Integrin Beta-4 expression in colorectal-cancer.

Integrin alpha 6 beta 4 plays an important role in the interaction of epithelia with basement membranes, and its expression appears to be profoundly altered during tumor progression. Using a quantitative immunochemical assay, we investigated the expression of the beta 4 subunit associated with alpha 6 in 25 primary carcinomas, and in matching normal mucosae. alpha 6 beta 4 was expressed in all the carcinoma and mucosa samples.

[Video-assisted mediastinoscopy. A new application of television technology in surgery].

Since 1959, when mediastinoscopy was introduced by Carlens, the practice has been technically unchanged. The authors suggest how the new video technologies could be very helpful to this procedure leading to an ergonomic position for the operator and a faster performance. Initial experience is reported.

Primary leiomyosarcoma of the aorta: report of a case and review of the literature.

Leiomyosarcoma of vascular origin is an extremely rare lesion especially when it occurs in the arteries. In the present study, we report a case of such a neoplasm, originating in the wall of the descending aorta and give an ample review of world references on the subjects of primary aortic neoplasm. Wright classified aortic tumors into two categories concerning the site of origin in the aortic wall: the first involves the intima, the second group consists of tumors arising in the media or adventitia.

[Chemo-antibiotic prophylaxis in general surgery. A study of 1722 cases].

Up until now the problem of surgical infections has been one of the most important which surgeons must confront daily. In 1989 our Institute began programs for control and surveillance of surgical infections; these include, among others, the use of chemo-antibiotic prophylaxis protocols applied to all of the patients hospitalized for surgery. The authors report two years application of three protocols of chemo-antibiotic prophylaxis related to 1722 patients, in which we pointed out the passage from 27.

[Mediastinoscopy in a general surgery department. The evaluation of 186 cases].

A series of 186 cases of mediastinoscopy performed in a department of general surgery is reported. The main indications for this procedure are: histological diagnosis of mediastinal masses, definition of bronchopulmonary neoplasms and thoracic esophagus ones with indication for surgery. The results obtained are: sensibility 90.

[Anatomo-clinical considerations on early gastric cancer].

After having asserted the still rising interest for an as early as possible diagnosis of gastric cancer, authors refer on a group of patients who are carriers of Early gastric cancer. After having touched upon localization and histological characteristics of neoplasms, linger on the rules that leaded their therapeutic choice and they report the results of a follow-up dragged ten years long. They terminate affirming only a timeliness diagnosis can consent a really decisive therapeutic approach.

[Our experience with early gastric cancer].

Authors assert that, in Early gastric cancer diagnosis, anatomicomedical characteristics expressed on the basis of canons formulated by Endoscopy Japanese Society and by Lauren's unexipered classification are of particular interest. After having referred on characteristics observed on a group of patients, in the light of data given from medical Literature, they try to extrapolate aetiopathogenetic factors. These, together with anatomicopathological characteristics of the lesion, are the premises for a wise radical therapeutic choice.

[Esophageal anastomosis using a stapler: new technical variants].

Stapling techniques are considered the safer alternative for esophageal anastomosis in the Authors experience. In order to further improve results they suggest stapled esophageal anastomoses should be constructed avoiding purse-string sutures and the use of purse-string devices or Satinsky forceps.

[Evaluation of prognostic parameters in colorectal carcinoma. I. Histopathological variability].

A careful histopathological analysis was performed on a series of 244 unselected surgically removed primary colonic and rectal cancers. Tumours were staged according to the TNM system. Tumour type (adenocarcinoma or mucinous carcinoma), grade of differentiation, character of invasive margin, degree of peritumoural lymphocytic infiltration, venous and neural invasion were found to be correlated with the clinico-pathological stage and in some ways interrelated.

[Vascular microsutures with resorbable and nonresorbable sutures. A comparative study].

Modern technology has recently provided us with new resorbable suture material for use also in vascular surgery. Clinical use of these sutures has been impeded however by not little mistrust and by old dogmas without a rational experimental basis. We have therefore begun studies of two slowly resorbable materials, polyglactin 910 and polyglycolic acid, in comparison with two classic nonreabsorbable materials, nylon and polypropylene, used in experimental model of end-to-end anastomosis rats'infrarenal aorta, following up the healing process and its evolution after an interval.

[Aplasia of the internal carotid. A clinical case report].

Among the anomalies of internal carotid artery, agenesis and aplasia recur with a low rate: only about sixty cases are reported in literature. We observed a case of aplasia of the left internal carotid in a 49 year old male suffering from hypertension and showing cerebro-vascular symptoms due to TSA pathology: it was studied with arterial angiography and duplex scanner. The angiographic examination raised a suspicion of left internal carotid thrombosis; on the contrary the duplex scanner revealed a correct diagnosis of carotid aplasia.

[Mechanical staplers in colorectal surgery: cost-benefit ratio].

The cost/benefit ratio of stapled anastomoses in colorectal surgery has been retrospectively evaluated on the basis of a 8 year experience taking into account the overall costs in surgery as well as short term and long term benefits. With this aim, our experience was divided in two periods: 1st period: November 1970-January 1981: 598 hand sutures; 2nd period: February 1981-December 1988: 787 stapled sutures. Mechanical suturing was found to be superior based on the following: a) the average postoperative hospital stay decreased from 20.

[Clinico-statistical findings in Fournier's gangrene].

Pathophysiological mechanisms of Fournier's gangrene are reported. Variety and progression of clinical manifestations are stressed as well. The importance of an accurate therapeutic protocol in the treatment of this peculiar and serious disease is therefore underlined.

[Role of screening as an index of predictability in the early diagnosis of nonpalpable lesions of the breast].

The Authors, on the basis of their personal experience and supported by more significative data from the international literature, underline the validity of the screening in detecting non palpable lesions of the breast. They conclude by asserting that mortality for breast cancer may be further reduced if more and more women undergo screening programmes.

[Autologous dermal graft in the treatment of hernia of the abdominal wall. A clinical contribution].

The A.A. after reporting the different methods of treatment of the abdomen wall herniation relate about the advantages of autologous dermis graft.

[Wilms' tumor in adults].

The Authors report a case of Wilms' tumor in a 38-year-old woman. Through a review of such neoplastic condition some etiopathogenetic and clinical considerations are made. It is concluded that postsurgical adjuvant therapy in adulthood must not differ from that of childhood.

[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.

[Gastric volvulus. Clinical contribution].

After discussing the classification of the various types of gastric volvulus, the aetiopathogenetic factors that occur in this rare stomach pathology are reviewed. The personal series is reported and the clinical, radiological and above all therapeutic aspects connected with the pathology discussed. It is concluded that, in these cases too, the aims to pursue are the formulation of early diagnosis and implementation of quick, correct treatment for the purpose of eliminating the basic pathology and preventing necrosis of the gastric wall setting in.

[Use of mebendazole in the treatment of pulmonary hydatidosis].

After recalling the various therapeutic aids proposed for the treatment of hydatid disease, personal experience in the use of mebendazole in patients suffering from pulmonary hydatidosis is reported. On the basis of the results obtained, it is concluded that mebendazole represents a useful therapeutic approach provided it is administered in full doses and for a long period in well selected cases, namely patients with cysts of limited dimension and, probably, of comparatively recent onset.