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Biomedical subjects

F Ottaviani

Publications and source records attributed to F Ottaviani.

At least 127 records · Page 7Linked to original sources

Breast carcinoma metastatic to the ethmoid sinus: a case report.

We report a rare case of breast carcinoma metastatic to the ethmoid sinus. An 83-year-old female patient with an intraductal breast carcinoma presented the first symptoms of metastasis to the paranasal sinuses four years after radical mastectomy and axillary node dissection. A review of the literature revealed that only three such cases have been described so far. Symptoms and imaging results are not specific and usually similar to those of primary neoplasms in this region. This case underlines the importance of suspecting a metastasis in patients with a history of malignancy.

Aged↗

Mucociliary clearance and mucosal surface characteristics before and after total laryngectomy.

Forty heavy smokers, all males aged between 40 and 70 and affected by laryngeal cancer underwent mucociliary clearance evaluation the day before total laryngectomy, 60 days after and, in 6 of them, 5 years later. Specimens of nasal and tracheal mucosa were obtained during laryngectomy and other subsequent operations. Before total laryngectomy, no significant changes in nasal mucociliary clearance were observed in smokers and controls, and the nasal ciliary carpet was fairly well preserved. Bronchial mucociliary clearance was impaired in all patients, owing to the coexistent chronic obstructive bronchitis. 60 days after the operation, nasal mucociliary clearance was significantly improved when compared with the preoperative data and controls, owing to the increase in the endonasal temperature and humidity, and to the reduction of the nasal blood flow and disappearance of the nasal cycle, which follow tracheostomy. Surface morphologic studies show a change in the squamous epithelium of the anterior third of the nasal fossa into a columnar ciliated one. During the first 3 months after the operation, tracheobronchial mucociliary clearance increased of 50% vis-à-vis the preoperative data. During this period a clinically evident bronchial hypersecretion was observed. The reduction in nasal and tracheobronchial mucociliary clearance function which became evident 6 years after the operation, is probably due to secondary chronic infections.

Adult↗

Tonotopic organization of human auditory cortex analyzed by SPET.

Single photon emission tomography (SPET) was used to map blood flow increases in the temporal and parietal cortex of 16 normally-hearing subjects after auditory stimulation. Eight subjects were stimulated with a multifrequency 40 dB HL pure tone at 250, 500, 1000, 2000, 4000 Hz, each frequency varying every 30 s. Single 500 Hz pure tones at 40 dB HL were delivered to the remainder of the subjects. Five bilaterally deaf subjects were used as controls. Marked cerebral flow increase following acoustic stimulation with a significantly prevalent activation of the contralateral temporal cortex was achieved (p < 0.001). According to the tonotopic organization of the human auditory cortex, low monofrequency stimulation activated the most lateral sagittal tomograms (from 48.75 to 56.25 mm laterally to the brain midline) only, while multifrequency stimuli activated all sagittal tomograms (from 18.75 to 56.25 mm). On the basis of these results, it is likely that SPET is able to give real information on the cortical distribution of the auditory frequency range, taking into account the number and position of the activated slices. Further clinical investigations in order to define the relationships among blood flow cortical increases, stimulus intensity and auditory threshold, are in progress.

Adult↗

[The restoration of the vocal possibilities for the laryngectomized patient with a tracheoesophageal prosthesis].

The experience reported concerning vocal rehabilitation employing tracheoesophageal prostheses (TEP) in laryngectomized subjects at the University of Milan is based upon 149 patients who underwent procedures for total laryngectomy from November 1986 on in nearly all cases (137), a primary procedure was followed in order to insert a Blom Singer prosthesis. Some technical modifications in creating the fistula during the reconstruction phase of laryngectomy reduced the number of postoperative and local complications of the fistula. The men phoniatric rehabilitation time is 38 days from the procedure. The most important aspects affecting the length of rehabilitation are the presence of lower respiratory tract disorders and contemporaneous postoperative radiotherapy. The mean lifetime of the prostheses is 92 days, the main restricting factor being the care taken by the patient. Microbiological studies showed the virtually constant association between fungi and Pseudomonas sp. Nevertheless, infection of the fistula and forced removal of the prosthesis occurred only in 1 patient. Other complications were as follows: granulation tissue at the tracheal side of the fistula into the trachea or oesophagus, 6 and 1 respectively; enlargement of the fistula, 5; others, 15. Fifteen percent of the patients does not succeed in achieving a tracheoesophageal voice because of respiratory insufficiency, difficult neuromuscular control or psychological problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchi↗

[Carotid body tumors: the clinical, diagnostic and therapeutic aspects].

