[Premature birth in patient with cervix incompetence and history of myasthenia gravis].

Cervical incompetence it's a dilatation of the cervix during the third trimester of pregnancy that ends with the interruption of it. The incidence in Chile is about 0.1-2% of the total pregnancies and it's one of the causes of preterm birth.

[Laparoscopy in traumatic abdominal emergencies].

Over the past few years the laparoscopic technique has changed most of the concepts of traditional surgery and is today the standard approach in elective surgery for many pathologies requiring surgery. Unfortunately the same cannot be said for emergency surgery, though much progress has been made in this field, too. The Authors examine the most important abdominal diseases that can be diagnosed and, possibly, treated by the laparoscopic approach in the emergency setting, concluding that laparoscopic management of such conditions is a feasible proposition in many cases.

[Intraperitoneal neoplastic dissemination of incidental gallbladder carcinoma after laparoscopic surgery].

Background: Several laboratory and clinical studies have raised the concern that laparoscopic procedures might worsen the prognosis of patient with malignant disease due to premature intraperitoneal cancer cell dissemination. The aim of the study was to examine the risk of the dissemination in patients with unsuspected gallbladder cancer diagnosed after laparoscopic cholecystectomy (LC).

Methods: A retrospective clinicopathologic study was performed on 5 patients with unsuspected gallbladder cancer without preoperatively diagnosis among 1280 patients that underwent LC in the period 1993-2002.

[Intrabiliary rupture of hepatic hydatid cyst].

Spontaneous hepatic hydatid cyst rupture into the biliary tract is unusual. The authors describe a case of a 62-year-old man with a hepatic hydatid cyst, showing that it is possible to confirm rupture into the biliary system with cholangiography-MRI. Surgical treatment remains the best form of management.

[Diagnostic problems of choledochal cysts in the adult].

Choledochal cysts are rare malformations of the biliary tree, the precise pathogenesis of which remains unclear. The authors present the case of a 21-year-old man with a choledochal cyst and discuss the main issues regarding the diagnosis and treatment of this uncommon lesion. In particular, of all the diagnostic techniques available, magnetic resonance cholangiopancreatography (MRCP) could become the imaging technique of choice for defining the pancreatobiliary ductal anatomy with at least the same degree of accuracy as that of diagnostic ERCP, while avoiding the potential complications associated with the latter.

[Conservative treatment of hepatic trauma].

Liver trauma has increased over the past few years. In haemodynamically stable patients with hepatic injuries a conservative approach is possible, mainly as a result of the reliability of the diagnostic tools available which allow accurate monitoring of the patients. Computed tomography (CT) of the abdomen is extremely useful for documenting the extent of the damage.

[Appendiceal mucocele].

Mucocele of the appendix is a rare lesion, characterised by distension of the lumen due to accumulation of mucoid substance. Mucocele is often asymptomatic and is found incidentally during surgical explorations or ultrasonography studies. This report illustrates the clinicopathologic features of a case of appendiceal mucocele observed during an emergency laparotomy.

[Surgical problems in the aged patients].

Authors, considering the increasing of the middle duration of life and the increasing of geriatric population, examine various surgical problems in the elderly. They took in consideration not only the age, but all the other markers of surgical risk related to the surgical illness, to the associate illness and to the type of operation. After reporting their experience in the treatment of geriatric patients, they conclude that a scrupulous surgical preparation, a correct indication to the operation and an accurate overseeing after surgery are necessary to do that the elderly patient faces surgical intervention with the same capability of success of the young.

Pre and intra-operative methods of staging gastric cancer.

The aim of this paper was to examine the indications and limits of pre- and intra-operative instrumental diagnosis of gastric cancer. In order to achieve this effectively, the authors emphasized the importance of proper staging methods and obtained a detailed description of tumor diffusion. The most important diagnostic instruments considered were magnetic resonance, endosonography, intra-operative echography, pre- and intra-operative immunoscintography and a cytological examination of peritoneal lavage fluid.

[Surgical management of hereditary medullary carcinoma of the thyroid in patients with "RET" proto-oncogene mutation].

The authors report their results in 64 individuals belonging to 11 families with MEN 2 and familial medullary carcinoma of thyroid (CMT) syndromes. They show amplification and restriction techniques, type, site and incidence of genetic alteration in the observed cases; besides they illustrate the adopted surgical management related to the mutation. They stress the concept that genetic test allows to detect the population with altered gene before laboratory or clinical evidence, with the great advantage to indicate an early surgical approach.

[Medullary carcinoma of thyroid gland].

The authors present the characteristic features of medullary carcinoma of thyroid (CMT) and underline the necessity to identify RET proto-oncogene that is the cause of hereditary transmission of CMT. Physiology of C cells and clinical syndromes are reported and the importance of a genetic screening in population at risk is emphasized; this test has shown to be reliable and easy to apply. They report their experience on techniques of amplification and restriction for RET proto-oncogene identification in relatives of patients with MEN or familial CMT syndromes.

