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Biomedical subjects

G Caruso

Publications and source records attributed to G Caruso.

At least 91 records · Page 5Linked to original sources

Supratentorial dorsal cistern epidermoid cyst in childhood.

Epidermoid cysts (ECs) are rare developmental lesions occurring anywhere along the central nervous system. Usually affecting adult patients, the occurrence of supratentorial dorsal cistern ECs has been reported in only 1 certain case of pediatric age. An additional pediatric case is presented. An 11-year-old boy had an 8-year history of petit mal seizures. Neurologic examination on admission was negative. T1-weighted magnetic resonance images demonstrated homogenous, hypointense, intradural, extracerebral, right frontal, precentral, parasagittal mass with relatively high signal intensity on T2-weighted images. The lesion was completely removed using a microneurosurgical technique with special care taken with regard to the adjacent nervous and vascular structures. Histologically, an EC was diagnosed. The patient had no recurrence for 2 years and seizures were significantly reduced. This case suggests the need to include ECs in the differential diagnosis of intradural supratentorial extracerebral lesions in childhood.

Brain Diseases↗

Regional and distant metastases in laryngeal and hypopharyngeal sarcomas.

Cervical node and distant metastases are the most important prognostic factors in malignant laryngeal neoplasms. Owing to the unusual occurrence of laryngeal sarcomas, the prevalence of their metastases has never been analyzed in detail. We reviewed the laryngeal sarcomas reported in the literature and noticed that both regional and distant metastases are rare events and variable for different histotypes. These observations have obvious therapeutic and prognostic implications.

Humans↗

Long-term outcome of migraine therapy: predictive value of the frontotemporal nitroglycerin test.

We evaluated whether type of response to the migraine-induction test with a nitroglycerin ointment applied to the frontotemporal head region could predict the efficacy of antimigraine therapy. Forty-two patients with migraine without aura underwent the test before and 2 months after antimigraine therapy. Two and 4 months after treatment withdrawal, most subjects with a negative response to the post-treatment test maintained treatment benefit, whereas benefit was lost in patients with an early onset migraine response.

Adult↗

Modulation of vesicle shedding in 8701 BC human breast carcinoma cells.

Vesicles, shed in the extracellular medium by several kinds of normal and tumoral cells, are known to play important roles in cell-cell and cell-matrix interactions and to participate in mechanisms by which tumoral cells acquire metastatic capability and evade immune surveillance. Regulation of the shedding phenomenon and molecular mechanisms involved in extracellular vesicle production are not known and are the subject of this investigation. Fetal calf serum stimulated shedding short after its addition and its stimulatory effect was dose dependent. This effect was reduced after gelatin-Sepharose adsorption indicating a possible involvement of gelatinases on its stimulatory effect. This conclusion was confirmed by the inhibitory effect of bathophenanthroline. Shedding of membrane vesicles decreased after treatment with all trans retinoic acid, a molecule known for its capability to induce cell differentiation. Brefeldin A, an inhibitor of intracellular vesicle movements, and methylamine, an inhibitor of exocytosis, did not abolish shedding. Quercetin, an inhibitor of phosphatidyl inositol 4 kinase and 1,4 phosphatidyl inositol 5 kinase, and 8-Cl-cAMP, a site selective cAMP analogous which induces growth inhibition and differentiation, significantly decreased the amount of shed vesicles.

8-Bromo Cyclic Adenosine Monophosphate↗

Microbiological monitoring of Castellammare Gulf (TP) waters for their suitability in marine aquaculture.

A three year investigation into the microbiological conditions of the waters of the Gulf of Castellammare (TP) was carried out in order to evaluate the possible utilization of this area as an aquaculture site. Analysis of a total of 168 samples was aimed at estimating the quantitative distribution of total and fecal coliforms, enterococci and halophilic vibrios. The qualitative distribution of Vibrio species was also studied with particular reference to potentially pathogenic species. Coliforms showed the highest densities (10(2)-10(3) CFU/100 ml) in November 1993 at the coastal stations and mostly negative values during the subsequent samplings; in contrast, halophilic vibrios prevailed in the warm months. V. alginolyticus and V. fluvialis prevailed respectively among the Vibrio population grown at 35 and 24 degrees C, grouped in 13 and in 4 clusters at similarity levels of 81-96%. Quantitative data demonstrate the presence of low levels of microbial contamination, which suggests the general suitability of the area for fish farming.

