Last-male sperm precedence in Rhynchophorus ferrugineus (Olivier): observations in laboratory mating experiments with irradiated males.

The Red Palm Weevil (RPW) Rhynchophorus ferrugineus (Olivier 1790) is an invasive pest from southeastern Asia and Melanesia that in the last 30 years has spread widely in the Middle East and Mediterranean Basin. Its stem-boring larvae cause great damage to several palm species of the Arecaceae family, many of which are economically important for agricultural and ornamental purposes. Therefore, great attention has recently been focused in studying this species to identify sustainable and effective eradication strategies, such as sterile insect technique (SIT). The rapid spread of RPW is associated with its high reproductive success. To evaluate the suitability of a SIT strategy, particular physiological and behavioral aspects of RPW reproduction, such as the presence of polyandry and post-copulatory sperm selection mechanisms, were investigated. To determine paternity of progeny from multiply mated females, double-crossing experiments were carried out confining individual females with either a wild-type male or a γ-irradiated male (Co-60). Fecundity and fertility of females were scored to evaluate post-copulatory sperm selection. Results showed that progeny were almost exclusively produced by the sperm of the second male, suggesting that a last-male sperm precedence is expressed at high levels in this species, and providing interesting insights for an area-wide RPW management strategy such as the SIT.

[Aneurysms of the popliteal artery. A clinical case and revision of the literature]. / Gli aneurismi dell'arteria poplitea. Presentazione di un caso clinico e revisione della letteratura.

The authors report their experience about one case of popliteal artery aneurysm. The patient was treated with aneurysm resection and dacron by-pass graft. The good surgical results and high risk of natural complications of popliteal aneurysms suggest that operation in the asymptomatic stage should always be attempted.

[Lithiasis of the common bile duct and transduodenal papillosphincterotomy. Analysis of our cases]. / Litiasi della via biliare principale e papillosfinterotomia transduodenale. Analisi della nostra casistica.

The results obtained from 1978 to 1987 with the use of transduodenal papillosphincterotomy in bile duct lithiasis are reported. The operation was performed on 126 patients and produced 4.7% immediate mortality. The indications and the most frequent post-operative complications were studied. Routine intra-operative cholangiography had been carried out. The long-term results were very good in 86% of the cases, average in 13% and poor in 1%. Provided one limits its indications to cases when it is really necessary, papillosphincterotomy does not involve a higher risk than other biliary operations.

[Comparison of 67 pancreatic head tumors and 27 periampullary tumors]. / Confronto tra 67 tumori della testa pancreatica e 27 tumori periampollari.

The authors, in the period from Jan. 1980 to Dec. 1990, observed 67 patients with tumor located in the head of pancreas and 27 patient with periampullary tumors. These included 18 tumors originated from the ampulla of Vater and 9 from distal common bile duct. Operability rate ranged from 62.6% pancreatic carcinoma to 94.4% tumors of ampulla, according to the tumor location. Resectability rate ranged from 9.5% for pancreatic adenocarcinoma for 94.1% to ampullary tumors. Considering 23 resections, 18 were pancreatoduodenectomies and 5 local excisions for tumor of ampulla. Mortality was 7.7% after non resectional treatment and two patients (8.7%) died in the immediate postoperative period after radical resection. Multivariate analysis on all patients operated (n. 65) revealed that 5 years survival rate was significantly related to intent of operation (palliative = 0 - curative = 8.6%), histologic type, and site. In fact no patient with pancreatic adenocarcinoma achieved a 5 years survival rate. Two patients with adenocarcinoma of ampulla survived 5 years. Cancer of the head of pancreas is quite malignant because, owing to pancreas position, an early diagnosis is very hard. Most times resective surgical treatment is impossible because of the cancer diffusion.

[Intestinal obstruction caused by colorectal neoplasms]. / L'occlusione intestinale da neoplasia colo-rettale.

The Authors report their ten-year experience in 85 cases of colorectal carcinoma presenting with large bowel obstruction. They underline the high morbidity and mortality of such condition related to the late diagnosis and the poor general conditions of the patients. After reviewing the literature they point out that the best treatment consists in dealing both with the intestinal obstruction and its cause during the same operative time. The post-operative mortality after radical treatment is acceptable especially when compared to derivative procedures.

[Liver abscess: clinical cases and review of the literature]. / Gli ascessi epatici: casistica clinica e revisione della letteratura.

Personal experience with liver abscess is presented. After a review of the epidemiologic and aetiologic factors most commonly influencing hepatic abscesses formation, the Authors discuss their clinical and diagnostic aspects. Furthermore various surgical options are examined for the proper treatment of these conditions.

[Percutaneous drainage of liver abscesses]. / Il drenaggio percutaneo degli ascessi epatici.