[Ambulatory treatment of inguinal hernia].

The Authors report their experience about the inguinal hernioplasty operation by implantation of prostheses in prolene following the Licthenstein technique. Prolene mesh strengthens the inguinal canal wall, with no suture tension point. The technique is performed under local anesthesia, in day-hospital system, consenting the patient a rapid reinstatement in the social-working ambit.

[Primary adenocarcinoma of the duodenum].

Adenocarcinoma of the duodenum represents a rare neoplasia characterized by an indefinite symptomatology, at least early, and deceitful, that, therefore, arrives at surgeon, almost always, in advanced stage. The Authors, taking from a clinical case, recently observed, as a starting point, review the literature, referring the etiopathogenetic hypothesis that explain the relative rarity of this neoplasia. They therefore report the diagnostic and therapeutic procedure to carry out in these patients.

[Gastric precancerous conditions].

The Authors examine the anatomopathological and clinical features of the main gastric precancerouses and explain the diagnostic therapeutic protocols used. The diagnostic and therapeutic strategy can not leave a strict interdisciplinary collaboration out of consideration between radiologist, endoscopist, anatomist, gastroenterologist and surgeon. They conclude, in fact, affirming that the mentioned collaboration represents the one possibility for improving the results at distance of this neoplasia.

[Role of suture materials in the treatment of inguinal hernia].

The Authors evaluated the role suture materials have in recurrent groin hernia. According to the Literature and to their experience, it is concluded that suture materials seem not to have a significant influence on relapse.

[Biliary peritonitis caused hy hydatid disease].

After specifying that rupture of a hydatid cyst in the peritoneal cavity is one of the most serious and rarest complications of hepatic hydatidosis, attention is paid to the peritoneal hydatid (o chole-hydatid). The aetiopathogenetic mechanisms and the anatomo-pathological features of this type of lesion are described in brief. Finally, the personally employed diagnostic protocol and therapeutic strategy in the face of this feared complication are reported.

[Malignant melanoma of the skin: current diagnostic and therapeutic approaches].

The Authors claim that the treatment of malignant melanosis of the skin is a problem of undiminished topical interest owing to its highly aggressive characteristics. Risk factors and pre-neoplastic lesions are reviewed, and the signs of malignant transformation are described along with the appropriate treatment. The Authors stress the importance, for therapeutic and prognostic purposes, of accurate clinical staging and macro- and microscopic study of the primary tumour.

[Conservative surgical treatment of acute hemorrhagic necrotizing pancreatitis].

The Authors though in theirs' opinion medical treatment is the primary therapeutical approach to Acute Necrotizing Haemorrhagic Pancreatitis (A.N.H.

[Indications and limitations of subcutaneous mastectomy in the treatment of breast carcinoma].

The reasons that led to subcutaneous mastectomy in some initial stage breast cancer patients are reported. After removal of the mammary gland, this surgical technique provides for prosthetic reconstruction and should therefore be confined to women with initial stage cancer who for psychological or aesthetic reasons refuse more destructive operations. The technique is described and results obtained discussed, recalling that this type of non-destructive operation will be increasingly in demand in the future but needs preclinical diagnosis of the local disease and its systemic diffusion.

[Clinical remarks on acute volvulus of the cecum].

On the basis of a case of acute volvulus of the caecum, the rarity of the condition is stressed and its aetiopathogenetic and clinical aspects analysed, particular emphasis being laid on therapy.

[Aminoglutethimide in the treatment of metastasizing breast carcinoma in old age].

After first analyzing the basic pathophysiological aspects and the mechanism of action of aminoglutethimide, the authors report on their experience with the use of this steroid biosynthesis inhibitor in a group of geriatric patients with advanced cancer of the breast. After illustrating the results of their study, the authors conclude by stressing that the use of this drug appears to improve the quality of life of the patients with a significant increase in rates of complete or partial remission of the neoplastic disease.

[Sequential therapy with antiestrogens and progestational drugs in carcinoma of the breast in an advanced stage].

After discussing the mechanism of action of antioestrogens and medroxy-progesterone-acetate, the authors report on their experience with the sequential use of these two hormones in a group of patients with advanced cancer of the breast. After illustrating the results of their study, the authors conclude by stressing that the sequential use of these drugs appears to improve the quality of life of the patients with a significant increase in rates of complete or partial remission of the neoplastic disease.

[Use of tumor markers in monitoring thyroid carcinoma].

The authors report on their experience regarding the use of tumours markers for the pre-operative monitoring and subsequent follow-up of patients suffering from thyroid carcinoma. All patients were subjected to radio-immuno-assay for circulating thyroglobulin, a valuable indicator of residual and metastatic thyroid tissue. The patients suffering from medullary carcinoma of the thyroid and their immediate families were also monitored by periodic thyrocalcitonin assay.