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1.
Mov Disord ; 14(2): 331-5, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10091629

ABSTRACT

Painful tonic spasms (PTS) are now regarded as a typical symptom of multiple sclerosis but pathologic or radiologic findings rarely have been described. We report clinical and magnetic resonance imaging records of five original cases. In all of them, lesions likely responsible for unilateral PTS involved the motor pathway at the level of the posterior limb of the internal capsule or the cerebral peduncle on the opposite side. Closeness of motor fibers seems to be the most important underlying anatomic factor because it enables involvement of a higher proportion of axons by a single demyelinating lesion and radial spread of ephaptic activation. In turn, preservation of the underlying pyramidal-spinal tract could make it easier for the pathologic discharge to reach the peripheral effectors and generate PTS.


Subject(s)
Brain/pathology , Dystonia/pathology , Multiple Sclerosis/pathology , Muscle Spasticity/pathology , Pain/pathology , Adult , Dystonia/physiopathology , Efferent Pathways/pathology , Female , Humans , Magnetic Resonance Imaging , Multiple Sclerosis/physiopathology , Muscle Spasticity/physiopathology , Nerve Degeneration/pathology , Pain/physiopathology
2.
Minerva Chir ; 48(19): 1047-51, 1993 Oct 15.
Article in Italian | MEDLINE | ID: mdl-8309600

ABSTRACT

This study analysed 90 cases of symptomatic cholelithiasis treated with laparoscopic cholecystectomy. 27% of the cases studied suffered from microlithiasis, 44% from multiple calculosis with calculi measuring 1 to 2 cm in diameter, 25% from single calculi measuring up to 4 cm in diameter, and 4% from a benign proliferative pathology of the cholecystic wall. Calculosis of the main biliary tract was also found in 3 patients and was treated by preoperative endoscopic papillosphincterotomy. In addition to routine tests and ultrasonography, endovenous cholangiography, or retrograde cholangiography (ERCP) in cases of suspected calculosis of the biliary tract, was always performed prior to surgery. Mean operating time was 60 min. Two procedures were converted into laparotomy due to laceration of the cystic artery. In one case laparotomy was performed on day two due to choleperitoneum following a lesion of the cystic duct. Pneumoperitoneum could not be performed in three cases. Mean hospital stay was 48 hours. No other intra- or postoperative complications were reported. These results support the opinion that laparoscopic cholecystectomy is a safe method, with few limitations and represents the treatment of choice in the therapy of symptomatic cholelithiasis.


Subject(s)
Cholecystectomy, Laparoscopic , Cholelithiasis/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged
3.
G Chir ; 10(4): 203-6, 1989 Apr.
Article in Italian | MEDLINE | ID: mdl-2518557

ABSTRACT

The US intraoperative diagnostic procedure is useful either for the higher sensitivity rate or for the surgical decision making. The Authors' intraoperative diagnostic experience in pancreatic diseases is reported: 23 exocrine and endocrine neoplasms, 3 chronic pancreatitis and 8 acute pancreatitis cases are discussed.


Subject(s)
Pancreatic Neoplasms/diagnostic imaging , Pancreatitis/diagnostic imaging , Humans , Intraoperative Period , Pancreatic Neoplasms/surgery , Pancreatitis/surgery , Ultrasonography
4.
Minerva Chir ; 44(5): 915-7, 1989 Mar 15.
Article in Italian | MEDLINE | ID: mdl-2725919

ABSTRACT

The accidental finding of a carcinoid tumour in Meckel's diverticulum, a very uncommon event, triggered a physiopathological and clinical analysis of this very interesting but very rare association. The value of systematic identification and removal of the diverticulum during laparotomy is underlined.


Subject(s)
Carcinoid Tumor/complications , Ileal Neoplasms/complications , Meckel Diverticulum/complications , Carcinoid Tumor/pathology , Humans , Ileal Neoplasms/pathology , Male , Middle Aged
5.
Minerva Med ; 78(16): 1247-50, 1987 Aug 31.
Article in Italian | MEDLINE | ID: mdl-3627535

ABSTRACT

Two cases of thyroid metastasis from breast cancer are reported, both occurring in patients previously given radical mastectomies. It is emphasised that postoperative follow-up should also monitor rarely affected sites of metastasis from breast cancer.


Subject(s)
Breast Neoplasms/pathology , Thyroid Neoplasms/secondary , Adult , Female , Humans , Mastectomy , Middle Aged , Thyroid Neoplasms/surgery
9.
Chir Ital ; 33(3): 647-60, 1981 Jun.
Article in Italian | MEDLINE | ID: mdl-7307205

ABSTRACT

The Authors report their experience concerning 120 patients with Raynaud's Disease (50 pats.) or Syndrome (70 pats.). All patients were studied before and after treatment, by clinical, thermometric, oscillographic and photoplethysmographic observation and by the Doppler examination, in order to evaluate the functional and organic component of the disease. Surgical treatment was reserved to 45 patients with secondary or primitive Raynaud's phenomenon refractory to medical therapy. The treatment of choice was thoracic sympathectomy. The result was excellent in 64% of cases, fair in 26%, and nil in 8%. 75 patients were treated with various drugs for a period of 6 months or 1 year. In 54% of cases the result was excellent, fair in 29%, and nil in 16%. The Authors conclude that diagnosis of Raynaud's Syndrome is above all clinical, that a leading part is played by photoplethysmography and the Doppler examination, and that medical therapy is indicated in the first instance, since it is capable of preventing the rise of those distal trophic disorders that constitute one of the main indications of surgical treatment.


Subject(s)
Raynaud Disease/diagnosis , 1-Propanol/therapeutic use , Adult , Aspirin/therapeutic use , Ergot Alkaloids/therapeutic use , Female , Griseofulvin/therapeutic use , Humans , Male , Middle Aged , Raynaud Disease/drug therapy , Raynaud Disease/surgery , Sympathectomy , Tetrahydropapaveroline/analogs & derivatives , Tetrahydropapaveroline/therapeutic use , Vasodilator Agents/therapeutic use , Xanthinol Niacinate/therapeutic use
10.
Chir Ital ; 33(1): 264-72, 1981 Feb.
Article in Italian | MEDLINE | ID: mdl-7261208

ABSTRACT

Thirty duodenal ulcer patients were subjected to proximal selective vagotomy (p.s.v.) and modified Dor antireflux plastic surgery. Accurate clinical, radiological, endoscopic, gastrosecretory, radioimmunological and PH-manometric tests were made before and 7 and 30 days after surgery. The results confirm the effectiveness of p.s.v. in treatment of ulcerous disease, and the usefulness of combining modified Dor plastic surgery in order to prevent postoperative feedback.


Subject(s)
Duodenal Ulcer/surgery , Vagotomy, Proximal Gastric , Vagotomy , Adult , Duodenal Ulcer/diagnosis , Evaluation Studies as Topic , Female , Gastric Acid/metabolism , Gastric Acidity Determination , Humans , Male , Vagotomy/methods , Vagotomy, Proximal Gastric/methods
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