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Biomedical subjects

P Bassi

Publications and source records attributed to P Bassi.

At least 55 records · Page 3Linked to original sources
PubMed1991

Warning signs in subarachnoid hemorrhage: a cooperative study.

The present study is part of a survey of subarachnoid hemorrhage cases observed in 16 neurosurgical and 8 neurological departments in Italy between June 1985 and June 1986. Warning signs preceding major hemorrhage were analyzed in 364 patients with intracranial aneurysms confirmed by angiography and reliable clinical history. Seventy-four (20.3%) had warning signs. Clinical features of premonitory warning signs were compared with symptoms of 78 patients without a history of minor leak and clinical grade 1 (according to the criteria of Hunt & Hess) at admission. Symptoms of warning signs are generally clear enough to be considered a misdiagnosis of intracranial aneurysm. Thunderclap headache described as severe, unusual and sudden was the main symptom in every case though the higher frequency of focal of diffuse signs in groups with a correct diagnosis attracted more careful attention in referral and diagnostic-therapeutic management. Improving the identification of minor leak and defining diagnostic strategy are discussed.

Adult↗
PubMed1991

Inverted papilloma of the renal pelvis.

The authors describe a rare case of inverted papilloma of the renal pelvis. A pathological, clinical and epidemiological review of this lesion is given. Up-to-date diagnostic work-up is outlined.

Humans↗
PubMed1990

MR cisternography of the cerebello-pontine angle and internal auditory canal in diagnosis of intracanalicular acoustic neuroma.

One hundred and fifteen patients, suffering from sensorineural hearing loss were tested with a 1.5 T superconducting magnet. The authors describe utility of both T1-weighted multiple slice and T2-weighted multiple echo images for the evaluation of cerebello-pontine angle, internal auditory canal and their neurovascular content. In seventy-three cases MR cisternography was normal. The remaining forty-two cases were subdivided into twenty extracanalicular masses, eleven small intra-extracanalicular and nine purely intracanalicular lesions. All the lesions were histologically proven acoustic neuromas, except one intracanalicular mass which was a meningioma. Examination was inconclusive only in two cases and decision was then made to follow the clinical course. Advantages of MR cisternography over CT and air CT cisternography, such as absence of ionizing radiation and contrast material, easy multiplanar evaluation of the region of interest and the possibility to delineate both the cisternal and canalar extremities of the tumor mass are pointed out.

Adult↗
PubMed1990

Incidence of antibodies blocking thyrotropin effect in vitro in patients with euthyroid or hypothyroid autoimmune thyroiditis.

Autoantibodies blocking the TSH-dependent production of cAMP in thyroid cells (TSH-BAb) have been described in atrophic thyroiditis (AT; idiopathic myxedema) and in neonates with transient hypothyroidism, but their incidence in autoimmune thyroiditis in relation to thyroid status remains to be completely established. To this purpose TSH-BAb were evaluated in a group of 140 consecutive patients with autoimmune thyroiditis, which included 26 cases of AT and 114 subjects with goitrous Hashimoto's thyroiditis (HT); among the goitrous group 27 were euthyroid (HT-E), 32 had subclinical hypothyroidism (HT-SH), and 55 had clinical hypothyroidism (HT-H). TSH-BAb were measured in immunoglobulin G prepared by DEAE-Sephadex A-50 by determining their ability to inhibit TSH-dependent cAMP production in a differentiated strain of cultured rat thyroid cells (FRTL-5). Using this sensitive and reproducible method, TSH-BAb were detected in 12 of 26 (46%) patients with AT, in 1 of 27 (3.7%) subjects with HT-E, in 3 of 32 (9.4%) with HT-SH, and in 20 of 55 (36%) with HT-H. The prevalence of TSH-BAb was higher in AT vs. HT-H (P less than 0.001), HT-SH (P less than 0.001), or HT-E (P less than 0.001), and in HT-H vs. HT-SH (P less than 0.001) or HT-E (P less than 0.001). Mean TSH-BAb levels in AT were higher than those in HT-H (P less than 0.005) and HT-SH (P less than 0.025); the difference was not significant between HT-H and HT-SH. An inverse correlation was found between TSH-BAb levels and estimated goiter weight (P less than 0.005). The results of the present study indicate that 1) in autoimmune thyroiditis TSH-BAb are detectable almost exclusively in hypothyroid patients, their prevalence being higher in overt hypothyroidism than in subclinical thyroid failure; 2) the prevalence of TSH-BAb and their mean levels are higher in hypothyroid patients with AT than in those with HT; and 3) therefore, the presence of circulating TSH-BAb appears to be related to the development of hypothyroidism and thyroid atrophy.

Adult↗
PubMed1990

Combination therapy with platinum and etoposide of brain metastases from breast carcinoma.

