Pantethine improves the lipid abnormalities of chronic hemodialysis patients: results of a multicenter clinical trial.

In the course of a post-marketing surveillance program on the effectiveness and tolerability of pantethine in the treatment of hyperlipidemia, the effects of the drug were explored in 31 patients with dyslipidemia undergoing chronic hemodialysis. The mean duration of treatment was 9 months (min. 7 months, max. 24 months), with oral doses of 600 to 1200 mg of pantethine daily (mean daily dosage 970 mg). Improvement was noted in terms of total blood cholesterol in the 7 patients with basal hypercholesterolemia (p less than 0.01) and highly significant reduction of serum triglycerides. No variations of HDL-cholesterol or total Apo-A were detected. None of the patients experienced any adverse effects from the treatment. In the light of extensive experience with the drug, plus the results of this study, the authors conclude by stressing the importance of an effective and readily tolerated product, such as pantethine, for the treatment of dyslipidemia in patients on chronic hemodialysis.

Bellini duct (collecting duct) carcinoma of the kidney.

Carcinoma of the collecting ducts, or Bellini carcinoma, is a rare renal tumour and, unlike most renal cell carcinomas, it derives from distal tubules. It displays highly aggressive behaviour and has a poor prognosis. In this study, the authors present three cases which they observed over the past three years.

[New attitudes in the therapy of splenic injuries]. / Nuovi orientamenti nella terapia delle lesioni spleniche.

The serious sepses, even deadly, which can follow an operation of splenectomy because of the reduced immunological capacities persuaded the Authors to confirm the necessity to safeguard spleen especially after lesions due to traumata.

[Adenomatoid tumor of the epididymis]. / Il tumore adenomatoide dell'epididimo.

Primary tumors of the epididymis are very rare. The neoplasms most frequently affecting the epididymis are adenomatoid tumors. In this report, the authors describe a case observed personally. Various histogenetic hypotheses and the histological characteristics of the tumor are discussed.

[Spontaneous rupture of the transplanted kidney]. / La rottura spontanea del rene trapiantato.

The spontaneous breakage of a kidney is a rare complication which may occur in the first weeks after a transplantation. The cause which can determine it is not yet cleared up, although the Authors think the greatest responsibility for this can be ascribed to rejection. In this work the authors report the experience and casuistry of the Transplantation Centre of Verona.

[Renal leiomyoma (presentation of a clinical case)]. / Il leiomioma renale (presentazione di un caso clinico).

The authors report a case of symptomatic renal leiomyoma. Such neoplasm is very rare and, as to the symptomatic form, only some tens of cases are recorded.

[Gastric leiomyoma (presentation of 3 clinical cases)]. / Il leiomioma gastrico (presentazione di tre casi clinici).

Gastric leiomyoma represents a rather rare report in abdominal surgery, above all because it very often shows no symptoms. Among the non-epithelial gastric neoplasms, it occupies the second place after lymphoma. After describing its anatomo-pathological aspects and clinical features, the authors report their casuistry, including three observations of such neoplasm, and point out that both the endoscopic inspection and the bioptic abstraction, contextually performed, were not so useful in formulating a sure preoperative diagnosis.

[Lymphocele after renal transplant: considerations based on a clinical case]. / Il linfocele dopo trapianto renale: considerazioni da un caso clinico.

The Authors study again the problems of lymphocele in kidney transplantation by showing an interesting clinical case: a lymphocele with smallest size, developing an intensively compressive action on iliac vein. In the light of the experience of 354 transplantations, they discuss the etiopathology and clinics thereof. They particularly emphasize the diagnostical role of echography. Whereas the asymptomatic lymphoceles require no treatments for their trend to be reabsorbed, the symptomatic ones need a quick solution of the compressive effect. Then they consider the therapeutical solutions suggested as an alternative to the interperitoneal marsupialization, which remains the most widely used method.

[Desmoid tumors (apropos of a clinical case)]. / I tumori desmoidi (a proposito di un caso clinico).

The authors, starting from a case of desmoid tumour of abdominal wall, they had the opportunity to observe, discuss its possible etiopathogenetic factors, and confirm the validity of operation as the only therapy.

[10 cases of xanthogranulomatous pyelonephritis]. / Considerazioni su 10 casi di pielonefrite xantogranulomatosa.

Xanthogranulomatous pyelonephritis (XGP) is a chronic inflammation of the kidney usually associated with renal stones, recurrent urinary tract infections or endocrine disorders. A correct preoperative diagnosis is rarely made, since no specific clinical or radiological pattern is known. Differential diagnosis must include renal tuberculosis and renal carcinoma. Ten cases of XGP are reported. Clinical findings, radiological and pathological features, biolaboratory abnormalities are discussed.

