Biomedical subjects

Vincenzo Denaro

Publications and source records attributed to Vincenzo Denaro.

10 recordsLinked to original sources

PubMed2007

Surgical management of cervical spine osteoblastomas.

The treatment of cervical spine osteoblastomas requires complex therapeutic and reconstructive strategies depending on the tumor's location, local aggressiveness, and proximity to the surrounding neurovascular structures. Despite careful removal, lesions recur in as much as 10% of patients. Preoperative embolization is useful to minimize intraoperative bleeding and decrease the relapse of vascular tumors, but its role in osteoblastoma surgery is yet to be defined. We asked whether preoperative embolization with marginal resection would lead to osteoblastoma recurrence, and whether marginal excision with reconstruction would improve neurologic symptoms. We retrospectively analyzed a consecutive series of patients with cervical spine osteoblastoma, treated by one surgeon with a combined approach of preoperative embolization, marginal excision, and spinal reconstruction. One of nine patients presented with a monoradiculopathy, whereas only two patients presented with symptomatic spinal cord compression. At followup, all patients showed neurologic improvement, no tumor relapse, and adequate bony healing. Followup imaging studies showed cervical alignment was maintained. Although we report only a small uncontrolled cohort, the data suggest preoperative embolization and a tumor-free margin are consistent with a prolonged disease-free interval or complete tumor eradication.

Adolescent↗

PubMed2006

Multiple osteochondroses of bilateral knee joints: a case report.

Knee injuries in young athletes include not only the typical adult bone injuries, ligament and cartilage, but also the growth plate lesions. Osteochondroses are idiopathic, self-limited disturbance of enchondral ossification in which a rapid growth spurt is present. The patella could be affected by two different kinds of osteochondroses: Kohler syndrome and Sinding-Larsen-Johansson. Here we are reporting the first case of simultaneous location of osteochondroses of the two ossification centers of both patella. A 9-year-old boy, competitive skater, presented a history of anterior knee pain involving both knees. Standard X-rays, axial patellar view, MRI and arthro-MR were performed. In order to follow the natural history of the pathology and the evolution of the healing, examinations at 2 years were repeated. We proposed the young skater a medical and a physiotherapeutic treatment based on unloading, isometric exercises, NSAID. As the symptoms improve a gradual return to competitive sports activity was allowed. The case mentioned above can be considered an atypical case because the patient suffered for a bilateral knee osteochondroses, involving simultaneously the primary ossification centre (Kohler syndrome) and the secondary ossification centre (Larsen syndrome) of the patella.

Arthroscopy↗

PubMed2006

To detach the long head of the biceps tendon after tenodesis or not: outcome analysis at the 4-year follow-up of two different techniques.

The aim of this study was to determine whether or not detaching the biceps tendon from the glenoid after tenodesis performed with the inclusion of the biceps in the rotator cuff suture results in an improved outcome. From 1999 to 2001, 22 patients had an arthroscopic rotator cuff repair and associated biceps tendon lesions that were repaired with two new arthroscopic techniques of tenodesis incorporating the biceps tendon in the rotator cuff suture. Patients were randomised into one of two groups: tenodesis without tenotomy (group 1) and tenodesis with tenotomy (group 2). Preoperative and postoperative functions were assessed by means of a modified UCLA rating scale and shoulder ROM. The mean follow-up period was 47.2 months (range 36- 59). In group 1 (tenodesis without tenotomy), eight patients had an excellent postoperative score and three a good postoperative score. The UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative average rating of 10.5 (5-15) to the postoperative average score of 33 (29-35) (P<0.05). In group 2 (tenodesis with tenotomy), the UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative rating of 11.1 to the postoperative score of 32.9 (P<0.05). No statistically significant difference in the total UCLA scores was found when comparing the repairs performed with or without tenotomy. Follow-up results with regard to ROM were not different between the two groups, and the range of motion was improved in all measured directions. In this series, every patient qualified as having good to excellent results according to the UCLA score. This study suggests that there is no difference between detaching and not detaching the biceps after including it in the repair.

Adult↗

PubMed2006

Bilateral complete discoid medial meniscus combined with posterior cyst formation.

Bilateral discoid medial menisci is an extremely rare condition of the knee and it can be associated to other pathological findings, including anterior portion cyst formation. We report on the clinical features, radiographic findings, treatment and results of one patient who presented a bilateral medial discoid meniscus combined with posterior portion cyst of the left knee. To the best of the author's knowledge, this is the first case of bilateral medial discoid meniscus associated with posterior portion cyst formation.

