BOLD signal sign and transient vessels volume variation.

The purpose of this work was to investigate the relation between BOLD signal sign and transient vessels volume variation induced by apnea. This stimulus consisting of breath holding after inspiration is able to induce a light slowing down in venous blood flow like in a sort of Valsalva maneuver. We observed diffuse negative BOLD responding areas at cortical level and a stronger negative response in correspondence of the main sinuses. These phenomena seem to be unrelated to a specific neural activity, appearing to be expressions of a mechanical variation in the hemodynamics. Our study suggests that particular care must be considered in the interpretation of fMRI findings, especially when patients with vascular-related cerebral diseases are involved.

[Parathyroid cysts]. / Le cisti paratiroidee.

The Authors review the world literature on parathyroid cysts and report a case of this uncommon disease. The importance of an early pre-operative diagnosis by ultrasound, blood calcium level and parathyroid hormone assay with fine needle aspiration biopsy is pointed out. According to several surgeons, only the functioning parathyroid cysts require operation; needle aspiration may be appropriate therapy for the nonfunctioning ones.

[Respiratory complications in compressive goiters]. / Complicanze respiratorie nei gozzi compressivi.

Authors' experience in respiratory complications of compressive goiter is reviewed. Three cases with typical symptoms, relative therapy and outcome are reported. Appearance of respiratory distress should urge to avoid delay in elective surgery performing. In case of acute respiratory failure, immediate emergency tracheostomy is mandatory, subsequently followed by elective intervention. In case of malignancy, if radical surgery is not possible, tracheostomy is the short and medium-term palliative surgical treatment of choice.

[Magnetic resonance in the evaluation of intracranial aneurysms]. / La Risonanza Magnetica nella valutazione degli aneurismi intra-cranici.

Eighteen patients affected by intra-cranial aneurysms, with size ranging from 3 to 30 mm, were studied by means of MRI, CT, and angiography. MRI was performed using Spin-Echo (SE) sequences with different Repetition Times (TR) and Echo Times (TE), which allowed the characterization of the lesions in relation to the relaxation times. MRI could identify all the aneurysms. In 13 subjects the parent vessels could be seen. In 5 patients the aneurysms could be recognized only after angiography, due to their dimension (less than 4 mm). The "flow effects" and the presence of methemoglobin and hemosiderin in the thrombosed portion of the lumen allowed both the detection of flow abnormalities and the characterization of laminate intra-aneurysmal thrombosis. In conclusion, MRI appears to be a sensitive methodology in the detection of intracranial aneurysms, even more sensitive than CT and Angiography in characterizing this kind of lesions.

Papillary-cystic tumour of the pancreas. Case report.

A papillary-cystic pancreatic tumour was excised in a 19-year-old girl, who was apparently free from recurrence 20 months later. Despite morphologic indications of malignancy, the prognosis after surgical removal of this uncommon tumour is good. Its origin probably is the epithelial cells of the small pancreatic ducts. The case is described and the literature is reviewed.

Enzymatic and metabolic changes in peripheral serum after superior mesenteric artery ligation in dogs.

Modifications in serum levels of creatine phosphokinase (CPK) lactic dehydrogenase (LDH), glutamic-oxalacetic-transaminases (GOT), glutamic-pyruvic-transaminases, L-gamma-glutamyl transferases, alkaline phosphatase, glycemia, serum nitrogen, creatinine, amylase, sodium and potassium were measured in dogs during experimentally induced acute mesenteric infarction, in the attempt to establish useful criteria for the early diagnosis of mesenteric infarction. Twelve dogs were studied, 6 being submitted to simple laparotomy and 6 to ligation of the superior mesenteric artery which caused mesenteric infarction. Venous blood samples were collected for 24 hours after surgery in all animals in order to detect any changes in the above-mentioned enzymatic and metabolic parameters. All animals were killed after the experiment and autopsy studies carried out. Animal with mesenteric infarction displayed a significant increase in serum total CPK, LDH, GOT and alkaline phosphatase. This observation may be useful in the diagnosis of acute mesenteric infarction.