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Biomedical subjects

L Ferrante

Publications and source records attributed to L Ferrante.

At least 73 records · Page 4Linked to original sources

Long-term results of surgical treatment of spinal lipomas. Report of 18 cases.

We report the long-term results of surgery on spinal lipomas in a series of 18 patients. Four patients had congenital lipomas with spina bifida and/or myelomeningocele and the other fourteen had tumoural (true) lipomas. Simple decompression or subtotal removal afforded a very good prognosis in all patients with intradural lipomas whose preoperative neurological deficits were slight. In the light of the long follow-up, the lack of difference in biological behaviour between congenital and tumoural (true) lipomas leads us to regard the two types as a single maldevelopment entity of dysembryogenetic origin.

Adult↗

Pharmacokinetics of sulbactam/ampicillin in humans after intravenous and intramuscular injection.

We investigated the pharmacokinetic properties of sulbactam/ampicillin (S/A), after intravenous (0.5/1.0 and 1.0/2.0 g) and intramuscular (0.5/1.0 g) coadministration in 10 male subjects. After 1.0/2.0 g intravenous doses of S/A the half-lives (t1/2 beta) were 1.14 +/- 0.14/1.09 +/- 0.16 h. The values for plasma clearance (CLp) were 198.83 +/- 26.27/250.33 +/- 39.28 ml/min and the renal clearance (Clr) 173.50 +/- 19.66/208.80 +/- 26.43 ml/min. The post distributive volumes (V beta) were 19.67 +/- 3.24/23.56 +/- 5.76 liters. Similar values were obtained after 0.5/1.0 g of S/A intravenous coinjection. After 0.5/1.0 g intramuscular coadministration the t1/2 beta values were 1.26 +/- 0.18/1.20 +/- 0.15 h. The values for Clp were 208.00 +/- 28.73/243.17 +/- 33.24 ml/min, for Clr 179.50 +/- 20.26/202.67 +/- 27.61 ml/min and for V beta 22.27 +/- 4.12/25.30 +/- 4.87 liters. The renal clearance of sulbactam is comparable to that of ampicillin and both clearances are greater than the glomerular filtration rate, suggesting active renal tubular secretion of the two drugs. The large volumes of distribution, and the ratio K12/K21 = 0.5 show the extensive distribution of the two drugs into extracellular fluids. The very similar values of the pharmacokinetic parameters of sulbactam and ampicillin confirm that the kinetics of the two drugs closely resemble one another.

Adult↗

Mutism after posterior fossa surgery in children. Report of three cases.

Three patients aged 5 1/2 to 9 years old with mutism after posterior fossa surgery are presented. The entity is discussed with a review of 15 additional previously reported cases in children aged 2 to 11 years. In all 18 patients, a large midline tumor of the posterior fossa (medulloblastoma in nine cases, astrocytoma in five, and ependymoma in four), often attached to one or both lateral recesses of the fourth ventricle, was removed. Mutism developed 18 to 72 hours after the operation (mean 41.5 hours) in patients with no disturbance of consciousness and no deficits of the lower cranial nerves or of the organs of phonation. All of these children had spoken in the first hours after surgery. The disorder lasted from 3 to 16 weeks (mean 7.9 weeks). Speech was regained after a period of dysarthria in six of the 10 cases for whom this information was available. The various hypotheses advanced to explain the pathogenesis of this speech disorder are analyzed.

Astrocytoma↗

On a case of early-onset post-traumatic facial hemispasm.

In a 49 year old woman an injury to the right frontotemporal region was quickly followed first by paresis and then by spasm of the right side of the face. The early onset of the spasm prompts a critical review of current views on the pathogenesis of facial spasm.

Brain Concussion↗

Cerebral cavernous angioma in children.

Cerebral cavernous angioma is a rare vascular malformation at any age and is very rare in childhood. In the literature available to us, we have been able to trace only 50 cases, to which we have added the 6 cases from our own series. The incidence in pediatric group is higher at 0-2 years (26.8%) and at 13-16 years (35.7%). The clinical onset shows epilepsy in 45.4% of cases, hemorrhagic syndrome in 27.3%, intracranial hypertension in 16.4%, and focal neurological deficits in 10.9%. Furthermore, we discuss the neuroradiological features (CT, angiography, and MRI) and the therapy of pediatric cavernous angioma.

Adolescent↗

Cerebral meningiomas in children.

Cerebral meningiomas are rare tumors in children that represent 1.4% of CNS tumors and 1.5% of intracranial meningiomas. We have analyzed 197 cases of cerebral meningiomas under 16: 178 cases were taken from the available literature and 19 from our series. When comparing pediatric meningiomas with those of adults, we noted some differences. Before the age of 16 there is a slight preference for males; the intraventricular variety is more frequent; cystic meningiomas and the absence of dural attachment are more frequent findings; the neuroradiological diagnosis is more difficult.

Adolescent↗

Microsurgical treatment of glossopharyngeal neuralgia: case reports.

Three patients with excruciating glossopharyngeal neuralgia underwent microsurgical operations in the posterior cranial fossa. In each patient, neurovascular compression was found involving the posteroinferior cerebellar artery and involving the 9th and 10th cranial nerves. In two of the patients, the compression was caused by arachnoiditis and in the other by an arterial loop. In each patient, neuralgia was successfully eliminated by microvascular decompression and by section of the upper rootlets of the vagus nerve. In one patient, partial section of the 9th cranial nerve was also performed. Because of the frequent involvement of the vagus nerve in the pathogenesis of this condition, open surgery should be preferable to percutaneous thermorhizotomy, which is unable to act selectively on the 10th cranial nerve.

