Biomedical subjects
Publications and source records attributed to G Giuffrè.
The authors report a case of epidermoid cyst of the spleen, in which cytologic findings were characteristic and suggested this diagnosis. Histologic and immunohistochemical findings are described in the attempt to clarify the histogenesis of this cystic lesion.
In a study performed on 20 subjects with central retinal vein occlusion (CRVO) aged 40 years or less we found the ischemic form in 20%. Disc edema was a common finding at the onset, while macular edema was less frequently seen. Systemic or ocular disorders that could be related with the development of the CRVO were often found; a patient was affected with myasthenia gravis and another with Sturge-Weber syndrome: these two diseases were not previously reported in association with CRVO. In only two of the 11 patients followed-up the visual acuity improved. The visual prognosis in CRVO of young people is often poor; the more frequent cause of the reduced visual acuity is chronic cystoid macular edema.
The purpose of this work is to consider the sensibility, reliability, and utility of the computerized electromyography and kinesiography in the diagnosis and study of the functional results in patients affected of single or bilateral previous fractures of the condyles. The Authors analyse three clinical parameters and compare them with thirteen parameters gathered from the computerized data and the kinesiogram and electromyogram analysis of a selected sample of thirteen patients with previous fractures of the condyles. This comparison has shown the greatest reliability and sensibility (a larger quantity of instrumental data as regards the clinical checkup and absence of false negative diagnosis) of these techniques with regard to ordinary clinical checkup. Furthermore the features of objectivity, non invasion and easy repetition, indicate that computerized electromyography and kinesiography play an important role in the diagnosis and study of the functional results of fractures of the condyles and in the follow-up examination.
Ninety patients (163 eyes) with tilted disc syndrome were examined in order to show possible chorioretinal degenerative lesions associated with the typical ectasia of the infero-nasal fundus observed in this anomaly. Eighteen out of the 163 eyes had pigmentary accumulations, either branched, linear or dotted and five had roundish areas of chorioretinal atrophy. Furthermore, in 7 eyes areas of pigmentary atrophy at the posterior pole were observed. The most serious lesions were represented by macular choroidal neovascular membranes, seen in 3 eyes, which were responsible for the loss of vision in these eyes. A relationship was found between the depth of the ectasia, the degree of tilt of the optic disc and the development of chorioretinal degeneration. Because of possible complication by macular choroidal neovascularization, the tilted disc syndrome can not be regarded in every case as a benign and not evolutive ocular anomaly.
A 66-year-old man with typical anterior ischemic optic neuropathy in one eye suffered from edema of the optic disc without functional changes in the fellow eye. However, 7 months later, a reduction in visual acuity, a change in the visual field and a worsening of the contrast-sensitivity curve demonstrated the development of typical anterior ischemic optic neuropathy in this eye as well. After another 6-month period, in addition to these changes, an extensive subretinal neovascular membrane developed in the papillomacular area, which further reduced the patient's visual acuity and required treatment with laser photocoagulation. To our knowledge, this is the first case report of the occurrence of a subretinal neovascular membrane as a complication of anterior ischemic optic neuropathy.
Using a silver staining technique (AgNOR technique), we have investigated the nucleolar organizer-associated proteins (NORs) in formalin-fixed paraffin embedded specimens of 20 large bowel adenocarcinomas, 10 tubular adenomas with low grade dysplasia and 10 villous adenomas with high grade dysplasia; the mean number of small NOR (SN), large NOR (LN) and total NOR (TN) was determined for each case. A significant difference (P less than 0.001) in the mean number of SN and TN was found when adenocarcinomas were compared with the adenomatous lesions; in addition, low grade and high grade dysplasia, present in tubular and villous adenomas respectively, could be clearly differentiated by this procedure. It may be suggested that the significant increase of AgNOR counts encountered in high grade dysplasia strongly supports the idea that morphological nuclear changes may reflect the severity of malignant potential of dysplasia in large bowel adenomas.
Idiopathic preretinal macular fibrosis is an affection characterized by the development of preretinal membranes, macular distortion and, sometimes, macular edema. These changes as well as the consequent reduction of the visual acuity may vary very widely from one case to another. In this study, the degree of correlation among the various retinal morphological changes and among them and the visual acuity was investigated. This study shows that the importance of retinal distortion is strictly dependent on the appearance of the preretinal membranes that the appearance of the preretinal membrane and the importance of the retinal distortion are equally valid predictors of visual acuity, that the macular edema (defined as fluorescein leakage) depends mainly on the degree of contraction of the preretinal membrane and that such leakage does not represent the best parameter in order to predict the visual acuity.
