[Meningioma associated with malignant glioma and adenocarcinoma of the breast].
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Adenocarcinoma↗
Biomedical subjects
G Caruso
Publications and source records attributed to G Caruso.
Intraoperative recordings of spinal somatosensory evoked potentials to tibial nerve and sural nerve stimulation.
Somatosensory evoked potentials (SSEPs) to stimulation of the tibial nerve at the knee (TN-K) and ankle (TN-A), and the sural nerve at the ankle (SN-A), were recorded from 3 or 4 spinal levels during surgery for scoliosis in 11 neurologically normal subjects. With stimulation of all 3 nerves, the propagation velocity along the spine was nonlinear: it was faster over cauda equina and midthoracic cord than over caudal spinal cord. Over the mid-thoracic cord, TN-K SSEP propagation was faster than that of TN-A and SN-A SSEPs, whereas over the caudal spinal cord these values were similar on stimulation of all 3 nerves. These data suggest that fast conducting second order afferent fiber systems contribute to spinal cord SSEPs evoked by stimulating both mixed and cutaneous peripheral nerves.
Adolescent↗
Anomalies of the P1 segment of the posterior cerebral artery: early bifurcation or duplication, fenestration, common trunk with the superior cerebellar artery.
In a series of anatomical dissections on 100 fixed human brains, 3% of anomalies of the precommunicating segment of the posterior cerebral artery (P1) were found, among which a case of duplication of the P1 segment. This finding is very unusual and it is much rarer than the many other anatomical patterns reported in the circle of Willis. It is to be considered a very early bifurcation, as reported at the middle cerebral artery level. Another two unusual anatomical patterns were found. One was a large fenestration of the P1 segment, which is rather frequent in the vertebrobasilar system. The other was a bilateral common trunk between the posterior cerebral artery and the superior cerebellar artery, which represents a rare anatomical variation. The existence of such "anomalies" can be explained by the embryological development of the region. Their pathogenic and neurosurgical implications are discussed in the light of the literature.
Arteries↗
Extracerebral course of the perforating branches of the anterior communicating artery: microsurgical anatomical study.
Damage to the perforating branches arising from the anterior communicating artery, because of their blood supply to the septal nuclei and anterior hypothalamus, explains the memory impairment and the electrolyte disturbances that often follow the surgery of aneurysms located in this part of the circle of Willis. The microsurgical anatomy of these branches was studied on 60 fixed human brains, with special attention to their number, caliber, and vascular territory. The direction of the branches was evaluated, measuring the angle formed by them with the postcommunicating segment of the anterior cerebral artery. The variability of this anatomical region is discussed in light of the literature.
Cerebral Arteries↗
Esophageal varices and hepato-pulmonary syndrome in liver cirrhosis.
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Esophageal and Gastric Varices↗
Surgical treatment of a rare congenital anomaly of the vertebral artery: case report and review of the literature.
A case of an abnormal loop of the vertebral artery compressing both the cervicomedullary junction and the accessory nerve is reported. The embryological development of the vertebrobasilar system may explain this anatomical anomaly. The possibility of an abnormal location of the vertebral artery may complicate the lateral C1-C2 puncture for myelography. Only five similar cases have been reported previously, but none of them presented any clinical symptomatology, and surgical treatment was never required. The present patient was cured by microvascular decompression. The pathogenetic and surgical implications are discussed in light of the literature.
Accessory Nerve↗
Motor and somatosensory evoked potentials in hereditary spastic paraplegia.
Motor evoked potentials (MEPs) from the arms and legs to transcranial stimulation of the motor cortex and somatosensory evoked potentials (SSEPs) from stimulation of the nerves of the arms and legs, were recorded in 11 patients with hereditary spastic paraplegia. Electrophysiological abnormalities were found to be distributed differently among the systems examined; the longer the pathway, the higher the incidence and severity of impairment. MEPs from the leg were either absent or clearly reduced or prolonged in all patients. Eight patients showed abnormal cortical SSEPs on stimulation of the leg (absent or reduced responses in four, slowed central conduction velocity in seven), but only two of these patients had abnormal MEPs from the arm (absent responses). Cortical SSEPs on stimulation of the median nerve were reduced in two patients. Mean values of amplitude and central conduction velocity for MEPs and SSEPs from the leg were significantly different between patients and controls. Such differences were not found for either MEPs or SSEPs from the arm. This distribution of abnormalities, which suggests a differential involvement of the spinal pathways, parallels the reported pathological pattern in which degeneration of axons is more common and severe in the motor and sensory fibres supplying the leg.
