Biomedical subjects

G Spanu

Publications and source records attributed to G Spanu.

At least 19 recordsLinked to original sources

PubMed1996

Spinal chondroma of the lumbar tract: case report.

BACKGROUND: Cartilage-forming tumors are benign cartilaginous tumors that rarely affect the spinal canal: they account for 2% of all spinal tumors and 2.6% of all benign bone tumors. Pathologically, they may be classified as chondromas, osteochondromas, chondroblastomas, and chondromyxoid fibromas. This oncotype may remain asymptomatic (it is confined within the vertebral structure) or may present as a hard paravertebral swelling (it invades the paravertebral structures) or more rarely, with a slowly-developing neurologic syndrome (it extends into the vertebral canal). METHODS: Thirty-one cases have been reported (including our case) of benign cartilage-forming tumors localized in the lumbar column. Only three cases of chondroma of the lumbar spine presented with lumbar radicular pain. We report a fourth case and review clinical and radiologic characteristics of these lesions. RESULTS: Eleven out of the 31 cases were diagnosed as chondromas, 17 as osteochondromas, while in three cases the histopathologic diagnosis was not reported. Seventeen cases originated from the neural arch, seven from the vertebral body, two from the spinous process, and in five cases the exact localization was not reported. This tumor is more frequent in males (21 cases out of 31), than in females (five cases); in five cases the sex was not reported. Mean duration of symptoms was 23 +/- 5.1 months (range: 1-96); chondromas have a short clinical history before diagnosis (13.8 +/- 3.4 months) compared to osteochondromas (28.6 +/- 7.6). Clinical presentation with local swelling is reported in 10 cases, in 10 cases local pain without radicular irradiation, in six cases lumbar pain with sciatica, in two cases signs and symptoms of cord compression, one case of cauda syndrome, while in four cases no clinical details are reported. Among the six cases presenting with sciatica, four were chondromas (in all cases the L4 level was involved), and one osteochondroma, while in one case the histopathologic diagnosis was not reported. CONCLUSION: Computed tomography is important and indispensable for preoperative diagnosis, giving a precise indication of tumor extent and location and its relationship to the adjacent structures; while MRI is helpful in detecting patterns related to histologic malignancy. It is important to examine the whole tumor histologically because it is known that there may be small areas that show signs of malignancy; thus is more likely in chondromas than osteochondromas.

Adult↗

PubMed1995

Anterior cervical discectomy: an analysis on clinical long-term results in 153 cases.

During the last three decades, the anterior approach to the cervical spine with interbody fusion has been increasingly preferred in the operative treatment of herniated cervical disc. Most studies on surgical procedure without interbody fusion are retrospective and reported that the bone graft is not important for the success of this technique. Between 1983 and 1993, 153 patients underwent surgery for the treatment of cervical degenerative disc disease: in 139 cases the technique without fusion was applied. This retrospective study analyze clinical and radiological parameters in order to verify any possible prognostic factor. 108 patients with radiculopathy and 31 patients with myelopathy were followed up clinically for at least 12 months up to 10 years. An excellent or good long-term result was achieved in 90.9% of patients with radiculopathy and 58.1% of those with myelopathy. The age of the patients, the duration of symptoms before diagnosis and the pathogenesis of disc herniation did not represent significant parameters influencing the outcome of patients. The results of the present study show that anterior discectomy without fusion lead to good clinical long-term results, either in patients with pure radicular syndrome, or in cases with myelopathy. The presentation with pure radicular signs is the most important factor in predicting a good overall outcome.

Adult↗

PubMed1994

Endothelin and aneurysmal subarachnoid haemorrhage: a study of subarachnoid cisternal cerebrospinal fluid.

Endothelin (ET) is considered one of the most potent vasoconstrictor polypeptides; several experimental studies have suggested its possible role in the pathogenesis of arterial vasospasm after subarachnoid haemorrhage (SAH). Previously reported data on plasma and CSF levels of endothelin in patients with a diagnosis of SAH have been controversial. Cisternal endothelin CSF levels and the possibility that they could be related to vasospasm and other clinical patterns of SAH were investigated. CSF samples were obtained from 55 patients admitted after angiographic diagnosis of intracranial aneurysm. Levels of ET-1 and ET-3 were measured through radio-immunoassay technique. Twelve patients who had operations for unruptured aneurysms were considered control cases; 43 patients with SAH were classified according to: Hunt and Hess grading at admission, vasospasm grading, CT classification and timing of surgery. In all 55 patients ET-1 was measured, while positive levels of ET-3 were found only in 17 cases of 48. No linear correlation was found between cisternal CSF ET-1 levels when considering time of surgery, CT classification, Hunt and Hess grading at admission, and vasospasm grading. The results of ET-3 assay should be considered with great caution because of the low percentage of positive cases. Cisternal CSF levels of ET-1 and ET-3 are not directly related to the occurrence of arterial vasospasm after the aneurysm rupture, or to other major clinical patterns of SAH; however, ET-1 expression occurs either in paraphysiological (unruptured aneurysm) or in pathological conditions (SAH). It is suggested that ET may potentiate, or may be potentiated by, other factors playing a consistent pathophysiological role in the development of vasospasm.

