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F Scaravilli

Publications and source records attributed to F Scaravilli.

At least 91 records · Page 5Linked to original sources
PubMed1994

Varicella-zoster virus infection of the central nervous system in the acquired immune deficiency syndrome.

Productive varicella-zoster virus (VZV) infection of the central nervous system (CNS) was demonstrated in 11 acquired immune deficiency syndrome (AIDS) patients using immunocytochemistry and in situ hybridization. A characteristic zoster skin eruption was seen in only four cases. From our own series and 11 other cases in the literature, we identified five clinico-pathological patterns of VZV infection of the CNS in AIDS patients which could occur simultaneously. (i) Multifocal encephalitis predominantly involving the white matter, likely to be due to haematogenous spread of the infection was found in four cases. (ii) Ventriculitis was found in three cases. In two cases there was complete acute or chronic necrosis of the ventricular wall with marked vasculitis; in the third, the ependymal lining appeared irregular with foci of VZV-infected ependymal cells, some of which protruded into the ventricular lumen. (iii) Acute haemorrhagic meningo-myeloradiculitis with necrotizing vasculitis was observed in two cases. In one, this was associated with ventriculitis and was possibly due to shedding of infected ependymal cells into the ventricular lumen and secondary seeding of the CSF. (iv) Focal necrotizing myelitis was seen in one case. It followed cutaneous herpes zoster and was considered to result from neural spread from the diseased dorsal root ganglion similar to cases previously described of encephalitis limited to the visual system following VZV ophthalmicus, or bulbar encephalitis following a trigeminal zoster. (v) Vasculopathy involving leptomeningeal arteries and causing cerebral infarcts was seen in four cases, it was associated with meningitis in most cases. These findings are in keeping with the observation in non-AIDS patients that VZV spread to the CNS may follow different routes. Our study tends to show that VZV infection of the CNS occurs more frequently in AIDS than previously suspected and suggests that it must be considered as a diagnosis in cases of encephalitis, ventriculitis, focal myelitis, acute myeloradiculitis and cerebral infarcts in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Immunohistochemical changes and PCR detection of HIV provirus DNA in brains of asymptomatic HIV-positive patients.

The stage of HIV infection at which the virus enters the nervous system remains poorly understood. Examination of brains of HIV-positive non-AIDS patients often shows lymphocytic meningitis, myelin pallor and gliosis, but no immunohistochemical (IHC) evidence of the virus. In this study we have examined a number of brains from HIV-positive patients with (23) and without (8) AIDS as well as brains from 5 HIV-negative controls by morphological, morphometric, IHC and polymerase chain reaction (PCR) methods in an attempt to establish at what stage of the infection HIV can be detected in the brain and to correlate its presence with the pathological changes in the cortex. HIV-1 proviral DNA was found by PCR in the cortex of the majority of AIDS and in 2 out of 8 non-AIDS cases. Astroglial reaction was observed in the cortex of the majority of AIDS brains but not in most of the non-AIDS brains which showed, in addition, a dramatic reduction of glial fibrillary acidic protein staining around blood vessels; moreover, in this group the density of microglial cells was higher than in the AIDS group. These results show that: 1) HIV proviral DNA can be found in the brains of HIV-positive non-AIDS patients; 2) in the same group there is an increase in density of microglial cells which 3) appears to be transient, since AIDS brains without neuropathology show a lower density of these cells. They also suggest that the status of 'immune reaction' existing in AIDS may predate this period.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1994

PCR detection of HIV proviral DNA (gag) in the brains of patients with AIDS: comparison between results using fresh frozen and paraffin wax embedded specimens.

AIMS: To adapt the polymerase chain reaction (PCR) technique of HIV detection to paraffin wax embedded brain tissue and to compare the results with those obtained using frozen tissue. METHODS: HIV antigen and HIV proviral DNA were detected in specimens of frontal lobe using immunohistochemistry and PCR, respectively. DNA was extracted from fresh tissue using standard methods whereas the technique for extracting DNA from paraffin wax embedded tissue was partly modified. RESULTS: Twenty cases were examined. HIV DNA was detected in 16 cases in frozen specimens. Of these, 15 were also positive when paraffin wax embedded material was analysed. CONCLUSIONS: This study shows that HIV proviral DNA can be detected in formalin fixed, paraffin wax embedded brain tissue by PCR. The results obtained from paraffin wax embedded specimens showed a similar degree of reliability to those from fresh frozen brain. Factors such as fixative, fixation time, and delay in performing post mortem examinations did not seem to influence PCR amplification as positive results were obtained with specimens left in fixative for up to eight months, as well as in cases where post mortem examinations had been delayed for up to four days.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Development of cortical fibres into the gracile nucleus of the rat: an ultrastructural study.