[Renal-colonic-cutaneous fistula secondary to xanthogranulomatous pyelonephritis]. / Fistola reno-colon-cutanea secondaria a pielonefrite xantogranulomatosa.

The appearance of intestinal fistulas secondary to kidney disease is a rare occurrence. Even rarer are complex fistulas involving several organs or systems [correction of apparati]. In this study, the authors report on a case of reno-colo-cutaneous fistula which set in as a complication of xanthogranulomatous pyelonephritis.

[Spontaneous perirenal extravasation of urine]. / Lo stravaso perirenale spontaneo d'urina.

Perirenal urinary extravasation in the course of violent renal colic appears to occur much more frequently than is reported in the literature. In this study, the authors report on three such cases observed personally in the space of one year and discuss the pathophysiological factors which may give rise to this phenomenon.

[Malignant neoplastic pathology in patients given a kidney transplant]. / La patologia neoplastica maligna nel paziente sottoposto a trapianto renale.

The incidence of malignant neoplasms in patients subjected to pharmacological immunosuppression following kidney transplantation is higher than that observed in the control population at large. In our unit, in a study population of 451 patients undergoing a total of 462 kidney transplants over the period from 1968 to 1986, four malignant neoplasms (0.9%) were observed in 3/369 (0.8%) patients treated with azathioprine (1 ovarian papilliferous cystoadenoma, 1 embryonal carcinoma of the testicle and 1 Kaposi's sarcoma) and in 1/93 (1.1%) patients treated with cyclosporin (1 Kaposi's sarcoma). The neoplasm was successfully controlled only in the first case after bilateral extended adnexectomy.

[Hyperparathyroidism in patients having undergone a kidney transplant]. / Iperparatiroidismo in pazienti sottoposti a trapianto renale.

The persistence or onset of hyperparathyroidism following kidney transplant is characterized by an incidence ranging from 2.6 to 70% according to the various statistics available. In a total of 462 kidney transplants performed in our department, hyperparathyroidism was detected in 9 patients. Surgery took the form of parathyroidectomy 8/8 plus autograft in 3 cases, parathyroidectomy 3/4 in 2 cases, 7/8 in 2 cases, and 4/8 in 1 case. Serum calcium values returned to normal in all patients after the operation.

[Cyclosporin A in immunosuppressive therapy of kidney transplants (clinical results in 55 patients)]. / La ciclosporina A nella terapia immunosoppressiva del trapianto di rene (risultati clinici su 55 pazienti).

The authors report the results of a clinical study of the use of cyclosporin A plus low-dose steroids in a consecutive series of 55 kidney transplants with follow-up ranging from 6 to 20 months. The clinical results (rejects, immunosuppressant side effects, 12-month survival of transplant and patient) are compared with those of a similar group of patients on "traditional" therapy (azathioprine plus high-dose steroids). The results of the study confirm the efficacy of cyclosporin A in preventing and controlling acute reject crises in the course of allogenic transplant, though many of the problematic issues related its clinico-therapeutic management remain open questions.

[Primary retroperitoneal tumors (clinical findings in yolk sac tumor, vascular leiomyosarcoma and extraosseous chondrosarcoma)]. / Tumori retroperitoneali primitivi (rilievi clinici sul tumore del sacco vitellino ("yolk-sac tumour"), leiomiosarcoma vascolare e condrosarcoma extrascheletrico).

Primary retroperitoneal tumors (PRT) constitute about 0.02 per cent of all tumors examined in the Department of Pathology of our hospital. We report 3 cases of malignant PRT - yolk-sac tumour, vascular leiomyosarcoma and extraskeletal chondrosarcoma - selected for their histological rarity and clinical features. Recent techniques available for the diagnosis of these neoplasms and surgical treatment are discussed. The role of radio-chemotherapy is also dealt with.

[Adenoma nephrogenic. Morphologic aspects]. / Adenoma nefrogenico. Aspetti morfologici.

Nephrogenic adenoma is a rare lesion of urothelial mucous membrane. At present, the cases described in literature are 85. In this work the Authors study the morphologic aspects and etiopathogenetic theories.

[Urologic complications in kidney transplants: experience in 274 transplants]. / Le complicanze urologiche nel trapianto renale: esperienza su 274 trapianti.

The urological complications after a renal transplantation still represent an event anything but rare, ranging, according to the different statistics, from 0.9% up to 23%, with a mortality between 0 and 25%. In this work done by the Verona Centre the experience on 274 transplantations is reported. The urological complications weighed with 6.2% and absence of mortality among the patients. The importance of the prevention and precocious diagnosis is confirmed.