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Biomedical subjects

E Ippolito

Publications and source records attributed to E Ippolito.

At least 55 records · Page 3Linked to original sources
PubMed1995

Update on pathologic anatomy of clubfoot.

Serial histological sections in three planes (frontal, sagittal, and transverse) in four cases of clubfoot in fetuses aborted at 16-20 weeks were studied and compared to identical sections obtained in three normal feet. The talus was deformed, with its neck medially angulated and its head dome shaped. The body of the calcaneus was medially bowed and was tilted and rotated medially underneath the talus, and both the talus and the calcaneum were in plantar flexion. The tilting of the talus and the medial tilting and rotation of the calcaneus accounted for the varus deformity of the hindfoot. The varus and adduction deformity of the heel and midfoot caused the supination seen in clubfoot. The skeletal components of the forefoot were adducted as a result of the medial displacement of the navicular and cuboid. Ligamentous and tendon abnormalities were also observed with increased fibrosis of muscle tissue, which may be an important factor in causation of clubfoot.

Calcaneus↗
PubMed1995

The Herring lateral pillar classification for prognosis in Perthes disease. Late results in 49 patients treated conservatively.

We reviewed the radiographs of 49 patients with Perthes' disease at the stage of fragmentation and also after the end of skeletal growth to assess the value of the lateral pillar classification of Herring. The average age of the patients at diagnosis was 7 years 6 months and the mean follow-up was 24 years. Ten of the 11 Herring group-A hips showed good reconstruction of the femoral head. There were good results in group-B hips when the patients were less than nine years of age at diagnosis. All 11 group-C patients showed hip deformity at follow-up. The Herring classification provides a valid long-term prognosis in Perthes' disease, although age at diagnosis is also an important prognostic factor. The classification is relatively easy to apply, is reliable, and requires only an anteroposterior radiograph taken during the fragmentation stage of the disease.

Adolescent↗
PubMed1994

Second messenger formation altered by different dialysis membranes in human leukocytes.

A number of agents stimulate transmembrane cell-signaling in different cell types through the formation of the second messenger diacylglycerol (DAG) which activates protein kinase C (PKC). The aim of this study was to investigate phospholipase C activation, DAG formation, and cellular adhesion to dialysis membranes after simulated dialytic treatment of either human leukocytes or clonal hematopoietic cells. Cells were circulated for 60 minutes in a closed-loop dialysis system using three different dialyzers: cuprophan (CU), polysulphone (PS), and AN69 (PAN). Another cell aliquot was left within the dialyzers without circulation. Samples were taken at different time intervals and cells counted. Cells were labeled with tritiated glycerol overnight, and DAG was measured by thin-layer chromatography. Our data showed that cells tended to adhere with more efficiency to CU than to the synthetic dialyzers. Circulation in the in vitro dialysis circuit resulted in the rapid (5 min) formation of [3H]DAG (CU 1.95-; PS 1.34-; PAN 1.24-fold increase over untreated cells). The DAG level peaked at 15 to 30 minutes and remained constant thereafter (CU 1.70; PS 1.96; PAN 1.66). When we measured DAG formation in cells that had been kept in the dialyzers without circulation, we found that cells exposed to CU showed a much higher and rapid activation than those exposed to PS or PAN, as if CU per se was able to activate early cell signaling (CU 1.95-; PS 0.97-; PAN 1.09-; DAG, -fold increase over control).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1994

Histology and ultrastructure of arteries, veins, and peripheral nerves during limb lengthening.

The effects of lengthening of the metacarpal bone on peripheral nerves and blood vessels were studied in 8 calves. Specimens for light and electron microscopy were obtained from the palmar neurovascular bundle at 1 cm (8% of the initial length), 2.5 cm (20% of the initial length), and 4 cm (33% of the initial length) of metacarpal lengthening. In 2 calves, specimens were studied 2 months after the end of the lengthening procedure. At 8% of lengthening, myelinated fibers of the palmar nerve showed moderate degenerative changes in the myelin sheath. This became severe at 20% and 33% of lengthening, and affected the axoplasm as well. At 20% of lengthening, the palmar vein started to show fibrous metaplasia of the smooth muscle tissue of the tunica media. This became much thinner than normal. The palmar artery showed moderate alterations of the inner part of the tunica media and the intima. The palmar nerve and blood vessels recovered their normal structure almost completely 2 months after the end of the lengthening procedure. The morphologic alterations of peripheral nerves and vessels may constitute the pathophysiologic basis of the nervous and circulatory disturbance observed in clinical practice.

Animals↗
PubMed1992

Epiphyseal chondroblastoma of bone. Long-term effects on skeletal growth and articular function in 15 cases treated surgically.

