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Biomedical subjects

Luigi Ferrante

Publications and source records attributed to Luigi Ferrante.

At least 19 recordsLinked to original sources

Age estimation by pulp/tooth ratio in canines by peri-apical X-rays.

Estimation of age in individuals has received considerable attention in forensic science, in which it is a widely used method for individual identification, together with paleo-demographic analyses to establish mortality patterns in past populations. The present investigation, which is a continuation of a previously published pilot study, was conducted to examine the possible application of the pulp/tooth area ratio by peri-apical images as an indicator of age at death. A total of 200 peri-apical X-rays of upper and lower canines were assembled from 57 male and 43 female skeletons of Caucasian origin, aged between 20 and 79 years. They belong to the Frassetto osteological collection of Sassari (Sardinia) and are housed in the Museum of Anthropology, Department of Experimental and Evolutionistic Biology, University of Bologna. For each skeleton, dental maturity was evaluated by measuring the pulp/tooth area ratio on upper (x(1)) and lower (x(2)) canines. Very good agreement was found between intraobserver measurements. Statistical analysis was performed in order to obtain multiple regression formulae for dental age calculation, with chronological age as dependent variable, and gender, and upper and lower canines as independent variables. Stepwise regression analysis showed that gender did not contribute significantly to the fit (p=0.881) whereas variables x(1) and x(2) and the first-order interaction between them did. These two variables explained 92.5% of variations in estimated chronological age and the residual standard error was 4.06 years. Lastly, two simple linear regression equations were obtained for age estimation using canines from the maxilla and mandible separately. Both models explained 86% of variations in estimated chronological age and allowed an age-at-death estimate with a residual standard error of about 5.4 years.

Adult↗

Papillary glioneuronal tumor. Case report and literature review.

OBJECTIVE AND IMPORTANCE: Papillary glioneuronal tumor is a recently described neoplasm composed of gliovascular pseudopapillae associated with intervening neuronal cells ranging from neurocytes to ganglion cells. This tumor is not currently included in the WHO classification of tumors of the central nervous system. We describe a new case of papillary glioneuronal tumor and analyze the data for a series of further 15 patients from international literature. CLINICAL PRESENTATION: A 27-year-old man presented to us for generalized seizure. CT and MRI showed a cystic tumor with mural nodule in the left frontal lobe. INTERVENTION: Frontal craniotomy with gross total removal of the tumor was performed. Histopathological examination was positive for papillary glioneuronal tumor. CONCLUSION: The clinical, radiologic, and pathological features of our case are strikingly similar to those of the previous reported cases. A review of the literature disclosed only 15 other cases of these tumors. It is important that every new case of PGNT is reported to allow its recognition and classification.

Adult↗

Meningiomas infiltrating the superior sagittal sinus: surgical considerations of 328 cases.

The aim of the study was to discuss our management strategy and results of patients affected by meningiomas infiltrating the superior sagittal sinus. We describe 328 patients with meningiomas that were infiltrating the superior sagittal sinus. All the patients were surgically treated. Patients with meningioma involving the anterior segment of the sinus underwent total sinus resection. Patients with meningioma that was infiltrating the middle and posterior third of the sinus had a complete sinus removal if the dural sinus was completely obliterated by meningioma and incomplete removal if the sinus was not occluded. The tumour removal was grade I according to Simpson's grading system in 193 cases and grade II or III in the remainder. The superior longitudinal sinus was totally resected in 215 patients and marginally resected in 113. The tumour reappeared in 38 patients. The number of re-interventions did not affect clinical outcome. The extent of removal significantly influenced the regrowth or recurrence rate. Our results suggest that the risks of aggressive surgery, with sinus reconstruction, may be avoided, and conservative surgery for meningiomas that are infiltrating but not obliterating the superior sagittal sinus may be a reasonable choice.

Activities of Daily Living↗

Pituitary macroadenomas: preoperative evaluation of consistency with diffusion-weighted MR imaging--initial experience.

