Globalization and transition are two processes that have the same goal and that goal is to change the current or existing state. Globalization is change on a global scale while the transition is taking place within one or more countries. Globalization has made the world different. From the first economists Adam Smith and David Ricardo to today's economic theorists, the basis of social change, especially at the global level, is a change in the sphere of economy and in the economic structure of both the developed and the developing countries. Economic changes condition both the social as well as the political changes. These changes do not come one without the other. The common basis and desire of the agents of change is to achieve them in accordance with the set goals and achievements that are desirable for its protagonists. However, changes often take place against the will and expectations of its protagonists and actors. The consequences are often unpredictable although controlled and programmed. The programmed changes are part of the globalization strategy whose actors are developed countries.

January, 1994, through January, 1995, eighteen patients (17 men; median age: 59.9, range: 32-73) with biopsy-proved squamous cell carcinoma (n = 15), adenocarcinoma (n = 2) or undifferentiated carcinoma (n = 1) of the esophagus were treated with concurrent chemo-radiotherapy. All patients had inoperable lesions for unresectable disease (11 patients) or concomitant illness (7 patients); median Karnofsky score was 70 (range: 60-80). According to the 1988 American Joint Committee on Cancer Staging system, one patient was graded as Stage IIA (T2N0 + oropharyngeal cancer T4N1), two Stage IIB (T2N1), twelve Stage III (8 T3N1, 1 T4N0, 3 T4N1) and three Stage IV (2 T3N0M1, 1 T4N0M1). Treatment consisted of two courses of chemotherapy by cisplatin (75 mg/m2 i.v. on days 1 and 29) and 5-FU (1000 mg/m2/24 hours by continuous infusion from days 1 to 4 and from days 29 to 32) along with one course of concomitant radiotherapy at 45 Gy (1.8 Gy per fraction, one fraction per day and 5 fractions a week). After 15-30 days, the patients were treated with a boost dose of 7 Gy by high-dose-rate intraluminal brachytherapy. All patients are assessable for toxicity and seventeen for response. The combined treatment was generally well tolerated, with only one case of WHO grade III toxicity (thrombocytopenia). Eight of the eighteen patients had a complete response (47%); four a partial response (24%); four a minimal response (24%) and one showed stable disease (5%). Only one patient developed local progression, and four distant metastases. All the eight patients with CR are alive without local recurrence (two distant metastases) with a mean follow-up of 6 months. This treatment regimen provides good local tumor resolution with no major toxicity. The value of this study protocol will be determined by the rate of long-term survivors.

La frequenza con cui il rene e interessato in occasione di traumi toraco-addominali penetranti varia, secondo i dati della letteratura, fra il 7% (SCOTT e coll., 1969) e il 14% (TYNBERG e colI., 1973). La gravita del quadro clinico legata alIa frequente presenza di lesioni associate, che generalmente richiedono un intervento chirugico d'urgenza, rende spesso difficile la diagnosi preoperatoria della lesione renale. E pertanto importante stabilire i principi della valutazione d'urgenza e delI'eventuale trattamento chirurgico delle lesioni renali da trauma penetrante.