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Biomedical subjects

L Stella

Publications and source records attributed to L Stella.

At least 73 records · Page 4Linked to original sources

Intracavernous giant fusiform aneurysm of the carotid artery treated with Gianturco coils.

A 30-year-old man with a giant fusiform aneurysm of the intracavernous segment of the right carotid artery, clinically revealed by right painful ophthalmoplegia with exophthalmos, was treated by closure of the carotid artery in the neck with two paediatric Gianturco coils. The aneurysm, which had already shown partial spontaneous intraluminal thrombosis on CT and angiography, was no longer filled and its volume progressively decreased, with almost complete recovery of the oculomotor deficits. Serial CT and angiography performed seven months after treatment demonstrated the reduction in size of the aneurysm, its exclusion from the circulation and a good supply of the intracranial vascular bed, without the necessity of an extracranial-intracranial by-pass.

Adult↗

Arachnoid cyst of the quadrigeminal cistern.

Arachnoid cysts of the quadrigeminal region are rare. We report two new cases. The first is a 29-year-old woman, who had a recurrence five years after sub-total removal of the cyst wall. Initially it was communicating and was treated by a ventriculo-atrial shunt; later it became noncommunicating and direct drainage of the cyst cavity was required. The second was a 25-year-old female, successfully treated by wide removal of the cyst wall thus creating a large communication with the subarachnoid space. Diagnosis of these lesions, as regards either morphological or functional features, nowadays rests largely on CT. Choices about treatment are extremely difficult. The most radical one, namely, complete removal of the capsule, is not without risks and disadvantages. More prudent methods, such as partial removal of the capsule and/or drainage of the cyst and the ventricles, seem on the whole to be preferable, but careful pre- and post-operative evaluation of CSF dynamics are essential for a satisfactory and long-lasting outcome.

Adult↗

In vitro effects of halothane on lymphocytes.

Many reports indicate that anaesthesia affects several immunological functions that decrease the immune response, but the mechanisms involved are still unknown. We investigated the in vitro effect of halothane on human lymphocyte metabolism and plasma membrane function by evaluating the intracellular concentration of 3',5'-cyclic adenosine-monophosphate (cAMP), phosphodiesterase enzyme activity, NAD+/NADH intralymphocytic ratios and the degree of antibody and lectine-induced 'capping' of surface markers. Our results demonstrated an impaired lymphocyte capping of surface immunoglobulins and concanavalin A receptors 60 min after exposure to halothane at the concentration of 1% in oxygen. This phenomenon was reversible after 24 h and it was unrelated to the presence of adherent cells during the culture. Furthermore, halothane was able to induce a persistent increase in cAMP intracellular concentrations, which was reversible within 48 h. This effect was not dependent on adherent cells or on phosphodiesterase enzyme inhibition. Finally, no alteration in NAD+/NADH ratios after halothane exposure was observed.

Cyclic AMP↗

Surgery of the lumbar intervertebral disc. Results of a personal minimal technique.

Surgery of the intervertebral disc, despite its relative simplicity, has a high failure rate at the functional level. There is often severe residual pain which is a real problem because it is so difficult to treat either the symptom or its cause. We report the results of 122 procedures in 100 patients, some of whom had multiple lesions, using a technique (already described in a preliminary paper) consisting of an interlaminar approach modified to provide greater preservations of neural, bony and joint structures. The results were very good, both soon after operation and at later follow-up (between six months and five years). There were no cases of recurrence or pseudo-recurrence, one case of contralateral recurrence (cured by further operation) and a very low incidence of residual backache. These results confirm that, provided the patients have been well selected so that not every patient with lumbar backache is operated on but only those with proven disc lesions, operation does fundamentally influence the quality of the results.

Humans↗

Congenital dermoid cysts at the anterior fontanelle. Report of three cases in Italian children.

The authors report three cases in Italian children of congenital dermoid cyst at the anterior fontanelle. These are the first case reports in Europeans. Their rarity, however, is probably only apparent, since the latest reports in the literature show their wide-spread incidence. The anatomo-clinical and radiological findings and the surgical features of the three cases are described and the main pathological aspects of these cases are briefly discussed.

