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Biomedical subjects

L Angelini

Publications and source records attributed to L Angelini.

At least 109 records · Page 6Linked to original sources

Focal lesion of the right cingulum: a case report in a child.

A body with a focal lesion of the right cingulum, subjected to cingulectomy for the removal of a tumour, is the first case of an isolated unilateral cingulum lesion to be reported. The presenting symptoms consisted of serious behavioural abnormalities: lack of social restraint, heightened sexuality, bulimia and aggressiveness, all of which ceased after surgery. Neuropsychological tests, done before and after the operation, provided no evidence that the higher cognitive functions, including memory, were impaired.

Astrocytoma↗

Neurological and psychological side effects after stereotactic thalamotomy in patients with cerebral palsy.

We describe the incidence of neurological and psychological side effects after stereotactic thalamotomy in 24 patients with abnormal movements secondary to cerebral palsy. The results of operation are outlined only briefly and, in terms of motor improvement, have been satisfactory. The side effects are categorized as motor or sensory impairments, autonomic disturbances, and mental disturbances. Their frequency and the recovery period are indicated; all of the side effects have been transient. Pathophysiological explanations of these side effects are proposed, correlated with different targets and hemispheric dominance. From our data we can conclude that (a) all side effects after stereotactic thalamotomy are more frequent in patients with cerebral palsy than in other patients and (b) the short time required for the side effects to reverse and their complete remission indicate that they are mainly due to perilesional edema, as suggested by computed tomographic scans.

Adolescent↗

Host resistance in relation to survival in breast cancer.

The degree of lymphocytic infiltration in and around breast tumours together with sinus histiocytosis and follicular hyperplasia in regional lymph nodes has been studied in 310 cases of breast cancer treated with standard radical mastectomy. The presence of these features was regarded as evidence of host resistance against the tumour and made possible the division of patients into three classes-no or poor reaction, good reaction, and strong reaction. The grading was shown to have a close correlation with prognosis. The relationship between host defensive factor grading and malignancy, nodal metastases, and survival was also examined. The results support the hypothesis that prognosis in breast cancer is closely related to a histological picture of cell-mediated immunity against the tumour.

Breast Neoplasms↗

Surgery for benign insulinoma: an international review.

In a multiinstitutional review, data on 396 patients with benign solitary or multiple insulinomas operated on in 15 centers were collected. In these 396 patients, 419 laparotomies (375 primary procedures and 44 reoperations) were performed. The rate of unnecessary laparotomies was 1.7%. Complications occurred after 132 operations (31.5%), requiring 27 reinterventions (6.4%). Ten (2%) patients died within 30 days of surgery. The success rate of first procedures in the centers was 94.9%. After reoperation, all but 2 (99.5%) of these patients were cured. The overall cure rate including those patients who had their primary operations elsewhere was 97.5%.

Adenoma, Islet Cell↗

Primary antiphospholipid syndrome and neurologic events.

The occurrence of lupus anticoagulant and anticardiolipin antibodies was demonstrated in a girl affected by recurrent episodes of visual disturbances, with ophthalmologic evidence of visual impairment and sometimes accompanied by migraine. Systemic lupus erythematosus was excluded on the basis of both clinical and serologic criteria and the diagnosis of primary antiphospholipid syndrome was made. Vascular pathogenesis was suggested by the characteristic symptoms. The serologic demonstration of antiphospholipid antibodies made it possible to relate the illness to an immune-mediated thrombotic tendency. This patient demonstrated that the diagnosis of primary antiphospholipid syndrome must always be considered in focal cerebral or retinal ischemia in childhood.

Antibodies, Anticardiolipin↗

Burst suppression and impairment of neocortical ontogenesis: electroclinical and neuropathologic findings in two infants with early myoclonic encephalopathy.

We report the electroclinical and neuropathologic correlations in 2 children aged 2.5 months affected by early myoclonic encephalopathy characterized by epileptic seizures, erratic myoclonus, and an EEG pattern of burst suppression. Despite different etiologies, the neuropathologic findings showed similar abnormalities in both cases, with no substantial impairment of the myelination processes. Islands of matrix tissue scattered in the periventricular region and neurons aligned marginally in the bulbar olives were detected. The presence of numerous large spiny neurons dispersed in the white matter along the axons of the cortical gyri was the most striking finding. The neurons have been interpreted as abnormally persisting interstitial cells in 2.5-month-old children. These early generated neurons, normally present during neocortical histogenesis, are programmed to die near the end of gestation or soon after birth. The interstitial cells are regarded as a waiting compartment of afferent fibers during cortical development. Their persistence in our patients represents an anatomic condition for cortical disconnection providing a pathophysiologic basis to burst-suppression phenomena.

