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M Monteleone

Publications and source records attributed to M Monteleone.

At least 19 recordsLinked to original sources
PubMed2002

The Viladot-Regnauld operation for hallux valgus.

Of 54 patients, we reviewed 26 with 28 operations for hallux valgus according to the Viladot-Regnauld technique. Follow-up was 18.7 (12-26) years. In 26 operations, the score according to Kitaoka and modified by Calder was excellent or good, and in two, fair. There were no complications. Average valgus angle correction was 15 degrees (8 degrees-29 degrees) and average intermetatarsal angle correction was 7 degrees (4 degrees-12 degrees). Sesamoids were medialised, on average, by at least 25% compared to the pre-operative situation. The results confirm the validity of this surgical procedure.

Adult↗
PubMed2002

Regional migratory osteoporosis: a pathogenetic hypothesis based on three cases and a review of the literature.

Regional migratory osteoporosis (RMO) is a migrating arthralgia of the weight-bearing joints of the lower limb which mainly affects middle-aged males. Its aetiology is unknown. The association of RMO with generalised osteoporosis has recently been reported. A concurrent systemic osteoporosis was also reported in some cases of transient osteoporosis of the hip (TOH), a disorder closely related to RMO. In its turn, TOH is considered a reversible stage of avascular necrosis of the hip (AVN), and the aetiopathogenesis of both of them remains strongly debated. We report three cases of RMO associated with generalised severe idiopathic osteoporosis. Three men, in the fourth and fifth decades of life, complained of at least four episodes of arthralgia in the lower limbs, with a migratory pattern, radiographic focal osteoporosis and final clinical resolution. The most striking common feature of these patients was the presence of a severe systemic osteoporosis with a prevailing trabecular involvement. We suggest that a prolonged or exaggerated activation of regional acceleratory phenomena (RAP) is the cause of transient osteoporosis. Bone tissue microdamage due to osteoporosis may be the most frequent noxious stimulus that turns RAP on, and, bone tissue microfracture is the most prevalent consequence. When this pathogenetic pathway is activated, the progression from focal osteoporosis and bone marrow oedema to avascular necrosis is associated with the amount of structural damage.

Adult↗
PubMed2001

Ext-mutation analysis in Italian sporadic and hereditary osteochondromas.

Osteochondromas represent the largest group of benign tumors of bone. Multiple osteochondromatosis or hereditary multiple exostoses (EXT) is an autosomal dominant inherited disorder characterized by the presence of multiple benign cartilage-capped exostoses. EXT is genetically heterogeneous with at least 3 chromosomal loci: EXT1 (8q24.1), EXT2 (11p11-p13), and EXT3 (19p). In <5% of EXT patients, the inactivation of both copies of EXT alleles (LOH) is associated with malignant transformation. We have analyzed the EXT1 and EXT2 genes in 9 unrelated EXT families and in a patient with a sporadic osteochondroma, all originating from Italy. Four families show an EXT1 mutation, consisting of a small deletion in 3 of them and a small insertion in the 4th. All these mutations lead to premature termination of translation and thus a truncated EXT1 protein. Three families presented EXT2 mutations consisting of nucleotide substitutions leading to alterations of the third intron splice-site, to an amino acid substitution and to a nonsense mutation. All these mutations cosegregate with the disease phenotype. The sporadic osteochondroma patient carried a novel missense mutation in exon 11 of EXT2 gene, leading to an amino acid substitution. Seven of these mutations have never been described before. EXT2 missense mutations were also confirmed by amino acids conservation between human and mouse and by analysis of a healthy control population. In conclusion, our study provide further evidence that loss of function of the EXT1 or EXT2 gene is the main cause of EXT supporting the putative tumor-suppressor function of these genes.

Adolescent↗
PubMed2001

Effects of different sports on bone density and muscle mass in highly trained athletes.

