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Biomedical subjects

D Turini

Publications and source records attributed to D Turini.

At least 55 records · Page 3Linked to original sources

Cystometric evidence that capsaicin-sensitive nerves modulate the afferent branch of micturition reflex in humans.

Intravesical instillation of capsaicin (0.1 to 10 microM) in six patients (five with hypersensitive disorders of the lower urinary tract, one with benign prostatic hyperplasia) produced a concentration-related reduction of the first desire to void, bladder capacity and pressure threshold for micturition. At a threshold concentration of one microM, capsaicin also produced a warm to burning sensation referred to the suprapubic area during the collecting phase and to the urethra during micturition. All the patients with hypersensitive disorders of the lower urinary tract reported disappearance or marked attenuation of their symptoms for a few days after capsaicin application. In three other patients with hypersensitive disorders of the lower urinary tract, intravesical instillation of capsaicin's vehicle (0.1% ethanol in saline) did not produce significant cystometric changes nor modify the symptomatology. These observations provide the first indication that capsaicin-sensitive structures (nerves?) may be present in the human urinary bladder as they have been shown to occur in various other species.

Administration, Intravesical↗

Potent contractile activity of endothelin on the human isolated urinary bladder.

Endothelin (1 nM-0.3 microM) produced a concentration-related contraction of mucosa-free muscle strips excised from the dome of the human urinary bladder. The response to endothelin was unaffected by either atropine (1 microM) or nifedipine (1 microM) at concentrations that abolished the response to carbachol and KCl, respectively. These findings indicate that mechanisms other than activation of dihydropyridine- and voltage-sensitive calcium channels may be involved in the action of endothelin on smooth muscles.

Adult↗

Multiple sources of calcium for contraction of the human urinary bladder muscle.

1. KCl, carbachol, neurokinin A and endothelin produced concentration-dependent contractions of mucosa-free muscle strips from the dome of the human urinary bladder. The maximal response to carbachol or neurokinin A exceeded that to KCl, while the maximal response to endothelin approached that to KCl. 2. Nifedipine (1 microM) abolished the response to KCl, reduced the response to carbachol or neurokinin A but had no effect on the response to endothelin. Bay K 8644 (1 microM) markedly potentiated the response to KCl but had little or no effect on the response produced by the other stimulants. 3. Superfusion of the strips with a nominally calcium (Ca)-free medium containing EDTA (1 mM) for 30 min markedly reduced the response to carbachol, neurokinin A and endothelin, although a small response was still evident at high concentrations. Likewise, after a prolonged (60 min) superfusion of the strips with a high K (80 mM) Ca-free medium plus EDTA (1 mM) these three agonists still produced a small contractile response. 4. The nifedipine (1 microM) resistant response to carbachol, neurokinin A or endothelin was markedly depressed by LaCl3 (1 mM). In contrast, the nifedipine-(1 microM) resistant response to carbachol was not modified by NiCl2 (0.1 mM) or omega-conotoxin (0.1 microM). 5. Caffeine produced divergent effects depending upon the temperature of incubation: a relaxation at 37 degrees C and a concentration-dependent (2.5-20 mM) contraction at 25 degrees C. The latter was markedly inhibited by procaine (3 mM) but unaffected by nifedipine (1 microM). 6. After a prolonged (60 min) superfusion with a high K, Ca-free medium containing EDTA the response to carbachol (100 microM) was abolished by previous exposure to procaine (3 mM). Conversely, the response to endothelin (1 microM) was unaffected by procaine. The response to endothelin in these experimental conditions was also resistant to LaCl3 (1 mM). 7. These findings indicate that multiple sources of Ca are mobilized for contraction of the human bladder muscle by different stimulants. Dihydropyridine- and voltage-sensitive Ca channels provide the major if not the sole source of Ca for the response to KCl, play some role in the response to muscarinic (carbachol) or NK-2 tachykinin receptor stimulation but are not involved in the response to endothelin. Carbachol, neurokinin A and endothelin all mobilize a Ca pool (either extracellular or located at membrane level) which is LaCl3-sensitive but nifedipine-resistant. Neither T- nor N-type channels appear to be involved in the response to carbachol. In addition, these agents mobilize a tightly bound Ca pool independently from membrane depolarization. This latter pool is probably a procaine-sensitive intracellular source of activator Ca mobilized by caffeine and carbachol. The failure of procaine to prevent the response to endothelin in high K, Ca-free medium raises the possibility that this peptide mobilizes an intracellular source of activator Ca, distinct from the caffeine- and carbachol-sensitive pool.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

Revascularization of the right ischemic kidney by gastroduodenal artery.

