Uterine diffuse adenomatoid tumor. Does it represent a different biological entity?

Adenomatoid tumor represents a type of mesothelioma apparently confined to the genital tract and characterized by its benign behavior. Its morphological aspects are well known and, until now, it has been described as a nodular mass except for a case diffusely infiltrating the entire myometrium in an immunosuppressed patient. We report a case of benign mesothelial tumor characterized by histological, immunophenotypical and ultrastructural features of an otherwise typical adenomatoid tumor but diffusely growing below uterine serosal surface into the myometrium without discernible borders. The existence of a diffuse type of adenomatoid tumor might reflect a different nature of this neoplasm leading to the hypothesis that this variant of benign mesothelioma represents a distinct biological entity.

[Fibrin-glue in the treatment of a bronchocutaneous fistula]. / Trattamento di una fistola bronco-cutanea con colla di fibrina.

The treatment of postoperative chronic thoracic fistulas with fibrin glue can be the non-operative ideal solution for the relative simplicity of the execution technique.

[Malignant fibrous histiocytoma. Two case reports and review of the literature]. / L'istiocitoma fibroso maligno. Presentazione di due casi e revisione della letteratura.

The authors report two cases of malignant fibrous histiocytoma localised in the gluteus maximus and re-evaluate some clinical and biological aspects of the neoplasia. Although its histiogenesis is still unsure, the tumour can be classified into various isotopes: the vorticoid-polymorphous variety (70%), and the myxoid, giant cell, angiomatous and inflammatory varieties. It is the most common soft tissue sarcoma in adults and onset is most frequently observed on the trunk and limbs. Biological behaviour shows a marked tendency to local recidivation, with metastatic diffusion occurring mainly late. The choice of therapy consists of more or less radical surgical removal with or without ratio- and immunotherapy. The results of surgery are influenced by the technique used, and the biological and clinical behaviour of the tumour; in view of the numerous case reports of anomalous behaviour, these factors are only indicative. Therapeutic efficacy is on the whole greater in cases of tumours with diameters of less than 5 cm and more superficial localisations compared to the deep muscular fascia.

[Risk factors and breast carcinoma: our experience in a department of senology]. / Fattori di rischio e carcinoma mammario: esperienza di un servizio di senologia.

In relation to their experience, the Authors affirm that currently an early diagnosis of breast cancer, in an absolute preclinical stage, is obtainable by adequate screening using specific methods especially among women who are at greater risk. Primary prevention is not achievable at present; however some considerations based on protocols which provide a surgical prophylactic therapy in high risk breast pathologies and in very selected patients, are possible. In the light of these considerations secondary prevention has a predominant role and may be more effective and curative if the treatment is carried out in the earliest stages of the disease.

[Poland syndrome. Problems of reconstructive and aesthetic surgery--a clinical case]. / La sindrome di Poland. Problematiche di chirurgia ricostruttiva ed estetica e presentazione di un caso clinico.

The Authors report a case of Poland's syndrome formerly undergone reconstructive surgery with unsatisfactory results. Therefore, a new surgical reconstructive strategy having aesthetic purposes is illustrated.

[Local anesthesia in breast augmentation]. / L'anestesia locale negli interventi di mastoplastica additiva.

The Authors report their experience in the application of local anesthesia during breast prosthesis implantation.

[Use of ketorolac in patient controlled analgesia (PCA) in postoperative pain]. / Impiego del ketorolac in patient controlled analgesia (PCA) nel dolore postoperatorio.

The investigators analyzed postoperative analgesia quality by randomizing 28 patients (ASA I-II) in two group. I group (14) received ketorolac 120 mg throughout a 24 hs observation period via a pump (20 mg initial bolus, 2 mg demand bolus, 5 min lock-out time 4 mg/h continuous infusion, 48 mg maximum dose not including initial bolus. II group (14 patients) were treated with ketorolac 30 mg im every 6 hs. During the study several parameters were recorded: MR, SAP, RR, SatO2 and pain level by noting' pts' filuing VAS. In the I group pain level dramatically dropped from 6.37 +/- 1.44 to 3.5 +/- 1.11 (p < 0.01) during the first 3 hrs. Pain level continued to decrease in a significant way up to 6 hs after the end of the surgical procedure (p < 0.01). Even in the II group patients the pain level drop in the first 3 hrs was significant (p < 0.01), never the less it did not show any further change throughout the following observation period. RR decreased from 19.7 +/- 3.7 to 15.9 +/- 3.2 (p < 0.01) in the first group, in the first 3 hrs, while in the II group patients lowered from 26.4 +/- 2.2 to 23.6 +/- 2.4 (p < 0.01) in the same time fraction. Results show a significant analgesic effect in both groups of patients in the first 3 hs. However pain control is more dramatic and stable up to the 6 hs in the patients of I group.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pneumatosis cystoides intestinalis. Etiopathogenic and clinical considerations regarding a case]. / La pneumatosi cistica intestinale. Considerazioni etiopathogenetiche e cliniche a proposito di un caso.

