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Biomedical subjects

C Della Rocca

Publications and source records attributed to C Della Rocca.

50 records · Page 3Linked to original sources
PubMed1986

Treatment of secondary hyperparathyroidism of predialysis chronic renal failure with low doses of 1,25(OH)2D3: humoral and histomorphometric results.

Treatment of secondary hyperparathyroidism and the osteodystrophy of predialysis chronic renal failure (CRF) with 1,25(OH)2D3 has been advocated by several authors, but also opposed by others for alleged renal toxicity. However, current concepts of the pathogenesis of the early occurrence of secondary hyperparathyroidism in predialysis CRF point to deficiency of 1,25(OH)2D3 as a primary factor. The aim of this study was to evaluate if administration of 1,25(OH)2D3 (0.25 microgram daily) in a dose which would not induce hypercalcemia, would improve humoral and bone histomorphometric parameters in predialysis CRF. 15 patients with predialysis CRF (mean age 51.2 +/- 16.9 years, range 13-73 years), serum creatinine 4.93 +/- 1.7 mg/dl, were treated with the vitamin D metabolite for an average of 16.2 +/- 11.3 months, at the end of which a transiliac bone biopsy for histomorphometry was performed. In addition, 23 patients comparable for age, serum creatinine and causes of renal failure, served as controls. Treatment did not induce hypercalcemia nor adversely modify the rate of decline of renal function. Alkaline phosphatase fell significantly while immunoreactive parathyroid hormone (iPTH) and osteocalcin showed a moderate, not significant, decrease. Compared to the control patients, the bone histomorphometric parameters active resorption surface and active osteoblastic surface were significantly lower and almost normalized by treatment. In conclusion, the study provides conclusive evidence of the absence of toxicity of the metabolite at the low doses employed, together with good therapeutic response on bone histology. Treatment at this dosage could be made in the early stages of predialysis CRF without need of close and continuous monitoring of serum biochemical parameters.

Adolescent↗
PubMedDate not supplied

Malignant peripheral neuroectodermal tumor (MPNET) of the kidney.

BACKGROUND: Malignant peripheral neuroectodermal tumors (MPNETs) are primitive neuroblastic tumors that arise, unlike neuroblastomas, outside the autonomic nervous system. A renal origin has been described in very few cases. CASE REPORT: We report the case of a young male patient with a large MPNET of the right kidney, studied with ultrasound and computed tomography before surgical resection. The main radiologic features, the microscopic appearance and the typical immunohistochemical findings, are described and discussed.

Adult↗
PubMedDate not supplied

Synovial metastasis of the shoulder detected by arthroscopy as the presenting manifestation of lung adenocarcinoma.

A case in which a post-traumatic shoulder impairment revealed the presence of the joint involvement by a metastatic localization of lung adenocarcinoma is presented. The patient was a 60-year-old white man, a smoker, in apparent healthy condition complaining of pain and stiffness from a 1-year-old traumatic accident to the right shoulder sustained during a tennis match. He had been unsuccessfully treated for 6 months with physical therapy. Because of the negativity of the usual imaging studies, a diagnostic arthroscopy was performed. It revealed the presence of a traumatic rupture of the glenoid labrum and of an atypical gelatinous synovial formation in the medial wall of the joint; it was histologically and immunohistochemically diagnosed as adenocarcinoma, probably originating in the lung or in the gastrointestinal tract. The pulmonary origin of the neoplasm was confirmed by computed tomography. The patient underwent chemotherapy and eventually died with contralateral lung and femur metastases 8 months after the diagnosis. The clinical importance of this rare observation is discussed.

Adenocarcinoma↗
PubMedDate not supplied

Concurrent chemoimmunotherapy in metastatic clear cell sarcoma: a case report.

Clear cell sarcoma is a rare tumor with a poor prognosis. The therapeutic approach in the metastatic disease stage is controversial: to the authors' knowledge the use of concurrent chemoimmunotherapy has not been previously reported. We present a case of a 57-year-old male with metastatic clear cell sarcoma treated simultaneously with subcutaneous interferon-a 2b and six courses of chemotherapy according to the CyVEDIC regimen. Disease stabilization lasting 17 months was achieved.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Primary aspergillosis of the larynx in a patient with Felty's syndrome.

