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Biomedical subjects

A Iannelli

Publications and source records attributed to A Iannelli.

At least 73 records · Page 4Linked to original sources
PubMed1991

Intracranial tumors of the first year of life. A cooperative survey of the 1986-1987 Education Committee of the ISPN.

The introduction of new diagnostic tools for neuroimaging has resulted in the early recognition of congenital brain tumors. In the present report the authors describe an International Multicenter Series of 886 children with brain tumor, in whom the diagnosis was obtained during the first 12 months of life. Most of the tumors were located within the supratentorial compartment. In spite of a relatively high operative mortality, surgery still appears to be the more effective therapy. Radiotherapy in this age group is of little value due to the vulnerability of the infantile brain. At the present time, the use of chemotherapy is still controversial.

Brain Neoplasms↗
PubMed1990

[Intracranial tumors in the 1st year of life].

The introduction of the new diagnostic tools for neuroimaging has resulted in the early recognition of congenital brain tumors. In the present report we describe 39 children, in whom the diagnosis of an intracranial tumor has been obtained during the first 12 months of life. These patients represent 14.4% of a pediatric population of 271 children with brain tumors, observed in the same period of time (11 years) in the Neurosurgical Institute of the Catholic University of Rome. Most of the tumors were located within the supratentorial compartment. Midline tumors were common. Sixteen children underwent the total removal of the tumor. Four infants could not be operated either because their poor general condition or the extension of the tumor. In one case, treatment was refused by the parents. The remaining children underwent the partial removal of the tumor, which was followed by chemotherapy (malignant tumors) or by serial neuroradiological examination (benign tumors), with the aim of postponing radiotherapy at the end of 2 years of age at least. The total mortality (surgical deaths: 7 cases) and deaths during the follow-up period (11 cases) was 38.5%. Out of the 24 surviving children, 8 (20%) are normal: 7 (17%) exhibit only minimal neurosurgical deficits; 9 (22%) are seriously handicapped. One child has been lost for the follow-up observation.

Age Factors↗
PubMed1989

[Craniostenosis. Analysis of 161 cases surgically treated during the first year of life].

One hundred-sixty-one cases of children operated on for craniostenosis in the first year of life at the Neurosurgical Department of the Catholic University of Rome in the period 1982-1986 are presented. The average age at diagnosis was 6 months and at operation 7.4 months. The patients considered in the present study were subdivided into two groups according to the prevalent involvement of sagittal suture or of the anterior sutural group (coronal metopic, spheno-frontal and spheno-palatine sutures). In fact, these two groups differ considerably not only in the characteristics of the pathological process of early fusion of the cranial sutures, but also in the technique required for surgical correction. Four children with premature fusion of all cranial sutures are considered separately. Congenital malformations of the bone structures or changes in ocular motility were presented in 7.9% of 63 patients with sagittal craniostenosis and in 14.7% of the group with premature fusion of the anterior cranial sutures. Surgical correction (linear craniectomies extended to the cranial base for the group with sagittal craniostenosis, craniectomies with advancement of the supraorbital margin and rotation of the bone operculum for the group with anterior craniostenosis) proved satisfactory in the great majority of cases. Postoperative morbidity was particularly low. Apart from postsurgical anaemia which required blood transfusion on the third day in 15.5% of operated patients, the only complications were transitory hyperpyretic states observed in 6.2% of cases. Only one child died for reasons related to the surgical procedure. The low postoperative mortality (0.6% of cases) and the low percentage of bone pathology recurrence (7.4%) compared with the results of other series involving older children, seem to indicate that the early surgical correction of bone malformations does not bear additional risk for the patient, permitting at the same time normal functional development of the brain and a more gradual morphological remodelling of the skull.

Craniofacial Dysostosis↗
PubMed1984

Surgically treatable growth retardation due to non-neoplastic pituitary-hypothalamic dysfunction.

