[A case of lipoma of the parapharyngeal space. Report of an unusual clinico-radiologic finding].
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Adult↗
Biomedical subjects
S Pappalardo
Publications and source records attributed to S Pappalardo.
[Introduction to the study of the Willis circle with transcranial color Doppler: methodological notes and preliminary experience].
To date, adult intracranial circulation has been studied only with pulsed-wave Doppler US, which is a useful diagnostic tool even though several technical and practical limitations are related to the difficult location of intracranial vessels. Recently, dedicated color-Doppler transducers have been proposed, which can pass through the skull which makes a physiologic barrier for the US beam: this technique has been called transcranial color-Doppler (TCD). We report on our personal experience with TCD in 30 healthy volunteers (12 men and 18 women, age range: 17-75 years) submitted to TCD for Willis circle imaging. We used an ATL Ultramark 9HDI unit with a phased array transducer (3.5 MHz) and 2 MHz Doppler frequency; the PRF was 3000 Hz, with 80% color gain. 100 Hz wall filters were used. The middle cerebral artery was always shown correctly in all subjects, while the posterior one was depicted only in 7 cases (23.3%); in contrast, the anterior cerebral artery was demonstrated in 3 cases only (10%). Nowadays, TCD is mostly applied to normal intracranial circle studies, to assess normal blood speed values more accurately. To this purpose, both the direct visualization of blood vessels and the flowmetric values obtained measuring the incidence angle are useful pieces of information. TCD permits a more accurate study of intracranial local blood flow in the Willis circle and of its changes in pathologic conditions. In contrast, TCD yield is poor in characterizing intracranial tumor tissue.
Adult↗
[Unusual case of intralabyrinthine schwannoma: diagnostic potential of the sequences with flow-sensitive magnetic resonance].
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Adult↗
[Progressive gingival recession: a 2-stage surgical technic].
A technique for treating gingival recession which provides a means of achieving two objectives, interrupting the disease process and aesthetic covering of the exposed root, are described. A two step procedure is used: 1) a free submarginal gingival graft is positioned high enough to attach the gum, 2) the exposed root is covered with a bipediculated crown flap. A biological glue was used instead of suture after preparing the root surface with citric acid.
Adult↗
[Magnetic resonance in the study of the facial nerve: methodological approach and normal anatomy].
The authors report their experience in the study of facial nerve anatomy by means of MR Imaging. The seventh pair of cranial nerves was studied in 6 healthy and informed volunteers with a super-conductive MR unit at 0.5 T using surface and head coils. Slices were 3 mm thick and were acquired on the axial and sagittal planes, when the petrous and the mastoid bones were studied. The parotid gland was studied with 5-mm slices acquired on the axial, angled axial, and sagittal planes. In all cases T1-weighted images (TR 450, TE 30) were performed. If the above research protocol, which is relatively simple and direct, is applied, the whole course of the facial nerve up to its main distal branches can be almost completely demonstrated.
Facial Nerve↗
Growth hormone and somatomedin-C secretion in patients with polycystic ovarian disease. Their relationships with hyperinsulinism and hyperandrogenism.
Nineteen women with polycystic ovarian disease (PCO; 9 obese) and 15 normal ovulatory women (7 obese) were studied at their follicular phase. All patients had an oral glucose tolerance test (OGTT) before and after treatment with gonadotropin-releasing hormone (GnRH) agonist (Buserelin 400 micrograms/die s.c. for 8 weeks) to investigate the relationship between ovarian steroidogenesis and insulin and growth hormone (GH) and insulin-like growth factor (SmC) secretion. Luteinizing hormone, follicle-stimulating, estradiol, androstenedione, testosterone, dehydroepiandrosterone sulfate, cortisol, insulin, GH and SmC were measured basally at the time of OGTT. PCO patients showed higher androgen basal levels than control patients. All subjects showed a normal glycemic response to OGTT. The mean fasting level and area under the curve of plasma insulin were also significantly greater in PCO than in control patients (p less than 0.05), while GH and SmC plasma concentrations did not differ between the groups. Despite a considerable decrease in androgens and the similar levels in both PCO and control women, buserelin treatment did not determine any significant changes of insulin and GH-SmC secretion. GH and SmC did not correlate with ideal body weight (IBW), insulin or androgens, whereas insulin correlated with both testosterone and androstenedione levels (p less than 0.05) and with IBW (p less than 0.01); after the buserelin regimen only IBW remained related to plasma insulin (p less than 0.01). In conclusion results of this study confirm that hyperinsulinism is a characteristic picture of PCO and is related in an unclear way with hyperandrogenism and obesity.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Isolated jejunal angiomatosis. A rare cause of intestinal hemorrhage].
