Inferior wall restoration: anatomic and surgical considerations.

Congestive heart failure that results from inferior infarction is caused by a triangular change in ventricular geometry, which involves the septum, lateral wall, and base supplied by the right coronary artery. The extent of damage is determined by the anatomic distribution of coronary blood flow. Mitral insufficiency is accentuated from damage to the basal region, especially when the occluded right coronary vessel has multiple inferior branches and wraps around the apex.

[Biliary complications during videolaparoscopic cholecystectomy. Remarks on methodology and indications in the training period].

In our study we have considered the activity of a surgeon working in our Surgery Department during his laparoscopic training period. We focus our attention on a date related to the same complications checked in 27 cases of cholelithiasis operated by the same surgeon. We have observed three cases of biliary cholelithiasis fistulas, all of them during the three last operations.

[Heterogeneities of ventricular repolarization and vulnerability to arrhythmia. How to detect them with noninvasive methods?].

Vulnerability to arrhythmias can be influenced by two conditions: a dynamic (beat-to-beat) variation of repolarization sequence, and a state of heterogeneity of repolarization, i.e. a greater than normal dispersion of recovery time.

[Medullary carcinoma of the thyroid. A clinical case].

A case of medullary thyroid carcinoma is reported. Moreover, the main peculiarity, the correct diagnostic approach and the therapeutic indication of this rare pathology are described.

Dual-chamber pacemaker implantation in a young woman with Ebstein's anomaly.

A case of 28-year-old woman with Ebstein's anomaly and complete AV block, requiring a permanent dual-chamber pacemaker implantation, is described. The ventricular lead was successfully placed in the right ventricular outflow tract and there was no problem associated with positioning of the atrial electrode in the right atrial appendage, with good sensing and threshold. The subsequent clinical course was uncomplicated and the patient has remained asymptomatic throughout the eight-month follow-up.

[Improvement of endoscopic resection procedures in relation to the volume of prostatic adenoma].

First choice therapy of obstructive prostatic hyperplasia is still represented by endoscopic transurethral resection of the prostate, despite new techniques for tissue ablation have being proposed. The issue aims to answer to the questions arising about indications of this procedure, and introduces to the knowledge of physical laws which regulate irrigation during and after operation and to the different techniques of irrigating flow derivation whose application reduced morbidity depending on tissue volume and "resection time". Moreover, the new technique of continuous resection with simultaneous suprapubic evacuation of tissue chips (Turbo-TUR) will be illustrated in details, as it permitted to extend indications and advantages of endoscopic surgery to bulky adenomas, electively submitted to open surgery up to now.

Mapping of ventricular repolarization potentials in patients with arrhythmogenic right ventricular dysplasia: principal component analysis of the ST-T waves.

Background: Nonuniform recovery of ventricular excitability has been demonstrated to facilitate the reentry circuits leading to the development of ventricular tachyarrhythmias. This can also occur in arrhythmogenic right ventricular dysplasia (ARVD). In fact, in patients with ARVD, abnormalities of ventricular repolarization are often observed on 12-lead ECGs, but their predictive value for the occurrence of malignant arrhythmias is yet to be established.

A newly-described myotonic disorder (proximal myotonic myopathy--PROMM): personal experience and review of the literature.

The aim of this study is to describe the essential characteristics of a family affected by the newly-described proximal myotonic myopathy (PROMM) The clinical, laboratory and genetic findings are described and compared with those reported in the literature, and the clinical spectrum of the manifestations that are similar to but distinct from myotonic dystrophy (MD) is also explored. This has practical implications because the cases so far described suggest that the long-term prognosis with PROMM seems to be more favourable than that of patients with MD.

Idiopathic right pulmonary artery aneurysm with pulmonary valve insufficiency.

A case of idiopathic right pulmonary artery aneurysm with pulmonary valve insufficiency simulating a mediastinal teratoma occurred in an asymptomatic 13-year-old boy. The key to correct diagnosis was pulmonary angiography. The patient was successfully treated with surgery.

[Initial experiences in the treatment of benign prostatic hypertrophy with laser (side firing)].

After a short literature review about the topic, the AA. present a 6 months follow up of 15 patients treated with prolase II fiber (cytocare) for BPH. In 80% we got good results about the symptom score and urinary flow, but at the endoscopic control in some cases we found an irregularity in the prostatic urethral as there was some prostatic residual tissue.

Mutation in the S4 segment of the adult skeletal sodium channel gene in an Italian paramyotonia congenita (PC) family.

The periodic paralyses are a group of autosomal dominant muscle diseases sharing the common feature of episodic stiffness and weakness, usually occurring with muscle cooling (as in the case of paramyotonia congenita, PC phenotype) or changes in extracellular K+ levels resulting from various precipitating factors (hyperkalemic periodic paralysis, HYPP and hypokalemic periodic paralysis, HypoPP). It is now known that HYPP maps to chromosome 17q, and that PC and a form of myotonia congenita without periodic paralysis also map to the 17q locus, thus indicating that they derive from allelic variants. So far, these disorders have been described in various ethnic groups but, to our knowledge, have never been reported in Italy.

[Percutaneous closure of interatrial defect using the buttoned double-disk prosthesis].

Background: Surgical repair is the procedure of choice for atrial septal defect correction. Even though surgical mortality is low (< 1%), morbidity is significant (anesthesia, thoracotomy, cardiopulmonary bypass, longer hospitalization and intensive care unit monitoring). Transcatheter methods to occlude atrial septal defects have been in development during the last two decades.

[The behavior of late potentials in myocardial infarct patients undergoing myocardial revascularization].

Ventricular late potentials recorded on the body surface in patients with old myocardial infarction (MI) are considered to reflect slow conduction, due to the presence in the infarct border zone of viable myocardium within scarred tissue. To assess the prevalence of late potentials in a population with old MI and no malignant arrhythmias and to verify whether myocardial revascularization may influence the substrate responsible for the occurrence of late potentials, 80 patients with old MI (75 males, 5 females), aged 55 +/- 9 years, undergoing coronary surgery, were studied. A Marquette MAC15 HiRes electrocardiogram recorder was used to identify late potentials before and after surgery.

Clinical use of body surface potential mapping in cardiac arrhythmias.

Body surface potential maps have and certainly will have a very important role in the field of clinical arrhythmology, specifically for the localization of accessory pathways, for the detection of the origin of ventricular arrhythmias and for the identification of patients at risk of sudden death. In this particular setting, surface maps are certainly more useful than other more costly and sophisticated imaging techniques.