[Attempted heroic amniosynthesis in the 16th week of pregnancy].
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Biomedical subjects
Publications and source records attributed to A Fortuna.
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After defining rheumatoid arthritis as a diffuse disease of the connective tissue developing into ankylosis, stress is laid on the need for rehabilitation measures to back up basic medical treatment. The use of physical means is strictly conditioned in R.A. by the scrupulous search for the physiotherapeutic phase of the disease to avoid new acute phases. The marine climate as therapy can be excluded in the classical sense where air and rest are the only treatments. It is useful to associate climatotherapeutic technique and prudent balneotherapy and kinesitherapy, but only after identifying the physiotherapeutic phase of the disease. As criteria of effectiveness of the therapeutic possibilities of a stay by the sea, subjective parameters (pain), objective parameters (joint tumefaction) and serological parameters may be adopted.
The clinical, surgical, and pathological data from 35 published cases of oligodendroglioma and of one personal case are analysed and compared with those from other tumours of the cord and from cerebral oligodendrogliomas. Oligodendroglioma of the cord has a slightly lower average age than other gliomas and is closer to that of glioblastoma. In oligodendroglioma of the cord, as of the brain, acute onset or aggravation of the symptoms and an oscillating course are frequent. Two correlated data are particularly worth noting: a) the mean CSF protein content in oligodendroglioma of the cord is higher than in any other glioma; b) intracranial hypertension, in the form of papilloedema or hydrocephalus, or both, was present in 31% of cases. This signifies cerebral oligodendrogliomatosis, which was found in 6 out of 10 necropsied cases. At operation most oligodendrogliomas of the cord appear as infiltrating "gelatinous" tumours, though a minority have a firm consistency and apparently clearcut contours, which seem to be associated with a better prognosis. Postoperative radiotherapy seems to be useful.
A series of 31 primary orbital mass lesions in patients up to 15 years of age is presented (malignancies: 5 sarcomas, 1 retinoblastoma; benign lesions: 7 optic nerve gliomas, 4 pseudotumors, 4 angiomas, 3 fibrous dysplasias, 2 dermoids, 1 hemiangioblastoma, 1 osteoma, 1 neurofibroma, 1 eosinophilic granuloma, 1 echinococcus). All the patients were operated upon using the subfrontal-extradural approach. The pathological and roentgenological features, and the long-term follow-up are analyzed. In the author's experience, computerized tomography scan (CT scan) is useful in planning the surgical approach more than in the pathological differential diagnosis. In orbital pseudotumors, without visual function impairment, CT scan is also useful in checking the results of conservative steroid therapy. The author's stress the importance of performing radical surgery, either along with (in benign lesions, including optic nerve gliomas) or followed by radiotherapy (in malignancies).
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The authors report six cases of so-called spinal subdural arachnoid cysts, emphasizing the clinical and myelographic findings which, if not properly evaluated, may be misleading diagnostically. The literature of so-called perineural cysts and of extradural arachnoid cysts is likewise reviewed. Their clinical, roentgenological, and pathological features are examined. A common pathogenesis for all these lesions is proposed. It implies disruption and secondary proliferation of the arachnoid membrane. Hence, the term arachnoid diverticulum is advanced to include all lesions communicating with the subarachnoid space. Their varying relations with the subarachnoid space depend on the sites of the primary abnormalities and on hydrodynamic factors. Numerous observations of associated arachnoid diverticula, either perineural, subdural, or extradural, further favour a common pathogenesis.
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