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Biomedical subjects

E Alcini

Publications and source records attributed to E Alcini.

At least 55 records · Page 3Linked to original sources

[Correlation between ultrasonography imaging and surgical findings in scrotal trauma].

The Authors report their experience of 20 cases of scrotal trauma. The etiopathogenesis of lesions are stressed as well as the importance of an early diagnosis, in order to plan a correct treatment avoiding immunological and atrophic outcomes. All of the patients underwent a diagnostic ultrasonographic examination. Eighteen of them were surgically treated, whereas last two recovered by means of a week antibiotic and anti-inflammatory medical therapy. The scrotal sonography showed a 100% sensibility for testis injuries and a 80% specificity for albuginea fractures. In fact a fracture of the tunica albuginea was found in two cases although they showed a normal scrotal sonogram. It is worth of mention that in the authors' experience the ultrasonography generally understages the testis damages. Only the surgical exploration is believed to be able to make a sure diagnosis of type and seriousness of the scrotal injury.

Adolescent↗

125I seeds implantation plus pelvic lymphadenectomy in the management of localized prostate cancer.

In this study the authors present their experience of treatment of intraglandular prostate cancer with 125I seed implantation. At ten years, the overall survival for T1 and T2 stages is 71% and 57% respectively; and for G1, G2 and G3 grades the survival rate is 84%, 54% and 44% respectively; NED ten-year survival is 53% and 52% for T1 and T2 stages, 84%, 40% and 33% for G1, G2, and G3 grades respectively. The statistical evaluation seems to confirm that iodine brachytherapy is suitable for well differentiated and small volume tumors. Local recurrences, complications and side effects are also reported and compared to corresponding data collected following external radiotherapy and radical prostatectomy; the survival results are similar, but the incidence of complications is lower following implantation and in particular regarding continence and potency. In conclusion, the authors believe that iodine seed implantation could offer patients, who are often young and asymptomatic, satisfactory chances of survival and a very high quality of life.

Adult↗

The role of ultrasonography in scrotal traumas.

Fourteen patients with a variety of scrotal lesions have been investigated. In 12 cases surgical exploration was performed, and 2 patients with scrotal wall haematoma received drug treatment. In the early detection of scrotal traumas ultrasonography is of utmost importance for the definitive diagnosis to be set up.

Adolescent↗

Growth-inhibitory effect of quercetin and presence of type II estrogen binding sites in primary human transitional cell carcinomas.

Eight cases of transitional cell carcinoma (TCC) of the bladder were investigated for the presence of estrogen receptors (ER) and Type II estrogen binding sites (Type II EBS). All these tumors specifically expressed type II EBS, while only 3 of 8 cases contained low amounts of ER. All the cases assayed for the presence of both nuclear and cytoplasmic type II EBS revealed the presence of these binding sites in the two compartments. Both cytoplasmic and nuclear receptors were similar to type II EBS described in other tissues relative to their binding specificity for estrogens and quercetin and their sensitivity to reducing agents. Quercetin, 10 microM., was effective in inhibiting in vitro bromodeoxyuridine (BrdUdR) incorporation by TCC cells. Rutin, which bound little if any to type II EBS, did not show any inhibitory effect on in vitro BrdUdR incorporation by tumor cells, suggesting a type II EBS mediated effect of flavonoids. Although the mechanism of the antiproliferative activity of quercetin remains to be fully clarified, the possible therapeutic potential of quercetin and related flavonoids should be considered.

Aged↗

Refluxes in orthotopic neobladders: can the ileocecal sphincter be considered an adequate antireflux mechanism?

OBJECTIVES: To evaluate the usefulness of the ileocecal sphincter in preventing ureteral refluxes in ileocecal orthotopic neobladder, thus avoiding the use of antireflux technique for ureteroileal anastomosis. METHODS: From 1980 to 1992, 95 patients underwent orthotopic bladder substitution. In 30 our detubularized ileal reservoir was used and in 65 first only an integral ileocecal segment was used and subsequently multiple transverse teniamyotomies on the cecal portion to increase the capacity and reduce the pressure. The upper urinary tract was indirectly protected in the ileal reservoir technique by leaving an integral 8 to 10 cm long afferent segment folded behind the reservoir and in the ileocecal technique by the ileocecal sphincter, thus keeping the anastomosis between ureters and ileum simple and direct. RESULTS: The mean follow-up of the 65 patients with ileocecourethrostomy is 37 +/- 33 months (range, 2 to 141 months); in 13.8% of the patients (9/65) monolateral refluxes appeared, but without any evident clinical consequences. The appearance of monolateral stenosis on the ureterointestinal anastomosis requiring treatment occurred in 4 patients (6%): 3 underwent an endoscopic treatment and 1 a surgical one. Modifications of renal function with respect to the preoperative status were not verified in any of the patients. CONCLUSIONS: The ileocecal sphincter is an effective antireflux mechanism for an orthotopic neobladder in which multiple transverse teniamyotomies (5 to 7) increase the capacity of the neobladder itself, reduce its internal pressure, and confer a nearly spherical configuration. Moreover, a correct anastomosis between the cecum and membranous urethra decisively reduces the resistance to emptying of the neobladder, thus avoiding too strong pressures against the ileocecal sphincter. The integrity of the circular muscular layer maintains a healthy tonic wall: this fact, combined with the low peripheral resistances, ensures good emptying and a stable capacity. The procedure is easy to perform and not time-consuming; these considerations lead us to consider the ileocecal unit an excellent structure for bladder substitution.

