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Background: The aim of this study was to retrospectively evaluate the therapeutic efficacy of the Knutson's paste, a solution composed of saccharose and povidone-iodine, in the management of perineal dehiscence following repair of post-partum laceration or episiotomy., Methods: Thirty-seven women with post-partum perineal dehiscence were included in the study, conducted between September 2020 and December 2022. Patients self-applied the Knutson's paste three times per day for 14-21 days. Clinical evaluation was performed weekly; healing was defined as the closure of the wound margins. Recovery of sexual function was investigated with Female Sexual Function Index (FSFI) questionnaires at 6 months., Results: All women achieved complete healing, and no one required resuturing. Full healing was achieved in 16.9±2.6 days. Second-degree dehiscence required significantly more days (24±2.64) to achieve healing compared to first-degree dehiscence (15.8±2.08). A mean of 3.4 outpatient visits was necessary during follow-up. The healing process and time were not associated with age, Body Mass Index (BMI), or birth weight. Around 50% of patients reported satisfying figures on FSFI questionnaires., Conclusions: The Knutson's paste is a valid medicament for conservative treatment of post-partum perineal dehiscence. Due to its low costs and non-invasiveness, it could represent an alternative to the resuturing approach, especially in low-income countries and for women who refuse surgical revisions.

Background: Mid- and long-term sequelae of COVID-19 on cardiorespiratory fitness are unknown. Aim of the study was to assess the mid-term impact of mild-moderate COVID-19 on cardiorespiratory fitness evaluated by cardiopulmonary exercise testing (CPET) in élite athletes., Methods: 13 elite cross-country skiers with previous mild-moderate COVID-19 symptoms underwent CPET before resuming seasonal training (COVID athletes). 13 élite detrained cross-country skiers, matched for principal confounding factors, were taken as controls (control group). Resting peripheral oxygen saturation, pulmonary function test, echocardiography, bioelectrical impedance analysis and CPET (modified XELG2, Woodway, USA) were performed in all participants., Results: Median recovery time in COVID athletes was 34 days (IQR 33-38 days). COVID athletes reached earlier the onset of the aerobic threshold (4'48" vs. 6'28", R 2 =0.15, F=4.37, P<0.05) than controls, whereas the time to anaerobic threshold and maximal efforts did not significantly differ between groups. Oxygen consumption was lower at the aerobic threshold in COVID athletes than controls (VO2/kg 28.6 mL/min vs. 38.9 mL/min, R 2 =0.39, F=15.34, P<0.01), whereas no significant difference between groups was found both at the aerobic threshold and at peak exercise (all P<0.05). Findings from resting echocardiography and pulmonary function test were similar between the two groups., Conclusions: Élite cross-country athletes, previously affected by mild-moderate COVID-19, reached earlier the aerobic threshold than controls, whereas the remaining CPET parameters did not differ between groups. Such changes were not associated with any detectable difference in resting pulmonary and cardiac examination. Subjects affected by mild-moderate COVID-19 may require a longer time course of re-adaptation to aerobic exercise.

Background: To highlight differences in clinical practice among referral (hub, HH) or satellite (spoke, SH) hospital vascular surgery units (VSUs) in Lombardy, during the COVID-19 pandemic "phase 1" period (March 8 - May 3, 2020)., Methods: The Vascular Surgery Group of Regione Lombardia Register, a real-word, multicenter, retrospective register was interrogated. All patients admitted with vascular disease were included. Patients' data on demographics, COVID-19 positivity, comorbidities and outcomes were extrapolated. Two cohorts were obtained: patients admitted to HH or SH. Primary endpoint was 30-day mortality rate. Secondary outcomes were 30-day complications and amputation (in case of peripheral artery disease [PAD]) rates. Univariate and multivariate analysis were used to compare HH and SH groups and predictors of poor outcomes., Results: During the study period, 659 vascular patients in 4 HH and 27 SH were analyzed. Among these, 321 (48.7%) were admitted to a HH. No difference in COVID-19 positive patients was described (21.7% in HH vs. 15.9% in SH; P=0.058). After 30 days from intervention, HH and SH experienced similar mortality and no-intervention-related complication rate (12.1% vs. 10.0%; P=0.427 and 10.3% vs. 8.3%; P=0.377, respectively). Conversely, in HH postoperative complications were higher (23.4% vs. 16.9%, P=0.038) and amputations in patients treated for PAD were lower (10.8% vs. 26.8%; P<0.001) than in SH. Multivariate analysis demonstrated in both cohorts COVID-19-related pneumonia as independent predictor of death and postoperative complications, while age only for death., Conclusions: HH and SH ensured stackable results in patients with vascular disease during COVID-19 "phase 1." Despite this, poor outcomes were observed in both HH and SH cohorts, due to COVID-19 infection and its related pneumonia.

