Biomedical subjects
Publications and source records attributed to A Giovannini.
Report of two cases of Behçet syndrome in children, one with the features of a neuro-Behçet syndrome and the other with chiefly severe ocular changes. Both children were treated with transfer factor when previous treatment had proved ineffective. Some years after the beginning of treatment, which is still continuing, transfer factor may be said to be of value in Behçet syndrome.
The authors discuss one case of ocular onchocerciasis. Not only corneal damage (punctate keratitis) is present, but also chorioretinal signs are seen: in the right eye at an advanced stage and in the left one provoked by the onset of the specific treatment using diethylcarbamazine citrate. During the 1 st year follow up, a further evolution of the chorioretinal lesion was noted in the right eye, while the left eye presented a partial regression of the above lesions. The characteristic angiographic findings, the particular site (temporal paramacular) and the arousal of the lesions provoked by the treatment are factors which denote the importance of choriocapillaritis, probably due to immunity reactions.
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The hemodynamic effect of timolol maleate in open angle glaucoma was studied rheo-oculographically. Increase in the ocular pulse which reaches maximal amplification 2 h after the instillation of the drug was observed. The maximal pressure lowering effect appeared 3 h after instillation, as if the hemodynamic effect were the trigger for the pressure lowering effect.
A case of pigmentary retinopathy attributed to an oral contraceptive is described. After suspension of the drug the ocular symptoms regressed, whereas the ophthalmoscopic and fluorescein angiographic picture did not reflect this regression. Fluorescein angiography, used in this condition for the first time, showed that the amount of pigment was much greater than that observed ophthalmo-scopically.
The problems of the enchondroma of the hand, its diagnostics and treatment if discussed in this paper. 12 cases of handskeletonenchondroma, 9 with pathological fracture, 3 without fracture, are the occasion of this report. The treatment is in our opinion the scraping of infested tissue (excochleation) and filling the defect with bonemeal and immobilise the hand in plaster-bandage for 4 to 5 weeks. 8 to 12 weeks after operation the defect and fracture were consolidated.
The principles of rheography with "infinite time constant" are utilized. After applying a suction cup electrode mechanism, by gradual increases of the vacuum, ocular pressure rises above venous pressure, and without modification of arterial inflow, the venous outflow is blocked; in consequence an increase of blood accumulation in the interior of the eye occurs. The electrical impedance variation, as a result of the latter, gives the recorded tracing a "slow" rising curve, that maintains the same pulse morphology. After being analyzed and elaborated on with certain mathematical formulae, this curve makes it possible to calculate the blood flow in the eye in a unit of time. Statistics on normal patients of various ages are reported.
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PURPOSE: Evaluation of choroidal alterations associated with idiopathic choroidal neovascularization (ICNV) and the possible relation between this affection and Multifocal Choroidopathies (MC). METHODS: The authors analysed, using high definition videoangiography, the choroidal findings in 21 consecutive patients affected by ICNV (7 males and 14 females; 19-46 years; mean age: 31.8 years); with a follow-up at 5-30 months (mean 13 months). Moreover, a retrospective study of 20 cases of ICNV (11 males and 9 females; age: 17-39 years; mean age: 29.3 years) with a follow-up at 6-11 years (mean 8.9), was performed. RESULTS: In 7 eyes, the indocyanine green angiography (ICGA) showed choroidal hypofluorescent spots similar to those observed in MC (in 3 cases even in the fellow unaffected eye), in 2 of them the regression of the spots was observed after steroid therapy. In 2 eyes, the ICGA revealed hyperfluorescent spots; in one of them the complete regression of the spots after oral cyprofloxacine was observed. In 6 patients (10 eyes), choroidal permeability alterations could be visualized (in 4 cases even in the unaffected eye). CONCLUSIONS: The indocyanine green angiographic findings (hypo and hyperfluorescent spots, choroidal permeability alterations) could support the theory of Gass which considers that ICNV is not idiopathic but secondary to a widespread choroidal inflammatory disease. The similarity of the ICGA alterations in ICNV and MC, the observation that cases of ICNV would become MC in the follow-up, could allow the hypothesis of a close connection between these two affections.
BACKGROUND: Manifestations of serpiginous choroidopathy have been well described, but very little is known about its true pathogenesis. By virtue of the enhanced imaging of the choroidal circulation, indocyanine green angiography may offer information on the causative factors of the disorder. METHODS: Indocyanine Green (ICG) videoangiography was carried out in 17 patients with serpiginous choroidopathy. A full ophthalmological examination and intravenous fluorescein angiography were simultaneously done as well. The patients were studied at 3 different stages of the disease as follows: 1) with acute manifestations; 2) with subacute lesions; 3) in the inactive or healed state. RESULTS: Acute Lesions: Indocyanine angiography showed active choroidal involvement in the acute stage beyond the limits delineated by corresponding fluorescein studies. Subacute Lesions: ICG angiography showed resolution of choroidal involvement in advance of clinical and fluorescein angiographic changes in some eyes. Healed Lesions: ICG angiography showed better delineation of the atrophic choroid with clearer definitions than corresponding fluorescein studies. Late staining of fibrovascular tissue within atrophic zones was similar to fluorescein findings. Two patients in the healed state showed multifocal hypofluorescence (one patient) and hyperfluorescent choroidal lesions (one patient) with no clinical or fluorescein counterparts, possibly representing occult lesions. CONCLUSIONS: ICG angiography may be useful in understanding certain clinical features of the entity, such as a clearer documentation of the extent and nature of the choroidal damage and possible sites at risk for future recurrences. However, it adds little to our current management of the disorder.
BACKGROUND AND OBJECTIVE: To assess the role of optical coherence tomography (OCT) in the evaluation and follow-up after vitrectomy for diabetic macular edema. MATERIALS AND METHODS: The 18 eyes of 12 patients affected by presumed diabetic vitreous-induced macular edema underwent biomicroscopy with a Goldmann contact lens, fluorescein angiography, and OCT. RESULTS: OCT revealed two patterns of edema. The first group (15 eyes) was characterized by widespread thickening of the neurosensory retina with an increased nonhomogeneous reflectivity of the inner retinal layers; cystoid-like spaces of absent or reduced reflectivity in the neurosensory retina were also present. In the second group (3 eyes), a cystoid macular edema with a dome-shaped foveal profile because of a markedly increased retinal thickness in the foveal region was observed. The disappearance of the physiologic foveal profile was always seen. Biomicroscopy revealed an increased reflex of the inner limiting membrane in the first group and minimal alterations in the second one. Four patients (7 eyes) underwent vitrectomy with posterior hyaloid removal. In 5 eyes, the patients experienced a visual improvement greater than two Snellen lines. The restoration of the normal foveal profile and the reduction of the retinal thickness on the OCT were evident in all cases one month after surgery. CONCLUSION: OCT appears to be a useful tool in the diagnosis and management of diabetic macular edema and in the monitoring of the morphological changes after vitrectomy.
The authors present the method known as proximal tibial osteotomy for the treatment of genu procurvatum. The importance of an accurate preoperative study, particularly aimed at avoiding negative repercussions on the position of the patella, and of a correct anatomical exposure with isolation of the peroneal nerve for any iatrogenic lesions, must be emphasized; a condylic plate was used to stabilize osteotomy was stabilized, adapting well to the anatomy of the region, and allowing us to obtain correction of any associated deformities on the frontal plane.
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