Hepatorenal bypass can successfully accomplish revascularization of the right renal artery when the aorta or the iliac vessels cannot be used for a standard renal bypass or renal autotransplantation. The use of the hepatic circulation can be increased by the gastroduodenal to renal artery bypass procedure. Herein we report a clinical case of severe hypertension in a patient with a solitary functional kidney and an extensive atheromatous alteration of the aortoiliac segment. It has been corrected by means of a gastroduodenal end-to-side renal saphenous vein bypass graft.

Aged↗

Specific motor effects of capsaicin on human jejunum.

Capsaicin (1 microM) produced a biphasic effect on the motility of longitudinal muscle strips from human jejunum e.g. an initial inhibitory effect on nerve-mediated contractions followed by a delayed increase in motility. Neither effect was observed upon a second application of the drug, indicating desensitization, a proposed marker of the action of capsaicin on sensory nerves. Both substance P and neurokinin A produced a contraction of isolated human jejunum, while calcitonin gene-related peptide had a small and inconsistent inhibitory effect.

Adult↗

Contractile response of the human isolated urinary bladder to neurokinins: involvement of NK-2 receptors.

The contractile response to substance P (SP), neurokinin A (NKA) and arginin-neurokinin B (Arg-NKB) (a water soluble analogue of NKB) was investigated in detrusor muscle strips from the dome of the urinary bladder obtained from patients undergoing total cystectomy for carcinoma of the bladder base. Spontaneous activity and response to nerve stimulation indicated that the material used in this study has characteristics similar to those described for 'normal' human detrusor muscle. All neurokinins induced a concentration-related contraction with sensitivity at nM concentrations and the following rank order of potency: NKA (90) greater than Arg-NKB (22) greater than SP (1). These findings indicate the involvement of NK-2 receptors in the contractile response of human detrusor muscle to neurokinins.

Aged↗

Relaxation of isolated corpus cavernosum induced by smooth-muscle relaxant drugs. A comparative study.

Intracavernous injection of vasoactive substances are used in the treatment and investigation of impotence. We studied the effects induced by some pharmacological agents on strips of human erectile tissue. Specimens of corpus cavernosum were obtained from 16 men undergoing cystectomy or penectomy for bladder or penile malignancy. Strip preparations were mounted in thermostically controlled baths containing Krebs solution. Pharmacologic effects were monitored by means of an isotonic transducer. Papaverine was shown to be the substance able to cause the biggest relaxation effect. The authors compared the action of other drugs having a relaxant effect, studied the antagonist effects of epinephrine and dopamine on the pharmacologically relaxed preparations, and stressed that the relaxation of the erectile tissue has a determinant role in the appearance and maintenance of erection.

Adult↗

Conservative surgical treatment of renal cell carcinoma: clinical experience and reappraisal of indications.

During a 14-year period 36 patients who presented with renal cell carcinoma underwent conservative surgical treatment. The patients were divided into 3 groups according to treatment indications and condition of the contralateral kidney: group 1 included patients with a solitary kidney or bilateral tumors, group 2 patients had a damaged contralateral kidney and group 3 patients were without abnormalities of the contralateral kidney. Cumulative 6-year survival rates were 58 per cent for group 1, and 90 per cent for groups 2 and 3 combined. The over-all cumulative 6-year survival rate was 74 per cent. Based on these data extension of the indication for conservative surgical treatment seems to be justified in patients who present with low stage tumors and partial or potential damage to the contralateral organ.

