Lower plate serpentinite diapirism in the Calabrian Arc subduction complex.

Mantle-derived serpentinites have been detected at magma-poor rifted margins and above subduction zones, where they are usually produced by fluids released from the slab to the mantle wedge. Here we show evidence of a new class of serpentinite diapirs within the external subduction system of the Calabrian Arc, derived directly from the lower plate. Mantle serpentinites rise through lithospheric faults caused by incipient rifting and the collapse of the accretionary wedge. Mantle-derived diapirism is not linked directly to subduction processes. The serpentinites, formed probably during Mesozoic Tethyan rifting, were carried below the subduction system by plate convergence; lithospheric faults driving margin segmentation act as windows through which inherited serpentinites rise to the sub-seafloor. The discovery of deep-seated seismogenic features coupled with inherited lower plate serpentinite diapirs, provides constraints on mechanisms exposing altered products of mantle peridotite at the seafloor long time after their formation.

Nine years' experience of telecardiology in primary care.

The ITMS telecardiology network started in April 1995. Over nine years, about 7000 peripheral medical users (mainly general practitioners), who were experienced in using transtelephonic electrocardiography and who were spread throughout Italy, conducted teleconsultations with the Telecardiology Centre. A total of 106,942 patients were evaluated. Teleconsultation was carried out for non-cardiac symptoms or routine control for 30,444 patients (28%) and for symptoms suggestive of heart disease for 76,498 (72%). After teleconsultation, 61,908 patients (58%) were reported to have no heart disease, 27,947 patients (26%) had their drug dose adjusted and remained at home, 11,503 patients (11%) were sent to their cardiologist for further investigations and 5584 patients (5%) were urgently hospitalized. Among the hospitalized patients, the echocardiogram demonstrated an ST-elevation coronary syndrome in 1785 patients (32%), a non-ST-elevation coronary syndrome in 2236 (40%) and a life-threatening arrhythmia in 1354 (24%). Telecardiology improves the decision making of general practitioners, avoids unnecessary hospitalizations, reduces the time before treatment in cardiac emergencies, rationalizes health-care costs and promotes home care.

Comparative evaluation of the haemodynamic effects of continuous negative external pressure (CNEP) and positive end-expiratory pressure (PEEP) in mechanically ventilated trauma patients.

OBJECTIVE: To compare the haemodynamic effects of identical values of continuous negative external pressure (CNEP) and positive end-expiratory pressure (PEEP) in a group of mechanically ventilated patients. SETTING: General ICU, Vicenza Hospital, Italy. PATIENTS: 15 consecutive patients, admitted after road accident trauma. METHODS: We compared the haemodynamic effects of ZEEP, 10 cmH2O of PEEP, and 10 cmH2O CNEP, applied in random order, in 15 head trauma patients under going controlled mechanical ventilation; 9 had associated thoracic trauma, while 6 did not have lung involvement. CNEP was obtained with a "poncho". RESULTS: We observed a significant increase in CI during CNEP, compared with both ZEEP and PEEP 10 cmH2O. Accordingly the oxygen delivery index significantly increased during CNEP, compared with PEEP 10 cmH2O. Conversely, Qs/Qt decreased with CNEP, if compared with PEEP, both in patients with and without lung damage. CONCLUSION: CNEP can significantly increase CI in mechanically ventilated patients in patients with and without associated lung damage.

Primary hemangiopericytoma of bone - a case-report and literature-review.

Clinical, radiological and histological aspects of a case of primary bone haemangiopericytoma, treated by wide surgical resection and pre- and postoperative radiotherapy, are described. The patient was disease-free 20 months from the operation. From a literature review of 52 cases of this very rare tumour it emerges that the tumour is aggressive but of variable malignancy. Prognosis seems to depend on histology, size at diagnosis and treatment. The best available treatment is probably wide exeresis plus radiotherapy.

Palliative surgery of metastatic bone disease: a review of 83 cases.

Of a total of 83 patients with metastatic bone disease, surgery was performed in 17 cases at the prefracture stage, in 54 cases after complete fracture and in 10 cases to decompress the spinal cord. Positive short-term results were obtained in 75% of cases. 7 patients presented mild complications. In 2 cases, the patients had to be reoperated. 55% of the patients were still alive after 6 months, 31% after 12 months and 10% after 2 years.