Anastomosis, Surgical↗

Results of 4 years of experience with bladder replacement using an ileocecal segment with multiple transverse teniamyotomies.

Since 1987, 30 patients with bladder cancer underwent cystoprostatectomy with bladder replacement via ileocecourethrostomy. Multiple transverse teniamyotomies were made in the cecum to assure a large capacity reservoir with low pressures. The particular anatomy and physiology of the cecum, short length of the intestinal segment needed and teniamyotomies are the 3 factors that have allowed for good functional and metabolic results. All patients achieved daytime continence. After 3 years of followup 67% of the patients were continent at night if they voided every 3 or 4 hours and 22% if they voided every 2 or 3 hours, while 11% experienced enuresis. Urodynamic data after 1 year showed a mean capacity of 396 ml. for the new bladder, a mean full filling pressure of 28 cm. water and a mean maximum pressure of 55 cm. water. Post-micturition residual urine volume was consistently less than 55 ml. These results indicate that the ileocecal segment can be enlarged with myotomies through the tenia to produce an adequate capacity and a low pressure bladder replacement without the need for formal detubularization.

Cecum↗

Urethrospongiosal fistulas: clinical and therapeutic considerations.

From 1986 to 1990, 8 cases of urethrospongiosal fistulas were observed. All the patients had a history of bleeding after a difficult catheterization. The symptoms were not pathognomonic but the fistulas were visible only by X-ray examination. The authors suggest that urethrospongiosal fistulas are more common than one expects, especially in cases of bleeding after complicated catheterization. This is more frequent when coexistent urethral strictures or prostatic hypertrophy make the maneuver difficult. The authors also suggest that the urinary extravasation in the corpus spongiosum could explain the pathophysiology of the urethral manipulation syndrome according to Kelamy.

Aged↗

[Oncocytic carcinoma in a horseshoe kidney].

The Authors report a rare case of oncocytoma in a horseshoe kidney. The diagnostic path needed to assess the precise anatomy of the malformation and tumoral staging is out lined. Oncological problems dealing with oncocytoma are further discussed, together with the technical and surgical issues pertinent to the clinical case.

Adenoma↗

A comparative enzyme histochemical study of glucose metabolism in the conduction system of mammalian hearts.

A histochemical study of some enzymes of glucose metabolism was performed on the heart conduction system of rat, dog, rabbit, pig, calf and lamb. Histochemical activities revealed a higher rate of anaerobic metabolism and a lower rate of aerobic metabolism in the conducting cells in comparison with the working myocardial fibres. An increase of the histochemical activities from the atrioventricular node to the distal portions of bundle branches was noted. The importance of the high glycogen content and the high phosphorylase activity in the heart conduction system was discussed.

Animals↗

Acute idiopathic scrotal oedema: rare disorder or difficult diagnosis?

This study reports our experience in 6 cases of acute idiopathic scrotal oedema. Although children were the primary targets, this pathologic condition was also encountered in adults. Specific diagnosis of acute idiopathic scrotal oedema, opposed to other causes of scrotal swelling, is based on history, an objective examination, velocimetric Doppler exam and echography. Correct diagnosis is important in order to avoid unnecessary surgery. We are inclined to consider acute idiopathic scrotal oedema as an allergic disorder and recommend a follow-up within two days.

Acute Disease↗

[Aneurysm of the left sinus of Valsalva with fistula in the right atrium. A case report].

A case of an aneurysm of the left sinus of Valsalva ruptured in the right atrium is reported. This anomaly was diagnosed in a 30 year old woman who had a continuous systo-diastolic murmur and no signs of cardiac failure. The diagnosis of aneurysm of the left sinus of Valsalva was been determined using 2-D echocardiography, Cardioangiography, in addition, enabled us to recognize the fistula which connected the left sinus of Valsalva with the right atrium. The rarity of this case is supported by two pieces of data: A) aneurysms of the left sinus of Valsalva are the rarest of the sinus of Valsalva aneurysms; B) generally the sinus of Valsalva aneurysms rupture into the adjacent cardiac cavities, while the anomalous fistolous conduits are quite uncommon. The case reported confirms that from an aneurysm of the sinus of Valsalva an atypical fistolous conduit may arise. This could be detected by cardioangiography. In addition echocardiography, is very important, at least as a preliminary examination, for the diagnosis of the sinus of Valsalva aneurysms.

