Su quattro casi di atrofia girata della cariotide senza alterazioni aminoacidiche

3nonenoneI.MOTOLESE; P.A.MOTOLESE; E. MOTOLESEI., Motolese; P. A., Motolese; Motolese, Eduard

Rottura diaframmatrica con erniazione intratoracica del fegato. Presentazione di due casi clinici

Gli Autori presentano due casi di rottura diaframmatica da trauma chiuso toraco-addominale, con erniazione intratoracica del fegato, conseguenti ad incidente della strada. La diagnosi preoperatoria è stata posta mediante esecuzione di esame TC. Al momento dell’intervento si è optato per l’accesso laparotomico, mediano per un paziente e bisottocostale per l’altro, che ha permesso la riparazione diretta della lesione diaframmatica e una adeguata gestione delle lesioni associate, presenti in entrambi i casi. Non si è fatto uso di materiale protesico e la ricostruzione del diaframma è avvenuta in sutura a punti staccati in materiale non riassorbibile. Nella nostra esperienza la riparazione della lesione diaframmatica è sempre stata possibile attraverso un approccio laparotomico e senza l’ utilizzo di materiale protesico. Riteniamo che, in questi casi, l’approccio migliore sia proprio quello laparotomico che permette non solo la riparazione della lesione diaframmatica, ma anche la gestione delle lesioni associate. Utilizziamo in genere una sutura a punti staccati in materiale non riassorbibile per lacerazioni di minor entità e una continua, se possibile in doppio strato, per quelle più grandi

Use of Amniotic Membrane Transplantation in Isolated Conjunctival Bowen Disease: A Case Report

PURPOSE: To report a case of isolated conjunctival Bowen disease treated with surgical resection and amniotic membrane transplantation. METHODS: Interventional case report. RESULTS: A 70-year-old man was admitted to our clinic with a large conjunctival verrucous plaque well-demarcated in the correspondence of the bulbar conjunctiva in the superior quadrant of the left eye with involved limbal and corneal surface. Ophthalmologic examination on slit-lamp examination and color fundus photographs were carried out before surgery and the results were evaluated. CONCLUSIONS: Treatment options and treatment studies of Bowen disease are difficult because there are a variety of different protocols and the success of the management depends on several factors (body site, lesion size, number of lesions, and thickness). In the conjunctival localization of the lesion, amniotic membrane transplantation appears to be a useful therapeutic choice after surgical resection of the lesion used to reconstruct ocular and conjunctival surfac

Pseudophakic eye globe disruption

PURPOSE: Scleral rupture due to bulb bursting can result from a heavy contusion. Owing to refined surgical techniques and the use of antibiotics and cortisone-based medication, more conservative concepts have followed. In major ruptures, the results were almost always very poor, with atrophy or subatrophy of the eyes. METHODS: A 63-year-old man with major left ocular trauma and intraocular lens dislocation in the subconjunctival area was referred to the authors for clinical and surgical evaluation. RESULTS: Surgery was performed 3 weeks after the trauma to allow for improvement in the patient's condition. The reabsorption of a palpebral-frontal hematoma, which made bulb exploration almost impossible, was fundamental in order to proceed. After 1 year, the best-corrected visual acuity was 0.9. In fact, great improvements in surgical techniques in recent years have allowed us to consider the problem of major rupture in a new way, both technically and from an organizational point of view. CONCLUSIONS: In terms of organization, the concept of urgent surgical procedures must be reevaluated, because besides traumatic damage, incomplete surgical measures may result. This makes all treatment useless, in both barely equipped and highly specialized centers