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Biomedical subjects

P Pricca

Publications and source records attributed to P Pricca.

16 recordsLinked to original sources

Atraumatic patellofemoral joint disorders. Long-term results of surgery.

Clinical and radiographic follow-up was done on a group of patients with atraumatic patellofemoral joint disorders who had been treated surgically by realignment of the extensor apparatus at the authors' institution from 1985 to 1989. The preoperative radiographic examination in the 65 patients treated (for a total of 74 realignments) evaluated the following parameters: sulcus angle, Insall-Salvati index, and congruence angle. The 46 patients who returned for follow-up (after an average of 2 years and 3 months) were evaluated clinically according to a classification system proposed by the authors which is based on objective clinical data and a multi-factorial assessment of pain. Moreover, radiographic follow-up of the same 46 patients made it possible to quantify the degree of realignment achieved with each type of surgical technique. The clinical and radiographic data made it possible to determine more precise indications for each type of surgical procedure in relation to the disease involved, using a correct diagnostic approach and making a thorough evaluation of the clinical, anatomical and pathological features.

Adolescent

[Diagnostic definition of cerebral lesions in a case of AIDS: importance of the use of magnetic resonance].

The present study describes a case of AIDS with asymptomatic intracranial focal lesions. The DDD-enhancement CT technique detected the lesions as inflammatory or neoplastic. A subsequent MR demonstrated the vascular nature of the intracranial findings. MR in the neuropathology of AIDS can be of primary importance in the detection of the intracranial focal lesions, thus avoiding a cerebral stereotaxic needle biopsy.

Acquired Immunodeficiency Syndrome

[Neuro-AIDS: a multicenter neuroradiological study].

The results are described of a retrospective multicentric CT/MR study of 141 neuro-AIDS patients (IV group CDC classification); 114 patients were drug addicted, 13 homosexual, 8 polytransfused, and 6 had other risk factors. The mean age was 29.6 years. The pathologic agent was identified in 47 cases by c.s. fluid examination, biopsy, autopsy or specific treatment response: it was HIV in 20 cases, toxoplasmosis in 11, cryptococcosis in 9, leishmaniasis, salmonella and papovavirus in single cases. In the follow up of 2 cases, a Kaposi's sarcoma and a primitive CNS lymphoma occurred. The main clinical features were AIDS-dementia complex (45% of cases) and focal neurologic manifestations (36%). The neuroradiological protocol consisted of 238 CT exams (97 controls), most of them with DDD (delayed double dose) technique, 7 MR exams (0.15 T) and 2 angiographies. CT findings were divided into 3 groups: negative (16%), atrophic (47%) and focal lesions (37%). In the first and second group, HIV and cryptococcal infections were the main pathologic agents. In the third group toxoplasma infections were discovered, and TB granulomas and other pathologic conditions, with ring-like or nodular enhancement, in cortical/cortico-medullary location. In follow-up patients a high tendency of evolution towards focal lesions was observed, even in negative cases. The DDD enhancement technique allowed in most cases both the demonstration of very small lesions and their grading. According to the literature CT, though a highly sensitive method, is inferior to MR imaging; however our experience in this field is currently insufficient. The specific diagnosis of pathologic agents of neuro-AIDS is difficult, due to the high number of opportunistic AIDS-related infections and neoplasms, with overlapping features: differential diagnostic criteria can be assessed only by comparing the clinical, microbiological, topographic, CT and MR findings. CT and MR exams are necessary to guide and monitor therapy and to plan stereotaxis biopsy.

Acquired Immunodeficiency Syndrome

[Computerized tomography in surgically treated lumbar disk hernia. Multicenter study].

