[Influence of a follow-up milk formula on weight-height growth and iron status. General considerations on the feeding of infants between 4 and 7 months old]

We have studied 100 children nourished with a "follow-up formula" (Printania Nestlè), which composition is in accordance with ESPGAN recommendations. The children are showed a regular growth and a good patrimony of the iron.

Disintegrating force as a new formulation parameter

Some coated aspirin tablet formulations were evaluated by relating their properties to disintegrating force development patterns. The treatment of disintegrating force-time curves was effected using the Weibull distribution as proposed for dissolution. Such parameters as the maximum disintegrating force developed, the time needed to reach 63.2% maximum disintegrating force (tau d) the shape parameter, the lag time, and the input value were used for evaluating the formulas examined. It was concluded that the input values, the integrating force development rate at tau d, can be employed as a new formulation parameter since, when correlated with the crushing strength, it allows an overall evaluation of the formula examined.

[Malignant melanoma of the small intestine]

Three patients with intestinal metastases from a malignant melanoma are presented. The pathological and clinical findings are reviewed. The symptoms are variable , but usually include unexplained anemia, gastrointestinal bleeding, abdominal pain and intestinal obstruction. X-ray examination of gastrointestinal tract can reveal multiple metastatic lesions with so-called typical "Bull's eye" sign. Surgical excision is indicated and extended survival due to improved chemotherapy and immunotherapy is stressed.

[Function test of renal excretion of water and sodium after water loading in liver cirrhosis]

Water loading was used as a diagnostic test in the study of renal excretion of water and sodium during the clinical stages of cirrhosis of the liver in 25 patients free from clinical and instrumental signs of ascites, 26 with treatable ascites, and 14 with intractable ascites. The water load consisted of 20 cc/kg water administered i.v. as a 5% glucose solution. Examination of diuresis in the ensuring 5 hr showed that: 1) clearance of free water is the most sensitive parameter for the detection of patients at short-term risk for the onset of ascites; 2) very low urinary sodium is an indicator of refractory ascites, whereas values are virtually the same and higher in subjects without ascites or with treatable forms; 3) chloruresis in only reduced significantly in cirrhosis with refractory ascites.

[The importance of thyroid hormone determination in the course of acute and chronic liver diseases]

The RIA values of thyroid hormones in the course of acute and chronic liver disease were studied to see whether they were related to the severity of the picture in a series of 50 healthy subjects and 133 with various hepatopathies: 26 with acute viral hepatitis, 18 with alcoholic liver disease, 16 with alcoholic cirrhosis without ascites and 33 with ascites, 14 non-alcoholic cirrhosis without ascites and 24 with ascites. A reduction in T3 proportional to the seriousness of the clinical and laboratory findings was noted in chronic forms, whereas both T3 and T4 were high in acute viral hepatitis. There was no difference in T3 values in alcoholic and non-alcoholic cirrhosis of similar gravity, showing that the fall in serum T3 is not a specific alcohol-induced lesion. T3 less than 25 ng/100 ml proved the best index in the prediction of mortality (chi 2 = 20,5; p less than 0,0005).

[Laparosplenectomy in Hodgkin's disease]

Assessment of a series of 102 cases of laparotomy with splenectomy in the diagnosis of Hodgkin's disease is undertaken in an explantation of the indications for its employment in relation to the progress of the disease and its histological type. An account is also offered of the salient features of each surgical stage, and the findings made during surgery by comparison with those obtained in other ways, i.e. preoperative appraisal based mainly on lymphography, hepatosplenic scintiscans, and functional exploration of the liver. Analysis of the results in the light of the histological data and their clinical and pathological relations enables four conclusions to be drawn: 1) isotopic investigations and functional tests carried out prior to surgery are insufficient, or at any rate poorly reliable; 2) absence of gross criteria for the sufficiently precise determination of splenic Hodgkin sites intraoperatively; 3) discrepancy between the lymph node histology and the lymphographic picture; 4) high incidence of primary subdiaphragmatic splenic involvement. The opinion is expressed that laparosplenectomy is a sound procedure for establishing the actual extent of Hodgkin's disease, and hence permitting more logical and more accurate further management. Emphasis is also laid on the fact that removal of the spleen may protect the liver from the possible spread of the disease via the porta, and make irradiation of the left hypochondriac region with its attendant dangers unnecessary.

[Free perforation by primary and localized hodgkin's disease of the small bowel (author's transl)]

The observation of a case of Hodgkin's disease primarily localized in the small bowel and with clinical picture of free perforation prompts the AA. to report the unusual enteric symptoms of this disease and to examine its pathologic and clinical features. Although Hodgkin's disease of the small intestine as a cause of perforation is extremely rare, the AA. describe the prominent frequency of abnormal serum proteins and of long lasting diarrhea with syndrome of florid malabsorption as primary manifestations of ileum involvement. Moreover the AA. indicate that while diagnosis of this peculiar location is rarely made clinically, it requests laparotomy and its confirmed by histologic specimen. The AA. suggests radical surgery and extensive radiotherapy in the treatment of primary Hodgkin's disease of the small bowel.

[Volvulus of the sigmoid. Case report]

Reference is made to a series of 7 cases of volvulus of the sigmoid colon in a brief account of the aetiopathogenic factors and anatomopathological aspects most commonly assigned to this form. Its typical clinical picture and radiological diagnosis are described and the controversial matter of the best method of treatment is discussed. Comparison of the literature results suggest that elective resection is to be preferred, or non-invasive decompression followed by devolvulation and simple colopexy of the wall.

[Clinical considerations on primary malignant lymphomas of the stomach]

Starting from a critical revision of eight cases of primitive malignant gastric lymphoma that they had observed during the last four years in Surgical Clinic of University of Pavia, the AA. refer the notions in regard to this neoplastic form. After having discussed the problems of etiopathogenesis of lymphoma and the most characteristic clinical forms, the AA. describe the modern views of diagnosis and the therapy on the base of literature and their personal casistry. Outlined the necessity of a precocious diagnosis and the possibilities that gastroscopy with looked at biopsy affers, the AA., also on the base of their experience, show like selective therapy of primitive malignant gastric lymphoma, the surgical treatment with complememtary cyclic polichemioterapy.

[Internal biliary drainage in benign diseases of the extrahepatic bile ducts]

Through analysis of a fairly large series of cases treated by internal biliary drainage for non-neoplastic disorders of the terminal choledochus and papilla (72 cases of choledochal anastomosis, mostly to the duodenum; 238 cases of surgery of the Oddi sphincter), the authors present a remarkable accurate picture of the indications for this kind of surgery and of the immediate and long-term results obtained with it. Their collected observations also provide an opportunity for comparison with published reports from other quarters; in particular, the authors offer a detailed discussion of the relative advantages and limitations of the two main procedures in this category, namely papillosphincterotomy and choledocoduodenal derivation. From their own experience and in good agreement with current dominant opinion, they conclude by recommending the last-named procedure as the most rewarding, provided that the indications be correct and the operation be done with the necessary technical accuracy.

[Elastic ligature in the treatment of hemorrhoids (author's transl)]

The authors report their experience with 57 patients suffering from first, second, and third-degree hemorrhoids. Elastic ligature of internal hemorrhoid nodules was done ambulatorily with good results and no important complications. From these results, and considering the ease of the procedure, the authors agree with other experts that this method of treating hemorrhoids may become more and more popular.