Adult↗

[An echocardiographic study of patients with left bundle branch block].

24 patients (19 females and 5 males) between 45 and 81 years of age (average age 61.6) with chronic left bundle branch block and with no signs of reduced left ventricular function have been studied by M-Mode echocardiography. These patients have been split into three groups: A) pts. with normal indexes of left ventricular function and normal thickness of the left ventricular walls; B) pts. with normal indexes of left ventricular function and thickness of the interventricular septum at upper limits or increased; C) pts. with different cardiac pathologies but with no signs of reduced ventricular function. The contractility indexes and the motion of the interventricular septum in both the basal and the medial portion have been studied. The results did not show any important variation concerning the ventricular function compared to the normal values. The study of the septal motion pointed out, as a main feature of the left bundle branch block, a preejective posterior motion followed by: a) a normal posterior systolic motion of the interventricular septum, or b) a posterior systolic motion followed by a further posterior protodiastolic motion (delayed motion), or c) an anterior systolic and posterior diastolic motion (paradoxical motion). The alterations of the septal movement ranked in different degrees. The clearest alterations were peculiarly found in the patients of the first group. The patiens of the third group, besides, have shown the lightest alterations. The results allowed to deduce that patients with left bundle branch block can have both normal motion or alterations of the interventricular septum motion of different degree.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Bladder replacement by ileocaeco-urethrostomy or ileo-urethrostomy with a reservoir after cystoprostato-vesiculectomy for bladder cancer. A functional evaluation.

The purpose of this study was to evaluate the function of the intestinal segments used to replace the bladder after cystoprostato-vesiculectomy. The series included 30 patients, 10 of whom underwent clinical, radiological, urodynamic and electromanometric investigations. Seven patients had an ileocaeco-urethrostomy (ICUS) and 3 had an ileo-urethrostomy with a reservoir (IR). The results were good in all patients and there was no sign of tumour recurrence. All were completely continent during the day but during the night only those who observed the 2-h intervals between voiding were continent. The radiological findings for 1 patient showed grade I asymptomatic vesicoureteric reflux. In all cases, periodic pressure waves were observed during electrocystomanometric tests at basal levels, with the IR patients showing waves higher in frequency and lower in amplitude. Prostigmin induced a significant variation in motor activity in IR patients only. The urodynamic tracings showed an almost physiological flow in both groups. Cystomanometry revealed good compliance in both types of new bladders. The height and width of contraction waves during filling was greater in ICUS than in IR patients. Good perineal sphincteric activity was demonstrated by electromyography. Low passive resistance was indicated by the urethral pressure profile. Preliminary analysis of data indicated good functional micturition and renal function in both ICUS and IR patients. Slight differences were found between the two intestinal segments used for bladder replacement.

Aged↗

Bladder reconstruction after cystectomy: use of ileocecal segment and three-loop ileal reservoir.

We report on 11 patients who in 1980-1982 had bladder reconstruction, after cystectomy for bladder cancer, utilizing the ileocecal valve as an antireflux mechanism and a direct urethrocecal anastomosis. They received preoperative irradiation (2,000 rad) and had some early complications such as pelvic abscesses and temporary urinary fistulas. We have since omitted preoperative radiation on cases performed in 1984-1987 and they did not have these complications.

Follow-Up Studies↗

LH-RH analogue treatment for advanced prostate cancer.

The trial drug was ICI 118.630 (Zoladex). Inclusion criteria were histologically confirmed advanced prostate cancer (T greater than 2 or N+ or M+), life expectancy greater than 3 months, and no previous radiotherapy, orchiectomy, or chemotherapy. Treatment started in November 1984; 30 patients were recruited. The period of treatment ranged from 6 to 144 weeks (median of 59.5 weeks). One patient died after 6 weeks of rapidly progressive renal failure. Data were updated to the end of August 1987. The mean age was 67.9 years (53-83 years). Subjective response was evaluated by a mean symptoms score (using daytime micturition, nocturia, dysuria, hesitancy, and flow) and a score of three different items: patients' activity, bone pain, and use of analgesics. Only 7.1% of the patients showed a permanent positive response. Four different objective responses (complete, partial, stable disease, and progression) were possible after evaluating the T category, tumor dimensions, metastases, and prostatic acid phosphatase. Testosterone (T) and plasmatic LH levels rose after administration: T dropped below the castration level (1 ng/ml) within a few days and remained constantly low. The rate of progressive disease was 27.6%; disease control was possible in 72.4% of the patients (PR or SD).

Aged↗