Last-male sperm precedence in Rhynchophorus ferrugineus (Olivier): observations in laboratory mating experiments with irradiated males.

The Red Palm Weevil (RPW) Rhynchophorus ferrugineus (Olivier 1790) is an invasive pest from southeastern Asia and Melanesia that in the last 30 years has spread widely in the Middle East and Mediterranean Basin. Its stem-boring larvae cause great damage to several palm species of the Arecaceae family, many of which are economically important for agricultural and ornamental purposes. Therefore, great attention has recently been focused in studying this species to identify sustainable and effective eradication strategies, such as sterile insect technique (SIT). The rapid spread of RPW is associated with its high reproductive success. To evaluate the suitability of a SIT strategy, particular physiological and behavioral aspects of RPW reproduction, such as the presence of polyandry and post-copulatory sperm selection mechanisms, were investigated. To determine paternity of progeny from multiply mated females, double-crossing experiments were carried out confining individual females with either a wild-type male or a γ-irradiated male (Co-60). Fecundity and fertility of females were scored to evaluate post-copulatory sperm selection. Results showed that progeny were almost exclusively produced by the sperm of the second male, suggesting that a last-male sperm precedence is expressed at high levels in this species, and providing interesting insights for an area-wide RPW management strategy such as the SIT.

[Aneurysms of the popliteal artery. A clinical case and revision of the literature]. / Gli aneurismi dell'arteria poplitea. Presentazione di un caso clinico e revisione della letteratura.

The authors report their experience about one case of popliteal artery aneurysm. The patient was treated with aneurysm resection and dacron by-pass graft. The good surgical results and high risk of natural complications of popliteal aneurysms suggest that operation in the asymptomatic stage should always be attempted.

[Lithiasis of the common bile duct and transduodenal papillosphincterotomy. Analysis of our cases]. / Litiasi della via biliare principale e papillosfinterotomia transduodenale. Analisi della nostra casistica.

The results obtained from 1978 to 1987 with the use of transduodenal papillosphincterotomy in bile duct lithiasis are reported. The operation was performed on 126 patients and produced 4.7% immediate mortality. The indications and the most frequent post-operative complications were studied. Routine intra-operative cholangiography had been carried out. The long-term results were very good in 86% of the cases, average in 13% and poor in 1%. Provided one limits its indications to cases when it is really necessary, papillosphincterotomy does not involve a higher risk than other biliary operations.

[Comparison of 67 pancreatic head tumors and 27 periampullary tumors]. / Confronto tra 67 tumori della testa pancreatica e 27 tumori periampollari.

The authors, in the period from Jan. 1980 to Dec. 1990, observed 67 patients with tumor located in the head of pancreas and 27 patient with periampullary tumors. These included 18 tumors originated from the ampulla of Vater and 9 from distal common bile duct. Operability rate ranged from 62.6% pancreatic carcinoma to 94.4% tumors of ampulla, according to the tumor location. Resectability rate ranged from 9.5% for pancreatic adenocarcinoma for 94.1% to ampullary tumors. Considering 23 resections, 18 were pancreatoduodenectomies and 5 local excisions for tumor of ampulla. Mortality was 7.7% after non resectional treatment and two patients (8.7%) died in the immediate postoperative period after radical resection. Multivariate analysis on all patients operated (n. 65) revealed that 5 years survival rate was significantly related to intent of operation (palliative = 0 - curative = 8.6%), histologic type, and site. In fact no patient with pancreatic adenocarcinoma achieved a 5 years survival rate. Two patients with adenocarcinoma of ampulla survived 5 years. Cancer of the head of pancreas is quite malignant because, owing to pancreas position, an early diagnosis is very hard. Most times resective surgical treatment is impossible because of the cancer diffusion.

[Liver abscess: clinical cases and review of the literature]. / Gli ascessi epatici: casistica clinica e revisione della letteratura.

Personal experience with liver abscess is presented. After a review of the epidemiologic and aetiologic factors most commonly influencing hepatic abscesses formation, the Authors discuss their clinical and diagnostic aspects. Furthermore various surgical options are examined for the proper treatment of these conditions.

[Intestinal obstruction caused by colorectal neoplasms]. / L'occlusione intestinale da neoplasia colo-rettale.

The Authors report their ten-year experience in 85 cases of colorectal carcinoma presenting with large bowel obstruction. They underline the high morbidity and mortality of such condition related to the late diagnosis and the poor general conditions of the patients. After reviewing the literature they point out that the best treatment consists in dealing both with the intestinal obstruction and its cause during the same operative time. The post-operative mortality after radical treatment is acceptable especially when compared to derivative procedures.

