Scintigraphic recording of blood volume shifts.

UNLABELLED: A scintigraphic device consisting of small scintillation probes tightly fixed to the skin was developed to record intravascular blood volume shifts continuously and simultaneously at several sites. The aim of the present study was to ascertain the reliability of the measurements obtained, show the blood shifts induced by common daily activities in healthy subjects and clarify the mechanisms responsible for hemodynamic changes. METHODS: Measurements were made in three fields of the right lung, the liver, thighs and calves of 16 men during Valsalva maneuver, hyperventilation, various posture changes and treadmill walking. Some tests were repeated. RESULTS: The measured blood volume shifts were always in the expected direction and in accordance with those reported in the literature; they also were reproducible. Therefore, the measurements were reliable. A pattern of blood volume changes peculiar to some common daily activities was recorded in subjects moving freely. Insights were obtained on the mechanisms responsible for the blood volume shifts. CONCLUSION: Our noninvasive technique provides reliable continuous measurements of blood volume changes at several sites during common daily activities and could be applied not only in healthy subjects but also in patients.

[Gallbladder calculi: what therapy of choice?]. / Calcolosi della colecisti: quale terapia in elezione?

The Authors have analyzed all different methods for the treatment of gallbladder stones which are performed today: the non invasive treatment of the gallstones (oral dissolution therapy and the extracorporeal shockwave lithotripsy), the minimally invasive procedures (contact dissolution therapy and the cholecystolithotomy) and at the end the new surgical techniques (the "minicholecystectomy" and the laparoscopic cholecystectomy). From this study and their experience, based upon 1346 standard cholecystectomy, the Authors have reached the following conclusions: 1) the cholecystectomy remains the only definitive therapy for the gallbladder stones and it is the gold standard to which must be compared the other alternative therapies; 2) the laparoscopic cholecystectomy, even though introduced recently, would become the only method used for cholecystectomy.

[Significance of serum alkaline phosphatase in secondary hepatic localizations (author's transl)]. / Significato della fosfatasi alcalina serica nelle localizzazioni epatiche secondarie.

The Authors analysed 292 patients with tumours particularly liable to hepatic metastatization, excluding from a wider set of cases all those which on grounds of age, bone localisations and other kinds of hepatic disease might have falsified the serum A. Ph. values. Analysis of their results led to exclusion of any direct relationship between hyperphosphatemia and degree of hepatic metastatization. It is also concluded that pathological observation of this enzyme, in the absence of semeiological data indicating secondary hepatic pathology, must be considered as grounds for fuller diagnostic investigation.