Biomedical subjects

G Caruso

Publications and source records attributed to G Caruso.

At least 181 records · Page 10Linked to original sources

PubMed1990

Patients compliance in an early detection program for upper aero-digestive tract tumours in north-eastern Italy.

An early detection program for tumours of the upper respiratory and digestive tract has been conducted from December, 1988 to May, 1989 in the Friuli Venezia-Giulia region, Northeastern Italy. This region shows very high mortality rates for cancers in these sites. Six hundred seventy-one high risk patients (i e habitual smokers and/or drinkers) were referred to Ear, Nose and Throat (ENT) specialists from 16 General Practitioners (GPs) for a free examination as part of the screening program. Four hundred thirty-six patients underwent the visit (65%) with fifty-five precancerous lesions and eight epithelial tumours detected among them. This program appears to have accomplished its aims of establishing a closer relationship between GPs and ENT specialists, discovering early cancerous and precancerous lesions, and targeting high risk patients with an educational message against smoking and heavy drinking.

Adult↗

PubMed1990

Flavone acetic acid distribution in human malignant tumors.

The pharmacokinetics of flavone acetic acid (FAA) after a dose of 4.8 mg/m2 given i.v. over 1 h was investigated in 13 patients with different solid tumors. The mean volume of distribution and clearance were 52 +/- 4 l/m2 and 2.6 +/- 0.2 l/h x m2, respectively. A tumor or metastasis biopsy was obtained from six patients 2 h after the end of infusion. Tumor FAA levels ranged from 39.6 to 148.8 micrograms/g and were similar to those obtained after a therapeutic i.v. dose of 200 mg/kg FAA in animals bearing Pan/03 tumor, which is very sensitive to the drug. Although FAA tumor concentration could be detected only during one interval and we therefore cannot draw a definitive conclusion, differences in the agent's antitumor activity in mice and patients (i.e. very active in the former and inactive in the latter) are apparently not due to discrepancies in drug distribution and pharmacokinetics.

Adult↗

PubMed1990

The effect of stimulus frequency on spinal and scalp somatosensory evoked potentials to stimulation of nerves in the lower limb.

The effect of variation in the stimulus frequency on spinal and cortical somatosensory evoked potentials (SSEPs) to common peroneal nerve stimulation at the knee (CPN-K) and tibial nerve stimulation at the ankle (TN-A) was studied in 11 healthy subjects. Six stimulus frequencies, 0.7, 1.5, 3.0, 5.0, 7.0 and 10.0 Hz, were used in random order. With increasing stimulus rate spinal responses remained unchanged. By contrast, early cortical responses became significantly reduced in amplitude or undetectable for stimulation frequencies above 3.0 Hz for the CPN-K and 5.0 Hz for the TN-A. In 2 subjects the configuration and the latency of CPN-K SSEPs were affected by stimulus frequency. Similar changes were not observed in TN-A SSEPs.

Adult↗

PubMed1990

Somatosensory evoked potentials and motor cortex stimulation in myelopathies.

Short latency somatosensory evoked potentials (SSEPs) to stimulation of the tibial nerve at the ankle and at the knee and motor action potentials (MAPs) recorded from the tibial muscle during transcranial stimulation of the motor cortex were recorded in 21 patients with myelopathy. The electrophysiological results were compared with the clinical evolution over 12 months. Both scalp SSEPs and MAPs were absent in 10 patients with clinically 'complete cord transection.' The clinical and electrophysiological data remained unchanged in these patients. Scalp SSEPs were present at the first examination in all 11 patients with clinically 'incomplete cord lesion.' All these patients improved in the following year. The clinical recovery was almost complete in 3 patients who had normal scalp SSEPs but varied markedly in 8 patients with abnormal SSEPs. Normal MAPs were obtained in 1 of the 3 patients who showed the best clinical recovery. In the other subjects, MAP findings did not show a clear correlation with either the clinical signs or the course.

Action Potentials↗

PubMed1990

Head and neck cancer and ageing: a retrospective study in 438 patients.

