Biomedical subjects
Publications and source records attributed to M Ruggieri.
The authors report their experience with the diagnosis and surgical correction of varicoceles in 20 patients. They stress the usefulness of the Doppler Ultrasound for the diagnosis of subclinical varicocele.
We reviewed clinical and histological findings in 55 patients with interstitial cystitis and 21 with voiding dysfunction secondary to other pathological conditions. Of our interstitial cystitis patients 36% would fail to meet the research definition proposed at a recent National Institutes of Health workshop. Detrusor mastocytosis was present in 64% of our interstitial cystitis patients compared to 80% of the noninterstitial cystitis group. There was no statistically significant difference in mean detrusor mast cell counts between interstitial cystitis and noninterstitial cystitis patients. Biopsies of 12 patients who did meet the proposed National Institutes of Health research definition were evaluated by immunohistochemical techniques. Early results are inconclusive. These studies indicate that interstitial cystitis is a complex disease whose diagnosis presently still must be made from a symptom complex rather than from objective histological criteria, including mastocytosis or the presence of any specific immunoreactive cell.
The Authors report their experience with stapler model T.A. 30 in lung resections; 100 stapled sutures were carried out in the IV Surgical Department of the University "La Sapienza" of Rome, during the period 1980-88. The use of stapler with two rows of staples allows a secure closure of the bronchial stump. Moreover, it prevents granulomas caused by suture material. The bronchopleural fistulas, serious complications of manual suturing, did not occur. Finally, this method is simpler and rapidly feasible in comparison with classic ones.
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Cancer of the lung is becoming increasingly common. In the U.S., it has the highest mortality of the neoplastic diseases, well ahead of cancer of the colon and rectum. Surgical and/or complementary management is poorly effective because it comes too late. Early diagnosis and treatment are essential, therefore. Preclinical diagnosis may be possible radiographically in certain fortunate cases, but this is never an early diagnosis. The latter is only possible through active bronchial cytology (bronchial brushing, selective washing, PBS) during and after flexible fibrobronchoscopy, which can be carried out under local anaesthesia at the outpatient level and causes very little distress to the patient. Data from a personal series are cited in support of the view that cytodiagnosis should be routinely employed in subjects at high risk (heavy smokers, persons with chronic bronchitis, emphysema, etc.).
In pursuance of an investigation of oesophageal physiopathology, a study has been made of the problem of the functional regulation of the inferior oesophageal sphincter in the light of new findings. Experiments carried out on six dogs made it possible to study functional modifications of the oesophagus after vagotomy, completing the technique by administering pentagastrin for the first time in vivo. Radiological and mano metric controls showed in the post-operative period a dilated oesophagus with a fall, in the lower third, of normal pressure values that did not undergo change, unlike what happened in the non-denervated oesophagus after administration of pentagastrin. The results obtained show that the integrity of the nervous structures is not only necessary for the perfect coordination of oesophageal peristalsis, but vital for normal functional response of the inferior oesophageal sphincter, since gastrin action is always mediated by release of acetylcholine by the post-gangliar vagal nerve endings.
An 8-year-old Italian boy, born to consanguineous parents, with clinical, histopathologic, and ultrastructural findings of lipoid proteinosis is reported. The main signs of the syndrome-papulonodular, hyperkeratotic and verrucous lesions distributed over the skin of the head and extremities, hoarseness, and dysphagia-were present in the child. The mother had papulonodular lesions on her hands and also complained of slowness in healing.
To address the prevalence of congenital bone malformations in neurofibromatosis type 1 (Nf1; compared with Nf1 bone anomalies and tumors), we studied the Nf1 population of 135 children (70 boys, 65 girls) seen at the neurofibromatosis clinic, University of Catania, Italy, in the period 1990 through 1996. Twelve (8.8%) of the 135 children had congenital bone malformations: unilateral or bilateral postaxial polydactyly type A (n = 1) and type B (n = 1), bilateral postaxial polydactyly type A in association with preaxial polydactyly type 1 (n = 1) and bilateral preaxial polydactyly (n = 1); clynodactyly (n = 1); multiple segmentation anomalies of the vertebrae (n = 6), and complex costovertebral anomalies (n = 1). We found a higher frequency of polydactyly (2.9%) in comparison to that in the general population (0.014-0.12%) and in our national (0.027%) and regional (0.066%) population, and a higher frequency of vertebral (5.1%) and costovertebral (0.7%) malformations. This is the first study to state the overall prevalence of congenital bone malformations in an Nf1 population. Interestingly, polydactyly (postaxial type) and Nf1 was previously reported only once.
This report is of 26 patients diagnosed with microcytoma of the lung in stages I, II, and IIIa. All patients received surgical treatment as well as postoperative chemoradiotherapy when indicated by stage. Mean survival rates were 16 months for stage 1, 10 months for stage II and 6 months for stage IIIa disease. For many years surgery was considered contraindicated in the treatment of pulmonary microcytoma. Now a multidisciplinary approach is being used in which surgery has a crucial role. Microcytoma of the lung has a poor prognosis due to its early metastasis and rapid growth. It is crucial to have early diagnosis and accurate, consistent staging as the basis for treatment. A review of literature shows that the use of surgery, chemotherapy and radiotherapy are all important in treatment of microcytoma. Chemotherapy is successfully utilized preoperatively to improve local control, decrease neoplastic mass, induce histological regression and as postoperative adjuvant therapy. Radiotherapy has been shown to be effective preoperatively to reduce local mass and prophylactically for cerebral metastasis. Surgery is crucial to irradicate the neoplastic mass, improve staging accuracy, decrease the possible selection of neoplastic clones resistant to postoperative therapy, decrease local recurrence and allow less aggressive chemoradiotherapy. We feel the most effective protocol for pulmonary microcytoma includes preoperative chemotherapy and radiotherapy when indicated followed by surgical intervention and finally successive adjuvant therapy. The limited number of our cases does not consent a statistically significative conclusion. Our data confirm the importance of the surgical procedure in stages I and II, where according also to other authors, the best results are obtained. Surgical indication in stage IIIa is still discussed due to precocius lymphnode dissemination that significantly affects long-term survival.
A case of Herpes simplex virus encephalitis (HSVE) is reported in a 5 year old boy, who relapsed twice during the acute phase of the disease. The second relapse was completely cured by increasing the daily treatment with acyclovir to a dosage of 60 mg/kg intravenously for two weeks and 30 mg/kg by mouth for a further week. The full disappearance of the symptoms and the regression of cerebral lesions could be correlated to a prompt diagnosis and to the dosage of acyclovir employed, higher than that suggested for diseases caused that was by other members of the Herpes virus family.