Adult↗

PubMed2006

Toward an optimum system for intervertebral disc organ culture: TGF-beta 3 enhances nucleus pulposus and anulus fibrosus survival and function through modulation of TGF-beta-R expression and ERK signaling.

STUDY DESIGN: Rat lumbar discs comprising nucleus pulposus, annulus fibrosus, and cartilaginous endplates were cultured for 1 week in a specialized media containing either TGF-beta1 or TGF-beta3. Role of TGF-beta isoforms on cell function was evaluated. OBJECTIVE: To develop an in vitro organ culture of rat intervertebral disc and evaluate effects of TGF-beta3 on disc cell function. SUMMARY OF BACKGROUND DATA: An in vitro model system is of considerable value in understanding the cell biology of the intervertebral disc. Development of a useful organ culture model would enhance understanding of disc function in health and disease. MATERIALS AND METHODS: Rat lumbar intervertebral discs were maintained in organ culture in media supplemented with TGF-beta3 or TGF-beta1 for 1 week. Tissue morphology was studied using routine histologic, histochemical and immunohistochemical techniques. Cell function was assessed by gene expression, sulfate incorporation, and Western blot analysis. RESULTS: After 1 week in culture with TGF-beta3 and TGF-beta1, the gross morphology and tissue architecture of the disc were preserved. TUNEL analysis indicated that there was no evidence of cell death in the nucleus pulposus or the anulus fibrosus. The level of Alcian blue staining in the nucleus pulposus was similar to that of the freshly isolated disc. However, when compared with TGF-beta1, TGF-beta3 elevated the expression of critical matrix genes, enhanced [S] incorporation into proteoglycans, preserved the expression of TGF-beta receptors, and decreased aggrecan turnover. There was also increased activation (phosphorylation) of ERK, a critical signaling protein. Moreover, inhibition of ERK activity, in the presence TGF-beta3, resulted in suppression of collagen Type II, aggrecan, TGF-beta-RI, TGF-beta-RII and TGF-beta-RIII mRNA expression. CONCLUSIONS: TGF-beta3 maintains the phenotype of disc cells in organ culture. It exerts this effect, in part, by elevating the levels of activated ERK1/2, which in turn regulates the expression of TGF-beta-RI and TGF-beta-RII.

Activin Receptors, Type I↗

PubMed2005

Morphologic comparison of cervical, thoracic, lumbar intervertebral discs of cynomolgus monkey (Macaca fascicularis).

The aim was to analyze the morphological differences of the intervertebral disc and endplates at different levels. Forty-five vertebral motion segments were obtained from the spine of nine 3 to 4-year-old cynomolgus monkeys (Macaca fascicularis). From every spine, five discs were sectioned (C5-C6, T3-T4, T9-T10, L2-L3, L4-L5). In all the groups, tissue samples were collected and sections were stained with Masson's trichrome, Safranine-O and van Gieson's connective tissue stain to analyze the intervertebral discs. Immunohistochemistry was performed, using specific antibodies to detect collagens I and II. The intervertebral disc height, the maximum nucleus pulposus height, the superior and inferior endplate heights were histomorphometrically measured and different indexes were calculated to compare the differences between specimens of the same animal and between discs of the same level, and finally the differences between groups of discs of different levels. There were no differences existing in annular fibers anchoring on the endplate between discs of different levels. A positive immune reaction for type I collagen was observed in the longitudinal ligaments and in the annular region adjacent to them. Collagen II immune reactivity was found in the annulus close to the nucleus pulposus, in the endplates and in the nucleus. There were no differences between discs of different levels in the collagen I and II localization. The height of the discs varied along the spine. The smallest value was measured in T3-T4, with a larger increase caudally than cranially. The highest value was measured in L2-L3. A cervical disc was 55% the height of a lumbar one. The endplate height increased along the length of the spine. The inferior EP was always higher than the superior. The study provides a detailed structural characterization of the intervertebral disc and may be useful for further investigations on the disc degeneration process.

Animals↗

PubMed2005

Nucleus pulposus replacement: basic science and indications for clinical use.