Results are reported of a multicenter analytic-statistical CT study on 128 postoperative lumbar herniated disk (HD) cases (50 at L4-L5, 64 at L5-S1, 2 at L3-L4, 12 multiple). CT was performed from 10 days to 204 months (47.7 months of mean) after surgery, in 51 patients without and in 77 with intravenous contrast medium (42 in bolus, 35 in perfusion). In 59 cases (38%) a recurrent hernia was found, and in 8% a new hernia. In 81% of patients epidural fibrous scars were demonstrated, in a rough 50% of cases associated with recurrent/new hernia: posterior fibrosis was found in 81% of cases, while unilaterally, bilaterally, or anteriorly extended fibroses were present in 20%, in 4.7%, and in 29% of cases respectively. In 72% of the patients injected with contrast medium, various kinds of fibrosis contrast enhancement were detected. In 8% neither fibrosis nor recurrent herniation was found. In 22% of cases lateral and/or central bony canal stenosis was present, in 26% vacuum disk, in 9% intracanalar calcifications, in 39% and in 19.5% dural sac stretching and compression respectively. In 5 cases a pseudomeningocele was found, and in 3 only a postoperative diskitis. Fibrosis is an almost inevitable postoperative consequence (4 out of 5 cases); it can be demonstrated by CT with high sensitivity and good specificity. A series of diagnostic criteria, such as the post-contrast media reaction, allow fibrosis to be discriminated from recurrent hernia. However, the possible association must be kept in mind of both diseases and/or of included roots in the scar. Myelography is hardly ever able to supply further resolutive diagnostic elements, while Myelo-CT is sometimes more useful. The importance of bone changes is questionable, with the exception of evident cases of canal stenosis, also because in most cases the radiologist cannot count on a preoperative CT study. Furthermore, the correlation between CT and clinical findings (possible asymptomatic fibrosis) is often difficult, which gives way to contrasting therapeutic attitudes.

Adult

[Computed arthrotomographic evaluation of chronic lesions of the cruciate ligaments].

The high incidence of cruciate ligament injuries as a result of acute knee trauma with hemarthrosis and abuse of diagnostic arthroscopies call for a suitable radiological imaging of the central pivot. Computed Arthrotomography (CAT) was used to examine the knee joint in 20 cases of clinically suspected chronic cruciate ligament injury. The images were correlated with arthroscopic and/or arthrotomic findings. Thirteen lesions of the anterior cruciate ligament (ACL) (65%) were found, plus 1 lesion of the posterior cruciate ligament (PCL) (5%), 2 associated lesions of ACL + PCL (10%), and 4 normal cases. Confirmation of pathology was available in all cases but one by arthroscopy and/or surgery. The central pivot diseases were classified as follows: absence, detachment, partial or complete tear. CAT findings of cruciate ligament injuries are emphasized and the role of the technique as compared to arthroscopy is discussed. CAT is useful in 3-D evaluation of central pivot and detection of different cruciate ligament injuries, with high sensitivity-specificity for ACL and high specificity-moderate sensitivity for PCL. In the evaluation of the chronic unstable knee, CAT is highly accurate and gives the surgeon useful information towards the planning of therapeutic procedures. CAT is almost non-invasive, well tolerated and easy to perform in out-patients, which make it a first-choice procedure in the screening of chronic ligament injuries.

Accidents, Traffic

[Early angio-computer tomography of ruptured cerebral aneurysms in subarachnoid hemorrhage].

In acute subarachnoid hemorrhage a ruptured cerebral aneurysm can be detected by Computed Angiotomography (Angio-CT). In a hyperdense cistern by extravasal blood, a round low-density defect on plain CT which turns into high-density nodular mass with afferent and efferent arteries, is an important finding of ruptured aneurysm. The inverting-density cisternal defect in connection with cerebral arteries is essential for the direct and early Angio-CT diagnosis of ruptured aneurysm.

Adult

[Oto-palato-digital syndrome. Clinico-radiological study].

Oto-palato-digital (OPD) or Tyabi syndrome is a familiar, X-linked bone dysplasia with intermediate expression, in females or autosomal dominant with more severe manifestations in males. In the past both the clinical features (flat face with sunken and broad nasal bridge, antimongoloid slant of palpebral fissures, palatoschysis, conductive deafness, short and broad thumbs and big toes, nail dystrophy) and radiological findings (thick and dense base of the skull, prominence of supraorbital ridges, middle ear bone deformities with dense ossicles, large and broad vertebral bodies, posterior defects of neural arches of the vertebrae, carpal and tarsal bone fusions, short and broad nail phalanges) have been well described and established. The present report describes 7 patients (4 females and 3 males) all belonging to the same family (the first described in this country) and all presenting the clinical and radiological features of OPD syndrome. A cranial and spinal CT was performed on one patient, with peculiar findings.