PURPOSE: It is known that participating in sports can have a beneficial effect on bone mass. However, it is not well established which sport is more beneficial for increased bone mineral density (BMD) and appendicular muscle mass (AMM). This study investigated the effects of different high-intensity activities on BMD and AMM in highly trained athletes. MATERIALS AND METHODS: Sixty-two male subjects aged 18--25 yr participated in the study. The sample included judo (J; N = 21), karate (K; N = 14), and water polo (W; N = 24) athletes who all competed at national and international level. Twelve age-matched nonathletic individuals served as the control group (C). All athletes exercised regularly for at least 3 h x d(-1), 6 d x wk(-1). Segmental, total BMD, and AMM were measured with a dual-energy x-ray (DXA) absorptiometry (Lunar Corp., Madison, WI). DXA analysis also includes bone mineral content (BMC) and fat and lean masses. RESULTS: Total BMD(C) was significantly lower (mean +/- SD: 1.27 +/- 0.06 g x cm(-2), P < 0.05) than either judo or karate athletes (total BMD(J) (1.4 +/- 0.06 g x cm(-2)) and total BMD(K) (1.36 +/- 0.08 g x cm(-2))) but not different from the W athletes (total BMD(W) (1.31 +/- 0.09 g x cm(-2))). AMM was significantly lower in the C group compared with the three athletic groups (P < 0.05). Fat mass was higher in the W versus J and K athletes but not different from the C group (P < 0.05). CONCLUSIONS: This cross-sectional study has shown that athletes, especially those engaged in high-impact sports, have significantly higher total BMD and AMM than controls. These results suggest that the type of sport activity may be an important factor in achieving a high peak bone mass and reducing osteoporosis risk.

Absorptiometry, Photon↗
PubMed1998

Graft-tunnel mismatch in endoscopic anterior cruciate ligament reconstruction. Intraoperative and cadaver measurement of the intra-articular graft length and the length of the patellar tendon.

The results of a study conducted on 50 knees endoscopically reconstructed for an anterior cruciate ligament (ACL) lesion with a free bone-patellar tendon-bone graft and 9 cadaver knees are reported. The mean lengths of the patellar tendon (45.48 +/- 4.71 mm) and intra-articular ACL graft (20.44 +/- 1.98 mm) were measured in the operated knees. The mean length of the tibial bone tunnel (51.62 +/- 2.60 mm) was also measured with a tibial guide at 55 degrees. No statistically significant correlation was found between these three measurements. The length of the patellar tendon was weakly correlated with body height. Measurement of the tibial tunnel on the cadaver knees with increasing degrees of inclination revealed a mean length increase of 0.68 mm per degree (confidence limits: 0.49-0.86). Comparison between the tunnel lengths obtained with the guide and those measured with a Kirschner wire showed a mean difference of 2.3 mm. It is thus desirable to make the tunnel about 53 mm long to ensure excellent fixation of a 28 mm bone block with a 25 mm interference screw. Correct measurement of the anatomical structures involved is in any event an essential requirement for proper execution of the surgical technique.

Adolescent↗
PubMed1998

Pharmacokinetics of ifosfamide administered according to three different schedules in metastatic soft tissue and bone sarcomas.

Ifosfamide is a leading drug in soft tissue sarcoma therapy. Recently high dose therapy (>9 g/m2) has been introduced in different schemes to obtain a higher response rate. All these higher doses can be administered following two different schedules: continuous infusion 24 hours a day for 4-5 days or bolus administration for 5 consecutive days. In this study we compare the differences in the pharmacokinetic profile between the two schedules. In both schemes we saw a very important autoinduction phenomenon, with a corresponding half-life decrease and total body clearance increase during the days of therapy. The clearances were not directly correlated with the administered dose. We can conclude that ifosfamide continuous infusion therapy is equivalent to fractionated administration, at least from a pharmacokinetic point of view. Short-term infusion is subjectively better tolerated and is therefore preferred.

Adult↗
PubMed1995

Long-term results of the Leeds-Keio anterior cruciate ligament reconstruction.

