[Kidney transplantation in the HBsAg+ patient. Our experience]. / Il trapianto renale in pazienti HBsAg+. Nostra esperienza.

HbsAg serum positivity in patients on the waiting list for kidney transplant and modifications of survival rate and transplanted kidney function deriving from this clinical situation are nowadays a matter of investigation and scientifical controversy. Authors analyse data deriving from their own series of renal transplant in HbsAg+ patients comparing them with literature.

[Renal transplantation in patients over 60 years of age. An increasing clinical reality]. / Il trapianto renale nei pazienti ultrasessantenni. Una realtà clinica in aumento.

The elevation of the uremic population age, the longer survival of dialysis, the increasing number of elderly donors, together with the safer surgical, anesthesiological and immunological procedures have led all over the word to an improvement of over 60s patients transplantation program, with very good results. The authors present their own experience of renal transplantation in elderly recipients and a review of what is reported in the literature on the question.

[Pregnancy in women undergoing a kidney transplant. Our experience and a review of the literature]. / Gravidanza in donne sottoposte a trapianto renale. Nostra esperienza e review della letteratura.

The chances of pregnancy for uremic women are usually very low, because of hormonal balance changes which determine a strong reduction in fertility. Epidemiological studies reveal that pregnancy in hemodialyzed women in fertile patients 4.6-6 months after a well functioning kidney transplant, one fertile transplanted woman over 50 can become pregnant. In the first transplant era, pregnancy after kidney transplant was considered "a big hazard", especially because of the possible side-effects of immunosuppression drugs on foetus development, and the risk of a worsening in the mother's renal function. Therefore, women were strongly recommended to avoid pregnancy. More recently, several reported papers have shown that pregnancy can be safely carried on also by transplanted women, under careful criteria and monitoring. Our experience too, even if limited in number (4 patients) reported in this article confirms this conviction.

[Vascular bench surgery in renal transplant]. / Chirurgia di banco vascolare nel trapianto di rene.

The development in the number of patients for renal transplants has not been matched to the kidneys supplied. On this subject the authors think that this chronic deficit could be improved by making use of all the organs by using a series of technical means during bench surgery; which enable optimisation of use of kidneys with vascular abnormalities or those injured upon removal. The authors report their experience of 450 renal transplants operated between January 1981 and December 1985 and of the evolution vascular bench surgical techniques which enable use of a considerable number of kidneys which would otherwise have been discarded. Moreover, it helped the implant, shortened surgery time without prolonging hot ischemia, and did not increase the number of complications.

[Carcinoma of the distal choledochus: its differential diagnosis and surgical treatment. Our experience]. / Il carcinoma del coledoco distale: diagnosi differenziale e trattamento chirurgico. Nostra esperienza.

Carcinomas of the biliary tree present very difficult problems in diagnosis and treatment. Low common bile duct tumors, excluding papillary tumors, are rare but not easily detectable preoperatively and correctly treated. Authors report their clinical experience on the argument.

[Interstitial radiotherapy with 125I in non-resectable pancreatic carcinoma]. / Radioterapia interstiziale con 125I nel carcinoma pancreatico non resecabile.

The authors analyze results of 220 patients suffering from pancreatic cancer treated in their department from 1982 to 1992. Among these patients 24 of them underwent surgical operation for positioning of radioactive pills. The discussion is on indication and results of this technique, considering also what's reported in scientific literature on the argument.

[Malignant schwannoma of the omentum. Considerations in a clinical case]. / Schwannoma maligno omentale. Considerazioni su un caso clinico.

Authors describe a rare case of malignant schwannoma of the omentum. The diagnosis of schwannomas is often late because of the absence of early clinical signs. Clinical, diagnostic and histopathological considerations of these neoplasias are described in this work.

[A rare thyroid vascular anomaly: a unique thyroid artery arising from the right carotid bifurcation]. / Rara anomalia vascolare tiroidea: unica arteria tiroidea a partenza dalla biforcazione carotidea destra.

The evidence of thyroid vascular anomalies is is frequent and may manifest itself with an anatomic alteration. The absence of the inferior thyroid artery is reported in 1% of the cases, while a thyroid artery arising from the common carotid artery has been found in 2% of examined patients. In the observed case we retain that the rarity is not only due to the contemporary presence of two anomalies, but also to the presence of an anomalous vessel which arises from right carotideal bifurcation and bloody supplies either right lobular or left lobular of thyroid, thus resulting the sole gland's arterial vessel.

[Intrahepatic jejunostomy by trans-scission approach in neoplasms of the superior biliary confluent (SBC)]. / Intraepatico-digiunostomie per via trans-scissurale per neoplasie del confluente biliare superiore (CBS).

The Authors consider the trans-scission approach as a quick and safe alternative approach for doing intrahepatic bilio-intestinal anastomoses for the surgical treatment of well confined cancers of hepatic hilus (type I and II of Bismuth e Corlette). This approach should be recommended particularly when the presence of anatomical variations makes the hilar approach hazardous.

[Endometriosis of the distal ileal loop. A clinical case report]. / Endometriosi dell'ultima ansa ileale. Descrizione di un caso clinico.

Intestinal endometriosis is a rare lesion characterized by a difficult differential diagnosis with other intestinal diseases. The authors report the case of a woman suffering from endometriosis involving the distal ileal loop.

