L'Ateneo parmense. Acta bio-medica : organo della Societa di medicina e scienze naturali di Parma最新文献

An experience with 125 over 70 aged patients, undergone surgery for biliary lithiasis, is here reported. These operations represent 17 percent on the whole performed ones for non malignant biliary tract diseases in Institute of Surgical Pathology of the University of Parma. As the age gets elder, we can see a percent increase of complications of lithiasis, and particularly of acute cholecystitis, of common bile duct diseases and generally of emergencies. Mortality rate was 5,6%. After cholecystectomy for uncomplicated gallstones mortality rate was zero. After operations for complications of cholelithiasis it was 9.3% (6,8% in elective, 18,7% in emergent surgery). According to the Authors, these results suggest that surgical elective indications in the aged patients have to be extensive, in order to reduce the risk of worse and often unavoidable complications.

Human leukaemic cells were agglutinized by diphtheria toxin during an incubation of two hours. the agglutination behaved as a phenomenon of prozone. The cells grouped only in the zone with fitting proportion between toxin and cells, while no aggregation took place where lower or higher doses of toxin were used. The toxin didn't induce the agglutination of granulocytes taken from patients with acute infections diseases or taken from healthy donors. Normal lymphocytes too were not glutinated by toxin. The leucocytic agglutinability caused by toxin may be correlated to changes on the membrane induced by malagnity.

Reconstruction of the oral plane of a primary cleft palate using tibial periostal graft at the primary repair stage seems a highly appealing technique: -- the osteogenic power of the periosteum used as a free transplant has been demonstrated long ago (Ollier, Axhausen); -- two requisites must be filled when primary palate repair is undertaken: maintainance of the nasal fossa size and maintenance of the palatal fibromucosa that must be not submitted to any traction whatsoever, otherwise endognathia will arise. A vast, tight and strong periostal plane will be obtained with the periostal graft, the latter bringing also bone to the cleft. Better still, such a periostal graft can be extended backwards over the entire length of the cleft bony palate which will subsequently create a situation requiring simple soft palate repair.

The Authors described their experience in 41 patients operated on because of gallbladder cancer. The overall mortality was 20%. Four cases suitables for a "radical" wide resection showed an average survival of 8 months, while 2 on 3 patients with in "situ" carcinoma treated by simple cholecystectomy are still alive at more than 3 years, the other dying after five years because of disease not related to the gallbladder cancer. The bad general prognosis of the disease is mainly related to the delayed diagnosis together with the anatomical relations of the gallbladder as demonstrated by the discouraging survival in the "radically" widely resected patients. It must be considered consequently categorical to realize an early cholecystectomy, the only possible preventive procedure, in the height risk patients.

The Authors, as they present two rare cases of pheochromocytoma of Zuckerkandl's organ, prove how patient's history physical examination and laboratory findings can at the most address towards a presumptive diagnosis of pheochromocytoma; they also prove that for a sure diagnosis is necessary first echotomography and after arteriography.

Cutaneous syndrome called porphyria tarda-like of dialyzed patients may involve risk of infections besides aesthetic complications. We have described a very serious case of which the therapeutic problem has become oppressive inducing various attempts, already used for porphyria cutanea tarda or completely new. The only treatment which brought improvement in symptomatology was repeated venesection. Aminoacidic loss during dialysis appears as possible pathogenetic hypothesis for this syndrome.

The Authors have studied 456 pregnancies on young women under the age of eighteen; this record was on 27.215 deliveries in ten years (1970-1979) at the Department of Obstetrics and Gynecology of the University of Parma. From 1970 to 1979 the number of adolescent in pregnancy has triplicated. It has been found that obstetric pathology was 45,25%: this was more in premature rupture of membranes, preeclampsia, premature delivery and urinary infections. The spontaneous delivery has been 90,35% of the total; premature delivery has ben 9,15%; low birthweight has been 9,19%. The incidence of malformations was 2,84%, while the perinatal mortality was 26,31%: the majority of this mortality was recorded after delivery.

The Authors report 22 cases treated with palliative operations for malignancy of the pancreas or distal common bile duct with jaundice and discuss criteria of choice and advantages of using the gallbladder or bile duct. Besides survival, rate of disappearance and late recurrence of jaundice are considered according to type of surgical procedure.

The Authors evaluate the Doppler ultrasonic detection in the assessment of lower limbs arterial occlusive disease, particularly concerning the haemodynamic pattern of those patients undergoing a surgical treatment. The research is accomplished on a group consisting in hundred not selected patients, all subjected to aortography. A comparative study was undertaken between angiographic findings and ankle sistolic pressure measurement together with flow velocity profile. Reduction of ankle sistolic pressure and appearance of flow velocity profile changes, resulted highly correlated with clinical stage and angiographic alterations. The Authors consider therefore the Doppler ultrasound assessment as being able to give, together with the always necessary angiographic study, more accurate informations either on the run-off and the haemodynamic consequences of a stenosis, or on the overall evaluation of multisegmental lesions.