Aim: Every medical act lawfulness always comes from a valid consent of the patient, who can freely decide only if he has been correctly informed by physician about all the features which concern his own health. The aim of this study was to value, in a group of patients undergoing initial therapies performed by dental hygienists, the real level of information supplied by hygienists when the informed consent was obtained., Methods: One hundred patients, who needed oral hygiene professional treatments performed by dental hygienists, were selected. Prior to the therapies, the patients' informed consent was obtained; after the treatment, each patient filled up a questionnaire covering the main information concerning pathology and therapies., Results: A total of 88% of the interviewed persons defined as comprehensive the information supplied by the dental hygienists. Nevertheless, the most part of the patients was not able to correctly describe the treatment, regarding urgency of therapies, operative procedures, intrinsic difficulties, risks and complications, dental hygienists' professional rule., Conclusions: It is at present hard to reach a valid level of information, both due to the difficulty to use a language that should be scientific and understandable at the same time, and to all the cultural, social and intellectual characteristics which determine the real state of comprehension of each patient.

Aim: Anxiety in adolescence is a complex phenomenon, but could affect oral hygiene and compliance to dental therapies in young people., Methods: Owing to the importance of anxiety in coping with odontostomatologic therapy, 2 groups of adolescent subjects (age range 16-20 years) have been compared: a group of patients under treatment at the Policlinico Gemelli (45 subjects, 27 females and 18 males) and a control group of students (39 subjects, 20 females and 19 males). Different aspects of anxiety have been analysed by the STAI Y-I test (state anxiety), STAI Y-2 test (trait anxiety) and the Dental Anxiety Scale, on the basis of the hypothesis that the group of patients should show higher anxiety levels as to state anxiety and dental anxiety. Data were evaluated by the analysis of variance method and Student's t test as regards mean differences., Results: The group of patients showed significantly higher state anxiety than controls, and significant differences as to trait anxiety were also found. In both groups girls were significantly more anxious than boys. Our results confirm the hypothesis that high anxiety levels are related to odontostomatologic treatments. Patients from Policlinico Gemelli showed a significantly better knowledge of dental hygiene than control group., Conclusions: A better knowledge of dental hygiene is not sufficient to reduce anxiety. Preventive measures that could reduce anxiety and ensure a better compliance in adolescent patients are thus discussed.

Nonpenetrating traumas of the extracranial carotid artery are uncommon and frequently involve the carotid bifurcation. We report a case of asymptomatic post-traumatic pseudoaneurysm of the common carotid artery in a 32-year-old woman, detected by chance 12 years after a cervical injury. Of all the investigations, only echo-Doppler permitted the detection of an intimal tear at the level of the aneurysmatic dilatation. After aneurysmectomy, 8 mm PTFE graft replacement was carried out. We believe that routine use of echo-Doppler ultrasonography in all asymptomatic patients with a definite history of contusive cervical trauma should be recommended. In our opinion, the absolute surgical indication resulted from the local and neurological complications potentially stemming from the pseudoaneurysmatic dilatation.

Background: Broad is the spectrum of congenital chest wall deformities. Fortunately the severe life-threatening deformities (i.e. ectopia cordis and Jeune's disease) are rarer than the more frequent pectus excavatum and carinatum. Funnel chest is the most common anterior chest wall deformity, it results from posterior depression of the sternum and cartilages, from the third to the eighth; it occurs more frequently in boys than in girls (4:1 ratio). While the deformity may be recognizable at birth, especially during crying spells, it progressively worsens during childhood, producing, sometimes, respiratory and cardiac impairment., Methods: The authors report their experience, from April 1970 to December 1998, in correction of Pectus Excavatum using a single surgical technique, at the Borgo Roma Hospital of Verona. During this period 51 patients (mean age 14 years) affected by this deformity, were treated performing a sterno-chondroplasty with internal fixation. Most of the patients (94%) required operation for the esthetic and psychological reasons only. The grade of funnel chest (according to the Chin Classification) was: type I in 59.6% of patients, type II in 31.4% and type III in 11.7%. The surgical technique consisted in the modification of the Ravitch's technique (subperichondrial cartilage resection, transverse osteotomy with internal stainless steel strut fixation). We considered the intervention advisable to correct an existing defect or to prevent its progression. We don't think, in fact, that spontaneous recession of the deformity may occur., Results: The follow-up varied from 4 to 18 years. The result was classified according to the classification of Humphreys and it was excellent in 64.7%, good in 17.7%, fair in 9.8% and poor in 7.8%., Conclusions: This technique proved to be safe and effective, it can be performed with no mortality, very low complication rate and satisfactory results.