Adolescent↗
Endolaryngeal synovial sarcoma. An update on diagnosis and treatment.
An extremely rare case of synovial sarcoma localized in the larynx is reported together with a review of 6 similar neoplasms previously reported in this unusual region. In this case, the patient is still tumor free 16 years after therapy.
Adult↗
Prenatal diagnosis of craniopagus.
The long-term prognosis of craniopagus, a congenital abnormality of monozygotic twinning, is strictly correlated to the type of shared cerebral structures. Hence, the purpose of prenatal diagnosis is not only to detect this malformation, but also to identify the fused cerebral structures. The authors report a prenatal diagnosis of a craniopagus during the second trimester of pregnancy. Comparison of ultrasound data with the pathological findings underlines that ultrasound is of great value in detecting malformations, but it is not alone sufficient to identify the types of conjoined cerebral structures.
Adult↗
[Association of chronic obstructive bronchitis and upper digestive pathology. A clinical study].
The association of chronic obstructive pulmonary disease (COPD) with esophageal-gastric and duodenal disease is very common. In our experience 21.8% of patients with COPD were affected by peptic ulcer and 50.9% by inflammatory disease of upper digestive tract. This association appears independent from smoking and alcohol abuse. Dyspepsia and corticosteroid therapy were associated with endoscopic lesions (dyspepsia was present in 75.6% of patients with abnormal endoscopy vs 42.8% without endoscopic lesions, p less than 0.01 and corticosteroid therapy in 43.9% vs 0, p less than 0.001). On the contrary therapy with theophylline and beta 2-adrenoceptor-agonists is not associated with digestive disease. Spirometric parameters and blood gas analysis were not different among patients with and without endoscopic lesions. We suggest endoscopy of upper digestive tract in patients affected by COPD with dyspepsia and/or corticosteroid therapy.
Adrenal Cortex Hormones↗
[The structural organization of the human myocardium: the interrelation between myocardial fibers and interstitial connective tissue].
The complex tridimensional structure of the human ventricular myocardium has rarely been studied in the past. In the normal heart, in the lapse of time of few weeks of the embryonic life, a radical transformation from a chaotic plexiform organization to a complex tridimensional structure occurs. From then on, the ulterior growth of the myocardial fibres will only be dimensional and quantitative, because the spatial geometry is to be considered definitive. The role of the interstitial connective tissue in following the development of the myocardium, possibly inducing or influencing it, is still unclear. We have performed an histologic study on serial sections of the ventricular mass of 7 human embryos and fetuses, from 5 to 20 weeks of gestational age. The sections have been evaluated for their morphologic characteristics as evidentiated by histochemical (PAS, trichrome, Gomori silver technique) and immunohistochemical (myosin, actin, desmin, myoglobin, vimentin, fibronectin, smooth muscle cell, endothelial factor VIII) stainings. The results show that myocardial growth is mantellar, proceeding from the epicardium toward the endocardium, with progressive structural organization in strata, variably related one to the other depending upon the considered site of the ventricular mass. The interstitium grows in parallel to the myocardial growth, beginning with a thin network surrounding each fibre that progressively in time is transformed in a complexly arranged and more densely packed structure. The collagen fibres appear initially at epicardial level, particularly around the coronary vessels.(ABSTRACT TRUNCATED AT 250 WORDS)
Connective Tissue↗
[The vascular aging process: the potentials of intravascular echography].
Intravascular ultrasonography is a new diagnostic technique, based on the utilization of very small ultrasonic transducers, with high emission frequency (20-30 MHz) that can be introduced in cardiac cavities as well as in arterial vessels. Because of its technological characteristics this technique has a great potential for the evaluation of the morphological and functional alterations usually involving the arterial wall as a consequence of ageing. Intimal thickening, medial intimalization, reduced systolic-diastolic excursion of the vessel walls affected by ageing as well as by arterial diseases can be easily identified.
