[Failed dissolution of a gallstone by methyl tert-butyl ether: importance of predicting gallstone chemical composition]. / Mancata dissoluzione di un calcolo colecistico con metil-tert-butil-etere: l'importanza di predire la composizione chimica del calcolo.

In December 1986 we attempted direct chemical litholysis using methyl-tertiary-butyl-ether (MTBE) in a sixty-year-old man with severe ischemic heart disease who had suffered frequent episodes of biliary colic due to a radiolucent gallstone. MTBE was infused for a total of 17 hrs over a period of 5 days; however the gallstone diameter remained unchanged. The patient was subsequently cholecystomized and chemical analysis revealed that the gallstone was a pigment stone. The need for accurate prediction of gallstone composition before beginning an invasive, such as MTBE infusion, is emphasized.

Use of 131I-19-cholesterol in functional dynamic studies of the adrenals in vivo. II. Clinical application.

Functional dynamic studies of the adrenal in vivo employing 131I-19-cholesterol were carried out as a further screening test, according to the method previously described (Pavonia and Magrini, 1977), on seven patients in whom hyperadrenocorticism was suspected on the basis of clinical symptoms. The data obtained in basal conditions, under ACTH stimulation, and under dexamethasone suppression, compared with each other and supported by the results of conventional examinations, demonstrate that the quantitative information provided by this radioisotope test is correlated with the functional state of each adrenal, thus confirming the potential value of the method for diagnostic purposes. The functional dynamic test proposed does not require a higher dose of tracer than morphologic studies and the radiation risk (approximately 2.5 rad to the ovaries or gonads) seems acceptable in adult subjects.

[New orientations in the treatment of proclaimed tetanus: use of continuous peridural anesthesia]. / Nuovi orientamenti nel trattamento del tetano conclamato: uso della peridurale continua

Notes on the typical infectious and toxis picture associated with tetatus and the physiopathological aspects of the disease are followed by the presentation of continuous C8-L2 peridural anaesthesia, giving antalgic relief and partial motor block, as a primary form of therapeutic management. A classic two catheter technique is employed and fractioned doses are used so as to exploit the action of the local anaesthetic absorbed by the patient over several days. Sedation of the orthosympathetic leads to reduced catecholamine production, hypometabolism and cardiac sedation. Analgesia and relaxation are achieved by blocking the local and general spasms typical of the disease. Success with the method in serious cases is mentioned and its use in all forms is recommended.