This paper discusses the long-term results of the anterior cruciate ligament (ACL) reconstruction with the Leeds-Keio (LK) prosthetic ligament. For this type of reconstruction we used arthrotomy and an arthroscopy-assisted technique. The fixation was obtained with two bone plugs, and the distal portion was also attached with a staple. A postoperative protocol was used with a progressive range of motion and weight bearing after 50 days. We performed 50 LK operations in professional and amateur athletes aged 17-39 years with an isolated anterior instability. We reviewed at follow-up (5-7 years) 37 patients; 8 were lost, and 5 had a subsequent failure. At the Lysholm score the patients were classified: 19 excellent, 13 good, 3 fair, and 2 poor. At the IKDC grading the patients were classified as follows: 2 class A, 22 B, 8 C, and 5 D. The Lachmann test was 1+ in 15 patients, 2+ in 7, 3+ in 2, and negative in 13; pivot shift was 1+ in 9, 2+ in 7, 3+ in 2, and negative in 25. Results of the KT 1000 test at 30 lb side to side was < 3 mm in 23 patients, 3-5 mm in 6, 6-10 mm in 6, and > 10 mm in 2. In view of the results observed and the progressive deterioration over the years, this procedure should no longer be performed as an ACL substitute.

Adolescent↗
PubMed1995

Magnetic resonance imaging versus arthroscopy for the investigation of the osteochondral humeral defect in anterior shoulder instability. A double-blind prospective study.

A double-blind prospective study was done with 15 patients with anterior shoulder instability to determine the diagnostic efficacy of magnetic resonance (MR) imaging versus arthroscopy in the evaluation of chondral or osteochondral lesions of the humeral head. MR produced 6 true positives, 5 true negatives and 4 false negatives, and its accuracy and sensitivity were 60% and 87%, respectively, whereas arthroscopy gave 8 true positives, 5 true negatives and 2 false negatives, with a sensitivity of 80% and an accuracy of 87%. All lesions diagnosed with either method were regarded as positive by definition, with the result that the specificity was always 100%. The differences in diagnosis sprang from the false negatives. The 40% discrepancy between the two methods was probably due to our distinction in MR between intra- and extra-articular osteochondral lesions. In the first group (the 4 MR false negatives), there were three instances of first-degree intra-articular lesion and one diagnostic error (third-degree lesion). In the second (the 2 arthroscopy false negatives), the lesions were of the extra-articular type. It is thus advisable to employ both of these methods to ensure the correct diagnosis of a Hill-Sachs lesion, and hence the correct choice of treatment.

Adolescent↗
PubMed1994

X-linked agammaglobulinemia, growth hormone deficiency and delay of growth and puberty.

Coinheritance of X-linked agammaglobulinemia and growth hormone deficiency (XLA/GHD) has been classified as an independent primary immune deficiency. We evaluated the pattern of growth and endocrine function in seven XLA subjects (ages 10.9-20.1 years); four belonged to two different XLA pedigrees and three represented sporadic XLA cases. Three had reached adulthood (final stature 176.0, 173.5 and 165.0 cm, respectively) and their retrospective growth showed delay in growth and puberty during adolescence. In the other four subjects, growth hormone production was measured by growth hormone pharmacological stimulation tests (clonidine, arginine): three of four patients had insufficient growth hormone responses (peak growth hormone < 10 micrograms/l); all three had delayed puberty; their growth hormone responses increased after "priming" with testosterone, reaching values > 10 micrograms/l in two of them and allowing diagnosis of "true" growth hormone deficiency in the third. The fourth was a normally growing subject who showed a normal growth hormone response both before and after testosterone priming. Six out of the seven subjects showed a growth pattern consistent with delay in growth and puberty. Our results suggest that true XLA/GHD is rarer than previously supposed and that subnormal responses to growth hormone stimulation tests may be found without sex steroid priming of the test in adolescence. The most probable growth pattern in XLA appears to be delay in growth and puberty, as has already been described for other chronic diseases.

