Biliary reflux after cholecystectomy: a prospective study.

The authors carried out a prospective study to ascertain whether cholecystectomy itself might be the cause of duodenogastric reflux. Patients with cholelithiasis were examined and underwent the following tests: hemanalysis, gastroscopy with biopsy, 24 hour pH-metry and acetaminophen test. Twelve patients were selected. Six months after the operation the tests were repeated. All patients were asymptomatic. Hemanalysis was normal in all 12 patients and no difference was seen in the tests of 5 of the patients; however in the other 7 differences were observed in all the tests. The authors conclude that cholecystectomy helps to provoke duodenogastric reflux in predisposed patients, and that this reflux may be asymptomatic.

Increased plasminogen activator enzymes of the tunica vaginalis in long-standing idiopathic hydrocele.

Previous research has shown increased fibrinolytic activity of the serous membranes as a reaction to stimuli that did not destroy their mesothelium. Large amounts of fluid remarkably stretch and chronically stimulate the tunica vaginalis in long-standing idiopathic hydrocele. For these reasons, a prospective controlled study was carried out in 30 male patients in order to investigate the possible alterations of the fibrinolytic capacity of this serosa by a method suitable for measuring plasminogen activator content of a single layer of cells. A possible role of plasminogen activator enzymes as a protective barrier against incidental absorption of fibrin/fibrinogen from the hydrocele fluid into vaginal tissues is considered.

Fibrinolytic activity of mesothelial lining of the displaced peritoneum.

Because of the suggestive analogy between a large hernial sac and the irreversibly displaced serosa, a prospective controlled study has been carried out in order to compare the fibrinolytic activity of mesothelial cells of the sac and of the parietal peritoneum in man. Results suggest the importance of undamaged mesothelial cells for the fibrinolytic activity of the peritoneal serosa. Careful defense of the mesothelial lining from direct trauma and damage has therefore to be regarded as necessary and perhaps sufficient requirement to preserve the fibrinolytic activity of attached peritoneal flaps dislocated to cover or separate the surgically deperitonealized surfaces.

Fibrinolytic activity of the human peritoneum.

A new method is presented to measure the content of plasminogen activator in single layers of mesothelial cells to investigate the fibrinolytic activity of the human peritoneum. The results demonstrate the synthesis of plasminogen activators in different areas of the peritoneal serosa. In the omental peritoneum, the fibrinolytic activity is significantly higher than in other parts of the peritoneum.

[Endothyroid (non-chromaffin) branchiomeric paraganglioma. Description of a clinical case]. / Paraganglioma branchiomerico endotiroideo (non cromaffine). Descrizione di un caso clinico.

A case of endothyroid paraganglioma in a 9-yr-old girl is described. Subtotal lobectomy was performed and the tumour was not recognised until a histological examination has been carried out on a section embedded in paraffin. Only two other cases could be found in the literature. An account is given of the diagnosis of this form, and reference is made to its prognostic aspects since there is a remote possibility that metastasis may occur many years after surgery.

[Our experience with reparative and derivative operations for non-cancerous lesions in the extrahepatic bile ducts]. / La nostra esperienza negli interventi riparativi e derivativi per lesioni non neoplastische delle vie biliari extraepatiche

17 reparative operations on the bile ducts, 7 of which were immediate (5 for peroperative lesions and 2 for "spontaneous" lesions) and 10 reoperations to deal with sclero-cicatricial lesions, were studied. 7 reconstructive operations (plastic or end-to-end anastomosis) and 10 derivative operations with a preference for hepato- or choledocho-jejunostomy on defunctionalized loop were carried out. The former were reserved for lesions without or with minimum loss of substance, the latter for extensive lesions. Operative mortality is high and higher still in immediate interventions. Long term results were good in all cases but one.