To evaluate whether age over 70 years represents a prognostic factor in head and neck cancer, we reviewed all cases observed between 1981 and 1984. Four hundred and thirty-eight (438) patients were considered in relation to three age groups (less than or equal to 59, 60-69, and greater than or equal to 70 years, defined as non-elderly, mid-elderly and elderly respectively). The main parameters analyzed included histological diagnosis (no difference emerged among the three age groups); anatomical site (hypopharyngeal carcinoma was most frequent in non-elderly patients); TNM stage (an higher incidence of early stages was seen in the elderly); performance status (better in the non-elderly); previous illnesses (life-style related diseases were more frequent in the non-elderly); contraindications to surgery (more frequent in the elderly); surgical treatment ('en bloc' resections were more often employed in the non-elderly); post-operative complications and local control (no difference between the three groups); multiple primary malignancies (head and neck, oesophagus and lung were more frequent in non-elderly patients) and survival (no difference). Although age affects several features of head and neck cancer patients, it does not appear from the present study to be an independent prognostic factor for local control and survival. With regard to survival, stage appeared to be the most important prognostic factor.

Age Factors↗

PubMed1990

Microsurgical anatomy of the cisternal course of the perforating branches of the posterior communicating artery.

Both the perforating branches--especially the extracerebral segments--and the arachnoidal anatomy at the level of the posterior communicating artery were studied in 60 human brains previously fixed in formalin. The close relationships between this artery and the oculomotor nerve are described, and it is noted that each of them is enclosed in its own arachnoidal compartment, which in the case of the posterior communicating artery is to be distinguished from the interpeduncular cistern. The latter cistern was found to contain only the terminal segments of the posterior communicating artery. The hypothalamic branches were within the inner wall of the arachnoidal cistern surrounding the posterior communicating artery. The variations in diameter of this artery are explained by its embryological development and are not related to the number and the diameter of the perforators. The posterior communicating artery was absent at times. The surgical implications of such a variable anatomical arrangement are discussed in the light of the literature.

Brain↗

PubMed1990

Perforating branches of the basilar bifurcation.

The perforating branches of the upper basilar artery and of the first (P1) segment of the posterior cerebral artery were studied in 50 fixed brains obtained from human cadavers. No vertical branches arose from the basilar bifurcation. The upper basilar artery gave rise to horizontal branches, which were studied with reference to their angle of origin. Perforating arteries arising from P1 segments were found in all specimens. Rare branches were found to come from the inferior and anterior surfaces of P1 segments. The anatomical patterns of these branches are discussed in the light of previous reports. Preoperative knowledge of some anatomical aspects (the position of the basilar apex, the angle between the right P1 and left P1 segments, and relationships to the dorsum sellae and the mammillary bodies) can help in the selection of a neurosurgical approach and may improve the operative results in the surgical treatment of basilar apex aneurysms.

Basilar Artery↗

PubMed1990

Takayasu's arteritis: a case report and discussion of differences in eastern and western cases.

The possibility of a different clinical expression of Takayasu arteritis (TA) in different geographic areas has been discussed in previous reports. However, many aspects of this problem still remain unclear. A very atypical case of TA concerning the early onset and the unusually slow progress of the disease is reported. Referring to anatomicopathological, clinical, and therapeutic prognostic criteria reported in literature from oriental countries, many discrepancies appear evident. This is consistent with the hypothesis of two different clinical varieties of TA and suggests that, both in its prepulseless stage and after its actual recognition, this disease could show a less malignant progress in western countries.

Arteries↗

PubMed1990

[Echographic study of cryptorchidism].

The authors, after a nosologic review of cryptorchidism, illustrate their positive diagnostic experience with ultrasound. Limits as well as clinical advantages, in relation to the diagnosis and follow-up, are also described.

Adolescent↗

PubMed1990

[Conjunctival contamination in orthopedic surgery].

Operating theatres expose health workers to close contact with body fluids and thus to the risk of contracting blood-borne infections. The conjunctiva of the eye offers a portal of entry for infection; an abrasive mixture of bone, marrow and blood propelled at high speed by power tools and reamers could damage any epithelial surface. 100 consecutive operations were studied and contaminating particles were counted on the glasses lens. 67% out of 100 times the surgeon's and the assistant's glasses were contaminated. Orthopaedic surgeons work in a high-risk environment and should protect themselves against possible contamination of the conjunctiva by wearing glasses with broad lens.

Conjunctiva↗

PubMed1990

Respiratory function and liver cirrhosis.

