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R Coppola

Publications and source records attributed to R Coppola.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Preliminary studies of alpha rhythm and neuropsychological impairment in schizophrenia.

Patients with chronic schizophrenia had their EEGs recorded during medication withdrawal. Neuropsychological testing was done on the same patients during a period of 'optimum' functioning during neuroleptic treatment. Correlations between alpha activity, verbal IQ and Halsted-Reitan battery performance were evident over the entire scalp. This led us to examine whether these correlations were related to the inability of a substantial proportion of these patients to generate significant alpha activity. Patients unable to generate significant alpha activity tended to have neuropsychological impairment. These preliminary results suggest that this measure of brain physiology may relate to functional impairment in schizophrenia.

Adult↗
PubMedDate not supplied

The relationship of occipital skull asymmetry to brain parenchymal measures in schizophrenia.

It has long been hypothesized, but never proven that an organic brain injury early in life predisposes to schizophrenia. Since brain and cranial development are closely linked, if such an event occurred early enough in the premorbid course of schizophrenia, it could conceivably effect skull architecture. To approach this question, the occipital bone depth and the occipitomedian angle were measured in 50 patients with chronic schizophrenia and in 35 medical controls. Strong correlations emerged between the skull asymmetry indices and the occipital and temporal lobe parenchymal asymmetry indices. There were no statistically significant differences in cranial asymmetry measures between the patients with schizophrenia and the medical controls. However, when the comparison was limited to right handed individuals with homolateral sighting dominance, a weak, but statistically significant trend was observed for more symmetrical slanting along the sagittal suture in the schizophrenic patients. In addition, cranial asymmetry was weakly predictive of increased prefrontal markings in the schizophrenic patients. The congruence of skull findings with parenchymal variables suggests that certain aspects of skull and parenchymal architecture are co-determined.

Adolescent↗
PubMedDate not supplied

Physiological characteristics of capacity constraints in working memory as revealed by functional MRI.

A fundamental characteristic of working memory is that its capacity to handle information is limited. While there have been many brain mapping studies of working memory, the physiological basis of its capacity limitation has not been explained. We identified characteristics of working memory capacity using functional magnetic resonance imaging (fMRI) in healthy subjects. Working memory capacity was studied using a parametric 'n-back' working memory task involving increasing cognitive load and ultimately decreasing task performance. Loci within dorsolateral prefrontal cortex (DLPFC) evinced exclusively an 'inverted-U' shaped neurophysiological response from lowest to highest load, consistent with a capacity-constrained response. Regions outside of DLPFC, in contrast, were more heterogeneous in response and often showed early plateau or continuously increasing responses, which did not reflect capacity constraints. However, sporadic loci, including in the premotor cortex, thalamus and superior parietal lobule, also demonstrated putative capacity-constrained responses, perhaps arising as an upstream effect of DLPFC limitations or as part of a broader network-wide capacity limitation. These results demonstrate that regionally specific nodes within the working memory network are capacity-constrained in the physiological domain, providing a missing link in current explorations of the capacity characteristics of working memory.

Adolescent↗
PubMedDate not supplied

[Surgical resection of pancreatic cancer].

AIMS AND BACKGROUND: Surgical resection offers the only potential cure for pancreatic carcinoma. Although the overall prognosis remains a dismal, several recent series have reported an encouraging increase in 5-year survival after resection, exceeding 20%. As the reasons for this improvement are not clearly understood, numerous clinico-pathological parameters (demographic, intraoperative and histopathologic factors) have been investigated to evaluate their role in predicting long term survival. In this single-institution study, immediate and long-term outcome after pancreatic resection in patients with pancreatic adenocarcinoma was retrospectively evaluated, focusing attention on the possible impact of different clinico-pathologic factors on long-term survival. METHODS: Sixty-six patients with a confirmed histologic diagnosis of adenocarcinoma of the pancreas, treated by pancreatic resection at the Department of Surgery of the Catholic University of Rome in the years 1988-1997, were retrospectively analyzed. Morbidity and survival data were reviewed and potential prognostic factors were compared statistically by univariate analysis. RESULTS: There was no postoperative mortality. Twenty-five patients (38%) developed major operative complications. Pancreatic fistula was the most common complication, and occurred in 7 patients (11%). The actuarial overall and disease-specific survival for all 66 patients were respectively 58% and 59% at 1 year, 27% and 31% at 3 years, and 13% and 20% at 5 years, with a median survival time of 13.4 months. Nodal status was the only single factor significantly affecting survival by univariate analysis. The 3-and 5-year survival rates were respectively 35% and 19% for node-negative patients and 7% and 0% for node-positive patients (P = .04). A positive correlation with improved survival, even if not of statistical significance, was shown for other pathologic or intraoperative factors. Among the former, 5-year survival rates were better for patients with negative resection margins as compared to patients with positive margins (12% vs 7%, P = ns). Among the latter, a better actuarial 5-year survival rate was shown for patients with shorter operative time (< 4 hours, 21% survival vs > 4 hours 5%, P = ns) and for patients that received fewer transfusions (0-2 blood units, 14% survival vs 3 or more blood units, 0%; P = ns). Age, gender, tumor diameter and tumor grading showed no influence on survival in this series. CONCLUSIONS: Our series confirmed that nodal status is the strongest independent predictor of survival. Limited intraoperative transfusion, reduced operative time and clear margins could also yeald a prognostic significance, and require further confirmation in larger series.