Child, Preschool↗

Effect of naloxone on the loss of consciousness induced by i.v. anaesthetic agents in man.

The effect of a specific opioid antagonist, naloxone, was studied in two comparable groups of patients who received i.v. the dose of an anaesthetic agent required to produce loss of consciousness in 50% of subjects. The first group received naloxone 0.006 mg kg-1 5 min before induction of anaesthesia; the second group received a similar volume of saline solution. Thiopentone, Althesin, diazepam, ketamine and propanidid were studied. The differences in percentage of unconscious patients between the naloxone-treated group and the control group were statistically significant for diazepam, ketamine and propanidid. Naloxone did not modify the induction of anaesthesia with thiopentone or Althesin.

Adult↗

Effects of naloxone on prolactin, luteinizing hormone, and cortisol responses to surgical stress in humans.

To evaluate the possible involvement of endogenous opioid peptides in the responses of PRL, LH, and cortisol to surgical stress, we have studied the effect of naloxone on these hormones in otherwise normal subjects of both sexes undergoing cholecystectomy for gallstones. In 24 subjects (12 males and 12 females), premedication consisted of atropine sulfate (0.007 mg/kg BW); general anesthesia (30 min later) was induced by thiopental (7 mg/kg) and maintained constant by 1% ethrane in a 70%:30% nitrous oxide-oxygen mixture. In 6 males and 6 females, naloxone (0.4 mg) was injected iv before anesthesia induction. After skin incision, a clear PRL release was observed in all subjects; this was more evident in females than in males. PRL release was significantly lower in naloxone-pretreated subjects. LH release was observed only in males and was significantly higher in naloxone-pretreated subjects. Cortisol release occurred in both sexes in a similar way and was not significantly different in naloxone-pretreated subjects. Cortisol release occurred in both sexes in a similar way and was not significantly different in naloxone-pretreated subjects. These results indicate that endogenous opioid peptides are involved in stress-induced PRL and LH release in humans.

Adult↗

Dorsolumbosacral phlebography.

Two variations on the currently most commonly used technical method for phlebography are described. The first variation involves an original method for visualizing the dorsolumbosacral epidural plexus via the retrograde route from the azygos vein. If necessary this can be associated with catheterization and simultaneous injection into an ascending lumbar vein or into a lateral sacral vein. This method permits exploration from T7 to S1 and provides phlebograms of excellent quality, owing to the reduction in the flow caused by countercurrent injection. The second variation involves visualizing the epidural venous plexus by means of double percutaneous transfemoral catheterization of the hypogastric veins, using balloon catheters. This method is performed easily and rapidly. Preferential flow is obtained via the epidural plexus, and there is less diversion of the contrast medium through anastomoses and less filling of the vena cava. The specific indications for these methods are described. The availability of alternative methods beyond the traditional one renders epidural phlebography more reliable and more manageable, and it ensures certainty of diagnosis.

Azygos Vein↗

The empty sella.

The data from 55 patients with empty sellae seen during the past five years are examined. The clinical and radiological features most helpful in defining and classifying each case are identified. The most frequent and most serious complications and the warning signs useful in diagnosis are discussed. The indications for and the results of surgical treatment are reviewed.

Adolescent↗

Benign intrasellar cysts.

Four cases of benign intrasellar cysts are reported. Three of these were treated surgically. Their origin and typical clinical features are discussed, in particular the altered pituitary function and visual disturbances. Computerized tomography has many advantages over traditional neuroradiological tools in reaching a diagnosis. The indication for active treatment and the surgical techniques and the methods used in the prevention of complications are outlined.

Adult↗

Phlebography of the cavernous and intercavernous sinuses.

The study of pituitary diseases is described, with visualization of the cavernous and intercavernous sinuses accomplished through percutaneous, transfemoral catheterization, using special methods to ensure its reliability. The most characteristic normal and pathological findings are described. The value of this method and the indications for its use in diagnosis are discussed. The possibility of combining morphological investigations with regional functional studies of pituitary hormones by selective blood sampling is suggested. This technical development opens new prospects for the future and further broadens the indications for use of this procedure.

Adenoma↗