[Percutaneous drainage of liver abscesses]. / Il drenaggio percutaneo degli ascessi epatici.

Three patients with hepatic abscess were treated by percutaneous drainage ultrasonographically or tomographically guided. The treatment was effective in two out of three patients. The low morbidity and the high success rate obtained suggest that this therapeutic modality should be used before considering any surgical approach.

[Non-parasitic splenic cyst]. / Le cisti spleniche non parassitarie.

The Authors report a case of epithelial cyst of the spleen. The pathogenetic hypothesis as well as the clinical patterns of this rare disease, which is usually found in children and young adults, are considered.

[Surgical treatment of abdominal aortic aneurysm. Factors affecting mortality and morbidity]. / Il trattamento chirurgico degli aneurismi dell'aorta addominale. Fattori che influenzano mortalità e morbilità.

In this report, based on a 5 year experience, 76 operation were performed electively for intact abdominal aortic aneurysm and 55 were emergency procedure for ruptured aneurysm. Factor affecting mortality and morbidity in the cases are analysed. Three patients died of cardiac causes following elective aneurysm repair, a mortality rate of 3.9%. No patients died of pulmonary causes, renal failure or required dialysis. No patient developed a graft infection, stroke or intestinal ischemia. Mortality rates for surgical repair of ruptured AAA averaged 32% and the principal cause of death is cardiac disease (50%). The second cause is renal failure. Declining of operative mortality for intact aortic aneurysm is related to earlier diagnosis using non invasive methods and correct preoperative study.

[Cystic dilatation of the common bile duct]. / La dilatazione cistica della via biliare principale.

The Authors report a case of cystic dilatation of the common bile duct and a review of the Literature. The lesion is a congenital malformation of infancy or childhood, being rare in adult life. The main symptoms are biliary colic with jaundice and fever. Modern techniques such as abdominal ultrasonography, CT, ERCP, PTC generally provide to achieve preoperative diagnosis. When radical surgery is possible the complete excision of the cyst is the management of choice. The case reported is classified as type 1 of Todani's classification. Surgical management consisted in a complete excision of the cyst. Bile flow was re-established by hepaticojejunostomy.

[Intestinal obstruction due to phytobezoars]. / L'occlusione intestinale da fitobezoari.

The authors report nine cases of small bowel obstruction due to phytobezoars, observed from January 1982 to October 1991. The main factors in the pathogenesis of phytobezoars, particularly alimentary habits and previous gastric surgery, are considered. In five patients the operation, always performed in emergency, consisted in a longitudinal enterotomy. In two cases the plasticity of the phytobezoar allowed for a manual progression beyond the ileocecal valve. In two patients an intestinal resection was necessary. The authors prefer the finger fracture technique with manual progression of the phytobezoar beyond the ileocecal valve when the ileal loop is well conserved and the phytobezoar itself has enough plasticity.

[Primary retroperitoneal tumors]. / I tumori retroperitoneali primitivi.

The Authors report 7 cases of primary retroperitoneal tumors observed in a five-year period. On the basis of the literature data, they examine the diagnostic, therapeutic and prognostic features, emphasizing the need for a surgical treatment supported, only when useful, by radio- and chemotherapy. The importance of an early diagnosis, thanks to modern technologic progress, is also stressed, echography in particular.

[Treatment of the abdominal aorta combined with a second surgical procedure]. / Il trattamento dell'aorta addominale combinato con una seconda procedura chirurgica.

The synchronous performance of aortic graft with a second surgical procedure should be avoided because of the risk of subsequent graft infection. The Authors reported the experience of 21 patients who underwent synchronous aortic graft with second surgical procedure. No graft infection occurred and it is concluded that such combined operation may be safer to perform than staged surgery in elderly patients.

[Spontaneous bilio-digestive fistulas of lithiasis origin: our experience]. / Le fistole bilio-digestive spontanee a genesi litiasica: la nostra esperienza.

The Authors report their experience with spontaneous bilio-digestive fistulas of lithiasic origin. They examine the difficulties of diagnosis and treatment of this pathology also in consideration of probable complications, in particular the biliary ileus, in old patients often presenting metabolic or cardiopulmonary disorders, which contribute to worsen the prognosis.