Adult↗
PubMed1994

Anterior cruciate ligament mechanoreceptors. Histologic studies on lesions and reconstruction.

The fate of mechanoreceptors was studied in torn and reconstructed anterior cruciate ligaments in animals and in humans. In untreated anterior cruciate ligament lesions in humans, morphologically normal mechanoreceptors remained in the ligament for 3 months after the injury. After that time, their number gradually decreased. By the 9th postinjury month, only a few free nerve endings were present. Even free nerve endings were totally absent in the biopsy specimens from 1-year-old lesions. In experimental animals, anterior cruciate ligament reconstruction with autologous patellar tendon resulted in the presence of mechanoreceptors in the reconstructed anterior cruciate ligament. When an artificial ligament was used, no mechanoreceptors were found. Morphologically normal mechanoreceptors were present in 2 patients with a lax biologic anterior cruciate ligament reconstruction 9 and 10 years after the operation.

Animals↗
PubMed1993

The bone-ligament junction: a comparison between biological and artificial ACL reconstruction.

The physiological bone-ligament junction is composed of four zones: ligament, fibrocartilage, calcified fibrocartilage and bone. It plays a very important part in the distribution of mechanical loads applied to ligaments so as to diminish stress concentration or shearing at the interface. This paper examines types of bone and neoligament insertion after anterior cruciate ligament (ACL) reconstruction with a Dacron prothesis, the Leeds-Keio scaffold ligament (LK), patellar tendon with LAD augmentation (PT+LAD) and bone patellar tendon bone alone (PT). The anterior cruciate reconstructions were implanted in 16 sheep via double-isometric bone tunnels without postoperative knee immobilization. Histological examination of the new insertions (using haematoxylin-eosin, Giemsa, Masson, and Mallory stains) was performed following animal sacrifice after 2, 3, 6 and 9 months. A layer of fibrocartilage between the bone and the ligament was observed with PT, followed by a nearly normal insertion after 6 months. With PT, followed by PT+LAD, the augmentation was surrounded by fibrous tissue (also noted inside the LAD). The PT insertion was virtually physiological after 3-6 months. With the LK scaffold, fibrous tissue was noted in and around the scaffold, even after 6 and 9 months. With the Dacron prosthesis, fibrous tissue around the ligament was unaccompanied by ingrowth into the prosthesis. Nerve endings (pacinian corpuscles) were only present in the PT. These findings show that even after 9 months artificial ligaments are separated from bone by fibrous tissue and devoid of the histological and biomechanical features of a physiological junction.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Overnight growth hormone secretion in short children: independence of the sleep pattern.

PURPOSE: to analyze the interrelationships between GH secretion and pattern of sleep. PATIENTS: 18 children (10 male, 8 female; mean age 9.1 yr, range 5.1-14.3 yr), with short stature (mean height standard deviation score (SDS) -2.52, range -3.86-(-)1.88; mean height velocity SDS -1.1, range -2.40-(-)0.08), including 9 children with genetic short stature and 9 with idiopathic short stature. METHODS: blood samples were taken every 15 min from 2000 h-0800 h, and GH profiles were analyzed by the PULSAR computerized peak identification algorithm; simultaneous sleep was analyzed by electroencephalogram recording. RESULTS: no significant correlation was noted between GH secretion parameters and any of the electroencephalogram parameters evaluated: stage 1 (S1) percent, stage 2 (S2) percent, slow-wave sleep (SWS) percent, rapid eye movement sleep percent, wakefulness (W) percent, and sleep efficiency (EFF); there was no significant difference in GH secretion between children with EFF less than 76% and those with EFF more than 76% (P > 0.5). Maximal GH peak coincided 9 times (50%) with SWS, 3 times (17%) with S2, 3 times with W, twice (11%) with S1, and once (6%) with rapid eye movement sleep. First GH peak coincided 12 times (67%) with W, 3 times with S2, twice with SWS, and once with S1. There was no significant difference comparing the percentage of sleep stages occurring in the 15 min of maximal GH increment, in the 15 min preceding it, and in those following it; there was no significant difference comparing the percentage of sleep stages occurring in the 15 min preceding the onset of a GH peak and in those following it. CONCLUSIONS: GH secretion in short children seems independent of the sleep stage and efficiency; in children it is possible that GH secretion relates with sleep per se and with neurohormonal changes occurring at nighttime rather than with a specific sleep stage or sleep stage sequence.

