Validation of an integrated experimental set-up for kinetic and kinematic three-dimensional analyses in a training environment.

Biomechanical analyses using synchronized tools [electromyography (EMG), motion capture, force sensors, force platform, and digital camera] are classically performed in a laboratory environment that could influence the performance. We present a system for studying the running sprint start that synchronizes motion capture, EMG, and ground reaction force data. To maximize motion capture (Vicon 612 with six cameras), a special dim environment was created in the stadium. "Classical" tools were combined with "purpose-built" tools intended to analyse the different aspects of movement. For example, a synchronization system was built to create a common time-base for all data recordings and a portable EMG system was synchronized by a cable that was "disconnected" by the athlete's movement out of the blocks. This disconnection represented an independent event recorded by different tools. A "gap" was measured for some sprint start events between kinetic and kinematic (motion capture) data. Calibration results, measurements of time "gap", and duration of the independent event were used to validate the accuracy of motion capture and the synchronization system. The results validate the entire experimental set-up and suggest adjustment values for motion capture data. This environment can be used to study other movements and can easily be applied to several sports.

[Extranodal non-Hodgkin's lymphomas. Review and our experience]. / I linfomi non-Hodgkin extranodali. Review e nostra esperienza.

The authors report their experience concerning 12 cases of extranodal lymphoma (6 gastric, 1 duodenal, 2 ileal, 1 rectal, 1 splenic, 1 mammary). Extranodal lymphomas are increasing because of the high number of patients with AIDS and new extra-European immigration. Surgery is important not only for diagnosis, but above all for therapy. The great majority of extranodal lymphomas is diffuse rather nodular. Diffuse histiocytic type is the most commun pathologic feature. Prognosis of gastroenteric lymphomas is better than adenocarcinomas of gastrointestinal tract. The surgical techniques are the same as those used for the others tumors, and combined-modality therapy appears superior to local therapy alone for patients with extranodal disease characterized by unfavorable histology, site or stage. The classification is that of Ann Arbor, but for many authors the TNM system was an useful predictor of survival in patients treated with surgery.

[Meckel's diverticulum. Personal experience]. / Diverticolo di Meckel. Esperienza personale.

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in 1-3% of autoptic studies. It's remnant of the omphalomesenteric duct which connects the primitive gut to the yolk sac in early fetal life and the failure of obliteration may result in an omphalomesenteric fistula, an enterocyst, a fibrous band connecting the small intestine to he umbilicus. It's a true diverticulum arising from the antimesenteric border of the small bowel and often is associated with inflammatory bowel disease. Usually Meckel's diverticulum is asymptomatic; when it's complicated by bleeding, obstruction and inflammation, occurs as a symptomatic lesion but it's difficult to diagnose, because its signs and symptoms are identical to such common as Crhon's disease, appendicitis, and peptic ulcer diseases. The preoperative diagnosis of a Meckel's diverticulum, especially in the adult when asymptomatic, is still a serious problem; X-ray, US, radioisotopic scan and TAC are noninvasive, nonspecific test for the detection of this lesion. Many authors had suggested (to prevent its complications), the routine search during every laparotomy, with its surgical resection also in asymptomatic cases. The authors report their fifteen years experience in the diagnosis and treatment of 29 cases of patients with Meckel's diverticulum in the Susa Hospital (1976-1991).

[Schwannoma of the ultimate ileal loop. Case report and review of the literature]. / Schwannoma dell'ultima ansa ileale. Case report e review della letteratura.

The paper reports a rare case of malignant ileal schwannoma. A review of the most recent literature confirms the diagnostic and therapeutic procedures used by the authors. Minimal resection or necessary resection in relation to the site and local situation are the only real therapy apart from palliative surgery. It is vital to identify any possible polycentric manifestation since schwannoma is often associated with Recklinghausen's disease. Radiotherapy and chemotherapy are completely ineffective. Responses were obtained in around 30% of cases in the most common trials; the gastrointestinal localization also appears to be even less responsive. The most active drugs are decarbazine, doxorubicin and ifosfamide, associated with CIVADIC or MAID polychemotherapy protocols. It is often difficult to diagnose malignancy; the overall survival rate (taking grading into account) is 7-10% after 10 years and 50% after 5 years for those forms with the lowest degree of malignancy. Antoni classified schwannoma into: type A with a solid component, and type B with a microcystic component. Treatment and prognosis are identical.

[A rare complication of obstetric pathology: uretero-uterine fistula]. / Una rara complicanza in patologia ostetrica: la fistola uretero-uterina.

Accidental iatrogenic injuries of ureters and bladder in patients with abdominal and pelvic pathology are described as a possible lesion of a surgical or gynaecologic treatment. The ureteral lesion is less frequent in obstetric surgery, but the young age of the patients and the gravity of the consequences, impose a very serious problem for a early diagnosis with a conservative surgical treatment. On the contrary, this important injury, bears an important surgical management with possible functional damage of the reno-urinary tract. The Authors report the experience about the observation and treatment of a case of a young woman, 29 years old, who had a uretero-uterine fistula, after a cesarean section for the first pregnancy.

