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R De Caro

Publications and source records attributed to R De Caro.

At least 37 records · Page 2Linked to original sources
PubMed1995

The persistent primitive hypoglossal artery: a rare anatomic variation with frequent clinical implications.

The case of a persistent primitive hypoglossal artery (PHA) in a 72-year-old man dead from myocardial infarction is presented. The autopsy showed the presence of a semicircular marginal infarct on the surface of the left cerebral hemisphere. The PHA anastomized the basilar artery origin with the left internal carotid artery, running through the left hypoglossal canal together with the hypoglossal nerve. The vertebral and posterior communicating arteries were hypoplastic. The PHA represented the morphological base on which the cerebral vascular insufficiency acted, following the generalized circulatory insufficiency due to the myocardial infarct, causing the cerebral infarct. Based on the embryology of the cranial arteries and on the morphological findings we suggest that the persistence of the hypoglossal artery: 1) precedes the vertebral and posterior communicating arteries hypoplasia causing it by competition for the territory of distribution; 2) gives rise to an almost complete dependence of the cerebral circulation from the carotid system with predictable ischemic consequences in the case of a critical reduction of the carotid blood flow; 3) may be associated with an anomalous structure of the vessel wall and exposes the basilar trunk to an unusual haemodynamic stress, predisposing to the onset of aneurysms.

Aged↗
PubMed1994

Correlation of testicular volume, histology and LHRH test in adolescents with idiopathic varicocele.

Testicular growth failure as well as a well-documented histological damage have been reported in adolescents with varicocele. However, the proper management of this disorder in childhood is still debated due to the lack of seminal data and to the large number of adults with varicocele who have no fertility problems. In order to identify the subset of patients who are at risk of developing impaired testicular function and thus candidates for early varicocelectomy, we have studied 15 adolescents 10-17 years old with a grade II-III left-sided varicocele. Testicular volume and gonadotropin response to LHRH stimulation were evaluated preoperatively and compared to the histological findings from bilateral testicular biopsies. An abnormal left testicular histology was observed in 7 boys (46.6%) but only 3 of them (20%) showed severe testicular damage. The difference in size between the right and the left testis was never significant and was of no value in detecting subjects with abnormal histology. A good correlation was found between testicular injury and an increased response of both gonadotropins to the administration of LHRH. Decreased testicular volume does not seem to be a reliable predictor of early testicular damage. The assessment of gonadotropin response to LHRH may provide an additional objective means of evaluating adolescents with varicocele.

Adolescent↗
PubMed1994

The organization of subperitoneal connective tissue in the female pelvis.

The organization of the subperitoneal connective tissue in the female pelvis was studied in 6 cases, aged between 58 and 65, deceased from extrapelvic diseases. The pelvic viscera were removed as a whole with the surrounding subperitoneal tissue using a circular cut performed at the level of the pelvic walls. The specimens were fixed in 5% formalin. The bladder dome, uterine body and rectum, up to the anorectal junction, were removed. In two cases the specimens were dehydrated and embedded in paraffin. Ten micron sections were stained with Haematoxilin-Eosin and Azan-Mallory. In 2 other cases the specimens were plastinated according to Von Hagens E12 technique; the passage in acetone at room temperature lasted 24 hours. In the remaining 2 cases the plastination with E12 was carried out after a passage in acetone at room temperature which lasted about 15 days in order to fully remove the lipids from the subperitoneal adipose tissue. The morphological findings demonstrate that the subperitoneal tissue of the female pelvis has an areolar structure with small adipose lobules separated by thin fibrous laminae connected to the vasculo-nervous bundles and to the parietal and visceral layers of the fascia pelvica. The three dimensional spatial organization of the network of thin connective laminae constitutes an anatomical device with possible supporting properties.

Connective Tissue↗
PubMed1991

Fenestration of the vertebrobasilar junction.

A fenestration of the vertebrobasilar junction was found in an 80-year-old man during autopsy. It was associated with thrombosis of the vertebral arteries which had caused a left Wallenberg syndrome. The left limb of the fenestration presenting the same transverse diameter as that of the remaining part of the basilar artery appeared to be its direct (true) origin. The right limb had a lesser transverse diameter and appeared to bridge the lateral surface of the rostral end of the right vertebral artery and the basilar trunk. According to the authors, this fenestration could have been caused by the persistence of the cranial part of a primitive lateral vertebrobasilar anastomosis, rather then by the usual incomplete fusion of the primitive paired basilar arteries.

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PubMed1991

Giant coronary aneurysm associated with aortic mucoid medionecrosis.

A case of sudden death due to rupture of a dissecting aneurysm of the ascending aorta in a 38-year-old man is presented. The patient had a clinical history of severe hypertension. The autopsy also revealed the presence of a voluminous aneurysm of the right coronary artery and a solitary multilocular cyst of the right kidney. It is thought that a prodromal influenza-like syndrome and the renal lesion could have played a role in causing the vascular pathology.

Adult↗
PubMed1989

Scanning electron microscopy of 'normal' urothelium in patients with infiltrating bladder carcinoma.

'Normal' dome biopsies from 20 cystectomies for infiltrating bladder carcinomas were studied with scanning electron microscopy (SEM). All cases showed alterations ranging from minimal changes to numerous pleomorphic microvilli, and were classified according to Herd and Jacobs. The SEM findings and grades were correlated with dome histology and the results were quite good. However, in our opinion, the Herd and Jacobs classification and subclassifications are poorly reproducible without morphometric analysis. Nevertheless the SEM study is useful to strengthen the diagnosis of dysplasia/carcinoma in situ in 'healthy'-looking urothelium.

