[Description of a case of intervertebral vacuum phenomenon].
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Biomedical subjects
Publications and source records attributed to S Bighi.
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Bone changes of varying degree and distribution were observed by the Authors in 10 carriers of beta-thalassaemia intermedia in skull, ribs, hand, elbow and knee bones. When they are present, skeletal changes are the same of homozygous beta-thalassaemia, but less marked and spread. Instead, symptomatology is more homogeneous, usually characterized by mild anaemia and morphological changes of red cells with haemoglobin values in the 6-11 g/dl range, splenomegaly, jaundice, gallstones, crural ulcers. The clinical state goes through the asymptomatic condition to a more severe condition with typical appearance of Cooley's anaemia.
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A xeroradiographic investigation of the skull, hand and elbow bones were carried out by the authors in 50 patients with beta-thalassemia major and in 14 with beta-thalassaemia intermedia. The results were extensively compared with x-ray images. The xeroradiographic method, for its edge contrast enhancement effect and great latitude, better documented than x-ray widening of the medullary cavities and cortex thinness in the shaft of long bones. The diploic space of the skull appeared more detailed; the "hair-brush" pattern and outer table were also particularly demonstrated. The use of "positive mode" imaging is the main requirement in the study of skull and extremities. The changes observed with xeroradiography were statistically more characterized than that seen with x-ray, enhancing the evolution of bone involvement due to actual longer survival of these patients.
Personal experience with technetium99m pertecnetate scanning in the diagnosis of Meckel's diverticulum is reported. The data reported indicate that the scan can be considered positive when the lower right quadrant of the abdomen shows a definite accumulation of radioactivity. Of 12 children examined, 4 responses were positive. These 4 patients were submitted to surgery and this confirmed the presence of Meckel's diverticulum containing gastric mucosa, and of an ulcer in the adjacent ileal mucosa. After discussing the clinical value of the investigation and having examined the problem of false positives and false negatives, in relation to reported data, it is concluded that scanning with technetium has a vital role to play in the diagnosis of haemorrhage due to Meckel's diverticulum.
The plica is a synovial fold inside the knee joint that may become symptomatic if for any reason the fold is converted into a bowstring. In 42 patients with chronic knee problems, arthrograms of the knee were obtained with evidence of the plica syndrome. Twenty-four were asymptomatic, 18 symptomatic, and of these 16 were excised. After a mean follow-up period of 3 years, 10 of the symptomatic patients were free of symptoms, while eight were unchanged or worse. The plica syndrome is not common, and careful assessment must be made by exclusion with clinical examination, double-contrast arthrography, and arthroscopy.
Antibodies are in several instances a reliable marker indicating vigorous immune response against infectious agents and in several viral diseases presence in the blood of specific anti-viral antibodies indicates an effective protection. However, this is not always true. For example, in the case of hepatitis C virus (HCV) an important human pathogen considered the causative agent of the nonA- nonB hepatitis, in spite of an intense antibody response there is no protection against a new infection and in the majority of infected individuals the virus overcomes host defences establishing a persistent infection. Here we describe how the dissection of the humoral immune response against HCV glycoprotein E2 of infected patients was useful for a better comprehension of the virus-host interplay. Cross-reactive antibodies directed against E2 are produced by the HCV-infected patient, but not all of them are protective, and some could even result to be detrimental for the patient. The cross-reactive anti-HCV/E2 humoral antibody response is complex and not necessarily completely beneficial to the host.
The authors reviewed 122 patients affected with popliteal cysts and treated between 1975 and 1985 with or without surgery; follow-up ranged from 1 to 7 years (average 3 years and 2 months). The patients were subdivided into 3 age groups, and observed for the clinical, anatomo-pathological and therapeutic differences among them. Cysts affecting children and adults were considered to be acute, or chronic bursitis, and those affecting elderly patients true cysts deriving from the joint cavity. The diagnostic effectiveness of arthrography and sonography is emphasized.
Three cases of posterior apophyseal fracture of a lumbosacral vertebral body are described. This disco-apophyseal lesion is typical of adolescents and sports-related trauma. Like all acute and chronic apophysiolyses it is probably enhanced by a constitutional weakness of the apophyseal area, closely fused with the anulus fibrosus of the disc.
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