Aquaculture↗

Association between an aneurysm of the anterior inferior cerebral artery and an arteriovenous malformation fed by the same artery.

An unusual case of distal aneurysm of the anterior inferior cerebellar artery (AICA) associated with a cerebellar arteriovenous malformation in a 35 year-old woman is reported. The clinical presentation was a subarachnoid hemorrhage, that is the sudden onset of headache while she was driving her car. In the following days the patient experienced a cerebellopontine angle syndrome: unsteadiness, tinnitus and hearing loss in her left ear, along with drop episodes. All symptoms disappeared in about a week. She consulted a neurosurgeon only a month later. On the day of admission in the Neurosurgical Department of Résidence du Parc Clinic her neurological status was normal. Neuroradiological investigations showed the association between the two distal AICA malformations. At surgery it was possible either to clip the aneurysm or to remove the AVM. The origin of the hemorrhage has not been clearly identified. The patient had an uneventful recovery and returned to her job three months later. The aneurysm was located on the same artery that supplied the AVM. This association is rare at the AICA level. The possible development of the aneurysm induced by increase in flow through the AVM is discussed in the light of Literature data.

Adult↗

Distribution of Synechococcus sp. and Synechococcus bacillaris in the waters of the Straits of Magellan (April 1995-early austral autumn).

During the last oceanographic cruise carried out in the Straits of Magellan (April 1995), a serological approach was used in order to determine the distribution and composition of the picophytoplankton community with respect to two cyanobacteria species, Synechococcus sp. and bacillaris, characterized respectively by phycoerythrin and phycocyanin as the main accessory photosynthetic pigment. In the period examined, the Straits were characterized by generally low concentrations of total picophytoplankton (10(5)-10(6) cells/l). The qualitative composition of the community showed the prevalence of the species Synechococcus sp. in the Pacific basin, whereas S. bacillaris appears to be predominant in the central area. The immunofluorescence method proved to be effective in the study of the diversity of these microorganisms in aquatic environments.

Antibodies, Bacterial↗

Aneurysms of the supra-aortic trunks in Takayasu's disease. Report of two cases.

Takayasu's arteritis is a chronic inflammatory disease of unknown etiology, which affects the aorta and its branches. The resulting lesions can be of steno-occlusive or aneurysmatic type; the latter form is relatively rare. The authors report 2 cases which came under their observation for treatment. The first was a young man of 22 years with aneurysm of the common right carotid artery and of the subclavian left intrathoracic artery. The carotid aneurysm was operated first; arterial reconstruction was ensured by means of a dacron bypass as the saphenous vein was not usable. Three months later, exeresis of the subclavian aneurysm was performed with a left thoracotomy in the IV space. The postoperative course was uneventful and no untoward event has been observed during follow-up (15 months). The second case was a young girl of 16 years with poststenotic aneurysmatic dilatation of the anonyma artery, tight stenosis of the left renal artery and occlusion of the right renal artery. The patient underwent median sternotomy and removal of the aneurysmatic wall together with the stenosis, and a dacron patch was applied. During preoperative angiography, the stenosis of the left renal artery had been treated with PTA; one month after the first operation, a right aorto-renal bypass was fashioned with the saphenous vein. Postoperative stay was free from complications on both occasions and complete normalization of the pressure values was obtained, which persists after 12 months.

Adolescent↗

Static and dynamic posturography in prevalent laterally directed whiplash injuries.

Static and dynamic posturography was used to study patients who had experienced a prevalent laterally directed whiplash in a car accident. Results of both static and dynamic examinations were recorded. Findings showed that the whiplash injury had provoked shifting of the pressor center of the body toward a side that was at least indicative of the kind of cervical twist experienced, even when not corresponding to the prevalent direction of the trauma incurred.

Adult↗

Liver inflammation and acute respiratory distress syndrome in a patient receiving hepatitis B vaccine: a possible relationship?