[Block of the cervical plexus in surgery of the carotid artery. Our experience with 142 cases]. / Il blocco del plesso cervicale nella chirugia della carotide. Nostra esperienza su 142 casi.

The main anesthesiological problem in TEAC operations is the possibility of evaluating the degree of tolerance after carotid artery clamping. When facing this situation, some anesthesiologists prefer to administer general anesthesia, others prefer loco-regional anesthesia. On the basis of their background and experience, the Authors, from 1.1.1987 to 12.31.1988, have performed 142 nerve blocks of the superficial and the cervical plexus. The proposed technique is simple. No side effects are observed. Moreover it is gratifying for the surgeon and safe from risks for patients. Loco-regional anesthesia permits a close neurologic monitoring that is easily understandable and inexpensive. When performing this kind of surgery, this technique seems to be valid and effective.

[Modifications of B lymphocyte membrane markers in patients with osteosarcoma]. / Modificazioni indotte sui marcatori di membrana B linfocitari, in pazienti portatori di osteosarcoma

A study was performed on the B lymphocyte membrane markers in patients with osteosarcoma. The findings obtained would indicated apparently normal cell function conditions (intracytoplasmic membrane immunofluorescence, PWM lymphocyte blastogenesis) and a marked cytotoxic lymphocyte drop ("killer" lymphocytes: EA rosettes).

[Anti-inflammatory agents and lymphocytary reactivity]. / Farmaci antiinfiammatori e reattivita' linfocitaria

The acetylsalicylic acid, like other drugs with analogous properties, is an anti-inflammatory drug, whose mechanism of action is still unknown. Lymphocyte release, on stimulation, phlogogenic substances (lymphokines) which are responsible for some phlogistic processes, above all chronic. Acetylsalicylic acid inhibits some lymphocyte functions, therfore its mechanism of action may be possibly accounted for by this activity. This paper dealt with the effect observed that acetylsalicylic acid on mitogen-induced lymphocyte blastization. In vitro it was observed that acetylsalicylic acid inhibits blastization only when it is present in the incubation medium and that the inhibitor effect is dose dependent. In vivo, in the rat, it was observed that acetylsalicylic acid inhibits blastization only when administered some hours before lymphocyte withdrawal. The Authors believe that this effect may be accounted for by a metabolite of the drug itself.

[Sensitization to metals in patients submitted to arthroplasty]. / Sensibilizzazione ai metalli in pazienti sottoposti ad artroplastica

The sensitization of the patients submitted to arthroplasty has been pointed out with increasing frequency. This paper attempted to establish the occurrence rate and the importance of this sensitization in patients submitted to arthroplasty of metallic or plastic type, by means of the patch-test, blastization and macrophage inhibition test. The highest positivity incidence was observed towards chromium (9.7%) and cobalt (6.4%) in the patients submitted to arthroplasty of metallic type, while that of plastic type showed a 1% positivity to methylacrylate. These data stress the importance of the adoption of the patch-test in all patients, before being submitted to any type of prosthesis, and of the preferential use of those prostheses which turned out less sensitizing.

[Studies on various parameters of the T-dependent lymphocyte system in the course of osteosarcoma]. / Studio di alcuni parametri del sistema linfocitario T dipendente, in corso di osteosarcoma

Some parameters of the T-lymphocyte dependent system have been studied in 20 patients with osteosarcoma. The functional condition of T lymphocytes, stimulated with mitogens (PHA and Con-A) has been investigated by evaluating DNA neosynthesis by means of the incorporation of the tritiated thymidine in lymphocyte cultures. The percentage of rosette-forming T l-mphocytes with sheep erythrocytes has been assessed. The findings would indicate a constant inhibition of DNA biosynthesis in patients with osteosarcoma, only in correspondence of PHA stimulation. This finding would agree with E rosette pattern. In this case also neoplastic patients do show, in comparison with the controls, a constant drop of the number of T lymphocytes forming rosettes with sheep erythrocytes.