Brain Diseases↗

PubMed1993

Antioxidant enzymatic activities after experimental subarachnoid hemorrhage in rats.

Lipid peroxidation has been hypotesized as one of possible factors involved in the pathogenesis of neuronal damage and delayed vasospasm after subarachnoid hemorrhage. In the brain there are anti-oxidant enzymatic systems which act as scavengers of superoxides and free radicals. In the present study the pattern of enzymatic anti-oxidant activities (Cu-Zn and Mn superoxide dismutase, and glutathione peroxidase) was investigated in an experimental model of subarachnoid hemorrhage in the rat in order to verify whether the hemorrhagic insult may be responsible for an impairment of such anti-oxidant systems. Enzymatic activities were assayed in three different rat brain areas (cerebral cortex, hippocampus and brain stem) of sham-operated and at 30 min, 1, 6 and 48 h after subarachnoid hemorrhage induction. After the hemorrhage induction the Cu-Zn superoxide dismutase activity in cerebral cortex was significantly reduced at all the set times (p < .05), while Mn-superoxide dismutase activity was significantly decreased since 1 h (p < .05) until 48 h (p < .05). Glutathione peroxidase activity was significantly reduced only in the late phase (48 h) of subarachnoid hemorrhage (p < .01). In the hippocampus, all enzymatic activities were significantly reduced in the late phase. In the brain stem Cu-Zn superoxide dismutase was significantly impaired at 1 and 6 h (p < .05) after subarachnoid hemorrhage induction, while in the late phase (48 h) reached the control value. The mitochondrial Mn-superoxide dismutase was significantly reduced since 1 h (p < .05) until 48 h (p < .02) after subarachnoid hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1991

Effects of nicardipine treatment on Na(+)-K+ ATPase and lipid peroxidation after experimental subarachnoid haemorrhage.

The calcium theory of neuronal damage has been recently adapted to subarachnoid haemorrhage (SAH). It is proposed that haemorrhagic insult to the brain causes free radical-mediated destructive reactions of membrane phospholipids, and the consequent decrease of phospholipid-dependent enzymatic activities, such as Na(+)-K+ ATPase. In the present study we have studied the effects of Nicardipine treatment on lipid peroxidation and Na(+)-K+ ATPase activity after experimental induction of SAH. SAH was induced in anaesthesized rats by slow injection of 0.3 ml of autologous arterial blood into the cisterna magna. We assessed the extent of lipid peroxidation by measuring the level of thiobarbituric acid reactive substances (TBARS) and Na(+)-K+ ATPase activity in 3 different rat brain areas (cerebral cortex, hippocampus and brain stem) of sham-operated (0.3 ml of mock CSF into cisterna magna) and at 1 hour, 6 hours and 48 hours after SAH induction; simultaneously, we investigated the capacity of cerebral lipid peroxidation by measuring the accumulation of TBRAS in homogenates of brain areas incubated under aerobic conditions. Na(+)-K+ ATPase activity decreased in the cerebral cortex at 1 hour and 6 hours and in brain stem at 1 hour after SAH, while the same enzymatic activity did not change in the hippocampus. There was no significant difference in lipid peroxide content between sham-operated and haemorrhagic animals; Nicardipine treatment reduced the TBRAS content and induced the recovery of Na(+)-K+ ATPase activity, exerting a brain protective role against the detrimental effects of the haemorrhage.

Animals↗

PubMed1988

Effect of nimodipine on mitochondrial respiration in different rat brain areas after subarachnoid haemorrhage.

The mitochondrial respiration was evaluated in three different rat brain areas (cerebral cortex, hippocampus and brain stem) after experimental subarachnoid haemorrhage (SAH). The haemorrhage was induced by injecting 0.35 ml of autologous arterial blood into cisterna magna. Intravenous administration of Nimodipine (2 micrograms/kg/min for 30 minutes) was started immediately after the haemorrhage induction. At the set time (1 hour after SAH procedure), animals were sacrificed and non-synaptic mitochondria from the above mentioned areas were isolated. The following respiratory parameters were evaluated utilizing glutamate plus malate and succinate plus rotenone as substrates: state 3, state 4, uncoupled state, respiratory control ratio (RCR) and ADP/O ratio. SAH significantly influences respiratory parameters, mainly RCR; the cerebral cortex and brain stem seem to be more sensitive during the acute phase of vasospasm which follows SAH procedure. Nimodipine treatment significantly ameliorates mitochondrial respiratory conditions.