Brain↗

Subacute cervical myelopathy in a child with cerebral palsy. Secondary to torsion dystonia?

A 12-year-old girl with a spastic dystonic tetraparesis due to cerebral palsy showed a subacute cervical myelopathy. X-ray films of the cervical spine demonstrated a subluxation of C4 on C5. Myelography and computerized tomography of the cervical spine performed under general anesthesia demonstrated only a minimal rotation of C3 with respect to C4 and a rather narrow cervical canal. In the reported case the most important factor in the spinal cord impairment was probably the anterior-slipping of the 4th cervical vertebra. The subluxation, secondary to torsion dystonia as demonstrated by its relief during general anesthesia, very likely caused a long-standing, although intermittent, spinal cord compression.

Cerebral Palsy↗

[Intraoperative echography: the state of the art].

The intraoperative ultrasound (IOUS) is a diagnostic technique, of not recent introduction in the clinical practice, that nevertheless has not yet achieved the capillary and extensive diffusion that would deserve for his elevated sensitivity and specificity in the study of parenchymas (particularly liver and pancreas) as well as in the study alterations of ducts (for example the biliary tree) or of vessels. The authors, in the present article, describes the present uses and the actual diagnostical potentialities of the IOUS in the varied fields of more frequent uses in surgery and particularly in the liver surgery, in the surgery of the common bile duct and in the pancreatic surgery; and in addiction pointing out the possible advantages that the introduction of more recent technologies (for example the color and the power Doppler) n the routine of operating room will bring in the correct surgical management and particularly in oncologic surgery.

Biliary Tract↗

[Randomized prospective study of early removal of drainage in breast cancer surgery].

Axillary seroma is absolutely the most frequent complication of breast cancer surgery. The Authors have accrued 100 consecutive breast cancer patients in a randomized study in order to compare seroma incidence by removing drains on 2nd postoperative day (1st arm) versus 3rd postoperative day (2nd arm); 48 patients were accrued in the first arm and 52 in the second. All patients received a standard axillary dissection. Two suction drains were placed. A compressive medication was applied after surgery. Patients started physiotherapy on the 1st postoperative day. The overall seroma prevalence was 21%. We have 8/48 (16%) seromas in the 1st group and 13/52 (25%) in the 2nd. No significant differences were registered between two arms. Clinical seroma was treated by needle aspiration and medication with a steroid. Conclusions coming out from this study are: 1) early drains removal doesn't increase seroma rate; 2) axillary clearance has to be performed removing en bloc the fatty tissue respecting surgical plains; 3) apply a compressive bandaging; 4) early arm physiotherapy; 5) medication with steroid may reduce the fluid formation.

Breast Neoplasms↗

[Use of abdominal wall retractor Laparo Tenser in gasless laparoscopic cholecystectomy].

High pressure CO2-peritoneum for laparoscopic surgery is not indicated in patients with impairment of cardiorespiratory and renal function and in high risk patients and in obesity. On the other site the uncontrolled abdominal insufflation and the blind insertion of the first trocar in patients with extended intraperitoneal adhesions, often cause bleeding and the intestinal loops dislocation, and can determine visceral lesions. In these patients gasless technique with an abdominal laparolifter can be employed. We report an experience of 36 patients undergoing laparoscopic cholecystectomy by a subcutaneous planar retractor. It was observed a good operative exposure in 83.3%; the surgery was safely performed in 88.8%. Two suprafascial hematoma related to the insertion of the needles of the Laparo Tenser occurred. A regular post-operative discharge was observed in 84.4%. These good results supports the extension of the laparoscopic approach for the cholecystectomy to complicated or to high risk patients.

Abdominal Wall↗

[Periareolar subcutaneous quadrantectomy: a new approach in breast cancer surgery].

Plastic and oncological breast surgery are becoming more and more closer as one surgical treatment. The term "oncoplastic surgery" refers to the use of plastic surgery techniques in breast cancer surgery, in order to avoid and to correct the adverse aesthetic findings. The care of cosmetic sequelae of breast cancer surgery has reached an important therapeutic role for psychological consequences of disease and because of the higher patients expectations of a good aesthetic result. Considering the concept of oncoplastic surgery, since 1999 the Authors began to use a periareloar approach in the breast conserving therapy (BCT), associated to axillary dissection performed through the same periareolar incision. This technique, original from the oncological point of view, is not different from the traditional quadrantectomy in the extension of the glandular resection, while the skin may be preserved in according to the conventional protocols of BCT. Oncological and aesthetic results have proved to be safe and satisfactory.

Adult↗