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Biomedical subjects

R Bergamaschi

Publications and source records attributed to R Bergamaschi.

189 records · Page 11Linked to original sources

Synovial hemangioma. Description of a case.

Intra-articular angioma, or vascular hamartoma, is a tumor-like lesion essentially made up of anomalous blood vessels localized in the joint capsule, in the synovial membrane, or in both structures. There are two anatomical varieties: one circumscribed localized and one extended. There seems to be predilection for the female sex, and age of onset ranges from birth to 20-30 years of age; it occurs more frequently in the knee, less in the elbow, in the wrist and in the ankle. Symptoms, which often begin after local trauma, include joint swelling and pain, both characterized by discontinuity and long duration. Sometimes there is an increase in swelling, repeated episodes of hemarthrosis (or hydrarthrosis), forced position and functional limitation of the joint, increase in skin temperature. Final diagnosis can only be obtained with histological examination, although MRI may be useful and arteriography clearly reveals it, if the harmatoma is extended enough and communicating with the circulation. Histological examination carried out on fragments of tissue taken in loco reveals a labyrinthine agglomerate of fissures and lengthening cavities, with walls that are generally thick and of a venous-like anomalous type. The course of the disease is slow, with periods of remission of local symptoms of varying duration. Treatment is surgical and it consists in complete removal when possible of the angiomas. The results, particularly in the localized form, are satisfactory; recurrence is infrequent and it is generally due to incomplete excision of the neoformation.

Hemangioma↗

Reliability and upper normal variability limits of pattern reversal visual evoked potential parameters.

Twenty healthy volunteers aged 21-48 years (10 males, 10 females) were submitted to pattern reversal visual evoked potentials with 15' and 30' checks. The recordings were repeated after 7 days to assess reliability and upper normal variability limits of the following parameters: latencies of N70, P100, N140 and peak-to peak amplitudes of N70-P100, P100-N140. Reliability was tested with intraclass correlation coefficient, which was excellent or good for all parameters. Test-retest variability limits were computed with = 0.01 for absolute latency differences and relative amplitude differences.

Adult↗

Spondyloepiphyseal dysplasia tarda: description of one case.

The authors describe the case of an Italian male aged 19 years who came to their observation for severe limping with reduction in hip movement and spondyloepiphyseal radiographic modifications of an osteochondrodysplastic origin. The studies carried out led to a diagnosis of spondyloepiphyseal dysplasia tarda (SEDT).

Adult↗

Pancreatogastrostomy following pancreatoduodenectomy: a safe drainage procedure.

The propensity for leakage and disruption at the site of the pancreatojejunostomy is a major reason for morbidity and death after pancreatoduodenal resection. The purpose of this study was to evaluate the safety of pancreatogastrostomy as an alternative method of restoring pancreatointestinal continuity. From January 1989 to June 1991, 32 patients (28 with malignant tumors and 4 with chronic pancreatitis) underwent pancreatogastrostomy following pancreatoduodenectomy. There were two postoperative deaths (6.2%) one of which could in part have been due to the anastomotic technique, too tight with postoperative pancreatitis as a result. There was one pancreatic fistula (3%) which recovered with further surgery. That pancreatogastrostomy is safe is well documented in the literature. That it is safer than the conventional anastomosis or provides a better functional result is still to be proved.

Anastomosis, Surgical↗

Ataxia-telangiectasia: MR and CT findings.

OBJECTIVE: The aim of our study was to describe the neuroradiologic features of 12 patients with ataxia-telangiectasia (A-T), a degenerative multisystemic autosomal recessive hereditary disorder with onset in childhood. Clinical features include cerebellar ataxia, oculocutaneous telangiectasias, and recurrent bronchopulmonary infections. Patients present varying states of immunodeficiency and a high incidence of neoplasms. Chromosomal instability with a rearrangement of chromosomes 7 and 14 is always present. MATERIALS AND METHODS: We describe the neuroradiological findings (10 MR and 2 CT) in 12 subjects: 11 with A-T and 1 heterozygote parent. RESULTS: The images revealed a diffuse cerebellar atrophy, with marked involvement of the vermis and unusual decreased thickness of the superior cortex of the cerebellar hemispheres. Hypoplasia of the inferior vermis and a large cisterna magna were also frequent signs. CONCLUSION: Magnetic resonance is the technique of choice in this type of disorder since it permits better visualization of the posterior fossa structures.