The Authors report a case of solitary small bowel angiodysplasia and emphasise the rarity of this site. The importance of angiography is stressed in terms of its fundamental role in the diagnostic process and in its ability to evaluate not only the site but the extension of this type of lesion, thus enabling a surgical approach to be defined.
Aged↗
Patellofemoral dysplasia in infantile cerebral palsy.
The authors have studied the biomechanical basis of functional alterations in the extensor apparatus of the knee in cases of infantile cerebral palsy. Several interesting aspects of the problem, some of which are controversial, have emerged from this study and from a review of patients with flexion contracture of the knee treated surgically: 1. The neurological pathology of the motor system leads to problems of posture and dysplastic conditions of the hip (coxa valgus, etc.) which favour the development of patellofemoral pathology. 2. By contrast, the early clinical manifestations of this pathology are relatively insignificant and completely overshadowed by the major problems of adaptation and compensation imposed by the more serious overall disabilities which face the patient in order to stand and walk. The knee plays a prevalently static role at this stage and is not particularly stressed during joint movement. 3. The clinical manifestations of patellofemoral pathology are thus paradoxically brought into focus by surgery on the flexor apparatus to deal with contracture. Although on the one hand this improves function, on the other it brings to light the more complex functional mechanisms of the knee, thus emphasizing any deficit in the extensor apparatus.
Biomechanical Phenomena↗
Prosthetic reconstruction of the anterior cruciate ligament of the knee: the roles of CT scan and M.R.
The authors examined 10 patients treated by intra-articular reconstruction of the anterior cruciate ligament with an artificial ligament in terylene (Kejo-Leeds type). Clinical evaluation was supplemented by CT scan and magnetic nuclear resonance (M.R.). The basic parameters assessed were the positioning of the tunnels, biological anchoring, presence of reactive synovitis, growth and modification of periligamentous fibrous tissue, characteristics and relationships of the extra-articular plastic. CT scan was better at determining the tunnels, evaluating biological anchoring and visualising the new ligament in its intra-articular course. Magnetic nuclear resonance was better at evaluating changes in the periligamentous tissue. The authors therefore conclude that M.R. is preferable in the early follow-ups, while CT scanning has greater diagnostic value in follow-ups after six months.
Adult↗
Multiple lumbar arachnoid cysts. Case report.
Arachnoid cysts are a rare cause of compression of the contents of the lumbar spinal canal; in the literature only about 100 cases are reported. The various methods of diagnosis are discussed in the light of a recent case observed by the authors.
Adult↗
High domed tibial osteotomy in the treatment of angular deviations of the knee. A new system of surgical instrumentation.
The case reports are presented of 26 knees with angular deviations in the frontal plane (19 varus and 7 valgus), treated by high domed tibial osteotomy with external skeletal fixation. Clinical and radiographic controls were carried out at a minimum of 6 months and a maximum of 3 years later. The new surgical instrumentation devised by the authors is described; this allows precise measurement of the angle of correction at operation.
Adolescent↗
The use of computerized tomography in the study of the cruciate ligaments of the knee.
Computerized tomography was used to investigate the knee joint, without the aid of a contrast medium, in 253 patients referred with a variety of diagnoses. The authors report in particular their experience in the visualization of the cruciate ligaments and assessment of the location, extent and nature of any relative lesions. Computerized tomography proved to be an extremely reliable means of investigating all the capsulo-ligamentous structures, both intra- and extra-articular. The diagnosis was accurate in 94% of cases with disorders of the cruciate ligaments.
Absorptiometry, Photon↗
Human knee ligaments: mechanical tests and ultrastructural observations.
The authors carried out mechanical tests on the collateral and cruciate ligaments of the human knee, using two different types of apparatus. They report and discuss the results of these tests relative to loads, stiffness and deformations. They also describe the electron microscopic findings in samples taken from above and below the macroscopic rupture. These observations are compared with those made in samples from unstressed ligaments.
