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Biomedical subjects

G Caruso

Publications and source records attributed to G Caruso.

At least 19 recordsLinked to original sources
PubMed1995

Squamous cell carcinoma of the posterior pharyngeal wall: characteristics compared with the lateral wall.

Squamous cell carcinoma of the posterior oro- and hypopharyngeal wall (SCCPPW) is a relatively rare tumour. A retrospective investigation of 63 patients with SCCPPW and 449 patients with carcinoma of the lateral oro- and hypopharyngeal wall, treated between 1964 and 1992, has been carried out. Most SCCPPW were asymptomatic, macroscopically superficial and at early stages. They were usually detected by chance during an examination for a different type of malignancy. Fifty-seven percent of SCCPPW patients had multiple tumours; however this occurrence did not alter the survival rate. The crude five-year survival rate for SCCPPW was 22 percent and was not significantly different from that of patients with lateral wall tumours. Moreover, both local control and recurrences also were not statistically different.

Carcinoma, Squamous Cell↗
PubMed1995

Charcot-Marie-Tooth disease: molecular characterization of patients from central and southern Italy.

The syndrome of peroneal muscular atrophy, or Charcot-Marie-Tooth (CMT), disease represents the most common inherited peripheral neuropathy, with a prevalence of about 1 per 2500. The disease is usually transmitted in an autosomal dominant fashion, although it can display all the mendelian patterns of inheritance. The chromosome 17-linked form (CMT1a) appears to be the most common form of the disease in all the ethnic groups studied so far, Italians included, and is due to a tandem duplication in 17p11.2. In order to study the distribution of CMT types and to establish a genotype-phenotype correlation in patients from Central and Southern Italy, we collected 19 CMT pedigrees diagnosed in the years 1992-1993. Simple tandem repeats (STR) polymorphism analysis with the marker RM11-GT and Southern blotting with the probes pVAW409R3 and pVAW412 were performed, demonstrating a high prevalence (about 60%) of 17p duplication in the families studied. No clinical or electrophysiological differences were noted between CMT1 patients with or without 17p duplication, respectively. Two families affected by CMT2 showed no evidence of rearrangement at the D17S122 locus. These data are consistent with the hypothesis of a different molecular basis for CMT2.

Blotting, Southern↗
PubMed1995

[Neoadjuvant intralesional chemotherapy for breast neoplasm in advanced stage. Assessment of its efficacy with Doppler color].

Twenty women with breast cancer confirmed at cyto-histology, 4 of them with axillary lymph node metastases, were submitted to neo-adjuvant chemotherapy with the conventional systemic treatment combined with intralesion drug administration and monitored by means of color-Doppler ultrasonography (CDU). Before treatment, CDU demonstrated marked color signal increase in 18 cases. After treatment, tumor vascularity clearly decreased and response was more apparent since treatment had been local rather than systemic. In this paper, the consistent semiology of breast cancer is discussed together with the progressive changes in CDU color signal, the latter a valuable parameter for surgical timing. Histology, performed during treatment and on the surgical specimen, allowed treatment results to be monitored, showing a rich proliferation of connective tissue and the persistence of rare neoplastic nests. In 2/4 patients with lymph node metastases, the latter lesions reduced in size. The postoperative follow-up of these patients, which was the object of our study, currently ranges 4 to 36 months, in which period of time no relapses have been observed. The results obtained so far suggest the effectiveness of combined parenteral and local drug administration in the preoperative treatment of breast cancer. Moreover, this approach makes surgery feasible even in the most advanced forms (T3-T4). CDU is the most accurate method to monitor neo-adjuvant treatment effectiveness.

Aged↗
PubMed1995

[Mental disease between norm and history].

After a brief discussion of the concept of statistical, social and functional norm, the authors stress that the latter is related to the constant evolution and hence uncertain nature of scientific knowledge. With regard to mental disease it is underlined that, during the history of psychiatrics, social aspects have often been confused with functional ones, and uncommon statistical aspects have been interpreted as abnormal. Likewise, as it changes over time even the social norm has interfered with functional norms and consequently with the pathological process.

Humans↗
PubMed1995

[Magnetic resonance in the evaluation of lesions of the posterior tibial tendons].