PURPOSE: To prospectively evaluate use of diffusion-weighted (DW) magnetic resonance (MR) images and apparent diffusion coefficient (ADC) maps for determination of the consistency of macroadenomas. MATERIALS AND METHODS: The study protocol was approved by the institutional ethics committee, and informed consent was obtained from all patients. Twenty-two patients with pituitary macroadenoma (10 men, 12 women; mean age, 54 years +/- 17.09 [standard deviation]; range, 21-75 years) were examined. All patients underwent MR examination, which included T1-weighted spin-echo and T2-weighted turbo spin-echo DW imaging with ADC mapping and contrast material-enhanced T1-weighted spin-echo imaging. Regions of interest (ROIs) were drawn in the macroadenomas and in normal white matter on DW images, ADC maps, and conventional MR images. Consistency of macroadenomas was evaluated at surgery and was classified as soft, intermediate, or hard. Histologic examination was performed on surgical specimens of macroadenomas. Mean ADC values, signal intensity (SI) ratios of tumor to white matter within ROIs on conventional and DW MR images, and degree of enhancement were compared with tumor consistency and with percentage of collagen content at histologic examination by using analysis of variance for linear trend. RESULTS: The mean value of ADC in the soft group was (0.663 +/- 0.109) x 10(-3) mm(2)/sec; in the intermediate group, (0.842 +/- 0.081) x 10(-3) mm(2)/sec; and in the hard group, (1.363 +/- 0.259) x 10(-3) mm(2)/sec. Statistical analysis revealed a significant correlation between tumor consistency and ADC values, DW image SI ratios, T2-weighted image SI ratios, and percentage of collagen content (P < .001, analysis of variance). No other statistically significant correlations were found. CONCLUSION: Findings in this study suggest that DW MR images with ADC maps can provide information about the consistency of macroadenomas.

Adenoma↗

Reliability in age determination by pulp/tooth ratio in upper canines in skeletal remains.

Estimation of age of skeletal remains is one of the most complex questions for anthropologists. The most common macroscopic methods are based on dental wear and histological evaluation of bone remodeling. These methods are often qualitative, require great technical expertise, and have proved inexact in the estimation of ages over 50 years. Certain dental methods investigate the apposition of secondary dentine, in the study of tooth cross-sections, and X-rays to study width, height, and pulp area. The primary author previously proposed a method of estimating the age of a living person based on the pulp/tooth ratio (PTR) method in the upper canines. The aim of the present study is to verify whether the PTR method can also be used to estimate the age at death of skeletal remains. This paper investigates the study of historical samples of known age as a means to validate the proposed method.

Adolescent↗

Intracranial meningiomas in children: report of 27 new cases and critical analysis of 440 cases reported in the literature.

We accumulated 440 cases of intracranial meningiomas in patients under 16 years of age, and another 27 personal. This review confirms the existence of specific clinical features of spontaneous and radiation-induced meningioma in children. In addition, we discuss various points that suggest a more aggressive behavior of meningiomas in children than in adults. (J Child Neurol 2006;21:31-36).

Adolescent↗

Human milk oligosaccharides inhibit the adhesion to Caco-2 cells of diarrheal pathogens: Escherichia coli, Vibrio cholerae, and Salmonella fyris.

Breast-fed children, compared with the bottle-fed ones, have a lower incidence of acute gastroenteritis due to the presence of several antiinfective factors in human milk. The aim of this work is to study the ability of human milk oligosaccharides to prevent infections related to some common pathogenic bacteria. Oligosaccharides of human milk were fractionated by gel-filtration and characterized by thin-layer chromatography and high-performance anion exchange chromatography. Fractions obtained contained, respectively, 1) acidic oligosaccharides, 2) neutral high-molecular-weight oligosaccharides, and 3) neutral low-molecular-weight oligosaccharides. Experiments were carried out to study the ability of oligosaccharides in inhibiting the adhesion of three intestinal microorganisms (enteropathogenic Escherichia coli serotype O119, Vibrio cholerae, and Salmonella fyris) to differentiated Caco-2 cells. The study showed that the acidic fraction had an antiadhesive effect on the all three pathogenic strains studied (with different degrees of inhibition). The neutral high-molecular-weight fraction significantly inhibited the adhesion of E. coli O119 and V. cholerae, but not that of S. fyris; the neutral low-molecular-weight fraction was effective toward E. coli O119 and S. fyris but not V. cholerae. Our results demonstrate that human milk oligosaccharides inhibit the adhesion to epithelial cells not only of common pathogens like E. coli but also for the first time of other aggressive bacteria as V. cholerae and S. fyris. Consequently, oligosaccharides are one of the important defensive factors contained in human milk against acute diarrheal infections of breast-fed infants.

