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Biomedical subjects

E de Divitiis

Publications and source records attributed to E de Divitiis.

15 recordsLinked to original sources
PubMed1992

Clinical management of prolactinomas: a ten-year experience.

A ten-year experience on 36 patients bearing macroprolactinomas (MP) and 86 others bearing microprolactinomas (mP) is reported in this study. Different therapeutical approaches were used: 1) trans-sphenoidal surgery in 24 patients with MP and in 25 with mP; 2) medical therapy with the oral form of bromocriptine (BRC) in all the 24 patients with MP previously subjected to surgery, in 48 patients with mP ab initio, and in 16 out of 25 patients with mP previously subjected to surgery; 3) medical therapy with the long-acting injectable forms of BRC in 12 MP- and 13 mP-bearing patients, and 4) conventional radiotherapy in 12 of the 24 patients with MP previously subjected to surgery. The follow-up, performed five years after surgery, showed that: a) all the 24 patients with MP but one had normal PRL levels during BRC administration, with a rebound of hyperprolactinemia in all cases after withdrawal; b) during the treatment BRC caused normalization of PRL in 15 of the 16 mP-bearing patients surgically treated and in all the 48 mP-bearing patients only treated with BRC; c) in 20 of the 25 patients the treatment with injectable retard BRC caused the normalization of plasma PRL and the shrinkage of the tumor mass in all the patients with MP but one, as revealed by seriate CT scans. In conclusion, the surgical treatment of prolactinomas was ineffective to normalize plasma PRL levels in most patients whereas BRC, in standard or in retard forms, was able to normalize plasma PRL levels, reduce the tumoral mass and preserve the pituitary residual tissue. BRC should be, therefore, used as first choice therapy both for MP and mP.

Adolescent↗
PubMed1991

Hemodilution and revascularization for early treatment of stroke: an experimental trial.

A new experimental trial to investigate the usefulness of early therapeutic measures in case of acute I.V.D. has been performed, on the basis of a previous already reported experience. A combined treatment consisting of hemodilution and revascularization starting 16 hours after the onset of cerebral ischemia was tested. The study was performed in a population of 20 New Zealand male rabbits in which an acute cerebral ischemia was achieved by means of extracranial ligation of both common carotid artery and of one vertebral artery. The animals were divided into two groups. 1st group: no treatment; 2nd group: revascularization + hemodilution. Better results were observed in treated group considering either CBF rates or histological changes.

Acute Disease↗
PubMed1990

Pituitary adenoma and parasellar cysts.

Two cases of pituitary adenoma associated with a parasellar cyst are reported; only one similar case has been described previously. Even though such an association may be coincidental, a pathogenetic relationship between the two lesions in one of our cases may be assumed: shrinkage of the prolactin-secreting pituitary adenoma by means of bromocriptine therapy did, in fact, cause collapse of the cyst. Such an occurrence must not be disregarded in considering the therapeutic approach.

Adenoma↗
PubMed1989

Forced subarachnoid air in transsphenoidal excision of pituitary tumors (pumping technique)

Inversion and prolapse into the sella of the superior capsule and the diaphragma sellae is the only condition that warrants, at least macroscopically, radical removal of tumors with suprasellar extension operated on via the transsphenoidal route. If this does not occur spontaneously, air can be introduced into the subarachnoid space through a lumbar spinal catheter to produce forced dissection of the suprasellar cisterns and collapse of the tumor capsule ("pumping technique"). This method permits complete removal of the neoplastic tissue. In a series of 124 transsphenoidal operations for tumors with suprasellar extension, spontaneous descent of the capsule occurred in only 26 cases. Forced dissection using air distension of the cisterns was carried out in 88 cases, with complete success in 56 cases, partial success in 20, and no effect in 12. There were no complications or unwanted side effects in any patient.

Air↗
PubMed1988

Unusual complication with use of lyophylized dural graft.

A patient, who had undergone removal of a meningioma and the involved dura, developed Jacksonian fits in the postoperative period. There had been precocious resorption of the patch of lyophilized dura mater used to repair the dural defect and this was followed by development of a pseudomembrane adherent to the cortex. After its removal, the patient recovered completely. Activation of reactive reparative processes, proliferative action by fibroblasts, reabsorptive phenomena, new vessel formation, are the main pathological events involved in this as in similar cases, but their sequence and the precipitating cause are not easily recognizable.

Adult↗
PubMed1979

Primary sellar chondromas.

Two cases of chondromas arising primarily from the sella turcica are reported. The eight cases reported in the literature are reviewed. The basic clinical and radiological findings of these tumors and the difficulties of diagnosis and treatment are discussed.

Adolescent↗
PubMed1978

Giant intramedullary ependymoma. A case report.

After a review of the international literature, the authors report a case of intramedullary ependymoma extending from the 1st cervical level to the 1st lumbar level completely removed in a one stage operation. The good functional recovery of the patient is emphasized.

Adult↗
PubMed1978

[The pseudo-vascular syndrome of intracrânial metastases (author's transl)].

Our statistic consist of 162 cases of metastatic tumors of the brain (M.T.B.), of which 120 verified under surgery or at autopsy, and 42 diagnosed in the pre-operative phase and not undergone surgery. The pseudo-vascular form has been found in 58 cases (36%). If we only consider the supratentorial localizations, this percentage rises to 43,5%. This onset of symptomatology is quite predominant in males (52 cases 42%) compared to females (6 cases: 16%). The MTBs that in our statistics produce a greater frequence of pseudo-vascular forms are the MTBs of melanomas (66%), those of unknown origin (42%) and those of pulmonary origin (35%). These neoplasms are distinctly more frequent in males. On the contrary the mammary metastases responsible for most of the female MTBs originate to a pseudo-vascular form in only 22% of the cases. The etio-pathogenetic mechanism is double; it may be the manifestation either of arterial occlusion by neoplastic cells (embolia neoplastica attiva) or of disruption of the vascular wall and hemorrhage. As far as the diagnosis is concerned this syndrome can be quite easily recognised only when an extraneuraxial tumor is found, especially with a marked neuraxial tropism.

Adult↗
PubMedDate not supplied

Accuracy of the analysis of multiple small fragments of glial tumors obtained by stereotactic biopsy.

To examine the reliability of the diagnoses reached on multiple small fragments of cerebral glial tumors obtained via stereotactic biopsy, samples obtained from 100 consecutive glial tumors (during real or simulated biopsy) were studied by cytology and histology. In comparison to the definitive diagnosis made on the whole tumor, a correct positive diagnosis on the biopsy sample was made by histology in 96% of cases and by cytology in 93% of the cases (with 96% correct results when combining both methods). A correct identification of the tumor type and grade was achieved by histology in 82% of cases and by cytology in 80% of the cases (with 85% correct results when combining both methods). The limits of stereotactic biopsy are related to the difficulty of identifying all of the typical tumor features on tiny tissue fragments of a pleomorphic neoplasm, such as a glioma. This study demonstrates that better results may be obtained by using both cytology and histology to study multiple stereotactic biopsy samples from glial tumors.

Adolescent↗