[Postoperative intra-abdominal adhesions: prevention and treatment]. / Le aderenze intraddominali postoperatorie. Prevenzione e trattamento.

The formation of adhesions after abdominal surgery is a very frequent event, often burdened by complications. Different techniques and materials have been tested in order to reduce peritoneal damage and the onset of adhesions. While the introduction of improved surgical techniques has been decisive, the use of drugs and irritating solutions has not produced significant results. Promising results have been obtained by the use of barrier systems that allow the peritoneal surfaces to be mechanically separated during healing and re-epithelialization: Interceed (TC7)--Absorbable Adhesion Barrier--appears to be the most appropriate material for this purpose at present, given that it has been demonstrated to be of use in reducing both the incidence and extent of adhesions. The use of this material in general surgery over the past to years or so appears to the authors to be indicated in the event of secondary abdominal surgery with detachment and extensive peritoneal damage, and in more restricted surgery performed on the true pelvis in women of child-bearing age.

[Pseudotumor of the supraclavicular fossa]. / Lo pseudotumore della fossa sovraclaveare.

The authors focus on a physiopathologic manifestation, most often misdiagnosed, which present as a "lipomatous-like mass in the supraclavicular fossa". This is generally at the origin of sophisticated radiologic tests and, not infrequently of useless biopsies. The paper analyzes the different reasons leading, alone or in combination, to the phenomenon by which the mediastinal fat is pushed toward regions where no limits anatomic structures exist, such as the supraclavicular fossa. Knowledge of the above causes, together with a careful physical examination plus a standard postero-anterior-X-ray can easily lead to a correct diagnosis of "pseudotumor of the supraclavicular fossa", avoiding costly and needless diagnostic and therapeutic interventions.

[Problems of immunological monitoring and lung excision for carcinoma]. / Problemi de monitoraggio immunologico ed exeresi polmonare per carcinoma.

Following a number of remarks on the desirability of introducing into the practice of bronchopulmonary cancer surgery certain immunological ideas, a monitoring programme to be adopted in candidates for lung exeresis and for their subsequent monitoring is presented. The data to emerge thus far may be correlated fairly precisely with the prognosis and from this point of view their use in the selection of patients to be operated might be hypothesised.

[Initial observations on the use of levamisole in the immunostimulation treatment of patients operated on for lung cancer]. / Prime osservazioni sull impiego del Ievamisolo nel trattamento immunostimolante dei pazienti operati di resezione per carcinoma polmonare.

The results obtained with levamisole in the immunostimulating of 59 resected and non-resected lung carcinoma patients are presented. The effectiveness of the treatment was assessed in terms of survival, length of the free interval, etc. Cutireaction to the drug was repeatedly monitored. It is felt that the overall results were insufficient evidence of the true effectiveness of this manner of treatment, even though some data indicative of the therapeutic action of the drug were obtained.

[Comparison between automatic substraction devices and computer subtraction in radioisotope pancreatography]. / Confronto fra dispositivi automatici di sottrazione e sottrazione al computer nella pancreatografia radioisotopica.

Reference is made to several indicative cases in a personal series. Their comparative examination with a scanner and a gamma camera computer showed that: a) noticeably different findings were given by the two methods with regard to cystic, neoplastic, and inflammatory lesions of the pancreas, whereas; b) computerised subtraction was much more sensitive in lesions due to cysts and pancreatitis, even though there was no significant difference between the two methods in the case of neoplasia.

[Current role of pancreatic scintiscanning in the study of pancreatic symptomatology]. / Ruolo attuale della scintigrafia pancreatica nel contesto della semeiologia del pancreas.

A brief reference is made to the part once assigned to scintiscanning as a method of approach to diseases of the pancreas. It is felt that the lack of confidence now displayed in this technique is based preconceptions. A new diagnostic approach is therefore proposed and briefly described. The advantages and disadvantages of the diagnostic techniques included in the proposed scheme are examined. The view is expressed that a fresh assessment should be made of nuclear pancreatography, since it is still a fundamental diagnostic tool.

[Radiopaque hemithorax, with special reference to scintigraphic methods]. / L'emitorace radiopaco con particolare riguardo alle metodiche scintigrafiche.

Radioopaque hemithorax is frequently observed. The various situations in which it may occur are examined aetiopathologically, along with the general and specifically radiological methods used for its investigation. Particular attention is given to the employment of radio-isotopes for this purpose and the methods involved. Results obtained with perfusion are noteworthy, and even more so those achieved with positive tracers such as 67Ga citrate and 57Co Blm, especially in the differential diagnosis of pleural effusion and mesothelioma through what is described as the "paradox effect".

[Surgical indications in aspecific pneumopathies]. / Indicazioni chirugiche in pneumopatie aspecifiche.

A degree course lecture based on a review of the relevant literature and experience gained at a 1000-bed lung hospital (S. Luigi Hospital, Orbassano) is presented in a shortened form. Attention is drawn to the revival of discarded techniques due to anaesthesiological and medical advances. This has considerably extended the surgical indications.

[Surgical treatment of echinococcal cysts with double hepatic and pulmonary localizations]. / Sul trattamento chirurgico delle cisti da echinococco a doppia localizzazione epatica e polmonare.

On the basis of some personal cases and with reference to world literature on the subject, the surgical treatment of liver and lung localized echinococcus cyst is discussed. Special attention is paid to 1) thoracotomy which may in some cases become a thoraco-phreno-laparatomy, the only approach which leads to really effective control of the field; 2) problems of suction drainage, particularly as regards diaphragm mobility in cases of thoraco-phreno-laparatomy.

[Early diagnosis of pulmonary embolism by means of scintigraphy]. / Diagnosi precoce dell'embolia polmonare mediante scintigrafia.

The occasions on which lung embolism is likely to occur and proceed with or without initial clinical symptoms are described. Lung scintiscanning technique, complemented by special expedients and personal experience, is explained. It is felt that the method helps in the early detection of suspect or clinically silent forms, as well as in the corroboration or ruling out of a clinical diagnosis as soon as this is possible. Scintiscanning is also of assistance in showing the anatomopathological features and extent of the process. The technique is simple and readily tolerated, even by patients with slight respiratory or circulatory disturbances. On the other hand, it is not competitive with conventional and well-tried angiopneumography.

[Scintigraphic diagnosis of pancreatic diseases: random analysis of 100 patients]. / La diagnostica scintigrafica delle pancreopatie: analisi randomizzata di 100 pazienti.

After a brief statement on the procedure of selection of the patients, the article describes how the cases were studied, since some difficulties arose through the lack of homogeneity of the subjects. The cases are then commented and an effort is made to evidence the outstanding data which can be deduced, and in particular a study is made of the percentage of overall unreliability of scintillographic examination, the "false positives" and the "false negatives", which are rather low. The Authors conclude with the consideration that scintiscanning of the pancreas now constitutes a valid method of investigation of pancreatic pathology.

[Surgical technics indicated for spontaneous pneumothorax. Personal experience in 266 operations]. / Tecniche chirurgiche indicate per il pneumotorace spontaneo. Esperienza personale relativa a 266 interventi

The surgical techniques best suited for timely management of spontaneous pneumothorax are described. Results in 266 cases are discussed and compared with the recent literature. Reference is also made to a little known technique: photothermostimulation, and the results it offers are illustrated. Encouraging results have been obtained from rapid frottage of the parietal pleura and this is described. Emphasis is placed on the advisability of early operation to forestall possible surgical and anatomofunctional complications, to ensure good recovery of respiratory capacity, and to prevent mechanical sequelae involving the cardiorespiratory system.