Out of 90 children, examined because of growth failure, 15 have been treated surgically. The diagnoses were intrasellar arachnoid diverticulum or empty sella (5 cases), enlarged chiasmatic cisterns (5 cases), chronic 'occult' hydrocephalus (5 cases). Surgery was followed by an immediate increase in growth rate in almost all the cases, even if the result was persistent only in some subjects. In percentage, better results were obtained in patients with enlarged chiasmatic cisterns and chronic occult hydrocephalus than in patients with arachnoid diverticulum or empty sella. The evaluation of prolactin serum levels was demonstrated to be useful both in preoperative diagnosis and postoperative control.

Adolescent↗
PubMed1983

Spontaneous thrombosis of an aneurysm of the great vein of Galen.

A case of a thrombosed aneurysm of the vein of Galen in a 9-year-old boy is reported. Previously, only ten clotted aneurysms of the vein of Galen have been described. In our case, thrombosis occurred spontaneously after birth. Clinical presentation was characterized by signs of hydrocephalus, with an abrupt deterioration after several years of satisfactory clinical evolution. The patient was successfully treated with a ventriculoperitoneal shunt.

Brain↗
PubMed1981

Heparin-urokinase treatment in aseptic dural sinus thrombosis.

Five patients affected by aseptic dural sinus thrombosis have been treated with a combination of heparin sodium and urokinase. In all of them, the therapy was followed by complete clinical recovery. Postoperative cerebral angiography showed patency of the involved sinuses in all.

Adolescent↗
PubMed1980

Effects of artificially induced increases in intracranial pressure on epileptic activity.

The effects of induced increases in intracranial pressure (ICP) on epileptic activity following topical application of penicillin on the cerebral cortex or dorsal hippocampus were investigated in rabbits. Enhanced basal epileptic activity was brought about by the rise in the ICP, obtained with repeated lumbar infusions of saline. In some animals, this increased activity was already evident during the test, while in others it became obvious only at the end of the procedure. When induced, the increased epileptic activity could persist even after the ICP had returned to within normal limits.

Animals↗
PubMed1980

Early diagnosis and surgical indication in craniosynostosis.

9 children, presenting with clinical symptoms of craniosynostosis, and 4 with microcrania underwent calvaria bone scanning and a lumbar subarachnoid constant-infusion manometric test as integrating procedures for the diagnosis and surgical indication. In all the patients with craniosynostosis, calvaria bone scanning revealed the pathological sutures as areas of diminished or absent radionuclide accumulation, while a normal isotope uptake was observed at all the cranial sutures in the children with microcrania. A biphasic response to the infusion test, with an early rapid increase in the intracranial pressure and a late compensation, characterized 8 of the 9 children with craniosynostosis. The response to the infusion test was normal in all the cases with microcrania and in 1 child regarded as affected with coronal synostosis on the grounds of clinical and calvaria bone scanning findings.

Craniosynostoses↗
PubMed1977

Normal limits of the lateral cerebral ventricles on the lateral phlebogram: a statistical analysis.

The highest points of the subependymal veins of the lateral cerebral ventricles (frontal horn, body and atrium) and the height of the body have been evaluated in selected patients. Through a statistical analysis, they have been demonstrated to depend on the height of the supratentorial compartment of the skull. Taking into account this relation, the results obtained furnish reliable criteria for evaluating ventricular enlargement or sectional deformity.

Humans↗
PubMed1976

Interaction of epileptic activities of bilateral deep temporal origin. An experimental study.

The interaction of epileptic activities obtained with electrical or chemical (penicillin) stimulation of the amygdaloid nuclear complexes of the two sides was studied in acute experiments on the rabbit. Several findings indicate that reciprocal influences between the two epileptogenic amygdalae can occur. Inhibitory as well as facilitatory interactive phenomena were observed. The occurrence of interaction and its sign seem related to the level of epileptic activity.

Amygdala↗
PubMedDate not supplied

[Colostomy vs self-expanding metallic stents: comparison of the two techniques in acute tumoral left colonic obstruction].

