PubMed Health⌕ Search

Biomedical subjects

L Cervoni

Publications and source records attributed to L Cervoni.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Neurinomas and ependymomas of the cauda equina. A review of the clinical characteristics].

A retrospective review of 603 cases of intradural benign tumors of the cauda equina are presented (283 schwannomas and 320 ependymomas). For each tumor, the clinical course and long-term postoperative results were analyzed: it emerged that differential diagnosis between neurinomas and non tumoral lesions is not possible if based on clinical findings alone and that neuroradiological diagnosis is more accurate when MRI is employed. Long-term prognosis of neurinomas was always favourable, while in the ependymomas, early diagnosis gives excellent results because prognosis is apparently directly correlated to the length of preoperative clinical history.

Adolescent↗
PubMed1997

[Intramedullary cervical neurinoma. A case report and review of the literature].

A case of intramedullary neurinoma of the cervical spinal cord in a patient with no sign of von Recklinghausen's disease is reported. It was diagnosed by computed tomography and magnetic resonance imaging and treated surgically. Discussion examines etiology, role of diagnostic procedures and surgical treatment of this rare tumor.

Adult↗
PubMed1997

Spontaneous movement of metallic foreign bodies. Case report.

We report a case of missile injury to the brain with an unusual complication. The bullet migrated by its mere weight to a distant location through the brain parenchyma after initially lodged in a superficial site. Movement of the bullet was first detected on CT scan and the significance and treatment of this finding is emphasized.

Adult↗
PubMed1997

Severe head trauma. Review of the factors influencing the prognosis.

A series of 72 severely head injured patients are reported, 24 (33%) with surgical intracranial hematomas. All patients were intensively cared for under the same therapeutic regime; intracranial pressure (ICP) was monitored and treated if increased. The series mortality was 39%. Uncontrollable increase of ICP (UI-ICP), always fatal, was observed in 18% of patients and in 13 of 28 deaths (46%); the incidence of UI-ICP among deaths was higher in patients less than in those more than 40 years old (55% vs 25%). Patients with UI-ICP were frequently deeply comatose and with arterial hypotension on admission; almost all died in the first days. Patients directly admitted from the scene with well staffed Life Flight Helicopter Emergency Care compared with those directly admitted from the scene with different type of ambulance service (paramedics, police, firemen and private) had a mortality rate significantly less (20% vs 54%) and an incidence of UI-ICP strongly lower both among patients (5% vs 29%) and among deaths (25% vs 54%). Thus in this small series intensive care after admission was not effective to obtain good results if patients had received poor preadmission emergency care. Review of the literature on main clinical predictors of outcome in severe head injury, have made possible some observations. Ischemic and intracranial hypertension brain lesions were generally present in patients killed by head trauma; while diffuse axonal injury, frequently responsible for vegetative, severe disability survival and late deaths, was observed only in 20-30% of postmortem examinations. Old age, poor neurological status and cardiocirculatory and respiratory disturbances prior to and upon admission positively worsened the outcome, while intracranial hematomas had a more variable predictive value. Intracranial hypertension was a definitively ominous predictor only if very high when the risk to be or become uncontrollable seems to be much elevated. UI-ICP, often fatal despite any aggressive therapy, was the single most frequent killer after severe head injury, responsible for about half of all deaths after admission. The different outcome among severe head injury series could be conceivably related to a different frequency of UI-ICP. Besides the severity of head injury and delay and mode of admission, we suggest that preadmission respiratory and cardiocirculatory and the quality of emergency medical system could strongly affect the incidence of uncontrollable increase of ICP in admitted patients and thus the mortality rate and favorable recovery of the series. The advanced preadmission emergency care service with intensive care after admission could significantly explain the better results often observed in severe head injury series.

Adolescent↗
PubMed1997

Desmoplastic fibroma of the skull. Case report and review of the literature.