STUDY DESIGN: A critical review of available and emerging nucleus pulposus replacement implants. OBJECTIVES: To review the biomechanics, design, and clinical data of currently available and developing nucleus pulposus replacement technologies. SUMMARY OF BACKGROUND DATA: The interest in minimally invasive treatment of degenerative disc disease has grown as the technology for intervertebral motion-sparing devices continues to improve. Replacement of nucleus pulposus without anular obliteration represents a tempting alternative to spinal fusion procedures. The aim in nucleus pulposus replacement is to slow adjacent level degeneration, restore normal loads to the diseased level, and restore segmental spinal biomechanics. METHODS: A literature review of currently available biomaterials, biomechanics, and available preclinical and clinical data on nucleus pulposus replacement implants. RESULTS: New synthetic biomaterials have recently been developed to closely mimic native biomechanics during compressive loading cycles of the intervertebral disc. This, in conjunction with improved understanding of global spine biomechanics, has allowed the development of novel nucleus replacement implants. These implants are currently at different stages of preclinical and clinical investigations. CONCLUSIONS: Although some of the newly designed prosthesis have shown some promising results in preclinical studies, rigorous short- and long-term clinical evaluations will be critical in evaluating their true efficacy.

Biocompatible Materials↗

PubMed2005

Computed tomography-guided and arthroscopically controlled en bloc retrograde resection of a juxta-articular osteoid osteoma of the tibial plateau.

Osteoid osteoma represents approximately 10% to 11% of all the benign bone tumors. The localization at the articular and juxta-articular level of the knee is an atypical picture that causes both diagnostic and therapeutic problems. We present the case of an osteoid osteoma of the lateral tibial plateau just beneath the joint level. The lesion was removed by a rear-entry computed tomography (CT)-guided drill under arthroscopic control and the bony defect filled with bone graft harvested from the proximal tibial metaphysis. Postoperative CT scans at 3 months, and 1 and 2 years were performed. The result of the kneeling test to evaluate donor-site morbidity 1 year after the surgery was negative. There were no immediate or delayed complications. Currently (2 years postoperatively), the patient has no pain and has gone back to his normal active daily lifestyle and routines. The follow-up CT scan 2 years after surgery showed complete excision of the lesion and perfect positioning of the bone graft. This new approach/technique enabled us to avoid damaging the proximal structures, to examine the lesion, and to fill the bony defect. Moreover, as shown by CT scan at follow-up, iatrogenic lesions to the cartilage of the tibial plateau were not reported.

Adult↗

PubMed2003

Arthroscopic ganglion cyst excision in the anterolateral aspect of the knee.

We present a case of ganglion cyst of the knee treated arthroscopically. Ganglion cysts typically arise from the anterior or the posterior cruciate ligament. In this case of an anomalous location, a 3.5-cm mass arose directly from the anterolateral articular capsule, lying over the lateral meniscus, displacing Hoffa's fat pad and joining the pretibial bursa. We removed it arthroscopically using only medial portals to avoid cystic wall damage and fluid leakage from the lateral portal. Arthroscopic evaluation was performed starting from the inferomedial portal to assess the cyst location, and shifting to the mid patellar portal. From that portal, we were able resect the cyst, opening the wall and shaving and aspirating the myxoid fluid.

Adult↗

PubMed2002

Pamidronate induces modifications of circulating angiogenetic factors in cancer patients.

PURPOSE: Recently, new experimental data suggested that, besides inhibiting osteoclasts, bisphosphonate may also have an antitumor effect. Antiangionetetic activity is one of the possible mechanisms of anticancer activity attributed to bisphosphonates. The purpose of this study was to evaluate the modifications in angiogenic cytokines levels after pamidronate infusion. EXPERIMENTAL DESIGN: Twenty-five consecutive cancer patients with bone metastases treated monthly with disodium pamidronate infusion were evaluated prospectively for circulating levels of vascular endothelial growth factor (VEGF), gamma-IFN, interleukin (IL)-6, and IL-8 at different time points: just before and after 1, 2, and 7 days after pamidronate infusion. RESULTS: Basal VEGF levels decreased significantly 1, 2, and 7 days after pamidronate infusion. gamma-IFN and IL-6 levels increased 1 day after the infusion but rapidly decreased after 2 days. Moreover, our data showed a statistically significant negative correlation between VEGF and gamma-IFN levels (P < 0.0001) and a positive correlation between VEGF and IL-8 (P = 0.04). CONCLUSIONS: This study confirms that pamidronate could have antiangiogenic properties through a significant and lasting decrease of VEGF serum levels.

Aged↗