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The antegrade sclerotherapy of spermatic veins suggested by R. Tauber in 1988 is one of the most interesting methods for treating varicocele. This technique consists of isolating and cannulating a dilated spermatic vein and then injecting a sclerosing mixture. The procedure is carried out under local anaesthesia and through a small scrotal incision. Antegrade sclerotheraphy is relatively cheap, easy and quick to perform and seems as reliable as surgical ligation and section of the spermatic veins, which is why, in our opinion, antegrade sclerotherapy plays an important role in treating varicocele. This paper describes our preliminary results.

Objective: There are several kinds of male genital pain which can cause mental suffering. Usually, they emerge during ordinary urological or andrological examinations. These distresses, sine materia, can be divided into different groups. Design and Method: The first group, which is the most frequent one, mainly affects the testicles; usually, this kind of distress last all life and it is often associated with surgery and/or frequent examinations to the genitals during childhood. The second group encompasses cases of real penodinia: the patients express their discomfort especially uncovering the glan and, for this reason, this action is never done. This distress is not always referred to as pain, but more often as bothersome. Sexual intercourses are permitted. Often the patients undergo a circumcision that usually has a complicated postoperative course. The males of the third group correspond to the women suffering from vaginismus. The patients do not even tolerate the approach of the hand to the penis and they make the same actions and the same movements as the vaginismic women. The patients are unable to have sex. This phenomenon is rare. In a perspective of multi-disciplinary and integrated methodology, the patients were treated with traditional surgery and/or with administration of drugs and/or with sexual therapy according with the integrated Kaplan method and/or with techniques for the rehabilitation of the pelvic floor. Results: Some clinical cases will be presented and discussed. Conclusions: The Authors describe new categories of male genital pain, never defined before, similar to Vulvodynia or Vaginism in women.

Carcinoids represent 1–2% of the rectal cancer. We report the case of a woman with a rectal carcinoid and a hypogastric node metastasis. We propose a less invasive treatment of the metastase using In11-octreotide-scintigraphy and intraoperative gamma-probe detector.

Coastal areas ecosystem, representing one of the most delicate and complex relationship between natural environment and human activities, is one of the main subject of Governments programs for environmental monitoring and eco-sustainable environmental management. This paper describes a quantitatively evaluation of MODIS water leaving reflectance products on coastal areas, where the occurrence of land contaminated pixels (mixed sea-land) and a different atmospheric absorption, make often unreliable or ambiguous the values measured from satellite and the quality flag related to values of these areas, often marks them as unreliable. The evaluation is performed by comparison to in situ measurements acquired in the framework of IMCA project (Integrated Monitoring of Coastal Areas) from June 2006 to May 2008. The user can perform his own atmospheric corrections setting the best models and parameters for the area of interest.In order to allow an easy access and management of different data set, pre-processing and processing parameters selection, a prototype of Web Gis for environmental monitoring has been realized.

Background: There is an increasing body of evidence suggesting that subjects with rheumatoid arthritis (RA) are characterized by acceleration of atherosclerotic process of arterial wall. However, all investigations performed so far to evaluate subclinical atherosclerosis in RA included subjects without selection for age and degree of disease activity that may represent confounding factors in such an evaluation. Objectives: To verify signs of accelerated subclinical atherosclerosis in young subject suffering from RA but with low disease activity. Methods: Thirty-two patients with RA and 28 age- and sex-matched control subjects with non-inflammatory rheumatic diseases were enrolled. Inclusion criteria were age less than 60 and low disease activity with score £3.2 according to DAS28, while subjects with traditional risk factors for and/or overt cardiovascular disease were ruled out from the study. Both patients and controls underwent evaluation of carotid and femoral artery intima-media thickness by ultrasounds. Results: Patients had higher intima-media thickness than controls of all the sites evaluated at carodit artery level, whereas there were no differences at the comparison of the superficial and common femoral artery wall. At the univariate analysis, a positive correlation between LDL cholesterol levels and intima-media thickness at the carotid bifurcation was found. Conclusions: Young patients with RA and low disease activity have acceleration of atherosclerosis development as shown by increased intima-media thickness of carotid artery with respect to subjects without inflammatory rheumatic disease. It is conceivable that the organic damage of arterial wall could be the result of persistent endothelial dysfunction induced by chronic inflammation and immune dysregulation which characterize RA.

