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V Nizzoli

Publications and source records attributed to V Nizzoli.

At least 19 recordsLinked to original sources

Estrogen and progesterone receptors in human meningiomas: biochemical and immunocytochemical evaluation.

BACKGROUND: The observation that human meningiomas are rich in steroid hormone receptors has led to the hypothesis that their growth may be hormonally dependent. This study aims to correlate the biochemical expression of estrogen (ER) and progesterone receptors (PgR) with their nuclear immunoreactivity in a large series of meningiomas. METHODS: The occurrence of ER and PgR in patients with primary untreated meningiomas was studied with a dextrancoated charcoal method (DCC) and the results were compared with those of an immunocytochemical assay (ICA). Progesterone and estrogen receptor determinations were performed on 103 and 99 meningiomas respectively using the DCC assay. Forty-six and 44 of these samples were immunocytochemically evaluated for the presence of PgR and ER respectively. RESULTS: Of the 46 samples evaluated by both the methods, 89% were found PgR positive by DCC and 70% by ICA. The overall concordance between PgR-DCC and PgR-ICA was 80%. Whereas low concentrations of ER were found in 8/44 samples (18%) assayed by DCC, specific staining was never observed in any of the samples tested by ICA. CONCLUSIONS: Our findings confirm that the majority of meningiomas are devoid of ER and that the biochemical evidence of PgR correlates well with the nuclear localization of progesterone receptors determined by immunocytochemistry.

Adult↗

[Subarachnoid hemorrhage: cerebral damage, fluid balance, intracranial pressure and pressure-volume relation].

Changes in osmolality and electrolyte concentrations are observed frequently in patients with subarachnoid haemorrhage (SAH). Intracranial pressure (ICP) plays a determinant role in the development of secondary brain damage following SAH and may be caused by haemorrhage itself, oedema formation and disturbance of cerebrospinal fluid (CSF) dynamics. The relationships among these factors are the aim of this investigation. In 17 comatose SAH patients, ICP was monitored through a ventricular catheter; serial of pressure-volume index (PVI) and CSF formation and reabsorption were performed. Arterio-jugular differences for oxygen and lactate were measured. The average ICP recorded for each 12 hour interval was 18.9 mmHg (SD = 5.9); mean cerebral perfusion pressure (CPP) was 75 mmHg (SD = 13); the lowest CPP value was 30 mmHg. Mean PVI was 22.7 mL (SD = 7.4), ranging from 5 to 36. Eleven patients however, showed a PVI less than 15 mL at some point during testing. Values of CSF dynamics indicated disturbances of CSF reabsorption in 11 cases. When the cause of ICP rise was identified in CSF disturbances, treatment was successful, even in case of reduced PVI. Mean C(a-v)O2, corrected for a PaCO2 of 40 mmHg, was 3.7 mL.dL-1 (SD = 1.1) ranging from the extremely low value of 0.2 to 6.8 mL.L-1. Three patients with extremely low C(a-v)O2 values showed a cerebral production of lactate and developed areas of ischaemia on the CT scan. Hyponatraemia, considered as a sodium plasma concentration of less than 135 mmol.L-1, was detected in seven patients. Hyponatraemia was treated by infusion of hypertonic sodium solutions. Mannitol (1 g.kg-1.d-1 in four doses) was infused if the sodium plasma concentration was not corrected by the former treatment or if ICP exceeded 20 mmHg. Treatment was aimed at preserving cerebral perfusion by providing adequate pre-load, low viscosity (Ht 30%) and sustained arterial pressure. Correction of hyponatraemia was therefore achieved more through hypertonic fluids infusion than by using diuretics.

Adolescent↗

[Arterio-jugular difference of oxygen and intracranial pressure in comatose, head injured patients. II. Clinical correlations].

The ICP monitoring is currently used in the treatment of the head injured patients in order to avoid dangerous increases of the pressure and critical reduction of cerebral perfusion pressure (CPP). The cerebral blood flow is dependent on the CPP and is kept constant, under normal circumstances, by autoregulation. When autoregulation is impaired or overwhelmed oxygen delivery becomes uncoupled to the metabolic needs of cerebral tissue: in such a condition the rate of oxygen extraction changes and the artero-jugular difference for O2 (AVDO2) reflects this change. The AVDO2 can be used as an estimate of the CBF and can detect a situation of hyperemia (low AVDO2) or ischemia (high AVDO2). In 224 comatose head injured patients the ICP was measured using ventricular or subarachnoid catheters: the CPP was continuously assessed and the outcome was evaluated six months after the trauma. In 45 patients the AVDO2 was studied and the data were corrected for a PaCO2 of 40 mmHg and investigated. The severity of the ICP is decisive for the prognosis and, accordingly, the number of times the CPP is below 60 mmHg plays a major role in the outcome. The mortality rate was 21% for the patients without ICP greater than 20 mmHg and 54% for the patients with severe increases in ICP. The mean values of AVDO2 were low, ranging around 4.6 vol%; only 4 patients showed some temporary evidence of ischemia, as assessed by an AVDO2 greater than 8 vol%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Neurological results in spinal cord metastases.

Btween 1971 and 1978 140 cases of spinal metastasis treated by decompression or possible removal of secondary neoplasm, were studied. Patients were divided according to their preoperative neurological conditions and then evaluated on the ground of regression of spinal cord and root symptom. The possibility of treating this type of compressive spinal pathology surgically is discussed.

Female↗

[Intracranial and spinal dermo-epidermoid tumours. Anatomoclinical study (author's transl)].

The authors review the previous report of intracranial or spinal dermo-epidermoid tumours, in concern with both nosographical and biological problems. They report their clinical and anatomical findings on a patient who presented the same tumours within the skull and in the vertebral canal. The authors underscore the rarity of such finding, the length of the course. albeit a few symptoms and no positive neuroradiological findings had been remarked, and the quite atypical eventual troubles.

Brain↗