[Our experience in elective surgery of hemorrhagic ulcerative rectocolitis: ileo-anal anastomosis with reservoir].
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Biomedical subjects
Publications and source records attributed to A Saggio.
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The Authors report their experience on ileal-anal anastomosis with a J-pouch. A videotape illustrates the surgical technique. At last functional results are shown.
The authors describe the ultrastructural alterations of the pulmonary parenchyma produced in dogs by endotoxic shock, and they examine the effects that a 'secretolytic' drug (bromexine) has in modifying those changes. In the animals under shock there is a complete breakdown of the normal structure of the pulmonary parenchyma. According to the authors, these lesions are caused by the damage of the lining layer and of the cells which produce the constituents of the surfactant system. In dogs under shock and treated with bromexine the authors have seen a better organization of the pulmonary parenchyma: the cellular limits of the pneumocytes of types I and II were more clearly defined and the osmiophilic bodies were increased both in number and volume. The authors conclude that the damage of the lining layer and of the pneumocytes of type II plays an important role in the development of the ARDS and they say that bromexine can improve clinical and morphological aspects of that syndrome.
The authors, showing a case of breast retroareolar leiomyoma, study the literature thereabout, and emphasize the rareness of such disease, the impossibility of a correct preoperative diagnosis and the features of absolute benignity of this lesion.
An immunologic study was undertaken on 89 lung cancer patients and on the basis of results obtained so far, a protocol of active, aspecific immunotherapy by living bacterial vaccines (BCG) and/or synthetic immunopotentiator (methisoprinol) was carried out. First results obtained in patients undergoing immunostimulation are reported together with the observation that while positive humoral effects seem present in stage I and II patients, in cases of spread of the disease results are substantially negative.
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The authors report their experience with a technique for reconstruction of the abdominal wall, without opening the peritoneal sac, in patients with ventral hernia. After detailing the basic principles and advantages of the technique, they conclude by stating that it constitutes an effective procedure for repair of ventral hernias of the median line without endoabdominal morbid associations.
The first case of human liver infestation due to liver fluke in Sicily is reported. After a clinical review of parasitosis, the autochthonous nature of the case is mentioned to highlight its epidemiological and prophylactic importance, especially in those regions where climatic conditions and living and working habits favour infestation. Finally, attention is called to diagnostic difficulties, treatment and appropriate hygiene and dietetic measures.
On the basis of the morphological aspects found during a series of experimental investigations on the ultrastructural aspects of the lung under shock in the dog, the authors deny that type II pneumocytes belong to the group of alveolar macrophages and maintain that they are of an epithelial nature. This is confirmed by the presence of desmosomal junctions with the type I pneumocytes. In the "shock lung" induced by Escherichia Coli endotoxin, the type II pneumocytes appear to be severely damaged with particular involvement of the osmiophilic inclusions, sites of synthesis and/or heaping up of the principal phospholipidic constituents of the surfactant system.
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It is by now an established fact that the status of the immune system stands in some relationship with the onset and evolution of malignancy. To clarify this relationship the authors investigated the immune system of patients with pulmonary carcinoma, with special regard to the functions of the T and B lymphocyte lines. After suitable explanation of their experimental protocol, which involved immunological monitoring and the study of relationships between immunological changes and the extent and histological type of malignancy, and also the effects of any treatments being administered, the authors describe the results obtained in 18 preoperative patients. The study revealed an overall diminution of cell-mediated immune activity: less strongly positive DNCB skin tests, reduced capacity for making E rosettes, reduced blast transformation with PHA. With B lymphocytes the EA rosette test was often depressed, whereas antibody titers were normal or even above normal, and the pokeweed blast test was invariable above normal values. These preliminary results show that at the time of diagnosing malignancy, the greater aggressiveness characteristic of the less differentiated cellular types, or of stages of diffuse malignancy, is associated with overpowering of cell defenses and (within certain limits) enhancement of the humoral response.
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The authors describe an original method for the setting up of pulmonary parenchymal preparations to be observed with electron microscopy. The salient aspects of this method are: the material fixed with a supersaturated uranyl acetate solution and colored, after simple dehydration and inclusion in Epon 812, with bismuth subnitrate. With this method it is possible to obtain a good definition of the morphological aspects and a greater contrast of the phospholipidic structures of the pulmonary parenchyma.
The authors describe two cases of heterotopic pancreas tissue involving the stomach. After some general comments on the frequency and anatomopathological aspects of this disease, they discuss the clinical features and modern technics for the diagnosis of heterotopic pancreas tissue, with special emphasis on gastroscopic detection and execution of aimed biopsy specimen collection. Last, they discuss the indications for surgical treatment of the disease.
The Authors describe 5 cases of Bochdalek's posterolateral diaphragmatic hernia in terms of their clinical, diagnostic, and therapeutic aspects. They also explain their criteria in the choice of surgical approaches and describe reconstruction methods used in the repair of large hernias. Finally, they propose a special schedule of postoperative management to be used in connection with neonatal surgery, where surgical mortality is still high.
After a brief recall of the main problems of post-colostomy patients, the authors describe the method of colonic irrigation, which affords the complete discharge of fecal matter and continence over the ensuing 24 hours. The authors give an account of the results obtained with this methodology at the Stoma Center of Catania; and they conclude that the method in question, applied correctly and appropriate cases, seems to represent the treatment of first choice for the postoperative management of colostomy cases.