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Biomedical subjects

G Virgili

Publications and source records attributed to G Virgili.

At least 19 recordsLinked to original sources
PubMed1997

Retinal neovascularization in a case of macular branch retinal vein occlusion.

BACKGROUND: Retinal neovascularization (RNV) has never been described in cases of macular branch retinal vein occlusion (MBRVO), due to the limited amount of ischemia in this form of retinal vein occlusion. Ischemic areas as wide as 5-10 disc diameters were required by previous studies to count as ischemic cases of central or major branch retinal vein occlusion. CASE REPORT: A 56-year-old woman who had been suffering from MBRVO for 3 years presented at the posterior pole a zone of non-perfusion, extending over 7.5 disc areas, and three small tufts of RNV. RNV regressed after two subsequent laser treatments of the ischemia. Retrohyaloid hemorrhage was observed 2 months after the first treatment. CONCLUSION: Since the average diameter of the non-perfused area was about 2.75 disc diameters, this case demonstrates that small RNVs can appear in less extensive areas of ischemia than is generally believed.

Female↗
PubMed1997

Benign schwannoma surrounding and obstructing the ureteropelvic junction. First case report.

With a varied presentation and a difficult preoperative diagnosis, schwannoma accounts for only a small percentage of retroperitoneal tumors. Moreover, malignant schwannoma of the adrenal gland, kidney and renal pelvis has previously been described. We report the first case of benign schwannoma causing obstruction by external compression of the ureteropelvic junction. A case report of a male patient who complained of a 3-month history of dull lumbar pain on the right side is reported. Using intravenous pyelogram, sonography and computed tomography a benign tumor of the retroperitoneum was suspected. Upon exploration, the suspected diagnosis of the tumor's retroperitoneal origin was confirmed. After the histological and immunohistochemical studies the diagnosis was verified. The diagnosis, treatment and histological features of benign schwannoma are discussed. A brief review of the literature is also included.

Humans↗
PubMed1996

Endoscopic ballistic lithotripsy in the treatment of bladder calculi in patients with neurogenic voiding dysfunction.

Bladder stones represent a troublesome complication in patients suffering from neurogenic voiding dysfunction, in whom prompt and effective therapy is required. A variety of endoscopic lithotripsy methods are available; however, current devices can be tedious to use. We have treated 17 patients affected by bladder calculi and spinal cord injury or multiple sclerosis by means of the ballistic lithotripter EMS Swiss Lithoclast. The mean diameter of the stones was 2.7 cm. The mean operative time was 27 minutes. There were five intraoperative complications, including crises of autonomic dysreflexia (three patients) and light hematuria (two patients). There was no malfunction of the lithotripter and no long-term complications. All the patients were stone free at 6 months postoperatively. In conclusion, endoscopic lithotripsy with the ballistic lithotripter proved to be a very effective, rapid, and safe method for treating bladder calculi in patients with neurogenic bladders.

Adult↗
PubMed1996

Indocyanine green angiography in vitelliform macular lesions.

Many vitelliform macular diseases have been described through the years. Some arguments still exist about the appropriate terminology, the classification criteria and the etiopathogenesis. The alterations of the retinal pigment epithelium, the lipofuscin storage and the role of the choriocapillaris are being investigated. The aim of our study was to describe indocyanine angiographic features in Best's disease and pattern distrophies. Twenty-one eyes of 14 patients underwent indocyanine and fluorescein angiography. The indocyanine angiogram showed hypofluorescent and hyperfluorescent areas. The possible etiopathogenesis of the lesions includes a role of the retinal pigment epithelium.

Coloring Agents↗
PubMed1996

[Milk of calcium renal stone: echographic diagnosis].