Cowden's disease is an inheritable multiple neoplastic syndrome represented by benign and malignant lesions of skin, digestive tract, mucosae, breast and thyroid. The syndrome, first described by Lloyd and Dennis in 1963, includes benign lung lesions, described in the literature only as hamartomas. The unusual condition of our case consists of multiple and bilateral lipomatous lesions of the lung and of adipose colonic polyps, diagnosed respectively by video assisted mini-thoracotomy and by endoscopic biopsies.

Aims: To evaluate the efficacy of intravenous calcitriol as a means of significantly reducing plasma PTH in long-term hemodialysis with severe hyperparathyroidism., Experimental Design: prospective study., Follow-Up: 12 months., Setting: hospital hemodialysis centre., Patients: 14 chronic hemodialysis patients, 6 males and 8 females, mean dialytic age 6.3 +/- 2.7 years, mean age 65.3 +/- 10.5 years, PTH-I > 500 pg/ml; normal serum calcium, serum phosphate, serum aluminium; normal or increased alkaline phosphatase; signs of hyperparathyroidism on hand X-ray; non-responder to oral calcitriol; 12 patients completed the study., Treatment: intravenous calcitriol 6 micrograms/week post-dialysis, half dose during the study of 7 patients; preventive calcium salt suspension; reduced calcium in dialysis bath, low dose aluminium hydroxide and intravenous disodium clodronate to treat and prevent hyperphosohoremia and hypercalcemia., Findings: in basal conditions: PTH-I, total serum calcium, serum phosphate, total alkaline phosphatase, serum aluminum, ultrasonography, neck scintigraphy; serum calcium, serum phosphate, alkaline phosphatase each week in the first 45 days, every 2 weeks up until the third month, every month until the twelfth month; PTH-I every 3 months, serum aluminium after 12 months., Results: Reduction of PTH-I from 1006 + 363 to 303 + 136 pg/ml in 12 patients who completed the study, with occasional, controllable hypercalcemia and hyperphosphoremia; dropout 2/14 (14.2%)., Conclusions: Intravenous calcitriol is an efficious and easily managed long-term treatment for hemodialysed patients who would otherwise undergo parathyroidectomy.

Primary cecal lymphoma are very rare. The case is reported of an elderly woman having voluntary preliminary chemotherapy with consequent cecum perforation due to tumoral necrosis, some days after the first chemotherapy. The diagnostic, clinical and therapeutic protocol is analysed and stress is laid on the rare clinical cases described. Resection is advisable in the still delimited forms in order to avoid surgical complications due to preliminary chemotherapy and in order to classify precisely the neoplasm.

Bochdalek's hernia is a congenital posterior diaphragmatic defect, resulting from persistence of the pleuroperitoneal canal of embryonic life. Bochdalek's hernias are rare occurrences in adult patients and they present commonly with digestive symptoms and need surgical therapy. This article describes a case of an 88-year-old female with symptomatic right Bochdalek defect containing intra-abdominal viscera with no hernial sac.

Insulinoma is the most common endocrine tumor of the pancreas. It arises from the beta-islet cells of Langerhans. Insulinomas synthesize and secrete insulin autonomously in the presence of low blood glucose levels, causing spontaneous hypoglycemia and characteristic clinical symptoms. The authors examined data the from the most important international research projects on this topic during the past 20 years. Insulinomas are rare, with an annual incidence of 0.5 per million population. Up to 90% patients have benign solitary pancreatic insulinomas. People of all ages can be affected with this neoplasm. The authors reported a case of a large insulinoma of the body and tail of the pancreas, with atypical psychic symptoms. A distal pancreatectomy with splenectomy was performed. No surgical complications occurred in the postoperative course. The psychic symptoms were emphasized with refusal of food. The patient underwent Parenteral Nutrition and was discharged 24 days after the operation. The surgical removal of the tumor permitted the patient to recover completely, with glucose and insulin blood levels in normal range.

