[Thyroid ectopia: problems in diagnosis and therapy]. / L'ectopia tiroidea: problemi di diagnosi e terapia.

The Authors report the cases of ectopic thyroid (n=22) observed among the thyroid pathologies that underwent surgical approach in the last 20 years (n=2670), to discuss their clinic characteristics other than the diagnostic and therapeutic approaches. Sometimes asymptomatic or emerged after thyroidectomy, the ectopic thyroid may generate functional troubles or, most frequently, local compression that require surgical approach that, in the opinion of these authors, is ever indicated also for asymptomatic forms. Based on author's experience, also if statistically rare, it is not possible to neglect the neoplastic degeneration, elapsed in two out of 22 cases analyzed.

[Biliary acute pancreatitis: an etiopathology and evolution review of 148 cases]. / Pancreatitis aguda biliar. Una revisión etiopatogénica y evolutiva de 148 casos.

BACKGROUND: A retrospective analysis of the etiologic factors and physiopathogenic mechanisms underlying an acute biliary pancreatitis episode put in evidence the complexity of the attempt to acquire a clear understanding of the entity. In this presentation the authors try to re-examine the main factors involved in the triggering of the disease. Besides the classic theories and their own approach to the management of an acute pancreatic inflammation episode are discussed. AIMS: The main purpose of this endeavor was to identify and discuss the etiopathogenic mechanisms that were prevalent in a series of 148 patients observed and treated in a 10 years period. Besides, another distinctive aim was to analyze their evolution and somehow to try to assess their probable prognosis. PLACE OF APPLICATION: Close community. POPULATION: The whole group of patients that were admitted with the diagnosis of acute pancreatitis in the time period comprised between 1987-1997. METHODS: The acute pancreatitis subgroups and their respective number of patient included were the following: BILIARY ACUTE PANCREATITIS 140 CASES POST ERCP 8 CASES CONCLUSIONS: As a result of the present reviewing endeavour several observations deserve to be pointed out: a. The pancreatic gland undoubtedly is a neuroendocrine organ, that is subjected to complex neural and hormonal influence. b. Undeniably, the involvement of the autonomic nervous system in the physiopathogenic mechanism of acute pancreatitis has been surprisingly disregarded. c. The biliary acute pancreatitis variant is the most frequent. What we consider a simplification is to accept the Opie's postulation without taking into account the intermediate steps, centered on autonomic reflexes, that ultimately lead to the acute inflammatory lesions. d. Although without an absolute proof, it is undeniable that "stress" is a primary etiology in some cases of acute pancreatitis. e. We favor the idea that the pancreas functional status influences on the extension and intensity degree of the acute pancreatic inflammatory lesions.

Pancreatitis aguda biliar. Una revisión etiopatogénica y evolutiva de 148 casos. / [Biliary acute pancreatitis: an etiopathology and evolution review of 148 cases]

BACKGROUND: A retrospective analysis of the etiologic factors and physiopathogenic mechanisms underlying an acute biliary pancreatitis episode put in evidence the complexity of the attempt to acquire a clear understanding of the entity. In this presentation the authors try to re-examine the main factors involved in the triggering of the disease. Besides the classic theories and their own approach to the management of an acute pancreatic inflammation episode are discussed. AIMS: The main purpose of this endeavor was to identify and discuss the etiopathogenic mechanisms that were prevalent in a series of 148 patients observed and treated in a 10 years period. Besides, another distinctive aim was to analyze their evolution and somehow to try to assess their probable prognosis. PLACE OF APPLICATION: Close community. POPULATION: The whole group of patients that were admitted with the diagnosis of acute pancreatitis in the time period comprised between 1987-1997. METHODS: The acute pancreatitis subgroups and their respective number of patient included were the following: BILIARY ACUTE PANCREATITIS 140 CASES POST ERCP 8 CASES CONCLUSIONS: As a result of the present reviewing endeavour several observations deserve to be pointed out: a. The pancreatic gland undoubtedly is a neuroendocrine organ, that is subjected to complex neural and hormonal influence. b. Undeniably, the involvement of the autonomic nervous system in the physiopathogenic mechanism of acute pancreatitis has been surprisingly disregarded. c. The biliary acute pancreatitis variant is the most frequent. What we consider a simplification is to accept the Opies postulation without taking into account the intermediate steps, centered on autonomic reflexes, that ultimately lead to the acute inflammatory lesions. d. Although without an absolute proof, it is undeniable that [quot ]stress[quot ] is a primary etiology in some cases of acute pancreatitis. e. We favor the idea that the pancreas functional status influences on the extension and intensity degree of the acute pancreatic inflammatory lesions.