A study was made on the development of cortical synapses in the gracile nucleus of rats using degeneration methods. A total of 46 animals, 1 adult and 45 neonates whose ages varied from 1 to 7 days, had the right somatosensory motor cortex destroyed. The survival period varied from 1 to 30 days. Identification of axonal terminals in the gracile nucleus was also achieved by tracing the cortical fibres of 1 adult rat using horseradish peroxidase-wheat germ agglutinin (HRP-WGA). Degenerating axodendritic and axosomatic terminals that originated from cortical fibres were seen in the adult animal which survived 2 days. Their origin was confirmed by the presence of HRP-WGA inside the terminals. Light or electron microscopic changes were not seen, and in particular, the gracile nucleus was not smaller than in the control adult animals which survived 30 days or in neonates which survived 8-30 days, consistent with the small component of cortifugal fibres believed to terminate in secondary sensory nuclei. In neonates that survived a shorter period, terminal degeneration was only seen in cases operated at 4 days and later, indicating that cortical axons do not synapse in the gracile nucleus until postnatal day 4. Our results provide further support for the existence of a period in which the fibres approach their target but do not penetrate it to form synaptic junctions during the growth of cortical axons toward their targets, since previous studies have demonstrated that cortical fibres persisting to adulthood decussate completely at the level of the medulla at 12-36 h after birth.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Nigral degeneration in neuroacanthocytosis.

We counted nerve cells in different subregions of the substantia nigra in three patients with neuroacanthocytosis and compared the results with those of age-matched Parkinson's disease and control patients. Two patients with neuroacanthocytosis and clinical parkinsonism in life had a reduced neuronal density in the substantia nigra, while in a third patient without parkinsonism, this number was at the lower limit of the control range. In neuroacanthocytosis with parkinsonism and in Parkinson's disease, the ventrolateral region of the substantia nigra was most severely affected, although in neuroacanthocytosis cases, nigral neuronal loss was more widespread.

Aged↗
PubMed1993

Herpes simplex type 1 encephalitis in acquired immunodeficiency syndrome.

A severe acute necrotizing herpes simplex virus type 1 encephalitis, apparently mediated by macrophages or cytokines or both, was seen in a patient with acquired immunodeficiency syndrome. The necrosis had a distribution similar to that seen in immunocompetent subjects. Viral inclusions were abundant and meningeal reaction was minimal, as previously described in one anergic patient.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Intrinsic malignant glioma of the pineal gland.

The case of a 6-year-old girl who presented with a glioblastoma multiforme arising from the pineal gland is reported. Most so-called gliomas of the pineal region originate from neighbouring structures; authentic malignant gliomas of the pineal itself are extremely rare. This appears to be only the second fully documented case reported in the world literature.

Brain Neoplasms↗
PubMed1993

Reliability of histological diagnosis including grading in gliomas biopsied by image-guided stereotactic technique.

We report clinical and pathological data of 419 image-guided stereotactic biopsies. In the present series the diagnostic yield, estimated by comparing the original histological diagnoses with follow-up data, was found to be approximately 94% in gliomas. As it has been suggested that malignancy of astrocytic gliomas may be considerably underestimated in the small tissue samples obtained by stereotactic biopsy, we have reviewed 160 adult, diffuse supratentorial astrocytic tumours, correlating the original Kernohan tumour grades with survival. In this grading system, although there was generally a good correlation between histological grade and survival probability (P < 0.0001), no distinction could be made between the grade 3 (anaplastic astrocytoma) and grade 4 (glioblastoma) groups. Tumour grades obtained by applying the criteria of the more recent Daumas-Duport grading system were also determined and correlated with survival. These latter tumour grades not only correlated well with survival (P < 0.0001), but also enabled us to identify a group of patients with intermediate grade malignancy (grade 3, anaplastic astrocytoma), surviving longer than those with grade 4 tumours. Image-guided stereotactic biopsy is a useful means of providing tissue samples for histological diagnosis of brain neoplasms, including gliomas. Histological grading of adult, diffuse supratentorial astrocytic gliomas diagnosed by this technique is possible and should be carried out using an appropriate grading system.

Adolescent↗
PubMed1993

Proliferating cell nuclear antigen (PCNA): expression in samples of human astrocytic gliomas.

In this retrospective study, 55 astrocytic tumours were stained with monoclonal antibody PC10 which recognizes the proliferating cell nuclear antigen (PCNA) in formalin fixed, paraffin-wax embedded sections. All the cases were graded using the Daumas-Duport system and the PCNA labelling indices (LIs) were correlated with tumour grades. Mean PCNA LI was 4.1% in the grade II, 8.1% in the grade III and 26.1% in the grade IV group. Six juvenile and cerebellar (grade I) astrocytomas had a mean PCNA LI of 5.6%. In general PCNA LI increased with tumour grade, but there was considerable variation of LIs especially in grade IV tumours which often had very high PCNA LIs (up to 72.7%). PC10 may be a useful complementary technique in surgical neuropathology, but the significance of the high LIs, seen in a proportion of glioblastomas, needs to be further determined.