[Surgical treatment of acute necrotic-hemorrhagic pancreatitis]. / Il trattamento chirurgico della pancreatite acuta necrotico-emorragica.

The clinical course of an episode of acute pancreatitis varies from a mild transitory form to a severe necrotizing form characterized by multisystem organ failure and mortality in 20% to 40% of cases. Mild pancreatitis does not need specialized treatment, and surgery is necessary only to treat underlying mechanical factors such as gallstones or tumours of papilla of Vater. On the other hand, patients with severe necrotizing pancreatitis need to be identified as early as possible after the onset of symptoms to start intensive care treatment. Patients with infected necrosis, approximately 10 to 20%, must undergo surgical intervention, which consists of an organ-preserving necrosectomy followed by postoperative drainage-lavage or the method of "open abdomen". The Authors report a series of 20 patients operated on for acute necrotizing pancreatitis from 1998 to 2000. They describe the indications and methods of treatment, in particular the additional procedure following necrosectomy.

[A gun-shot lesion of the internal carotid. A clinical case and review of the literature]. / Lesione della carotide interna da arma da fuoco. Caso clinico e revisione della letteratura.

The authors report a case with penetrating zone II neck wound and internal carotid artery injury. Optimal evaluation and management with vascular injury remains controversial. A review of retrospective studies reported in the literature has demonstrated that physical examination alone may be as accurate as arteriography in detecting significant cervical vascular injuries requiring operative repair. Not unexpectedly, the results of carotid artery repair in neurologically stable patients have been excellent, in front of the results of revascularization in patients with equivocal or less-severe neurologic deficits.

[A case of xanthogranulomatous pyelonephritis. Diagnostic and therapeutic problems]. / Un caso di xantogranuloma pielonefritico. Problemi diagnostici e terapeutici.

The use of the modern diagnostic imaging techniques allows in most cases a diagnosis of nature of the lesions involving parenchymal organs. The authors report a case of renal xantogranuloma, rare pseudotumoral inflammatory pathology, treated by radical extended nephrectomy on the basis of a pre-operative diagnosis of malignant tumor. Despite the risk of false positives, in front of a renal mass whose nature is sufficiently characterized by the imaging techniques, the routine use of more invasive investigations such as arteriography and percutaneous needle biopsy seems not justified.

[Gallstone ileus. Our experience]. / Ileo biliare. La nostra esperienza.

Five patients were operated on for gallstone ileus over a 10-year period. Plain abdominal radiograms performed at admission were diagnostic in only 2 patients while other procedures such as ultrasonography and gastroduodenoscopy were required in 2 patients. Obstructing stones were located in the terminal ileum in three patients and in the duodenum in two. A one-stage procedure consisting in the removal of the impacted stone, fistula repair, and cholecystectomy was performed in three patients, two of whom died. Removal of impacted stones was the only surgical treatment in the remaining two patients, with no mortality. The Authors conclude that enterolithotomy alone should be the standard procedure for gallstone ileus. The repair of cholecysto-enteric fistula should be scheduled on elective basis and only if there are continuing or recurrent symptoms.

[Cecum-colon invagination due to cecal adenocarcinoma. Apropos of two cases]. / Invaginazione cieco-colica da adenocarcinoma del cieco. A proposito di due casi.

The Authors report in an elderly patient a ceco-colic intussusception caused by carcinoma of the cecum, and evaluate etiology and pathogenesis, the most frequently affected anatomical sites, and the various clinical manifestations of the disease. Regarding the latter, the Authors emphasize chronicity of the suboccf1p4ve status in the adult patient vs. the clinical picture of intussusception in the paediatric one. Hemicolectomy represents the most common therapeutic approach, especially when intussusception is irreducible or with the evidence of severe colonic ischemia.

[Blunt traumatic rupture of the diaphragm]. / Le rotture del diaframma da trauma chiuso.

Lesions of the diaphragm are uncommon but important complications of blunt thoraco-abdominal traumas. Their incidence is increasing over the last decades as a consequence of the increase of the road traumatology. Preoperative diagnosis is often difficult especially when the diaphragmatic lesion is associated with other skeletal or visceral injuries that may mask the clinical or radiological signs. The Authors report 12 cases of traumatic lesions of the diaphragm due to blunt trauma observed from 1980 to 1997 and that underwent surgery. In particular they discuss about the importance of an early diagnosis and a correct surgical approach to reduce morbidity and mortality. Nine patients were operated by laparotomy; thoracotomy was performed in one case and the combined approach in the last two patients.