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F Reale

Publications and source records attributed to F Reale.

At least 19 recordsLinked to original sources
PubMed1998

Clinical and electrophysiological findings and follow-up in tarsal tunnel syndrome.

The authors report clinical and electrophysiological findings in 59 patients with tarsal tunnel syndrome (TTS) and follow-up in 23 of them. The entrapment was prevalent in females; was bilateral in 6 patients and involved medial plantar in 7 and lateral plantar nerves in two cases. Eleven presented with other nerve entrapment syndromes or focal mononeuropathies, due to hereditary neuropathy with liability to pressure palsy or systemic diseases. The other 48 subjects had TTS without any other related entrapment syndromes: 23 were idiopathic cases, 13 had a history of local trauma, 3 had systemic diseases and the others had external or intrinsic compressions. The most frequent symptoms were paraesthesia or dysaesthesia (86% of feet) and pain (55%). Hypoaesthesia of the sole and weakness of toe flexion were evident in 74% and 22% of feet, respectively. Absence of sensory action potential or slowing of sensory conduction velocity (SCV) of the plantar nerves were present in 77% of feet; significant differences of SCV between affected and unaffected plantar nerves and/or between distal sural and plantar nerves were evident in 14%. Abnormalities of plantar SCV were therefore absent in only 9% of feet. Distal motor latency was delayed in 55% and electromyography showed neurogenic changes in 45% of sole muscles. Five cases (6 feet) underwent surgery with excellent or good results in 5, 4 of them also showing improvement in distal conduction of the plantar nerves. Nine were treated with local steroid injections, with good results shown in 6 patients. Nine other patients who did not receive any therapy showed a disappearance of symptoms or good outcome in 6 cases. The subjects with poor therapeutic results had S1 radiculopathy or systemic diseases. The authors underline that patients with connective tissue diseases should not be treated by surgical decompression because they may have subclinical neuropathy. Some subjects with idiopathic or trauma-induced TTS recover spontaneously. Surgical release should be limited to cases with space-occupying lesions and when conservative treatments fail.

Action Potentials↗
PubMed1997

Neoplasia associated with atypical glandular cells of undetermined significance on cervical cytology.

The clinical importance of atypical glandular cells of undetermined significance (AGUS) on cervicovaginal smear has not been well defined. Between January 1990 and April 1996, 127 smears were reported as showing AGUS changes by the cytopathology division at the University of Massachusetts Medical Center. The medical records of these women were reviewed: 17 women were excluded because of previous hysterectomy or gynecologic cancer, 85 were biopsied, 16 were followed by repeat smears, and 9 were lost to follow-up. Forty-four women had negative biopsies or cervicitis. There were 15 endometrial lesions: 10 hyperplasias (2 with atypia) and 5 adenocarcinomas. Twenty-five women had cervix lesions including 3 endocervical atypias, 12 low-grade cervical intraepithelial neoplasia (CIN), 6 high-grade CIN, one adenocarcinoma in situ, and 3 invasive adenocarcinomas. One patient had ovarian cancer. Two of the 16 women followed by repeat pap smear eventually had a cancer diagnosis: one with cervix cancer and one with colon cancer. We were unable to identify a subgroup of women with AGUS who were at increased risk for serious pathology when we compared multiple demographic variables, symptoms, or the presence of coexistent squamous abnormalities on cervical cytology. The mean age of the 15 women with endometrial lesions was 59.9 years, which was significantly older than those patients with cervix lesions who had a mean age of 38.9 years. The presence of AGUS on cervical cytology is a marker for significant gynecologic neoplasia and should be investigated with colposcopically directed biopsies, endocervical curettage, and, in older women, endometrial biopsy.

Adult↗
PubMed1997

Neuroma of the sural nerve as a complication of stripping of the small saphenous vein.

BACKGROUND: Two cases of neuroma of the sural nerve after stripping of the small saphenous vein are reported. PATIENTS: This 39-year-old woman and this 52-year-old man complained of paresthesia and burning pain, which worsened with walking, in the area of the sural nerve, about 1 month after saphenectomy of the small saphenous vein. RESULTS: Exploratory surgery in both cases led to the identification of the spindle neuroma-in-continuity of the sural nerve confirmed histologically. The nerve was sectioned and the proximal stump implanted under the deep fascia. This resulted in complete remission of the symptoms in one case, and partial in the other. CONCLUSION: It is likely that the nerve was lacerated during stripping, as a process of periphlebitis might cause adhesion of the vein to the nerve, and then the spindle neuroma developed. The authors underline the necessity of including neuroma of the sural nerve among the possible, albeit rare, complications of stripping of the small saphenous vein.

