The ilizarov apparatus in the treatment of thalamic fractures of the calcaneus.

The authors present a new method for the treatment of severe thalamic fractures of the calcaneus by the Ilizarov apparatus. The versatility of this apparatus makes it possible to restore the anatomy of the area, in particular, the total height of the talo-calcaneal complex and correction of varus or valgus deviation while leaving the ankle joint free. This method was used to treat 10 cases of severe thalamic fracture. If the apparatus is maintained for at least 3 months there is no subsequent loss of correction and the results are very good.

[A case of solitary myeloma of the glenoid cavity. Notes on glenoidectomy]. / Su un caso di mieloma solitario della glenoide. Note sulla glenoidectomia.

A case of solitary myeloma of the glenoid cavity is presented; the case was operated 6 years after the onset of symptoms; there was no recurrence of the disease or hematologic pathology. Total glenoidectomy is described.

[Spontaneous hematomas of the rectus abdominis muscle. Diagnosis and therapy]. / Gli ematomi spontanei del muscolo retto dell'addome. Diagnosi e terapia.

Two cases of spontaneous hematoma of rectus abdominis muscle are described. This clinical syndrome, may be easily confused with other acute abdominal syndromes. A careful clinical history, a careful physical examination and above all echography will always solve the diagnostic problem. With a correct diagnosis the treatment of choice is conservative. The surgical operation will be reserved to the huge hematomas with some complication.

[Current data on transhepatic percutaneous cholangiography in the differential diagnosis of jaundice]. / Attualità della colangiografia percutanea transepatica nella diagnosi differenziale degli itteri.

The authors stress the actuality of percutaneous transhepatic cholangiography (P.T.C.) in differential diagnosis of jaundice, for absence of complications, low cost, simplicity of execution, and high percent of success. They derive their technique by Okuda et al., with some proper variations. Particular stress is placed on the decompression of biliary tree before and after injection of contrast medium (M.D.C.). Results obtained coincide with those of other authors.

[Correlations between membrane and bubble oxygenators in patients treated with or without methylprednisolone. Haemodynamic and metabolic parameters (author's transl)]. / Correlazioni tra ossigenatori a membrana e ossigenatori a bolle in pazienti trattati e non con metilprednisolone. Parametri emodinamici e metabolici.

We studied 64 patients who underwent cardiac surgery. Hemodynamic and metabolic variables-cardiac index (CI), total peripheral resistances (TSR), oxygen consumption and (VO2), urinary output, alveolar-arterial oxygen difference (delta A-a O2) - were related with oxygenator (bubble or membrane oxygenator) and with treatment (with or without methylprednisolone). 31 patients were perfused with membrane oxygenator (MO), 33 with bubble oxygenator (BO), 13 patients MO and 18 patients, BO were treated with methylprednisolone (mps). The analyzed variables were sampled 15 minutes after the start and one to five times during the perfusion. At first data were analyzed in terms of mean values in whole set of time intervals. Only delta A-a O2 showed statistically significant difference between the MO and the BO group (282 +/- 110 versus 361 +/- 82, p less than 0.005). Between nomps-treated and mps-treated patients statistically significant difference were found in TSR (2.134 +/- 362 versus 1.785 +/- 317, p less than 0.005) and in delta A-a O2 (293 +/- 92 versus 355 +/- 108, p less than 0.02). Secondo analysis is concerning time change of variables. The time behaviour of TSR is similar in all groups studied, but a statistically significant lower value was found in mps-treated patients in every time interval. The VO2, in the last time interval, is statistically higher in the mps-treated than in the nomps-treated patients (p less than 0.05) and furthermore, for the same temperature change, the rise of VO2 is higher in the mps-treated (p less than 0.001). The delta A-a O2 shows time increase both in the MO and in the BO group, but the MO patients start from statistically significant lower values than the BO and the behaviours remain parallel for all analyzed time. The results are interpreted and discussed in relation to hemodynamic and metabolic patterns of perfusion as good or bad tissue perfusion.