Twenty-two consecutive patients with brain metastases from breast carcinoma were treated with a combination of platinum (100 mg/m2 day 1) and etoposide (100 mg/m2 days 4, 6, 8) every three weeks. Five (23%) achieved a complete response (CR) while 7 (32%) obtained a partial response (PR) for an overall response rate of 55%. The 95% confidence interval for combined CR and PR was 34-76%. Five patients received brain irradiation after reaching the maximum degree of objective remission by chemotherapy. Median duration of combined CR plus PR was 40 weeks (12+; 152). Median duration of survival was 58 weeks (2; 208+). Fifty-five percent of the patients were alive at one year. Our study demonstrates that this combination treatment is highly effective in the management of brain metastases from breast carcinoma.

Adult↗
PubMed1990

[Endo-urology in diseases of the upper urinary tract other than tumors and calculi].

Thirty-three patients underwent percutaneous treatment for upper urinary obstructive disease in our Institute. Cold-knife incision of 16 cases of uretero-pelvic junction obstruction and 4 cases of infundibular stenosis was performed. Balloon dilatation of the caliceal neck was performed in 1 patient with caliceal diverticulum. In 4 of the patients treatment failed requiring open surgical correction. Thirteen patients presented iatrogenic ureteral obstruction: balloon dilatations or cold-knife incisions were performed. Four of the 9 patients evaluable obtained significant benefit from the endourological treatment. Endopyelotomies for UPJ obstruction seem effective and reduce morbidity and operating times. Ureteral obstructions appear less responsive to the endo-urological approach. Definitive conclusions concerning the effectiveness of these procedures requires larger series of patients and longer follow-up.

Adolescent↗
PubMed1989

Acquired intravesical ureteral diverticulum: an unusual late complication of ureteroneocystostomy.

An unusual case of late ureteral obstruction following a Politano-Leadbetter ureteroneocystostomy performed 11 years previously is reported. Fibrosis of the distal ureter associated with vascular compression of the extravesical ureter presumably led to development of a ureteral intramural diverticulum. This case illustrates the necessity of careful ureteral placement and emphasizes the importance of close followup for many years, even in asymptomatic patients.

Adult↗
PubMed1989

[Long-term results of the surgical treatment of diaphyseal double fractures of the forearm in adults with plate or intramedullary nailing].

In this study the authors find that in the fractures of the forearm in the adults, osteosynthesis with tubular plates and compression, where is possible, is to prefer as the intramedullary nailing. Plates give a better reduction and immobilization of the fractures and allow a quickly healing, but they request a finest surgical technique than the intramedullary nailing. Our review is of 44 bifocal fractures of the forearm in adult over 127 cases that we have treated in the Orthopaedic Department of the University of Florence. Our follow-up ranged between 12 and 1 year. Eleven have been operated with Kirschner pins and 2 with Rush nailing with excellent results in 54%, and 31 with AO plates with good and excellent results in 80%.

Adolescent↗
PubMed1989

[The optic pathways: a magnetic resonance study at 1.5 tesla. I. Anatomy].

The authors retrospectively examined one hundred and twenty-nine patients who had undergone MR examination of the sellar, parasellar and orbital regions, to evaluate MR capabilities in demonstrating the optic pathways and their relationship to the most important anatomical structures nearby. T1-weighted images allowed a very good evaluation not only of the optic pathways as a whole, but also of the intracanalicular and intracranial segments of the optic nerve; the optic tracts and geniculate bodies were also clearly demonstrated. Optic radiations were clearly visible on both T1- and T2-weighted images. The orbital portion of the optic nerve could be evaluated with T1-weighted images, which showed its external profile. However, only multi-echo T2-weighted images allowed the nerve to be differentiated from perineural spaces, filled with cerebrospinal fluid, thus giving a true cisternographic effect.

Geniculate Bodies↗
PubMed1988

Obstruction or no obstruction.

The authors review critically such parameters as symptomatology, post-micturition residual urine, bladder trabeculation and uroflowmetry that in the actual state of the art appear more accredited in the evaluation of lower urinary tract obstruction. All have some interpretative limits. However, uroflowmetry appears to be the most reliable and for this reason it is the first step in the study of suspected infravesical obstruction. It can discover equivocal situations in which pressure-flow studies only supply diagnostic help in order to avoid false diagnosis of infravesical obstruction and useless therapeutic approaches.

Diagnosis, Differential↗
PubMed1988

Measurement of TSAb directly in serum using FRTL-5 cells.

