[Aberrant pancreas in gastric site]. / Il pancreas aberrante a sede gastrica

The conclusions contained in recent and past literature regarding the heterotopic pancreas are reviewed. A case of accessory pancreas located in the stomach, whose clinical, radiological and endoscopic aspects simulated a carcinomatous process, is reported. The case is studied anatomo-pathologically and important aspects, including surgical, noted.

[Multiple diverticulosis of the small intestine]. / La diverticolosi multipla del piccolo intestino.

A case of jejunum-ileum multiple diverticulosis observed during a cholecystectomy due to cholelithiasis, is reported. Stress is laid on this unusual localization of diverticulosis in the small intestine. The clinical picture can be silent or present an acute or chronic symptomatology and radical surgical treatment can performed or not. When the disease involves all the intestine, without presenting serious inflammatory phenomena and without clinical symptoms (as in the case observed), medical and not surgical treatment can be envisaged.

[Prodromic syndrome and recovery time in acute myocardial infarction]. / Sindrome prodromica e tempi di ricovero nell'I.M.A.

The presence of prodromic syndrome and the time between the first symptoms and the actual admission to hospital have been considered in a personal series of 644 patients with acute myocardial infarction. The applicability of a systemic thrombolysis protocol has been examined in a subgroup of 108 patients. The high percentage of patients who had prodromic syndrome (46.8%) and of patients who have been admitted in C.C.U. too late (39.2% over the sixth hour) emphasized the need of a sanitary education program in order to get faster admission times of the ischemic patients.

[Surgery of malignant neoplasms of the esophagus]. / La chirurgia delle neoplasie maligne dell'esofago.

A series of malignant cancers of the oesophagus operated in the period 1968-1978 is reported. The importance of preoperative denutrition is considered and the various nutritional techniques are outlined, with a note on their advantages and defects. Right intrathoracic oesophagogastroplasty carried out in malignant cancers of the middle third of the oesophagus is particularly discussed. This surgical technique is held to be preferable to intestinal transpositions in substitution of the oesophagus, and the results obtained in this series support the opinion.

[Hepatic artery aneurysm as a cause of hemobilia]. / L'aneurisma dell'arteria epatica come causa di emobilia

1) Haemobilia must be kept in mind as a cause of gastrointestinal haemorrage. 2) The presence of an hepatic artery aneurysm gives a peculiar triad of symptoms: abdominal pain, gastrointestinal haemorrage and jaundice. 3) Selective angiography is the elective diagnostic aid. 4) The diagnosis may be difficult also at operation, because the aneurysms can be very small. 5) The most used surgical treatment are ligation of the hepatic artery, the excision of aneurism, the endoaneurysmorrhaphy or the end-to-end anastomosis.

[Cholecystosis]. / Le colecistosi

Cholecystosis conditions include those diseases of the gallbladder whose aetiopathogenesis is to be sought in a hyperplasia of the tissues making up the cholecystic wall (hyperplastic forms) and in an overload of this wall on the part of organic substances or minerals such as lipides or calcium salts (thesaurismosic forms). After discussing the classification, pathological anatomy, aetiopathogenesis, frequency, symptomatology, laboratory and radiological examinations, prognosis complications and treatment of these conditions, a personal series of 36 surgically treated cholecystoses is reported.

[Carcinomas of the small intestine]. / I carcinomi dell'intestino tenue.

Two cases of carcinoma of the small intestine are described. In spite of its large epithelial surface, this organ is rarely a cancer site. For these reason, an account is given of cases observed over the previous year. In addition, mention is made of the pathological anatomy, symptomatology, preoperative investigation, and treatment of this form.

[Echocardiographic diagnosis of rupture of the interventricular septum and release into the wall of the left ventricle (with formation of pseudoaneurysm) in inferior myocardial infarction]. / Diagnosi ecocardiografica di rottura del setto interventricolare e della parete libera del ventricolo sinistro (con formazione di pseudoaneurisma) in infarto miocardico inferiore.

A case of inferior myocardial infarction in a 77 years old woman suffering from angina pectoris for 8 years, is reported. The clinical course was complicated by mild heart failure secondary to interventricular septum repture, diagnosed by Doppler-echocardiography. The patient was discharged in III-IV NYHA class with medical therapy. Then, unstable hemodynamic conditions and episodes of angina pectoris occurred again. Five months after acute myocardial infarction, echocardiography confirmed the interventricular septum defect. An echocardiographic control, performed 17 months after the acute episode, documented, besides previous data, the presence of a pseudoaneurysm of the inferior wall with a large cavity in communication with the left ventricle.

[Torsade de pointes during an atropine sulfate test in a patient with congenital long QT syndrome]. / Torsione di punta durante test con atropina solfato in paziente con QT lungo congenito.

After a brief revision about the long QT syndrome, we report the case of a 52 year old man admitted to hospital for a syncopal attack. His electrocardiogram was considered normal: sinus bradycardia and U waves were recorded. The echocardiogram revealed anterior mitral leaflet redundancy and possible tricuspid prolapse. During the atropine test, after a normal increment of sinus frequency, 2 runs of self-limited torsade de pointes appeared. The electrocardiogram showed lesion wave at first, and then prolonged QT. During the intracavitary study, premature ventricular stimulation caused torsade de pointes. After propranolol iv it was no more possible to induce major ventricular arrhythmias anymore. Coronarography was normal. Nadolol therapy was begun. On 6 months follow-up the patient is asymptomatic.

Rapid detection of antibodies to infectious bovine rhinotracheitis by 'macro' and 'micro' ELISA.

Two kinds of enzyme-linked immunosorbent assay were evaluated in their ability to detect specific antibodies against Bovine Rhinotracheitis Virus (IBR-IPV). The tests were called MACROELISA and MICROELISA, according to the kind of the solid support used for antigen insolubilization, polystyrene beads and microtitration plates respectively. Partially purified virus was used to coat both beads and plates; a single dilution of examples was tested and protein A linked to peroxidase was employed as enzyme tracer. Quantitative instrumental results from MACROELISA and qualitative visual results from MICROELISA were compared with serum neutralization titers. The results clearly show that ELISA tests are suitable for IBR serologic detection, being sensitive, specific and accurate over serum neutralization method.