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Biomedical subjects

A Mazzoni

Publications and source records attributed to A Mazzoni.

150 records · Page 9Linked to original sources
PubMedDate not supplied

[Treatment of petrous bone cholesteatoma].

Cholesteatoma involving the petrous compartment of the temporal bone is rare and is a difficult surgical challenge for the neuro-otological surgeon. A series of 60 cases of petrous bone cholesteatoma is presented. The diagnosis, surgical treatment, results, and complications are discussed. Our present surgical attitude is based on closed obliterative procedures that allow a wide field exposure with radical removal excision, control and protection of vital structures, and management of problems related to the facial nerve. The treatment of dura mater involved by matrix is still unsolved. Regular follow-up with CT and MRI is mandatory.

Adolescent↗
PubMedDate not supplied

[The sub-occipital approach in functional surgery of acoustic neuroma].

In this study the Authors analyze 380 acoustic neuroma removals carried out from 1972 to 1992 focusing their attention on 90 attempts to save hearing by employing a suboccipital approach. In this series the facial nerve was preserved in 99% of the cases with completely normal function in 78%. The cochlear nerve was anatomically preserved in 96% of the subjects. According to the Shelton-Brackmann classification applied to evaluate hearing results, good hearing (Class A = PTA < or = 30 dB; SDS > or = 70%) was obtained in 12% of the cases, serviceable hearing (Class B = PTA < or = 50 dB; SDS > or = 50%) in 13%, measurable hearing (Class C = any measurable hearing) in 19% and anacusis (Class D) in 56% of the patients. CSF leak occurred in 6.6% of the cases, meningitis in 2.2%, paresis or paralysis of the ninth and tenth cranial nerves in 3% and ataxia in 2%. In acoustic neuroma surgery, hearing preservation is a new but complicated topic. In fact, some operative steps--such as the separation of tumor from nerves and arteries, tumor mass reduction, exposure of the end of the IAC--certainly influence surgical results, but are a matter of uncontrollable variance even within series from the same surgeon and render hearing preservation an innovative idea still awaiting, however, a controllable procedure. The ethical feasibility of hearing preservation is confirmed by our results in which hearing preservation attempts using a suboccipital approach have the same morbidity that the translabyrinthine route would have in the same patient.

Adult↗
PubMedDate not supplied

[The incidence, etiology and clinical significance of visceral mycoses in patients with AIDS].

The incidence, aetiology and clinical significance of visceral mycoses in HIV-infected subjects were evaluated by a retrospective survey of the clinical and microbiological records of 237 consecutive AIDS patients followed-up since 1984. Seventy-four patients out of 237 (31.2%) (56 males, 18 females; 55 IV drug abusers, 7 heterosexuals, 6 homobisexuals, 3 blood recipients and 3 children with congenitally-acquired HIV infection) presented 77 different episodes of visceral fungal infection as a whole, represented by candidiasis in 56 cases (oesophageal 45, pulmonary 5, sepsis 2, eye involvement 2, endocarditis and invasive oropharyngeal infection in the remaining 2 patients), cryptococcosis in 17 cases (meningoencephalitis in all subjects, with disseminated infection in 11 of them), and aspergillosis in 4 cases (pulmonary 2, cerebral and cranio-facial in the remaining 2 patients). In 57 out of 74 patients (77%), visceral mycoses were diagnostic or concurrent with the diagnosis of AIDS. Fungal diseases, as a whole, showed a significantly higher incidence (p < 0.03) among drug abusers, whereas homobisexual men presented a significantly lower frequency (p < 0.001, chi-square test) than AIDS patients with other risk factors for HIV infection. The onset of cryptococcosis was significantly associated with the male sex (p < 0.005, Fisher exact test). All subjects suffering from a visceral mycosis were severely immunosuppressed, with a higher rate of neutropenia in patients developing Candida and Aspergillus spp. infection (23 out of 56 patients with visceral candidiasis and 3 out of 4 cases of aspergillosis had an absolute neutrophil count lower than 1500 cells/mm3), while a severe reduction in CD4+ lymphocyte count was more evident among patients with cryptococcosis (13 out of 17 patients had a CD4+ cell count lower than 50/mm3). After remission of the primary episode of fungal infection (obtained in 80.5% of cases), the incidence of relapse observed in a long follow-up period (mean time 57.6 +/- 39.2 weeks) was elevated both for patients with cryptococcosis (7 cases out of 17) and subjects with candidiasis (19 cases out of 53), with no significant difference among patients receiving a secondary prophylaxis or not (22 relapses observed in 53 patients treated with maintenance antifungals versus 4 episodes in 8 patients followed for a comparable mean time with no antimycotic treatment). Fifty-two out of 74 patients (70.3%) have died up to now; in 21 of them death was due to or associated with the visceral mycosis (cryptococcosis in 11 cases, candidiasis in 8, aspergillosis in 2).(ABSTRACT TRUNCATED AT 400 WORDS)

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[AIDS-related cryptococcosis: diagnostic aspects, prognostic and therapeutic implications].

Diagnostic techniques of AIDS-related cryptococcosis were assessed in a series of 43 HIV-infected patients, and microbiological features were correlated to the clinical course and outcome of disease. Polysaccharide antigen detection was the most sensitive method for central nervous system infection, followed by direct microscopy and culture: in 4 patients this visceral mycosis was initially diagnosed by the detection of isolated cerebrospinal fluid antigen. Thirty-one patients out of 43 suffered from disseminated infection (with positive blood cultures and/or antigenemia). The occurrence of clinical relapses, a lethal outcome, and time to relapses or to death, did not differ significantly between patients with isolated central nervous system and those with disseminated cryptococcosis.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Transfer of chimeric receptor gene made of variable regions of tumor-specific antibody confers anticarbohydrate specificity on T cells.

The antitumor specificity of T cells can be induced by gene transfer using a recently developed therapeutic approach (T body). In this work, we genetically conferred anticarbohydrate specificity onto T cells using the variable regions of monoclonal antibody MLuC1, which binds the Lewis(Y) (LeY) tumor-associated antigen that is overexpressed on several human carcinomas. The variable regions of MLuC1, which are in a single-chain Fv (ScFv) configuration, were cloned and spliced in a eukaryotic expression vector with both the gene encoding the signal-transducing gamma-chain of the human Fcgamma receptor and a flexible hinge domain. The chimeric ScFv-gamma gene was expressed in a murine cytotoxic T-cell hybridoma. Transfectants receiving vector only served as a negative control (mock). Screening for functional transfectants was carried out using a tumor growth inhibition assay. The soluble form of MLuC1 ScFv was recovered from bacteria periplasm and tested for binding to LeY-expressing cells by the fluorescence-activated cell sorter analysis. Despite the low binding ability of the soluble MLuC1 ScFv, 7 of 13 genetically engineered cytotoxic T lymphocyte clones inhibited the growth of LeY-positive cells and did not affect growth of LeY-negative cells. None of the mock clones tested specifically inhibited tumor growth. These data indicate that, by chimeric MLuC1 ScFv-gamma gene transfer, it is possible to confer anticarbohydrate specificity onto T cells and extend the applicability of the T-body approach to tumor-associated antigens that are naturally not recognized by T cells.

Amino Acid Sequence↗