Chirurgia italiana
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This paper describes the various technics of orthopedic surgery currently used to correct scoliosis and maintain correction. Among corrective methods they illustrate the use of the Cotrel plaster corset (E. D. ⋯ Once correction is achieved, it must be maintained to the end skeletal growth; this is done with various types of orthopedic corsets (Lyonnais, La Padula, Milwaukee), which are used according to the patient's age and anatomical type of deformity. The authors discuss in particular the forces that are applied to the occiput and mandible with the Milwaukee corset (Logan, Cochran and Waugh), the values being recorded in diverse situations including the upright stance, ambulation, sitting position, position, supine position, and sleep (Galante, 1970). The authors also made a comparative study of the conventional Milwaukee corset (with broad chin bearing) versus the Milwaukee with hyoid bearing; and finally they illustrate the results obtained by Andriacchi and his associates in selecting the Milwaukee corset for patients with idiopathic scoliosis on the basis of the mathematical model of the rachis.
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In view of the considerable therapeutic significance of blood transfusion in connection with major surgery and of the various problems involved, the author offers a discussion of the best ways to use whole blood and blood derivatives in the surgical patient. First he gives a synthetic outline of the pathophysiology of blood losses; then he sketches a set of guidelines to appropriate remedial treatment; and last, he discusses the risks and drawbacks associated with blood transfusion.
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During the course of nine years 494 patients suffering from oesophageal cancer have come under our observation, including 13 cases characterised by the phenomenon of double neoplastic localisation. In some cases, in view of the histological identity of the two neoplasias, remote endocanicular colonisation may be presumed, while in other cases the rise of the tumour "disease" may be correlated with the action of carcinogenetic agents on sites of lesser resistance in organisms whose immunitary defences have been decreased in relation to neoblastogenesis. This is supported by the increase in the incidence of malignant neoplasias in patients subjected to immuno-suppressive treatment.
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A rare case of haemoperitoneum from rupture of haemocholecyst is described. The origin of the haemorrhage, on the basis of the case history, clinical, intra-operative and anatomo-pathological data, was in all probability intrahepatic. In addition to discussion of the incidence of this morbid event, the article refers to the most frequent causes of haemobilia, the physiopathological mechanisms supporting it, the symptomatological triad characterising it even when aspecific, and the available diagnostic possibilities.