The authors analyze their experience of surgical treatment of post-mastectomy lympho-edemas of the upper arm. They have performed 14 operations, each upon patients with praecox or later oedema, following Cariati's classification, and with median age of 56.5 years. Seven patients were present at the follow-up in 6 has been performed microsurgical lympho-venous anastomosis, in 1 a fasciotomy of the forearm and in 1 patient some silastic tubes were positioned in her subcutaneous tissue. An improvement of the subjective symptoms has been recorded in 57.14% of the patients, while the objective ones have improved in 50% of the patients. The authors think that the microsurgical treatment of the lymphedema post-mastectomy of the upper arm is the first choice nowadays.

A case of 17-alpha-hydroxylase deficiency in a genotypic male is described. The patient, who had grown up as a female, at the age of 18 years by chance was seen for enteritis. She presented primary amenorrhea and lack of secondary sexual characteristics combined with hypertension and mild hypokalemia due to excess of mineralcorticoids. The hormonal profile observed under basal conditions was evocative of a deficiency in 17-alpha-hydroxylase. High plasma aldosterone concentrations, in the face of suppressed PRA, were related to interference in RIA method: low plasma aldosterone values were observed when HPLC separation was applied. Eunucoid appearance and gigantism (195 cm) has rarely been observed as a fenotypic expression of this enzymatic deficit, but are justified by deficiency of both androgens and estrogens.

Castleman's disease is an unusual condition characterized by uncontrolled growth of lymphoid tissue. The first case was recorded by Castleman in 1956. In this paper a case of the above-mentioned disease is reported with regard to its unusual clinica-histologic aspect (localized form of plasmacellular type) and surgical therapeutic strategies.

Previous reports have shown the utility of combined lung and brain surgery in patients with a primary non small cell lung cancer (-NSCLC) and solitary brain metastasis. This paper reports our recent data with the aim to rationalize the indication of this surgical approach. Over a period of eighteen years (1975-1992), 50 patients with NSCLC and solitary brain metastasis underwent combined lung and brain surgery. Fifteen of these patients had a synchronous presentation while the remaining 35 had a metachronous presentation of lung cancer and single brain metastasis. There were no operative deaths and complete remission of neurological symptoms was obtained in 46 patients (92%). Actuarial overall five year survival was 16% with a median survival of 21 months. Age, gender, histology, T status, size and site of NSCLC, site and location of brain metastasis and the association with adjuvant therapy did not significantly affect survival. The variables that were associated with a significantly prolonged survival were type of lung surgery, N status and interval between the two operations. Patients with synchronous presentation had a five-year survival of 6.6%. By contrast the actuarial five-year survival of those patients with the diagnosis of brain metastasis after the removal of NSCLC was 19%. In this subset of patients those with N0 status and a median interval between lung and brain surgery longer than 14.5 months had a significantly longer survival. We may conclude that combined lung and brain surgery is recommended both for relieving neurological symptoms and for prolonging survival. This is particularly true in those patients with limited loco-regional involvement and a late single brain metastasis.

The authors report the preliminary data of a study which aims to identify the variables (socio-demographic, clinical and nosographic) which may be used to predict the evolution of psychiatric disorders. A retrospective follow-back study was carried out using the medical records and any other documentation available from medical and psychological centers in order to identify the evolutionary stages of disease and possible pre-disease antecedents. The sample group examined was selected from users attending the Diagnosis and Treatment Psychiatric Unit at Pavia Hospital who were found to have undergone infantile neuropsychiatric outpatient or hospital treatment during childhood. The preliminary phase of the study reports the results of the first 42 cases. The predictive value of the diagnosis made during childhood emerges from an analysis of the results and consequently emphasises the need to orient Infantile Neuropsychiatric structure not only towards diagnosis and care but also, towards a more strictly therapeutic action.

