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Biomedical subjects

A Marra

Publications and source records attributed to A Marra.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Associated olfactory groove meningioma and acoustic neurinoma.

The authors describe the case of a 71-year-old man without signs of phacomatosis with a history of progressive psychomotory lowering and two simultaneous tumors of the olfactory groove and of the cerebellopontine angle, as demonstrated by CT scans. Histologic examinations showed the lesions to be a meningioma and a neurinoma. The rarity and the possible pathogenesis of this association are discussed.

Aged↗
PubMedDate not supplied

Clinical value of cervical mediastinoscopy in the staging of bronchial carcinoma.

Whether mediastinoscopy is indicated in the preoperative staging of bronchogenic carcinoma is still a controversial issue. It may be performed routinely (to exclude locally inoperable patients from surgery), selectively, or it may be regarded as superfluous (in centers which prefer an extended lympho adenectomy at the time of thoracotomy). We regard mediastinoscopy as indicated for the following purposes: 1) staging of NSCLC and SCLC; 2) diagnostic (mediastinal masses or lung tumors without previous histology); 3) restaging after primary chemotherapy; 4) assessment of prognosis in patients with borderline operability. The indication for 224 mediastinoscopies performed at our institution in the period from September 1991 through March 1999 was mainly for staging (59.2%) or diagnostic (30.6%). Eight (5.4%) patients underwent mediastinoscopy for the assessment of operability, and 7 (4.8%) after primary chemotherapy for the restaging of loco-regionally advanced lung cancer. Sensitivity and specificity rates were 87% and 100%, respectively, with an accuracy of 93% for the mediastinoscopy performed for the staging of lung cancer at all stages. If we consider the N2 tumors (42 cases) alone, the sensitivity was 76.7% and the specificity 100%, with an accuracy of 83.3%. Overall positive and negative predictive value resulted 100% and 87%, respectively, according to the data reported in literature. Our data confirm the role of mediastinoscopy as the gold standard for regional staging of lung cancer.

Biopsy↗
PubMedDate not supplied

[Unusual case of hypercondensing malignant osteodysplasty: osteopetrosis].

Osteopetrosis, known also as Albers-Schonberg disease, is a genetic disorder causing a generalized sclerosis of the bones and the reduction of the marrow. The diagnosis is often secondary to pathologic processes and its usually observed through specific X-ray researches. The principal cause of osteopetrosis is to attribute to a deficit of bone resorption and remodelling. Osteomyelitis is a complication of osteopetrosis. The purpose of this article is based on several point: 1) to know the cause of osteopetrosis, then to classify and check it; 2) to present the case who did not respond to of a patient with osteopetrosis complicated by maxillary and phalanx osteomyelitis common therapies and give an accurate analysis.

Child↗
PubMedDate not supplied

Isolated aspergillosis of the sphenoid sinus. Case report.

The Authors report a rare case of isolated sphenoid sinus aspergillosis in a 69-year-old man. The patient had a complete recovery. The preoperative CT-scans and the preoperative and postoperative MRI are shown. The incidence, the pathology, the various clinical presentations, the prognosis and the management of this disease are debated.

Aged↗
PubMedDate not supplied

Associated cervical schwannoma and dorsal meningioma. Case report and review of the literature.

The association between spinal meningiomas and neurinomas without clinical signs of neurofibromatosis is very rare with only four cases reported in literature. A case of 70-year-old woman with a history of progressive paraparesis is presented. A cervico-dorsal magnetic resonance with contrast showed two tumors with different enhancement. The patient had examination negative for neurofibromatosis. At histological examination cervical schwannoma and a dorsal meningioma were found. The Authors debate the rarity of this association, the possible pathogenesis and the MR findings.

Aged↗
PubMedDate not supplied

Intramedullary cervical cavernoma. Case report.

A rare case of intramedullary cervical cavernoma with complete neuroradiological examination is described. The Authors debate about clinical course, radiological examination and surgical indications.

Adult↗
PubMedDate not supplied

Oculodentodigital dysplasia. A case report.

This report describes a rare case of oculodentodigital (ODD) dysplasia, an autosomic-dominant disease with alteration on the gene GJA1 of connexin 43 on the human chromosome 6q22-q23, highlighting the anomalies affecting face, eyes, teeth and limbs. The case described shows bilateral microphthalmia, microcornea, syndactyly and other phenotypic alterations characteristic of this syndrome, such as: nose of reduced size with hypoplasic wings, partial stenosis of the choanae, micrognathia, ogival palate and hypoplasia of the enamel. The authors emphasize the importance to know the principal features of ODD syndrome in order to make a correct diagnosis and the role of the dentist in the treatment of this pathology.