[Malignant neoplasms arising "de novo" after a kidney transplant. Our experience and a review of the literature]. / Neoplasie maligne "de novo" insorgenti dopo trapianto renale. Nostra esperienza e revisione della letteratura.

The incidence of "de novo" cancers in kidney transplanted patients, especially because of immunosuppressive treatment, seems to be increased. The authors analyse their experience and review the literature.

[Abdominal tuberculous lymphadenitis simulating pancreatis cancer]. / Linfoadenite tubercolare addominale simulante un carcinoma pancreatico.

The Authors report the case of a patient symptomatic for fever, weight loss and abdominal pain submitted to abdominal sonography and CT which identified a mass of the pancreatic head. The patient underwent laparotomy plus biopsy; the istologic and bacteriological diagnosis demonstrated a tuberculous lymphoadenitis in spite of a normal cutaneous tuberculin test. Abdominal localization of TBC infection therefore is increasing in epidemiological studies, and thus it must be included in the differential diagnosis of subdiaphragmatic disease.

[Prosthetic salvage operation in patients on hemodialysis]. / L'intervento di "salvataggio protesico" nei pazienti in emodialisi.

The use of PTFE, vascular prosthesis (Gore-Tex), in the vascular access for hemodialysis, is a very reliable and exploited method. Thrombosis is the most frequent complication. The prosthetic "salvage operation" allows an immediate functional recovery. The authors examine their series from 1986 on, analyzing the surgical technics employed and the results obtained.

[Diverticulitis of the appendix: a rare cause of acute abdomen]. / La diverticolite dell'appendice vermiforme: rara causa di addome acuto chirurgico.

Diverticulosis of the vermiform appendix, either single or multiple, congenital or acquired, is rather infrequent and usually asymptomatic. However, it may be complicated by flogosis configuring an acute abdomen hardly recognizable from an acute appendicitis not related to the diverticular disease. The Authors report a case of acute appendicular diverticulitis surgically treated. A brief review of the literature is also reported.

[Angioneurosis due to vibrating tools with special reference to plethysmographic and Doppler vascular diagnosis]. / L'angioneurosi da strumenti vibranti, con particolare riferimento alla diagnostica vascolare pletismografica e Doppler.

Angioneurosis, together with bones and joints disorders, represents the most frequent clinical syndrome due to vibrating instruments. The authors report a general presentation of the disease, particularly focused on indications, usefulness and methods of plethysmography and Doppler C.W., as noninvasive diagnostic procedures.

[Cystic lymphangioma of the adult: our experience and review of literature]. / Linfangioma cistico dell'adulto: nostra esperienza e revisione della letteratura.

Cystic lymphangioma is an uncommon benign pathology, usually reported in children, rarely in adult. Its embryopathogenesis is still controversial: it seems to arise from the lymphatic vessels, mainly in the cervico-cranial district. It is macroscopically characterised by multiple cystic non-communicating concamerations. Definitive diagnosis used to be intraoperative and was usually an unexpected finding. Nowadays, with modern imaging technologies, CT and MRI, diagnosis can be assumed before intervention even though certain diagnosis can still be reached only with histological examination. Imaging techniques can help for a precise mapping of the lesion and definition of its limits with the other structures, improving therapeutic success. Various therapeutical options are reported in literature, but complete surgical excision is still considered the best approach and the most successful. The Authors report their experience and review the literature on cystic lymphangioma in adult.

[Jejunal adenocarcinoma: case report and review of the literature]. / Adenocarcinoma isolato del digiuno: considerazioni su un caso e revisione della letteratura.

Adenocarcinoma of the jejunum is a rare tumor. The diagnosis is often difficult and not early. The Authors report a case recently observed in their clinical practice and successfully operated, reporting also what's in the literature about.

[Isolated unilocular hydatidosis of the kidney: a rare clinical event]. / Echinococcosi granulosa isolata del rene: evenienza clinica rara.

The authors report a case of granulomatous hydatid disease of the kidney recently observed in a 47-year-old female patient with a preoperative diagnosis of nephrolithiasis. The rarity of the location and the likely asymptomatic nature of the disease are, in the authors opinion, of clinical and scientific interest.

[Deep venous thrombosis after leg amputation. Review of the argument]. / La trombosi venosa profonda dopo amputazione degli arti inferiori. Review sull'argomento.

Patients undergoing lower extremity amputation are perceived to be at high risk for deep vein thrombosis (DVT). DVT can cause micro or macro pulmonary embolism and often the post-thrombophlebitic syndrome. The chronic condition can affect patient quality of life and his residual working capacity. Usually the echo-Doppler or the color-Doppler is used as a prevention and diagnostic method, identifying patients at high risk. Following the Authors examine and report the Literature opinion about the topics.

[Retrorectal hamartomatous cysts or "tail gut syndrome": a case report and review of the literature]. / Cisti amartomatosa retrorettale o "tail gut syndrome": caso clinico e revisione della letteratura.

Retrorectal cyst hamartomas or so called tail gut syndrome are dystopic lesions, rarely reported in Literature, characterized by the presence of cysts lined by mucous-producing ciliated epithelium. The Authors report a case, recently observed and surgically treated, in a 55 year old male, hospitalized because of an abscess and fistula in the right buttock diagnosed to be a cyst hamartoma. The Literature is reviewed as well.