A colosphincterometrographic study in 40 normal subjects revealed the existence of a colosphincteral reflex hitherto unknown to man. In all cases, insufflation of 30-40 cc air into a balloon placed 50 cm from the anus produced a relaxation of the internal sphincter muscle of the anus (colosphincteral reflex), a subjective feeling of imminent defaecation, and reflex contraction of the external sphincter muscle. The discovery of this new reflex suggests that the physiological mechanism of defaecation may even commence above the ampulla recti, which has always been regarded as the only reflexogenic segment of the large intestine.

Anal Canal↗

PubMedDate not supplied

[Ulcerative colitis and Crohn's disease of the colon. Diagnostic validity of the various disciplines].

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Colitis, Ulcerative↗

PubMedDate not supplied

[Therapeutic strategies in the treatment of esophageal cancer: our experience].

Esophageal cancer has a poor prognosis. The Authors in reviewing esophageal carcinogenis stress the importance of an early diagnosis to improve surgical results and compare their experience with those of other Authors.

Esophageal Neoplasms↗

PubMedDate not supplied

[Hepatic cysts: a case report and anatomicopathological and clinico-therapeutic considerations].

The recent observation of a case of non-parasitic cyst of the liver brought the authors to a literature review. A 62 year old male, affected by type 2 diabetes and hypertension, after a CT scan and ETG, underwent resection and "capitonnage" of the cyst. Three months after surgery a CT scan showed a complete repletion of the cavity previously occupied by the cyst as a consequence of regeneration and reorganization of the hepatic parenchyma. In conclusion, hepatic cysts are rare and clinically relevant only when huge. The diagnosis is possible with the use of ETG and CT scan of the abdomen, however, in some cases angiography is also useful. The intervention of choice is the "capitonnage" of the cyst.

Cholecystectomy↗

PubMedDate not supplied

[Carotid surgery and its monitoring in our experience].

Carotid endarterectomy (CEA) is the elective surgical procedure to prevent stroke due to stenosis of the carotid bifurcation. During a period of 17 years the Authors performed 215 operations on the carotid arteries of 168 patients. The average age was 64.6 and the male/female ratio was 3/1. Patients were symptomatic in 75.8% of cases and asymptomatic in the remaining 24.2%. Preoperative investigations consisted of echo-Duplex scanning, arteriography, cerebral CT or MRI. Indications for surgery were: stenosis wider than 70% in 173 cases, ulcerated or "high-risk" stenosis in symptomatic patients in 37 cases, and carotid malformation in 5 cases. The intraoperative use of shunt (12% of the operations) was selective, depending from the results of our monitoring system: stump pressure and transcranial Doppler (TCD) of the middle cerebral artery (MCA) ipsilateral to the procedure. The global major stroke/mortality rate was 3.3% (7/215), the minor morbidity was 8.8% (19/215). Mortality rate was 0.5% (1/215). The major stroke/mortality rate for symptomatic patients was 4.2% and for asymptomatic patients was 0%. The average follow up was 58 months (range 1-192) for 200/215 patients, with 15/215 patients (7%) lost. The postoperative incidence of stroke after 4 years was 8.5% (17/200), with an annual mortality rate of 1.6% (min. after 2 months, max. 118, average 55 months). CEA is a safe procedure to prevent cerebral infarctions, but it still carries an operative risk. A better monitoring would allow to understand the mechanisms of clamp-induced ischaemia and prevent it, therefore decreasing the operative risks and extending the surgical indications to a higher ratio of asymptomatic subjects. TCD is becoming essential for our goal: it is useful in deciding to insert an intraoperative shunt, check the carotid flow, recognize embolic events, and also during the initial phase of carotid preparation.

Adult↗