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Abstract
We describe a sciatic schwannoma spanning the sciatic notch in a 39-year-old woman with persistent pelvic pain after caesarean delivery. The tumour was detected by pelvic CT scan and MRI. Anterior transabdominal surgery allowed the en bloc removal of both the pelvic and the buttock component of the tumour.
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Affiliation(s)
- A Consales
- Department of Neurosurgery, Ospedale Bellaria, Bologna, Italy
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2
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Granieri E, Monaldini C, De Gennaro R, Guttmann S, Volpini M, Stumpo M, Fazio P, Casetta I. Multiple sclerosis in the Republic of San Marino: a prevalence and incidence study. Mult Scler 2008; 14:325-9. [PMID: 18208882 DOI: 10.1177/1352458507084114] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Studies on the distribution of multiple sclerosis (MS) carried out in Southern Europe in the last years have shown a significant increase in the frequency of the disease. A previous descriptive survey in the Republic of San Marino, northern Italian peninsula, published in 1984 established that this area is at high risk for MS. We updated the frequency estimates of the disease by adopting a complete enumeration approach. On 31 December 2005, 50 MS patients (36 women and 14 men) yielded a crude prevalence rate of 166.7 per 100, 000 (95% CI 123.7-220), 235.3 (95% CI 165-327.4) for women and 95.2 (95% CI 52-160) for men. The average incidence from 1990 to 2005 was 7.9 (95% CI 5.3-11.1) per 100,000, 11.7 (95% CI 7.6-17.3) for women and 3.9 (95% CI 1.7-7.7) for men. We did not detect any significant temporal trend over the study period. These results confirm that in San Marino the disease occurs more frequently than that suggested in the past and support the data on MS frequency in continental Italy. The marked increase in MS prevalence ratio is partly due to the increasing survival of patients and the accumulation of new incidence cases owing to the reduction in diagnostic latency for better quality of neurological diagnostic procedures. However, an increased incidence of the disease could be considered.
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Affiliation(s)
- E Granieri
- Sezione di Clinica Neurologica, Dipartimento di Discipline Medico-Chirurgiche della Comunicazione e del Comportamento, Centro Sclerosi Multipla, University of Ferrara, Italy.
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3
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Passavanti G, Pizzuti V, Costantini F, Bragaglia A, Minacci CC, Stumpo M, Paolini R. The Role of Histopathologic Grading in the Staging of Localized Prostate Cancer. Urologia 2004. [DOI: 10.1177/039156030407100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
One of the most important parameters in the staging of prostate Cancer is the Gleason Grading, although the Gleason assessed In biopsy is not always the same as the final grading. We have therefore tried to find out whether the use of histopathologic grading might offer some extra information about the biological nature of prostate Cancer. 53 patients underwent a radical open prostatectomy for prostate Cancer. Mean age was 66.16ys; pre-biopsy PSA was 1.92-47 ng/mL. Histopathologic grading was assessed on the biopsy tissue, while grading, Gleason and the pathological stage were assessed on the operation piece. The 53 patients were classified according to their bioptic grading (BG), postoperative grading (PG), stage and PSA. BG=PG in 33 cases (62.26%). 17 patients (30.07%) showed a BG<PG and 3 (3.77%) BG>PG. If we analyze such data according to the stage: 1T1c:GB=GP. 9T2a: 6(66.6%)GB=GP, 2GB<GP and 1GB>GP. 19T2b:10(52.63%)GB=GP, 9(47.3%)GB<GP. 11T2c:11GB=GP. 13T3: 5GB=GP, 6GB<GP and 2GB>>GP. Prostate carcinoma staging still shows a large number of limits related to the unpredictability of neoplasm behaviour. The present trend is to use several parameters. We think that the use of the histopathologic grade can be a useful tool to be added to the ones we already employ. We think histopathologic grading should be used with other grading methods, instead of replacing Gleason, which is still quite effective.