FRTL-5 cells were shown to be suitable for the measurement of thyroid stimulating antibody (TSAb) present in sera of patients with Graves' disease. Current methods for the assay of TSAb require the separation of immunoglobulin G (IgG) from patient sera. In this report the possibility to measure TSAb directly on serum was evaluated using FRTL-5 cells. To this purpose cells were seeded in 96-well plates and cultured for 4 days in medium deprived of TSH. Using this system bovine TSH was able to produce a significant stimulation of cAMP production at 1 microU/ml. Whole normal serum completely inhibited the stimulation of TSH as well as that of TSAb, while diluted serum was devoid of any effect. Heat inactivated sera and IgGs, prepared by DEAE Sephadex separation, were diluted in hypotonic medium and incubated with cells for 1 h at 37 C. After incubation cAMP was measured in the assay medium by RIA. In some experiments the effects of graded dilutions of sera and IgGs with known TSAb activity were compared. Sera as well as IgGs increased the cAMP production, but, at the highest concentrations, an inhibitory effect was evident. For this reason sera were tested after appropriate dilution. Thirteen/27 (48%) sera and 22/27 (81%) IgGs from patients with Graves' disease were TSAb positive. The effect of Graves' sera on adenylate cyclase stimulation was completely inhibited by an anti-human IgG. The results of stimulation produced by Graves' sera and IgGs were highly correlated (r = 0.97, p less than 0.001). In conclusion it is possible to measure TSAb directly in serum using FRTL-5 cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Therapeutical aspects of intrarenal artery aneurysms.

The relative infrequency of aneurysms of the branches of the renal artery produces some indecision as to the surgeon's therapeutical choice. The purpose of this study is to carefully examine the indications for surgical treatment and to select precise therapeutical criteria on the basis of 8 patients in whom aneurysms of the main renal artery or of its branches were diagnosed from 1978 to 1986. In 1 patient, the disease was bilateral with a ruptured main artery aneurysm. 5 aneurysms were treated surgically (the ruptured one by nephrectomy, 2 by ex situ revascularization and 2 by in situ revascularization). In the remaining cases, only periodical controls were performed. In 4 surgically treated patients, angiographic follow-up demonstrated a regular renal revascularization and in 1 patient a thrombosis on the site of the anastomosis. On the basis of personal experience, surgical treatment is required for aneurysms larger than 1.5 cm in size without or with partial calcification, aneurysms occurring in pregnant women or in patients likely to conceive in the future, expanding aneurysms, and renin-mediated hypertension. The introduction of microsurgical techniques and renal preservation makes it possible for the urologist to chose between various therapeutical means for the treatment of intrarenal aneurysms. Reconstruction of anatomical continuity of the arterial supply avoiding unnecessary operative demolishment is feasible.

Aneurysm↗
PubMed1988

Bilateral single ectopic ureter.

A case of successfully treated bilateral single ectopic ureter with a follow-up of 13 years is reported. The genesis of the incompetence of the vesical sphincter and its treatment are discussed.

Choristoma↗
PubMed1988

Prognosis of bladder cancer. III. The value of radical cystectomy in the management of invasive bladder cancer.

From January 1979 to June 1982, 141 consecutive patients with bladder transitional cell carcinoma were treated with a single stage lymphadenectomy plus radical cystectomy. The survival rate observed in our patients, based on the TNM classification, was comparable with that reported for other groups employing contemporary surgery. Survivorship for patients with deep invasive tumors was also estimated by breaking down the pT3 stage, and patients with tumor confined to the bladder wall (pT3a) were separately evaluated from those with tumor extended outside (pT3b). The results obtained with this subdivision showed that pT3a patients have almost the same survival rate as pT2 patients. From these results it is concluded that radical cystectomy is a satisfactory curative treatment of bladder cancer confined to the bladder wall, whatever the extension of the muscular involvement. Such considerations suggest that, in order to achieve a more objective analysis of the results after radical cystectomy for invasive bladder cancer, a modification of clinical staging is necessary. Moreover, a simplification of the classification methods should provide a better identification of the elements required to assess the prognosis and to improve treatment planning.

Adult↗
PubMed1988

[Dissection of the internal carotid artery. Personal case reports and a review of the literature].

The clinical and angiographic features of 20 patients affected by internal carotid artery dissection are reported. In one patient the neurological signs were related to a traumatic event, in two cases the symptoms presented after hyperextension of the neck during athletic events, while their onset was apparently spontaneous in the remaining 17 patients. Plain CT was normal in 14 cases and positive for ischemic necrosis in 6 patients. Angiography demonstrated extensive/segmental stenosis of the internal carotid lumen in 12 cases (60%), pseudoaneurysmal dilatation in 3 cases (15%), and complete carotid occlusion in 5 patients (25%). The "double lumen" feature was seen in 3 cases at the origin of the dissection. One patient died, surgical ligature of the internal carotid artery was performed in two cases, while the other patients received medical treatment with platelet inhibitors, except for the young patient affected by post-traumatic artery dissection. Complete recovery was observed in 82% of the patients. Follow-up angiograms demonstrated normal recanalization of the internal carotid artery in 4 out of 6 patients; one of them had two false aneurysms which following angiograms demonstrated to be completely resolved. Regression of stenosis was observed in 6 of the remaining patients by Doppler US. On the whole, the recanalization of the internal carotid artery was observed in 59% of cases. Angiographic findings seemed not to play a decisive role in the prognosis of carotid dissections, which largely depends on the overall patient's condition and on the presence/absence of ischemic cerebral damages.

Adolescent↗