Herein we report the first case of primary aspergillosis of the larynx in a patient with Felty's syndrome. A 53-year-old man, a florist by profession, with a 12-year history of rheumatoid arthritis and on treatment with steroids, was admitted because of hoarseness, and intermittent fever of 2 weeks' duration. On admission, physical examination and laboratory data showed, among other findings, splenomegalia and neutropenia. At bone marrow examination, normal cellularity with mild dyserythropoiesis was observed. A fiberoptic laryngoscopy showed white plaques on both the true vocal cords. Both culture and microscopic examination of these lesions provided the diagnosis of invasive process by Aspergillus flavus. A computed tomography of the middle ears, paranasal sinuses, and chest was normal. Thus, primary aspergillosis of the larynx and Felty's syndrome was diagnosed, and the patient was successfully treated with granulocyte colony-stimulating factor and systemic antifungal agents. Felty's syndrome, corticosteroid use, and occupational risk probably rendered our patient susceptible to Aspergillus infection.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Immunohistochemical and ultrastructural investigation of neural differentiation in Ewing sarcoma/PNET of bone and soft tissues.

The authors evaluated the role of immunohistochemistry and electron microscopy in defining neural differentiation in 28 cases of Ewing sarcoma/PNET. The panel of primary antibodies used included vimentin, MIC-2, NSE, S-100 protein, leu7, neurofilaments, GFAP, and chromogranin A. Cases were considered undifferentiated when neural markers were absent, poorly differentiated if one neural marker was present, and well differentiated if two or more markers were observed. Cases were also evaluated for the presence of cytoplasmic processes, microtubules, and neurosecretory granules as ultrastructural features of neural differentiation: the tumor was classified as well differentiated if two of these features were present; and poorly differentiated if one was evident; all other cases were considered undifferentiated. According to immunohistochemistry, 10 cases (35.7%) were undifferentiated, 12 cases (42.9%) were poorly differentiated, and 6 (21.4%) were well differentiated. According to the ultrastructural analysis, 10 tumors were undifferentiated (35.7%), 14 poorly differentiated (50%), and 4 well differentiated (14.3%). The overall concordance between the two techniques was low (35.7%), and both modalities were concordant in classifying only 1 well-differentiated, 5 poorly differentiated, and 4 undifferentiated tumors. In conclusion, the authors suggest that investigations devoted to test the prognostic significance of neural differentiation in these neoplasms should employ both immunohistochemistry and electron microscopy, separately and in combination, to assess what is the most effective choice for predicting the clinical course.

Adolescent↗
PubMedDate not supplied

Central giant cell granuloma of the palate; unusual localisation in a five year old child.

The central giant cell granuloma of the maxillo-mandibular region is a relatively uncommon lesion (3.5%-0.1%). Essentially, it occurs in the second decade of life and it is mainly located in the mandibular region. The female/male ratio is 3:1. The authors present an unusual localisation of central giant cell granuloma in a five year old child's maxillary bone. After a surgical curettage of the lesion, an eighteen months follow-up examination did not show any recurrence.

Child, Preschool↗
PubMedDate not supplied

Localized bacillary angiomatosis in the oral cavity: observations about a neoplasm with atypical behavior. Description of a case and review of the literature.

Bacillary angiomatosis is a rather frequent infectious pathology appearing mainly in the skin but can also affect the liver, spleen, heart, bones, lungs, muscles, central nervous system and other organs. The localization of the lesion in the oral cavity is rather rare, as it is evident in the literature. Bacillary angiomatosis can be clinically similar to the Kaposi's sarcoma and histologically confused with angiosarcoma, epitheloid hemangioma and pyogenic granuloma. A case of bacillary angiomatosis of the oral cavity in an immuno-competent patient is described. The high tendency to relapse, the capability in migration and to involve several localizations at the same time have induced the authors to deepen the research to exclude the possibility that it could be a Kaposi's sarcoma or a pyogenic granuloma and to get to an accurate diagnosis in order to resolve the disease.

Adolescent↗
PubMedDate not supplied

Microcarcinoma and incidental carcinoma of the thyroid in a clinical series: clinical behaviour and surgical management.

OBJECTIVES: Papillary thyroid microcarcinomas (PTM) have not yet an agreed clinical management. The Authors compared PTMs with papillary thyroid carcinoma of larger size (LPTC) and incidental and not-incidental carcinomas. MATERIALS AND METHODS: Review of clinical data of 67 patients (54 women, 13 men) prospectively stored in a standardised way in an electronic patient record system. RESULTS: There were 36 cases of microcarcinoma (53.7%). Differences were not significant between PTM and LPTC groups as to patients personal data, TNM and MACIS staging, nodal involvement (8.3% vs 19.3%) and multifocality (25% vs 38.7%) while capsular invasion was significantly higher in LPTC (25% vs 54.8%). Nineteen incidental tumors were detected at pathological examination and they were all microcarcinomas. They were smaller than the remaining 17 not-incidental microcarcinomas but showed a similar clinical behaviour. There were not cancer related deaths nor recurrences in the follow up period in any group. CONCLUSIONS: Despite the excellent prognosis of PTM, a subset of these tumours shows aggressive biological and clinical features, like nodal or capsular invasion and multifocality. Actually, with the exclusion of size, they do not show any relevant difference from differentiated thyroid carcinoma of larger size. Since predictive cytogenetic markers are still missing, their treatment should then be the same as for conventional thyroid cancers.