BACKGROUND AND PURPOSE: We present a rare case of desmoplastic fibroma of the skull. Desmoplastic fibroma is a distinctive and rare neoplasm of bone that histologically and biologically mimics desmoid soft tissue tumor. Only 6 cases have been reported in the skull and none of these was diagnosed by MRI. CLINICAL PRESENTATION: A 64 year-old woman, operated on in June 1991 for left mastectomy due to a ductal adenocarcinoma and again in October 1994 for a left frontal metastatic adenocarcinoma, was admitted in our Department of Neurosurgery because a control cerebral MRI had detected a diploic lesion, isointense on T1-weighted images and hyperintense on T2, with moderate enhancement, localized in a right parietal site. Neurological examination was negative. The lesion was surgically removed and a cranioplasty was performed. Histological diagnosis was desmoplastic fibroma. Twelve months after treatment she has no neurological symptoms or signs of cerebral lesions (MRI) or systemic metastasis (total body CT). CONCLUSION: In the literature the number of desmoplastic fibroma is too small and the follow-up period too short to permit any conclusions regarding the aggressiveness of the tumor.

Female↗
PubMed1996

Comparison of DNA-protein interactions in intact nuclei from avian liver and erythrocytes: a cross-linking study.

DNA-protein cross-linkages were formed in intact nuclei of chicken erythrocytes and liver cells by the action of cis-diammine dichloroplatinum (II). Most cross-linked proteins were components of the nuclear matrix, and their heterogeneity reflected the different complexity of liver and erythrocytes matrices, respectively. Some basic proteins, including histones, were also cross-linked, particularly in erythrocyte nuclei. South-Western blotting revealed that a variety of proteins isolated from the cross-linked liver nuclei recognized DNA specifically. In this group of proteins two relatively abundant, acidic, species of 38 and 66 kDa, respectively, might represent novel DNA-binding proteins from the nuclear matrix. In the case of erythrocytes, only the basic proteins showed a DNA-recognition capacity, and among them there were some unidentified species, absent from liver. Lamin B2 was cross-linked but was unable to recognize DNA, and the same was true for other abundant, cross-linked proteins from both types of nuclei. This led to the hypothesis that for some DNA-nuclear matrix interactions the aggregation typical of matrix proteins is essential for the specificity of DNA recognition. Hybridization analysis of the DNA isolated from the cross-linked complexes showed that SARs (scaffold attachment regions) and telomeric sequences were well represented in the cross-linked fragments, that the cross-linked DNA of liver was partially different from that of erythrocytes and that two defined SAR sequences were found to be present only in the cross-linked DNA. These results are in agreement with the present views on DNA-nuclear matrix interactions, which are usually studied on isolated nuclear matrices or purified proteins. Instead, our results provide experimental evidence obtained directly from intact nuclei.

Animals↗
PubMed1996

Thermal stability of hexameric and tetrameric nucleoside diphosphate kinases. Effect of subunit interaction.

The eukaryotic nucleoside diphosphate (NDP) kinases are hexamers, while the bacterial NDP kinases are tetramers made of small, single domain subunits. These enzymes represent an ideal model for studying the effect of subunit interaction on protein stability. The thermostability of NDP kinases of each class was studied by differential scanning calorimetry and biochemical methods. The hexameric NDP kinase from Dictyostelium discoideum displays one single, irreversible differential scanning calorimetry peak (Tm 62 degrees C) over a broad protein concentration, indicating a single step denaturation. The thermal stability of the protein was increased by ADP. The P105G substitution, which affects a loop implicated in subunit contacts, yields a protein that reversibly dissociates to folded monomers at 38 degrees C before the irreversible denaturation occurs (Tm 47 degrees C). ADP delays the dissociation, but does not change the Tm. These data indicate a "coupling" of the quaternary structure with the tertiary structure in the wild-type, but not in the mutated protein. We describe the x-ray structure of the P105G mutant at 2.2-A resolution. It is very similar to that of the wild-type protein. Therefore, a minimal change in the structure leads to a dramatic change of protein thermostability. The NDP kinase from Escherichia coli behaves like the P105G mutant of the Dictyostelium NDP kinase. The detailed study of their thermostability is important, since biological effects of thermolabile NDP kinases have been described in several organisms.