"Milk of calcium renal stone" (liquid renal calculosis) is a quite uncommon lithiasis distinguished by the presence of a semiliquid suspension of calcium salts or a "seed-like" sediment in a caliceal diverticulum or an ectasia segment of the collecting system. We reviewed 5 patients (1 male and 4 females, mean age 48.6 years), with a history of urinary tract infection, renal pain or haematuria. All patients underwent renal ultrasonographic assessment in both clinostatic and orthostatic position. Three patients underwent intravenous pyelography before ultrasound. Ultrasonography showed a sonolucent "levelled" image with a posterior acoustic shadow inside a hydro-caliceal dilation (2 pts.) or caliceal diverticulum (3 pts.); the persistence of the "level" in both clinostatic and orthostatic position allowed an immediate diagnosis in all patients. Intravenous pyelography performed before renal ultrasound showed no abnormality in 1 patient and was misleading in two; it otherwise confirmed the diagnosis when performed after renal ultrasonography. Three patients underwent surgery, two patients refused therapy; sonographic follow-up showed no evolution of the morphologic picture. Once considered as exceptional, liquid renal calculosis still remains rare pathology and accounts for 0.6% of all the urinary lithiasis diagnosed by ultrasound in our series. An accurate sonographic assessment allows a reliable diagnosis of this particular lithiasis and an easy discrimination from solid lithiasis, nephrocalcinosis, medullary sponge kidney and hydropyonephrosis. Hence, a correct diagnosis of this rare condition lets uneffective and improper treatments be avoided.

Adult↗
PubMed1996

[Color Doppler echography in the diagnosis of nonspecific granulomatous prostatis: personal experience].

Non-specific granulomatous prostatitis (NSGP) is a rare but important pathology of the prostate because it often is confused with prostatic cancer. In fact, NSGP, presents at digital rectal examination as an area of increased consistency and painful, and at endorectal ultrasonography as an hypoechoic area with inhomogeneous echo structure. The frequent elevation of Prostatic-Specific Antigen (PSA) serum level vanish, moreover, its role of a differential factor. Since 1994 we used Echo-color doppler (ECD) in the evaluation of prostate cancer with satisfying results. The aim of our work is to value the route of ECD in the diagnosis of NSGP, and in the differential diagnosis with prostate cancer, actually only bioptic . Since January 1994 we observed 9 cases of NSGP; 7 patients with prostatic symptomatology and 2 with PSA serum level between 4 and 10 ng/ml. In all patients we performed endorectal US who showed, in 7 cases, nodular hypoechoic areas in the peripheral or central zone of the prostate, and in 2 cases the presence of evident BPH. In 5/7 cases with hypoechoic areas, ECD-US showed an increase of color intensity intra-perinodular. In 2 patients with BPH no marked color enhancement was observed. The diagnosis of NSGP has been done after needle biopsy in the 7 patients with suspect nodular areas, and in the 2 patients with BPH, after histological examination secondary to open prostatectomy. Our experience shows that ECD-US scanning picture in NSGP is superimposable with the prostatic cancer one. In fact the anatomical presupposition on the grounds of the "positivity" in ECD-US, focal hypervascularization, is present in ECD scanning pictures of both pathologies. In conclusion, ECD doesn't give an advantage in the differential diagnosis between NSGP and prostate cancer that actually remains only bioptic .

Aged↗
PubMed1996

[Correlation between bladder echography and urodynamic examination in patients with multiple sclerosis].

Ultrasonography take a predominant place in the evaluation of urologic complications in SM patients. SM can cause urinary disorders according to entity and level of the primary lesion with important repercussion on the upper urinary tract. Aim of this work is to value the sensibility of ultrasonography in the identification of bladder wall abnormalities indicative of involvement of upper urinary tract, correlated with urodynamic evaluation. Since 1993 we performed 116 urological ultra sound in patients with Multiple Sclerosis. We considered pathologic bladders with wall abnormalities or with stones, considering those abnormalities as secondary to altered emptying of the bladder. 65 patients showed wall abnormalities while 51 patients had any alteration evaluated with ultrasonography. In the first group the amplitude of uninhibited detrusor contractions was 74 cmH2O, while in the second group it was 61 cm H2O: the difference was statistically significant. Furthermore the incidence of upper tract alterations was significantly higher in the first group (p = 0.005), even in absence of signs of renal failure. Thus, ultrasonography demonstrated a high sensibility in detecting bladder conditions possibly conducive to upper urinary tract deterioration.