The study was performed to compare visual evoked potentials of old aphakic and pseudophakic patients (61 to 80 years) with age-matched controls. No differences were found between latencies of the two groups. Thus it seems that increased lens density of old subjects does not influence the processing of the visual stimulus.
The main posterior watershed zone of the choroid is located between the nasal edge of the optic disc and the fovea and represents the area situated between the territories supplied by the temporal and nasal posterior ciliary arteries. In the fluorescein angiographies of 800 normal subjects a watershed zone was not observed in 33.1% due to technical reasons and in 22.3% due to the simultaneous filling of the peripapillar and macular choriocapillaris. In the remaining 44.6% the watershed zone was well outlined: it was straddling the optic disc in about half of these cases and involved the temporal half of the optic disc and the close choroid in the other half. Very rarely the watershed zone involved the nasal half of the optic disc or the papillo-macular area. The position of the watershed zone could be important to explain the visual field defect in anterior ischemic optic neuropathy and glaucoma.
A 24-year old woman displayed a coloboma of the right optic nerve with multiple small parapapillary retinochoroidal colobomas. This rare association makes one suspect that the pathogenesis of colobomatous defects of the optic disc area are caused by a faulty closure of the embryonic fissure and an abnormal maturation of the cells of the anlage of the optic nerve head.
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The filling times of the retinal and choroidal circulation were evaluated in 17 patients with central retinal artery occlusion by means of fluorescein angiography. A correlation between the filling times of the two circulations was found. However, two filling patterns were seen: first, both fillings delayed; second, both fillings normal. It is probable that in the former case an obstructive disease of the carotid arteries exists, while in the latter case an important pathology of the carotid arteries is lacking, favouring a rapid restoration of the retinal circulation. This hypothesis seems to be confirmed by the results of the Doppler velocimetry of the carotid arteries.
Three members of a family were affected by a pattern dystrophy of the retinal pigment epithelium transmitted by autosomal dominant inheritance. In addition to grossly impaired electro-oculograms and normal electroretinograms, the patients showed lesions of the fundus of the eye recalling those seen in Best's disease, multifocal Best's disease, and pattern dystrophies. The intrafamilial variability of the fundus lesions showed by this pattern dystrophy demonstrates the problems in the diagnosis of some dystrophies of this group.
A patient is described in whom a post-traumatic subretinal membrane changed with time from a hypofluorescent to a hyperfluorescent appearance. It is suggested that the early hypofluorescence was due to a masking effect of the hyperplastic retinal pigment epithelium and the late hyperfluorescence to pigment defect and staining of the membrane.
Fourteen cases of choroidal ruptures were studied in order to know the traumatic causes involved in such lesions and the subjects at higher risk. Moreover the visual acuity and the ophthalmoscopic and fluorescein angiographic features of the affected eyes were recorded. We found that the choroidal ruptures always were consequent to a contusive trauma, generally an object thrown against the patient, and that the group at higher risk was formed by young males. The number and location of the choroidal ruptures were variable, but in most cases the ruptures were more than one and located at the posterior pole. The choroidal ruptures were frequently associated with subretinal hemorrhages and, in half cases, with pigmentary changes. A patient showed a subretinal neovascular membrane and another one presented a macular fibrovascular scar. The fluorescein angiography characteristically showed hypofluorescence of the choroidal rupture in the early phases of the test and hyperfluorescence in the late venous phase due to staining of the tissue of the rupture. Seven patients were re-examined some years later. The patient that at first examination showed the subretinal neovascular membrane developed a fibrovascular scar caused by bleeding of the new vessels, while the patient that at the previous examination showed a fibrovascular scar did not reveal important changes. Among the five remaining patients, one maintained a low visual acuity due to the pigmentary changes occurring in the macular area; another, that had a macular rupture, recovered a fairly good vision after resorption of the macular hemorrhage; and the other three did not show relevant changes of either the visual acuity or the appearance of the lesions.
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Penbutolol has proved particularly effective and suitable for the treatment, even on a long-term basis, of recently developed hypertension, especially in its hyperkinetic forms. The drug produces minimal side effects, is well tolerated and gives an early therapeutic response. In addition penbutolol does not cause any significant alterations in the biohumoral parameters of the patients treated and is ideal for combination with dihydralazine, reserpine and dihydrochlorotiazide in the treatment of more stubborn cases, making it possible to reduce the doses of the other drugs without causing bradycardia.