Adult↗
PubMedDate not supplied

Ampullary carcinoma: prognostic significance of ploidy, cell-cycle analysis and proliferating cell nuclear antigen (PCNA).

BACKGROUND/AIMS: The aim of the present study is to assess the nuclear DNA ploidy patterns, the fraction of cells in the various phases of the cell cycle as determined by flow cytometry and to evaluate Proliferative cell-nuclear antigen (PCNA) expression in order to examine the relationships between phase-two molecular factors, clinicopathological aspects and outcome of patients with cancers of the ampulla of Vater. METHODOLOGY: Paraffin-embedded specimens from 18 cases of cancers of ampulla of Vater radically resected between 1985 and 1995 were analyzed by flow-cytometry and immunohistochemical staining with monoclonal antibody to the PCNA. The relationships between cell-proliferation kinetics, PCNA-positive cancer cells, clinicopathological findings and the clinical course were evaluated. RESULTS: Pathologist reports documented 17 papillary adenocarcinomas and one case of mucinous carcinoma. According to the TNM classification, 4 patients were in stage I, 7 in stage II and 7 in stage III. Locally advanced ampullary tumors (T3-T4) had a significantly worse prognosis (p = 0.01); survival at 3 and 5 years for stage I-II patients (11 cases) was 90% and 79% as compared to 42% and 42% for patients with stage III (8 cases), respectively (p = n.s.). Thirteen cancers (72%) were diploid and 5 (28%) aneuploid. Patients with aneuploid tumors were younger (mean age: 59 years) than patients with diploid tumors (mean age: 66 years; p = 0.04). No significant correlation was found between size of the tumor (T), lymphnodal status (N), grading (G) or aneuploidy. Difference in terms of survival between aneuploid and diploid patients was relevant (16 vs. 121 months) but, due to the small number of cases, was not statistically significant (p = n.s). The mean value of S-phase fraction (SPF) was 14.8%. PCNA positive rate significantly correlates with size of the tumor (T1-T2 vs. T3-T4; p = 0.03). Actuarial overall survival resulted in 70%, 63% and 31% at 1, 5 and 10 years, respectively. The high rate of diploidy (72%) supports the relative benign behavior of ampullary cancers. CONCLUSIONS: PCNA positive rate significantly correlates with size of the disease. Aneuploidy, although without significant prognostic value, correlates well with survival. Because of the wide range of all variables, more data are needed to establish the relationships between pathological factors, DNA ploidy and PCNA rate and their significance as molecular predictors of prognosis in ampulla of Vater cancers.

Adult↗
PubMedDate not supplied

[Vesico-ureteral reflux: diagnostic and therapeutic procedures].

The vesico ureteral reflux (VUR) is the most common uropathy associated to urinary tract infections (UTI). The identification of V.U.R. is very important to avoid reflux nephropathy and it's complications. To avoid the exposure to unnecessary and injurious x-rays, the authors propose patient selection based on the presence or absence of distal ureteral dilatation and on the time elapsed between typical or atypical symptoms of u.t.i. and fever. First of all, it is essential to diagnose pielonephritis. After ultrasound and radionuclide scintigram with DMSA they select the infants who need cystourethrography. The infants with V.U.R. undergo antibiotic prophylaxis until spontaneous or surgical recovery. The duration of prophylaxis depends on the degree of V.U.R. and the age of the infant at diagnosis.

Age Factors↗
PubMedDate not supplied

Oxaliplatin may induce cytokine-release syndrome in colorectal cancer patients.

INTRODUCTION: Oxaliplatin, a third-generation platinum analogue, is a novel compound with proven anti-tumor activity in colorectal cancer. Moreover, oxaliplatin appears to be relatively well tolerated and easy to handle, even on an outpatient basis. PATIENTS AND METHODS: Five advanced colorectal cancer patients treated with oxaliplatin-based chemotherapy developed, after the end of oxaliplatin infusion, similar idiosyncratic reactions characterized by chills, high fever, hypotension, abdominal pain, nausea and often diarrhoea. Venous blood for IL-6 and TNF-alpha assessment was drawn just after the beginning of the reaction and 15 and 30 minutes later. After drawing the third venous sample, intravenous dexamethasone (8 mg) was administered and the drawing of other two venous samples was performed (180 and 360 minutes after the beginning of the reaction). RESULTS: TNF-alpha and IL-6 serum concentrations significantly decreased after steroid therapy administration. The decrease of TNF-alpha and IL-6 levels went along with the clinical complete regression of symptoms and signs in all the 5 patients. No statistically significant correlation was found between other laboratory parameters and basal cytokine levels or cytokine decrease after steroid therapy. DISCUSSION: Our results clearly show that that idiosyncratic reaction observed in colorectal cancer patients after oxaliplatin infusion may be due to a massive release of cytokines such as TNF-alpha and IL-6. Symptom regression following steroid therapy administration went along with significant decrease of cytokines levels, confirming that TNF-alpha and IL-6 play a role in the pathogenesis of this reaction.