We describe a patient in whom clinical evidence of liver and lung dysfunction developed after he received the second dose of recombinant hepatitis B vaccine, despite no serologic evidence of viral hepatitis. However, liver biopsy specimens demonstrated both surface antigens and core antigens, possibly indicating silent hepatitis B virus infection. A search for an infective etiology for the patient's subsequent clinical deterioration in lung function did not yield pathogens: postmortem examination revealed evidence of immune complex-mediated organ injury in the liver, lungs, and kidneys.

Antigen-Antibody Complex↗

Cortico-spinal pathways and inhibitory mechanisms in hepatic encephalopathy.

Transcranial magnetic stimulation of the cerebral cortex was used to study motor system function in 31 cirrhotics (29 post-necrotic and 2 cryptogenic) with and without hepatic encephalopathy (HE). The results were compared with those of 14 healthy subjects matched for age. A significant increase of central motor conduction time, a significant raising of the motor evoked potential (MEP) threshold at rest and a significant reduction of the MEP/muscle action potential (MAP) amplitude ratio were found only in patients with chronic stable (12 patients) and recurrent (9 patients) HE. Vice versa, a significant shortening of the central silent period was observed in all 31 cirrhotic patients. The peripheral silent period was normal in all instances. These results indicate that the damage to the cortico-spinal pathways is related to the progression of cirrhosis to HE, and that cirrhotic patients present a dysfunction of the inhibitory motor mechanisms before HE is clinically manifest.

Adult↗

Broadened Friedreich's ataxia phenotype after gene cloning. Minimal GAA expansion causes late-onset spastic ataxia.

We describe three siblings from an Italian family affected by an autosomal recessive spinocerebellar degeneration. Gait ataxia, presenting between 38 and 45 years, was the first symptom in all three patients. Dysarthria, dysmetria, brisk tendon reflexes, extensor plantar response, and scoliosis were constant features. Disease progression was slow. Electrophysiologic studies demonstrated a slight reduction in sural nerve sensory action potential in only one patient. Analysis of GAA expansion within the X25 gene showed that patients were homozygous for the expansion, with the shorter expanded allele ranging from 120 to 156 triplets. The size of the GAA expansion may be smaller than we previously described. Such minimal expansions may result in atypical forms of Friedreich's ataxia.

Action Potentials↗

Myocardial dysplasia in a 3rd-trimester fetus. An ultrasound and pathologic study.

Arrested myocardial development, often described as spongiosum heart, has been reported in association with obstructive semilunar valve disease and, much more rarely, as a primary disease in adolescents and adults. To our knowledge, this condition has never been diagnosed in utero. We describe the echocardiographic and pathoanatomic findings of the 1st case of myocardial dysplasia detected in utero by ultrasound. A 28-year-old woman, gravida 2, para 1, was referred to our unit at 34 weeks of gestation due to severe fetal hydrops. On echocardiography, we observed gross fetal cardiomegaly (particularly of the septal and ventricular myocardium), an unusually bright myocardial echostructure, thick trabeculations in both ventricular chambers, and severe loss of myocardial contraction. There were normal ventriculoarterial connections and no signs of obstructive semilunar valve disease. After fetal death, necropsy confirmed the presence of spongiosum heart and the diagnosis of myocardial dysplasia--which term best describes this disorder in its various temporal expressions. Because this condition has never before been observed prenatally, no consideration has been given to intrauterine management. We recommend that fetal cardiac function be monitored echocardiographically whenever a pregnant patient has a positive family history of this disease. There is a possibility that the life of the affected fetus might be prolonged beyond the gestational period by avoiding intrauterine cardiac decompensation, through early delivery. We recommend further that the parents of these children be advised of the risks associated with future pregnancies. Little is known about the pattern of inheritance of myocardial dysplasia, but the disorder appears to be familial. Therefore, the possibility that it may recur within the same generation must be taken into account.

Adult↗

[Fetal uropathies: anatomo-pathologic background].