Adult↗

Biological, diagnostic and therapeutic aspects of a case of renal cell carcinoma occurring with bladder and contralateral adrenal metastasis.

We report a case of renal cell carcinoma occurring with bladder and contralateral adrenal metastasis discovered preoperatively with computerized tomography. Surgical treatment consisted of radical nephrectomy, with preservation of the ipsilateral adrenal gland, contralateral adrenalectomy, and transvesical resection of the bladder neoplasm. The hypothesis for the mechanism(s) of spread and treatment modalities are discussed.

Adrenal Gland Neoplasms↗

Galanin: a potent modulator of excitatory neurotransmission in the human urinary bladder.

Galanin (GAL) produced a concentration (0.3-100 nM)-related inhibition of the atropine-sensitive component of the contractions induced by field stimulation of detrusor strips from the dome of the human urinary bladder. GAL had an ED50 of 2 nM for the inhibition. The effect of GAL was prevented by atropine (1 microM) and was not seen when the strips were stimulated with a cholinomimetic or KCl. These data suggest a possible neuromodulator role of GAL in the human urinary bladder.

Aged↗

Caval extension of renal cell carcinoma. Results of surgical treatment.

Twenty-eight patients with renal cell carcinoma extending to the vena cava underwent surgical treatment consisting of radical nephrectomy and removal of tumor thrombus, which was at the level of the renal veins in 23 cases, the hepatic veins in 4, and extending above the diaphragm in 1 case. In 7 patients lymph nodes were invaded, and 8 had both positive nodes and extrarenal tumor diffusion discovered at surgery. The mean survival was 41.7 months for patients with only venous extension of the tumor, 16 months for patients with positive nodes, and 10.2 months for those with both nodal and extrarenal tumor diffusion.

Adult↗

Simultaneous bilateral adrenal involvement by renal cell carcinoma: experience with 3 cases.

We report 3 cases of renal cell carcinoma and synchronous bilateral adrenal metastases discovered preoperatively with computerized tomography and other imaging techniques. Surgical treatment consisted of radical nephrectomy through a transperitoneal approach, with adjunctive lower polar resection in a patient with bilateral renal tumors, and contralateral adrenalectomy. Subsequent steroid treatment was given.

Adrenal Gland Neoplasms↗

Removal of renal cell carcinoma extending to the supradiaphragmatic vena cava with the aid of cardiopulmonary bypass.

A woman with renal cell carcinoma confined within Gerota's fascia but extending to the supradiaphragmatic vena cava was successfully treated with the aid of cardiopulmonary bypass. The approach was a subcostal chevron incision coupled with a midline sternotomy. The rationale and indications for aggressive surgery of renal cell carcinoma with massive caval extension are discussed.

Carcinoma, Renal Cell↗

Intracavernous therapy in impotence after pelvic trauma. A preliminary study.

Pelvic trauma, especially when complicated by a posterior urethral disruption, may cause impotence in 50% of patients. The treatment of this kind of impotence has always been troublesome for the urologist. In fact penile prostheses or the revascularization procedures have sometimes been failures. We present a series of 6 patients with impotence after pelvic trauma managed by intracavernous injection of papaverine and we describe here the preliminary results obtained.

Adult↗

Chronic total renal artery occlusion: a diagnostic challenge.

Chronic renal artery occlusion must be suspected whenever a moderate hypertensive patient over 50 years of age presents increase of blood pressure refractory to treatment, sometimes causing heart failure or stroke. This suspicion is reinforced by the presence of renal insufficiency and of anatomical and/or functional lateralization of renal damage at intravenous pyelography.

Adult↗

Surgical repair of ureteral defects.

A nineteen year surgical experience with 35 patients requiring repair of ureteral defects is reported. Causes of ureteral damage are described, and the result of 18 patients treated with ileal ureter are compared with those of 17 cases where surgical procedures preserving urothelial continuity were used, such as bladder psoas hitch and renal autotransplantation. Significantly better results were observed with the latter techniques.

Adult↗