Posterior tibial tendon (PTT) tears are the most common cause of unilateral flatfoot in adults. It is a chronic pathologic condition with a degenerative inflammatory character which usually affects middle-aged or elderly women, with no history of trauma. PTT tears occur more rarely in young patients, after an acute traumatic event. Clinically, PTT tears present with pain along the tendon, increased by weight bearing, swelling and functional limitation. PTT tears are surgically classified in three types: with tendon hypertrophy, with tendon atrophy and with complete tendon tear. The three different anatomicosurgical patterns require different therapeutic approaches. This work was aimed at investigating MR capabilities in recognizing the direct and indirect signs of PTT tears, assessing MR sensitivity in different types of tears. Fourteen patients with clinically suspected PTT tears and 10 control patients underwent MRI of the ankle (0.5 T, GE Vectra) following a study protocol including SE T1-weighted and FSE T2-weighted scans acquired on the axial and sagittal planes. In all patients, the transverse diameter, the shape and the section surface of the lesions were calculated on the axial planes at different levels; all these parameters were compared with those of the adjacent tendons, i.e., flexor longus ditae and flexor hallucis. Moreover, the probable presence was investigated of intratendineous signal intensity changes, of peritendineous synovial fluid and of indirect signs of PTT tear, i.e., the lack of longitudinal talonavicular alignment and the bulging of the medial navicular tubercle. According to MR results, the 14 patients were subdivided into 8 patients with type-I tears, 2 with type-II tears and 4 patients with type-III tears. The measures of healthy and injured tendons were in substantial agreement: in fewer cases, agreement was found also between symptomatic and control patients with intratendineous signal changes. Thus, the specificity of the two parameters was reduced. Finally, such indirect signs of PTT tear as a hypertrophic navicular tubercle and the lack of longitudinal talonavicular alignment exhibited good specificity, but sensitivity was barely sufficient. MR diagnoses were confirmed at surgery in 6 patients with type-II and type-III tears. In conclusion, MRI appears to be a suitable modality for recognizing and classifying PTT tears and a useful tool for the treatment and follow-up of these patients.

Adolescent↗
PubMed1995

Peripheral neuropathy in liver cirrhosis. A clinical and electrophysiological study.

Clinical symptoms and/or signs of peripheral neuropathy were found in 17 of the 19 patients we studied with liver cirrhosis. In 16 of the 19 patients electrophysiological abnormalities were also observed. Mild-moderate alterations involved both motor and sensory fibres, with a higher incidence in the lower rather than upper limbs, and indicated a fibre loss rather than a fibre demyelination. These changes were observed in both alcoholic and non-alcoholic cirrhotics, suggesting a primary role of liver cirrhosis per se. In fact, both the clinical and electrophysiological abnormalities were related to the severity of the liver disease. A careful clinical examination could reveal the presence and extent of neuropathy in most cirrhotic patients.

Aged↗
PubMed1994

Median nerve sensory responses evoked by tactile stimulation of the finger proximal and distal phalanx in normal subjects.

We compared the characteristics of near-nerve recorded sensory potentials elicited in response to electrical stimulation of digital nerves versus tactile stimulation of the digital skin in 17 healthy subjects with a mean age of 26 years. We also calculated the density of Meissner's corpuscles in the distal and proximal phalanx of digit III of 6 males who had suffered a violent death, but were free from diseases of the peripheral nerve system. Responses to tactile stimulation had a longer latency and lower amplitude than responses to electrical stimulation. Unlike electrically elicited responses, responses to tactile stimulation, which consisted of six or seven main spike components plus several minor components, were similar in recordings from the wrist and elbow. However, with proximal stimulation the electrically evoked responses were more compact and had a higher amplitude and area, whereas the tactile evoked potential became significantly reduced in maximum amplitude and cumulative area. The differences in sensory conduction between distal and proximal could reflect activation of a larger number of nerve fibers when electrical stimuli are used and a smaller amount of mechanoreceptors when tactile stimuli are used.

Action Potentials↗
PubMed1994

Evoked potentials in inherited ataxias: a multimodal electrophysiological study.

A multimodal electrophysiological study, including median nerve somatosensory evoked potentials (SSEPs), motor cortical stimulation (CS) and brainstem evoked potentials (BAEPs), was performed on 34 patients with hereditary ataxias (HAs): 15 with Friedreich's disease (FD), 10 with early onset cerebellar ataxia (EOCA), and 9 with autosomal dominant cerebellar ataxia (ADCA). A higher incidence of abnormal central motor conduction was observed in FD than in EOCA patients, but was never observed in ADCA. A relationship between central motor conduction abnormalities and disease duration and clinical impairment was found only in FD patients. All FD patients showed severe impairment of the SSEPs that was not related to disease duration. In EOCA patients, less frequent and more variable SSEP abnormalities were observed. The lowest incidence of central SSEP abnormalities was observed in ADCA. The BAEP findings in all 3 groups of patients (but particularly those with EOCA) suggest prevalent brainstem damage.

Adolescent↗
PubMed1994

Determinants of compliance with an early detection programme for cancer of the head and neck in north-eastern Italy.

An early detection programme for cancer of the head and neck (H&N) has been conducted from January 1991 to January 1993 in Pordenone province, north-eastern Italy, an area with very high mortality rates for cancers in those sites. 627 high-risk individuals (491 males, median age 57 years and 136 females, median age 47 years) (i.e. smokers and/or drinkers of more than a half litre of wine or equivalent per day) were referred to a research nurse by 21 general practitioners. An educational message on the health hazards of tobacco and alcohol abuse was delivered together with an invitation to undergo a free ear, nose and throat (ENT) examination at a nearby hospital. 212 individuals (34%) underwent the ENT visit. The influence of various individuals' characteristics on the lack of compliance was assessed. Female sex and absence of ENT symptoms were associated with a more than two-fold higher lack of compliance. Current smokers were more than three-fold less likely to accept the invitation to undergo the examination. Conversely, alcohol intake and, within smokers, the amount smoked seemed unimportant. This study shows that the correct identification of high-risk individuals is expensive and the compliance with a H&N cancer early detection programme relatively low, especially among smokers.

