[Spinal cord ischemia following subrenal aortic clamping]. / La ischemia midollare conseguente a clampaggio aortico sottorenale.

The paraplegia caused by an aortic clamping just below the Renal artery is a rare but very complication in aortic surgery. Such a complication is even rarer if we consider the few cases reported in literature following a reconstructive surgery for occlusive chronic diseases of aortiliac axes. The authors have studied the case of a patient bearing the syndrome of Leriche; this one had an aortic clamping below the kidney and soon after developed an acute ischaemic syndrome below the spinal medulla with flaccid paraparesis, anal and vesical sphincteric diseases and persistence of deep tactile sensibility. After a reconstruction of vascular anatomy of the medulla they emphasize the importance, in such a disease, of the "arteria radicularis magna" of Adamkievicz and its place of origin. After they discuss the severe physioopathologic moments that are connected: with the direct ischaemia following aortic clamping in the cases where the arteria radicularis magna rises at a level lower than the clamping itself; with the embolism or thrombosis caused by surgical manipulation peroperatively (it might be the cause of paraplegia more frequent in aneurysmectomia surgery); with the severe hypotension per- and post operatively for the existence of arteriosclerotic disease of the lumbar arteries. Finally they analyses preoperatively diagnostic possibilities and per operatively methods used in preventing this sort of complication.

[The biosynthetic Omniflow prosthesis: preliminary experience]. / La protesi biosintetica Omniflow: esperienza iniziale.

The Omniflow biosynthetic prosthesis is made by a polyester net set on a silicon mandrel and planted on the sheep's back in order to from a tube of collagen that is fixed by glutaraldehyde at the moment of removing. This idea comes from the experience made in using glutaraldehyde as biologic fixative employed for the first time in the fixation of the cardiac valves by Carpentier in 1976 and in using nets of synthetic material set on a mandrel in man by Sparks in 1986, to form a tube of collagen to be used as a vascular prosthesis. Such a prosthesis has the advantage of the natural collagen deprived of its immunogenicity and also the increased resistance due to the polyester net. The authors report their experience in three arteriopathic patients employing Omniflow prosthesis used for the manufacturing of femoropopliteal bypass, a femoro-femoral bypass and for the substitution of an infected branch of axillobifemoral bypass. They describe the handling and the technique for the right application to avoid immediate complications, among which the most dangerous is the acute obstruction. Then they discuss the results which are encouraging even if the fellow up is too short. For such a reason they report the casuistic with long distance results obtained by the use of the same prosthesis by Raithel et Al., one of the largest experience in literature.

[Urethrocystography with and without a chain in cervico-urethral diseases]. / L'uretrocistografia con e senza catenella nelle affezioni cervico-uretrali.

The Authors evaluate cystourethrography with and without chain as a method to study urethral diseases. Indications and complications are considered positively, because they allow an easy and safe control of the cases operated.

[A case of so-called prostatic hypertrophy with endovesical projection of the lateral lobes]. / Un caso di c.d. ipertrofia prostatica con aggetto endovescicale dei lobi laterali.

A case of benign prostatic hyperplasia with lateral lobes large involvement is reported. On the basis of their own experience and a review of the literature the role of hormonal synergism in the development of the condition is outlined.