Biomedical subjects
Publications and source records attributed to D Di Trapani.
The authors refer on the pathogenesis, diagnosis and therapy of bladder diverticula, with particular reference to the endoscopic compression technique performed in 35 patients. The authors stress the usefulness of bladder ultrasonography in the follow-up of operated patients. Results are comparable to those obtained cystography.
The authors underline the diagnostic accuracy of transurethral bladder ultrasonography in the estimation of local infiltration of bladder tumors. The study was conducted on 21 patients who underwent either endoscopic resection or cystectomy. The clinical staging obtained by transurethral echography was compared with the pathological one. The results obtained by either method were comparable in all cases.
The authors consider the concentration of antibacterial drugs in the seminal fluid as a reliable experimental model for the study of pharmacokinetics in chronic prostatitis (c.p.). The study was conducted on 32 subjects, 20 of whom were affected by c.p. and 12 were normal controls. All subjects were treated with aztreonam at a dosage of 1 g.i.m. The assay was performed 1 hour after the injection, on seminal fluid, urine and serum samples. No difference was observed between normal subjects and patients with c.p. with regard to serum and urinary levels of the drug. There was a trend towards a higher concentration of the drug in the seminal fluid of patients with c.p. when compared to normal subjects, with mean values of 1.8 and 0.9 mcg/ml respectively. This difference was not statistically significant. Furthermore, the drug concentration of the drug in semen was below the sensitivity limits of the assay in 43% of normal subjects and in 10% of patients with c.p. In the latter group of patients the mean values of aztreonam concentration exceeded the minimal inhibitory concentrations for most aetiological agents causing c.p. In conclusion, it is suggested that aztreonam is likely to be effective in acute prostatitis, caused by Gram negative strains and may be indicated in selected cases for the treatment of c.p.
Transrectal ultrasonography was performed in 121 patients with the chronic prostatitis syndrome (CPS), and in 20 patients with urological pathology not involving the prostate gland. The ultrasonographic aspects of the seminal vesicles (SV) in normal subjects and in patients with the CPS are described. In the latter group, characteristic ultrasonographic patterns can often be obtained, even in patients affected by prostatodynia, in whom all the other clinical and laboratory findings were absent. They consisted of: (a) dyshomogeneous echo-structure of the prostate; (b) constant dilatation of the periprostatic venous plexus, greater than 150 mm2; (c) dilated, elongated SV, with thickening of their inner septa (they are sometimes asymmetrical), and (d) bladder neck hypertrophy.
Diagnostic accuracy in clinical staging of bladder cancer, using traditional methods, is still imperfect. Clinical and pathological staging do not always correlate. The accuracy of the new imaging techniques in the staging and in the follow-up of this kind of neoplasia, has yet to be assessed. Our study involved 7 patients with invasive bladder cancer who had undergone transurethral ultrasonography, CT scan, NMR and transurethral resection of the tumour. We have compared the clinical staging accuracy of the three imaging methods with the pathological reports. We conclude that transurethral ultrasonography is superior to the other methods, as far as local staging is concerned. In regional staging, NMR has shown very promising results and, in our preliminary opinion, may be more accurate than CT scan.
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The urogenital inflammations may be considered as "apparatus pathology". We analyze only inflammatory diseases of the prostate gland, because it may be extensible to the entire male genital apparatus. Among aethiological agents of infections an important role belongs to Chlamydia and Mycoplasma; we describe various methods for diagnosis of the Chlamydia and Mycoplasma infections. When objective clinical findings are poor or absent (such in prostatosis and prostatodynia) the transrectal ultrasonography demonstrates characteristic pictures useful for diagnosis and follow-up. Our clinical data and anatomo-pathological remarks suggest a real correlation between varicocele and genital inflammations (26%). This association doesn't represent the only cause of infertility, but frequently reduces the probability of male fertility.
The interest for varicocele in the determination of male infertility has increased during the last decades. Most researchers consider varicocele as the primary cause of male infertility, but recently another group of authors give it a secondary role in the alteration of spermatogenesis. We think that the major part of the controversy depends on an absence of a systematic approach to the problem. We give a primary importance to an accurate epidemiological evaluation which consists in a transversal and longitudinal survey of male subjects in puberal age. Our data show that left varicocele is practically inexsistent before the onset of puberty; the percentage incidence of this alteration increases progressively with puberal maturity and the tends to decrease slightly when maturity is complete. By correlating this pathology with puberty we can obtain more precise informations than when it is correlated to the regestrated age. The young patients who result suffering from varicocele, must be controlled carefully and periodically for the evaluation of the period and the opportunity of a therapeutic treatment.
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