Animals↗

PubMed1988

Lumbar canal stenosis: results in 40 patients surgically treated.

Authors present the clinical and neuroradiological characteristics of 40 patients treated for lumbar canal stenosis during a 10 years experience. The usefulness of computed tomography in comparison with myelography and plain X-rays of the spine is stressed. The surgical treatment was wide laminectomy involving one or more levels (two to four) plus an eventual foraminotomy but without discectomy. All patients were followed up and in 85% of cases a reduction of clinical symptoms was observed. Residual symptoms were also present in some of the improved patients, they generally accepted them without great dismay.

Adult↗

PubMed1988

Spinal subdural haematoma: a rare complication of lumbar puncture. Case report and review of the literature.

The Authors describe a case of spinal subdural haematoma presenting as a cyst. It ist noted that cerebrospinal fluid parameters were normal, in contrast to what is usually found in similar cases; furthermore, no sensorimotor impairment was seen. Histological examination showed an organised haematoma; that explains why CT scan was not diagnostic in this case. Haematoma is probably due to the rupture of a vein localised between the dura mater layers.

Adult↗

PubMed1987

Nitrosourea derivatives-induced pulmonary toxicity in patients treated for malignant brain tumors. Early subclinical detection and its prevention.

Nitrosourea derivatives, such as BCNU and CCNU, are considered useful chemotherapeutic agents in malignant brain tumors combined therapy. Pulmonary toxicity is one of the major side effects demonstrated both in experimental animal models and in human autoptic findings. Pulmonary fibrosis is the end point of progressive functional disorder of respiratory mechanism and alveolo-capillary gas exchanges. Authors present the results of a randomized, double-blind trial of 40 patients previously treated with surgery and radiotherapy and who subsequently underwent BCNU therapy for primary intracranial glioma. Patients underwent functional respiratory examinations at each chemotherapy course interval. Twenty patients received ambroxol (120 mg/day) for 40 days after chemotherapy course. Control patients received placebo with the same schedule and showed a significant reduction of pulmonary functional parameters (DLCO, MMEF, MEF 25%), whereas in the treated group there is no significant variation of these functional parameters. The mechanism of ambroxol is commonly related to the surfactant synthesis enhancement and to the action on bronchiolar pathways.

Adult↗

PubMed1987

Reliability of clinical examination and computed tomography in the diagnosis of extreme lateral disc herniation.

Twenty-eight cases of extreme lateral and foraminal disc herniation diagnosed by CT are reported. All cases have been surgically verified. In four cases (14%) CT diagnosis failed. The clinical pattern in these cases was not very different from that of typical disc herniation. The reliability of clinical diagnosis is 71%. EMG is seldom diagnostic. Myelography is uniformly of no value as a diagnostic measure.

Adult↗

PubMed1987

Complications following surgery for severe head injury.

The number of patients who survive, after severe head injuries, is becoming more and more consistent due to the remarkable progress made in intensive care and rehabilitation units. The aim of this study is to identify, in addition to direct structural damage, medical and neurological problems and describe their frequency within a group of patients with severe head injuries. Neurologic, metabolic, gastrointestinal, genitourinary, respiratory, cardiovascular, cutaneous and endocrinologic problems were more frequently found. All these problems, which were identified during the first month after head injury, are discussed regarding their clinical significance, therapeutic approach, and morbidity.

Adolescent↗

PubMed1986

[Cerebral vasospasm caused by subarachnoid hemorrhage].

Vasospasm is one of the most frequent complications of subarachnoid hemorrhage (SAH) and causes high mortality rates and serious neurologic deficits, resulting in invalidity. Diagnosis is based on precise clinical criteria (onset between the 3rd and the 8th day after the SAH) and is confirmed by angiographic examination. The etiology certainly involves many factors, though the identification of the primary cause (conductive to morpho-structural alterations of the artery walls) seems to be troublesome. Experimental evidence indicates that the basis of the reactions which cause the onset of the vasospasm lies in the blood which pools in the subarachnoid zone. The authors summarize the main pathogenetic theories, especially as far as the initial biochemical sequence is concerned. Among the numerous classes of substances involved in the genesis of vasospasms, a relevant role is played by oxyhaemoglobin, free radicals, lipidic peroxides and by the metabolites of arachidonic acid. The main purpose of vasospasm treatment is the possibility to eliminate and prevent ischemic complications. Early surgical exclusion of the aneurysm causing the bleeding allows for the removal of peri-aneurysmatic blood clots. Pharmacological treatment employs numerous classes of substances: among these calcium antagonists presently appear to give satisfactory results.

