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Biomedical subjects

C Milani

Publications and source records attributed to C Milani.

At least 37 records · Page 2Linked to original sources

[Endo-urology in diseases of the upper urinary tract other than tumors and calculi].

Thirty-three patients underwent percutaneous treatment for upper urinary obstructive disease in our Institute. Cold-knife incision of 16 cases of uretero-pelvic junction obstruction and 4 cases of infundibular stenosis was performed. Balloon dilatation of the caliceal neck was performed in 1 patient with caliceal diverticulum. In 4 of the patients treatment failed requiring open surgical correction. Thirteen patients presented iatrogenic ureteral obstruction: balloon dilatations or cold-knife incisions were performed. Four of the 9 patients evaluable obtained significant benefit from the endourological treatment. Endopyelotomies for UPJ obstruction seem effective and reduce morbidity and operating times. Ureteral obstructions appear less responsive to the endo-urological approach. Definitive conclusions concerning the effectiveness of these procedures requires larger series of patients and longer follow-up.

Adolescent↗

[Liposarcoma of the renal sinus].

The authors describe a case of liposarcoma of the renal sinus, a relatively uncommon tumor site. We briefly review its pathogenesis and underscore the importance of the preoperative differential diagnosis, particularly from other tumor masses that are often difficult to distinguish.

Aged↗

Hypothyroidism and thyroid autoimmunity in acute myocardial infarction (AMI).

It has been suggested that subjects with thyroid autoimmunity are more frequently affected by acute myocardial infarction (AMI), than the general population (Lancet ii, 155-158, 1977). Serum thyroid antibodies (microsomal and thyroglobulin) were measured in a cohort of 132 males admitted consecutively to the Coronary Unit of Clinica Medica II Univ. "La Sapienza" of Rome with AMI. In the AMI group the thyroid autoimmunity was twice as frequent as in an age matched random population (9.1 vs 17.4%), but the association was statistically weak (p less than 0.05). In the group over 60 y two cases of overt hypothyroidism were found and none in the control group. The prevalence of 2.5% is higher than that reported in previous surveys carried out in elderly populations. No differences have been demonstrated in concentration of serum cholesterol, triglycerides, apolipoprotein A and B between patients with and without thyroid autoimmunity, although the serum cholesterol of AMI patients and those with asymptomatic thyroiditis was significantly higher than that of the general population. It is concluded that the prevalence of thyroid autoimmunity and hypothyroidism are increased in AMI and migth thus contribute to development of hypercholesterolemia and/or immune mechanisms.

Adult↗

[Mitomycin C in the topical treatment of superficial neoplasms of the bladder].

From January 1982 to October 1987, 100 patients with multifocal superficial bladder cancer received intravesical MMC at the Institute of Urology, University of Padova. Seventy-three patients had papillary multifocal superficial bladder carcinoma (stages Ta-T1): treatment was divided into therapeutic (18 cases), and prophylactic (55 cases). 27 patients had carcinoma in situ. 39 patients affected by neoplasia relapsed to previous intravesical ADM treatment. All patients received 40 mg. intravesical MMC weekly for 8 consecutive weeks, repeating the cycle in cases of relapse. Complete response rates at 12 months was 53%, 50 to 67% for each group, respectively. Recurrence rate was lower compared to that before treatment; progression rate was also lower compared to a group who received only endoscopic treatment. In patients who relapsed with ADM treatment, the percentage of complete response was 69%. We underscore the efficacy of MMC in lowering relapse and progression in multifocal superficial bladder cancer, which represents the best indication for this kind of treatment.

Administration, Intravesical↗

Obstruction or no obstruction.

The authors review critically such parameters as symptomatology, post-micturition residual urine, bladder trabeculation and uroflowmetry that in the actual state of the art appear more accredited in the evaluation of lower urinary tract obstruction. All have some interpretative limits. However, uroflowmetry appears to be the most reliable and for this reason it is the first step in the study of suspected infravesical obstruction. It can discover equivocal situations in which pressure-flow studies only supply diagnostic help in order to avoid false diagnosis of infravesical obstruction and useless therapeutic approaches.

Diagnosis, Differential↗

Therapeutical aspects of intrarenal artery aneurysms.

