[Rare pathology of the breast: adenoma of the nipple].

Adenoma of the nipple is a benign pathology which histologically interests the epithelium of the galactophorous ducts. This pathology looks like Paget's disease both macroscopically and microscopically, therefore an exact differential histologic diagnosis is needed with the breast's carcinoma to undertake the most timely surgical therapy.

[Neurinoma of the brachial plexus: 2 case reports].

Neurinomas, also referred to as neurilemmomas and schwannomas, are rare benign tumours of the peripheral nerves. A small percentage of these lesions arise from the brachial plexus. The Authors report two cases of schwannoma arising from the brachial plexus.

[Rectorrhagia caused by lipoma of the hepatic flexure of the colon. A case report and review of the literature].

The Authors report a case of intestinal bleeding due to lipoma of the epatic flexure. Lipomas are the commonest mesenchymal benign tumors that can be found in the colon and are second as frequence only to the adenomatous polyps. They are most frequent in the right colon and shown an opposite distribution in comparison with adenocarcinomas and adenomatous polyps.

[Parietal implantation after thoracoscopic surgery: a case report].

The Authors report the case of a patient who underwent video-thoracoscopic resection of a solitary pulmonary metastasis. She presented, after about two years, a local relapse (implantation) in the trocar site. Pathogenesis and surgical therapeutic problems are discussed as well.

[Syndrome of inappropriate ADH secretion: a late complication of hemopoietic stem cell allograft].

An 11-year old boy with acute lymphoid leukemia underwent umbilical cord stem cell infusion. This was followed at day 15 by the onset of asymptomatic hypotonic isovolemic hyponatremia. The disorder could be attributed to a syndrome of inappropriate ADH secretion (SIADH), most probably related to the massive i.

[Laparoscopic splenectomy: analysis of 60 consecutive cases].

The purpose of the study was to analyze the results of 60 patients who were candidates for laparoscopic splenectomy. Over the period from May 1994 to May 2001, 60 patients were candidates for splenectomy. Laparoscopy was contraindicated in 3 cases because of ASA III and marked splenomegaly (2 cases) and previous gastric resection (1 case).

[Sex differences in incidence of mortality after acute myocardial infarction].

Background: Previous studies have indicated that the mortality after acute myocardial infarction (AMI) is higher among women than among men. However, whether this difference is attributable to the older age of the women studied or to the presence of other unfavorable prognostic factors remains unclear.

Methods: This retrospective study compares the clinical features, management and 30-day outcome in men and women from a consecutive, unselected series of 878 patients with AMI (225 women, 25.

[Principles of surgical technique of the anterior access to the thoraco-lumbar spine].

General surgeons are more and more frequently requested to prepare an operative exposure of the spine, in order to perform anterior maneuvers of removal and stabilization of the vertebral bodies. Since 1989 to date, in collaboration with the neurosurgical équipe of Prof. G.

[Abdominal approach to the treatment of the vestigial retrorectal tumors: our experience].

Although the vestigial retrorectal cysts are still rare, the number of the observed ones is destined to increase, as methods by imaging become routinely used in the clinical practice. Once diagnosed, the removal of retrorectal lesions should be mandatory. Therefore, by reporting three clinical cases, the Authors propose notes of technique above the abdominal approach used for the surgical treatment of these retrorectal congenital neoformations.

[Considerations and results of the use of paramomycin in the prevention of infectious complications in colorectal surgery].

The efficacy of short term prophylaxis in the prevention of infection has been tested in 72 patients who underwent surgical treatment for colorectal pathology. General tolerance to the antibiotics was good. The Authors took this remark as a starting point for reviewing the literature and making comments.

[Laparoscopic surgical treatment in abdominal emergencies: personal experience].

In recent years laparoscopic surgery has reached a crucial role in the surgical approach of both abdominal and thoracic pathologies. A diffused as elective surgery, its utilization has become necessary even in emergency surgery, both as diagnostic approach as curative aim. In this work the purpose of the Authors is to show their own experience in a six years period in the laparoscopic treatment of abdominal emergencies.

[Pneumatosis cystoides intestinalis in emergencies: clinical management and treatment. 2 case reports].

Pneumatosis Cystoides Intestinalis gives many diagnostic and therapeutic troubles especially when it occurs in patient admitted in an emergency setting. The Authors report two cases of PCI related to patients admitted into the Emergency Department (DEA II) with diagnosis of intestinal perforation, mode according to the radiological findings of free subfrenic air, but not confirmed at physical examination. The Authors discuss the role that imaging and physical examination play in evaluating this kind of patients, considering the etiopathogenetic hypothesis about this rare disorder.

[Epidemiological study on pathology and abnormalities of the external male genitalia].

The Authors report the outcomes of an epidemiology study concerning the external genital pathologies, carried out on 2400 young males, ranging between 18 and 22 years who underwent the medical inspection for admission to the Air Force Academy. Basing on an andrologic clinical and anamnestic protocol, 229 cases with genital abnormalities, and among them 171 cases of varicocele (8.16%), were detected.

[Testicular tumors in Italy: historical trends, geographic differences, and etiological hypotheses].