The authors describe the long-term sequelae of chondroblastoma in 15 patients with open growth plates, whose age at operation ranged from 8 to 15 years. At follow-up, the youngest patient was 21 and the oldest 48 years old. Upper limb length discrepancy ranging from 2 cm to 10 cm was present in the four patients who had a proximal humeral epiphyseal location; in three of them, the range of motion of the shoulder was also limited and X-rays showed marked irregularities of the humeral head. Lower limb length discrepancy ranging from 0.5 cm to 2 cm was found in five of the eight patients in whom the tumor affected lower limb epiphyses. One patient with proximal tibial epiphyseal involvement also had mild genu valgum. Radiographic osteoarthritis was present only in the trapeziometacarpal joint of a patient in whom the first metacarpal bone affected by the tumor was replaced by a free fibular graft. The abnormalities observed did not cause important functional loss in either the everyday or the working activities of any of our patients.

Adult↗
PubMed1992

HCV incidence in a dialysis center: preliminary reports.

Incidence of seroconversion to anti-HCV from December 1989 to May 1991 was evaluated in patients and in their sexual partners. In December '89, 13 of 66 and in May '91, 26 of 75 patients were HCV positive. 9 of 13 new, seroconverted patients had been transfused. Seroconverted mean dialytic age was lower than that of previous HCV-positive patients. All the sexual partners were HCV negative. Blood transfusion seems to be the main risk factor for HCV infection, while environmental contamination is still debatable.

Adult↗
PubMed1991

Juvenile and idiopathic kyphosis. Long-term follow-up of 20 cases.

Twelve patients with juvenile kyphosis and eight patients with idiopathic kyphosis were reviewed at an average follow-up of 19 years. The average age of the patients at follow-up was 33 years (range 26-45 years). All the patients but one, who had a posterior fusion of the dorsal spine, had been treated with a plaster cast jacket followed by a plastic brace. At the end of treatment there had been an improvement of about 30% on the original curves in both juvenile and idiopathic kyphosis. At follow-up, however, all the patients had lost the correction obtained and the curves had become worse than originally, those in idiopathic kyphosis more so than those in juvenile kyphosis. Despite the increase in their angular deformity, all the patients managed fairly well and only two complained of distressing back pain.

Adolescent↗
PubMed1991

Unusual physeal lesions of the lower limb. A report of 16 cases with very long-term follow-up observation.

Sixteen cases of physeal injury of the hip or the knee were reviewed, with an average follow-up observation of 23 years and 8 months. Obstetric lesions were present in four cases. The average patient's age at injury was 8 years and 6 months, whereas it was 32 years and 3 months at follow-up observation. All our cases but three were treated nonoperatively. According to our evaluation criteria, eight patients had a good result, three fair, and five poor. A lower limb discrepancy ranging from 1.5 to 6 cm was present in seven patients. Either varus or valgus angulation of the knee was observed in three patients, but was marked in only one. Four patients had radiographic signs of osteoarthritis and all but one, had had a type III or IV injury. The highest number of good results was observed in proximal femur injuries, whereas the highest number of poor results was found in those of the distal femur. The final result seems to be closely related, in distal femoral lesions, to the type of physeal injury according to Salter and Harris and, in proximal tibial lesions, to the quality of reduction. In obstetric lesions, the results are unpredictable because even good short-term results may deteriorate during skeletal growth.

Adolescent↗
PubMed1991

Long-term followup of physeal injury to the ankle.

Sixty-eight patients with a distal physeal injury to the tibia and/or the fibula were reviewed, with an average followup of 27 years and 4 months from the initial lesion. The average age at injury was 12 years and 6 months, whereas the average age at follow-up was 40 years. Seventeen patients had a type I Salter-Harris injury, 27 type II, 10 type III, and 14 type IV. All the patients but six were treated conservatively. According to our criteria of evaluation, 47 patients had a good result, 13 fair and eight poor. The type of Salter-Harris lesion, the amount of the initial displacement and the quality of reduction were the three main parameters which determined the end-result. Radiographic signs of osteoarthritis were present in 11.8% of our patients and all of them had presented type III or IV lesions, except for one who had a type II lesion.

Adolescent↗
PubMed1990

Aneurysmal bone cyst. Long-term follow-up of 20 cases.

Twenty cases of aneurysmal bone cyst were reviewed, with an average follow-up of 10.3 years. Twelve patients still had open growth plates at diagnosis, but all of them were fully grown at follow-up. The treatments performed were: resection of the cyst or of the whole affected bone, curettage, and curettage and bone grafting. Radiation therapy was a complementary treatment in three cases. Two patients relapsed, one that had been treated by curettage alone and one by curettage and bone grafting. Five patients showed skeletal deformities at follow-up. Two had lesions of the growth plate, most likely caused by radiation therapy, whereas in the other three growth had probably been impaired by surgical trauma.

Adolescent↗
PubMed1990

Pelvic stabilisation of a large chordoma of the sacrum. Description of a case.

Chordoma is a primary malignant bone tumour which derives form residue of the notochord. It constitutes 1.4% of all primary bone tumours, and in approximately half the cases it is localised in the sacrum. It is characterised by slow growth, but also by high local invasiveness, local recurrence and pulmonary metastasis. The literature reports many cases of chordoma of the sacrum, most of which do not extend beyond the second sacral metamere. The case presented here is a large chordoma which extended proximally as far as the 1st sacral metamere bilaterally, so that subtotal resection of the sacrum was required. There is very little data in the literature on the stability of the pelvis after such ample removal. Considering the young age of the patient we decided to stabilise the pelvis with Luque segmental instrumentation.

