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P Peruzzi

Publications and source records attributed to P Peruzzi.

At least 19 recordsLinked to original sources
PubMed2006

Genome-wide scan supports the existence of a susceptibility locus for schizophrenia and bipolar disorder on chromosome 15q26.

Schizophrenia (SZ) and bipolar disorder (BPD) are two severe psychiatric diseases with a strong genetic component. In agreement with the 'continuum theory', which suggests an overlap between these disorders, the existence of genes that affect simultaneously susceptibility to SZ and BPD has been hypothesized. In this study we performed a 7.5 cM genome scan in a sample of 16 families affected by SZ and BPD, all originating from the same northeast Italian population. Using both parametric and non-parametric analyses we identified linkage peaks on four regions (1p, 1q, 4p and 15q), which were then subjected to a follow-up study with an increased marker density. The strongest linkage was obtained on chromosome 15q26 with a non-parametric linkage of 3.05 for marker D15S1014 (nominal P=0.00197). Interestingly, evidence for linkage with the same marker has been reported previously by an independent study performed on SZ and BPD families from Quebec. In this region, the putative susceptibility gene ST8SIA2 (also known as SIAT8B) was recently associated with SZ in a Japanese sample. However, our allele frequency analyses of the two single-nucleotide polymorphisms (SNPs) with putative functional outcome (rs3759916 and rs3759914) suggest that these polymorphisms are unlikely to be directly involved in SZ in our population. In conclusion, our results support the presence of a gene in 15q26 that influences the susceptibility to both SZ and BPD.

Bipolar Disorder↗
PubMed2002

[Unsuccessful surgery of Cushing's disease. Role and efficacy of fractionated stereotactic radiotherapy].

BACKGROUND AND PURPOSE: To optimize and reduce the toxicity of pituitary adenoma irradiation, we evaluated the feasibility and effectiveness of fractionated stereotactic radiotherapy (FSR) in 51 patients with functional adenoma; 12 of them had Cushing's disease. PATIENTS AND METHODS: Eleven females and one male, median age: 49 years, 8 of them relapsed and 4 had persistent hormonal secretion after surgery. The delivered dose was 50 grays (Gy) (5 x 1.8 Gy/week) using 5 convergent micro-beams scanning in arc therapy mode. The median planned target volume (PTV) receiving 90 to 100% of the total dose was 2,1 cm(3). We used relocatable non-invasive stereotactic device Brain Lab, and adapted Linac for stereotactic radiotherapy. RESULTS: Nine out of twelve patients (75%) presented with complete remission after a median time of 29 months, 3/12 patients with partial remission. Actuarial probability to have hormonal persistent secretion was 88% at on year, 44% from 3 to 5 years, 22% at 7 years, and 11% to 0% after 7 years. The 12-corticotroph adenomas were significantly (p=0.007) more radiosensitive than 39 non-corticotroph adenomas. Toxicity was significantly lower for corticotrope adenoma, with no radio-induced pituitary deficiency and no neurological or optic injury. CONCLUSIONS: Combined surgery and FSR appears to be safe and effective for treatment of pituitary adenomas. However, long-term follow-up is required to determine the impact in terms of tumor response and hormone deficiency. The focused treated volume obtained by FSR seems more suitable for these benign tumours than standard radiotherapy. In addition to this conformal approach, the use of standard fractionation reduced the risk of severe damage to the optic chiasma, which is sometimes observed after radiosurgery and is inherent in single fraction radiotherapy.

Adenoma↗
PubMed2000

Differentiated cerebrovascular effects of physostigmine and tacrine in cortical areas deafferented from the nucleus basalis magnocellularis suggest involvement of basalocortical projections to microvessels.

