Study of the antireflux function of the Roux-en-y jejunal loop in reconstruction following gastrectomy.

Persistence of global orthograde peristaltic propulsion in the Y jejunal loop according to Roux makes this latter adequate for reconstruction of digestive transit after gastric resection or total gastrectomy, simultaneously avoiding reflux. Ectopic pacemakers can set in its proximal tract and favor intestinal and bile juice reflux in the gastric stump or esophagus, especially if the loop is too short and the new pacemaker is far from its superior margin. Moreover, the slower peristaltic waves can favor a relative stasis and, thus, a containing function, which could represent an element of morbidity over a certain limit. If the Y loop is not too long, but long enough to include the higher frequency ectopic pacemaker, which overcomes the lower frequency ones located distally, the positive aspects of both these characteristics can be exploited for satisfying and free of morbidity results. We believe that the best length is 35-40 cm, with positive clinical results. 99Tc-HIDA sequential scintigraphy clearly shows the absence of bile material reflux in the digestive tract proximal to the anastomosis.

[Whole body irradiation in conditioning for bone marrow transplantation. Experiences with 35 cases of leukemia]. / L'irradiazione corporea totale nel condizionamento al trapianto di midollo osseo. Esperienza su 35 casi di leucemia.

Total body irradiation, carried out in two different regimens (10 Gy single dose; 200 cGy X 5 fractions) has been used in 35 patients with acute leukaemia or chronic leukaemia in chronic or accelerated phase, in preparation for bone marrow transplantation. The dose rate was in the range of 2-4 cGy . min-1. No lung shielding was adopted. The role of total body irradiation in the development of interstitial pneumonitis is considered. Rather than to the regimen of total body irradiation--single dose or five fractions--the incidence of interstitial pneumonitis seems to be related to other factors; mainly to the presence of Graft-versus-Host-Disease: Five patients out of six with III or IV grade GvHD, developed interstitial pneumonitis; only one patient out of twenty without GvHD or with a low grade GvHD developed interstitial pneumonitis.

99mTc-Ca-gluconate renal scintigraphy in patients with chronic renal failure.

From use of 99mTc-Ca-Sn-gluconate in patients with various degrees of renal failure the following conclusions were drawn: 1. a good relationship exists between the parenchymal and vascular patterns in scintigraphy and the functional renal impairment; 2. the morphological definition is good, since in most cases a differential diagnosis can be made between diffuse parenchymal disease and space-occupying lesions even very low glomerular filtration rate values; 3. this technique is supplementary to i.v. pyelography in patients with relatively good glomerular filtration rate values and is a reliable alternative to i.v. pyelography in those with low creatinine clearance values.