Three patients with hepatic abscess were treated by percutaneous drainage ultrasonographically or tomographically guided. The treatment was effective in two out of three patients. The low morbidity and the high success rate obtained suggest that this therapeutic modality should be used before considering any surgical approach.

[Non-parasitic splenic cyst]. / Le cisti spleniche non parassitarie.

The Authors report a case of epithelial cyst of the spleen. The pathogenetic hypothesis as well as the clinical patterns of this rare disease, which is usually found in children and young adults, are considered.

[Surgical treatment of abdominal aortic aneurysm. Factors affecting mortality and morbidity]. / Il trattamento chirurgico degli aneurismi dell'aorta addominale. Fattori che influenzano mortalità e morbilità.

In this report, based on a 5 year experience, 76 operation were performed electively for intact abdominal aortic aneurysm and 55 were emergency procedure for ruptured aneurysm. Factor affecting mortality and morbidity in the cases are analysed. Three patients died of cardiac causes following elective aneurysm repair, a mortality rate of 3.9%. No patients died of pulmonary causes, renal failure or required dialysis. No patient developed a graft infection, stroke or intestinal ischemia. Mortality rates for surgical repair of ruptured AAA averaged 32% and the principal cause of death is cardiac disease (50%). The second cause is renal failure. Declining of operative mortality for intact aortic aneurysm is related to earlier diagnosis using non invasive methods and correct preoperative study.

[Cystic dilatation of the common bile duct]. / La dilatazione cistica della via biliare principale.

The Authors report a case of cystic dilatation of the common bile duct and a review of the Literature. The lesion is a congenital malformation of infancy or childhood, being rare in adult life. The main symptoms are biliary colic with jaundice and fever. Modern techniques such as abdominal ultrasonography, CT, ERCP, PTC generally provide to achieve preoperative diagnosis. When radical surgery is possible the complete excision of the cyst is the management of choice. The case reported is classified as type 1 of Todani's classification. Surgical management consisted in a complete excision of the cyst. Bile flow was re-established by hepaticojejunostomy.

[A gun-shot lesion of the internal carotid. A clinical case and review of the literature]. / Lesione della carotide interna da arma da fuoco. Caso clinico e revisione della letteratura.

The authors report a case with penetrating zone II neck wound and internal carotid artery injury. Optimal evaluation and management with vascular injury remains controversial. A review of retrospective studies reported in the literature has demonstrated that physical examination alone may be as accurate as arteriography in detecting significant cervical vascular injuries requiring operative repair. Not unexpectedly, the results of carotid artery repair in neurologically stable patients have been excellent, in front of the results of revascularization in patients with equivocal or less-severe neurologic deficits.

[Gallstone ileus. Our experience]. / Ileo biliare. La nostra esperienza.

Five patients were operated on for gallstone ileus over a 10-year period. Plain abdominal radiograms performed at admission were diagnostic in only 2 patients while other procedures such as ultrasonography and gastroduodenoscopy were required in 2 patients. Obstructing stones were located in the terminal ileum in three patients and in the duodenum in two. A one-stage procedure consisting in the removal of the impacted stone, fistula repair, and cholecystectomy was performed in three patients, two of whom died. Removal of impacted stones was the only surgical treatment in the remaining two patients, with no mortality. The Authors conclude that enterolithotomy alone should be the standard procedure for gallstone ileus. The repair of cholecysto-enteric fistula should be scheduled on elective basis and only if there are continuing or recurrent symptoms.

[Surgical treatment of acute necrotic-hemorrhagic pancreatitis]. / Il trattamento chirurgico della pancreatite acuta necrotico-emorragica.

The clinical course of an episode of acute pancreatitis varies from a mild transitory form to a severe necrotizing form characterized by multisystem organ failure and mortality in 20% to 40% of cases. Mild pancreatitis does not need specialized treatment, and surgery is necessary only to treat underlying mechanical factors such as gallstones or tumours of papilla of Vater. On the other hand, patients with severe necrotizing pancreatitis need to be identified as early as possible after the onset of symptoms to start intensive care treatment. Patients with infected necrosis, approximately 10 to 20%, must undergo surgical intervention, which consists of an organ-preserving necrosectomy followed by postoperative drainage-lavage or the method of "open abdomen". The Authors report a series of 20 patients operated on for acute necrotizing pancreatitis from 1998 to 2000. They describe the indications and methods of treatment, in particular the additional procedure following necrosectomy.

[Surgical treatment of tumors of the ampulla of Vater by local resection]. / Trattamento chirurgico dei tumori dell'ampolla di Vater mediante resezione locale.

