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Biomedical subjects

S Berrettini

Publications and source records attributed to S Berrettini.

53 records · Page 3Linked to original sources

Lethal midline granuloma: a case of Ki-1 lymphoma.

Lethal midline granuloma syndrome (LMG) is the clinical term generally used to describe a rare clinical entity of unknown cause characterized by a progressive and often fatal ulceration and destruction of the upper airway involving the nose, the paranasal sinuses and the soft tissues of the face. The following histopathologic entities have always been grouped under the term LMG: Wegener granulomatosis (WG), non-Hodgkin lymphoma, polymorphic reticulosis (PR) and idiopathic midline destructive disease (IMDD). Today in order to begin an adequate therapy a differential diagnosis is necessary. The progresses in clinical immunology and immunohistochemistry and cytophotometric findings are useful to define the LMG syndrome better. First of all the LMG must be discriminated from localized WG occurring in the midface. Serologic examinations of patients with WG in its active form show a high percentage of autoantibodies against cytoplasmic structures in leucocytes and monocytes. Moreover a review of the literature allows us to suppose that cases described as IMDD and PR are indeed a large evolutionary spectrum from almost benign to fatal malignant lymphoma. We report a case of Ki 1-lymphoma presenting as LMG syndrome.

Adult↗

Hibernoma of the larynx. Review of the literature and a new case.

Hibernoma is a rare, benign, soft-tissue tumour composed of cells similar to those of brown adipose tissue. Only seven cases in the cervical area have been reported and none in the larynx. A case of hibernoma of the pre-epiglottic area is presented and the histological, histogenetical and clinical features are discussed.

Aged↗

Effects of subacute exposure to noise on the noradrenergic innervation of the cardiovascular system in young and aged rats: a morphofunctional study.

The effects of subacute noise stress on the noradrenergic pattern and receptor-mediated responses were examined in aorta and atria of young and aged rats. Noise exposure increased the density of noradrenergic fibres and responses to the beta-adrenergic agonist isoprenaline in the cardiac tissue of young animals. In aged rats, the stressing stimulus markedly increased the maximal response to the alpha-agonist on the aortic musculature; on the contrary, a reduced responsiveness to the beta-agonist was observed at the cardiac level, without any noteworthy changes in the noradrenergic pattern in comparison to aged controls. The present results indicate that subacute noise stress induces both morphological and functional modifications of the noradrenergic nervous system and also that after subacute noise stress, morphological changes do not necessarily correspond exactly to functional data; the latter show responses that are more widely differentiated than the morphological ones.

Aging↗

Hearing and vestibular disturbances in Behçet's syndrome.

In order to evaluate the prevalence of audiovestibular disturbances in Behçet's syndrome, we submitted 20 consecutive patients and 20 control subjects to detailed audiologic and vestibular examination in the last 3 years. A sensorineural hearing loss was found in 12 patients, 2 of whom revealed sudden deafness. Two other patients with neuro-Behçet's syndrome showed a vestibular function deficit, and 3 others exhibited altered caloric stimulation test results. Two of these last patients also revealed a simultaneous bilateral auditory deficit. HLA typing showed the presence of the B51 antigen in 10 of the 14 patients with ear involvement, while only 3 of the 6 patients without ear involvement were HLA-B51-positive. Results suggest that audiovestibular involvement is common in Behçet's syndrome: sudden deafness may be the first sign of ear disturbance; vestibular lesions may represent an early sign of neuro-Behçet's syndrome; and the HLA-B51 antigen is associated with ear involvement. Otoneurologic study can reveal hidden brain stem lesions in Behçet's patients during flare-ups of the disease, even without obvious signs of neurologic deficits.

Adult↗

[Sudden deafness and Behçet's disease].

Behçet's disease is a multisystemic vasculitis of unknown aetiology. Generally, it is characterized by recurrent aphthous stomatitis, recurrent genital ulcers, uveitis with hypopion. Recently some authors reported that patients with Behçet's disease show frequently audio-vestibular involvement. We observed a 40 year-old man (case A) and a 66 year-old woman (case B) affected by Behçet's disease for more than 10 years, showing a sudden deafness occurring during an exacerbation of the disease. In both cases there was a sensorineural hearing-loss, unilateral or bilateral. One patient received early high-dose cortisone therapy. General symptoms and audiovestibular function, both have completely recovered.

Aged↗

TORPs and PORPs: causes of failure.

