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R Giuffrè

Publications and source records attributed to R Giuffrè.

At least 37 records · Page 2Linked to original sources
PubMed1990

Potential risk factors for brain tumors in children. An analysis of 200 cases.

Two hundred cases of verified brain tumors occurring in patients under 15 years of age were studied in relation to possible etiologic, genetic, and environmental risk factors. They were compared with 100 age-matched patients harboring solid neoplasms outside the nervous system, as well as with 100 normal children. In our study, first-degree relatives of a brain tumor child did not show a higher incidence of either tumors or of epilepsy and strokes as compared with controls. First-born children (46%) with higher birth weights showed a greater tendency to present brain tumors. Dystocia (18.5%), previous miscarriages (18%), and dietary restrictions during pregnancy (3%) were also noted in this study and compared with data in the literature. No evidence of a role of maternal chickenpox and toxoplasmosis could be found. The pharmacological risk also seemed to be minimal. The mother's hormonal profile is deduced from the age at menarche and delivery, as well as from a tendency to miscarriages and complicated pregnancies. With regard to the immunologic aspect, it is worth noting that 15% of the mothers complained of allergies. Live polio vaccine and zoonosis might suggest a possible role of virus-related factors in the oncogenesis of brain tumors in children. Radiation-related risk is possibly present in less than 5% of cases. Parental occupation is not relevant in this series.

Adolescent↗
PubMed1989

Biological aspects of brain tumors in infancy and childhood.

Notwithstanding the definitive systematization of the clinical features of childhood brain tumors, many biological laws governing this vast area of pathology still escape us. There are no sure explanations for the fickleness of supratentorial/subtentorial distribution in fetal life and in the first 15 years of life--something not found in later years. Another focus of discussion is the tendency of brain tumors in infancy to concentrate along the midline due to the fact that most infantile neuroectodermal tumors arise from the phylogenetically older structures of the CNS (periventricular regions, brainstem, cerebellum), in contrast to tumors of adulthood. Neuroepithelial tumors, much more frequent in childhood than in later years, exhibit substantial histological differences in infancy: mixed gliomas and primitive neuroectodermal tumors (not otherwise specified, or with astrocytic, ependymal, oligodendrocytic...cells) are the best examples. As to the question of whether a given oncotype exhibits different biological behavior according to patient age, there is no single answer: some malignant tumors (medulloblastomas, ependymomas, neuroblastomas) are more aggressive in infancy, in line with Collins' law, while others (optic gliomas) offer a better prognosis in younger patients. The most peculiar and disquieting aspect of brain tumors in infancy/childhood, however, is what emerged from a recent epidemiological survey. The survey was conducted on the close relatives of a boy with a brain tumor from point of view of a possible "second malignancy" in this boy. Since a brain tumor is a rare occurrence in the very young, it may signal heightened susceptibility to malignancy in the individual, extending to other tumors in the patient himself and even to other members of his family.

Brain↗
PubMed1989

Chronic subdural hematoma in extremely aged patients.

445 cases of chronic subdural hematomas have been operated on during the last 35 years (1951-1986). The ages of the patients ranged from 14 to 91 years and averaged 54 years. Two groups of patients were considered and compared: (A) extremely aged patients, who were over 75 years old, and (B) patients in their sixth decade of life whose age was in fact close to the mean age of chronic subdural hematoma patients in our experience. There were 35 cases (8% of the total number of cases) in group A and 113 cases (26%) in group B. Presumably etiological trauma was less severe in elderly patients who more frequently showed a background of hormonal derangement, such as liver and/or prostatic disease. Bilateral hematomas were detected more frequently in older patients. They usually presented with mental retardation, unlike younger patients who more frequently had symptoms and signs of increased intracranial pressure. Early postoperative complications occurred more frequently in older patients. However, this did not preclude obtaining good results in more than three quarters of them. The implications of these findings are discussed.

Adolescent↗
PubMed1984

Steroid receptors in CNS: estradiol(ER) and progesterone(PR) receptors in human spinal cord tumors.

To investigate the role of steroid hormones in the occurrence and growth of human spinal cord tumors and to study the biochemical basis of the sex related difference in the incidence of the various spinal oncotypes, ER and PR have been measured in 24 human spinal cord tumors (12 neurinomas, 6 meningiomas, 5 ependymomas and 1 astrocytoma) by means of sodium thiocyanate exchange assay at low temperature and with dextran-coated charcoal method and R5020 for PR. Cytoplasmic and nuclear receptors have been evaluated. Neurinomas are the oncotypes which contained both ER (usually in the nuclear fraction) adn PR: estradiol binding has been found only in one meningioma; ependymomas contained cytoplasmic ER and the astrocytoma had nuclear ER and cytoplasmic PR. The dissociation constant is in favour of a high affinity binding (Kd = 0.15 X 10(-9)M for ERc; Kd = 3.85 X 10(-9)M for ERn; Kd = 8.07 X 10(-9)M for PRc). The overall incidence of steroid receptors in the spinal oncotypes studied is higher in male than in female patients (63.64 vs 46.15% for ER and 100 vs 71.43% for PR). Further studies on a greater number of patients will help to define the correlation between different spinal oncotypes and steroid receptors as well as the possibility of an endocrine therapy as adjuvant treatment for selected patients.

