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Biomedical subjects

M Apuzzo

Publications and source records attributed to M Apuzzo.

13 recordsLinked to original sources
PubMed2000

[Gastric MALT lymphoma and Helicobacter pylori].

Aim of this paper is to evaluate the effects of eradicating Helicobacter pylori (Hp) on the course of low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. A total of 13 consecutive patients, 7 males and 6 females (median age 54 years) Hp-positive were included, all affected by low-grade B-cell gastric MALT lymphoma, stage I using established criteria; histologic assessment by gastric biopsies was performed. Each patient received anti-Hp therapy with standard protocol for 7 days and underwent endoscopy and histology every 3-6 months. Complete eradication was obtained in all patients (100%); on histology 9 patients showed complete regression, but in one of these lymphoma relapsing after 12 months was observed. Our findings confirm recent cooperative reports of Hp eradication rate and regression of gastric tumour (about 70%). In conclusion, the indolent clinical course of the disease justifies a first-line conservative approach with Hp eradication therapy.

Adult↗
PubMed1996

Pseudotumor associated with CNS lymphoma.

A 42-year-old immune-competent woman with orbital pseudotumor and presumed intracranial extension into the temporal lobe responded well clinically and radiologically to high-doses of corticosteroids. Five months later, she developed worsening headaches and recurrence of the temporal lobe lesion. Biopsy revealed a central nervous system (CNS) lymphoma with severe reactive gliosis abutting an area of subarachnoid lymphocytic infiltrate.

Adult↗
PubMed1990

[The duodenum and non-steroidal anti-inflammatory agents].

We have carried out a longitudinal study in order to confirm our preliminary data on the heavier involvement of the duodenum compared to the stomach after non aspirin non-steroidal anti-inflammatory drugs (NSAIDs). 53 patients with upper digestive haemorrhage due to recent intake of NSAIDs without preexisting known peptic pathology -28 p. from aspirin and 25 p. from NSAIDs other than aspirin--were selected. Aspirin and its derivatives mainly affected gastric mucosa whereas non aspirin NSAIDs the duodenum. 42 of these patients have been observed for two more years; independently of the treatment, ranitidine 150 mg daily vs antacids if needed, the annual rate of recurrence has been very low. These findings have further confirmed the accurate selection of our patients without previous peptic pathology (in this case the rate of recurrence would have been much higher) and also suggest a more rational diagnostic and therapeutic approach to these patients. We then observed a consecutive series of 107 patients affected with duodenal ulcer bleeding: 51 by NSAIDs and 56 not by NSAIDs; both groups were given H2-antagonists and blood transfusions if needed. The short term prognosis has been rather positive mainly for the NSAIDs group, in which no mortality has been observed, independently of the number of blood transfusions and length of hospitalization. In our experience the high percentage of NSAIDs duodenal ulcers (about 50%), shows an increase of this pathology, less severe than peptic one, even if expressed by a serious event as digestive bleeding. It is our opinion that these percentages and prognostic evaluations should be considered in therapeutic decision, limiting thus surgical and aggressive endoscopic procedures.

Adolescent↗
PubMed1989

Epidemiological study of duodenal erosive disease; its prevalence and nosological position in relation to ulcerative peptic disease.

The prevalence of erosive lesions was found to be 27.5% in 11838 cases examined during the last 10 years. In almost 66% of the cases, erosive lesions were localized in the duodenal bulb but mainly isolated and less often in the antro-pyloric area. In 55% of the cases, duodenal erosions coexist with ulcerative peptic disease, 20% in "active" phase and 35% in "inactive" phase. Erosive lesions, appeared autonomously in 45% of the cases. Morphologically, they can be divided in: a) periulcerative marginal erosions closely connected with activity of the ulcers; b) clustered, complete or incomplete erosions, which may or may not be associated with the ulcerative disease and often have a prolonged acyclic behaviour; c) scattered flat erosions which can at times be associated with the ulcerative peptic disease but are always related to a chronic widespread duodenitis. An epidemiological study was performed on 564 cases which were divided into 3 groups: a) cases with autonomous erosive disease; b) those with erosions associated with post-ulcerative scars; and c) those with erosions associated with active ulcers. The control group of 111 cases was characterised by duodenal active ulcers with no erosions. Statistical evaluation of the percentage differences between the 4 groups revealed that in duodenal erosive disease predisposing factors such as psychic temper, environmental and work conditions and eating habits are evident. In autonomous disease drug intake and spices and, to a less extent, alcohol and/or stress situations play a more important role. In erosions associated with an active ulcer, a dominant obsessive temper facilitated by a difficult family situation, bad eating habits and a great amount of smoking are prominent factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Duodenal Diseases↗
PubMed1989

Healing rate of duodenal ulcer with hyper-aggressive peptic activity under H2-receptor antagonists.

