SPECT in the long-term evaluation of osteointegration in intraoral and extraoral implantology.

Scintigraphic methods used in intraoral and extraoral implantology allow the evaluation of bone metabolism in the peri-implant zones, providing anatomic images and functional dynamics information on the osteointegration process. Twenty-five patients who underwent implantation operations for the application of intra- and extraoral prostheses were studied using technetium 99 m single photon emission computed tomographic (SPECT) procedures to evaluate osteointegration dynamics at 3 weeks, and 3, 6, 12, and 24 months. The study demonstrates that radiation emission peaks 3 weeks after surgery with the maximal bone remodeling activity and 6 months after surgery after the functional loading of the implants only in intraoral fixtures.

[The use of Holmstrom's flap in breast reconstruction].

The authors consider 12 cases of breast-reconstruction after mastectomy, made with the Holmstrom's flap, to verify the validity and the real utility of this way of reconstruction. It has been made a follow-up of 4 years, to verify, in course of time, the characteristics of the reconstructed breasts. All the patients have been operated in a general surgery department.

Immediate TRAM flap breast reconstruction in an obese patient with relapsing benign phyllodes tumor: report of a case.

The authors present a case of relapsing benign phyllodes cystosarcoma of the breast in an obese female treated with a simple mastectomy and an immediate reconstruction using a bipedicled transverse rectus abdominis musculocutaneous (TRAM) flap. After a brief review of treatment options for phyllodes tumors, they discuss the advantages of TRAM flap breast reconstruction, suggesting that it may also be applied in obese patients.

[Plastic surgery of the abdominal wall in laparocele in a patient with previous kidney transplant].

The authors report the case of a patient undergoing kidney transplant from a non-related but compatible living donor who subsequently developed a voluminous incisional hernia affecting almost the entire small intestine in the right iliac fossa, the site of earlier surgery. After having analysed the problems involved when a transplant patient requires further surgery owing to the chronic administration of drugs, the authors describe the case. The patient was treated using the insertion of a prolene graft and remodelling the abdominal wall in correspondence with the lower quadrants using abdominoplasty without repositioning the umbilicus.

[Plastic surgery by the Limberg-Dufourmentel method in the treatment of a pilonidal sinus. The anatomicosurgical considerations and an emblematic case].

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].

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.

[The use of osteointegrated implants in plastic surgery. Ear reconstruction].

The authors present the case of a 14-year-old patient suffering from first branchial arch syndrome with agenesia of the auricle in which the auricle was reconstructed using osteointegrated implants. The patient had previously undergone numerous attempts at reconstruction using traditional methods, all of which had failed. In order to ensure an accurate preoperative evaluation, the patient was studied using CT with a standard technique and three-dimensional image reconstruction for a qualitative and quantitative evaluation of bone thickness so as to allow the optimal positioning of fixtures.

[Primary hydatid cyst of the coracobrachial muscle. A clinical case].

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.

Papillary-like bladder calcifications following intravescical mitomycin C. A case report.

We report a case of bladder calcifications after intravescical mitomycin C in patient with recurrent superficial multifocal transitional cell carcinoma (TCC) of the bladder. The endoscopic appearance was particularly interesting since these calcifications occurred only in the areas of previous transurethral resection (TUR).

[Obstruction of the Le Veen shunt: a new surgical solution].

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.

[Darier-Ferrand dermatofibrosarcoma. General aspects and personal experience].

The Darier-Ferrand dermatofibrosarcoma is a cutaneous lesion with a clinic and recidivant progress that appears in both sexes in the same measure. The metastasis are rare. The authors describe a kind of treatment effected in 13 cases arrived to their observation.

[Gingival hyperplasia induced by cyclosporin 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].

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].

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.

[Surgery of epithelioma in the outer canthus].

We review the tumors localized in the orbito-palpebral region. Their prevalence varies between 2.5 and 16.

Gangliosides potentiate the immunosuppressive effects of cyclosporin A in rat skin allografts.

In vitro gangliosides exert inhibitory effects on cellular immune responses, largely relying on an impairment of the IL-2/IL-2 receptor interaction. In a previous study we have demonstrated synergistic effects of gangliosides and cyclosporin A (CyA) in the inhibition of the generation of in vitro allospecific immune responses in humans. To evaluate the possibility of using these drugs in immunosuppressive therapy in organ transplantation, we investigated the effects of the combination of a gangliosides mixture (GAMIX) and suboptimal doses of CyA on rat skin allografts in vivo.

[Surgical lesions of the facial nerve: anatomy, semiology and nervous function].

The extracranial part of the facial nerve is a frequent seat of lesions, which can be either congenital, or traumatic, or surgical, or neoplastic. The authors review the semeiology of the lesion and discuss the techniques for the preservation of facial nerve function.

Reduced nephrotoxicity and hepatoxicity in cyclosporin A therapy by enalapril and spironolactone in rats.

The aim of the study was to define a therapy to be combined with an immunosuppressive drug such as cyclosporin A, in order to partially reduce the nephrotoxic and hepatotoxic effects in the treated rats. Two drugs were considered: enalapril, which is an inhibitor of the angiotensin-converting enzyme, and spironolactone, which is an antagonist of aldosterone. These two drugs interrupt the renin-angiotensinogen-angiotensin chain after this has been activated by cyclosporin A, preventing peripheral vasoconstriction and more specifically the constriction of both glomerular arterioles and hepatic vessels from occurring, thus diminishing the cyclosporin A toxicity in both liver and kidney.

[Cyclosporin (CyA) and H2 antagonists].

An experimental study on rats in order to discovery any possible interaction between Ciclosporin (CyA) and H2-receptor antagonists has been carried out. The results obtained demonstrated that the serum levels of CyA were higher in rats treated with CyA and Cimetidine or Ranitidine, but not Famotidine. It is probable that the increase of ciclosporinaemia is the consequence of an increased hepatotoxicity due to administration of Cya in association with Cimetidine or Ranitidine.