Combined endoscopic approach in the treatment of benign broncho-oesophageal fistula.

The treatment of benign broncho-oesophageal fistula is usually surgical but sometimes other methods of treatment are preferred. The case history is described of an adult in poor general condition in which an endoscopic approach combined with the use of fibrin glue on the bronchial side and metallic clips on the oesophageal side was used to close the fistula.

Remifentanil-TCI and propofol-TCI for conscious sedation during fibreoptic intubation in the acromegalic patient.

Background And Objective: To evaluate the use of remifentanil-propofol administered as target-controlled infusion during awake fibreoptic intubation for anticipated difficult tracheal intubation in acromegalic patients.

Method: In all, 20 consecutive acromegalic patients underwent elective endonasal endoscopic transsphenoidal pituitary surgery. After premedication with midazolam 0.

[So-called benign broncho-esophageal fistula].

Broncho-oesophageal fistulae are rare lesions and may be benign or malignant. The articles in medical literature generally concern one case of BEF, and rarely more cases. The term "benign" is debatable, considering the severity of this disease in view of the aetiology and the bronchopulmonary complications.

Luxatio cordis due to right pericardium tear, a difficult diagnosis: report of a case.

Background: Dislocation of the heart is a rare complication of thoracic blunt trauma. A high index of suspicion of pericardium rupture is necessary to formulate an early diagnosis to reduce morbidity and mortality.

Patients: A 23-year-old man suffered a blunt thoracoabdominal trauma and was admitted 3 days later to a university hospital ICU for right heart luxation due to right pericardial tear.

[Bronchial endoscopy in respiratory disease].

Less than 50 years after the birth of the fiberoptic bronchoscope, bronchial endoscopy had had a considerable progress and has found a wide diffusion of its applications to many respiratory diseases. The author briefly explains the most important and used applications, wishing this diagnostic therapeutical method will soon become an independent discipline.

Phase I-II study of gemcitabine and paclitaxel in pretreated patients with stage IIIB-IV non-small cell lung cancer.

Gemcitabine and paclitaxel are among the most active new agents in non-small cell lung cancer (NSCLC) and are worth considering for second-line chemotherapy. In this phase I-II study, we combined gemcitabine and paclitaxel for second-line treatment of advanced NSCLC. Gemcitabine doses were kept fixed at 1000 mg/m2 on day 1 and 8, and paclitaxel doses were escalated from 90 mg/m2 on day 1 of the 21-day cycle.

High-dose rate brachytherapy of bronchial cancer: treatment optimization using three schemes of therapy.

Purpose: Our aim is to demonstrate that a fractionated high-dose rate endobronchial brachytherapy (HDRBT) treatment is tolerable for patients with advanced (IIIA-IIIB) non-small cell lung cancer and gives an improvement of symptoms. Patients and Methods. From January 1992 to July 1997, we treated 320 patients with external beam radiotherapy (EBRT) and concomitant HDRBT with Ir192.

[Palliative surgical treatment of thoracic esophageal cancer].

Background: Esophageal carcinoma is frequently diagnosed at an advanced stage, therefore most patients may only benefit from surgical or endoscopic palliation.

Methods: From 1982 to 1998, out of 247 patients who underwent palliation for thoracic esophageal carcinoma, 29 (11.7%) underwent surgical palliation.

Middle mediastinum lesions: preliminary experience with CT-guided fine-needle aspiration biopsy with a suprasternal approach.

The technical feasibility and safety of a suprasternal approach in the computed tomography (CT)-guided biopsy of lesions in the middle mediastinum was studied in 30 patients. Patients were positioned on their back with their head hyperextended. Biopsies were performed with local anesthesia and 22-gauge needles.

Analysis of polyunsaturated fatty acids in newborn sera: a screening tool for atopic disease?

It has been demonstrated that patients with atopic disease have anomalies of fatty acid composition, as a result of altered metabolism or abnormal incorporation of fatty acids into the tissues. In the present study, in 57 newborns 'at risk' for atopic disease, the polyunsaturated fatty acid (PUFA) levels were found to be lower in cord blood in infants who subsequently developed atopic disease than in non-atopics. In all babies, levels of arachidonic acid and dihomo-gamma-linolenic acid in sera at 1 and 3 months of age were lower than those in cord blood.

Methylprednisolone bolus: a novel therapy for severe atopic dermatitis.

Seven children suffering from severe atopic dermatitis, unresponsive to standard therapy, received an iv bolus dose of methylprednisolone (20 mg/kg/day) for three days. Immunological parameters were evaluated before and after treatment. At the end of bolus therapy both skin lesions and itching improved for several months in five of seven patients.

Use of a specific oral hyposensitization therapy to Dermatophagoides pteronyssinus in children with atopic dermatitis.

The aim of the present study was to evaluate the efficacy of an oral specific hyposensitization therapy in children with atopic dermatitis and positive prick skin tests and/or RAST to Dermatophagoides pteronyssinus (D.pt.).

Tumor markers and lung cancer: correlation between serum and bronchial secretion levels of CEA, TPA, CanAg CA-50, NSE and ferritin.

The levels of carcinoembryonic antigeny (CEA), tissue polypeptide antigeny (TPA), CanAg 50, neuron specific enolase (NSE) and ferritin were determined in bronchial secretion and serum of patients with neoplastic and non-neoplastic lung diseases. Simultaneous determination of two or three markers in the serum and in bronchoalveolar lavage (BAL) may be clinically useful for the diagnosis of lung cancer and even for the type of tumor. The positivity of CEA determined simultaneously in serum and in BAL of patients with lung cancer is higher than 80% whereas in patients with benign lung disease it is lower than 40%.

[Suture of the diaphragm by polyglactin 910 (Vicryl): histological study in the rat].

The Authors evaluated the histological aspects on 2nd, 7th, 21st day of diaphragma of rats sutured by polyglactin 910 (vicryl). In result they proved that the absorbment was complete on 21st day and the vicryl produced a greater inflammatory acute and chronic reaction.