Animals↗

Age estimation in children by measurement of open apices in teeth.

This paper concerns a method for estimating the age of children based on their teeth. The sample consisted of 455 Italian white children (213 boys, 242 girls) aged between 5 and 15 years. The purpose of the present investigation was to present a method for assessing chronological age based on the relationship between age and measurement of the open apices in teeth. Pearson's correlation coefficients between age and these variables showed that the correlations between age and the open apices in teeth were significant and negative. Furthermore, gender and the number of teeth with the apical end of the root canals completely closed (N(0)) showed a significant correlation with chronological age. With the aid of a stepwise multiple regression model, a linear relationship between open apices, N(0), and age was shown. Statistical analysis indicated that these morphological variables explain 83.6% of the variations in estimated chronological age. The median of residual errors between the actual and estimated ages was -0.035 years [interquartile range (IQR)=1.18 years].

Adolescent↗

Carpals and epiphyses of radius and ulna as age indicators.

Estimation of skeletal age using radiographic images is widely used for assessing biological growth in clinical and auxological studies. The most frequent areas used for age estimation in children and adolescents are tooth and wrist/hand, both giving good results with only a low level of radiation. In particular, ossification of the carpals shows good agreement with chronological age. This study of a sample of 150 Italian children and adolescents aged between 5 and 17 years focused on analyzing the possible applications of the proportion of carpal area (Ca) mineralization as a criterion of age estimation. The ratio between the total area of carpal bones and epiphyses of the ulna and radius (Bo) and Ca was calculated. This ratio (Bo/Ca) was used for linear regression analysis. The regression model, describing age as a linear function of the ratio Bo/Ca, yielded the following equation: Age=-3.253+0.719 g+20.610 Bo/Ca, and explained 83% of the total variance (R (2)=0.83). The median of the absolute values of residuals (observed age minus predicted age) was 0.08 years, with a quartile deviation of 1.59 years, and a standard error of estimate of 1.19 years.

Adolescent↗

Intrameningioma metastasis as first clinical manifestation of occult primary breast carcinoma.

Metastasis from extracranial tumor into an intracranial primary tumor is an uncommon event. A predominant tendency of meningioma to be the host tumor for breast carcinoma has been found. In the current report, three cases of breast carcinoma metastatic to intracranial meningiomas are described. In our cases, metastasis in meningioma was the first clinical manifestation of the occult primitive breast carcinoma. We review widely the literature concerning such rare occurrences and discuss all the postulated pathogenetic mechanisms. There are few cases reported in the literature on resonance magnetic imaging of metastatic carcinoma in meningioma. Two of our patients have been studied by MRI, but we do not find predictive radiological finding of this particular association.

Adenocarcinoma↗

Role of contrast-enhanced MR venography in the preoperative evaluation of parasagittal meningiomas.

Parasagittal meningiomas (PSM) may pose a difficult surgical challenge since venous patency and collateral anastomoses have to be clearly defined for correct surgical planning. The aim of this study was to assess the diagnostic value of contrast-enhanced (CE) magnetic resonance venography (MRV) in the preoperative evaluation of venous infiltration and collateral venous anastomoses in patients with PSM. CE-MRV was compared with phase-contrast (PC) magnetic resonance (MR) angiography, conventional angiography (when available), and surgery as a reference. Twenty-three patients undergoing surgery for meningiomas located adjacent to the superior sagittal sinus were prospectively evaluated. All the patients underwent both conventional MR examination and MRV. This was performed by means of PC and CE techniques. Both sets of angiograms (CE and PC) were evaluated by two expert neuroradiologists to assess (1) patency of the sinus (patent/occluded), (2) the extent of occlusion (in centimeters), and (3) the number of collateral anastomoses close to the insertion of the meningioma. Eight patients underwent digital subtraction angiography (DSA). All patients were operated on, and intraoperative findings were taken as the gold standard to evaluate the diagnostic value of MRA techniques. PC-MRV showed a flow void inside the sinus compatible with its occlusion in 15 cases, whereas CE-MRV showed the sinus to be occluded in five cases. CE-MRV data were confirmed by surgery, showing five patients to have an occlusion of the superior sagittal sinus. The PC-MRV sensitivity was thus 100% with a specificity of 50%. In those cases in which both MRV techniques documented occlusion of the sinus, the extent of occlusion was overestimated by PC compared with CE and surgery. CE-MRV depicted 87% of collateral venous anastomoses close to the meningioma as subsequently confirmed by surgery, while PC showed 58%. In the preoperative planning for patients with meningiomas located close to a venous sinus, CE-MRV provides additional and more reliable information concerning venous infiltration and the presence of collateral anastomoses compared with PC sequences.

