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Biomedical subjects

A Migliore

Publications and source records attributed to A Migliore.

13 recordsLinked to original sources

Intrinsic III ventricle craniopharyngioma.

A case of intrinsic III ventricle craniopharyngioma in an 11-year-old girl is presented. Only five cases in children have previously been reported in detail. The intraventricular location of a craniopharyngioma originates from ectopic remnants and causes intracranial hypertension without hormonal or neurological disorders. The tumor was safely removed by the transcallosal approach, and we confirmed that the floor of the III ventricle was intact.

Cerebral Ventricle Neoplasms

Nicotinamide treatment in subjects at high risk of developing IDDM improves insulin secretion.

Nicotinamide (NCT) has been shown to be effective in preventing the onset of type 1 diabetes mellitus (IDDM) in mice with non-obese diabetic (NOD) and beta cell damage, mediated by the diabetogenic agents including streptozotocin. NCT therapy in man has been shown to have a beneficial effect on the remission phase of IDDM, and its use is safe. In this open pilot trial we therefore studied the effect of oral NCT administration on insulin secretion rate and islet-cell antibody (ICA) titres in IDDM high risk subjects. NCT (25 mg/10 kg bw) was administered in 6/13 high risk patients identified by a family screening programme. Those subjects tested after eight months without treatment showed a decreasing secretion in comparison to onset baseline (56,1 +/- 37.8 versus 35,5 +/- 12.2), whereas the treated subjects showed an increasing insulin secretion after treatment (26 +/- 10 versus 50.2 +/- 26.6), in spite of ICA persistence. Statistical analysis shows an increased insulin secretion in the treated group versus the untreated group (chi 2 = 3.899, P = 0.048). No side-effects were observed. We conclude that NCT may repair beta-cell function in high risk subjects too if damage is not too severe; furthermore, the effect seems not to be mediated by an immune mechanism.

Adolescent

[Immunogenetic and functional study of first-degree relatives of patients with type I diabetes mellitus for identifying prediabetic subjects].

Insulin dependent diabetes mellitus is an autoimmune disease with HLA-related genetic susceptibility. There is a latent phase before overt disease. During this phase islet cell antibodies (ICA) as a marker of humoral autoimmunity are detected and i.v. glucose tolerance test (IVGTT) is decreased. The aim of our work was to correlate IVGTT, HLA typing and ICA testing in all siblings of IDDM patients in order to identify high risk subjects (HRS). IVGTT showed significantly lower insulin levels in siblings vs controls (P less than 0.0001). This phenomenon could be caused by HLA unrelated genetic predisposition to low insulin secretion. Insulin level values of ICA+ siblings were lower than those of ICA- siblings, even if the difference was not significant.

Autoantibodies

Primary central nervous system lymphoma: a case of long survival.

Despite combined treatment (surgery, radio--and chemotherapy) primary central nervous system lymphoma (PCNSL) has generally a poor prognosis. Long surviving cases (more than 5 years) are exceptional. We report a case of a patient completely symptom-free 79 months after craniotomy. Histological diagnosis was diffuse centroblastic-centrocytic malignant lymphoma. Immunohistological study of the lesion was performed. Repeated CT scans reveal no tumor recurrence and screenings for extraneural disease remain negative. The prognostic value of tumor histology is emphasized.

Brain Neoplasms

5-hydroxyindoleacetic acid (5-HIAA) levels in the cerebrospinal fluid of hydrocephalic children before and after ventricular shunting procedure.

21 cases of hypertensive hydrocephalus were investigated for lumbar 5-HIAA before and after operation. Seven groups (posterior fossa tumors) of patients aged between 2 and 12 years were tested after tumor removal; the others (nontumorous hydrocephalus) after ventricular shunting. This last group included 8 patients with noncommunicating hydrocephalus aged between 15 days and 12 years and 6 with communicating hydrocephalus aged between 6 months and 9 years. At the time of the second determination all patients presented an improvement of clinical signs of intracranial hypertension. A correlative analysis of 5-HIAA values before and after operation is made. In tumor cases, preoperative levels were higher than controls, and a significant decrease was found after operation in comparison with preoperative levels. In nontumor cases, a significant decrease was also observed in noncommunicating hydrocephalus, confirming clinical usefulness of the results for controlling the degree of the intracranial hypertension and, in consequence, shunt performance. In communicating cases the results were disappointing, because almost always postoperative levels did not differ from the preoperative ones. Possible interpretations of the data are analyzed.

Cerebrospinal Fluid Shunts

[Aortoplasty with dacron patch in the surgical treatment of aortic coarctation].

The indications for aortoplasty and the techniques employed are described. The advantages of using Dacron patches are explained, namely: restricted mobilisation of the aorta, no sacrifice of intercostal vessels, no risk of haemorrhage from ectasic collateral vessels with weak walls, or from the calcified aorta wall, and simplicity. The method requires lengthwise section (extended as necessary) of the aorta where it is restricted following the application of clamps, removal of the stenosing diaphragm and application of a lozenge-shaped patch, with continuous suture of the anterior edges of the opening in the vessel. It is pointed out that the method is especially indicated in cases with marked atheromatous alterations and in chil-childrens, whose aorta is thereby enabled to grow normally, since a sufficient part of the wall is left in its natural continuity.

Adolescent

[Disadvantages of mechanical valve prostheses in the surgical treatment of mitral insufficiency].

Various disadvantages may be encountered with mechanical valve prostheses in the surgical management of mitral insufficiency; namely: 1) Early and secondary disinsertion; this is nearly always partial and is usually accompanied by haemolytic anaemial. 2) Infection with nil response to antibiotics. Death from septicaemia may be rapid. Replacement of the prosthesis is otherwise mandatory. 3) Thrombosis, usually partial, accompanied by one or more embolisms. Thrombo-embolism is more frequently noted in the first 6 months after implantation and becomes less common as time passes. 4) Deterioration of the movable part (ball variance) consisting of changes in colour and shape, with swelling and unevenness of the surface, breakage, pitting and loss of elasticity. 5) Low stroke volume syndrome. 6) Erosion of the septum and serious rhythm disturbances. 7) Proliferation of endothelial tissue leading to narrowing of the orifice. 8) Disturbed movement of the movable part, leading to intermittent or permanent blockage and loss of opening or closing play due to the interposition of fibrin and blood clots.

Anemia, Hemolytic

Insulin adsorption to three-liter ethylen vinyl acetate bags during 24-hour infusion.

Insulin adsorption to ethylen vinyl acetate, 3-liter bags injected with 10 insulin units, during 24-hr infusion has been studied. Three different infusions systems (A, B, and C) were tested and eight bags for each system were used. An elevated insulin adsorption resulted in each system. The maximal insulin recovery, expressed as percentage of the original theoretical 3333 microIU/ml insulin concentration, was 19.54% (at time 6), 20.93% (at time 4), and 16.95% (at time 22) for system A, B, and C, respectively. "Dismissed insulin amount" after 24-hr infusion was 1590 +/- 279.5 microIU, 1505.8 +/- 430.5 microIU, and 1253.3 +/- 369.8 microIU for system A, B, and C, respectively. Comparison of insulin concentration values at different times revealed significant differences only at time 18 (if compared with times 0,2.4,6,8,12,14,16) ant at time 20 (if compared with time 4,6,8,10) for system A, and at time 4 (if compared with time 12,14,16,18,20,22,24) for system B. We conclude that a constant but low insulin delivery can be achieved using 3-liter EVA systems and a 24-hr infusion.

Adsorption