Adolescent↗
PubMed1993

A familial disorder associated with palatal myoclonus, other brainstem signs, tetraparesis, ataxia and Rosenthal fibre formation.

Three siblings presented with a progressive neurological disorder beginning in the third decade of life and characterised by palatal myoclonus, nystagmus, bulbar weakness and spastic tetraparesis. There was no evidence of intellectual deterioration or seizures. CT scan showed marked brainstem atrophy in two patients and basal ganglia calcification in one. MRI scan in one showed high signal in the brainstem and periventricular region and cerebral biopsy in this patient showed myelin loss and the presence of Rosenthal fibres. A similar disease affected the siblings' mother, maternal aunt and two of the aunt's daughters, suggesting an autosomal dominant mode of transmission of what appears to be a unique genetic disorder.

Adult↗
PubMed1993

[Adenocarcinoma of the cecal appendix].

The authors report one rare case of primary adenocarcinoma of the vermiform appendix. The patient, an 83 year old female, presented with a non-pathognomonic symptomatology; diagnosis was made postoperatively. Surgery consisted of appendicectomy. The patient, due to her poor general condition, died three days after surgery for cardiocirculatory complications. In the light of the very rare case published in the literature, some diagnostic, anatomic-clinical, therapeutic and prognostic aspects of this rare tumor are discussed.

Adenocarcinoma↗
PubMed1992

A follow-up study of isolated cases of suspected Huntington's disease.

We reviewed 49 patients in whom a diagnosis of Huntington's disease (HD) seemed possible on clinical grounds, but who gave no history of definitely affected relatives. In 32 with the typical clinical features of HD (progressive chorea and dementia, postural instability, abnormal initiation of saccadic eye movements), the diagnosis was confirmed in 7 patients who had had autopsies, affected relatives were found in 5 others, and HD remained probable in a further 13 who were reexamined. In the 17 with a less typical clinical picture, a diagnosis of HD appeared most likely in 2; other causes for chorea such as cerebrovascular disease, neuroacanthocytosis, recrudescence of Sydenham's chorea, and drug-induced tardive dyskinesia could be invoked in the remainder. We conclude that the likelihood of HD in a patient with the typical clinical features of this disorder but no history of affected relatives is at least 75%, which for practical purposes implies a risk to their children hardly less than in familial HD. The most plausible explanations for seemingly sporadic patients with HD are nonpaternity and mild, late-onset disease that is overlooked by other family members.

Adult↗
PubMed1992

Hemiballism and chorea in a patient with parkinsonism due to a multisystem degeneration.

Dyskinesias associated with dopaminergic treatment in idiopathic Parkinson's disease (PD) can be indistinguishable from those arising spontaneously in other conditions involving degeneration of, or damage to, the basal ganglia. However, those due to levodopa treatment of PD disappear on cessation of therapy. We report a patient with a clinical diagnosis of PD who, on levodopa treatment, developed hemiballism and chorea that were originally thought to be drug induced. However, the dyskinesias persisted despite stopping levodopa. Postmortem analysis showed a multisystem degeneration.

Aged↗
PubMed1992

The pathology of the posterior root ganglia in AIDS and its relationship to the pallor of the gracile tract.

The spinal cord and the thoracic and lumbar posterior root ganglia (PRGs) of 14 HIV-positive men and 7 age- and sex-matched controls were studied by routine histology, morphometric analysis of the number of nodules of Nageotte (nN) and the diameters of sensory ganglion cells, immunohistochemistry and in situ hybridization. In 7 patients (2 of whom had evidence of cytomegalovirus ganglionitis) there were increased numbers of nN and diffuse, mild infiltration with CD45R+ T lymphocytes; no B lymphocytes were observed. Macrophages were increased in number in all cases. Whenever more than one ganglion was examined from the same patient, the appearances were similar in all. There was no alteration in the distribution of ganglion cell diameters. Changes in the spinal cord included vacuolar myelopathy (5 cases), HIV myelitis (1 case), microglial nodules (3 cases) and pallor of the gracile tracts (GTP) in 7 cases, in 6 of whom it co-existed with increased numbers of nN. Seven cases had no abnormalities, except the increase in number of macrophages in PRGs. In spite of a correlation between sensory nerve cell loss and GTP our findings suggest that other mechanisms, such as 'dying back' may contribute to the pathogenesis of GTP. Moreover, sensory disturbances were found most commonly in association with nerve cell loss; however, loss of sensory ganglion cells was not necessarily associated with evidence of sensory impairment.

Acquired Immunodeficiency Syndrome↗