Adult↗
PubMed1994

Color Doppler ultrasonography in pediatric intussusception.

CDU was used in 11 children with intussusception. Demonstration of vascular images within the "pseudokidney" mass was possible in none of 11 cases. Of them, eight could be treated by hydrostatic reduction. In the remaining case, marked edema of the bowel wall did not allow reduction, and surgery had to be performed: no necrosis was observed in the surgical specimen. Both patients in whom CDU failed to demonstrate vascular signals had necrosis at surgery, and bowel resection was performed. Because of the limited number of patients examined at this time, no firm conclusions can be drawn from our experience. However, CDU seems a promising technique in detecting vascular changes occurring in intussusception, with a possible role as a predictive tool of bowel necrosis.

Child, Preschool↗
PubMed1994

[Angiogenetic capacity of breast neoplasms and correlation with color-Doppler semiology].

The authors correlated the presence/absence of color signal-as shown by color-Doppler ultrasonography (CDUS) in 22 cases of breast carcinoma-with lesion angiogenesis potentials, as evaluated in the histologic sections with the determination of the microscopic angiogenesis grading system (MAGS) index. In all 4 cases in which CDUS showed no color signal, MAGS index value exceeded 30, which is suggestive of high neoplastic neoangiogenesis potentials. In contrast, in 17 of 18 cases positive to CDUS, MAGS index value remained below 30 and the microscopic analysis showed the presence of many fresh vessels more than 1 mm in caliber. Consequently, the presence of color signals at CDUS exams may be related to the features of tumor feeding vessels and therefore a negative CDUS exam cannot be considered as a reliable sign to exclude a malignant lesion.

Breast Neoplasms↗
PubMed1994

[The echocardiographic assessment of the functional variations in the left ventricle induced by isometric stress in subjects with primary cardiomyopathy in the pre-dilated phase].

The aim of this study was to assess whether a sudden increase in left ventricular (LV) afterload in a pre-dilated condition of idiopathic cardiomyopathy, in associated with some non-invasively detectable impairment of LV function. Ten subjects (Group A, 7 males, 3 females, mean age 36.7 +/- 11.4 years), submitted to cardiac catheterization because of severe symptoms related to ventricular arrhythmias, were found to have normal coronary arteries and left ventricular function, but histological features suggestive of congestive cardiomyopathy at endomyocardial biopsy. Echocardiography was performed during handgrip for 5 min at 30% of the maximal effort, in order to obtain a sharp increase in systolic LV pressure of more than 40 mm Hg. Ten healthy subjects were used as controls (Group B). Results in Group A showed a significant decrease in LV ejection fraction (from 62.4 +/- 6.9 to 57 +/- 7; p < 0.005) and LV shortening fraction (from 34.2 +/- 5.1 to 31 +/- 4.3; p < 0.01); a significant increase in LV systolic volume (from 48.2 +/- 9.1 to 60.0 +/- 12.0; p < 0.005) and systolic stress (from 114.6 +/- 33.2 to 178.8 +/- 58.2; p < 0.001). At the first minute of recovery LV function normalized quickly while LV systolic volume remained moderately increased (52.5 +/- 10.2). In conclusion, in pre-congestive dilated cardiomyopathy a latent impairment in LV function can be detected during a sharp increase of LV afterload. Isometric stress is particularly useful in eliciting these transient changes, as the method allows a reliable echocardiographic examination during maximal stress and not only during the recovery phase, as in dynamic stress.

Adult↗
PubMed1994

[Effect of the chronic treatment with L-acetylcarnitine in Down's syndrome].

Neuropsychologic tests were performed in subjects with Down syndrome in order to assess the effect of a 90-day treatment with L-acetyl-carnitine (LAC). Findings were evaluated statistically (Wilcoxon test) and compared to three further groups of subjects: untreated Down syndrome, mental deficiency due to other cases treated and not treated with LAC (Mann-Whitney U-test). Treated Down syndrome patients showed statistically significant improvements of visual memory and attention both in absolute terms and in comparison with the other groups. No improvement was found in mentally deficient non-Down subjects, so that the favourable effect of LAC appears to be specific for Down patients. In view of the analogies of the pathology and neurochemistry between Down syndrome and Alzheimer degenerative deficiency (deficit of cholinergic transmission) it is suggested that the action of LAC in these pathologies is related to its direct and indirect cholinomimetic effect.

Acetylcarnitine↗
PubMed1993

The diagnostic potential of fetal renal biopsy.

The feasibility of fetal renal biopsy has been investigated in order to assess the diagnostic value of the histological specimen. Two fetuses with a severe bilateral renal abnormality (multicystic dysplastic kidney, Meckel-Gruber syndrome with polycystic kidney) and one fetus with Down syndrome (no detectable structural anomaly) were sampled. Histological findings in the biopsy specimens of cases 1 and 2 were diagnostic of an early obstructive renal disease. In case 3, the findings were consistent with normal development for gestational age of the kidney. Fetal renal biopsy is technically feasible; histological examination of the samples showed a good correlation with postnatal findings. Further studies of its diagnostic value are required.

Adult↗