Adenosine Diphosphate↗
PubMed1996

High-dose radiation-induced meningiomas following acute lymphoblastic leukemia in children.

The authors review three personal cases of patients who developed cerebral meningiomas following high-dose radiotherapy for acute lymphoblastic leukemia. Two patients were female and one male. Their ages when the leukemia appeared were between 11 and 15 years. All patients were treated with a course of prophylactic irradiation to the neuraxis for a total dose of 24 Gy. After an average interval of 10.4 years, all three patients presented a meningioma; histologically, one was meningothelial and two were fibrous. All three meningiomas presented atypical features. At follow-up 1, 4, and 4 years respectively after surgery, none of these patients presents neurological deficits or neuroradiological signs of recurrence. Forty-nine cases of high-dose radiation-induced meningioma are also reviewed.

Adolescent↗
PubMed1996

Solitary brain metastases from non-oat cell lung cancer: clinical and prognostic features.

The authors report 91 cases of solitary brain metastasis from non-oat cell lung cancer, 66 patients were males and 25 females; average age was 57 years (range 40-72 years). Surgical removal was total in 80 cases and partial in 11. All patients received postoperative radiotherapy and 40 chemotherapy. Histologically, the tumor was an adenocarcinoma in 51 cases (56%), a squamous cell carcinoma in 22 (24%), an undifferentiated carcinoma in 18 (20%). Median survival was 16 months and the main cause of death was progression of the primary cancer (59% of cases). Survival was influenced by staging of the primary tumor, while no prognostic significance was found regarding the type of clinical tumor onset, type of radiotherapy and the histotype of the lesion. Use of the "no internal touch" technique and brain radiotherapy reduced local brain relapse.

Adenocarcinoma↗
PubMed1996

Pleomorphic xanthoastrocytoma: some observations.

The authors describe 3 cases of cerebral pleomorphic xanthoastrocytoma, one of which has an unusual neuroradiological appearance, and review the clinical and prognostic features of the 96 cases reported in the literature. Pleomorphic xanthoastrocytoma is a neuroectodermal tumor that affects young patients, in a superficial or supratentorial site, most frequently at the temporal level. It is difficult to formulate a differential diagnosis with other neuroectodermal tumors or with meningioma on the basis et neuroradiological appearance, as demonstrated by one of the cases reported here. The prognosis of this tumor is very good, regardless of the type of treatment performed, although both relapse and, more rarely, malignant tumor evolution are possible.

Adolescent↗
PubMed1996

High-dose radiation-induced meningiomas in elderly.

The authors report 2 cases of cerebral meningiomas following high-dose radiotherapy in elderly patients treated for skull basaloma. These two are the first cases over 65 years old cases reported in the literature. The pathological and clinical characteristics of high-dose radio-induced meningiomas are the following: 1) children appear particularly sensitive to the development of this tumor; 2) there is a female patient predominance, in contrast to the male dominance observed in low-dose meningioma, 3) these tumors present a peak frequency in third decade of life; 4) frequently, these tumors are atypical and recur.

Aged↗
PubMed1996

Cerebral gliosarcoma: prognostic factors.

The authors report their results in a retrospective study of 6 cases of gliosarcoma. In 3 cases gliosarcoma presented features similar to those of glioblastoma, both at CT scan and macroscopically; in the other 3 cases they resembled meningioma. Average survival varied considerably and was correlatable to the CT features of the lesion (14 months for glioblastoma, 7 for meningioma). It seems likely that patients who have gliosarcoma with CT features suggestive of meningioma may have prolonged survival.

Aged↗
PubMed1996

Vasospasm following tumor removal: report of 5 cases.

