[Surgery of large ventral hernias. Personal experience in 1990-1997].

Background: The surgical treatment of large wall defects conventionally defined as an extension over 10 cm is discussed. The difficulty to contain the bowels that have lost law of domicile in the abdominal hollow, constitutes motive for notable increase of the endo-abdominal Pressure with serious consequences in the postoperative course and this leads to the use of prothesis meshes that allow the closing of the abdominal hollow with the Tension-Free technique.

Methods: Personal experience embraces 45 patients, with large wall defects, divided into 21 patients with overumbilical location, 14 with umbilical location, 10 with periumbelical location; a simple suture has been used in 7 cases, the reconstruction of the wall according to Stoppa in 36 cases and the apposition of Goretex net internally and Marlex net externally in 2 cases.

[Surgery of dysphagic diseases. Personal experience (349 surgical interventions)].

The authors report their surgical experience relating to dysphagic diseases of the esophagus (349 cases). In the light of these results, they describe the different surgical techniques used in the various pathologies: 1) Esophageal diverticula: The value of a careful evaluation of subdiverticular spasm is emphasised using preoperative manometry in cervical and epiphrenic diverticula, leading to subdiverticular myotomy when present. 2) esophageal achalasia and intermediate motor disorder: A clear difference must be drawn between these two diseases owing to the different motor behaviour of the esophagus.

Optimization of the solidification/stabilization process of MSW fly ash in cementitious matrices.

The solidification/stabilization (S/S) process of municipal solid waste (MSW) fly ash in cementitious matrices was investigated in order to ascertain the feasibility of a washing pretreatment of fly ash with water as a means of maximizing the ash content of cementitious mixtures. Four types of fly ash resulting from different Italian MSW incineration plants and ASTM Type III Portland cement were used in this study. Ash-cement mixtures with different fly ash/cement (FA/C) ratios were made using untreated and washed fly ash.

Lung microcytoma: a multidisciplinary therapeutic approach.

This report is of 26 patients diagnosed with microcytoma of the lung in stages I, II, and IIIa. All patients received surgical treatment as well as postoperative chemoradiotherapy when indicated by stage. Mean survival rates were 16 months for stage 1, 10 months for stage II and 6 months for stage IIIa disease.

Intracellular responses of onset chopper neurons in the ventral cochlear nucleus to tones: evidence for dual-component processing.

Intracellular responses of onset chopper neurons in the ventral cochlear nucleus to tones: evidence for dual-component processing. The ventral cochlear nucleus (VCN) contains a heterogeneous collection of cell types reflecting the multiple processing tasks undertaken by this nucleus. This in vivo study in the rat used intracellular recordings and dye filling to examine membrane potential changes and firing characteristics of onset chopper (OC) neurons to acoustic stimulation (50 ms pure tones, 5 ms r/f time).

[The diagnosis and therapy of dysphagic disorders of the LES].

Primary motor disorders of LES causing dysphagia consist in cardial achalasia and intermedius motor disorder (IMD), the last one different from achalasia because of normal motor pattern of the esophageal body. In this paper diagnostic and therapeutic procedures are examined according to an experience of 94 surgically treated cases (22 rioperations for surgical failures). Cardial dilatation as treatment of choice is recognized only for IMD in which a normal peristaltic behaviour of the esophagus can avoid the high danger of GER.

Muscimol suppression of the dorsal cochlear nucleus impairs frequency discrimination in rats.

The cochlear nucleus is composed of three sub-nuclei: the dorsal (DCN), anteroventral (AVCN) and posteroventral cochlear nucleus (PVCN). In addition to connections between these sub-nuclei, each nucleus receives frequency specific tonotopically organised input from the cochlea. Evidence suggests that connections from the DCN to the AVCN are inhibitory and organised tonotopically but the functional significance of this pathway has yet to be elucidated.

Intracellular responses of the rat anteroventral cochlear nucleus to intracochlear electrical stimulation.

The anteroventral cochlear nucleus (AVCN) is the first central processing site for acoustic information. The influence and extent of convergent auditory nerve input to AVCN neurons was investigated using brief (<0.2 ms) intracochlear electrical activation of spiral ganglion cells.

[Dilatation versus surgery in the treatment of cardial achalasia].

Both surgery and dilatation are useful for the treatment of cardial achalasia. The authors make a wide review of the literature with particular attention to reports comparing results of these procedures. This review evidences that surgery gives better results than dilatations (84.

Muscimol suppression of the dorsal cochlear nucleus modifies frequency tuning in rats.

The cochlear nucleus is composed of three sub-nuclei: the dorsal (DCN), anteroventral (AVCN) and posteroventral cochlear nucleus (PVCN). Intrinsic connections from the DCN to the AVCN are inhibitory and organised tonotopically. In this investigation, this pathway and its possible role in frequency tuning was examined using in vivo extracellular recordings.

Intracellular responses of the rat cochlear nucleus to sound and its role in temporal coding.

The anteroventral cochlear nucleus (AVCN), the first centre of the central auditory pathway, contains globular bushy cells, which are unique in their ability to produce fast excitatory post-synaptic potentials (EPSPs). Using in vivo intracellular recordings in the rat AVCN we examined these fast EPSPs in relation to temporal coding. At frequencies up to 2.

[Esophago-jejuno-gastroplasty in the treatment of peptic stenosis of the esophagus].

From 1973 to 1994, 21 patients with esophageal peptic stenosis were submitted to esophago-jejuno-gastroplasty with Merendino's technique. In 14 cases peptic stenosis developed after Heller's myotomy for achalasia, associated in 3 cases with fundoplication. In 3 patients the stenosis was secondary to fundoplication.

Intracellular recording of magnocellular preoptic neuron responses to olfactory brain.