Cholinesterase inhibitors used to treat Alzheimer's disease according to the principle of cholinergic replacement therapy have proved to be less beneficial than expected. The present study was designed to investigate the cerebrovascular response to physostigmine and tacrine in the experimental model of lesioning of the nucleus basalis magnocellularis (NBM), a model involving a cholinergic deficit. Regional cerebral blood flow was measured by the [14C]iodoantipyrine tissue sampling technique in conscious rats infused with i.v. physostigmine (0.2 mg/kg/h), tacrine (8 mg/kg/h), or saline, 3-5 weeks after unilateral lesion of the NBM with ibotenic acid. Physostigmine and tacrine dose-dependently increased blood flow in most cortical and subcortical regions compared to the control group. However, physostigmine caused smaller blood flow increases in several areas, mostly cortical, of the lesioned compared to the intact hemisphere. The converse was observed with tacrine. A facilitated circulatory response appeared in cortical areas deafferented from the NBM, especially in the frontal cortex. These results provide evidence for distinct NBM-dependent components of the cortical cerebrovascular effects of physostigmine and tacrine. They suggest the involvement of different cellular postsynaptic targets of the NBM. The physostigmine-type effects could involve direct projects onto an inhibitory cortical interneuron supersensitized by deafferentation. This arrangement may explain why physostigmine and perhaps other cholinergic agonists are unable to specifically compensate for a deficit in NBM functioning. The tacrine-type effects presumably involve projections to the microvasculature, including perivascular astrocytes. The neurovascular junction would be sensitized by deafferentation from the NBM. Our data suggest that the regulatory mechanisms of blood flow originating in the NBM might constitute a target of neurodegenerative processes of Alzheimer's disease.

Animals↗
PubMed1997

[Postoperative spinal extradural hematomas. 14 cases].

We report 14 cases of post-operative spinal epidural hematoma and compare them with 17 cases reported in the literature. These 14 cases have been drawn from a continuous series of 7950 patients operated on at our institution by the posterior route for a non-traumatic spinal pathology. The symptom-free period after initial surgery was shorter than 5 hours in 13 cases out of 14. The clinical picture was characteristic 11 times. It started with a stabbing pain in the operated site, followed by paresthesia, radicular pain and neurologic palsy which were always bilateral even when the operation had been unilateral. The diagnosis was always established rapidly when the compression was cervical or thoracic and with some delay when the lumbar area was concerned. All patients, except one, have been reoperated without any radiological investigation. The source of bleeding was found 12 time out of 14. Full recovery was obtained in all 14 patients but delayed recovery of a few weeks occurred in 3 patients for whom reoperation was delayed. None of the potentiating factors studied in this work were found to be decisive. Post-operative spinal epidural hematoma is a rather uncommon complication of spinal surgery occurring at a rate of 1 to 2 per thousand. The diagnosis is more often obvious because its clinical picture is similar to that of spontaneous spinal epidural hematoma. Early reoperation allows a full recovery. Special attention during the first six post-operative hours for all patients after spinal surgery is essential for early detection of such a complication.

Adult↗
PubMed1996

Tacrine overcompensates for the decreased blood flow induced by basal forebrain lesion in the rat.

The effects of tacrine on the cerebral blood flow (CBF) were investigated according to an experimental model of the cholinergic hypothesis in rats with unilateral lesion of the substantia innominata (SI). CBF was measured 1-2 weeks following SI lesion with ibotenic acid, using the tissue sampling [14C]iodoantipyrine technique in three groups of lesioned rats infused i.v. with tacrine at 3 or 8 mg kg-1 h-1 or with saline. SI lesioning resulted in moderate, significant blood flow decreases in the parietal, frontal and occipital cortical areas. In the intact hemi-brain, tacrine at a dose of 3 mg kg-1 h-1 had no significant effect, but at 8 mg kg-1 h-1 tacrine increased the blood flow in most of the cortical and subcortical regions investigated. The increases ranged from 21% (hypothalamus) to 101% (parietal cortex) compared with controls. Tacrine had greater effects in the lesioned hemisphere, even at the dose of 3 mg kg-1 h-1. The flow increases in the frontal or parietal cortex of the lesioned hemisphere were 1.5-3.6 times greater than in the intact hemisphere. Thus, in contrast to what was expected, tacrine overcompensates for the cerebrovascular effects of SI lesions.

Animals↗
PubMed1996

Lhermitte-Duclos disease associated with syringomyelia.

