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Biomedical subjects

A Iannelli

Publications and source records attributed to A Iannelli.

85 records · Page 5Linked to original sources
PubMedDate not supplied

[Experimental comparative study on the antiepileptic effect of clonazepam, sodium dintoine and phenobarbital administered parenterally].

A comparative study of the antiepileptic action of Clonazepam, phenythoin-natrium and phenobarbital has been performed in acute experiments in rabbits. The effort of the three drugs, administered intravenously, was studied on a) the epileptic activity induced by electrical stimulation of the amygdala, b) the interictal and c) ictal epileptic activity of an amygdaloid chemical focus (penicillin in gel). Clonazepam has a definite higher capacity, than the other drugs examined to prevent or to reduce the phenomenon of generalization of epilepsy. However, its effect has a shorter duration.

Animals↗
PubMedDate not supplied

Traumatic neuroma of the cystic duct with biliary obstruction. Report of a case.

A case of amputation neuroma of the biliary tract occurring 12 years after a cholecystectomy is reported. The patient, a 81 year-old man, presented with obstructive jaundice due to a stricture of the extrahepatic biliary tract. The stricture was resected and biliary reconstruction was achieved with a Roux-en-Y jejunal loop. The diagnosis of neuroma was obtained only at histology that showed hyperplastic nerve bundles, positive for protein S 100. The patient is well one year and six months after surgery without signs of recurrence of the stricture. Although the amputation neuroma of the biliary tract has already been reported, it seems worthwhile to emphasise this further report. This lesion is an unusual cause of benign stricture of the biliary tract that may pose difficult diagnostic problems.

Aged↗
PubMedDate not supplied

Intracranial tumors of the first year of life.

The introduction of new diagnostic tools for neuroimaging has resulted in the early recognition of congenital brain tumors. In the present report we describe a personal series of 39 children and an International Multicenter Series of 876 children with brain tumors, 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 a scarce value, due to the vulnerability of the infantile brain. At the present time, chemotherapy still plays a controversial role.

Brain Neoplasms↗
PubMedDate not supplied

[Dumbbell neurogenic tumors in children].

Dumbbell neurogenic tumours are unusual neoplasms in the pediatric age group. Six cases all in children under 10 years of age, have been reviewed with respect to diagnosis, management and results. Neurologic deficits have been found in 4 patients only; in the other 2 cases the tumours were occasionally discovered. Myelograms, sometimes associated with CT scan, allowed a correct diagnosis in all the patients. Initial treatment consisted in all the cases in laminectomy or laminotomy with total excision of the extradural tumour. The primary paravertebral tumours have been removed in one patient during the same neurosurgical operation, and in other three patients at a second stage. Two patients did not require the second operation: one recovered after chemotherapy and the other died few days after the first surgical procedure. Five patients are still alive: two, who had the tumour occasionally discovered, are free from disease; among the other 3 patients, presenting with neurological symptoms, 1 is free from disease without neurological symptoms and 2 have still long lasting sequelae. The authors emphasize the role of early diagnosis to prevent neurologic abnormalities and to achieve better results.

Child↗
PubMedDate not supplied

[Hydrocele and inguinal hernia after ventriculo-peritoneal shunt in childhood].

135 non tumoral hydrocephalic children have been operated on trough a V-P shunt in the period January 1975-June 1981. Of them, 10 (7.4%) presented an inguinal hernia or hydrocele in the postoperative period. Such complications required in 9 cases a specific surgical treatment, which was not followed by recurrence in any case; in one child the hydrocele subsided spontaneously. No relation was found with the type of shunt device inserted and the side of the operation.

Cerebrospinal Fluid Shunts↗
PubMedDate not supplied

[Relapse modalities in medulloblastoma].

