[Evaluation of the tolerance of a lipid emulsion administrated during total parenteral nutrition in surgical patients]. / Valutazione della tollerabilità di una emulsione lipidica somministrata in corso di nutrizione parenterale totale in pazienti chirurgici.

Tolerance's evaluation of a lipid emulsion given in course of parenteral total nutrition in surgical patient's. The first fat emulsions for intravenous application were thrown on the market in the 1920's years. Authors make a study on a limited sample of surgical patients about type and incidence of both immediate and late adverse reactions versus intravenous administration of Lipofundin S. They also suggest, on the same time, a protocol for the survey of these reactions. The results suggest a good tolerance to Lipofundin S intravenous administration and no influence on haematic biochemical parameters.

[Risk surgery of the carotid. A balanced assessment of the use of locoregional anesthesia]. / Chirurgia a rischio della carotide. Un primo consuntivo circa l'uso dell'anestesia loco-regionale.

The authors report their experience with regional anaesthesia in carotid surgery. They performed 80 carotid endarterectomies in 79 patients. Thirty-three patients were at high surgical risk because of contralateral internal carotid artery occlusion or bilateral stenosis (greater than 70%) or ischemic brain areas for past stroke. In this high risk group 4 strokes were registered in the postoperative period, while no strokes appeared in patients non at risk.

[Prognostic factors in surgery of ruptured aneurysms of the abdominal aorta]. / Fattori prognostici nella chirurgia degli aneurismi dell'aorta addominale rotti (nostra esperienza in 83 pazienti).

From 1978 to 1986 83 patients underwent surgery for ruptured abdominal aortic aneurysm. The intraoperative and post-operative mortality rates was 34%. This multivariant analysis has been performed with intention of identifying the specific factors that affected the surgical outcome of ruptured abdominal aortic aneurysms. Increased intraoperative mortality rates were associated with heart disease, while postoperative mortality rates were associated with preoperative hypotension, BUN, levels higher than 40 mg/dl and other factors like duration of operation, blood less, blood transfusion and pre-operative hematocrit.

[Aneurysms of the gluteal artery (description of a clinical case and review of the literature)]. / Gli aneurismi dell'arteria glutea (Descrizione di un caso clinico e revisione della letteratura).

The authors show a case of superior gluteal artery aneurysm they operated successfully. Starting from this case the Authors review the literature about the etiology, the clinical characteristics, the diagnosis and the various methods of treatment of this lesion.

[Subclavian and innominate steal syndrome (our experience with 29 patients)]. / Il furto della succlavia e dell'anonima (nostra esperienza in 29 pazienti).

Subclavian steal syndrome and innominate steal syndrome are well-known reasons of cerebral vascular insufficiency. Today this pathology can be corrected by extra-anatomic by-passes. In our experience in recent years (1980-1986) these by-pass (in our patients carotid-subclavian and subclavian-subclavian by-pass) gave very good outcomes. These are simple and poor-risk operations. Their patent after many years is very good.

[Arterial aneurysms of the upper limbs (our experience and review of the literature)]. / Gli aneurismi delle arterie degli arti superiori (nostra esperienza e revisione della letteratura).

The authors discuss about the very low incidence of the upper extremities aneurysms and about their post-traumatic etiology. They show their experience in 6 cases with a Follow up from 2 to 17 years. All the patients were operated on; in 2 cases the authors performed aneurysmectomy only and in 4 cases an axillo-brachial by-pass. The results are very good in every patient.

[Evaluation of materials and technics in vascular surgery using 111-Indium]. / Valutazione dei materiali e delle tecniche in chirurgia vascolare mediante Indio 111.

The thrombogenicity of the graft materials is a significant factor incriminated in early failures. Some improvements have been achieved by modification of physical characteristics of the material as porosity, compliance, durability in order to improve patency rates. Platelets are major determinants of thrombus formation and may still be thrombogenic by activation of the coagulation enzymes. The purpose of this work is to study the platelets deposition on different material grafts, utilizing autologous platelets labelled with 111-Indium. The radioactivity pulses was recorder before and 4 days after surgery in aortoiliac and femoropopliteal districts. The graft material used in aortoiliac occlusions was: velour, double velour PTFE; in femoropopliteal: Double velour, PTFE, saphenous vein, umbilical vein, bovine carotid. In some patients the operation was TEA with patch in PTFE. The authors show the results of this study in 92 patients in relation of the material graft an location.

[Thromboembolectomy by Fogarty's catheter (experience in 416 interventions)]. / La tromboembolectomia mediante catetere di Fogarty (esperienza su 416 interventi).

Thrombo-embolectomy by means of a Fogarty balloon catheter became part of routine surgical practice more than twenty years ago with a standardized method and technique. The authors report on a surgical population spread over ten years' activity (1975-1985) in the Institute of Surgical Pathology of the University of Verona with records of 416 emergency operations to remove thrombo-embolisms. Owing to its lack of operative mortality and the minimal trauma it causes, the technique is now strongly indicated and widely used. On the basis of their experience, however, the authors stress the need to adhere to certain basic principles: early recognition of the disease (within 12 hours); early anticoagulation of patients; immediate surgery. It is only by adopting such a policy that better results may be obtained in future and the number of amputations reduced.

[Chemodectomas of the glomus caroticum]. / I chemodectomi del glomo carotideo.

The authors review the nature, biological evolution, diagnosis and treatment of carotid body tumors both on the basis of data reported in the literature and in the light of their own experience with a population of 11 carotid body chemodectomas. All patients (except one) were subjected to total resection of the neoplasm. In one case, surgery was confined to a partial resection. Operative mortality was nil, and complications consisted in one case of Claude-Bernard-Horner syndrome, one lesion of the XII cranial nerve and one lesion of the X cranial nerve. Follow-up of the patients (min. 6 months, max. 10 years) has shown no recurrences or metastases.

Carcinoembryonic antigen and cancer: a comparative study.

The sera of 212 patients with malignant and non-malignant diseases have been radioimmunoassayed for the presence of the carcinoembryonic antigen (CEA) using 3 different kits produced of Hoffman La Roche, Switzerland (RCK), BY Sorin-IRE, Italy and Belgium (SCK), and by the Istituto Sieroterapico Milanese, Italy (ICK). In the presence of endodermically-derived system carcinomas, the RCK gave more positive results (72.6%) than did the SCK (63.1%) or ICK (56.2%). With regard to other carcinomas, ICK (50.0%) and SCK (47.1%) gave better results than did RCK (30.6%). The results are discussed in terms of clinical usefulness of the CEA assay and as regards reproducibility, procedural advantages, and economical cost of each kit. It is concluded that the CEA assay cannot be used for the diagnosis of gastrointestinal cancers, although it is useful as a measure of "cancerosity" for prognostic purposes. In this sense the double antibody method employed by SCK and ICK is clinically more advantageous than is the perchloric acid extraction-zirconyl phosphate gel precipitation method of RCK.