The relative infrequency of aneurysms of the branches of the renal artery produces some indecision as to the surgeon's therapeutical choice. The purpose of this study is to carefully examine the indications for surgical treatment and to select precise therapeutical criteria on the basis of 8 patients in whom aneurysms of the main renal artery or of its branches were diagnosed from 1978 to 1986. In 1 patient, the disease was bilateral with a ruptured main artery aneurysm. 5 aneurysms were treated surgically (the ruptured one by nephrectomy, 2 by ex situ revascularization and 2 by in situ revascularization). In the remaining cases, only periodical controls were performed. In 4 surgically treated patients, angiographic follow-up demonstrated a regular renal revascularization and in 1 patient a thrombosis on the site of the anastomosis. On the basis of personal experience, surgical treatment is required for aneurysms larger than 1.5 cm in size without or with partial calcification, aneurysms occurring in pregnant women or in patients likely to conceive in the future, expanding aneurysms, and renin-mediated hypertension. The introduction of microsurgical techniques and renal preservation makes it possible for the urologist to chose between various therapeutical means for the treatment of intrarenal aneurysms. Reconstruction of anatomical continuity of the arterial supply avoiding unnecessary operative demolishment is feasible.

Aneurysm↗

Bilateral single ectopic ureter.

A case of successfully treated bilateral single ectopic ureter with a follow-up of 13 years is reported. The genesis of the incompetence of the vesical sphincter and its treatment are discussed.

Choristoma↗

Prognosis of bladder cancer. III. The value of radical cystectomy in the management of invasive bladder cancer.

From January 1979 to June 1982, 141 consecutive patients with bladder transitional cell carcinoma were treated with a single stage lymphadenectomy plus radical cystectomy. The survival rate observed in our patients, based on the TNM classification, was comparable with that reported for other groups employing contemporary surgery. Survivorship for patients with deep invasive tumors was also estimated by breaking down the pT3 stage, and patients with tumor confined to the bladder wall (pT3a) were separately evaluated from those with tumor extended outside (pT3b). The results obtained with this subdivision showed that pT3a patients have almost the same survival rate as pT2 patients. From these results it is concluded that radical cystectomy is a satisfactory curative treatment of bladder cancer confined to the bladder wall, whatever the extension of the muscular involvement. Such considerations suggest that, in order to achieve a more objective analysis of the results after radical cystectomy for invasive bladder cancer, a modification of clinical staging is necessary. Moreover, a simplification of the classification methods should provide a better identification of the elements required to assess the prognosis and to improve treatment planning.

Adult↗

Prognosis of bladder cancer. I. Risk factors in superficial transitional cell carcinoma.

A retrospective study was carried out on 200 consecutive superficial transitional cell carcinomas of the bladder in order to identify which factors could influence the recurrence and/or progression of the tumor. Many parameters were considered, such as stage, grade, number, size, site, tumor-free interval and bladder mucosa mapping. A careful histological study of the initial tumor was employed and the tumors confined to the stromal core of the papillary tumor (T1a) were separated from those with invasion of the lamina propria of the bladder wall (T1b). The behavior of the T1b lesions observed in our study will be discussed in a forthcoming article. Recurrence occurred in 83% of our patients, and it was influenced by number and grade of the tumor and by the presence of dysplasia in normal-appearing mucosa. In 20% of our patients tumor progression occurred. Tumor progression was correlated with invasion of the lamina propria of the bladder wall, high-grade neoplasias, tumor-free interval, dysplasia or carcinoma in situ in normal-appearing mucosa. The results of our study suggest that, by these risk factors, a better prediction of the behavior of superficial transitional cell carcinoma and, as a consequence, more appropriate treatment can be provided.

Carcinoma, Transitional Cell↗

Prognosis of bladder cancer. II. The fate of patients with T1b transitional cell bladder cancer.

We have reviewed the tumor progress in 46 patients who presented T1b lesions in a previous study on the prognosis of superficial bladder cancer. A group of 12 patients with single or very few localizations was treated by transurethral resection. Five patients progressed and were submitted to cystectomy. Two of these 5 patients died within 3 years of the surgical treatment. Twenty-seven patients with multiple lesions underwent cystectomy soon after the initial diagnosis. Nearly 30% experienced progression; 4 patients died within 4 years after cystectomy. A delayed cystectomy was performed in 7 patients with multifocal disease; in all but one the tumor progressed; 5 patients died between 7 and 28 months after the surgery.

Aged↗

Aggregation-induced stability of dexamethasone receptors in rat kidney.

The stability of the dexamethasone-receptor complex of rat kidney cytosol was studied using homogenizing media of varying pH and composition. It was found that the complex is less stable with buffers usually employed for the study of steroid receptors such as Tris, EDTA etc., whereas the stability increases considerably with a solution composed of monothioglycerol 12 mmol/l and glycerol 5% in distilled water. Sepharose 4-B column chromatography revealed that the increased stability was associated with a larger form (probably an aggregate) of the receptor-steroid complex.

Animals↗