A 23-year-old man presented with a 2-week history of intracranial hypertension. CT showed a large, nonenhancing cerebellar mass with surrounding calcification and displacement of the fourth ventricle. MRI revealed a septate lesion, with low signal on T1-weighted and high signal on T2-weighted images. The cerebellar tonsils were displaced below the foramen magnum and there was associated syringomyelia. The MRI features were characteristic of Lhermitte-Duclos (LD) disease (dysplastic gangliocytoma) and the diagnosis was confirmed following surgery. In this case, we emphasise the usefulness of MRI in the diagnosis of LD disease and consider the possible pathogenesis of the associated syringomyelia.

Adult↗
PubMed1994

[Prone position and operative posture in neurosurgery].

The most satisfactory method of prone positioning for the posterior approach to the spine and posterior fossa has been influenced by the necessity of providing good operating condition: prone position without abdominal and thoracic compression with a patient's head in the neutral position. Communication between the cava veins and the vertebral venous plexus explain that induce positioning can produce an excessive venous intraoperative bleeding with decreased surgical visibility. Furthermore venous return to the heart decreased resulting in some degree of impaired cardiac output. Hemodynamic disturbances of cerebral or spinal cord bloods flows can occurred.

Cerebrovascular Circulation↗
PubMed1993

The cerebrovascular effects of physostigmine are not mediated through the substantia innominata.

This study sought to determine whether the cortical cholinergic projections from Meynert's nucleus are actually the target of the cholinesterase inhibitor physostigmine, which presents the ability to increase cortical blood flow. To this aim, the multiregional cerebrovascular effects of physostigmine in rats with and without lesion of the substantia innominata (SI), the equivalent of Meynert's nucleus of primates, were investigated. Unilateral SI lesions were made using ibotenic acid in three groups of rats. Four to 11 days later, the cortical choline acetyltransferase (ChAT) activity was measured in one group to assess the efficacy of the lesion. In the two other groups, the regional cerebral blood flow was measured using the [14C]iodoantipyrine technique, under physostigmine (0.2 mg/kg/h iv) or control conditions. SI lesion induced 27-59% fall in cortical ChAT activity in the ipsilateral hemisphere with the frontal area most affected. Despite these large biochemical differences, the lesion had little cerebrovascular effects. Side-to-side blood flow differences did not exceed 11% and did not strictly overlap the ChAT depletion. Physostigmine increased flow (38-66%) in all cortical areas, with no frontal predominance. Despite these considerable vasodilations, there were no significant differences between the lesioned and the intact hemisphere, nor any significant interaction between physostigmine and SI lesion. Thus, physostigmine does not actually activate the SI neuron terminals. This result suggests that cholinesterase inhibitors cannot be used as presynaptic markers of the cholinergic activity of this nucleus and casts doubts on their specificity as enhancement therapeutic agents in Alzheimer's disease.

Animals↗
PubMed1993

[Should Tolosa-Hunt syndrome still be an exclusion diagnosis?].

Since Hunt et al's description (1961) Tolosa-Hunt syndrome has been a matter of controversies about its nosological identity and differential diagnosis. We report 7 cases diagnosed between 1979 and 1990. Four of them had a low-resolution CT and the diagnosis was made after a long follow-up, according to classical criteria of exclusion. The last 3 cases had a modern high-resolution CT or a MRI (2 cases) and the diagnosis was established in a few days. MRI has considerably simplified the differential diagnosis but it has not completely resolved it. Alterations of shape and signal of the cavernous sinus are similar to those of lymphoma, sarcoidosis and meningioma. When MRI is normal diabetic ophthalmoplegia, migrainous ophthalmoplegia and giant-cell arteritis must also be considered. We conclude that the diagnosis of the Tolosa-Hunt syndrome can generally be made in a few days, without a cavernous sinus biopsy. There is no reason to doubt that this syndrome is a specific nosological entity.

Aged↗
PubMed1993

[Comparison of 2 consecutive series of aneurysmal subarachnoid hemorrhage with or without nimodipine and study of the temperature curve].