Respiratory function was studied in 27 patients with liver cirrhosis and in a control group of 36 subjects. A significant difference in the overall comparison of the cirrhotic patients vs the control group was found only for average values of PEFR and FEF 25% (p less than 0.05); the significant reduction of PEFR was still present in ascitic subgroup. Considering other subgroups created vs control group, a restrictive alteration was observed in patients in Child's class C, with lower albumin levels and in presence of hyperbilirubinemia. An obstructive dysfunction was present in alcoholic cirrhotic patients. A significant decrease (p less than 0.05) of FEF 25-75% and FEF 75% (a specific small airways function index) was observed in patients with esophageal varices vs patients without varices, not related to ascites. The small airway functional alteration seems related to hemodynamic features of portal hypertension.

Aged↗

PubMed1990

[Hydrocephalus and cerebral cysticercosis. A case report. Review of the literature].

A case of intraventricular and cisternal cerebral cysticercosis with no intraparenchymatous involvement is reported. The clinical features were characterized by episodes of blockage of the C.S.F. pathways producing acute hydrocephalus. On three occasions surgical treatment was required: two ventriculoperitoneal shunts and a ventriculocisternostomy were performed. The intraventricular cystic membranes found during the third operation suggested the diagnosis. Epidemiological arguments, the pathogenesis of hydrocephalus and diagnostic and therapeutic aspects are discussed in the light of the literature data.

Animals↗

PubMed1990

Increasing prevalence of gallstones in male veterans with alcoholic cirrhosis.

Cases of alcoholic cirrhosis identified at necropsy were studied for the prevalence and type of gallstones, compared with age- and race-matched autopsy controls. Data were examined from 1970-1977 and 1980-1987. In the early sample of 460 cirrhotic patients, 33% had gallstone disease, contrasted with 12% in the controls. In the 1980s, among 299 patients, 46% had gallstone disease, whereas it was present in 13% of the controls. The prevalence of stones was significantly greater in the patients than in the controls for both time periods and, among the patients, was significantly greater in the 1980s than in the 1970s (p less than 0.05). A comparison of cirrhotic patients with and without gallstones indicated a significantly higher incidence of ascites in the patients with gallstones. The gallstones in cirrhotics were more frequently pigmented than in the controls in both time periods. In 100 living patients with advanced cirrhosis studied by sonography during 1987 and 1989, the prevalence of gallstones was 43%, almost the same as the autopsy sample from 1980-1987. In these cirrhotics, ascites, encephalopathy, and varices were more prevalent in the patients with stones than those without. We conclude that pigmented gallstones are increasing in cirrhosis of the liver related to the severity of the liver disease.

Cholecystectomy↗

PubMed1990

[Micro-anatomy of collateral perforating branches of the middle cerebral artery].

The lenticulostriate arteries are the subject of a microanatomical study on 50 formalin fixed human brains. A single trunk arising from the middle cerebral artery is rarely found. In fact the branches are numerous and they are found to ramify before penetrating the anterior perforated substance. The length of the sphenoidal segment is variable and this aspect is discussed in the light of the literature data. The origin of the perforating branches is spread from the internal carotid artery to the bifurcation branches of the middle cerebral artery (M2 segment). On the other hand lenticulostriate arteries arising from the cortical branches of the middle cerebral artery are often found. These anatomical patterns are of essentially surgical interest. No branches must be damaged during the opening of the Sylvian fissure or during the dissection of an aneurysm in this region.

Cadaver↗

PubMed1989

T staging of the laryngohypopharyngeal carcinoma. A 7-year multidisciplinary experience.

Sixty-six whole-organ sectioned, nonirradiated, laryngopharyngectomy specimens that were removed because of cancer during a 7-year period were uniformly examined to determine the accuracy of perioperative T staging by high-resolution computed tomography (CT) and clinical evaluation (indirect-direct laryngoscopy) by comparing this preoperative staging with the postsurgical pathologic staging. The accuracy of the clinical vs CT staging for laryngeal carcinomas was 58.8% vs 70.6%, whereas the accuracy of the staging by combination of the two modalities was 88.2%. Combined staging modalities showed the same accuracy for laryngeal and hypopharyngeal carcinomas (88.2%), whereas clinical staging accuracy for hypopharyngeal carcinomas was lower (52.9%) and CT accuracy was higher (82.4%) than that observed for laryngeal carcinomas. In the majority of the cases that were staged inaccurately, the error was one of under-estimation: in particular, tumors confined to the mucosa and early infiltration of laryngeal fat spaces were not detected by CT.