Adult↗
PubMed1992

Radiation therapy for surgically proven para-aortic node metastasis in endometrial carcinoma.

The impact of para-aortic field radiation therapy upon survival was studied among 26 patients with para-aortic nodal metastases from carcinoma of the endometrium. Seventeen of these 26 patients received postoperative radiation therapy to the para-aortic field as a part of their primary therapy. Sixteen of the 17 also received adjuvant hormonal therapy. Nine of 17 patients (53%) are alive without evidence of disease (18-55 months) with a median survival time of 27 months. Of the remaining eight patients, six (35%) died of endometrial cancer at 6-38 months, with a median survival time of 14.5 months. Five of these patients had distant disease. Two of the 17 patients (12%) died of intestinal obstruction felt to be secondary to radiation enteritis, one of whom was disease free. No difference in survival was detected in patients treated with radiation therapy with microscopic versus macroscopic nodal involvement. Of the nine patients who did not receive para-aortic radiation, eight were treated with hormonal therapy (n = 6) or chemotherapy (n = 2). Seven patients died of disease from 5-28 months, with a median survival time of 13 months. One patient is alive at 12 months. Survival in the 17 patients treated with para-aortic radiation was better than the eight patients not treated with para-aortic radiation (p = 0.004). This survival difference remained significant for patients with microscopic but not macroscopic nodal disease. Para-aortic field radiation appears to improve survival, but has a significant complication rate, and should be reserved for patients with histologic evidence of para-aortic metastases.

Adenocarcinoma↗
PubMed1992

Left ventricular diastolic filling in type I diabetes mellitus: a pulsed Doppler echocardiographic study.

OBJECTIVES: Doppler echocardiography was used to assess left ventricular diastolic performance in young patients with type I diabetes mellitus and no clinical signs of heart disease. METHODS: The pattern of transmitral diastolic flow velocity was determined in 82 patients (56 men, 26 women; age 17.7 +/- 7.6) with type I diabetes mellitus and no heart disease. Maximal early diastolic flow velocity (E peak), maximal late diastolic velocity (A peak), the ratio of maximal flow velocity in late diastole to that in early diastole (A/E ratio) and the ratio of the time velocity integral of the diastole (1/3 FF) were measured in all 82 patients and repeated during exercise in 63 of them. Twenty healthy volunteers served as controls. RESULTS: Mean values of the Doppler indexes were not significantly different between the patients and the 20 controls, but diabetic patients with microvascular complications showed patterns of left ventricular diastolic flow velocity which suggested altered diastolic performance, namely lower E peak velocity, higher A peak velocity, raised A/E ratio and reduced 1/3 FF. Among the 63 examined during exercise, different diastolic flow patterns in response to effort made it possible to identify 15 patients with a high rate of autonomic dysfunction, indicating probable impairment of diastolic function and a need for close follow-up. CONCLUSION: Diastolic abnormalities may occur in young diabetic patients without evidence of heart disease and suggest Doppler evaluation is a sensitive method for identifying patients at potential risk of developing clinical heart disease.

Adolescent↗
PubMed1989

Radiosensitivity of human prostate cancer and malignant melanoma cell lines.

The relative radioresponsiveness of human prostate cancer compared to malignant melanoma is well known. The effects of beta-estradiol or testosterone on the X-irradiation survival of several human cell lines were studied, including: human prostate carcinoma cell lines PC3 and DU145 and human malignant melanoma cell lines A375 and A875. Lines PC3 and DU145 demonstrated 55-61 fmol per 10(6) cells of androgen receptor with no detectable estrogen or progesterone receptor. Cells were irradiated at 120 cGy/min dose rate. There was no detectable toxicity of up to 10(-4) M testosterone or beta-estradiol on PC3 or DU145 cells in the absence of X-irradiation. At plating efficiencies from 11-13%, and plating densities of 1 x 10(4) cells per 60 cm2 flask, cell lines PC3 and DU145 demonstrated a Do of 108.5 +/- 6.5, n 2.1 +/- 0.7 cGy, and Do of 143.5 +/- 1.5 cGy, n 2.4 +/- 0.5, respectively. The addition of testosterone or beta-estradiol at 10(-4) to 10(-10) M prior to or after, X-irradiation did not alter radiosensitivity. At the same dose rate of 120 cGy/min, malignant melanoma cell lines A375 and A875 had a Do of 125 +/- 2.5 cGy, n 1.56 +/- 0.8 SF2 0.65 +/- 0.03 and line A875 demonstrated a Do of 129 +/- 4.5 cGy, n 1.58 +/- 0.4 SF2 0.55 +/- 0.04, respectively. The radiosensitivity of melanoma cell lines did not decrease at low dose rate 5 cGy/min. Thus, the in vitro radiosensitivity of androgen receptor positive prostate cancer cell lines is not necessarily altered by the presence of androgen before or after irradiation. The data support the concept that all malignant melanoma cell lines do not show a broad-shouldered cell survival curve in vitro and intrinsic cellular radioresistance.