Abnormalities, Multiple↗
PubMedDate not supplied

[Total gastrectomy for gastric cancer: can the type of lymphadenectomy condition the long-term results?].

INTRODUCTION: Gastric cancer is the second tumor for frequency in the world. Surgery is still the only curative treatment. Good results in terms of long distance survival, postoperative morbidity and mortality have been achieved in the last years. The extension of lymphadenectomy is an important and discussed matter and it is not clear if lymphadenectomy may contribute to improve the surgical results. The Japanese surgeons were the first ones, in the 60's, to introduce a D2-D3 extended lymphadenectomy, but the real benefits of this technique are still being discussed. Indeed lymphonodal metastasis seem to be one of the most important prognostic factors in the gastric cancer and the level and the number of metastatic nodes are useful to predict the patients' survival. The aim of this study is to value the D2 lymphadenectomy in the patients who were treated with total gastrectomy for gastric adenocarcinoma, comparing the results both with the D1 lymphadenectomy and the D3-D4, paying attention to the survival rates related with the lymphonodal dissection. PATIENTS AND METHOD: From 1998 to 2004, we studied 87 patients with gastric cancer. Out of 78 patients treated surgically, 9 were judged unresectable. Out of 69 patients treated surgically, one died before surgery and so he was put away by this study. All the patients were treated with total gastrectomy and a GI tract reconstruction by Roux's Y termino-lateral esophageal-jejunal anastomosis. In 20 patients we also made a splenectomy. We followed the Japanese Research Society for Gastric Cancer guidelines, according to which nodes are gathered into 16 levels and divided in 4 groups (N1-N4) depending on the cancer localization. The extension of the lymphadenectomy has been classified according to the level of the removed nods. The patients were divided into 3 groups. First group: patients undergone a total gastrectomy with D1 lymphadenectomy. Second group: patients undergone D2 lymphadenectomy. Third group: patients undergone D3 and D4 lymphadenectomy. The data we obtained let us value the survival rate. RESULTS: Out of the 78 patients treated, 69 were resected with a 88.5% resection rate (69/78). Perioperatory mortality was 1.4% (1/69). Global survival was 53.8% (44/68). The 5 years survival for the Ia stage was 82.6%, 89.3% for the Ib stage, 67.8% for the II stage, 56.6% for the IIIa, 16.8% for the IIIb and 0% for the IV stage. In addition the 5 years survival in the patients without lymphnodal metastasis was 79%, much higher than the 30.6% obtained in the patients with lymphonodal metastasis (p <0.0001). In the patients who underwent D1 lymphadenectomy, survival was 73.4%, while we obtained a result of 70.4% and 13.8% respectively in the D2 and D3-D4 (p <0.05). In the advanced stages (IIIa, IIIb, IV), the survival rate in the patients with lymphadenectomy D2 vs D1 vs D3-D4 was 38.9% vs 0% vs 36.3% (p <0.0001). The survival rate based on the extension of the lymphadenectomy in the patients with lymphonodal metastasis resulted to be much higher in those patients who underwent a D2 lymphadenectomy (43.5% in 5 years) compared both to D1 (0% in 6 months) and (29.5% in 5 years) D3-D4 lymphadenectomy. CONCLUSIONS: The relation between long distance survival and extension of the lymphadenectomy in the patients with gastric adenocarcinoma is still being discussed. Different studies show the importance of a careful lymphadenectomy as the main mean for a better long distance survival in the patients with gastric cancer. Other studies showed a link between gastric cancer prognosis and number of positive nodes. If more than 7-8 nodes are affected with metastasis, prognosis is usually poor. Therefore the presence of nod metastasis has a negative influence in the prognosis of this tumor; for this reason D2 lymphadenectomy is the technique to be used for the treatment of the gastric adenocarcinoma, both for a good staging and a better long distance survival, but particularly in the advanced cancers which are, at the moment, the highest number of cases that reach the surgeon's attention.

Gastrectomy↗
PubMedDate not supplied

Surgical approaches to the clivus and upper cervical spine.

The surgical approach to the lesions of the craniocervical junction raises important problems about the choice of the access. The authors debate the advantages and the disadvantages of the principal approaches, presenting their clinical experience of 8 operated patients and discerning between intradural approaches and extradural submucosal or transmucosal approaches.

Adult↗
PubMedDate not supplied

Intraventricular subependymoma presenting as subarachnoid hemorrhage. Case report.

The Authors describe the case of an intraventricular subependymoma presenting as subarachnoid hemorrhage in a 42-year-old woman. The preoperative and postoperative CT-scans and Magnetic Resonance Images of this rare benign neoplasm are presented. The pathology, the clinical findings and the prognosis of this tumour are discussed.

Adult↗