Adolescent↗
PubMed1988

Lack of effect of cholestyramine on phenytoin bioavailability.

The effect of cholestyramine (4 g qid for 5 days) on the kinetics of phenytoin (400 mg orally) was investigated in normal subjects. Apart from a trend toward faster phenytoin absorption, the serum level profile of the drug during concurrent cholestyramine coadministration was similar to that observed in a control session. Areas under the serum phenytoin concentration curves were virtually identical in the two occasions. It is concluded that cholestyramine does not significantly affect the bioavailability of a single dose of phenytoin.

Adult↗
PubMed1988

Acquired Madelung-like deformity in a gymnast.

High-level gymnastic training may cause clinical and radiographic changes in the wrist. A case is reported demonstrating bilateral closure of the ulnar side of the distal radius epiphyseal plate in a patient with a history of high-level gymnastic training. Cumulative microtrauma to the ulnar side of the distal radius epiphyseal plate may cause premature closure leading to a Madelung-like deformity.

Adolescent↗
PubMed1988

Effect of flurithromycin, a new macrolide antibiotic, on carbamazepine disposition in normal subjects.

The effects of flurithromycin, a new macrolide antibiotic, on the disposition of a single oral dose of carbamazepine (CBZ) (400 mg) were investigated in seven normal subjects. Flurithromycin (2 x 250 mg thrice daily for 10 days) caused a slight increase in the CBZ area under the serum concentration curve and a moderate reduction in carbamazepine-10, 11-epoxide (CBZ-E) levels. These results suggest that flurithromycin can inhibit the conversion of CBZ to CBZ-E, although, at the dosage tested, the magnitude of this effect was significantly smaller than that observed after administration of erythromycin in the same subjects.

Adult↗
PubMed1987

Inhibition by erythromycin of the conversion of carbamazepine to its active 10,11-epoxide metabolite.

The serum levels of carbamazepine (CBZ) and its 10,11-epoxide metabolite (CBZ-E) were determined in seven subjects after a single dose of CBZ (400 mg) in the control state and during co-administration of erythromycin (500 mg three times daily for 10 days). Erythromycin treatment was associated with a decrease in CBZ clearance and a prolongation of CBZ half-life, while CBZ-E levels were markedly reduced. These data provide evidence that erythromycin inhibits the conversion of CBZ to its epoxide metabolite.

Adult↗
PubMed1987

Pharmacokinetics of co-trimazine after single and multiple doses.

Plasma and urinary levels of trimethoprim (TMP), sulfadiazine (SDZ) and N4-acetylsulfadiazine (N4-SDZ) were determined after administration of 1 g co-trimazine (equivalent to 180 mg TMP and 820 mg SDZ) (Kombinax) as a single dose and again once daily for 7 days to 6 normal subjects. Both TMP and SDZ were rapidly absorbed from the gastrointestinal tract with peak plasma levels being achieved within 4 h in all subjects. Elimination half-lives ranged from 8 to 13 h for TMP and from 9 to 15 h for SDZ. Approximately 50% of the administered dose of SDZ was recovered in urine within 24 h of the single dose (32% as unchanged drug and 17% as the N4-acetylmetabolite). For TMP, the urinary recovery during the 24 h following the single dose averaged 39%. Mean plasma levels of TMP, SDZ and N4-SDZ at steady state were moderately higher than those observed after a single dose, but no change in absorption or disposition kinetics of these compounds was seen after repeated dosing.

Adult↗