Adult↗
PubMed1984

Steroid receptors in the pathogenesis of chronic subdural hematoma.

Chronic subdural hematoma (CSDH), located between the dura mater and the arachnoid and usually characterized by a well-vascularized external capsule (HEM), has a higher incidence in male patients with elevated urinary estrogens than in female patients. In an attempt to increase our understanding of the physiopathogenesis of CSDH, total estrogen receptor (ER) was measured in HEM specimens from four male patients by a sodium thiocyanate exchange assay and cytosol progesterone receptor (PRc) in three specimens by a dextran-coated charcoal adsorption assay. Although no nuclear ER could be detected, ERc and PRc were found in all three specimens examined. The presence of ER in a mesenchymal tissue like HEM could suggest that, in addition to inducing vascular changes, estrogens might act directly on HEM through a receptor-mediated mechanism more pronounced in men than in women, whose vascular network is adapted to high estrogen values.

Aged↗
PubMed1984

Successful radical removal of an intracranial meningioma in 1835 by Professor Pecchioli of Siena.

In 1835, Pecchioli, Professor of Surgery and Operating Medicine at the University of Siena, removed a "fungus of the dura mater" (meningioma). The lesion was a large ulcerated cranial outgrowth at the level of the right sinciput, which at operation proved to originate from the dura mater and to be eroding the bone. Surgery was radical. The patient recovered and attended for follow-up review several times in the course of 30 months, always fit and with no sign of recurrence. This procedure was later selected for the competition for the chair of Surgery at the University of Paris in 1840. In 1847, Pecchioli summarized his surgical material spanning 16 years' activity, including neurosurgical operations.

History, 19th Century↗
PubMed1980

31 primary orbital mass lesions in infancy and childhood.

A series of 31 primary orbital mass lesions in patients up to 15 years of age is presented (malignancies: 5 sarcomas, 1 retinoblastoma; benign lesions: 7 optic nerve gliomas, 4 pseudotumors, 4 angiomas, 3 fibrous dysplasias, 2 dermoids, 1 hemiangioblastoma, 1 osteoma, 1 neurofibroma, 1 eosinophilic granuloma, 1 echinococcus). All the patients were operated upon using the subfrontal-extradural approach. The pathological and roentgenological features, and the long-term follow-up are analyzed. In the author's experience, computerized tomography scan (CT scan) is useful in planning the surgical approach more than in the pathological differential diagnosis. In orbital pseudotumors, without visual function impairment, CT scan is also useful in checking the results of conservative steroid therapy. The author's stress the importance of performing radical surgery, either along with (in benign lesions, including optic nerve gliomas) or followed by radiotherapy (in malignancies).

Adolescent↗
PubMed1979

Extracranial CSF shunting for infantile non tumoral hydrocephalus--a retrospective analysis of 360 cases.

A series of 360 consecutive extracranial CSF shunts performed between June 1960 and June 1976 for infantile non tumoral hydrocephalus is reviewed. The surgical methods used, the reasons for re-operation, the time distribution of post-operative complications, the causes of death and the long term results are analysed and discussed for each of the four groups: tetraventricular communicating hydrocephalus, triventricular hydrocephalus, obstructive hydrocephalus with a ventriculo-cisternal block and post-meningocele or post-myelomeningocele hydrocephalus.

Bacterial Infections↗
PubMed1979

Agenesis of the vermis cerebelli and malformations of the posterior fossa in childhood and adolescence.

Three cases of cerebellar vermis agenesis are reported and the relevant literature (19 other cases) is reviewed. Other posterior fossa malformations, such as a mega-cisterna magna, arachnoid cyst and Dandy-Walker syndrome, are discussed both from the pathological and clinical view point. We put forward a hypothesis that agenesis of the cerebellar vermis and Dandy-Walker syndrome could be regarded as two different stages of the same malformation.

Arachnoid↗
PubMed1978

Infantile craniosynostosis: clinical, radiological, and surgical considerations based on 100 surgically treated cases.

One hundred children affected by craniosynostosis were operated on from January 1952 to February 1977. Forty-six patients were operated on within the first year of life, and only 9 after six years of age. In 27 cases only one cranial suture was synostotic (mostly the coronal: 15 cases). In 36 cases two sutures were involved (mostly coronal plus sagittal: 25 cases). In 28 cases all the cranial sutures were involved. Also included in this series are seven cases of Crouzon's, one of Apert's, and one of Carpenter's syndromes. The clinical, radiological, and surgical features of this condition are discussed, and the long-term results are reported.

Acrocephalosyndactylia↗
PubMed1978

Cranial dermal sinuses in childhood and adolescence.

Forty-six cases of cranial dermal sinus found in patients up to 16 years of age are described: forty cases are recorded from the literature, six are personal cases. The clinical anatomical and radiological features, as well as the surgical findings of these unusual cranial congenital lesions are reviewed.

Adolescent↗