[Breast carcinoma in the elderly patient: which treatment?]. / Carcinoma mammario nell'anziano: quale trattamento?

We here describe our experience of the treatment of "breast cancer" in the elderly. The results in this group of patients (37 over 75 years) are like the younger group if: the local control is done; hormonotherapy is prescribed; chemotherapy is done even in the 70-80-year-old group. If a radical mastectomy isn't impossible in the patients over 80, even a simple mastectomy is safe. In this patients a conservative local treatment of the breast is not mandatory. Our over-75-year-old patients have no psychological problem related to mastectomy. They often don't accept obligatory radiotherapy after the conservative treatment of breast cancer, and moreover the breast cancer in the elderly is usual smaller, fibrotic and bigger than 3 cm. Lymph nodal status isn't important for overall survival, but only for the eventual chemotherapeutic treatment, so in patients over 80 year-old simple mastectomy is sufficient because we don't use chemotherapy for the general conditions of the same. The local control of axillary lymph nodes is obtained with radiotherapy if necessary. Screening for breast cancer must also include 70-75-year-old patients. Why is the breast cancer in elderly like the others patients? Some authors have seen that the immuno-reaction around the cancer in elderly is less than the same reaction observed in younger patients. So in the elderly there is a smaller production of "growth factors" important for the growth of the tumor and of "angiogenesis factor", fundamental for the initial growth of the cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

[Rupture and migration of central venous catheter]. / Rottura e migrazione di catetere venoso centrale.

In the period 1978-1990, 100 patients (44 males, 56 females) with various pathology, had a catheterisation of a central vein in the Hospital of Susa (TO). Subclavian vein was chosen with a percutaneous infraclavicular route. In 7 cases (7%) there were some mechanical complications, one of them was the accidental breakage of the catheter and its migration to the right heart. The authors describe this case and the possible cure by examining the most recent literature data.

[Our experience of parenteral nutrition (PN) in general surgery]. / Nostra esperienza in tema di nutrizione parenterale (NP) in chirurgia generale.

The problems caused by malnutrition in postoperative complications are well know as is the importance of parenteral nutrition (NP). Thanks to the improvement in instruments and methods, NP can be used not only in intensive therapy departments, but also in less well equipped ones. The Authors report their experience of the use of NP in 77 patients from January 1978 to December 1989 treated in the Surgical Department of the Civil Hospital of Susa (TO), USSL 36, Regione Piemonte.

[Spontaneous hematoma of the abdominal wall]. / L'ematoma spontaneo della parete addominale.

Spontaneous hematoma of the abdominal wall is an unusual event which has an aspecific symptomatology, common to other diseases. There are factors which create a predisposition to the formation of hematoma and others which trigger off this phenomenon. The paper reports 8 patients, aged between 35 and 85 years: predisposition, symptomatology, characteristics of hematoma and therapy are illustrated in a table. Diagnosis was generally made using ultrasonography and the prognosis was always benign.

Preventing infection related to insertion of an intrauterine device.

A study was undertaken to determine whether pelvic inflammatory disease (PID) resulting from the insertion of an intrauterine device (IUD) could be eliminated by inserting the IUD during ovulation and administering prophylactic antibiotics to cover insertion. IUDs, 95% of which were Progestaserts, were inserted within two days of probable ovulation in 288 patients. These study patients were compared with a matched control group of 288 patients not using IUDs. None of the 288 IUD patients (totaling 619 woman-years of IUD use) developed PID after insertion, and only 0.5% per 100 woman-years developed PID later. The incidence of PID seen in these patients was less than that observed in the control group. It was also less than that in the general population or that following legal induced abortion. The expulsion rate of 1% per 100 woman-years in our patients is the lowest ever reported. It probably is related to the low motility of the uterus and expansion of the cervix during ovulation; the latter facilitates insertion during ovulation.

Antepartum diagnosis of goitrous hypothyroidism by fetal ultrasonography and amniotic fluid thyrotropin concentration.

Ultrasonography of a 26-week-old fetus suggested the presence of a goiter. Amniocentesis was performed at 26 and 38 weeks gestation to evaluate thyroid function. An elevated amniotic fluid TSH level was found on both occasions, though amniotic fluid T4, T3, and rT3 levels were similar to those of euthyroid fetuses. The diagnosis of goitrous hypothyroidism was confirmed at birth. Therapy with thyroid hormone was instituted on the first day of life. Growth and development of the infant have been normal during the first year of his life. We suggest that the measurement of amniotic fluid TSH can be useful in the diagnosis of intrauterine primary hypothyroidism.

Localized ischemic colitis in a young woman with diabetes.

ischemic colitis involving a limited segment of the proximal transverse colon in a young diabetic woman was identified and treated. Important clinical, radiographic, and histopathologic findings are detailed.