Biomedical subjects
Publications and source records attributed to A Cecchini.
Computed tomography of dermoids and epidermoids usually demonstrates areas of variable hypodensity, located most frequently in the sellar region and in the cerebellopontine angle. This report presents two cases of hyperdense dermoids of the craniocervical region which are compared with six other cases described in the literature.
A review of immediate and delayed side effects noted in a consecutive series of 1,138 myelograms made with Iopamidol in the Services of Neuroradiology of various hospitals and university clinics at Pavia, Perugia, Vicenza, and Parma (all in Italy). The contrast was administered by lumbar spinal route at iodine concentrations of 200, 300 and 370 mg/ml, in amounts varying from 5 to 20 ml depending on segments being examined and extant clinical indications. The incidence and characteristics of complications (headache, nausea, vomiting, evidence of radicular irritation, etc.) were assessed in relation to examination technics, segments of spine being explored, iodine concentrations, and amounts of contrast injected.
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A patient with Wilson Disease presenting neurologic signs was treated with d-Penicillamine. Computerized cranial tomography (CT) performed before therapy showed symmetrical areas of low density in the region of the basal ganglia, enlargement of ventricles and bilateral increased density of the medial nuclei of the thalamus. This abnormality of the thalamus had not been reported previously in Wilson disease. After two years therapy there was an evident clinical improvement and at the same time a reduction of CT abnormalities. The reports on CT scanning in Wilson disease are reviewed.
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AIM: The authors performed a prospective study in a series of patients undergoing combined general and epidural anaesthesia for major abdominal surgery in order to define if the epidural catheter inserted for postoperative analgesia induced in the short-term (7-8 postoperative days) any cytopathologically appreciable inflammatory response. METHODS: From April to September 2001, 20 consecutive patients undergoing combined general and epidural anaesthesia for major abdominal surgery at the National Cancer Research Institute and Villa Scassi Hospital (Genoa), were recruited after obtaining Institutional Ethics Committee approval and written consent from the patients. The standard technique for epidural anaesthesia was adopted. Preoperatively, all patients received peridurally a dose test of 3 ml of 2% lidocaine (60 mg) followed by 5 ml of ropivacaine 0.75%, and a continuous infusion of ropivacaine 0.375% (5-10 ml/h; maximal dose=20 ml) intraoperatively. As regards the therapeutic management of postoperative analgesia, patients received a continuous infusion of ropivacaine 0.2% for at least 48 hours and supplemental bolus (2 mg/die) of morphine hydrochloride. The epidural catheter was always removed between the 7th and 8th postoperative day, and it was examined by the pathologist according to the Thin Prep 2000 procedure. RESULTS: The cytopathologic examination of the tip of the epidural catheter gave the following findings: amorphous material without cells (n=10); rare granulocytes and histiocytes (n=6); stromal cells (n=3), and rare lymphocytes (n=1). CONCLUSION: We were unable to detect any cytopathologically appreciable inflammatory response at the tip of the epidural catheter which could have suggested the occurrence of inflammation in the epidural tissues. Given the positive results of prophylactic epidural administration of small doses of corticosteroids in the reduction of postepidural anaesthesia back pain and their direct membrane action on nociceptive C-fibers, this kind of backache seems to be related to the stimulations of such nociceptors more than to a catheter-related inflammatory response of epidural tissues with possible evolution in peridural fibrosis, as reported following surgical intervention for lumbosacral disease.
Ten patients receiving propofol for the induction and maintenance of anaesthesia were compared with 10 patients in whom anaesthesia was induced with thyopentone and maintained with fentanil. The cardiovascular response to anaesthesia, the effects on coagulation and fibrinolysis and the neuroendocrine response have been investigated during surgical procedures exceeding 90'. There was a larger decrease in PA after induction in the propofol group versus control, but the overall quality of anaesthesia during induction and maintenance was comparable in both groups. No differences were found about blood coagulation and fibrinolysis between the groups. Important differences between the groups were instead found about the cortisol response to anaesthesia and surgery: in the propofol group there was a decrease in the cortisol concentration in 90' sample with no statistical significance, returning to the baseline value after 1 h from recovery. In the control group a significant increase of cortisol concentration was noted both at 90' and 1 h after the end of anaesthesia.
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Two cases of posterior inferior cerebellar artery aneurysms are reported. The diagnosis was made by dynamic multiplanar computerized tomography and afterwards confirmed by angiography and surgery. The role of CT in the diagnosis and follow-up of subarachnoid hemorrhage is discussed. Intracranial posterior fossa aneurysms are nicely demonstrated and localized by dynamic multiplanar CT.