Abdominal Pain↗
PubMedDate not supplied

[Pancreatic tumor: unusual onset of Von-Hippel Lindau syndrome].

The Von-Hippel Lindau (VHL) disease is a rare genetically determined syndrome. Clinical course depends on the occurrence of multiple tumors as central nervous system tumors, phaeochromocytoma and renal cell carcinoma. We describe the second case in the literature reporting about a patient affected by a pancreatic neuroendocrine tumor as the first clinical sign of VHL disease. It has been showed that only a strict follow-up can effectively improve survival. Based on the present case, the follow-up of patients affected by VHL syndrome should routinely include functional tests and imaging exams of the pancreas.

Adolescent↗
PubMedDate not supplied

[Signet-ring cell carcinoma of the Vater's ampulla: report of a clinical case].

We report the case of a sixty-six year-old man admitted at our hospital with a suspected malignant tumor of the ampulla of Vater. The patient underwent a Pylorus-preserving pancreatico-duodenectomy. Histology showed a signet-ring cell carcinoma of the ampulla of Vater. This case is the 13th report in the literature of a signet-ring cell carcinoma of the ampulla of Vater.

Aged↗
PubMedDate not supplied

[Cerebellar metastasis from pancreatic adenocarcinoma: report of a clinical case].

We describe a case of a metacronous cerebellar metastasis from pancreatic adenocarcinoma occurred in a 67 years old male. Central nervous system metastases from pancreatic carcinoma are mostly autoptic findings. To our knowledge, this is the first case reported in literature of cerebellar metastasis from pancreatic cancer; furthermore, this case calls attention on vomit presentation that could be erroneously attributed to an abdominal relapse. Due to the increasing frequency of central nervous system metastases observed in recent years in other types of cancer, some authors speculate that this event could represent a consequence of the prolonged natural history as the result of improved survival.

Adenocarcinoma↗
PubMedDate not supplied

[Xanthogranulomatous pyelonephritis and renal carcinoma. Report of a clinical case and review of the literature].

Xanthogranulomatous pyelonephritis is a rare disease of the kidney; renal parenchyma is replaced by lesions radiologically simulating clear cell carcinoma. We present a case of a 62-year-old diabetic woman observed at our institution for the appearance of back pain and dysuria. A CT scan revealed a large lesion of left kidney with psoas muscle infiltration and the patient undrwent a nephrectomy. Histology surprisingly showed a xanthogranulomatous pyelonephritis. Though recent reports demonstrated the feasibility of conservative management of XGP with antibiotics, the use of pre-operative biopsy is still limited by the risk of seeding and the high false-negative results. How to distinguish xanthogranulomatous pyelonephritis from renal cancer?

Carcinoma, Renal Cell↗
PubMedDate not supplied

[Hartmann's procedure in emergency surgery of the colorectum].

The authors report their experience with Hartmann procedure. 28 patients were treated: 21 males and 7 females. The mean age was 58 years. Perforative diverticulitis was the commonest indication (14 patients), followed by carcinoma (11 patients). Miscellaneous causes accounted for 3 patients. This procedure was primarily performed as an emergency operation (71%). One patient died post-operatively (3.5%); post-operative morbidity was 10.7%. A second operation was not planned if the first operation had been performed for palliation of metastatic or locally advanced cancer (7 patients). Restoration of colonic continuity was achieved successfully in 14 patients with no mortality and morbidity. According to their experience, authors believe Hartmann procedure to be the most suitable operation facing a left colon emergency. It is usually easy to perform and well tolerated by poor risk patients.

Anastomosis, Surgical↗
PubMedDate not supplied

[Ultrasonography in the monitoring of internal biliary drainage using an endoscopically inserted prosthesis].

Endoscopic retrograde biliary drainage by means of transtumoral endoprostheses is an effective technique for palliative decompression of malignant biliary obstruction. However, serial follow-up is required for an early detection of eventual long-term complications. In the present study 37 patients with malignant biliary obstruction, treated by endoscopic insertion of one or more biliary stents, were prospectively evaluated by sonography, with serial clinical and US examinations up to 10 months. In our experience, sonography could correctly identify both the endoprostheses and their location in the biliary tract. Most important, sonography has proved to be a sensitive method to detect possible stent dysfunctions, besides providing with information about the progression of the underlying malignancy.

Adenoma, Bile Duct↗