A total of 210 consecutive patients with aneurysmal subarachnoid hemorrhage (S.A.H.) of any clinical grade admitted from January 1985 through May 1990 were retrospectively studied to determine the effect of intravenous Nimodipine on survival and functional results and to analyse temperature curve as a prognosis factor. The 106 patients admitted from January 1985 through November 1987 constituted the reference series termed G1. The 104 patients admitted from December 1987 through May 1990 and treated with intravenous Nimodipine constituted the series termed G2. Of the 210 patients, 172 (82%) could be operated on with a similar mean operative delay in both series (G1 = 9.5 days, G2 = 9.8 days). Of the 210 patients, 153 (73%) survived with an average follow-up of 111 weeks for G1 and of 64 weeks for G2. Nimodipine treatment was associated with a significant increase of survival (11.8%, P = 0.05) which was not the result of improved operative technique but of a lower incidence of deaths caused by postoperative vasospasm (G1 = 5 deaths, G2 = 0 deaths, P = 0.05) and by rebleeding (G1 = 15 deaths, G2 = 5 deaths, P = 0.03). No significant difference between the two series G1 and G2 was observed regarding functional results in the 153 survivors, frequency and seriousness of clinical signs of vasospasm during the waiting phase for surgery, radiologic signs of vasospasm on initial and second angiography, cerebral infarctus on second C.T.-Scan. Analysis of temperature curves of the 210 patients revealed that a delayed fever with a plateau pattern was associated with a higher incidence of vasospasm, rebleeding, and deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

The optimal therapeutic range for oral anticoagulant treatment as suggested by fibrinopeptide A (FpA) levels in patients with heart valve prostheses.

Fibrinopeptide A is a good marker of in vivo thrombin formation. The aim of oral anticoagulants (OA) is to lower in vivo thrombin formation. We therefore assessed FpA levels on several occasions in 38 patients receiving OA for artificial heart valve prostheses and in 20 patients receiving OA for biological heart valve prostheses. The mean FpA level, 1.82 ng ml-1 (SEM 0.14, n = 176), in patients with artificial valves was significantly higher than the mean, 1.02 ng ml-1 (SEM 0.4), obtained in 41 healthy subjects (P = 0.01). FpA mean value for biological valves was 1.41 ng ml-1 (SEM 0.14, n = 76), which was not significantly higher than controls (P = 0.08). A decrease in FpA levels, for both artificial and biological heart valve prostheses, was associated with a parallel increase in the intensity of anticoagulation. When considering FpA values obtained in the optimal therapeutic range for oral anticoagulant treatment, (International Normalized Ratio [INR] between 3 and 4.5), the mean level for artificial valves, 1.87 ng ml-1 (SEM 0.18, n = 102), was significantly higher than the mean value, 1.25 ng ml-1 (SEM 0.16, n = 55), obtained for biological valves. From a biological point of view, this indicates that artificial valves should be kept at a higher intensity of anticoagulation.

Administration, Oral↗
PubMed1989

[Advantages of a cardiologic ambulatory care facility specifically organized for patients undergoing treatment with oral anticoagulant drugs].

In patients with artificial heart valve prosthesis oral anticoagulants reduce but not eliminate the thromboembolic complications however, they do increase the risk of bleeding. In the present study, the incidence of thromboembolic and hemorrhagic complications in two homogeneous groups of patients with artificial heart valves on long term oral anticoagulant treatment has been evaluated. Group A (99 patients; total follow-up = 309 years) were resident in the Triveneto regions and received a questionnaire while group B (104 patients; total follow-up = 370 years) were referred to our department's centre for the control of oral anticoagulant treatment. Both groups were kept at a therapeutic range of 20-30% in terms of prothrombin activity. The incidence of thromboembolic and hemorrhagic complications is expressed as the number of episodes per 100 patient/years. Thromboembolic episodes were 2.6 (1.3 fatal) in group A while they were 1.08 (0.27 fatal) in group B; the reduction of fatal thromboembolic events was statistically significant (p less than 0.05). Hemorrhagic episodes were 1.9 (0.63 fatal) in group A while they were 0.81 (0 fatal) in group B. We concluded that an organized control of oral anticoagulant treatment in patients with artificial heart valves is advantageous as it significantly reduces fatal thromboembolism. Moreover, it could reduce the incidence of total thromboembolic and hemorrhagic episodes by more than 50%.