The kidney malformations are complex anatomo-clinical entities that can be described with different classification approaches, based on morphological or etiopathogenetic criteria. The most serious fetal uropathies can be associated with the oligohydramnios sequence, due to insufficient urine escretion, related, for example to bilateral renal agenesis. A second malformation sequence can also be present, the so-called prune belly syndrome, in which an early urethral obstruction can produce abnormal bladder distension and finally renal dysplasia and globous dilation of the abdomen. The anatomo-pathological experience of the last ten years in the Institute of Pathological Anatomy of the University of Bari is based upon 154 cases of congenital uropathies in second trimester fetuses. Almost 80% of these cases presented also other associated anomalies, both chromosomal and non chromosomal syndromic or in casual combination. The possible echographic recognition of these pathologies, together with genetic and anatomopathological studies allow to categorize the fetal uropathies in two groups: the first characterized by an early or late obstruction of the urinary tract, in "sensu strictu" the true obstructive uropathies, and the second, formed by different morphologies all genetically determined.

Female↗

[Double-chamber right ventricle: a case report].

The double-chamber right ventricle is a congenital cardiac malformation usually associated with other cardiac defects, seldom isolated and in adult subject. It is characterized by the presence of an anomalous bundle that divides the right ventricle into two chambers. The clinical and electrocardiographic signs of isolated double-chamber right ventricle are few and not specific. An echocardiographic diagnosis of isolated double-chamber right ventricle is reported. In a 18-year-old asymptomatic male with systolic murmur 2/6 at third space over the left sternal border, right ventricular hypertrophy and intraventricular conduction delay at ECG, two-dimensional echo showed an anomalous transversal muscle bundle that divided the right ventricle into two chambers, superior and inferior. Color Doppler showed a diastolic tricuspidal-like flow through a paraseptal discontinuity of the bundle and a systolic jet that reached the right atrium, with a pressure gradient of 30.9 mmHg. The absence of symptoms and other cardiopathy, without significant right outflow tract obstruction, was considered as an index of a good prognosis; therefore cardiac catheterization was not advised.

Adult↗

[Potential uses of color Doppler in periskeletal soft tissue neoplasms].

Integrated imaging plays a fundamental role in the study of periskeletal soft tissue tumors, for both diagnosis and treatment planning. The steady and progressive technologic progress of color Doppler US equipment now permits the integration of conventional morphostructural parameters with the biofunctional data of lesion flow patterns and relative qualitative features. To assess color Doppler capabilities in differentiating benign from malignant soft tissue tumors, we reviewed the B-mode and color Doppler findings of 43 consecutive patients with a palpable periskeletal soft tissue mass. All patients were examined with a real time unit (Ultramark 9 HDI), with a broadband (5-10 MHz) linear transducer operating at 6.5 MHz for Doppler measurements. The PRF was set at 1500 to 800 Hz with 70% color gain; a 100 Hz wall filter was used. We kept the color box in the area of interest as small as possible to keep the frame rate high; pulsed Doppler studies were performed with a small sample volume and 2000 Hz PRF. The following signs were considered: morphostructural features; the presence/absence of color signals; the (peripheral/internal) site of vascular branches, their caliber and course; the number of afferent vascular poles; resistance index. As a rule, malignant masses tend to differ from benign masses for the presence of multiple vascular afferent branches, especially if they have an irregular pattern and caliber, and for the variability of the resistance index measured in different parts of the same mass. Further examinations, performed with second level imaging (CT and MRI) and microhistologic tests, respectively after biopsy and surgical resection, confirmed the high predictive value of color Doppler US, with only 1 false negative and 2 false positives; color Doppler sensitivity and specificity were 94.7% and 91.6%, respectively, which are higher values than those obtained with US alone (63% and 66.6%). Therefore, we believe that color Doppler US can be systematically applied to the study of periskeletal soft tissue masses, integrating conventional US for the correct selection of the patients to be submitted to second level investigations.

Adolescent↗

Pathological significance of first-trimester fetal nuchal oedema.

The pathological mechanism that causes the transient phenomenon sonographically defined as "nuchal translucency' is still poorly understood. Seven pregnancies in which the fetuses clearly presented this ultrasonic sign at 10-14 weeks' gestation were terminated because of an abnormal fetal karyotype. The pathological specimens, compared by morphometric analysis with normal fetuses of the same gestational age, showed oedema and dilatation of lymphatic capillary vessels. No particular relationship was found with any structural abnormality. We speculate that nuchal oedema is a transient non-specific phenomenon which is probably related to an early disarrangement of lymphatic connections.

Aneuploidy↗