Aged↗
Resistance of A-431 epidermoid carcinoma cells to early membrane changes induced by tumour promoters.
The A-431 human epidermoid carcinoma cell line was resistant to 12-O-tetradecanoylphorbol-13-acetate (TPA) inhibition of epidermal growth factor binding, enhanced incorporation of [3H]choline into phospholipids and uptake of 86Rb an [3H]2-deoxyglucose. The cells were also resistant to TPA-stimulated release of radioactive choline derivatives and arachidonic acid from cells prelabelled with [3H]choline or [14C]arachidonic acid, respectively. The A-431 cells did not metabolise [3H]TPA. Despite their TPA-unresponsiveness, A-431 cells contained specific, high affinity binding sites for [3H]phorbol-12,13-dibutyrate with characteristics similar to other cultured cell lines.
Arachidonic Acid↗
[The vertical root fracture].
Remembering the epidemiology and the possible etiologies of vertical root fractures, the authors distinguish between fractures that occur in vital teeth and vertical fractures of endodontically treated roots. They discuss predisposing factors, onset modality and follow-up. They describe the symptomatology and the few radiographic pathognomonic signs. They show the importance, prognostic and therapeutic purposes, of an exact differential diagnosis as regards periodontal problems. On the basis of personal experience and the literature they believe that the one certain resolutive therapy is extraction in the case of monorooted teeth and the root amputation of the fractured root in case of plurirooted teeth with a good periodontal supporting bone. They conclude by stressing the importance of a preventive global approach to reduce, among other things, the incidence of these unusual conditions that are difficult to diagnose, present no clear signs, and have an unfavourable prognosis.
Adult↗
Implant surface and osseointegration.
Oral rehabilitation by means of osteointegrated implants is gaining more and more importance, in particular due to the improved characteristics of the fixture: among these, the superficial microscopical morphology plays a role of primary importance, since it can influence the evolution of the osteointegrative process. Therefore, this led to many surface treatments which can improve the quality and the speed of formation of the bony tissue. The aim of this paper is a review of the literature on this topic in order to find out which processes of characterization of the surface implant are now available and which results can be obtained.
Dental Implants↗
Gingival overgrowth in renal transplant recipients induced by pharmacological treatment. Review of the literature.
Patients who undergo a renal transplant also require a pharmacological immunosuppressor therapy with cyclosporine (CsA) as well as anti-hypertensive calcium channel-blockers (CCBs); the former suppresses interferon and interleukin-2 production thus interfering with T cell cell-mediated activity, while the latter are used in order to counteract the nephrotoxicity of CsA which causes the local release, of thromboxane A2 with vascular vasoconstriction in the kidney. The use of both these drugs, particularly if used in association, leads to the onset of a clinical picture of variable entity, characterized mainly by a hypertrophy originating usually at the level of interdental papillae, and more pronounced in the anterior maxillary areas and the vestibular surfaces of the teeth, in a more or less symptomatic manner. The therapy is above all preventive, with an appropriate oral hygiene program, both professionally as well as at home, and with the use of substitutive drugs that do not present such side effects.
Angiotensin-Converting Enzyme Inhibitors↗
Local delivery of antimicrobial drugs in the treatment of chronic adult periodontitis.
AIM: The aim of this study was to evaluate the clinical and microbiologic results of local delivery of adjunctive antimicrobials in the treatment and management of patients with periodontitis. METHODS: The study population included 33 patients (age range, 37-49 years), with chronic adult periodontitis. Eleven of 33 received local treatment with 10% doxycycline injected directly into the periodontal pocket; 11 received local treatment with a chlorhexidine-based gel (1.5%) in situ; 11 received mechanical treatment with scaling and root planing. The crevicular fluid of the doxycycline-treated group was analyzed using high performance liquid chromatography over a period of 1 month. RESULTS: In the 11 patients treated with an antibiotic we observed a reduction in attachment loss and a reduction in probing depth of 1.4 mm; in the 11 chlorhexidine-treated patients we observed a reduction in attachment loss and a reduction in probing depth of 0.9 mm; in the remaining 11 patients the reduction in attachment loss and probing depth was less than those measured in the other two treatment groups. CONCLUSIONS: Our results suggest that direct delivery of antimicrobial agents to the infection site may be a useful adjunctive to conventional periodontal treatment.
Administration, Topical↗