The cases of six patients suffering from Vater's ampulla neoplasia were studied 1981 and 1995. All cases are described both clinically and in terms of diagnostic techniques. All patients underwent a transduodenal excision of the neoplasia. A number of factors provided an indication for ampullectomy: the extremely high surgical risk, the suspected benign nature of the lesion or the very small size of the neoplasm associated with no pre-surgery finding of lymphadenomegaly in the area. The following issues were analysed: the accuracy of results obtained by a correct pre-surgery diagnosis, short and long term complications and mortality related to surgery. All patients received a five years post-surgery follow-up. Results show that the ampullectomy can be considered, in selected cases, as a valuable alternative to pancreatoduodenectomy even if further and wider studies are necessary in order to obtain an accurate definition of the correct pre-surgical diagnostic approach and surgical indications.

[Blunt traumatic rupture of the diaphragm]. / Le rotture del diaframma da trauma chiuso.

Lesions of the diaphragm are uncommon but important complications of blunt thoraco-abdominal traumas. Their incidence is increasing over the last decades as a consequence of the increase of the road traumatology. Preoperative diagnosis is often difficult especially when the diaphragmatic lesion is associated with other skeletal or visceral injuries that may mask the clinical or radiological signs. The Authors report 12 cases of traumatic lesions of the diaphragm due to blunt trauma observed from 1980 to 1997 and that underwent surgery. In particular they discuss about the importance of an early diagnosis and a correct surgical approach to reduce morbidity and mortality. Nine patients were operated by laparotomy; thoracotomy was performed in one case and the combined approach in the last two patients.

[Intestinal obstruction due to phytobezoars]. / L'occlusione intestinale da fitobezoari.

The authors report nine cases of small bowel obstruction due to phytobezoars, observed from January 1982 to October 1991. The main factors in the pathogenesis of phytobezoars, particularly alimentary habits and previous gastric surgery, are considered. In five patients the operation, always performed in emergency, consisted in a longitudinal enterotomy. In two cases the plasticity of the phytobezoar allowed for a manual progression beyond the ileocecal valve. In two patients an intestinal resection was necessary. The authors prefer the finger fracture technique with manual progression of the phytobezoar beyond the ileocecal valve when the ileal loop is well conserved and the phytobezoar itself has enough plasticity.

[A case of xanthogranulomatous pyelonephritis. Diagnostic and therapeutic problems]. / Un caso di xantogranuloma pielonefritico. Problemi diagnostici e terapeutici.

The use of the modern diagnostic imaging techniques allows in most cases a diagnosis of nature of the lesions involving parenchymal organs. The authors report a case of renal xantogranuloma, rare pseudotumoral inflammatory pathology, treated by radical extended nephrectomy on the basis of a pre-operative diagnosis of malignant tumor. Despite the risk of false positives, in front of a renal mass whose nature is sufficiently characterized by the imaging techniques, the routine use of more invasive investigations such as arteriography and percutaneous needle biopsy seems not justified.

[Treatment of the abdominal aorta combined with a second surgical procedure]. / Il trattamento dell'aorta addominale combinato con una seconda procedura chirurgica.

The synchronous performance of aortic graft with a second surgical procedure should be avoided because of the risk of subsequent graft infection. The Authors reported the experience of 21 patients who underwent synchronous aortic graft with second surgical procedure. No graft infection occurred and it is concluded that such combined operation may be safer to perform than staged surgery in elderly patients.

[Acute occlusion of the abdominal aorta]. / L'occlusione acuta dell'aorta addominale.

The Authors report on two cases of acute aortic occlusion, related to cardiac embolism and thrombosis of aortic aneurysm. The singularity of the etiology adds interest to a pathology which is already, in itself, serious and complex and which requires the intervention of the surgeon, anesthesiologist-reanimator, cardiologist, and nephrologist. The diagnosis is mainly clinical. The use of Doppler and CT scan provide to achieve the diagnosis. Surgical treatment included transfemoral embolectomy, with a Fogarty catheter, in the patient with acute aortic occlusion related to cardiac embolism, and aortobifemoral bypass, in the other patient, affected by thrombosis of aortic aneurysm.

[Esophageal perforations. Diagnosis and treatment]. / Le perforazioni esofagee. Diagnosi e trattamento.

Perforation of the esophagus was retrospectively analysed in six patients. The age span was 30 years to 81 years, and the male to female ratio was 2 to 1. Each case was studied with regard to presentation, etiology, treatment and complications. The diagnosis was made at postmortem examination only in 1 patient. The perforation was iatrogenic in 1 of the patients and spontaneous in 5. Management was nonoperative in 3 cases and primary repair with drainage was performed in 2 patients. Overall mortality rate for the series was 33%. This series accumulated from a review of the literature emphasizes the importance of the influence of different methods of treatment and time lapsed between occurrence and therapy.