The authors discuss the epidemiology, histology, symptomatology, diagnosis and therapy of carotid body tumors, basing their discussion on three personal observations and on a case of cervical dermatocyst which showed clinical and radiological data consistent with diagnosis of a glomus tumor. Chemodectomas of the neck are more often seen in the carotid body and are considered histologically benign, although they might induce local or distant metastases. Clinical presentation is often non-specific and may only consist in a slowly growing mass in the higher jugular-carotid region. Among the various imaging techniques (CT, MR), supra-aortic selective angiography, including digital subtraction techniques, is now considered the most reliable tool, while ultrasonography and gammagraphy with 99mTc-gluconate or 131I-MBG are recommended for screening and family testing purposes. Biopsy is to be avoided as it is very likely to cause massive bleeding and because of the high percentage of false negatives. Surgery is the choice treatment, and lateral cervicotomy is the recommended approach for exeresis of the mass, while radiotherapy should be planned in patients with precise contra-indications for surgery and when the tumor mass has already reached the skull base. Pre-operatory selective embolization is still controversial.

Adult↗

[Ectopic thyroid gland].

Based upon the observation of four cases of ectopic lingual thyroid the authors discuss the etiopathogenetic, clinical-diagnostic and therapeutic aspects of this pathology. The clinical characteristics of the mass, scintigraphy, echography and CT scan of the neck, the T3, T4, TSH doses in the blood and fine needle aspiration of the mass have made adequate appraisal of its possible nature and have led to the identification of the presence of thyroid tissue in other sites. In regard to therapy, the authors believe that surgery is compulsory for patients showing clinical signs of upper airway obstruction despite suppressive therapy or when the lesion shows signs of malignant degeneration. After having mentioned the more commonly employed surgical approaches, emphasis is placed on median pharyngotomy as it permits the best visualization of the region, a careful excision of the mass and a valid control over bleeding. In most cases a tracheotomy proves unnecessary. The post surgical hormonal situation suggests the opportunity of a possible substitutive therapy with synthetic hormones or thyroid derivatives.

Adolescent↗

[Brain mapping of middle latency auditory potentials in normal subjects].

The MLRs of 20 normal hearing adults were recorded by cerebral mapping. In regard to the Pa and Na waves, it is suggested that two different generation sites exist because of the different spatio-temporal distribution of the waves over the scalp. It is demonstrated that amplitudes measured by the "grand average" technique are constantly lower than those obtained with the manual determination, and they conclude that manual determination represents the most reliable method in order to calculate waves amplitude. Finally, it is suggested that, due to the different generation sites for Pa and Na waves and to the uneven distribution of the Na wave over the scalp, Pa amplitude should be measured from the baseline and not from the Na negative deflection. Moreover, in 14 cases, when one ear was stimulated the Pa wave obtained at most recording points was significantly larger than the one recorded contralaterally.

Acoustic Impedance Tests↗

[Infantile autism].

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Autistic Disorder↗

[Influence of static stimulation of cervical and otolithic receptors on posturographic parameters].

In the present work 30 normal adult subjects (20 males, 10 females; age range 25-40 years) having no signs or symptoms of vestibular involvement were studied in order to verify whether posturographic parameters could be influenced by the static stimulation of cervical and otolithic receptors. The posturographic evaluation was carried out using a stabilometric platform (Bertec) with the subject standing and the head in one of the following positions: median position, turned left (45 degrees), turned right (45 degrees), tilted left (40 degrees), tilted right (40 degrees), with eyes both opened and closed. The data obtained indicate that wide standard deviations exist in the observed parameters and no significant changes were observed with the head turned either to the right or left nor with the head tilted in either direction. Moreover, the posturographic data obtained with eyes open were slightly reduced in comparison to those obtained with the eyes closed. One can, thus, conclude that neither cervical nor otolithic inputs influence posturographic parameters under static conditions, while visual inputs modify significantly posturographic data, except the coordinates of the foot center of pressure.

Adult↗

[Ultrastructural aspects of cholesteatoma of the middle ear].

Middle ear cholesteatomas were intraoperatively obtained from 6 male patients and studied under light (L.M.), transmission (T.E.M.) and scanning (S.E.M.) electron microscopy. Cholesteatoma proved to be formed by keratinizing squamous epithelium, or matrix, and by connective tissue, chorion or perimatrix. With regard to the matrix, a progressive differentiation of cells belonging to the stratum germinativum could be observed towards spinosum, granulosum and corneum cells with formation of keratinized lamellae. Moreover, keratinocytes and Langerhans cells were found in the stratum spinosum. The perimatrix consisted of granulation tissue, or inflamed subepithelial connective tissue displaying inflammatory cells. Furthermore, the advancing front of cholesteatoma proved to be formed by lymphocytes and plasma cells, partially covered by respiratory type epithelium.

Adult↗

[Biochemical typing of salmonellae by a miniaturized system (API - 50 E) (author's transl)].

The biochemical properties of clinical isolates of Salmonella have been studied by means of a commercially available miniaturized system (API - 50 E), which permit an easier examination of 50 chemical reactions. This miniaturized system seems to be helpfull not only in epidemiological researches but also in characterization of "atypical strains".

Computers↗