[Therapeutic strategy in carcinoma of the exocrine pancreas]. / Strategie terapeutiche nel carcinoma del pancreas esocrino.

A series of 311 consecutive patients undergone surgery for pancreatic carcinoma in the Department of General Surgery from July 1979 to March 2003. We performed 41 standard pancreaticoduodenal resections (13%: 30 DCP, 2 total pancreatectomies, 9 splenopancreatectomies), 235 by-passes (75.5%: 114 Roux-en-Y hepaticojejunostomies, 99 hepaticojejunostomies with GEA, 22 GEA), 35 explorations and biopsy (11.2%: 28 LE and 7 VLS). Mortality rate was: 2.4% in Resection, 3.7% in BB(+)-GEA, 18.8% in GEA, 0% in LE-VLS. Morbidity rate was: 43.9% in resection (pancreatic fistula 21.9, haemorrhage 12.1, pneumonia 4.8, infection and delayed gastric emptying 2.4), 10.3% in BB(+)-GEA, 27% in GEA, 5.7% in LE. Actual survival rate was at 3 and 5 years after resection 9.7% and 4.8% respectively with median 18 months; mean survival was after by-pass 11 months (min 3, max 38) with median 9 months.

[GIST: surgical treatment of 34 cases]. / GIST: trattamento chirurgico su 34 casi.

In our Department of General Surgery 34 patients underwent surgery for GIST from 1983 to 2002. In stomach (21 cases) we performed: 7 local resections, 7 partial gastric resections, 5 total gastrectomies, 1 total gastrectomy + splenopancreatectomy, 1 diagnostic laparoscopy with biopsy. In small bowel (5 cases) we performed a typical intestinal resection, while in colon localization (4 cases) 2 anterior colorectal resections and 2 right partial colectomies. In duodenal and omental localization (2 cases each) we performed local resection. There was no operative mortality or morbidity. Actual survival is 67.6%. Prognostic prediction on the basis of histological findings is difficult, thus after surgery we suggest a long last follow-up.

[The use of Rossavik's mathematical model in determining individual intrauterine growth curves. Our experience]. / Utilizzazione del modello matematico di Rossavik nella determinazione delle curve individuali di crescita intrauterina. Nostra esperienza.

OBJECTIVE: To evaluate the performance of Rossavik growth models, derived from II trimester ultrasound measurements, to predict growth in normally growing fetuses. DESIGN: Comparison between observed measurements after 25 weeks and those predicted by Rossavik growth models determined from the data collected in 2 ultrasound examinations at approximately 16 weeks and 24 weeks. SETTING: Teaching hospital obstetric unit, in Florence. SUBJECTS: Thirty women who delivered normal term fetuses in our unit, between January 1991 and December 1992. MAIN OUTCOME MEASURES: Determination of the expected growth curve after 25 weeks from the appropriate growth models, for these fetal parameters: biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL). The differences between sonographic measurement of each parameter, at various time points, and predicted values were expressed as a percentage of the predicted values. Head circumference and weight measured in each infant were also compared with the predicted values at term. RESULTS: Mean percent deviation values were comprised between -0.02% (+/- 2 SD: 3.9%) for BPD and +0.75% (+/- 2 SD: 4.6%) for FL. Pearson's correlation coefficients between predicted and observed fetal parameters, ranged from 0.89 for AC and 0.94 for BPD. For HC and estimated weight at birth, the percent deviations were 0.84% (+/- 2 SD: 5.6%) and 1.23% (+/- 2 SD: 10.5%), respectively. The mean percent deviations for all parameters, were not significantly different from zero. CONCLUSIONS: Our results confirm the accuracy of Rossavik growth model in predicting growth after 25 weeks in normally growing fetuses.