We review the main causes of failure using total and partial ossicular replacement prostheses in staged intact canal wall tympanoplasty. Most failures may be prevented by using a few surgical devices. Otherwise, when a graft perforation or a hearing impairment occurs, it requires another operation for new grafting and to replace the prosthesis.

Humans↗

Quantification of the parameters of the acoustic reflex in normal ears.

Measurement of the acoustic stapedial reflex parameters has proved to be a useful tool for evaluating the function of the acoustic-facial reflex. However, there is no agreement about the definitions of the parameters; moreover, most of the data have been obtained by manual measurement methods. The authors describe a computerized analytical method which permits the parameters to be measured according to the definitions and methods suggested by others and according to the new analytical method described, which is performed on the basis of the derivative of the stapedial reflex curve. The two methods are compared in 40 normal subjects.

Adolescent↗

[Use of fibrin glue in microsurgery of the ear. An analysis of operations at the Pisa ENT Clinic].

The authors report the indications for and methods of application of fibrin glue in reconstructive microsurgery of the middle ear. On the basis of 180 interventions, they describe in detail the use of fibrin glue in myringo- and tympanoplasty for correct fixing of grafts. Furthermore, they illustrate the particular use of fibrin glue in reconstruction of the incudostapedial joint, in covering eroded areas of the lateral semicircular canal and in one case of perilymph gusher.

Drug Combinations↗

Audiovestibular involvement in systemic sclerosis.

In order to evaluate the nature and association of audiovestibular disturbances and systemic sclerosis (SSC), 37 unselected SSC patients were studied with a detailed audiological and vestibular examination since November, 1987. Pure-tone audiometry, speech audiometry, impedance audiometry, brainstem response audiometry and vestibular function using electronystagmographic recording were performed. We found a rather frequent audiovestibular involvement (41%). A hearing loss was found in 14 SSC patients; hearing loss was sensorineural in 10 cases and mixed in 4 cases. The latter revealed a finding similar to tympanosclerosis. Four patients showed altered vestibular test values and only one of these had normal hearing. Sensorineural deafness was the more frequent pathological finding and in all cases the site of lesion was cochlear. SSC appears to be directly responsible for audiovestibular damage, since in 12 out of 15 patients with such involvement, no other apparent cause could be revealed. SSC may be included among the autoimmune diseases which may cause audiovestibular disturbances.

Acoustic Impedance Tests↗

[Bovine costal cartilage as material for otologic reconstruction: anatomo-functional results].

The Authors present their experience in using bovine cartilage as otological material reconstruction. Cartilage of the ribs is to collect from selected bred cattle and is first placed in an antibiotic solution for 3 days and then in a 70% ethyl alcohol in which it is stored for 20 days before being utilized. One hundred-nineteen cartilage heterografts have been implanted in the middle ear since January 1989. We report the results of 86 cases which were included in a followed study for at least 12 months. Bovine cartilage was used in 47 canal up techniques, 28 canal down techniques and 11 anatomic and functional rehabilitation of old radical cavities. The result prove most encouraging. In 74 cases we observed good anatomical results characterized by a new, intact eardrum with no sign of inflammation or a cavity lined with normal epithelium. No extrusion was found. Removal of cartilage implanted after a year enabled us observe the high tolerance of the graft and to carry out further histological examination. The histological findings indicated normal and intact cartilagineous matrix, lined with fibrous tissue and mucosa with no evidence of condrocytes. In cases in which the heterografts were utilized for ossiculoplasty, the post-operative air-bone gap was 11.1 dB and the mean hearing gain was 26.3 dB. Moreover, bovine cartilage is easily obtainable and available in pieces of sizes necessary for specific purposes in otologic surgery. Cartilage heterografts might well be a good alternative to autologous and homologous cartilage grafts.

Adolescent↗

[Histological and ultrastructural aspects of oto-mastoid cholesteatoma in children].

Cholesteatomas were intraoperatively removed from subjects under 14 years of age presenting widespread cholesteatoma with bone erosion. The samples were studied under light and transmission electron microscopy in order to consider the features of inflammation and bone erosion. The results showed that the perimatrix of cholesteatoma in children is rich in mononuclear inflammatory elements and generally presents the features of chronic, as well as acute, inflammation. The perimatrix infiltrates and erodes the surrounding bone. Next to the resorption areas many areas were observed having new bone the surface of which is lined with osteoblasts. The new bone formation activity is marked in these cases of childhood cholesteatoma and appears to be an attempt at spontaneous repair which is thwarted by the persistence of inflammation.