Administration, Oral↗
PubMed1989

[Synovial cysts and synovialomas of the lumbar spine. Histo-pathologic and neuro-surgical aspects apropos of 8 cases].

Based on 8 personal cases and a 81-cases review of literature, it's authors' opinion that cystic or solid masses issued form posterior lumbar articular process and called according to the cases synovial cyst, ganglion cyst, benign synovialoma, pigmented villonodular synovitis, are a single variety of benign degeneration of soft articular tissues. The cystic or solid feature of these masses depends upon the extent of their histiocytic granulomatous proliferation. They may be asymptomatic, accompany chronic lumbar pain or cause sciatica, seldom cauda equina syndrome. In case of sciatica, clinical picture rather consists of a narrow lateral recess than a discal protrusion. CT scan is the best investigation to get a right preoperative diagnosis. Postoperative prognosis is excellent and no anatomical recurrence has been reported.

Adult↗
PubMed1989

[Myelopathies caused by dorsal spinal canal spondylotic stenosis. 3 cases and a review of the literature].

Thoracic spondylotic myelopathies are exceptional, only 29 observations could be found in the literature; we intend to describe three new cases here. The patients, two women and one man, 64, 69 and 72 years old, complained of weakness of the lower limbs, more marked on one side, which had been progressing slowly from several months to eight years. Examination revealed asymmetrical paraparesis with distal sensitivity deficits without thoracic sensory level. In the first case, the myelography remained virtually unchanged in front of T11, T12; in the second and third cases, there was slight extradural compression at T9 and T10 respectively. Magnetic Resonance Imaging (M.R.I.) performed in two patients was evocative of a thoracic disk herniation. A chest CT scan enabled us to establish correct diagnosis: in the three cases irregular hypertrophy of the posterior elements was evident at T11 and T12, T9 and T10, T10 and T11 respectively, with osteophytes originating in the articular process and deeply embedded in the spinal canal. Decompressive laminectomy associated with medial facetectomy resulted in the gradual improvement of walking in all three patients. Myelography and MRI are both useful in demonstrating the level compression, usually situated in the low thoracic spine, however only the CT allows differential diagnosis with other etiologies, especially anterior compression such as disk herniation.

Aged↗
PubMed1988

[Meningioma of the optic canal. Diagnostic aspects apropos of 3 surgically treated cases].

Three cases of meningiomas originated in the optic nerve sheath in its intra-canalicular portion, have been operated on in Reims since we dispose of the TDM; it gave us the opportunity to re-define the way how to explore an area always difficult to investigate; indeed it has been impossible for a long time to clearly isolate meningiomas in the optic canal through the classical neuro-radiologic technics. The anatomic study confirms that the optic canal orientation is fixed, constantly inclined downward and forward with an angle of minus forty degrees with regard to the horizontal line; our work establishes that it is possible to apply it to the CT scan; in this incidence, TDM perfectly allows to visualize the optic canal and the optic nerve, from the anterior clinoid process to the posterior orbital pole. This incidence seems us to be interesting, in addition to classical neuro-ophthalmic planes, for early diagnosis or supervision of tumors of the optic canal.

Cranial Nerve Neoplasms↗
PubMed1988

[Cerebral abscess and Osler-Rendu disease. Apropos of 4 cases].

The authors report 4 cases of cerebral abscesses (C.A.) complicating Rendu Osler disease (hereditary haemorrhagic telangiectasia: H.H.T.). These cases and 43 others comparable found in literature enable to assess C.A. complicates H.H.T. by the way of pulmonary arteriovenous fistulas (P.A.V.F.). C.A. appears during known H.H.T. in only a quarter of cases; in all other cases C.A. reveals the disease. When the etiological search for metastatic C.A. fails to find any classical cause: O.R.L., stomatologic, cardiac, it seems important to suspect H.H.T., and research P.A.V.F. by chest X ray and pulmonary angiography. Preventive treatment consists in excluding pulmonary fistulas without waiting neurological complications of known H.H.T.

Adolescent↗