We evaluated the modality of relapse and progression of medulloblastoma in 45 patients observed between 1981-1991. Children aged over 2 years were treated with surgery and postoperative radio-chemotherapy; among 12 children younger than 2 years, 8 were treated with surgery and chemotherapy and 4 with postoperative irradiation of remaining tumor. Cerebrospinal fluid shunting system was placed in 32 patients (71.1%). Patients were organized into three groups: group I (25 cases) = total tumor removal; group II (11 cases) = subtotal tumor removal; group III (9 cases) = partial tumor removal. 22 children died (48.8%: 10 of group I; 7 of group II; 5 of group III) at variable time interval from the operation during the following period. Among 23 alive patients, 3 are surviving with recurrence and progression of disease (all of group I), 20 are disease-free (44.4%: 12 of group I; 4 of group II; 4 of group III). Average postoperative follow-up period: 6 years for group I/II and 2 years for group III. Even if disease-free children are those treated by total-subtotal surgical removal (while local relapse occurs principally in patients treated by partial surgical resection: 44.4% of local relapse vs 12% of group I and 27% of group II), extensive surgery does not exclude possibility of metastatic localization in cerebrospinal axis, that occurs in 1/5-1/6 of all the patients without differences in each group. CSF shunting system did not cause extraneural metastases in our patients. We obtained long term survival rates or apparent recovery in almost 50% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Intracranial supratentorial tumors: classification, clinical findings, surgical management.

Pediatric supratentorial tumors represent about 50% of all intracranial neoplasms. The most frequent tumors of the cerebral hemispheres are gliomas that arise from astrocytes, oligodendrocytes or ependymal cells. The incidence of the different histologic types is difficult to be established as many tumors have a mixed cellularity, thus classification is based on the prevalent oncotype or the most malignant component. Choroid plexus papillomas and ependymomas are the most common ventricular neoplasms. However, subependymal giant cell astrocytomas, subependymomas, teratomas are also observed. The parasellar region is a frequent site of pediatric tumors as craniopharyngiomas, optic pathway gliomas and germinomas. Pinealomas are less common. Signs and symptoms related to increased intracranial pressure are often reported and vary according to the patient's age. Macrocrania and a bulging fontanel can be observed in infants and toddlers, whereas headache, papilledema and vomiting are present in the older children. A tumor hindering CSF circulation may cause hydrocephalus. Focal signs include epilepsy and neurological deficits characteristic of tumor location. Total removal of the tumor is the ideal surgical therapy. When eloquent areas are involved, partial exeresis is indicated. Radiotherapy is usually administered to malignant tumors even if in younger children its use in markedly limited by the possible severe side-effects on the developing brain. Chemotherapy seems effective in some brain neoplasms, however most suitable drugs and dose need to be established. It may represent an alternative to radiotherapy in children less than three years of age.

Child↗
PubMedDate not supplied

Hepatic incidentaloma. Retrospective analysis of 35 cases.

At present imaging techniques and laboratory tests are employed very extensively to investigate obscure visceral symptoms. During these investigations it can happen that a liver lesion is discovered. This lesion, solid or cystic, when discovered in the liver of a healthy person, is called hepatic incidentaloma. This study analyzes retrospectively the diagnostic and therapeutic management of a series of 35 patients, with an asymptomatic lesion of the liver discovered incidentally. These patients had been observed over a period of five years (1988-1993). There were 22 benign lesions and 13 hepatic cell carcinomas (HCCs), three of which discovered in patients with non diagnosed cirrhosis. The presence of a risk factor for HCC in the past history of the patient with a hepatic incidentaloma strongly suggests that the lesion is malignant (p < 0.05). The average age of patients with malignant lesions was significantly higher than that of patients with benign lesions (65 vs 45 years; p < 0.01). Symptoms and/or signs did not help to distinguish between patients with benign and malignant lesions. Serum alkaline phosphatase (SAP) and alpha-fetoprotein levels were significantly higher in patients with malignancies (p < 0.01). A certain diagnosis was achieved preoperatively in 85% of the cases. In the remaining 15%, a definitive diagnosis was reached only after surgery. Surgical or percutaneous treatment was required in 80% of the cases. In conclusion, although in a minority of cases, surgery is still required for definitive diagnosis of a hepatic incidentaloma.

Adolescent↗