The objectives of this research were to determine the prevalence of essential and borderline hypertension in a population of blood donors and their families and to determine if there is a correlation between blood pressure and lifestyle and/or other cardiovascular risk factors. The study was comprised of 1976 individuals, of whom 1290 were men and 686 were women, aged 18-65 years. The prevalence of essential hypertension was 15.1% for males and 12.5% for females: the prevalence of borderline hypertension was 22.3% for males and 15.7% for females. The population was divided into two groups: the first group included only subjects (1170 men, 543 women) who did not regularly use drugs that could modify the blood pressure and the heart rate, the second group included the entire population. In the first group, the multiple regression analysis indicated, in order of importance: age, BMI (body mass index), and heart rate. These variables were important in determining the systolic blood pressure in both sexes, uricemia for males and glycemia for females. The diastolic blood pressure was dependent on BMI, heart rate, and alcohol in both sexes, and glycemia, LDL cholesterol, and uricemia in the men. In the second group, primary and borderline hypertension are significantly correlated with age, BMI, and uricemia in both sexes and glycemia in females. A program of health and nutritional education could modify some factors related to blood pressure, such as obesity and alcohol consumption. The result would be a reduction of the prevalence not only of essential and borderline hypertension, but also of metabolic diseases such as dyslipidaemias, diabetes and hyperuricemia, with a global reduction of the cardiovascular risk.

A case of iatrogenic subclavian arterio-venous fistula with pseudoaneurysm formation is described. Treatment by means of percutaneous embolization, on the venous side, with steel coils has been successful; in order to avoid complications, the arterial side was blocked by an angioplasty balloon. After discussing the more common complications of subclavian vein puncture, the Authors conclude that percutaneous embolization is a valuable alternative to surgery even in such a lesion, especially when the surgical risk is high.

The investigation on several forms of uremic osteodystrophy by means of bone mineral content (BMC) measurement led to contradictory conclusions. BMC in 27 patients on periodical hemodialysis treatment was measured correlating it to the seric levels of Ca, P, Mg, alkaline phosphatase (AP), calcitonin (Ct), osteocalcin (BGP), intact parathormone (PTHi), c-terminal and mean molecule PTH. Patients on dialysis treatment from a long period of time showed high AP and low BMC levels. This correlation proved significant just for the values recorded at a third distal site of radius. Patients with BMC under the normal range showed higher BGP levels and a longer period of dialytic treatment than those presenting normal BMC. The former showed a Ct inverse correlation as to age and mineralization indexes. Higher values of Ct and BMC have been reported in males rather than in females. Hence BMC is not suited to investigate different kinds of uremic osteodystrophy. Seric PTH dosage is certainly best fitted to discriminate patients affected with hyperparathyroidism from those with low turnover osteodystrophy. BMC determination is a valid support to evaluate the bone mineral loss in patients on haemodialysis treatment. It significatively correlates to the duration of the dialytic treatment; it is higher in female than in male population; it mainly affects cortical components rather than trabecular ones and is related to a seric Ct decrease.

A 18 years male had congenital hypoplasia of the right external iliac artery and thrombosis of its narrowest part. Congenital megacolon, anal atresia and hyposomical nanism were also present. Surgical intervention was indicated because he was developing arterial insufficiency and muscular hypotrophy of the right leg. A bypass was performed with a reversed autogenous vein between the common iliac artery and the common femoral artery.

Aggressive ulcerative HSV stomatitis was observed in a patient 10 months after allogeneic bone marrow transplantation. The patient was affected by acute myeloid leukemia (LMA) in second remission and, after bone marrow transplantation, supported a severe graft versus host disease. Intravenous acyclovir was administered during 22 days and ulcerative stomatitis completely healed.

In Italy, many patients with B-virus (HBV) and Delta-virus (HDV) end-stage liver disease, are potential candidates to liver transplantation. Several authors have reported 70 to 100% hepatitis recurrence rates. From june 1983 to may 1989, 72 transplants on 60 patients were performed at Liver Transplantation Department of the Maggiore-Policlinico Hospital of Milan. The results in 26 HBsAg positive patients (19 with HDV infection), that underwent liver transplantation, are reported. A detailed report of 17 of these patients with a follow-up longer 7 months, and the clinical course of 4 patients with HBV reinfection, 3 of which had hepatitis recurrence, is also presented. The occurrence of HDV-RNA in the serum of 5 patients, that were negative for HBsAg and also other HBV-HDV replication markers after transplantation is discussed, together with the observation that in these patients no hepatitis recurrences or alteration of the clinical course were evident.

The Authors report their personal experience of pure squamous cell carcinoma of the bladder. Between 1984 and 1988 they have observed 389 tumors of the bladder; squamous cell carcinoma was present in fifteen cases (3.8%). Epidemiology, pathology (gross configuration of tumor, histologic grading, staging according to the criteria of the UICC of 1987), presenting symptoms, treatment and survival have been considered. The Authors underline the importance of a careful histologic examination of the vesical tumors.

