Considerations about the experience in experimental microsurgery in Catania University

In the 1980s and 1990s Microsurgery has had a great diffusion in Italy. Our group, who worked in University of Catania, Sicily, got in touch with Sun Lee, the father of Experimental Microsurgery, and applied actively the microsurgical techniques both in the experimental and clinical field.Several Courses have been organized in Catania to involve young doctors who have been charmed by this new surgical branch.It is our opinion that in the present time Microsurgery could play an important role in the training of the general surgery residents. An experimental microsurgical training, together with simulators, could guarantee a more complete training of the residents, helping them to be familiar with surgical instruments and suture materials, improving their skill in performing microvascular anastomoses (carotid and femoral arteries) and more complex surgical operations (portocaval shunt) and leading them to a valid research activity.

RASA1 phenotype overlaps with hereditary haemorrhagic telangiectasia: two case reports

Background We report two cases of RASA1-related capillary malformation-arteriovenous malformation (CM-AVM1) syndrome mimicking hereditary haemorrhagic telangiectasia (HHT).Methods and results A 28-year-old man, previously embolised for cerebral arteriovenous malformations (AVMs), presented with epistaxis and typical nasal telangiectasias of HHT. CT scan revealed a large portocaval shunt. The second patient was a 9-year-old girl presenting with cyanosis and several mucocutaneous telangiectasias, similar to those observed in typical cases of HHT. CT scan revealed a huge and complex pulmonary AVM of the right lower lobe and a hepatic AVM within the left lobe. HHT diagnosis was considered possible according to the Curaçao criteria for the two patients, with at least two criteria for each. Genetic tests did not find any mutation in the three classic genes (Endoglin, Activin receptor-like kinase 1 or Mothers against decapentaplegic homolog 4), but identified in both cases an RASA1 mutation, known to cause CM-AVM1 syndrome.Conclusions Pulmonary AVM and portocaval shunt, usually encountered in HHT, have not yet been described in the CM-AVM1 syndrome. RASA1 screening may be considered in case of HHT suspicion, particularly when mutations are not found in the usually affected genes.