Aging↗
Pyridoxine neuropathy. A four-year electrophysiological and clinical follow-up of a severe case.
In a 54-year-old male a severe sensory neuropathy was observed during treatment for pulmonary tuberculosis with isoniazid (400 mg/day) and pyridoxine (600 mg/day). Eight months after withdrawal from isoniazid the sensory symptomatology was still progressing, although muscle strength was never reduced. A sural nerve biopsy revealed marked loss of large myelinated fibres. Only when pyridoxine treatment was interrupted did a slow improvement begin. A clinical and electrophysiologic follow-up showed a very slow and still incomplete recovery after four years. The possibility of an unusual individual susceptibility to toxic effects of pyridoxine is considered.
Electrophysiology↗
Ultrasonic and postnatal findings in left visceral isomerism.
Sonographic and postmortem findings of left visceral isomerism associated with polysplenia are reviewed. Particular stress is given to pathologic data, which could prospectively suggest some specific ultrasonic features in order to characterize this complex syndrome.
Abnormalities, Multiple↗
Ovarian varicocele: ultrasonic and phlebographic evaluation.
The aim of this work is to suggest a new diagnostic approach to the "female varicocele syndrome" which utilizes transvaginal ultrasonography. The presence of circular or linear anechogenic structures with a diameter greater than 5 mm, which were found in transverse and oblique sections of the lateral fornices, was indicative of pelvic varices. The vascular nature of these structures was confirmed with the Valsalva's maneuver and in the upright position. The presence of "pelvic varices" was confirmed by retrograde phlebography of the left ovarian vein in 46% of the cases. In such cases the parity was greater than in subjects without "pelvic varices" (chi square = 12.75, p less than 0.001), and the principal symptoms were characterized by pelvic pains and menstrual cycle disorders.
Adolescent↗
Electrophysiological and histological follow-up study in 15 Friedreich's ataxia patients.
A clinical and electrophysiological follow-up was carried out for 3 to 7 years on 15 patients with Friedreich's ataxia (FA). Sural nerve biopsy was performed once in all patients, and a second time 6-7 years later in three of them. Clinical worsening and progression of disturbance were evaluated according to IAP and IACR scales. Sensory orthodromic conduction along median and tibial nerves was typical of FA and did not change between first and last examinations, nor were there morphological changes between the first and the second sural nerve biopsies. Peripheral nerve involvement is thought to be a result of defective development of the largest neurons and to remain stable from a very early stage of the disease; the clinical worsening may then be due to a progressive involvement of the pyramidal tracts and the cerebellar pathways.
Adolescent↗
Robinow's syndrome: prenatal diagnosis.
The prenatal diagnosis of Robinow's syndrome was accomplished in our case by measuring the length of the long bones and the ulna/humerus ratio. Although the prenatal sonographic appearance did not show the typical 8-week fetal face, pathological findings confirmed this particular feature. In view of the strongly suggestive family history, the authors consider the possible mechanisms of genetic inheritance.
Adult↗
Genetic data and natural history of Friedreich's disease: a study of 80 Italian patients.
The clinical and genetic features of 80 patients with Friedreich's disease from 64 families are described. Diagnostic criteria were: no evidence of dominant inheritance, onset by the age of 20 years, progressive unremitting ataxia of limbs and gait, and absence of knee and ankle jerks. Furthermore, at least one of the following accessory signs was present: dysarthria, extensor plantar response and echocardiographic evidence of hypertrophic cardiomyopathy. Two peaks of onset age were evident at 6-9 and 12-15 years. Analysis of intra-family variation of onset age and absence of clustering of cardiomyopathy and diabetes did not suggest genetic heterogeneity. Peripheral nerve impairment was an early finding and showed slight further progression, whereas involvement of the cerebellar and corticospinal pathways appeared later and mainly accounted for the progressive worsening of the disease.
Adolescent↗