[Thoracoscopy in the diagnosis of pleural mesothelioma]. / La toracoscopia nella diagnostica del mesotelioma pleurico.

The Authors assess the results of thoracoscopy in 21 cases of pleural mesothelioma observed over the period from 1982 to 1991. The procedure yielded a correct diagnosis in 18 cases (in 2 cases, CTM due to adenoma at cytology allowed histological definition of the tumour). In 3 cases, thoracoscopy failed to detect the tumour, which was confirmed at a later stage. This type of investigation is indicated for the diagnosis of all pleural diseases and, in particular, for diagnosing mesothelioma (reliability in our series: 85.7%).

[Thoracoscopy in the staging of tumors of the lung]. / La toracoscopia nella stadiazione dei tumori del polmone.

The Authors review the results of thoracoscopy in 15 cases of pleural effusions concomitant with tumours of the lungs. In addition to defining the aetiology of the pleural effusion, the investigation completes the staging of the malignancy and affords both the possibility of reducing the number of exploratory thoracotomies and of resolving a number of cases at exeresis.

[Behavior of thyroglobulin after fine needle aspiration of the thyroid]. / Comportamento della tireoglobulina dopo agoaspirazione tiroidea con ago sottile.

The authors report the behaviour of serum concentration of thyroglobulin (TG) after fine needle aspiration biopsy of the thyroid. Compared with the basal level, serum concentration of thyroglobulin increase of 70% three minutes and of 341% sixty minutes after this maneuver. The authors agree with those who believe an interval of 10-15 days between fine needle aspiration biopsy of the thyroid and determination of serum concentration of thyroglobulin is necessary.

[Surgical therapy of Basedow's disease]. / La terapia chirurgica del morbo di Basedow.

The authors, in the light of the data of the literature, study the problem of the surgical treatment of Basedow disease. Besides those who suggest the total thyroidectomy as an ultimately curative intervention, most of surgeons prefer the subtotal thyroidectomy. However, the result of such operation is doubtful as to postoperative hypo- and hyperthyroidism, due to the operativeness of factors of not only biological, but also technical nature. In order to make the therapeutical result as satisfactory as possible, the literature suggests some particular surgical solutions, such as ligature of thyroid artery, limited subtotal thyroidectomy and modified subtotal thyroidectomy, which seem to obtain satisfactory results from the clinical standpoint.

[Behavior of creatine kinase-isoenzyme BB in the nodular pathology of the thyroid (preliminary note)]. / Comportamento della creatinakinasi-isoenzima BB nella patologia nodulare della tiroide (nota preliminare).

The literature indicates the presence of the BB isoenzyme of creatinakinase in the thyroid tissue. The CKBB, therefore, was dosed with radioimmunologic method in a group of 79 patients bearing nodular pathology of thyroid (12 carcinomata, 42 nodular strumata, 25 adenomata), to check whether such parameter could be used as marker in the thyroid neoplasms. The CKBB, however, did not show a statistically different behaviour in the three classes of pathology considered.

[Prevention of infection in thyroid surgery]. / Sulla profilassi delle infezioni in chirurgia tiroidea.

The Authors remark the clear infections are rare in thyroid surgery, whereas rather frequent are the light phlogistic forms, appearing through thermal movement, slight oedema and reddening of the cutaneous wound, drainage emergency point and upper cutaneous edge, which may make the postoperative course unideal. They report the observations done on 25 patients who underwent operation of thyroidectomy after preparation of skin, the evening before operation, with detergent and antiseptic solution containing cetrimide and chlorexidin, followed by dressing with alcoholic solution of quaternary ammonium salts. The patients were immediately treated before and after 8 and 16 hours from operation with amoxicillin. The results obtained confirm the validness of proximate antibacterial chemoprophylaxis in this surgery too.

[Unusual association of squamous and follicular carcinoma of the thyroid]. / Sulla singolare associazione del carcinoma squamoso e follicolare della tiroide.

The Authors report a case of thyroid squamous cell carcinoma associated to a counterlateral lobe follicular carcinoma, they had the opportunity to observe. The histogenetic hypotheses and problems of differential diagnosis are discussed.

[The isolated thyroid nodule: notes on our personal experience]. / Il nodo tiroideo isolato: appunti sulla nostra esperienza.

An analysis of 255 patients operated for isolated thyroid nodes is made. Of these, 81% were cold nodes and 19% hot. Carcinomas were present in 21 cases. One carcinoma appeared as a scintigraphically hot node. The frequency of carcinomas, in relation to the nodules observed, was roughly the same in the two sexes. There is parallelism in behaviour of the rate in the two sexes as regards cold nodes, while this is not true for hot nodes. The importance of some recent diagnostic techniques is briefly discussed.

[The relationship between thyroid surgical operations and blood calcium]. / Sul rapporto tra interventi chirurgici tiroidei e calcemia.

The behaviour of calcemia was studied in a group of patients subjected to surgical operation of varying extent on the thyroid (enucleoresection, hemithyroidectomy, subtotal and total thyroidectomy). Average calcaemia was found to be diminished in all groups of operated cases, in relation to the extent of the operation. Surgery interferes by significantly modifying the variability of calcaemia in the different groups. The frequency of cases with pre-operative calcaemia higher than the average and retaining a postoperative level higher than the minimum of the controls is roughly inversely proportional to the extent of the surgery. A comparison between calcaemia after subtotal thyroidectomy for nodular struma and for Graves' disease did not evidence any statistically significant differences.

[Rare non-functioning insular tumor of the pancreas]. / Raro tumore insulare non funzionante del pancreas

A case of cystic neoplasia with a cephalopancreatic localization, arising in a young woman aged 26 and derived from the beta-insular elements, is presented. The tumour had invaded the porto-mesenteric tract, and hence duodenopancreatic demolition had to be followed by venous repair by prosthesis. On the basis of the literature the biological complexity of this exceptional tumour is disscussed (especially in relation to prognosis), as well as the surgical treatment adopted in this patient, who is in excellent conditions more than three years later.