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A new method is presented for the closure of a central cylindrical breast exeresis, embracing, full thickness, the skin and the gland. For this reconstruction, performed without altering the original shape of the breast, without removing any additional healthy tissue, we used a skin-gland flap rotated from the inferior quadrant to correct the defect.

Aims: Twenty-three patients with liver metastases from colorectal cancer were entered into a prospective, phase II pilot study to evaluate the efficacy and feasibility of intra-arterial high-dose chemotherapy (IAHC) + intraperitoneal chemotherapy (IPC) combined with hemofiltration., Methods: All patients had abdominal laparotomy to position a hepatic artery infusion port and in 15 cases an implantable system for IPC. A double-lumen filtration catheter was placed in the vena cava via the saphenous or femoral vein and connected to a modified hemofiltration unit. The treatment schedule consisted of mitomycin (30-50 mg/m2) and epirubicin (60-90) mg/m2) as IAHC combined with cisplatin (60 mg/m2) given in a 2000 ml saline solution by IPC. The high-dose IAHC-IPC was followed by 4 cycles of intra-arterial standard dose chemotherapy through the arterial port-a-cath (6 mg/m2 mitomycin and 20 mg/m2 epirubicin) and if possible by another cycle of high dose IAHC-IPC., Results: We delivered a total of 31 cycles of IAHC, 21 of which were combined with IPC. Ten cycles of IAHC were administered without concurrent IPC because of painful adhesions, clinical contraindications or patient refusal. Seven of 23 patients (30%) were pretreated and with progressive disease after systemic chemotherapy. Among 22 evaluable patients, we obtained 2 complete remissions (9%) and 11 partial remissions (50%); moreover, 4 of 7 pretreated patients obtained a response to treatment. As a result, an objective tumor response was observed in 59% of patients (13/22). Therefore, a dose-response behavior was demonstrated also in tumors with a low chemosensitivity. The median duration of response and survival was 10 and 14 months, respectively. Toxicity was usually mild, but we reported one toxic death due to treatment complications., Conclusions: Further prospective randomized studies are needed to confirm the results of our study.

The authors report their experience on 37 cases of Early Gastric Cancer on 1978-1990 period. They underline the excellent results obtained with subtotal gastrectomy and lynphectomy without deaths neither returns. They stress the diagnostic precision of endoscopic exam now of first choice in the early diagnosis of Early Gastric Cancer.

The authors focus on some aspects of gallbladder primitive cancer and report their experience about 14 cases. They confirm the malignancy of the disease and the severe prognosis due to diagnostic delay. Only the mucosal localization may be radically treated even by simple cholecystectomy.

The authors report their experience for 158 cases of colon rectum cancer, surgically treated on surgical department of USL 1 Marche. Evaluated short term and long term results they conclude that the only possibility to improve presently the survival of this disease resides on early diagnosis depending to secondary prevention programs.

The authors report their experience on 149 surgical operations for thyroid nodules between 1979 and 1991 period. They underline the diagnostic preoperative difficulties related to solitary nodules existent before the fine needle-aspiration. Finally they observe that cytologic diagnosis allow to select malignant and benign lesions and planning surgical treatment.

The authors report their experience on sigma acute perforated diverticulitis. They affirm that best results are obtained with a surgical treatment "case for case" depending to anatomopathologic pattern, patient age and his general conditions.

On pre-operative period can be specify the histologic diagnosis with fine needle-aspiration. The authors present their experience data on 147 cases between 1988 and 1990. They underline that FNA is a simple examen that offer many advantages and then should be executed on all mammary nodules to decide if is needed surgical treatment and eventually which one.

The aetiopathogenesis and clinical picture of 3 cases of priapism are described, along with the treatment employed. The first patient suffered from thalassaemia minor, whereas in the second case priapism was a manifestation of aneurysm of the abdominal aorta perforated in the cava. In the last case, erection was a sequela of surgery for hydrocoele performed under peridural anaesthesia.