Testicular cancer is a rare tumour. Its incidence has been increasing in many parts of the world during the last decades. This cancer has an unusual age distribution with one peak in incidence in young adults (aged 20-39) and a second peak in over 60.

[Apudoma of Vater's ampulla: case report and review of the literature].

The Authors report a case of Vater's ampulla apudoma and after having examined the characteristics of these neoplasms they discuss clinical presentation, diagnostic and treatment problems of islet cell adenomas. They review the literature and make some remarks.

[Complications of inguinal hernia repair].

It's shown by literature and confirmed by Author's experience that, on account of the excellent results, prosthetic repair of inguinal hernia is more effective than "conventional" (Bassini, Mc Vay, Shouldice). Between January 1993 and December 2000 were observed 875 patients with inguinal hernia (814 monolateral, 61 bilateral); all patients underwent a Lichtenstein repair both in the primary version and in its variations (internal ring plastic, trasversalis plicate, plug repair). The patients were discharged from hospital within 24 hours after surgery in 90% of cases.

[Retroperitoneal leiomyosarcoma: clinical case].

The Authors have reported a case of retroperitoneal leiomyosarcoma. The retroperitoneal localization is quite unusual and early diagnosis is difficult. Only surgery operation and radio-chemotherapy can improve the prognosis.

[Sarcoidosis and clear cell carcinoma of the kidney: the sixth case?].

The Authors report a very rare case of clear cell renal cancer associated with sarcoidosis, incidentally discovered in a 39 year-old man, admitted for a not correlated pathology (multiple left rib fractures due to automobile crash). Problems related to a proper assessment of sarcoidosis are discussed as well as potential arising of a neoplasm during the entire follow-up period: for that, it must always be complete and accurate.

[Surgical treatment of varicocele in day surgery].

Aim of this study is the comparison between spermatic vein ligature (Ivanissevich technique) and low intrafunicular ligature in the surgical treatment of varicocele. The Authors present two groups of patients (total 61) operated between 1995 and 1999 with the above-mentioned surgical techniques. Apart from the utilized method, they didn't ascertain any improvements in the spermiograms of the patients older than 30 years.

Nebulized tobramycin in patients with chronic respiratory infections during clinical evolution of Wegener's granulomatosis.

Aminoglycosides are effective against Pseudomonas aeruginosa but with intravenous administration there are only very low concentrations achieved in sputum; therefore in order to obtain therapeutic levels in patients with endobronchial infections should be administered high doses with increased likelihood to produce both nephrotoxic and ototoxic effects. Direct aerosol delivery of aminoglycosides to the lower respiratory tract has the advantage to achieve high antibiotic sputum concentrations in the infected area with reduced risk of systemic toxic reactions because of minimal absorption into the circulation. Nowadays, except for patients suffering from cystic fibrosis and bronchiectasis, the administration of antibiotics through inhalers is not very much in use.

[The role of copper-releasing intrauterine device or levonorgestrel-releasing intrauterine system on uterine bleeding and iron status (prospective study of 8 years)].

Background: The aims of this study were the effects of copper intrauterine device (Cu-IUD) compared to progesterone (PRG-IUS) or levonorgestrel releasing intrauterine system (LNg-IUS) on menstrual bleeding, menorrhagia and dysfunctional uterine bleeding. The authors evaluated the effect of copper surface area on uterine bleeding.

Methods: Between March 1992 and November 1999, 223 women, referred to I Institute of Obstetrics and Gynaecology University of Rome, were recruited in a prospective study with follow up at 3, 6 and 12 months to evaluate the incidence of endometrial pathology.

[Endoscopic prosthesis in colonic malignant pathology].

The utilization of stents in neoplastic colon pathology finds a correct location in the therapeutic panorama. Authors report the use of enteric stents as definitive treatment in acute intestinal occlusion with inoperable malignant neoplasia as well as palliative treatment in intestinal occlusion with non-surgically resectable neoplasia.

[Use of ileostomy and colostomy as temporal derivation in colorectal surgery].

A retrospective study on 41 patients with primary stoma creation after low anterior resection of the rectum was made. Among the 41 patients 24 had a loop colostomy (Group A) and 17 had a loop ileostomy (Group B). The two groups were well matched for each of the data analysed and there was no significant difference in the rate of complications related to stomas creation and closure.

[Emergency treatment and diagnosis of appendix mucocele].

The Authors report a case of appendicular mucocele admitted in an emergency setting in the Emergency Department (DEA II). The patient, 78 y-old man, went to attention complaining diffuse abdominal pain: physical examination revealed mild tenderness and right lower quadrant pain to palpation. Rx plain and CT scan demonstrated a right iliac fossa cystic lesion with mural calcification, adherent to the caecum.

[Is blood transfusion a risk factor in colorectal surgery for cancer?].

Personal experience in the treatment of 93 cases of cancer of the large bowel and rectal localization is reported 32 patients (A group) received blood transfusions, 61 patients (B group) hadn't any transfusions or autotransfusions. Postoperative morbidity was 34.37% in A group and 14.