Carpal tunnel syndrome: a clinical electrophysiological study of 84 cases.

A retrospective study of 84 patients with carpal tunnel syndrome (CTS), for a total of 118 hands, was performed in order to check clinical aspects of the disease including age of onset, sex, side affected, other associated pathological conditions, and to assess the existence of correlation between the clinical picture and electrophysiological parameters. All patients were subjected to careful clinical observation and electromyographic and electroneurographic examinations. Our study confirms that the female sex is by far predominant, the most interesting ages being the 5th and 6th decades of life and the right side is more affected than the left. None of the patients had a family history of CTS. The sensory pathology is far more frequent than the motor one and the percentage of hands with sensory and motor deficit increases with the duration of the disease. As far as the electrophysiological data is concerned, the most important and also the earliest alterations fundamentally concern the distal motor latency and distal sensory conduction velocity of the median nerve and the amplitude of its sensory action potential (SAP). This study leads us to point out a significant correlation in CTS between electrophysiological (distal motor latency and distal sensory conduction velocity of the median nerve, amplitude of its SAP) and clinical parameters (symptomatology and duration of the disease).

Histological typing and nuclear evaluation of endometrial adenocarcinoma.

On the basis of the nuclear pattern "homologous adenocarcinoma" of the endometrium, arising in women under 40, may be divided into three cytologically distinguishable entities: 1) atypical adenomatous hyperplasia Grade 1; 2) atypical adenomatous hyperplasia Grade 2; 3) adenocarcinoma; probably different also at biological level.

[Diagnostic problems in adenocarcinoma of the endometrium in women less than 40 years of age]. / Problemi diagnostici in tema di adenocarcinoma dell'endometrio in donne al di sotto dei quaranta anni

Endometrial adenocarcinoma in women under the age of forty presents a different course according to its histology. Adenocarcinomas of the endometrium may be classified into 4 main types: type 1, homologous or endometrioid; type 2, fallopian-like; type 3, cervical-like; type 4, unclassifiable. The majority of homologous adenocarcinomas have a relatively benign course, whereas the other types are definitely malignant. There is no room for doubt between adenocarcinoma and atypical endometrial hyperplasia in women under forty unless the histological pattern is of the homologous or endometrioid type, because the other patterns are definitely malignant.

Tissue polypeptide antigen in normal and neoplastic urinary bladder. Preliminary reports.

Tissue polypeptide antigen (TPA) both in normal and neoplastic urinary bladders has been studied by immunocytochemistry. A comparison of TPA with epithelial membrane antigen (EMA), keratins and carcinoembryonic antigen (CEA) in various tumor grades and stages has been performed better to define TPA role in bladder carcinomas. Well-differentiated tumors were strongly stained for TPA with a uniform staining intensity. Undifferentiated tumors were weakly stained for TPA with an uneven staining intensity. There was no relation between TPA findings and stages of invasion. However, TPA seems to be a very helpful diagnostic tool for tumor grading and staging.

[Clinico-developmental aspects in 44 cases of polymyositis/dermatomyositis]. / Aspetti clinico-evolutivi in 44 casi di polimiosite/dermatomiosite.

A retrospective study, paying particular attention to the clinical and evolutive aspects of the disease, was performed on 44 subjects affected by polymyositis/dermatomyositis (PM/DM) and hospitalized at the Institute of Medical Clinics of the 1st School of Medicine of Naples University. On the basis of the different clinical pictures, the cases were classified into the following groups: primary PM (4); primary DM (19); DM/PM associated with malignancy (6); childhood DM/PM (3); PM/DM associated with connective tissue disorders (12). Diagnosis was established in terms of the following criteria: a) symmetrical and mostly proximal bilateral muscle weakness (100%); b) elevation of serum enzymes (86.3%); c) electromyographic findings of myopathy sometimes with fibrillation potentials, increased insertional irritability and pseudo-myotonic discharges (93.1%); d) muscle biopsy changes compatible with a clinical form of polymyositis (83.3% out of 30 cases); e) dermatological manifestations including particularly pink or lilac edema-erythema over the periorbital areas, wine-red maculae, Gottron's sign, "poikiloderma vasculare atrophicans", telangiectasias and skin vasculitis (86.3%). An involvement of the extraneural apparatus and organs was present in 40 patients; the most damaged was the osteoarticular apparatus, followed by esophagus, lung, heart and kidney; such pathology was rarely present in the childhood form. A follow-up of the disease has been performed in 36 cases and the therapy consisted fundamentally of high dose corticosteroids (mostly prednisone), associated, in a minority of cases, with methotrexate. A clinical improvement was observed in most cases and a remission of the disease in part of the latter. However, a worsening of the illness was noticed only in the patients suffering from PM/DM associated with malignancy, and mortality rate was 11.1% in all.