Adult↗
PubMed1995

Continuous wave Nd:YAG laser photocoagulation in proliferative diabetic retinopathy.

AIMS: The therapeutic efficacy of the continuous wave (CW) Nd:YAG laser (working in the free running mode) was investigated in proliferative diabetic retinopathy (PDR) comparing it with a conventional laser source such as the krypton laser. METHODS: Twenty four eyes of 12 patients affected with bilateral PDR were included and divided in two groups. The right eyes were treated with a red krypton laser and the left eyes with a CW Nd:YAG laser. RESULTS: Three months after krypton photocoagulation 10 eyes showed a reduction or a complete regression of PDR and two eyes were unchanged. In the CW Nd:YAG laser group no eyes showed any regression of new vessels, in seven eyes the angiographic features were unchanged, and in five eyes they worsened. All the eyes of the second group underwent retreatment with the krypton laser after 3 or 6 months. After a mean follow up of 13 months all eyes in the krypton group showed a reduction or complete regression of PDR; in the retreated group 10 eyes improved and two were unchanged. CONCLUSIONS: The statistical analysis showed a highly significant difference (p = 0.001) between krypton and CW Nd:YAG laser which indicated the lack of efficacy of the latter in the treatment of PDR. In the krypton laser group no significant difference (p = 0.05) after the retreatment was found confirming the efficacy of this treatment.

Adult↗
PubMed1994

[Urethral diverticuli in patients with spinal cord injury: echographic study].

Urethral diverticula, a not infrequent complication in patients with spinal cord injuries, usually involve the bulbous urethra which is particularly exposed to the trauma of catheterism. Indeed, the frequent association of urethral trauma and infection is often the cause of diverticula in these patients. Diagnosis is made by ascending urethrogram, voiding cystourethrogram and urethroscopy. Eight patients between 20 and 45 years of age with spinal cord injuries who had used an indwelling catheter for periods ranging from 1 to 18 months and who presented urethral diverticula at conventional investigation, underwent transperineal and penile contact ultrasonography using 3.5 and 7.5 MhZ real-time scanners. Ultrasonography was performed during intraurethral injection of saline solution through a catheter positioned near the external urethral meatus. Before the scan all patients had undergone a neuro-urological physical examination, urine analysis and culture, renal and bladder ultrasonography, ascending urethrogram and voiding cystourethrogram, urethroscopy and urodynamic investigation. Ultrasonography identified all urethral diverticula, defined them morphologically, visualized the diverticula filling and emptying phases and evaluated urethral wall and periurethral tissue characteristics, without exposing patients to any dangerous gonadal irradiation. Ultrasonography cannot replace radiological investigation but is a valid alternative in cases of contrast medium allergy, when monitoring inoperable diverticula and in postoperative follow-ups.

Adult↗
PubMed1994

[Echography in prostatitis].

In many infertile patients abnormalities in sperm are due to prostatic inflammatory disease. In the male reproductive system temporary episodes of inflammation, caused by newly discovered micro-organisms such as Chlamydia Trachomatis and Ureaplasma Urealyticum, may occur frequently and cause sub-clinical inflammation. This rapidly became chronic and induce the development of anti-spermatozoon antibodies. This latent clinical pattern and lack of symptoms often means diagnosis is late and medical treatment inadequate. In recent years attention has been focused on transrectal ultrasonography as a possible gold standard for diagnosing prostatic inflammatory disease. Widespread use of technologically advanced instruments has significantly improved the quality and definition of prostatic images. This paper discusses the current role of transrectal ultrasonography in the diagnosis of prostatic inflammatory disease. Abnormalities in the ultrasound pattern, caused by infection, are analyzed in detail and discussed critically in order to assess their role as markers of prostatic inflammation.

Humans↗
PubMed1993

Intralesional alpha interferon therapy in papillary superficial transitional cell carcinoma of the bladder. A pilot study.