Twenty-six patients with advanced colorectal cancer were treated with a combination based on multimodal biochemical modulation of 5-fluorouracil by means of high dose folinic acid, low-dose alpha-2b interferon and dipyridamole. The overall response rate was 42% (95% confidence intervals = 23%. 61%) with four complete remissions (15%). The median duration of response was 9 months and the median survival for responders was 15 months (all patients = 12 months). Toxic side effects included oral mucositis (grade III-IV = 38%) and a generally mild flu-like syndrome. This regimen seems active and safe enough to be compared with the combination of fluorouracil and high-dose folinic acid.

The rising interest on male genital aesthetics increased the number of patients complaining of short penis. therefore, the andrologist must be able to perform a correct diagnostic assessment and to make the correct therapeutical choice as well, even if there's no standard yet. The aim of this paper is to discuss some diagnostic troubles about penile shortness and, in particular, to explain the basic surgical strategies suitable for the treatment of "hidden penis".

The clinical pathological data regarding the 201 patients (203 operations running) who underwent radical mastectomy according to Madden in the II Division of General Surgery at Brescia Civil Hospital in the period 1993-1994, have been reexamined in order to check the real need of radical surgery. This further analysis, apart from the patients with neoplasias of considerable dimensions (T2;2 cm), has been carried out on 100 tumors smaller dimensions (T1;2 cm) and has confirmed the necessity of radical surgery in 87 cases. Of the 13 operations (6.4%) that have been considered "improper" 2 were due to erroneous clinical staging (dubious cutaneous infiltration) and 5 (2.5%) presented a neoplastic diameter of exactly 2 cm which only partially justified radical surgery. In six patients (2.9%) we haven't found clinical pathological elements which contraindicated conservative surgery.

Results are presented concerning the first two cycles of a breast cancer screening program carried out by USSL 41 (the local social health center). 38,000 women were examined in a period ranging from 1987 to 1993 and more than 250 early stage tumors were diagnosed. Early detection by screening is confirmed by tumor size and nodal involvement. Overall, this program carried out in Brescia met requirements set by international and national scientific committees. Good results were obtained as far as quality standards are concerned. The importance of screening is evaluated concerning surgical treatment undergone by the patients. The study of surgical treatment clearly shows the gradual progression of conservative surgery deviating from more destructive operations.

From January 1993 to December 1994, out of 244 cases of upper gastrointestinal hemorrhage observed 25 patients underwent surgical treatment. Twenty-nine bleeding varices were excluded from this study. Early endoscopy revealed the source of bleeding almost in all cases (84%). All patients received, at the time of admission, medical treatment associated in 7 cases (28%) to endoscopic injection therapy. Emergency surgery indications were massive bleeding persistent bleeding, rebleeding and macroscopic findings of lesions. The aim of this report is to verify the respective roles of medical, endoscopic and surgical therapies in relation to the nature of the bleeding lesion and the entity of the hemorrhage. Results with regard to indication, clinical data, surgical technique were compared with literature data.

The relationship between hyperthyroidism and carcinoma of the thyroid is still uncertain. The incidence of thyroid carcinoma ranges from 0.3 to 16.6%. Between 1984 and 1994 the Authors observed 9 patients affected with thyroid cancer and toxic nodular goiter (4 patients) or Basedow disease (2 patients) or scintigraphic evidence of single hyperfunctioning nodule (3 patients). Six out of the 9 cases were diagnosed as papillary cancer, while three as follicular cancer. A carcinoma was diagnosed before operation in only one case, while in the other 8 patients, the diagnosis was obtained by histological examination of the specimen. Four patients underwent subtotal thyroidectomy, while five patients underwent radical lobectomy. All patients are alive and in good health; the average follow-up was 48 months.

In this article the Authors, after describing the history of the penile prosthesis surgery and analyzing the technical progresses made in the last twenty years, offer their personal experience and data from the most recent literature about treatment of erectile dysfunction through the application af penile prosthesis, about the indications for the operation and the choice of the type of prosthesis. They also explain all the possible complications and eventual mechanical failures, which have considerably decreased in the last few years.

The clinical and histopathologic characteristics of a case of adenoid cystic carcinoma of the esophagus are reported. The authors reviewed the literature on the matter and stressed the more aggressive behaviour of the tumor that differs from the same tumor of the salivary glands and other anatomical sites. Surgical resection is the treatment of choice, however the aggressiveness of the tumor requires, also, a chemo and radiotherapeutic approach.