Cerebral vasospasm is a clinical/angiographical condition frequently observed after a subarachnoid hemorrhage due to the rupture of an intracranial aneurysm. Twenty cases of vasospasm observed after the removal of cerebral tumors have been reported in the literature; we here report on a further five. The time of onset of symptomatic vasospasm was 3-7 days after surgery; three of the patients died of an ischemic event induced by the vasospasm and two survive. Although no angiographic confirmation was obtained in our cases, serial transcranial Doppler (TCD) flow velocities were always high. It is suggested that the TCD-revealed accumulation of blood in the basal cisterns observed in all cases may have been responsible for this unusual condition, and it is therefore important to consider vasospasm as a probable etiological cause of clinical deterioration in patients undergoing the surgical removal of a cerebral tumor. For this reason, whenever any neurological deterioration occurs in such patients, it is advisable to perform TCD in order to verify the presence of any vasospasm and promptly commence suitable treatment.

Adult↗
PubMed1996

Solitary cerebral metastasis from melanoma: value of the 'en bloc' resection.

The authors report 19 cases of solitary cerebral metastases from malignant melanoma. In 15 patients, the primary lesion was known at the time the metastasis was diagnosed; deltoid-scapular in 4 cases, thoracic in 5, inguinal in 4 and neck in 2. The primary location was unknown in 4 patients. Presenting symptoms were: epileptic seizures in 9 cases, headache in 8, strength deficit of the limbs in 2. In 3 patients (16%) neurological symptoms were the first clinical sign of the systemic tumor; in 16 cases (84%) there was a long interval between treatment of the primary and appearance of the cerebral metastasis (average 3.8 years; median 3.4 years). All patients were submitted to surgery and radiotherapy (whole-brain in 14 and radiosurgery in 5). In 10 cases the lesion was removed 'en bloc' (no internal touch technique). Average survival was 9 months (median 8 months) and was influenced by 'en bloc' resection and whole-brain irradiation. None of the patients operated by the 'no touch technique' presented a recurrence.

Adult↗
PubMed1996

Primary spinal epidural non-Hodgkin's lymphomas: a clinical study.

BACKGROUND: The spinal epidural space is an uncommon presenting site in primary non-Hodgkin's lymphoma. The occurrence of spinal epidural disease ranges from 0.1%-6.5% among patients with non-Hodgkin's lymphoma. METHODS: We report a retrospective study regarding 19 patients with primary epidural non-Hodgkin's lymphomas analyzing the factors influencing prognosis of this tumor with emphasis on treatment. RESULT: Ten patients were females and nine males. The neurologic conditions of patients were assessed preoperatively and postoperatively according to Shaw's classification for neurologic disability. All cases underwent surgery accompanied by radiotherapy in 16 cases as well as chemotherapy in 13 cases. Histologically, the tumor proved to be a low-grade non-Hodgkin's lymphoma in three cases, intermediate-grade in four cases and, high-grade in 12 cases. At average follow-up of 7.2 years (range 5-15 years), 15 patients had died after an average interval of 31 months from treatment (range 3-130 months) and four patients are alive after an average interval of 61 months (range 32-86 months). CONCLUSION: It appears that the outcome in these patients depends on the gravity of preoperative deficits, whereas the survival is influenced by the type of treatment.

Adult↗
PubMed1996

Birthday of peripheral nervous system surgery: the contribution of Gabriele Ferrara (1543-1627).

SURGERY OF THE peripheral nerves has only recently achieved brilliant results thanks to technological advances in the development of neurosurgical instrumentation. In past centuries, few surgeons made relevant contributions to this topic and improvement was slow and difficult. Avicenna, Guglielmo da Saliceto, and Guido Lanfranchi reported some attempts to suture nerves directly, but Gabriele Ferrara was the first to give a lucid and succinct description of suturing of the stumps of a transected nerve. He described applying gentle traction on the retracted stumps, suturing using a special needle with an eye, after immersion in a decoction of red wine, rosemary, and roses (alcoholic disinfection?), and, finally, insulating the sutured segment with a mixture of oils. We are celebrating the 400th anniversary of the first edition of his fundamental work (1596-1996), and we truly esteem this surgeon, a pioneer of peripheral nerve surgery wo primarily contributed to its progress.

History, 16th Century↗