The tolerability, toxicity and therapeutic efficacy of recombinant interferon alpha-2a (rIFN alpha-2a), administered by intralesional injection, were evaluated in 15 patients with papillary superficial transitional cell carcinoma of the bladder, rIFN alpha-2a was delivered endoscopically in a single weekly dose of 3 x 10(6) IU for 4 weeks (total 12 x 10(6) IU). Transurethral resection of residual tumours was then performed. The response to treatment was assessed according to ultrasonographic, endoscopic and pathological findings. One patient achieved complete remission, 6 partial remission, 6 minor remission and 2 stabilisation of disease. All patients completed the course of treatment. A mild, transient, flu-like syndrome was documented after every injection. Immunological findings suggest that the antitumour effects of rIFN alpha 2a are not mediated through the immune system.

Aged↗
PubMed1993

[Cystic renal pathology].

Ultrasonography has a great interest in diagnosis of cystic kidney disorders for typical eco-pattern of this pathology. In this work we show the eco-pattern of the most common cystic kidney disorders. Particularly we examine simple cysts (typical, atypical, complicated), multicystic kidney dysplasia, autosomal recessive polycystic kidney disease (infantile) autosomal dominant polycystic kidney disease (adult age). The so-called neoplastic cysts (multiloculated cysts, multiloculated cysts nephroma, cystic nephroblastoma), medullar cysts (medullary sponge kidney, medullary cystic disease), parapyelic cysts, acquired cystic kidney disease in renal failure patients, parasitic cysts, epidermoid cysts. About this disorders we present the more typical and expressive ultrasonographic appearance and we define the role and the opportunity of diagnostic setting by echography, moreover ultrasonography allows us to make a differential diagnosis between cystic kidney disorders and other kidney disease.

Cysts↗
PubMed1993

[Echography during drug-induced erections in the study of penile plastic induration].

Clinical investigation is still fundamental in the diagnosis of La Peyronie's disease. In this study 36 patients underwent clinical investigation and ultrasound in basal conditions and during drug-induced erection, and the results were compared. In basal condition US does not provide much useful supplementary informations. During drug-induced erection US accurately visualizes plaque site and dimensions and anatomical abnormalities about corpora cavernosa, albuginea, septum and dorsal vessels.

Adult↗
PubMed1992

[Ultrasonography in the follow-up of patients after extracorporeal shockwave lithotripsy].

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized treatment of urinary stones, but created new clinical situations and problems in the interpretation of which x-rays and ultrasonography have proved invaluable. This paper defined the role of ultrasound in the follow-up of patients who had undergone ESWL and assessed its advantages and limitations in evaluating the efficacy of this form of therapy and in monitoring the elimination of stone fragments. The utility of ultrasound in the diagnosis and monitoring of the complications due to ESWL has been emphasized. Finally ultrasound is a valid tool when performing those echo-guided procedures which are essential for the treatment of obstructive complications secondary to ESWL.

Follow-Up Studies↗
PubMed1992

[Role of ultrasonography in the follow-up of surgically treated patients. Upper urinary tract. Complications after conservative surgery].

The Authors describe the purposes of ultrasonographic follow-up after both conservative surgery and endoscopic or endourological operations of the upper urinary tract. In these cases ultrasonography evaluates the results of normal surgery, the presence of early or late complications, and of iatrogenic lesions. The echo-patterns of deformations in the outline of the kidneys, of hematic, urinary or lymphatic collections (both retroperitoneal and intraperitoneal), of fistulas, of sclero-lipomatosis and of post-cicatrization hydronephrosis are described. The importance of evaluating the degree of obstruction by a dynamic ultrasonographic study with furosemide-test is emphasized. The ultrasonographic monitoring of urethral and pyelostomy setting of catheters is also described. The echo-patterns of retroperitoneal and intraperitoneal fluid collections and renal hematomas, in relation also the kind of fluid contained are widely discussed.

Endoscopy↗