Aged↗
PubMed1989

Anatomy of the optic nerve in elderly men.

The microscopic and ultrastructural modifications of glial and mesenchymal components of the optic nerve in the physiologic aging were studied in 182 human optic nerves. According to the age of subjects, a modification of topography of astrocytes was observed. In the 7th-8th decade, the axons of the optic nerve showed some phenomena of swelling and axonal degeneration. During the years, the central artery of retina showed an evident hyperplasia of intima and an increase of collagen of the media. While the connective tissue was good represented by the end of the 1st decade in the central vein of retina, the muscular tissue was almost absent. The interfascicular connective tissue increased considerably in the aging.

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PubMed1988

Intracranial sarcoma with reactive glioma: a clinicopathological case report.

The clinicopathologic picture of a case of so-called 'sarcoglioma' is reported. This tumor is characterized by a core of sarcomatous tissue, surrounded by an area of gradual transition from reactive to neoplastic glial cells; it occurs in children or in young adults and is very rare in comparison with the secondary sarcoma deriving from the vascular component of a glioblastoma (so-called 'gliosarcoma'). The clinical and laboratory features and the pathology of this case are discussed in detail.

Adult↗
PubMed1988

Congenital polyp of the prostatic urethra: report on 2 cases.

Congenital polyps of the prostatic urethra are an uncommon cause of obstructive uropathy, infection and/or hematuria in male children. A filling defect localized in the posterior urethra on the voiding cystourethrogram represents the peculiar diagnostic finding. Transurethral resection is the treatment of choice, according to the size of the polyp. Two cases of congenital posterior urethral polyps are reported and the main clinical and radiological features are discussed. This lesion has to be considered in the differential diagnosis of the voiding dysfunction in young boys.

Adolescent↗
PubMed1983

Traumatic primary brain stem haemorrhage. A clinical and experimental study.

We report 36 cases of post-traumatic "primary brain stem haemorrhage" visualized by the CT scan and confirmed at autopsy. Clinical experience shows that many technical factors influence the inability to visualize brain stem haemorrhages. Experimental injection of fresh blood into the pons and midbrain of cadavers shows that lesions as small as 0.25 ml in volume may be visualized. The volume and the anatomical configuration of traumatic lesions of the brain stem extended over a rostro-caudal direction, and their proximity to bony structures at the base of the skull are obstacles to the visualization of brain stem haemorrhages.

Adolescent↗
PubMedDate not supplied

Selective stroke of the solitary tract nuclei in two cases of central sleep apnoea.

Central sleep apnoea (CSA) is a breathing disorder characterized by repetitive central apnoeas with hypoxia interrupted by hyperventilation phases. In the literature, there are reports of CSA caused by brainstem infarcts. We report two patients (38 and 53 years old) with longstanding history of central sleep apnoea who died during sleep. In both cases the autopsy revealed acute bilateral hypoxic lesions at the level of the solitary tract nuclei. In one case, symmetrical selective neuronal necrosis was found in the dorsal part of the solitary tract nuclei. A chronic obstructive vasculopathy was also found, with thickening and fibrosis of the smallest vessels of the medullary tegmentum. In the other case, bilateral infarctions were found with the base at the ependymal lining of the 4th ventricle floor and the apex towards the solitary tract. An acute intramural hemorrhagic lesion in the premedullary segment of the left vertebral artery was also found. Episodes of hypoxemic hypoxia during sleep may worsen the effects of focal oligohemic hypoxia in the medullary tegmentum. Selective stroke of the solitary tract nuclei may be the acute fatal lesion in patients with both central sleep apnoea and lesions of the vertebro-basilar system. To the best of our knowledge, this is the first neuropathologic report of acute medullary ischemic-hypoxic lesions which may not be considered the cause of the CSA because of their recent onset. Our findings suggest that CSA, besides being caused by ischemic events at the level of the medulla, may also contribute to pathogenesis of strokes, through hypoxia or hemodynamic oscillations.

Adult↗
PubMedDate not supplied

Anatomy of segmental duplication in the human basilar artery. Possible site of aneurysm formation.

Segmental duplications of the basilar artery, previously reported exclusively as anatomical variations, owe their clinical interest to the possible association with aneurysms localized at the junctions of the fenestrated segments. The morphological characteristics of 5 cases of basilar artery segmental duplication without aneurysms, found at autopsy, are reported. In 3 of these the proximal junction of the fenestrated segment was studied with scanning electron microscopy and morphometry. In all cases the tunica media of the medial wall of the 2 branches showed a progressive thinning towards the junctions of the fenestrated segments and a small muscular gap at their apex. The limited medial defect might be embryologically ascribed to the persistence of the morphological individuality of the tunica media of the 2 branches at the point where the fusion of the primitive longitudinal neural arteries stopped. The review of the literature shows that the morphology of the junctions of the fenestrated segments is in conformity with that of the intracranial arterial bifurcations. For this reason the basilar artery fenestration exposes to the blood flow a new distal bifurcation where the same etiologic factors that are still under discussion in the origin of saccular intracranial aneurysms may be active.

Aged↗