[Pre-, intra- and postoperative somatosensory evoked potentials in cervical vertebral and spinal cord injuries]. / Potenziali evocati somatosensoriali pre-, intra- e postoperatori nei traumi vertebro-midollari cervicali.

Somatosensory Evoked Potentials (SEPs) to upper limb nerves stimulation, are able to detect cervical medullary dysfunction in case of cervical spine trauma. We have monitored cervical spinal cord functionality in 13 subjects with severe cervical spine trauma. In most of subjects, a prolonged P11onset-P13onset interval was found. Postoperatory a reduced P11onset-P13onset interval well correlates with clinical improving of medullary function. Intraoperatory, a transitory impairment of spinal cord function was found during medullary distraction and vertebral body fusion.

[Problems of alimentation in massive intestinal resections]. / Problemi di alimentazione nelle resezioni intestinali massive.

Before reviewing the consequences of extensive exeresis of the small intestine, the physiology of the entero-hepatic circulation of bile salts, the absorption of triglycerides and the varying sites of absorption of foodstuffs at intestinal level are discussed. It has been found that massive (i.e. at least 2/3) removal of the small intestine is incompatible with life owing to the onset of serious metabolic disturbances due to the increase in the speed of transit of foodstuffs from stomach to colon. Malabsorption of lipides causes steatorrhoea and is often associated with choleriform diarrhoea owing to the massive losses of water and electrolytes (Na, Cl, Ca, Mg). Some surgical techniques are illustrated and the local compensation mechanisms (anatomical adaptation of the intestinal mucosa, functional adaptation) designed to prolong transit time are described. Feeding must be parenteral for the first 2--3 months and oral during the alimentary adaptation phase.