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Background: The aim of this study was to evaluate efficacy and safety of the ATOMS system for the treatment of postoperative stress urinary incontinence (SUI)., Methods: We included all consecutive male patients referring for postoperative SUI and treated with ATOMS system from June 2013 to July 2017. Patients received anamnesis, 24 h Pad Test, Pad count, physical examination, urodynamic evaluation, ICIQ-UI SF questionnaire. We excluded patients with low bladder capacity and compliance, uncontrolled detrusor overactivity., Results: We treated 98 patients with median age of 70.21±10.02 years. The most common cause of SUI was open radical prostatectomy in 79 patients. Ten patients had undergone urethrotomy, 7 bladder neck incision, 14 adjuvant radiotherapy. Thirty-nine patients suffered of mild incontinence (24 h Pad Test <200 g), 49 moderate incontinence (200-400 g), 10 severe incontinence (≥400 g). Thirty-one patients underwent previous incontinence surgery: 29 ProACT, 3 artificial urinary sphincters (in 2 cases both devices), 1 bulking agents and subsequent male sling. Median follow-up was 21.5 months. We had a significant reduction of mean 24 h Pads Test, pad count and ICIQ-UI SF questionnaire (P<0.01). At last follow-up 47.96% of patients were dry and 79.59% reached social continence. A high incontinence grade, adjuvant radiotherapy, previous urethral surgery and incontinence surgery have been associated with lower continence results. We had complications in 33 patients (33.7%). The device was removed in 4 cases due to scrotal port erosion and in one case due to persistent pain., Conclusions: The ATOMS system seems to be an effective and safe surgical treatment for postoperative male SUI.

A retrospective study is reported carried out on a group of 166 patients affected by dyspeptic syndrome who presented at least 3 of the 9 symptoms which characterise this pathology. One hundred and twenty-eight patients underwent prokinetic drug therapy and 38 received placebo. Clinical parameters were evaluated following one month of therapy all patients in order to compare them to basal values. The results obtained confirm a satisfactory efficacy of the prokinetic treatment in improving dyspeptic symptoms. Although administered to a smaller number of patients, placebo was also found to play an important role in the multifactorial etiopathogenesis of the dyspeptic syndrome on a functional basis.

The development of reconstructive venous surgery has been hampered by the lack of suitable graft materials. Fourteen carbon fibre grafts (phi: 8 mm), 30 glutaraldehyde treated ovine collagen grafts and 29 polytetrafluoroethylene (PTFE) grafts were used to replace a 35 mm segment of infrarenal inferior vena cava in pigs. Prostheses were removed 1 hour and 7, 14, 28, 56 and 112 days after implantation. All specimens were examined by light and scanning electron microscopy. The 112 day patency rate was 67% for ovine collagen grafts, while all carbon and PTFE grafts thrombosed. The difference was statistically significant (p less than 0.01). During the first hour after implantation, a thick (800-900 microns) thrombotic layer deposited on the inner surface of carbon grafts. This layer possibly caused the subsequent complete occlusion of the tubular segments. A thin neointima (less than 200 microns) developed on the flow surface of ovine collagen prostheses. This favoured complete endothelialization of the graft inner surface as soon as four weeks after surgery. In conclusion, glutaraldehyde treated ovine collagen would represent the first sound material to be used as venous substitute.

A rare case of acutely thrombosed atherosclerotic aneurysm of the deep femoral artery is herein described. A review of the literature revealed 12 other reported cases of deep femoral aneurysm. However none were treated by resection and replacement using a human umbilical vein graft which was chosen in the present case because the autogenous saphenous vein was not available.

The aim of the present study was to evaluate the gastro-duodenal motility coordination, both during the interdigestive phase and after antroduodenal volumetric stimulus. It has been proved that it is possible to evoke the peristaltic gastric activity by stretching the gastric walls. Thus, the Authors simulated the mechanical conditions of the meal by inflating air into the antrum. They studied 5 healthy volunteers, whose age averaged 43 +/- 22.85 years. A 120 cm probe provided with two balloons at 7 and 21 cm from the distal end, and with 7 open-tips for manometric recording, was positioned by endoscopic way. The Authors were able to evaluate the Motor Antral Threshold (i.e. minimum air volume able to evoke an antral motor reflex), obtained by means of the antral inflatable balloon. The average values of this threshold showed to be 35 +/- 5 ml of air. While keeping the duodenal balloon inflated, the repetition of volumetric antral stimulus did not show any Motor Antral Threshold. This threshold showed up again with similar volumes in every patient after deflating the duodenal balloon. The results obtained suggest the existence of a negative duodenal-antral feed-back control on gastric emptying.

From 1977 through 1984, 58 arterial reconstructions using glutaraldehyde-tanned human umbilical vein (H.U.V.) grafts were carried out: 41 femoropopliteal, 4 composite aortopopliteal (a Dacron graft was inserted proximally), 5 femorotibial, 6 axillofemoral, 1 femorofemoral, and 1 iliofemoral bypass. Autogenous saphenous vein was absent or inadequate in all patients. Limb salvage was the primary indication for surgery (89.7%). Five and 8 years cumulative patency rates were 42.8% and 35.1% respectively for all H.U.V. by-passes and 52.4% and 41.9% respectively for femoropopliteal by-passes. Four out of the 5 femorotibial by-passes failed during the first month following surgery. Two of the 6 axillofemoral and 3 of the 4 composite aortopopliteal by-passes thrombosed within 1 and 3 years after surgery, respectively. Perioperative mortality was 5.1%, while overall mortality was 17.2%. The following conclusions can be drawn from these results: H.U.V. grafts did not achieve cumulative patency rates superior to those reported with autogenous saphenous vein, in limb salvage situations, when the saphenous vein is not available, the H.U.V. graft offers acceptable salvage rates, results from the 8-year follow-up period demonstrate the durability and long-term patency of H.U.V. grafts.

Five cases of surgically treated unrestrainable pulmonary haemorrhage are described. The satisfactory results obtained show that pulmonary exeresis, in some cases of haemorrhages, is the only effective method for saving the patient's life and removing the anatomic cause of the haemorrhage.

The formation of multiple aneurysms in the midportion of Dacron grafts has been reported only twice in the surgical literature. In the present case, three aneurysmal dilatations developed 6 years following an orto-femoral Dacron graft implantation. Multiple structural defects in the Dacron prosthesis appear to be the most likely cause of the graft failure.