Adult↗
PubMedDate not supplied

[Ulcerative colitis, thromboses of the cavernous sinuses and prostatic plexus and acute necrotizing hemorrhagic leukoneuraxitis: a case report of a syndromal association].

The authors describe a case of ulcerative colitis initially complicated by priapism due to cavernous sinus thrombosis and by prostatic plexus thrombosis and, subsequently, by a fatal acute necrotizing hemorrhagic leukoencephalitis. This complex and, apparently, until now unreported association supports the view that ulcerative colitis is the expression of a systemic disease. It also raises important pathogenetic problems which are discussed in connection with the vascular complications of ulcerative colitis reported in the literature.

Acute Disease↗
PubMedDate not supplied

[Environmental and occupational risk factors in keratosis of the larynx].

Laryngeal keratosis may frequently precede the appearance of carcinoma of the larynx which might well indicate that these diseases have a common denominator. A retrospective study of 120 subjects with laryngeal keratosis was examined. The intention of the Authors was to verify whether the principle risk factors involved in the appearance of laryngeal carcinoma were the same as those implicated in laryngeal keratosis formation. Sex age, work activity, cigarette smoke, alcohol consumption and vocal chord abuse were considered. Laryngeal keratosis takes keratosis with dysplasia as well as keratosis without. A link between these two types of keratosis and cancer was sought. In particular, the possibility that a persistent action of the mentioned risk factors could cause laryngeal dysplasia-free keratosis to change into dysplastic lesions and subsequently into cancer was investigated. A case-control study was performed in order to analyze the importance of work activity. Results were statistically significant (P < 0.001). The Cramer V2 calculation demonstrated a clear correlation between the number of cigarettes smoked and the appearance of dysplasia (V2 = 0.117; P < 0.005). Results showed a clearly different behaviour between sexes. The number of males was much higher than females as was the age at which keratosis appeared greater in males. The fact that the average age in which keratosis appeared preceded the appearance of laryngeal cancer by ten years indicates that this interrum is sufficient for keratosis with dysplasia to be transformed into cancer (due to the continued action of the mentioned etiologic factors, mainly referred to cigarette smoke). In our data analysis, no correlation was demonstrated between keratosis without dysplasia and cancer.

Adolescent↗
PubMedDate not supplied

[Osteomas and exostoses of the facial structures: a morphological study and the etiopathogenetic considerations].

The differential diagnosis of the osteocondensing lesions (osteomata and exostoses) is till today a topical issue for the experts. In order to test the reliability of the etiopathogenetic theories advanced up to now, the authors carried out a research on samples of tissue coming from surgical interventions for osteomata and exostoses of the maxillofacial region resortied with optical and polarized-light microscopes (OM-PLM). This research meant to analyze the morphological and structural characteristics of newly formed tissues; a considerable attention has been devoted to the difference between primary and secondary bone and to the quality of cementing lines. Thanks to the data resulted from this study, the authors advanced interesting theories about these pathologies either from an etiological and nosological point of view.

Diagnosis, Differential↗
PubMedDate not supplied

Short-term healing following the use of calcium sulfate as a grafting material for sinus augmentation: a clinical report.

Because of the frequent lack of bone in the posterior maxilla, sinus augmentation has become a commonly practiced treatment modality. Many different materials have been used for augmenting the sinus, and the ideal graft is yet to be found. The present article reports the results of sinuses grafted with calcium sulfate in 2 patients. Bone biopsies were harvested 9 months after the augmentation procedure. In the first patient, 3 titanium threaded-cylinder implants were placed in the grafted area after 9 months, while in the second, 1 acid-etched, screw-shaped titanium implant was placed simultaneously with the graft. Light microscopic evaluation revealed new bone formation with ongoing remodeling and progressive lamellar maturation in the specimens. No remnants of the alloplastic material were detectable in any section, either within the bone or in the medullary tissue. When reevaluated at the uncovering procedure, the implants were radiographically and clinically judged to be osseointegrated. These observations suggest that, when used in the appropriate form and with the proper technique, calcium sulfate is a promising graft material for sinus augmentation, producing adequate quantity and quality of new bone for implant placement.

Acid Etching, Dental↗