[Plastic surgery by the Limberg-Dufourmentel method in the treatment of a pilonidal sinus. The anatomicosurgical considerations and an emblematic case]. / La plastica secondo Limberg-Dufourmentel nel trattamento del sinus pilonidalis. Considerazioni anatomo-chirurgiche e presentazione di un caso emblematico.

Limberg-Dufourmentel's cutaneous flap may be used to fill in the loss of residual substance after the radical excision of sinus pilonidalis in the sacrococcygeal region. According to the authors, this technique enables some aspects of the locoregional anatomic conformation typically linked to the onset of this pathology to be modified, as well as permitting more accurate radical surgery. By way of example, the authors report the case of a 20-year-old subject with sinus pilonidalis who was successfully treated using this surgical technique.

[Surgical treatment of rhinophyma using dermo-epidermal graft. A case report]. / Trattamento chirurgico del rinofima con innesto dermo-epidermico. Caso clinico.

Rhinophyma is a nosographical form that has always attracted attention, even among non-experts, owing to the marked aesthetic damage it often causes. Several types of surgery have been proposed for its treatment in an attempt to elaborate a technique that is easy to apply and guarantees satisfactory results in clinical and aesthetic terms. After a short review of the general aspects of the pathology, the authors illustrate the case of a patient with rhinophyma treated with a full thickness dermo-epidermic graft, and emphasise that this surgical solution, provided that the indications are correct, is still a valid alternative.

[Primary hydatid cyst of the coracobrachial muscle. A clinical case]. / Cisti da echinococco primaria del muscolo coracobrachiale. Caso clinico.

Primary localization of hydatidosis in the musculoskeletal system is a quite rare occurrence. We report a case of a 67 year old man with an infestation of the coracobrachialis muscle. We discuss several instrumental and serologic diagnosis methods and the hypothesis of a primary muscular localization.

[Obstruction of the Le Veen shunt: a new surgical solution]. / L'ostruzione dello shunt di Le Veen: nuova soluzione chirurgica.

The authors propose an alternative which has been proved valid in four cases of peritoneovenous shunt with an occluded Le Veen valve for venous thrombosis implanted in cirrhotic patients with refractory ascites. After having explored the various possibilities using the vessels adjacent to the superior cava branch, the authors resolved the problem of reimplanting the valve by using an access route through the saphenous vein and inferior vena cava. Using this technique it was possible to reactivate the shunt with a marked improvement in the recurrent ascitic state and above all shunt functionality, and consequently in the clinical conditions and quality of life of these patients.

Optimization of pre-, intra- and postoperative hyperthermic treatment in inoperable lower bowel and liver tumors.

Traditional therapies in malignant tumors are often inadequate, either because the tumors aren not responsive or because the tolerance dosage has little effect. With this in mind, our study examined advanced tumors of the lower bowel and liver. We evaluated the results of 10 cases of anorectal epidermoid cancer. We treated these patients with radiofrequency hyperthermia, since previous radiotherapy was unsuccessful. The patients had significant tumor remission, along with a 'free-of-disease' follow-up of 10 months. In this paper, we also report the positive response in 10 cases of multifocal liver tumors. All these tumors had metastasized from gastrointestinal sites and were not responsive to traditional therapies. These patients had remission with a follow-up of 6 months. In the first cases, we associated 'low-dose' radiotherapy with hyperthermia; in the latter cases, we induced chemoembolization and also associated it with hyperthermia. We emphasize these associations and suggest the very important role of intraoperative hyperthermia in absolutely inoperable cases or in those cases previously diagnosed as unresectable.

[Gingival hyperplasia induced by cyclosporin A]. / Iperplasia gengivale indotta da ciclosporina-A.

Cyclosporine-A (Cy-A) selectively inhibits T cell function with minimal effect on humoral immunity. It is used specially in transplantation patients and in some cases, like other drugs, it causes gingival hyperplasia. In this article, after a review of the most recent pathogenetic hypothesis, the authors present their experience based on 10 cases of gingival hyperplasia in kidney transplantation patients in treatment with Cy-A.

[The optimal implantation of the peritoneal-jugular shunt with LeVeen valve]. / Impianto ottimale dello shunt peritoneo-giugulare con valvola di LeVeen.

The authors underline the efficacy of peritoneovenous shunting with LeVeen's valve in the treatment of refractory ascites in cirrhotic patients. Selection and appropriate preoperative management of patients are essential to assure good immediate and long-term results.

[Transhepatic and mini-laparotomic approach in the embolization of the left gastric vein]. / Approccio trans-epatico e mini-laparatomico nell'embolizzazione della vena gastrica sinistra.

The Authors depict the possibility to reduce the risk of variceal bleeding with the embolization of the left gastric vein through a transhepatic or mini-laparotomic approach. Such treatment applied in 5 cases was effective: during a mean one-year follow-up no rebleeding was registered, while the stabilization of a satisfying haemodynamic state in relation to the chronic liver disease was observed.

[Value of splenic embolization in patients with hypersplenism]. / Valore dell'embolizzazione splenica nei pazienti con ipersplenismo.

The authors describe the importance of embolization of the splenic artery by means of Gianturco coils in splenomegalic portal hypertension. They propose their first experience of six cases and the good results on the basis of clinical parameters, of bleeding of esophageal varices, of hematological values. They also show the influence of this method on hemodynamic, metabolic, and respiratory parameters, altered in cirrhotic patients.

Pulmonary vascular resistance changes in experimental hemorrhagic shock.

Hemorrhagic shock was experimentally induced in 40 mongrel dogs, and the resulting pulmonary vascular resistances studied. A mechanical test with closure of the left branch of the pulmonary artery and two pharmacological tests with isoproterenol (isuprel) and cyclic adenosine-monophosphate (cAMP) were performed. The results suggest that there is a block in the beta-control during prolonged shock, and that beta-control is restored by cAMP.