Biomedical subjects
Publications and source records attributed to G Bolla.
The Authors describe a case of gastrointestinal bleeding from a Meckel's diverticulum due to acid production by the heterotopic gastric mucosa and a case of bowel obstruction for the presence of a Meckel's diverticulitis. Diagnostic difficulties and choices of surgical therapy are then discussed.
The Authors describe a very rare congenital case of bronchogenic subcutaneous cyst of the scapular region occurring in a 8-year-old girl. Only 8 other cases have been published so far. The cyst was asymptomatic and was surgically removed. It measured 2.3 cm. in diameter. Histologically, the cyst was lined by ciliated columnar pseudostratified epithelium devoid of goblet cells and mucus secreting cells. The epithelium lacked immunoreactivity for estrogen and progesterone receptors. The cyst wall contained smooth muscle bundles, but cartilage was absent. Differential diagnosis with emphasis on cutaneous ciliated cyst (Mullerian cyst) is discussed. It appears conceivable that cutaneous ciliated bronchogenic cysts may show partial or fully developed features indicating their bronchial origin.
The Authors report a 10-years-old boy who was diagnosed as having upper esophageal stenosis. Biopsies of the stricture showed heterotopic gastric mucosa; endoscopic treatment was safe and effective.
The authors describe a case of duodenal perforated ulcer in a 3 day old, 4.080 Kg term female infant who was apparently well. Stress ulceration with duodenal or gastric perforation may be encountered in the first year of life, usually as a complication superimposed upon a serious illness for which the infant is receiving intensive therapy. The mortality of 40% in this patients, implies that effective preventive and therapeutic measures are not yet available and also emphasizes the serious nature of the underlying disorder.
Lichen sclerosus et atrophicus is main cause of phimosis in pediatric age and require surgical therapy. This one, characterized by partial circumcision followed by topical treatment with steroids, is safe and effective.
The Authors describe a case of chest wall hamartoma, very rare in infants and usually present at birth. This lesion, histologically, is benign. Surgical ablation is mandatory and curative, but the ablation of the tumor and the reconstruction of the large residual parietal defect are sometimes very difficult. In this case the surgical treatment was successful and the reconstruction of the thoracic cage was obtained with a particular surgical technique.
The authors introduce the case of a seven-years-old patient suffering from a tumor of the Leydig cells testicle, which is a pathological entity rare to be found during pediatric age. The clinical history is characterised by the absence of any endocrine phenomena, such as precocious pseudopuberty, which are usually linked to the presence of a "Leydigoma". Surgical therapy, in connection with the described constant evolution that favours such lesions during pediatric age, with the absence of any cellular anomaly which is typical of a malignant case and lastly, with the clear delimitation of the tumor from the healthy testicular parenchyma, has so far restricted itself to the enucleation alone, without orchiectomy.
Particular difficulties arise when trying to classify mediastinal fibrosis and determining its etiology and clinical evolution. In this paper, the Authors describe a case of mediastinal fibrosis which was characterized by a specific clinical origins (mild fever-anemia). It was not possible to establish the real etiology of the mediastinal lesion which in the end led to an unfavourable outcome that was linked to the local development of the illness, in spite of its benign histological characteristics.
The malignant rhabdoid tumor of the kidney determines clinical and prognostic evaluations due to the poor therapeutic answer and to the uncertain prognosis. The Authors describe a case of nephroblastoma with anaplasia of the blastemal elements associated to rhabdomyosarcoma areas.
Paraesophageal inflammatory pseudotumor is the cause of anaemia and intermittent fever. The surgical treatment determines a rapid and complete clinical resolution.
The Authors report two cases of mandibulofacial dysostosis: a three-months-old girl who presented with palpebral fissures in an antimongoloid direction, cleft palate, coloboma of the lower lid, hypoplasia of the malar bones and mandible, malformation of the external ears, two clefts between the mouth and left ear, minimal naso-frontal angle and a one-month-old boy who presented with similar structural deformities. These features can be considered characteristic of mandibulofacial dysostosis, whose most common finding is the presence of bilateral signs.
Inflammatory pseudotumor involving the common bile duct, is a very rare event. The Authors were able to observe such a case in a 10 year old boy and report here the peculiar clinical findings.
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We report the first case of probable protein-losing enteropathy revealing a cytomegalovirus/Yersinia enterolytica infection at the onset of a chronic lymphocytic leukaemia. Severe hypoprotidaemia, digestive tract yersiniosis, ulcerative and microgranulomatous enteritis with a large number of cytomegalic inclusions in mucosal cells, and incipient lymphoid proliferation were the most characteristic findings.
OBJECTIVES: Diagnosis of polymyalgia rheumatica requires the elimination of other inflammatory diseases due to the lack of a specific diagnostic criteria. Since results of muscle biopsy have been considered non-specific, we evaluated the full spectrum of histological, histochemical and biochemical data observed in 24 patients with suspected polymyalgia rheumatica. METHODS: From January 1989, the diagnosis of polymyalgia rheumatica was suspected in 24 patients (4 males, 20 females; mean age 67.8 years, range 50-88) hospitalized in our unit for inflammatory joint and muscle pain with a current duration of 6-30 months. Muscle biopsies were obtained in each case. RESULTS: Based on the histological, histo-enzymatic, ultrastructural and biochemical analyses, 19 patients fulfilled the criteria defining mitochondrial myopathies. After favourable outcome (reduced pain, involution of biochemical inflammatory syndrome) following prednisone therapy (0.5 mg/kg/day) a second muscle biopsy revealed identical abnormalities. CONCLUSION: These muscular diseases have been described mainly as hereditary encephalo-myopathies, but in our series the mitochondrial myopathy may have preceded the polymyalgia rheumatica or been acquired, aggravating the inflammatory process. Muscle biopsy might act as a referee for diagnosis.
The Authors describe a case of renal agenesis with ipsilateral ovarian dysplasia. The clinical features are abdominal mass and pain and then the treatment is laparoscopic ablation.