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Affiliation(s)
| | - V. Pizzuti
- UO Urologia Ospedale “Misericordia”, Grosseto
| | | | | | - C C. Minacci
- Servizio Anatomia Patologica, Ospedale “Misericordia”, Grosseto
| | - M. Stumpo
- Servizio Anatomia Patologica, Ospedale “Misericordia”, Grosseto
| | - R. Paolini
- UO Urologia Ospedale “Misericordia”, Grosseto
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4
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Affiliation(s)
- M Stumpo
- Neuropsychiatric Service, State Hospital, Repubblica di San Marino, San Marino, Italy
| | - M Poppi
- Division of Neurosurgery, Bellaria Hospital Bologna, Bologna, Italy
| | - G Rizzo
- Department of Neurological Sciences, University of Bologna, Bologna, Italy
| | - P Martinelli
- Department of Neurological Sciences, University of Bologna, Bologna, Italy
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5
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Toti P, DE Felice C, Schürfeld K, Stumpo M, Bartolommei S, Lombardi A, Petraglia E, Buonocore G. Cyclooxygenase-2 immunoreactivity in the ischemic neonatal human brain. An autopsy study. J Submicrosc Cytol Pathol 2001; 33:245-9. [PMID: 11846093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Cyclooxygenase-2 (COX-2) is known to be expressed in rat brain and up-regulated by ischemia. The administration of COX inhibitors before as well as soon after the ischemic insult reduces the extension of cerebral damage in rats. Overexpression of COX-2 has also been shown in the ischemic brain of adult human patients, while no information concerning COX-2 expression in neonatal ischemia is available. Intrapartum asphyxia and perinatal brain injury may result in cerebral palsy, mental retardation or epilepsy. COX-2 expression in the brain of neonates delivered after severe birth asphyxia was investigated using immunohistochemistry. Meningeal vessel walls of term and preterm babies widely expressed COX-2 immunoreactivity, as did periventricular large vessels in preterms. A number of brain cells (mature and immature cortical, periventricular and basal ganglia neurons, and oligodendrocytes of the cerebral white matter in brains from term neonates) also expressed COX-2. The present findings suggest that COX-2 may take part in enhancing neonatal brain damage via different mechanisms, such as those involving excitotoxicity and production of reactive oxygen species.
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Affiliation(s)
- P Toti
- Institute of Pathology, and Reproductive Medicine, University of Siena, Italy.
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6
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Spina D, Vindigni C, Presenti L, Schürfeld K, Stumpo M, Tosi P. Cell proliferation, cell death, E-cadherin, metalloproteinase expression and angiogenesis in gastric cancer precursors and early cancer of the intestinal type. Int J Oncol 2001; 18:1251-8. [PMID: 11351259 DOI: 10.3892/ijo.18.6.1251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to analyse the morphological, kinetic and molecular characteristics of low-grade (LGD) and high-grade dysplasias (HDG) in comparison with intestinal metaplasia type III (IM III) and normal mucosa (NM) as well as with early gastric cancer of the intestinal type (EGC). Based on this it was verified whether these categories are distinct, progressive proliferative steps from IM III to LGD, HGD and EGC, according to Correa's sequence of events. The morphology, mitotic index (MI), and the apoptotic index (AI) were assessed. The E-cadherin expression (E-Cad), matrix-metalloproteinase activity (MMP2), and the number of microvessels (NV) were also evaluated. Among the categories, MI increases from NM to IM III and LGD, and from LGD to HGD and EGC, while AI continues to increase also from HGD to EGC. E-cad decreases from NM to EGC, although not significantly from LGD to HGD; MMP2 is significantly more expressed only in EGC. Three groups are obtained by means of cluster analysis. The first group includes all the NMs and IM IIIs, all except 1 LGD, about half of HGDs, and 1 EGC. E-Cad is highly expressed, MMP2 and angiogenesis are low, the proliferative activity is low and mitoses are partly balanced by apoptoses. The second group includes some EGCs and HGDs and is characterised by a very high proliferative activity and cell death; there is an initial loss of cell adhesion, an increase of MMP2 and NV. The third group includes the majority of EGCs, but also 1 HGD: it has intermediate MI and AI, the lowest expression of E-Cad, the highest expression of MMP2 and the most numerous microvessels. These results underscore the necessity of evaluating each case individually within the same singular category of Correa's sequence. The use of kinetic and molecular parameters in addition to the morphological analysis may give important information on the behaviour of the various lesions.
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Affiliation(s)
- D Spina
- Institute of Pathological Anatomy and Histology, University of Siena, Siena, Italy
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7
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Abstract
The relation between clinical or histologic chorioamnionitis and early neonatal adverse neurologic outcome was investigated (n = 483). Histologic, but not clinical, evidence of chorioamnionitis was found to be a significant predictor of periventricular echodensity (odds ratio, 2.4; 95% CI, 1.8-3.2), echolucency (3.3; 1.9-5.6), ventriculomegaly (2.7; 1.8-4.2), intraventricular hemorrhage > or =3 (3.5; 2.4-5.2), and seizures (2.3; 1.4-3.7).