The magnocellular preoptic nucleus of the rat supplies centrifugal input to the olfactory bulb as well as projecting to other olfactory-related areas. The extent to which the piriform and entorhinal cortices can influence the activity of magnocellular preoptic neurons and hence that of the olfactory bulb were examined using intracellular in vivo recording. Stable recordings were obtained in 58 neurons impaled in the magnocellular preoptic nucleus.

Jejunal interposition for peptic stenosis of the esophagus following esophagomyotomy for achalasia.

Retrospective analysis of the results of esophagojejunogastrostomy in 21 patients with peptic stenosis after esophagomyotomy for achalasia is reported. All patients complained of severe dysphagia. The esophagogram showed the presence of a 2 to 3 cm long stenosis in the lower esophagus with a diameter < 10 mm.

Effects of inactivation of the magnocellular preoptic nucleus of olfactory bulb processing.

The magnocellular nucleus (MCPO) was inactivated in anaesthetized rats, using muscimol, a gamma-amino butyric acid ergic agonist, in order to examine the effect of suppression of its tonic activity on extracellular unit firing in the granular (GRL), mitral (MCL) and external plexiform (EPL) layers of the olfactory bulb (OB). In GRL there was a significant increase in unit activity during the first hour after muscimol injection (30 ng), followed by a significant decrease in activity during the following hour. No effect on activity in MCL was seen after muscimol injection into the MCPO.

[Prosthetic materials in surgery of esophageal cancer. Personal experience].

Even if the incidence of esophageal carcinoma is low (25% in comparison to rectal cancer) the total mortality of this disease is very high (superior to rectal cancer itself according to Am.Ca.SO.

[Use of an anesthetic cream in the surgical treatment of phimosis].

The authors present their technique of local anaesthesia in the surgical treatment of phimosis using a cream composed of an eutectic mixture of lidocaine and prilocaine (Emla). This cream, unlike injectable local anaesthetics, allows surgical procedures to be performed on the prepuce without pain.

Lesions in the magnocellular preoptic nucleus decrease olfactory investigation in rats.

The nuclear complex of the horizontal limb of the diagonal band and the magnocellular preoptic nucleus, components of the basal forebrain magnocellular system affected in Alzheimer-type dementia, supply centrifugal innervation to the olfactory bulb. The lateral magnocellular preoptic nucleus provides significant GABAergic input. Since its stimulation may facilitate olfactory bulb mitral cells, we have investigated the effect of sub-total electrolytic lesions in this nucleus on performance in a simple test of olfactory investigation and its habituation.

[Epidemiology of esophageal cancer].

The Authors examine the epidemiological features of esophageal cancer. This tumor is today the fourth neoplasm of the digestive tract, and represents 2-5% of all tumors.

Linear sebaceous nevus syndrome: report of a patient with unusual associated abnormalities.

A 9-year-old girl was diagnosed as having a linear sebaceous nevus syndrome (LSNS). The nevus sebaceus was located on the face, and the girl also had nevoid hypertrichosis on the neck, sensorineural deafness, partial anodontia, blocked tear ducts, labiopalatoschisis, and an area of micropolygyria in the left encephalic (cerebral) hemisphere. Electroencephalographic alterations were detected, but they were not accompanied by a history of seizures; furthermore, the child was not mentally retarded.

Pectus excavatum in adults: destructive surgery or simple correction of an aesthetic defect?

Pectus excavatum, a congenital depressive malformation of the sternum, is described since 1594 by Johannes Schenk and has successively been the subject of many studies because of its various inherent problems. The repercussions on the respiratory and cardiac dynamics caused by the compression on the mediastinal structures and by the reduction of the respiratory volume have only recently been valuated completely with the application of the latest techniques to diagnosis, cardiology and radiology. The aesthetic defect, often the first aspect to attract the attention of patient and doctor, has serious psychological implications, especially for what concerns the affective life and relationships in general.

Subcapsular splenic hematoma due to infectious mononucleosis.

Spontaneous subcapsular splenic hematoma formation without rupture in infectious mononucleosis is a very unusual occurrence. A conservative management is successful in those patients in stable condition. We describe the presentation and the clinical progress of a case in whom a sudden enlargement in hematoma's diameter needed a splenectomy to avoid the risk of blood effusion in the abdominal cavity.

[Dysphagia associated with aorto-cardiac compression on the distal esophagus: a rare event but not exceptional in the elderly].

Among the pathologies responsible for dysphagia in the elderly, the aortic compression on the distal oesophagus awakens a certain clinical interest. Cipho-lordosis, which is often present in aged females, worsens the effects of this compression causing other kinkings on the oesophagus already hypokinetic because of the age (presbyoesophagus). This illness often shows scare symptoms, but sometimes requires a pneumatic dilation to allow normal food assumption of the patient.

Modality of failure following resection of stage I and stage II non-small cell lung cancer.

The pattern and sites of recurrence were studied in 270 patients with resected Stage I (NO) or Stage II (Nl) non-small cell lung cancer (NSCLC). Survival, incidence, and type of intrathoracic locoregional recurrence versus distant extra-thoracic recurrence after surgical excision were analyzed. Prognostic parameters, such as postsurgical stage, histologic type, degree of cellular differentiation, and surgical approach, were examined to discern their influence on tumor recurrence.

Effects of lesions in the horizontal diagonal band nucleus on olfactory habituation in the rat.

The nucleus of the horizontal limb of the diagonal band, a component of the basal forebrain magnocellular complex affected in Alzheimer type dementia, supplies centrifugal innervation to the olfactory bulb. We have tested the hypothesis that horizontal limb of the diagonal band lesions will interfere with olfactory memory in a simple olfactory test paradigm. Lesions occupied a restricted volume, approximately 20%, of medial horizontal limb of the diagonal band.