Arachidonic Acid↗

PubMed1986

An analysis of cerebrospinal fluid shunt infections in adults. A clinical experience of twelve years.

The authors analyze a group of 451 shunt operations where 317 patients had hydrocephalus and 23 cases were reported positive after cerebrospinal fluid (CSF) cultures. Staphylococcus was the most frequent bacterial organism found (57%). This retrospective study of 23 patients in whom infection developed following placement of an extrathecal shunt, although not a complete biometric evaluation, shows an incidence of infection of 5%. The authors also indicate the limitations in antibiotic treatment when three significant aspects of therapy are not considered fully: 1. sensitivity of the identified organism, 2. CSF levels of the drug that can be attained, and 3. the pharmacokinetic action of the drug in the CSF.

Adolescent↗

PubMed1986

Normal-pressure hydrocephalus: twelve years experience.

The authors report on twelve years experience with so-called normal pressure hydrocephalus. If care is taken to make a correct diagnosis and give adequate treatment with a shunt, hydrocephalic dementia has a good prognosis. Such cases should be distinguished from other syndromes, particularly senile dementia and Alzheimer's disease. The occurrence of a syndrome of dementia should compel every neurologist and neurosurgeon to carry out careful investigations in order to determine the favourable time for possible treatment.

Adult↗

PubMed1985

Late post-traumatic headache in pediatric age.

In this study we evaluate the incidence and clinical characteristics of headache which arise 12-18 months after a cranial trauma in a pediatric age group of subjects. We contacted 217 individuals who had been hospitalized for head injury to return for check-up; of the 138 who responded, there were 86 males and 52 females (mean 9.2 years). The responders were given a complete physical and neurological examination and, in the presence of at least one parent, asked to fill out a headache questionnaire. Twenty-nine per cent suffered from headache, and in 6.5% the headache was migrainous in nature. The 138 patients were split up into three sub-classes in accordance with the nature of the trauma and two sub-classes in accordance with the presence or absence of fractures. The results were then compared with those obtained from a control population (246 patients with a mean age of 8.8 years). An increased headache frequency was found in those patients with average to severe trauma. We conclude that cranial trauma is not likely to be followed by headache unless accompanied by loss of consciousness and/or focal neurological signs.

Adolescent↗

PubMed1984

[Rehabilitative treatment of patients with primary and secondary spinal cord neoplasms].

The Authors present their studies concerning rehabilitation treatment in primary and secondary spinal cord tumors. They examine the problems inherent in this complex pathology. Rehabilitation was initiated in the acute phase of the illness with the aim of preventing secondary and tertiary damage that could jeopardize successive functional recuperation. The Authors believe that rehabilitation treatment, when used early enough, improves the day life for patients with spinal cord tumors.

Activities of Daily Living↗

PubMed1984

[Chemotherapy and immunotherapy of intracranial malignant gliomas].

Although in recent years a great attempt has been made in brain tumor chemotherapy, this therapeutic approach appears to be conditioned by a large number of problems such as cell kinetics, tumor growth modalities, and drug delivery. Therefore only a small number of drugs (BCNU, CCNU, streptozotocin, and procarbazine) clearly demonstrate effectiveness against these tumors. Immunotherapy raises the same and other problems. In fact, if immune reaction is quite possible inside the brain, unfortunately current immunostimulant methods are unable to produce significant improvements.

BCG Vaccine↗

PubMed1983

Cyclic nucleotides in experimental and human brain tumors.

It is well known that the system of cyclic nucleotides plays an important role in cell differentiation and proliferation. Cyclic AMP is capable of stimulating cell growth, and cyclic GMP is thought to control cell division and growth. The authors measured adenylcyclase activity (AC) and cGMP content in the tumor latency period and in early neoplastic proliferations in rats with brain tumors induced by transplacental ethylnitrosourea (ENU). AC activity, which is high during the first days of life, decreases until it reaches, at the 60th day, levels lower than those in control animals. Cyclic GMP, on the contrary, increases during the first month in treated animals and remains consistently higher than controls up to the 45th day. In fully developed experimental brain tumors (mixed gliomas, isomorphic and polymorphic oligodendrogliomas) the percentage of reduction in AC activity is significantly higher. AC activity was measured also in human tumoral tissue. In malignant tumors it is markedly lower than in benign tumors. In the same patients cAMP in the cerebrospinal fluid was measured with results similar to those obtained in tissues. These findings confirm that the system of cyclic nucleotides is implicated in all the developmental phases of brain tumors and therefore may reveal how research can clarify the first transformations of tumoral cells.

Adenylyl Cyclases↗