Female↗

Paediatric intracranial meningiomas.

Intracranial meningiomas are rare before the age of 16 years. Of 1397 intracranial meningiomas operated on by our service up to 1987, 19 (1.3%) were diagnosed before this age. In the literature accessible to us we have found another 274 cases. An analysis of the literature shows that intracranial meningiomas in paediatric patients differ from those in adults in the following respects: a slight predilection for males, a high frequency within the ventricular system, more frequent presence of intra- and peri-lesional cysts and more frequent absence of dural attachment. In addition, the neuroradiologic diagnosis of nature is more difficult in paediatric patients.

Adolescent↗

Cystic meningiomas.

Twenty-two cases of unusual intracranial meningioma associated with a cyst are reported and 144 published cases reviewed. The complex mechanisms leading to the formation of the cyst within the meningioma are analyzed on the basis of the surgical and histopathological evidence. The neuroradiological features (Computed Tomography and Angiography) which supply a correct preoperative diagnosis are discussed. It is clear from the literature how difficult preoperative diagnosis is, being possible only in 38% of cases with CT scanning and in 13% with angiography. It is necessary to remove not only the solid portion of the meningioma but also the cyst wall in order to prevent a recurrence. This is technically difficult for the type II intratumoural variety of Nauta's classification.

Adolescent↗

Alteration of the collagen type III/type I ratio and intracranial saccular aneurysms in GH-secreting hypophyseal adenomas.

In reporting a case of GH-secreting hypophyseal adenoma associated with a carotid-ophthalmic aneurysm we discuss the possible relevance of an alteration of the type III to type I ratio in arterial wall collagen to the formation of intracranial aneurysms, known to be multifactorial in mechanism. The increased turnover of collagen and the type III collagen deficiency in the vessel wall present in acromegaly suggest that this secondary connective tissue change may have a role in the formation of intracranial aneurysms in patients with GH-secreting hypophyseal adenoma.

Adenoma↗

Intracranial arterial aneurysms in early childhood.

Cerebral saccular aneurysms are rare in early childhood. Seventy-one cases in children under 5 years of age found in the literature, plus one case of our own, are analyzed. In early childhood these aneurysms seem to have features that distinguish them from the same variety in adults. In children a congenital pathogenesis appears more convincing because of the higher frequency in the first 2 years of life, the often peripheral site (41.6%), the high frequency of large (50%) or giant (26.8%) aneurysms, and the association with other cerebral and vascular congenital abnormalities. Onset was nonhemorrhagic in 18.1% of cases compared with 2.5% in adults. The surgical outcome seems better in children than in adult patients in terms of both morbidity and mortality.

Cerebral Angiography↗

Endaural extracranial repair for cerebrospinal otorrhoea with human fibrin glue: technical note.

A simple surgical procedure for the repair of cerebrospinal otorrhoea using human fibrin glue has proved safe and successful in two patients with post-surgical fistula. The procedure, which requires only mild sedation, is recommended for open or closed cerebrospinal otorrhoea accompanied by severe neurosensory hearing loss, as long as the fistula has not been caused by chronic inflammatory processes or given rise to intracranial infectious complications.

Aprotinin↗

Pharmacokinetics of bacampicillin using a compartment model with zero-order absorption.

The pharmacokinetics of bacampicillin, a prodrug of ampicillin which is absorbed from the gastrointestinal tract, were studied in 10 healthy male volunteers after administration of 1,200 mg in a single oral dose. The pharmacokinetic analysis was carried out by applying a single-compartment kinetic model with zero-order absorption. The apparent duration of absorption (T) was about 1 h for all subjects. The peak plasma concentrations (Cmax) were 17.89 +/- 1.82 micrograms/ml, and the mean plasma half-life during beta-phase was 1.17 +/- 0.14 h. The area under the curve was 41.22 +/- 5.29 micrograms.h/ml. The mean urinary recovery during 24 h amounted to 76.4 +/- 3.65% of the dose.

Adult↗

Pharmacokinetics of teicoplanin.

We investigated the pharmacokinetic properties of teicoplanin, after 200 mg i.v. and i.m. administration in 10 healthy male subjects by assuming a three-compartment open model with elimination from the central compartment. The mean peak plasma level was 7.16 micrograms/ml reached after 2.26 h. The half-life, the plasma and renal clearances, evaluated from i.v. data were 44.49 h, 15.31 and 9.08 ml/min, respectively. The same parameters after i.m. administration were 45.62 h, 15.31 and 9.46 ml/min. The estimates of creatinine clearance (Clcr greater than 80 ml/min), renal clearance and the low free fraction (fB approximately equal to 0.1) suggested a tubular reabsorption, FR, of the drug. The distribution volume at steady state after i.v. and i.m. administration (Vss = 41.29 and 44.76 litres) were nearly total body water. Bioavailability of the drug (F = 92.4%) showed an almost completely absorption of teicoplanin after i.m. administration. Urinary recovery was 49.6 and 47.9% of the dose after i.v. and i.m. administration, respectively.

Adult↗