Adolescent↗

[Lyophilized bone homografts in reconstructive surgery of the middle ear].

The authors present their experience with stored lyophilized bone allografts utilized in middle ear reconstructive surgery. The implants were cut from the cortical substance of the long bone in subjects deceased. A demineralization in 0.6 N HCl solution was performed in order to induce osteoinductive capacity to the bone matrix. From November 1986 to December 1988 this material was utilized in 45 operations: 31 canal up techniques; 7 canal down techniques; 4 anatomical and functional rehabilitation of old radical cavities. Good anatomical results without perforation of the tympanic membrane and without signs of inflammation or retraction were obtained in 33 cases (79%). Furthermore, no extrusion was observed in cases with retraction of the graft and protrusion of the prosthesis. In cases in which the homografts were utilized for ossiculoplasty, the post-operative air-bone gap was 21 dB and the mean hearing gain was 15 dB. The histological examination of two homografts, removed 13-18 months after implantation, appeared to be coated with normal mucosa and to contain areas of active bone formation.

Adult↗

[HIV infection and nosocomial risk: experience at the ORL Clinic of Pisa].

The risk of nosocomial risk of HIV infection and the problem of preventative measures to adopt has been modifying how workers in the health field deal with patients. In fact, the increased spreading of HIV infections within our population has led to the establishment of a national protocol of preventative measures by which no patient can be considered "safe". Consequently, the likelihood that contact with any patient can lead to infection causes the health care worker to look upon the patient as a potentially dangerous enemy, thus leading to a decline in the quality of health care. On the other had, although the risk of a health care worker being infected by HIV during routine work is low, preventative measures must be taken both during examination and during surgery. Unanimous agreement exists in regard to what measures are to be taken to prevent cutaneous and mucosa exposure of workers whenever the risk of accidentally coming into contact with the blood and/or other biological fluids exists. On the other hand, the use of an anti-HIV screening for all patients in order to distinguish between infected and non infected subjects is still subject to debate. Some feel such screening is unacceptable because it would deny sero-positive patients adequate care and could give rise to both false positives and false negatives while others propose routine screening feeling it to be helpful both to those who are sero-positive and to health care workers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Audiological and neuropsychological development study in a sample of school children from a low-iodine area of the Central Apennines that is endemic for cretinism].

We have evaluated neuropsychic development in 70 normal schoolchildren in an area of severe endemic goitre and cretinism in the Central Apennines (Montefeltro). In each subject we have studied auxological, psychometric and audiometric parameters, together with tympanograms and stapedial reflexograms. Auxological data were in the normal range, as were the stapedial reflexograms and tympanograms. On the contrary, 54.8% of the sample performed below the 25th percentile in psychometric tests (Raven test PM-47), being also 22.8% below the 5th percentile. Audiometric data showed a neurological hearing impairment in 3.1% of the children tested, as compared with 0.28% in the area of Pisa. These data point out that an impairment of central nervous system function still persists in this area of severe endemic goitre.

Child↗

[Delayed endolymphatic hydrops: an analysis of 12 cases].

Delayed Endolymphatic Hydrops (DEH) is a clinical entity which is characterized by an early phase with a profound sensorineural hearing loss in one ear. After a prolonged period of time (from 1 to 68 years) a late phase of the disease appears with different otologic symptoms. The ipsilateral type of endolymphatic hydrops appears in the deaf ear with consequent episodic vertigo. The contralateral type develops symptoms of endolymphatic hydrop in the previously normal ear, with the onset of fluctuating hearing loss and/or episodic vertigo. This paper is a review of 12 cases of DEH (7 ipsilateral and 5 contralateral, age ranging from 19 to 79 years). Diagnosis was established on the basis of clinical history and the results of audio-vestibular investigations, specifically designed to detect signs of endolymphatic hydrops (including the glycerol-test and neuroradiological imaging of the cerebello-pontine angle). In 8 patients the levels and frequency of anti-collagen I-II-IV-V, anti-laminin autoantibodies, complement, Ig and immuno-complexes were measured. Viral infections (measles, mumps, influenza) were thought to have caused the early phase in 6 cases. In the entire group of 12 patients the delay between the onset of the ear loss and vertigo averaged 12 years. In the group of the ipsilateral DEH, caloric tests showed in 5 cases a reduced or absent response of the deaf ear. About contralateral DEH, caloric tests showed bilateral reduced response in 2 cases, and, in 3 cases, a decreased response only in the previously normal ear. Regarding immunological study, an abnormal level of Ig and Complement was detected in 3 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