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8
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Toti P, De Felice C, Stumpo M, Schürfeld K, Di Leo L, Vatti R, Bianciardi G, Buonocore G, Seemayer TA, Luzi P. Acute thymic involution in fetuses and neonates with chorioamnionitis. Hum Pathol 2000; 31:1121-8. [PMID: 11014581 DOI: 10.1053/hupa.2000.16676] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chorioamnionitis represents the leading cause of preterm birth and related pathologic conditions as well as of fetal death and frequently occurs in symptom-free mothers. Recent radiologic findings have indicated that thymus size is significantly reduced in preterm infants born to mothers with subclinical, histologically proven chorioamnionitis. However, an accurate morphologic description of the thymus gland in fetuses and neonates with chorioamnionitis is lacking, although it is known that infection and other stress processes may cause lymphocyte depletion in the thymuses of infants and older babies (acute stress involution). We describe morphologic modifications in the thymus of fetuses with histologically proven chorioamnionitis and newborn infants with chorioamnionitis and proven sepsis. The main findings included (1) decreased organ volume (ANOVA, P < .0024); (2) reduced corticomedullary ratio (P < 10(-6)); (3) significant changes in the relationship between thymic parenchyma and thymic interstitial tissue with resulting increased organ complexity (P = .03); (4) severe reduction of thymocytes; and (5) other degenerative processes such as monocyte/macrophage infiltration of Hassall's bodies. These results indicate that chorioamnionitis, with or without sepsis, is associated with significant morphologic modifications in the thymus. We wish to note that the described thymic pathology is only one aspect of the fetal systemic inflammatory response syndrome with which chorioamnionitis is associated.
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Affiliation(s)
- P Toti
- Institute of Pathology, University of Siena, Italy
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9
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Affiliation(s)
- M Mondelli
- Servizio di EMG, Az. USL 7 di Siena, Italy
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10
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Stumpo M, Foschini MP, Poppi M, Cenacchi G, Martinelli P. Hypertrophic inflammatory neuropathy involving bilateral brachial plexus. Surg Neurol 1999; 52:458-64; discussion 464-5. [PMID: 10595765 DOI: 10.1016/s0090-3019(99)00142-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The present case is an example of hypertrophic inflammatory neuropathy (HIN). This entity is a rare tumor-like, chronic inflammatory, focal or multifocal, mainly demyelinating neuropathy of unknown origin, most frequently involving the brachial plexus. CASE DESCRIPTION The authors describe a 67-year-old man presenting with a nodular mass in his right supraclavicular fossa. A nodular mass grossly resembling a schwannoma originating from a single nerve fascicle was surgically removed from the right C6 spinal nerve. Histologically, endoneurial edema, fibrosis, focal chronic inflammation, and extensive "onion bulb" formation were seen. Electron microscopy studies and immunohistochemistry proved that the onion bulb-forming cells were schwannian in nature and that the whorls of onion bulbs surrounded a generally demyelinated axon. Three months following surgery the patient developed acute painless paralysis of his right biceps brachii muscle that rapidly reversed; after that he remained neurologically asymptomatic. MRI revealed multiple fusiform mass lesions involving the brachial plexus bilaterally. Electrophysiologic studies demonstrated a bilateral, asymmetrical, mainly demyelinating neuropathy involving the brachial plexus; they failed to reveal any abnormality suggestive of generalized neuropathy. CONCLUSION HIN is different from other focal tumor-like neuropathies and in particular from localized hypertrophic neuropathy (LHN).
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Affiliation(s)
- M Stumpo
- Institute of Neurology, University of Bologna, Italy
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11
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Toti P, Tanganelli P, Schürfeld K, Stumpo M, Barbagli L, Vatti R, Luzi P. Scarring in papillary carcinoma of the thyroid: report of two new cases with exuberant nodular fasciitis-like stroma. Histopathology 1999; 35:418-22. [PMID: 10583556 DOI: 10.1046/j.1365-2559.1999.035005418.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To describe two new cases of papillary carcinoma of the thyroid with exuberant nodular fasciitis-like stroma, one of which was characterized by previously unreported transformation into a poorly differentiated lesion. Moreover, we explore the presence of TGF-beta to help to clarify the pathogenesis of the collagen formation. METHODS AND RESULTS The case characterized by an aggressive behaviour exhibited areas of transformation into a poorly differentiated (insular) carcinoma of the thyroid. In both cases, as revealed by immunohistochemistry, neoplastic cells produced and secreted high amounts of TGF-beta. On the contrary, TGF-beta immunoreaction was never present in the normal thyroid or in papillary carcinomas without collagen bundles, while a weak, exclusively intracellular reaction was present in a patchy manner in cases showing intratumoral fibrous bundles. CONCLUSIONS The rare variant of papillary thyroid carcinoma characterized by exuberant stroma may give rise to more aggressive lesions, as do other histotypes of differentiated thyroid carcinomas. TGF-beta, the fundamental cytokine which mediates scarring and activation of myofibroblasts, most probably induces the exuberant stroma.
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Affiliation(s)
- P Toti
- Institute of Pathology, University of Siena, Siena, Italy.