Cell Survival↗
PubMed1988

Posterior acrylic surgical fixation of odontoid fractures.

Fourteen cases of odontoid fractures had, as primary treatment, a posterior surgical fixation (C1 + C2 + C3 and occiput in some cases) by means of acrylate and stainless steel wires, without waiting for the unpredictable final results of external systems of stabilization. The youngest patient was 20 years old, the oldest 84 years old. No immediate or late neurological complications occurred (follow-up: one year to ten years). All the patients were mobilized early without external fixation. Union of the dens took place in eleven cases, and good stabilization in the remainder. Thirteen patients recovered, one improved. Posterior acrylic fixation is the treatment of choice in cases of odontoid fracture, particularly in elderly patients in whom a solid union rarely is obtained.

Acrylates↗
PubMed1986

Exercise-induced bilateral anterior tibial compartment syndrome without pain.

We report the case of a 41 year old man who complained of a severe bilateral deficit of the anterior tibial compartment two hours after prolonged exercise. On admission there was no spontaneous or evoked pain, no objective sensory deficit but total loss of dorsiflexion of feet and toes. Electrophysiological investigation showed no voluntary or evoked electrical activity in tibial and extensor digitorum muscles; while peroneus longus and gastrocnemius muscles showed a near-normal pattern. On the other hand a weak motor response was obtained by direct stimulation of the anterior tibial muscle belly. An early bilateral fasciotomy was followed by almost complete recovery of the spontaneous and evoked motor activities of the tibial anterior muscles. On the basis of these findings we discuss the possible pathogenetic role of a neuroapraxic block of the deep peroneal nerve where it crosses the anterior fibular septum and supply a possible interpretation of the absence of pain.

Adult↗
PubMed1985

Acute bilateral epidural hematoma.

A case of acute bilateral epidural hematoma with different onsets is presented. The pathogenesis of the two hematomas is discussed. The importance and the limits of computed tomography scanning in these cases are stressed.

Acute Disease↗
PubMed1985

Calcified lumbar disc protrusion in an adolescent.

The case of an adolescent operated on for a calcified lumbar disc protrusion is reported. The literature reviewed shows the rarity of this condition. Moreover, the comparison of our case with similar ones shows that it is extremely peculiar.

Adolescent↗
PubMed1984

Extra-intracranial arterial bypass in typical carotid reversible ischaemic deficits: long-term follow-up in 100 patients.

The long-term follow-up of 100 consecutive patients who suffered from a reversible ischaemic attack (RIA) in the carotid territory and were submitted to extra-intracranial arterial bypass (EIAB) surgery in seven Italian Neurosurgical Centres is reported. The preoperative angiographic and clinical features, and the surgical complications are reported. The follow-up ranged from two to seven years with a mean of thirty-five months. In this period in the territory served by the bypass only two completed strokes and six RIAs occurred. Four patients died, only one for cerebral ischaemic problems. The results of the present series have been compared with those of the literature: they appeared consistent with other surgical series and clearly better than those of medical treated patients. The EIAB can then be considered a good therapeutic choice for the treatment of RIAs in carotid territory.

Adult↗
PubMed1984

Long-term follow-up in 257 ICA occlusion: comparison between EIAB-treated and untreated patients.

The purpose of this paper is to estimate the real value of the Extra-Intracranial Arterial Bypass (EIAB) in preventing or reducing further and more catastrophic ischaemic events in patients suffering from an Internal Carotid Artery (ICA) occlusion. 257 patients, suffering from ICA occlusion, are considered retrospectively: 122 of them submitted to EIAB and 135 medically treated or untreated. In both groups, homogeneous by sex, age, neurological grading distribution and length of follow-up, the following parameters were considered: the incidence of ischaemic recurrences during the follow-up period; the characters of the recurrences with particular reference to the fatal stroke; the rate of ischaemic events per year. The comparison between the outcome in surgically treated patients and in "untreated" ones indicates that the EIAB can be effective in preventing or reducing the ischaemic recurrences and the frequency of fatal stroke in TIA-, RIND, or stroke-patients suffering from ICA occlusion.

Adult↗