Problems of venous hemodynamics underlie several uro-andrological conditions, such as idiopathic or acquired varicocele, erective impairment from venous leakage, intercaval collateral pathways induction from venous obstructive processes (thrombosis, embolism, external caval compression). Particularly, the renal venous thrombosis seems to be ascribed to a primary membranous glomerulo-nephritis rather than to a reverse mechanism. Moreover, the caval obstruction proximal to the hepatic confluence can induce a portal system's impairment, such as in the Budd-Chiari syndrome. Some diagnostics (US, RX-CT, RM-CT) afford to day a better evidence of the underlying venous imbalances in the aforesaid conditions.

The Authors report about one surgical case of pulmonary carcinosarcoma recently observed. The literature is reviewed and the histogenesis of this rare affection is discussed.

Autotransfusion carried out in 100 patients undergoing chest surgery is discussed. The Authors emphasize the need to determine a protocol in transfusion procedures for thoracic surgery and stress the importance of using haemocomponents in lieu of whole blood, taking into consideration transfusional risks.

Because of isometric efforts are a normal component of the usual life, we studied 35 patients suffering from mild and moderate essential hypertension, by means of an isometric exercise test, using the "handgrip method". The purpose of the experimental work was the evaluation of pressure changes at the top of an isometric stress in basal conditions and the demonstration of the protective effect against pressure increase of nifedipine, acutely administered (20 mg sublingual). The results largely confirmed the usefulness of nifedipine in the treatment of hypertension at rest and at the top of an isometric exercise. Moreover, the pressure increase during the same effort after nifedipine administration is smaller than during a therapy with others antihypertensive drugs.

The anti-inflammatory actvity of desoxyribonuclease has been demonstrated on a number of occasions. It has been suggested that its particular features may mean that it possesses an antineoplastic action, especially if employed in asociation with radiation or chemotherapy. The drug, which depolymerises DNA, was administered for 15-60 days [ 1 million U. on alternate days] over a period of 1 yr. in a series of 99 patients, with or without radiation or chemotherapy. No evidence of its antineoplastic activity was obtained, though the anti-inflammatory effect was distinctly observed. Quickly reversible signs of intolerance were noted in about 4% of the series.

32 patients suffering from peptic ulcer have been selected. Of these 12 formed part of a previous series treated with cimetidine and subsequently relapsed; the other 20 were selected on the basis of endoscopic and functional examinations and were treated for the first time with cimetidine. The drug doses used were 1.2 g for 30 days and 0.3 g for a further 60 days. The purpose of the study was to check for possible recurrences by comparing the results obtained and their maintenance in the long term using these doses. 2 months after suspension of maintenance treatment there has not been any recurrence of the acute pain and dyspeptic symptomatology.

The paper shows that haemochromocytometric alterations occur at a very early stage and even in symptom-free cancer patients. This was confirmed by the examination of about 100 cases of confirmed cancer as yet not subjected to surgical, antiblastic or radiation treatment.

Chronic alcoholic gastritis is a very important social problem in the Health District of Arezzo, which covers an area where wine is an integral part of the diet. The etiology of this disease is related to the alcohol induced rupture of the gastric mucosal barrier. For this reason we wanted to verify the therapeutic effect of a "barrier acting drug" such as pirenzepine. A selected group of 50 randomized patients (46 males and 4 females, mean age 52.6 years) received in a double blind fashion 50 mg b.i.d. of pirenzepine or placebo for consecutive 4 weeks. Endoscopy and histological examinations performed before and after treatment together with the clinical evaluation of the dyspeptic symptoms, showed that pirenzepine was more active than placebo. In addition our results suggest that pirenzepine stimulates defence mechanisms of the gastric mucosa.

An assessment is made of the meaningfulness of endoscopy and histology in the diagnosis of oesophagitis via an examination of 240 endoscopies. An endoscopic diagnosis of oesophagitis was given in 69 cases. Biopsy was performed in only 44 cases. This confirmed the endoscopic diagnosis on all but one occasion. There were 1 histological and 10 endoscopic false negatives. It is suggested, therefore, that perendoscopic biopsy should always be performed to reduce false negatives in cases where oesophagitis or gastro-oesophageal reflux is suspected, or when hiatal hernia (even if asymptomatic) is present.