In 60 cases of hyper-aggressive duodenal ulcer an endoscopic examination was made, at short intervals (4,7,11,13,21,28 days) after the treatment with H2-receptor antagonists. The open trial was based on random cases under ranitidine 150 mg b.i.d. (31 cases) or cimetidine 400 mg b.i.d. (29 cases). The healing rate has been calculated from the regression slope of the ulcerative area in mm2. Regression does not have a linear slope; it is slow in the first week, increases in the second week, in which it reaches the maximum value, and then decreases gradually in the following weeks. H2-receptor antagonists have no doubt an accelerating effect on healing; cimetidine, in comparison with ranitidine, has a faster and more evident action in the first week. But then, it reduces its action more rapidly in the following weeks so that, on the whole, it turns out to be slightly less valuable. These results can be practically useful for the treatment of hyper-aggressive D.U. as far as early risks are concerned.

Cimetidine↗
PubMed1979

Checkerboard visual evoked response in evaluation and management of pituitary tumors.

As a routine part of the evaluation of patients with pituitary tumor, visual evoked responses (VERs) to checkerboard pattern reversal were recorded from 83 patients with tomographically documented pituitary tumor. VER tests were correlated with examinations of visual acuity, color perception, and visual fields and with computerized tomographic scan evidence of suprasellar extension of the tumor. The purpose of the VER recording was to determine the presence of visual system compression by the tumor and thus contribute to the decision of whether surgery was necessary. Each of the patients who had suprasellar extension of the tumor sufficient to produce a visual field abnormality also had an abnormal VER. In addition, some patients with suprasellar extension had normal visual fields but abnormal visual evoked responses. Thus, the VER provided earlier evidence of suprasellar extension causing visual system compromise than did conventional visual tests.

Adenoma, Chromophobe↗
PubMedDate not supplied

CT myelography in spinal cysticercosis.

Four cases of spinal cysticercosis were found in a series of 356 cases of CNS cysticercosis studied neuroradiologically. Cysticercal cysts were seen to migrate within the spinal subarachnoid space on myelographic studies. All four patients presented initially with hydrocephalus, which supports the notion that spinal leptomeningeal cysts have migrated from an intracranial site of origin. Computed tomographic myelography (metrizamide) allowed better localization and definition of the spinal cysticercal lesions.

Adult↗
PubMedDate not supplied

MR imaging of pineal region neoplasms.

Twenty-eight patients with tumor of the pineal region underwent magnetic resonance (MR) examination. Gadolinium DTPA was given to 13 patients. Histologic confirmation was obtained in all patients, including 10 germinomas, 4 pineocytomas, 4 pineoblastomas, 5 astrocytomas, 2 teratomas, 1 choriocarcinoma, 1 mixed germ cell tumor, and 1 metastasis from breast carcinoma. Pineal region neoplasms have remarkable heterogeneity in both histopathologic and MR appearances. Gadolinium DTPA enhanced MR increases the specificity of diagnosing pineal region neoplasms. In addition, Gd-DTPA provides better delineation of the tumor margin and demonstrates cystic components of the neoplasm. Our approach to pineal region neoplasms is to make a decision about whether stereotaxic biopsy or surgery should be performed on a certain patient. When a pineal region neoplasm is diagnosed as benign, such as a benign teratoma, on the basis of imaging, surgery is performed to resect the entire lesion. When a definitive diagnosis is not possible, sterotaxic biopsy is performed to obtain histological diagnosis for treatment planning. Gadolinium DTPA enhanced MR plays an extremely important role in target selection in stereotaxic biopsy of pineal region neoplasms and is also useful in the early detection of intracranial seeding. Spinal seeding is demonstrated on MR as well, thus alleviating the need for a contrast myelogram. Finally, Gd-DTPA enhanced MR can be used to monitor the effects of the various treatment modalities employed for pineal region neoplasms.

Adolescent↗
PubMedDate not supplied

[Concepts of development of the neurosurgical operative environment in the 21st century].

The operative environment has to a large extent defines the "state of the art and science" of neurosurgery, which is now undergoing rapid reinvention. In order to remain current, each neurosurgeon should periodically reconsider their personal operative environment and its functional design with reference to modernity of practice as currently defined. Historical trends and their analysis offer predictive guides for development of such settings with an eye toward the future. Examination of technical developments in decade timeframes defines the progress in capability and need. Progressive minimalism of manipulation and the presence of operative definition with increasing precision are evident, with concurrent miniaturization of attendant computerized support systems, sensors, robotic interfaces, and imaging devices. These trends and developments offer the opportunity for simplificity of setting design with higher functionality as the desired endpoint.

Equipment Design↗