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12
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Abstract
Chorioamnionitis, a major cause of preterm birth with significant neonatal morbidity and mortality, frequently occurs in mothers who are free of symptoms. A combined clinical, radiologic, and pathologic study of 129 very low birth weight infants indicated a significant association between a markedly decreased thymic size at birth and subclinical chorioamnionitis.
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Affiliation(s)
- C De Felice
- Department of Preventive Pediatrics and Neonatology, the Institute of Pathology, University of Siena, Italy
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13
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Spina D, Vindigni C, Presenti L, Lalinga AV, Stumpo M, Roviello F, Pinto E, Tosi P. Kinetic patterns in advanced gastric cancer as related to histotype and tumor extension. Oncol Rep 1999; 6:753-7. [PMID: 10373650 DOI: 10.3892/or.6.4.753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Kinetic patterns of advanced gastric cancers were analyzed for comparison between intestinal- and diffuse-types by using the mean values of mitotic index (MI), apoptotic index (AI), the sum of the two [i.e., the turnover index (TI)] and growth index (GI), and the values of the same parameters in the three layers (upper, intermediate, lower) in which cancers were subdivided from surface to depth. Site and extent of tumors, lymph node invasion, and p53 and PCNA expression were not different between the two histotypes; tumor cell dissociation (TCD) was higher in diffuse-type cancers. Mean MI, AI, TI, and GI were not different between the two histotypes, while MI, AI, TI, and GI were higher in the upper layer of intestinal-type cancers than in that of diffuse-type. MI and GI decreased while AI increased from upper to deeper layers in intestinal-type tumors; MI, AI, and TI increase from upper to lower layers in diffuse-type tumors. In intestinal-type cancers, but not in diffuse cases, TI and GI were higher in the T2 group than in T3. This different behavior between the two histotypes is discussed.
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Affiliation(s)
- D Spina
- Institute of Pathologic Anatomy and Histology, University of Siena, 53100 Siena, Italy
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14
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Toti P, Greco G, Motolese E, Stumpo M, Cardone C, Tosi GM. Cell composition and immunohistochemical detection of VEGF, TGF-beta, and TNF-alpha in proliferative vitreoretinopathy. J Submicrosc Cytol Pathol 1999; 31:363-6. [PMID: 10626004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Formation of vascularized membranes inside the vitreous leads to retinal detachment and blindness. In this paper it is shown that vitreal membranes are composed of newly formed vessels and myofibroblasts, immersed in a loose stroma with sparse histocytes. Vascular endothelial growth factor (VEGF) is clearly present in cellular constituents of the membranes and, therefore, represents a fundamental cytokine in their formation, while transforming growth factor-beta (TGF-beta) and tumor necrosis factor-alpha (TNF-alpha) are not. Considering that the composition of vitreal membranes clearly resembles scar tissue, the absence of TGF-beta in the membranes could explain their peculiar histological appearance.
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Affiliation(s)
- P Toti
- Institute of Pathology, University of Siena, Italy.
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15
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Abstract
PURPOSE To determine the histology and immunohistochemistry of anterior capsule fibrosis. SETTING Department of Ophthalmology and Neurosurgery and Institute of Pathology, University of Siena, Siena, Italy. METHODS Tissue sections from 3 patients with anterior capsule fibrosis after phacoemulsification and intraocular lens implantation were examined histologically. RESULTS The proliferating tissue was devoid of vessels and composed of dense fibrous tissue and numerous activated fibroblasts with contractile capacity (myofibroblasts). No TGF-beta, which is the most important cytokine in modulating myofibroblasts, was present in the fibrotic tissue. CONCLUSION The absence of the cytokine TGF-beta and inflammatory cells in the proliferating tissue confirms the unique character of the reparative activity within the eye.
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Affiliation(s)
- A Caporossi
- Dipartimento di Scienze Oftalmologiche e Neurochirurgiche, Università degli Studi di Siena, Italy
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16
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Martinelli P, Macrì S, Scaglione C, Stumpo M, Poppi M. Acute brachial plexus neuropathy as a presenting sign of peripheral nervous system involvement in paraproteinaemia. Acta Neurol Scand 1997; 95:319-20. [PMID: 9188910 DOI: 10.1111/j.1600-0404.1997.tb00218.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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17
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Abstract
We report the case of a patient who sustained an isolated injury to one of the two main branches of the posterior interosseous nerve of the forearm. Repair by epineurial suture was followed by complete recovery.
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Affiliation(s)
- M Poppi
- Division of Neurosurgery, Ospedale Bellaria, Bologna Italy
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18
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Abstract
The case of a patient with a small intraneural ganglion of the deep peroneal nerve is described, including the clinical and electrophysiological characteristics and the course four years after surgery.
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Affiliation(s)
- G Ciucci
- Divisione di Neurologia, Ospedale S. Maria delle Croci, Ravenna, Italy
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