[Non-invasive evaluation with continuous Doppler of the systolic pressure of the right ventricle in patients with tricuspid insufficiency]. / Valutazione non invasiva con Doppler continuo della pressione sistolica del ventricolo destro in pazienti con insufficienza tricuspidale.

Tricuspid regurgitation (TR) is detected by Doppler echocardiography in a high proportion of patients with right ventricle pressure or volume overload. Continuous wave Doppler (CW) provides a noninvasive estimation of the transtricuspid systolic pressure gradient, applying the modified Bernoulli formula to the maximum velocity of the TR jet. The purpose of this study was to test the accuracy of the CW prediction of systolic right ventricular pressure (RVPs), obtained adding a clinical estimate of the mean right atrial pressure (RAPm) to the Doppler derived pressure gradient. The study population consisted of 22 adult patients with Doppler proved TR, undergoing right heart catheterization (cath) for mitral valve disease (12 pts), atrial septal defect (8 pts), dilated cardiomyopathy (1 pt) or pulmonary hypertension (1 pt). Two studies were duplicated after nifedipine administration. TR was graded by pulsed Doppler flow mapping as mild in 7, moderate in 11, severe in 4 pts. RAPm was estimated clinically from the inspection of neck veins pulsatility (mmHg = pulsatility cm+5/1.3). At CATH RVPs ranged from 27 to 80 (46 +/- 17) mmHg, RAPm from 0 to 13 (6 +/- 3) mmHg. RVPs Doppler prediction showed a close correlation with CATH (r .97, SEE 4.2 mmHg), with a slight mean underestimation (-2 +/- 4 mmHg) (Fig. 3, Tab. I). The discrepancies between CW and CATH ranged from -9 to +10 mmHg, almost entirely due to inaccuracy of the RAPm clinical estimate (r .48, see 3.8 mmHg) (Fig. 4, Tab. I).(ABSTRACT TRUNCATED AT 250 WORDS)

[Early peak of CPK in acute myocardial infarct: a marker of clinical instability?]. / II picco precoce della CPK in corso di IMA: marker di instabilità clinica?

The evaluation of the CPK-peak time (CPK-p) during Acute Myocardial Infarction (AMI) is now considered as a reliable method to identify ischemic myocardial tissue reperfusion both spontaneous and pharmacologically-induced. The purpose of this study is to assess the clinical significance of this index over a non selected group of patients (pts) affected by a first episode of AMI looking for some variables possibly connected with it. This study includes 114 pts hospitalized in our Unit Coronary Care (UCC) and diagnosed as affected by AMI and not treated with anticoagulant and/or fibrinolytic drugs. They were divided according to CPK-p into 2 groups: group A (23 pts, 18M 5F, mean age 64.2 +/- 10.1y; CPK-p 11.9 +/- 3.3h, AMI Anterior 14/AMI Inferior 9) and group B (91 pts, 85M 6F, mean age 64 +/- 10.3y; CPK-p 25.7 +/- 4.5h, AMI Anterior 50/AMI Inferior 41). Moreover, a third group C has been studied including pts with similar clinical characteristics who underwent thrombolysis by intravenous infusion of Streptokinase (48 pts, 39M 9F, mean age 62.7 +/- 10.6y; CPK-p 15.2 +/- 7h, AMI Anterior 28/AMI Inferior 20). For each pt CKP-p has been evaluated as well as the pre-UCC time (T-pc), the maximum value of released CPK (CPK-max), the incidence of new coronary events such as angina, re-AMI, sudden death detected between the 1st (NEC-I) and the 6th month (NEC-II) after the acute event.(ABSTRACT TRUNCATED AT 250 WORDS)

Cutis marmorata telangiectatica congenita with multiple congenital anomalies.

Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular anomaly. Congenital persistent livedo reticularis, telangiectases, and superficial ulceration are the hallmarks of this syndrome. There is an association of CMTC with other congenital abnormalities in at least 50% of the patients. A newborn girl is described with a diagnosis of CMTC combined with multiple congenital abnormalities including imperforate anus, rectovaginal and urethrovaginal fistulas, and absent clitoris. These abnormalities have not been previously reported with CMTC. Congenital abnormalities that have been recognized with this syndrome are reviewed.

Investigation of temperature fields around embedded cryoprobes.

The temperature fields around cryoprobes were investigated analytically and experimentally. Two cryoprobes were employed: a spherically shaped general purpose probe utilizing liquid nitrogen and a cylindrical "glaucoma" probe utilizing the Joule-Thomson effect in gaseous CO2. Both probes were operated by commercial cryostats. The analytical solutions included a one-dimensional integral solution for the general purpose cryoprobe, and finite element solutions for both cryoprobes. Both solutions were based on the enthalpy method. Analytical and experimental results compared reasonably well. Deviations of these results are believed to be due, mainly, to the incomplete specification of the boundary conditions on the surface of the cryoprobe.