Pneumatosis cystoides intestinalis is a rare condition characterized by gas-filled cysts in the submucosa and/or subserosa of the intestine. The authors present a case of Pneumatosis cystoides intestinalis occurring in a patient with pyloric stenosis by duodenal ulcer and report a wide review of the literature. They discuss the major areas of study in its etiology, histopathology, diagnosis and treatment.

[Arteriomegaly: a clinical case report and review of the literature]. / L'arteriomegalia: presentazione di un caso clinico e revisione della letteratura.

The authors report a case of arteriomegaly and underline the importance of a correct diagnosis. A review of the literature, in fact, confirms the incidence of the disease is higher than usually believed. Therefore, a complete diagnostic evaluation is necessary to recognize the disease and assure the adequate treatment.

[The use of a transillumination method for locating the subclavian vein for its catheterization. A preliminary study]. / L'uso della metodica di transilluminazione per il reperimento della vena succlavia ai fini di un cateterismo mirato della stessa. Studio preliminare.

After commenting brief on the complications related to the cannulation of the subclavian vein, the paper outlines a simple and original method for finding the latter. An illuminator optical fibre is inserted in the fore region of the elbow and this enables the subclavian vein to be located by transillumination.

[Mechanical staplers in colorectal surgery]. / Le suturatrici meccaniche nella chirurgia del colon-retto.

The results obtained with manual and mechanical suturing are compared on the basis of a review of a personal colon-rectum series. The advantages offered by staplers in this type of surgery are pointed out in agreement with reported data.

[Mechanical endarterectomy using an original device. Preliminary experimental results]. / Endoarteriectomia meccanica con un apparecchio originale. Risultati sperimentali preliminari.

A prototype for the performance of mechanical thromboendarterectomy was constructed following various experimental designs and applications. The study was carried out on 25 aortobifemoral segments presenting typical obliterating arteriosclerotic lesions. The equipment consists of a flexible probe whose distal end was represented by a screened helical cutter and whose proximal end by an inlet and washing chamber. At the centre of these chambers and of the probe, a steel tube sets the cutter rotating at an adjustable speed. Good recanalisation was achieved in all vasal segments treated without damaging the vessel's wall. Although encouraging, results thus far are preliminary and require verification.

[Angioplasty of the deep femoral artery using a semirigid PTFE prosthesis. Experimental studies]. / Angioplastica dell'arteria femorale profonda con endoprotesi semirigida di PTFE. Ricerche sperimentali.

Underlining the importance of Profundus Femoral Artery and its capacity to make up for lower limb's haemodynamics during obliterative arteriopathy, the Authors conceive a funnel-shaped intravascular prosthesis, Goretex constructed (PTFE), to introduce, in case of obstruction, in the artery lumen with a suitable instrument. The research is performed through ten oldster dogs whose average weight is twenty-four kilograms. Isolated the deep Femoral Artery and carried out an arteriotomy of about two centimetres on the Common Femoral Artery, we bring the prothesis in Profundis Femoral Artery and we fix it to the wall of the Common Femoral Artery with 8/O microsurgical dots. After thirty days, the arteriographic test shows the patency of the endoprosthesis with normal peripheral flow in nine animals out of ten. By virtue of this preliminary experiment, the Authors point out the semplicity of this intervention, also feasible in local anaesthesia, the good tolerability of the prosthesis and its perfect integration with the surrounding arterious wall, without shifts or dissecting laminar flows between the external prosthesis wall and the vessel lumen of the animal.

[Current status of the emergency surgical management of closed trauma of the thorax]. / Stato attuale dei provvedimenti chirurgici d'urgenza nei traumi chiusi del torace.

The authors discuss problems related to emergency surgical management of non penetrating thoracic injuries. With reference to their own experience and current literature, they underline the etiologic, pathophysiologic, diagnostic and therapeutic features of the most frequent indications to the surgical treatment.