Adult↗

Gliomatosis cerebri in children. Case report and clinical considerations.

OBJECTIVE: Gliomatosis cerebri (GC) is an uncommon entity characterised by the diffuse overgrowth of large parts of the brain by glial cells. Reports in the literature often refer to adult patients, its occurrence in children being even more rare. CASE REPORT: We report the case of an 8-year-old boy with GC and discuss the problem of intra vitam diagnosis. CONCLUSIONS: Diagnosis of GC is very difficult; thus, cases diagnosed during life are rare.

Arachnoid Cysts↗

Gliosarcomas: analysis of 11 cases do two subtypes exist?

There are conflicting reports regarding gliosarcomas. The goal of this study is to examine clinical, radiological, surgical and therapeutic aspects of 11 patients with gliosarcoma. Between 1993 and 2001, 11 patients with cerebral gliosarcoma were treated at our Institute. Ten patients underwent surgery and one patient had stereotactic biopsy. Four patients received whole brain radiotherapy with (60)Co, five underwent radiotherapy with LINAC extended 2 cm beyond the edema margins. One patient refused any additional treatment after surgery and one patient was not treated postoperatively for poor clinical conditions (KPS 40). Chemotherapy (temozolomide) was administered to four patients. Four patients had a prevalence of sarcomatous component that corresponded to surgical and radiological aspects similar to meningioma while six patients showed a prevalence of gliomatous component and radiological and surgical aspects similar to those of glioblastomas. Surgical resection was total in six and subtotal in four patients. Patients with prevalent sarcomatous component showed median survival time more prolonged than patients with prevalent gliomatous component (71 +/- 6 weeks vs. 63 +/- 6; P=0.0417). Moreover, the survival rate differed in relation to the therapy: patients treated with multimodality therapy (surgery, radiotherapy and chemotherapy) had a longer survival time than patients treated in single or bimodality. Despite prognosis of gliosarcomas remains poor, a multidisciplinary approach (surgery, radiotherapy and chemotherapy) seems to be associated with slight more prolonged survival times.

Adult↗

"Supine-prone" dynamic X-ray examination: new method to evaluate low-grade lumbar spondylolisthesis.

Lumbar instability often causes clinical symptoms, and spondylolisthesis is a main factor of the low back pain. Segmental lumbar instability generally is due to a degenerative or listhesic process of the lumbar spine and radiological imaging is essential to diagnose it. Lumbar spine segmental mobility has commonly been studied by dyanamic radiographic methods. Dynamic X-rays, with maximal extension and flexion of the lumbar tract, represents the most widely used technique and a valid method to estimate sagittal segmental lumbar motion. Between 1998 and 2002 we treated 75 patients for low-grade spondylolisthesis. All patients underwent a preoperative dynamic X-rays examinination, to evaluate the degree of the lumbar mobility. We report a supine-prone position as new method to clearly estimate the slipping of lumbar vertebrae. The patients had a standard lateral X-rays film in the supine position, and then in the "prone" position. We compared the two methods and we found a higher degree of listhesis in 19 cases (14 I grade, 5 I-II grade), while there was no difference in 56 cases. The higher degree of listhesis was in the prone position. We believe that the supine-prone position is an economic method and should be mandatory performing a dynamic X-rays examination.

Humans↗

Brain metastasis from cutaneous squamous cell carcinoma of the dorsum. Case report.

The majority of cutaneous squamous cell carcinoma (SCC) are diagnosed early and cured using local treatment, although a minority of cases metastasize to regional structures. In this report the authors describe an unknown feature of skin SCC, namely, distant brain metastasis. This 54-year-old man, who had undergone surgery for moderately differentiated SCC of the dorsum (T2NOM0 stage), was admitted to our institution 11 months later with headache, vomiting, and ataxia. A magnetic resonance image documented a cerebellar lesion, which was totally removed. Results of histological studies revealed SCC. The patient received whole-brain radiotherapy (30 Gy over 2 weeks using a linear accelerator). A metastatic work-up showed enlarged inguinal and para-aortic lymph nodes that were histologically examined using excisional biopsy. Inguinal lymph nodes were tumor-positive and were dissected. The patient was subjected to two cycles of chemotherapy with cisplatin (75 mg/m2). After 3 months, a significant reduction in the size of the para-aortic lymph nodes was documented on control computerized tomography studies. Although the described case is unique, knowledge of the potential for this uncommon behavior in cutaneous SCC may be useful, especially because of its increasing incidence.