Abnormalities, Multiple

[Subarachnoid hemorrhage caused by rupture of cerebral aneurysm. Value of neuroradiological studies].

The role of neuroradiological examinations in the diagnosis and in the therapeutical indication of intracranial aneurysm are analyzed and discussed on the basis of a large review of the literature. Skull X-rays, Ct scan with and without intravenous contrast enhancement, magnetic resonance imaging and angiographic have different role and different timing. They are critically evaluated in order to point out an up-to-date diagnostic phase.

Cerebral Angiography

[Transient stenosing ureteritis in childhood. A rare complication of rheumatoid purpura].

A case of transient stenosing ureteritis in a boy presenting with the clinical features of Henoch-Schoenlein purpura (diffuse articular swelling, petechiae, abdominal pain) complicated by macroscopic haematuria with blood clots is reported. On urography the right collecting system and the right ureter up to the distal lumbar portion were dilated owing to tight ureteral stenosis at that level. Above the stricture, numerous ring-like functional ureteral wall defects were detectable. On the left a stenosis was evident at the lumbo-sacral level with mild dilatation of the ureter. A small filling defect due to subephitelial haemorrhage was evident in the upper part of this ureter. Three months later, after prednisone therapy, the urography was normal on the right: residual mild stenosis was still evident on the left. Radiological findings in Henoch-Schoenlein purpura and the possible differential diagnosis of this condition are discussed.

Child, Preschool

[Computerized tomography in the study of malignant tumors of the larynx].

A systematic investigation was carried out on 93 patients suffering from laryngeal tumours who underwent computed tomography and xeroradiography. A comparison is made between CT, xerographic, clinical and endoscopic findings. The value is stressed of functional informations obtained from CT performed during quiet breathing and phonation. The outstanding value of CT is the accuracy in definition of tumor extension and involvement of the laryngeal and paralaryngeal tissues. CT can be useful in diagnosis of regional lymph nodes metastases. The correct evaluation of the tumour is greatly helpful in surgical treatment and radiotherapy planning.

Epiglottis

[X-ray computed tomography in non-neoplastic pathology of the larynx].

The authors describe the CT findings in 57 patients suffering from various non-neoplastic disease of the larynx: chronic laryngitis, pseudotumor, paralysis, post-traumatic lesions, laryngocele, cyst. CT is usefull in evaluating site and extension of the disease, as well as its relations with the surrounding tissues. The densitometric evaluation and the functional tests are important in differential diagnosis with malignant neoplasms.

Adolescent

[Difficulties in interpreting a conspicuous retroperitoneal hematoma due to rupture of the inferior pancreatico-duodenal vessels at the onset of edematous-type acute pancreatitis].

The authors report on a case of conspicuous retroperitoneal haematoma with haemoperitoneum due to rupture of the lower pancreatico-duodenal vessels appearing at onset of an acute oedematous pancreatitis. After stressing the rarity of this event, the authors go on to discuss a number of aetiopathogenetic, diagnostic and therapeutic aspects.

Acute Disease

[Supra- and subtentorial "hourglass" dermoid. Clinical case and review of the literature].

Authors report a case of 58 year-old woman suffering from a "clepsydra" shaped dermoid tumor spreading from the middle cranial fossa to the left posterior cranial fossa. The diagnostic importance of computed cysternotomography and the minor diagnostic value of other techniques such as angiography and pneumoencephalography is emphasized. The clinical picture and the surgical procedure are discussed in relation to a review of data available in the literature.

Brain Neoplasms

[Multiplanar computerized angiotomography in the evaluation of aneurysms of the posterior inferior cerebellar artery].

Two cases of posterior inferior cerebellar artery aneurysms are reported. The diagnosis was made by dynamic multiplanar computerized tomography and afterwards confirmed by angiography and surgery. The role of CT in the diagnosis and follow-up of subarachnoid hemorrhage is discussed. Intracranial posterior fossa aneurysms are nicely demonstrated and localized by dynamic multiplanar CT.

Aged