Adult↗

PubMed1989

Functional and structural abnormalities in patients with dilated cardiomyopathy.

Passive diastolic properties of the left ventricle were determined in 10 control subjects and 12 patients with dilated cardiomyopathy. Simultaneous left ventricular angiography and high fidelity pressure measurements were performed in all patients. Left ventricular chamber stiffness was calculated from left ventricular pressure-volume and myocardial stiffness from left ventricular stress-strain relations with use of a viscoelastic model. Patients with dilated cardiomyopathy were classified into two groups according to the diastolic constant of myocardial stiffness (beta). Group 1 consisted of seven patients with a normal constant of myocardial stiffness less than or equal to 9.6 (normal range 2.2 to 9.6) and group 2 of 5 patients with a beta greater than 9.6. Structural abnormalities (percent interstitial fibrosis, fibrous content) in patients with dilated cardiomyopathy were assessed by morphometry from right ventricular endomyocardial biopsies. Heart rate was similar in the three groups. Left ventricular end-diastolic pressure was significantly greater in patients with cardiomyopathy (18 mm Hg in group 1 and 22 mm Hg in group 2) than in the control patients (10 mm Hg). Left ventricular ejection fraction was significantly lower in groups 1 (37%) and 2 (36%) than in the control patients (66%). Left ventricular muscle mass index was significantly increased in both groups with cardiomyopathy. The constant of chamber stiffness (beta*) was slightly although not significantly greater in groups 1 and 2 (0.58 and 0.58, respectively) than in the control group (0.35). The constant of myocardial stiffness beta was normal in group 1 (7.0; control group 6.9, p = NS) but was significantly increased in group 2 (23.5). Interstitial fibrosis was 19% in group 1 and 43% (p less than 0.001) in group 2 (normal less than or equal to 10%). There was an exponential relation between both diastolic constant of myocardial stiffness (beta) and interstitial fibrosis (IF) (r = 0.95; p less than 0.001) and beta and fibrous content divided by end-diastolic volume index (r = 0.93; p less than 0.001). It is concluded that myocardial stiffness can be normal in patients with dilated cardiomyopathy despite severely depressed systolic function. Structural alterations of the myocardium with increased amounts of fibrous tissues are probably responsible for the observed changes in passive elastic properties of the myocardium in patients with dilated cardiomyopathy. The constant of myocardial stiffness (beta) helps to identify patients with severe structural alterations (group 2), representing possibly a more advanced stage of the disease.

Adult↗

PubMed1989

Is adipose tissue a normal component of the myocardium?

We performed a histological comparative study between endomyocardial biopsies taken from 138 patients with various cardiac pathologies and from 42 autoptic hearts (all negative for right ventricular dysplasia), measuring the amount of adipose tissue in isolation or associated with fibrous tissue. In the clinical cases these features were present in 24 instances on the right and in one on the left side of the ventricular septum, to an extent of more than 20% of the section in six patients, clinically positive for right ventricular dysplasia. On autoptic biopsy, fibro-adipose tissue was found in seven hearts, with different distribution on both ventricles, but to a maximum amount of 20% of the section. The right side of the ventricular septum was affected in five instances. Therefore in our material there is a quantitative difference on right ventricular biopsy with respect to fibro-adipose tissue in normal hearts and in cases with right ventricular dysplasia.

Adipose Tissue↗

PubMed1989

Sensory (VEP, BAEP, SEP) and motor-evoked potentials, liquoral and magnetic resonance findings in multiple sclerosis.

In order to define the most suitable instrumental protocol for the diagnosis of multiple sclerosis (MS), 41 patients with definite (D = 14), probable (P = 14) and suspected (S = 13) MS were examined with CSF immunology, brain MRI and multimodal evoked potentials. The central motor tracts were also tested. The following alteration rates were found: MRI = 78%, CSF = 63.6%, VEP = 70.0%, median nerve SEP = 50%, peroneal nerve SEP = 68.0%, BAEPs = 35.7%, motor-evoked potentials (MEPs) = 74.0%. Altogether, EPs were abnormal in 90% of cases. Normal MRI with altered EPs were found in 22% of cases, whilst a normal EP battery with defective CSF or MRI findings were found in 7%. Twenty-six out of 27 patients with P or S forms were reclassified into a D one when considering EPs and MRI features.

Adolescent↗