[Personal experience in the prevention of the neonatal respiratory syndrome with corticosteroids].
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Biomedical subjects
Publications and source records attributed to F Colombo.
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Stereotactic biopsy of surgically unamenable intracranial lesions has been performed in our Neurosurgical Division since 1977. Riechert's apparatus is employed. An originally developed biopsy instrument and its advantages are described. Stereotactic coordinates of the biopsy site are found by CT scanner data using the technique described earlier by us. The series consists of 20 patients in whom a variable number of biopsy samples (from 1 to 5) was taken. Mortality and morbidity were nil. In 2 cases the stereotactic exploration led to a therapeutic maneuver: a cystic craniopharingioma and a cerebellar hematoma were extirpated. The clinical, neurological and histological features of 5 paradigmatic cases are illustrated. The relevance of histological diagnosis for adequate treatment is stressed. The indications for this surgical procedure are discussed.
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The Authors report their experience on the surgical treatment of spastic syndromes in children affected by cerebral palsy. The series consists of 21 patients: the mean age is 9.3 years. In 18 patients in whom the clinical picture showed spastic paraparesis a posterior selective lumbar rhizotomy was performed: 3 patients with disabling spastic tetraparesis underwent posterior cervical C1-C3 rhizotomy. The follow-up ranges from 4 months to 3 1/2 years. No mortality nor major complications were observed in the entire series. Clinical results can be considered good on the whole; they are related to the motivation to the movement, perceptive deficits, intellectual impairment.
Breathing abnormalities in patients affected by acute cerebral damage are herein studied as neurological signs of localizing value for the neurological diagnosis of the level of the lesion. Incidence and types of abnormal breathing pattern correlate with neurological syndromes, and in a given neurological syndrome the presence of these alterations entails a more severe outcome. Tachypnea shows the most significant correlations from a diagnostic and prognostic point of view.
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The radical surgical option we propose for Peyronie's disease consists in removing the sclerohyalinotic focus of disease and replacing it by an autologous dermal graft taken from the upper outer thigh area. Between 1981 and 1991, we operated on 335 patients with Peyronie's disease, 152 of whom underwent plaque excision and dermal graft. All could be assessed with a 2-year follow-up. Two main complications were observed: mild penile flexure due to scar retraction of the graft (35% of cases), and partial erectile deficit with decreased corporal rigidity (17% of cases). The degree of graft retraction is linked to the individual's histologic response. A mild deviation of the penis can occur some months after surgery and is not a relapse flexure due to disease progression, but is mere scar retraction and will spontaneously regress. Because the patient will date the onset of a postoperative erectile deficit from the time of the operation, it is advisable to assess preoperatively the erectile ability of all patients. Furthermore, an impaired erectile response could result from hypoaesthesia of the glans, postsurgical stress, and fibrosis of the erectile tissue. A retrospective assessment of radical surgery cases involving plaque excision and dermal graft led us to propose this option where precise indications apply, providing that other alterations of the erectile function are preoperatively assessed.
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