Adult↗
PubMed1990

Post-traumatic cubitus varus. Long-term follow-up of corrective supracondylar humeral osteotomy in children.

The results in twenty-four patients who had had a supracondylar osteotomy of the humerus to correct post-traumatic cubitus varus were reviewed after the patients had completed skeletal growth. The average age of the patients was 7.9 years at operation and thirty-one years at the time of follow-up. The average duration of follow-up was twenty-three years. According to our grading system, seven patients had a good; six, a fair; and eleven, a poor result. All but two of the nineteen patients in whom the humero-ulnar angle had been measured preoperatively lost correction that had been obtained at operation. No correlation was found between the quality of the result and either the age of the patient at operation or the amount of correction that had been obtained at operation. The correction that was obtained at operation was maintained in the two patients in whom the cubitus varus deformity had been caused by malunion of a supracondylar fracture. However, when the deformity followed either physeal injury or supracondylar fracture with damage to the physis secondary to the initial trauma, the correction was not maintained. At the most recent follow-up, three patients were symptomatic, and fourteen were dissatisfied with the cosmetic result because of the residual deformity of the elbow or the postoperative scar, or both. In spite of the partial recurrence of the deformity, which was sometimes severe, all but the three symptomatic patients had a very good functional result. Many of these patients worked at heavy manual labor.

Adolescent↗
PubMed1989

An ultrastructural study of slipped capital femoral epiphysis: pathogenetic considerations.

Two normal proximal femoral growth plates and core biopsies from six patients with slipped capital femoral epiphysis (SCFE) were studied by electron microscopy. In these SCFE patients, chondrocytes from all the zones of the plate were frequently smaller than normal, more irregular in shape, and many of them were degenerating, with formation of matrix vesicles and cellular debris. Floccular electron-dense material, most likely abnormal proteoglycan, was present in the hypertrophic rough-surfaced endoplasmic reticulum and Golgi apparatus as well as in the extracellular matrix, intermingled with collagen fibrils thinner than normal and loosely arranged. Mineralization of the abnormal matrix of the longitudinal septa of the degenerating zone was either scanty or absent, with scanty formation of irregular and thin bone trabeculae. The abnormalities observed in SCFE seem to be caused by a change in chondrocyte metabolism with consequent altered synthesis and/or extracellular aggregation of both collagen and proteoglycan, and scanty mineralization of the abnormal cartilage matrix.

Adolescent↗
PubMed1989

Chronic osteomyelitis. A long-term review of 37 cases.

The authors carried out a long-term review of 37 patients suffering from chronic osteomyelitis with the aim of studying the natural history of the disease and identifying any prognostic factors during the initial stage of the disease. Analysis of the data failed to identify any reliable prognostic parameters available at the onset of the disease. However, the worst results were observed in cases of osteomyelitis which had occurred after open fractures.

Adolescent↗
PubMed1987

Unicameral bone cysts--comparison between surgical and steroid injection treatment.

Two series of 20 patients each with unicameral bone cysts were compared, one treated before 1975 by curettage and bone grafting and the other treated after 1975 with methylprednisolone acetate (MPA) injections. At follow-up, the majority of patients were at the end of skeletal growth. In the MPA-treated series, the average age of the patients at diagnosis was 9.1 years, whereas the average age at follow-up was 16.7 years. The average follow-up interval was 7 years. The steroid-treated series had better radiographic final results than the surgically treated series, with a lower recurrence rate. The number of MPA injections required to heal the lesion ranged from one to six, with 70% of the patients requiring a maximum of three injections. Steroid injection treatment should be preferred to surgical treatment for the better final results, for the virtual absence of complications, and for the greater simplicity of execution and postoperative care.

Adolescent↗
PubMed1987

The long-term prognosis of unilateral Perthes' disease.

We have attempted to identify the most important long-term prognostic factors in Perthes' disease by studying 61 patients affected unilaterally. The average age at diagnosis was 7 years 5 months and at follow-up it was 32 years, an average interval of 25 years. The age at diagnosis, age at follow-up, Catterall group, acetabular coverage, femoral head subluxation and the other head-at-risk signs were statistically correlated with Stulberg, Cooperman and Wallensten (1981) radiographic classes and the Iowa hip score. Statistically significant correlations were found between Stulberg class and Iowa hip score; age at diagnosis and Stulberg class; age at follow-up and Iowa hip score; and between lateral subluxation of the femoral head and Iowa hip score. Three age-groups of patients were found to carry different long-term prognoses. Those below five years of age at diagnosis showed a statistically significant correlation between Catterall group and Stulberg Classes I and II. Patients between five and nine years of age at diagnosis showed a significant correlation between Catterall group and Stulberg Classes I, II, III and IV while in patients diagnosed after nine years of age there was no statistical correlation between Catterall group and Stulberg class, all having a poor prognosis and ending up in Stulberg Classes III, IV and V.

Adolescent↗