[Radiotherapy of inoperable, loco-regional epidermoid carcinoma of the lung. 5-year experience]

Results of chest radiotherapy on 48 patients with inoperable squamous-cell carcinoma are reported; 25 patients had continuous treatment whereas the remaining 23 patients had split-course. Objective remission was obtained in 71% of the cases; mean survival was 11.7 months for the whole series, and 14 months for responders. An advantage in objective remission rate for patients having a dose of 60 Gy or more was found. Split-course resulted in similar survival and objective remission rate but was less toxic than continuous treatment. In 43% of cases the disease progressed only loco-regionally. Radiotherapy was interrupted because of toxicity in 23% of cases and there was only a case of life-threatening toxicity.

Ultrasonography in the early diagnosis of congenital dysplasia of the hip

The authors discuss the feasibility of using ultrasonography in the early diagnosis of congenital dysplasia of the hip. Having used the methods of Graf and Harcke, they devised a new scan which always reveals the state of the limbus in neonatal congenital dysplasia. This has been used for two years as an additional technique in neonates with a positive Ortolani click to demonstrate the presence of an inverted limbus, which is not revealed in the Graf and Harcke scans although they give a very good overall picture of the femoral head and acetabulum. The disclosure of an inverted limbus at this early stage is of crucial importance in determining the correct treatment to be adopted.

Partial aplasia of the pectoralis major muscle with an anomalous distal insertion: two case reports

Two rare cases of subtotal aplasia of the pectoralis major muscle, a residual anomalous formation inserted abnormally into the medial humeral condyle, are discussed.

[Palliative radiotherapy of bone metastases. Comparison between 2 fractionations]

One hundred and twenty two symptomatic osseous metastases in 74 patients were treated with palliative irradiation, using two dose/time treatment plans. Pain relief was obtained in 92% of valuable cases (complete response in 68% and improvement in 24%). The complete responses were obtained in 4 weeks in 64% of responsive patients. The median duration of response was 166 days. In advanced cancer patients the short course radiotherapy achieved the same quality and duration of pain relief as conventional treatment.

Experimental suture of the peripheral nerves with "fibrin glue"

An experiment on rats is presented, concerned with a technique for suturing peripheral nerves by means of "human fibrin glue". The sutures were performed by three different methods: (1) the traditional technique; (2) using a special grooved Vitallium plate (presented by the authors in a previous paper) by means of which all sutures can be dispensed with, and which facilitates more rapid and complete regeneration of the nerve; (3) with "fibrin glue", used on its own or together with the special plate. On comparing the three methods it was found that fibrin glue achieves better approximation of the nerve ends and thus leads to more rapid and more complete regeneration of the peripheral nerve fibres. Combined use with the plate is preferred where there is a minimal loss of nerve substance.

Experimental osteosarcoma in the mouse, induced by Moloney's murine sarcoma virus

The writers report an experimental trial on the mouse, consisting in the induction of osteosarcoma by inoculation of Moloney's murine sarcoma virus (MSV-M) into the proximal metaphysis of the tibia. This experiment was conducted on 90 BALB/c female mice aged twenty-one days and of mean weight 12.8 g. One group of animals was also given immunodepressive drugs. The tumour developed in 100 per cent of cases, producing metastases in some of the animals and resulting in death in three cases. The radiographic changes were initially osteolytic followed later by new bone formation. The histological examinations confirmed that the tumour was of an osteosarcomatous nature. Cells characteristic of rhabdomyosarcoma were observed in the soft tissues surrounding the bone. The skeletal metastases had the characteristics of osteosarcoma, while those in the lymph glands and lungs had those of an undifferentiated sarcoma. The writers also took into consideration a series of previous trial performed at the Institute of Clinical Orthopaedics of the University of Milan, involving a total of 740 mice, in arriving at their final conclusion that MSV-M induces, in the mouse, an osteosarcoma similar to spontaneous osteosarcoma in man, capable of producing osteoid tissue, of giving rise to metastases, and of causing the death of the animal.

[Combined radiochemotherapeutic approach to bronchogenic carcinoma: criteria of applicability and limits]

The knowledge of the natural history of pulmonary cancer had led to both an improvement of the techniques and methods of radiation treatment and the use of chemotherapy in association with radiation therapy. Such an association leads to graver and more frequent pulmonary reactions. The development of a particular discipline (the toxicology of radiation) could contribute to predict the incidence and the extent of reaction. A more precise combined approach to the treatment of pulmonary cancer would therefore be possible.

[Spontaneous pneumothorax: an uncommon clinical first sign of the bronchial carcinoma (author's transl)]

Seldom the bronchial carcinoma begins with spontaneous pneumothorax. About 20 cases are reported in the literature. A personal observation is described concerning a 63 year old patient with clinical symptoms of spontaneous pneumothorax. The histologic diagnosis was bronchial spinocellular carcinoma.

Larsen's syndrome. Case report and discussion

The writers present the case of a small girl affected by Larsen's syndrome. Her brother had the same syndrome. Surgical reduction of the dislocated knees was performed at the age of two months, followed by immobilisation in a spica plaster. At operation it was found that both patellae, which are cartilaginous at that age, were absent. On the basis of recent literature and the heterogeneous manifestations of the syndrome, the authors discuss the pathogenetic theories, the differential diagnosis, and the current therapeutic possibilities.

Camptomelic syndrome. A rare type of congenital dwarfism associated with skeletal and other abnormalities

Three cases of the rare camptomelic syndrome are presented observed within fourteen months at the Mangiagalli University Clinic, Milan. The radiographic appearances and clinical characteristics are described, and compared with the thirty five cases in the literature. The differential diagnosis is discussed and the possibility of diagnosing this malformation prenatally is suggested.

A study of the development of fracture callus in the presence of an experimentally induced osteosarcoma

The results of two experiments are reported in which the formation of an osteosarcoma was induced in mice by the intraosseous injection of Moloney's virus. In the first group of fifty mice, a complete diaphyseal fracture was carried out nine days later at the site of the tumour. In the second group of 200 mice, a partial fracture was produced at the time of injection so that immobilisation was assured. The effects of cyclophosphamide and calcitonin administration were also studied in this group. The course of the repair processes of the bone was studied in both groups, and showed that, even in the presence of an osteosarcoma, these begin and can reach completion, though obstructed and delayed by the tumour.