Adolescent↗

Primary carcinoma of the gallbladder--review of 143 cases.

BACKGROUND/AIMS: We reviewed a consecutive series of patients with primary cancer of the gallbladder and looked for specific symptoms, signs, laboratory tests, radiological examinations, operative procedures, operative findings and survival. MATERIAL AND METHODS: The records of 143 patients with gallbladder carcinoma operatively treated between 1975 and 1990 were retrospectively reviewed. RESULTS: Abdominal pain was the most common symptom and present in 72% of our patients. Jaundice was present in 83 patients (58%) and weight loss in 68 (47.5%). The pre-operative diagnosis was made in only 28.7 per cent of the cases. Surgical procedures included cholecystectomy alone (24 patients), cholecystectomy and resection of the hepatic bed (17 patients), and exploration with biopsy or bypass (20 patients). Only 21.5% of patients underwent curative surgery. Overall five year survival rate was 11%. For patients whose tumor was limited to the gallbladder wall (T1, T2, T3), the acturial 5-year survival rate was respectively 100%, 29% and 23%. For patients with T4 and T5 tumor, the 5 year survival rate was nil.

Actuarial Analysis↗

Clinical aspects of fatigue in multiple sclerosis.

We studied 100 multiple sclerosis outpatients in order to assess the frequency of fatigue and to detect its relationships with other clinical findings. Fatigue was quantified by fatigue severity scale (FSS; range 1-7); current clinical neurological status and disability level were respectively scored by Kurtzke's functional systems and expanded disability status scale (EDSS). FSS mean score was 4.12; fatigue was totally absent in 3% of the patients. Fatigue started before onset of the disease in 7 patients, at onset in 12 and within the first year in 7. Fatigue intensity and frequency were related to each other. FSS mean scores were significantly higher in the patients with fatigue worsened by heat (p < 0.01), with chronic progressive disease (p < 0.0001), with motor symptoms (p < 0.0001) and with EDSS > or = 3.5 (p < 0.0001). Multiple regression analysis showed a significant effect of EDSS on fatigue (p < 0.0001), not attributable to differences in duration of the disease.

Adult↗

Facilitating intracorporeal colorectal anastomoses.

BACKGROUND AND OBJECTIVES: An experimental study was undertaken to evaluate whether a previously described technique for laparoscopic sigmoid resection with intracorporeal resection-anastomosis and specimen removal via a suprapubic incision could be facilitated and applied to the rectum. METHODS: Ten domestic pigs (median weight 41 kg) underwent low anterior resection of the rectum, which was transected with an articulating endoscopic stapler. Pursestring sutures were fashioned intracorporeally with a laparoscopic pursestring clamp. The anvil of a circular stapler was inserted through a 33 mm port into the colon and pursestring tied intracorporeally. A circular gun with a spike fixed to its shaft was introduced per anum and a double-stapled anastomosis performed. RESULTS: Complete doughnuts were obtained in all cases and anastomoses were all methylene blue tight. All porcine subjects had an uneventful 5-week postoperative course. The median anastomotic level from the anal verge was 5.2 cm. Histology of colorectal anastomoses revealed healing mucosa. CONCLUSIONS: The use of articulating endoscopic stapler, laparoscopic pursestring clamp, and circular stapler with a spike fixed to its shaft seems to facilitate a previously described intracorporeal approach to sigmoid resection which was safely applied to the rectum in a porcine model.

Anastomosis, Surgical↗