UNLABELLED: Self-expanding metallic stents is an alternative treatment to colostomy that is the treatment of choice in acute tumoral left colonic obstruction. AIM OF THE STUDY: To compare morbidity, mortality, length of hospital stay and treatment performed after desobstruction using the two methods. PATIENTS AND METHODS: Thirty-three patients admitted for acute obstruction of the left colon were retrospectively separated in two groups depending on the type of intervention performed to treat the obstruction ("colostomy" group: 17 patients and "self-expanding stent group": 16 patients). We studied complications after desobstruction, hospital courses and surgical strategy performed after the acute phase. RESULTS: Time between desobstruction and colectomy was shorter in the "self-expanding stent group" than in the "colostomy group" (18.5 days versus 73 days). Age superior than 75 years and colostomy were the two main factors predicting the risk of definitive colostomy (P < 0.05). Global mean hospital stay was longer in the colostomy group (32.7 days versus 19.3 days, P = 0.02). Two perforations and one local recurrence occurred in the "self-expanding stent group". CONCLUSIONS: Self-expanding metallic stent can decrease the permanent colostomy rate and the number of interventions. The recurrence rate seems to be theoretically increased with the stenting method. Then, colostomy must be done for patients in curative situation. The self-expanding metallic stent should be used as a palliative care.

Acute Disease↗
PubMedDate not supplied

Penetrating brain injuries from a dog bite in an infant.

Brain lesions due to dog bites are not frequent and mainly concern infants in the first years of their life because they are short in height, the size of the infant's head is relatively large compared to the body and the skull bones are thin. We report the case of an infant with bilateral skin, skull and brain injuries secondary to a dog bite, and review the relative reports in the literature. We stress the need to consider the possibility of penetration into the intracranial compartment occurring in cases of dog bites of the scalp, because these wounds on the scalp and the skull may appear relatively limited, small in size and slight, in spite of associated potentially dangerous deeper lesions involving the intracranial structures that may be missed on the first observation. Infection is the main possible complication, and may be the cause of permanent and serious neurological deficits. Prompt diagnosis and therapy are mandatory to avoid complications and to achieve good clinical results.

Animals↗
PubMedDate not supplied

5-fluorouracil plus folinic acid with or without ifosfamide in advanced colorectal cancer: a phase II randomized trial.

AIM: This phase II trial evaluated the biomodulation of 5-fluorouracil (5-FU) plus folinic acid (FA) with or without ifosfamide (IFO) in chemotherapy-naive patients with colorectal cancer. PATIENTS AND METHODS: Forty-eight patients were randomized to receive: FA (25 mg/m2 iv bolus days 1 to 3), followed by 5-FU (750 mg/m2 iv bolus days 1 to 3), arm A; or FA (25 mg/m2 iv bolus days 1 to 3), followed by 5-FU (750 mg/m2 iv bolus days 1 to 3) plus IFO (2,000 mg/m2 in 1000 mL 5% dextrose in a 2-hr infusion, days 1 to 3), arm B. Mesna was added during and after IFO to prevent hemorrhagic cystitis. Treatment was repeated every 21 days in both arms. RESULTS: Forty-five patients were assessable for response: in arm A, 5 patients achieved a partial response (overall response, 25%), and in arm B, 2 patients achieved a complete and 1 a partial response (overall response, 12%). Time to failure was 3.5 months (range, 1-38) in patients treated with 5-FU plus FA, and 3 months (range, 1-21) in patients treated with the IFO combination. The median survival time was 13.5 months (range, 1-49 months) in arm A and 16 months (range, 1-43 months) in arm B. Diarrhea, stomatitis and vomiting were the most common nonhematologic toxicities in both arms. The most notable hematologic toxicity was leukopenia; 15% and 20% of patients experienced grade 4 in arm A and arm B, respectively. CONCLUSIONS: IFO does not increase the activity of the 5-FU plus FA combination in advanced colorectal cancer.

Adult↗