Back↗

Spinal extradural schwannoma.

OBJECT: The authors endeavor to define the clinical and surgery-related profile of spinal nerve sheath tumors located in the extradural space outside both the dural sac and, apparently, the nerve roots' sleeve. METHODS: A series of 24 extradural schwannomas was retrospectively selected after reviewing the notes of spinal nerve sheath tumors surgically treated at La Sapienza University of Rome. Clinical data, tumor-related characteristics, and outcome were analyzed. Women predominantly harbored these tumors. On admission sensory nerve root dysfunction was infrequently reported, whereas pyramidal tract deficits were often present. The tumor, generally large, was most frequently located in the intermediate thoracic segments and high cervical region; only one was reported in the lumbosacral region. Considerable erosion of vertebral bodies was reported in almost one third of the cases. In four patients eloquent nerve roots, that of C-5 in three and that of S-1 in one, were involved with the tumor. Radical tumor resection, with preservation of the nerve roots, was possible in several cases, whereas in two patients manipulation and resection of the C-5 root produced transient and permanent, respectively, root palsy. At follow-up examination patients for whom walking was impossible before surgery were now able to walk. CONCLUSIONS: Extradural schwannomas can be distinguished from other nerve sheath tumors growing inside the spinal canal by their clinicoradiological features and unlikely nerve root origin. After surgery, recovery from pyramidal tract deficits, even severe, is noteworthy; in the authors' experience, however, resection of an involved appendicular root is more likely to result in a permanent and significant radicular deficit.

Adolescent↗

Extrathecal intraradicular nerve sheath tumor.

OBJECT: The purpose of this study was to analyze the clinical profile of patients harboring extrathecal and intraradicular nerve sheath tumors (NSTs), located inside the sleeve of an extrathecal nerve root and very often within the proximal portion of the spinal nerve, and to evaluate the incidence of long-term dysfunction of the tumor-affected roots if resected. These tumors have not received particular attention in the literature. METHODS: A single-institution series of 16 patients who had undergone surgery for intraradicular NSTs during a 50-year period was selected retrospectively. Data pertaining to clinical features, tumor characteristics, and results of surgery were analyzed. CONCLUSIONS: Extrathecal and intraradicular neurofibromas or schwannomas more frequently affect the lumbar and S-1 nerve roots, often producing root pain only. Selective en bloc enucleation sparing at least part of the motor rootlets is possible for small schwannomas of the extrathecal-preganglion segment of the radix, whereas total resection of the affected root is generally required for radical removal of neurofibromas and large schwannomas. In the authors' experience, neither deafferentation pain nor severe radicular weakness occurs after division of the nerve root harboring the tumor.

Adolescent↗

Tumor and metastasis suppression by the human RNASET2 gene.

The region 6q27 from human chromosome 6 has been reported to contain one or more tumor suppressor genes on the basis of cytogenetic, molecular and functional studies. We have recently carried out a detailed analysis of a candidate gene from 6q27 to evaluate its putative role as a tumor suppressor gene involved in ovarian cancer pathogenesis. The RNASET2 gene was shown to behave as a class II tumor suppressor and abolish the tumorigenic potential of an ovarian cancer-derived cell line. In this study, we have started the cellular and biochemical characterization of RNASET2 and showed that it is a secreted glycoprotein. Moreover, we have extended our previous studies by evaluating the effect of RNASET2 on the metastatic behavior of the highly-invasive ovarian cancer cell line HEY3MET2. From such analysis, RNASET2 was found to significantly decrease the metastatic potential of this cell line in vivo. Moreover, RNASET2-mediated suppression of tumorigenesis and metastasis was not affected by a double point mutation targeted to the putative ribonuclease catalytic sites, suggesting that tumor suppression by RNASET2 is not mediated by its ribonuclease activity. The potential biological implications of this unexpected finding are discussed in relation to the current evolutionary models.

Chromosomes, Human, Pair 6↗