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Biomedical subjects

L Cormio

Publications and source records attributed to L Cormio.

34 records · Page 2Linked to original sources
PubMed1995

Successful establishment of pregnancy by superovulation and intrauterine insemination with sperm recovered by a modified Hotchkiss procedure from a patient with retrograde ejaculation.

OBJECTIVE: To improve the quality of the sperm recovered from the bladder in a patient with retrograde ejaculation who already had failed to conceive after several attempts at IUI with sperm recovered by conventional techniques. SETTING: University Hospital. PATIENTS: A couple with male infertility due to retrograde ejaculation caused by the Zielke operation, a spinal fixation procedure performed to correct severe kyphoscoliosis. INTERVENTION: Superovulation and IUI of sperm recovered from the bladder using a modified Hotchkiss procedure involving the introduction into the bladder of Earle's balanced salt solution (EBSS) buffered with Hepes in sufficient quantity to bring the urinary pH and osmolarity to those of fresh ejaculate. MAIN OUTCOME MEASURES: Urine pH and osmolarity at baseline and after dilution with EBSS buffered with HEPES. Concentration, motility, and progression score of the sperm recovered from the bladder. RESULTS: Good sperm samples were achieved. Pregnancy was established when IUI was performed in association with superovulation induction. CONCLUSIONS: Determination of urine pH and osmolarity appears to be a useful method for choosing the ideal sperm recovery procedure. The modified Hotchkiss procedure described seems to be a promising alternative method for recovering sperm for artificial insemination.

Adult↗
PubMed1995

Biocompatibility of various indwelling double-J stents.

The biocompatibility of 8 double-J stent brands was evaluated both in vivo, by scanning electron microscopy and histological analysis of pig ureters intubated for 6 weeks, and in vitro, by cell culture methods. In vivo findings showed that superficial epithelial destruction was milder in the ureters intubated with hydrogel-coated stents than in those intubated with other stents. Inflammatory reactive changes were milder in the ureters intubated with silicone stents than in those intubated with other stents, while encrustation was more severe on silicone and Grey stents than the others. In vitro, the 3 stent brands made of "modified polyurethane" were found to be cytotoxic while the others were not. Overall, silicone and hydrogel-coated stents seemed to be more biocompatible than the others, and hydrogel-coated stents to be more suitable than silicone stents for long-term ureteral stenting, being less prone to encrustation. Although they are of an experimental nature, these findings may be of relevance to clinical practice.

Animals↗
PubMed1995

Ureteric injuries. Clinical and experimental studies.

The aim of the present study was to draw up some guidelines for the management of ureteric injuries. Clinical studies were undertaken to identify prognostic factors and guide selection of the best treatment option for each patient with a ureteric injury, and to determine the feasibility and efficacy of endourological treatment in the management of these injuries. Experimental studies were designed to develop a new surgical bladder elongation technique for the repair of extensive ureteric injuries and to determine the safety of double-J ureteric stents currently used for endourological procedures. The influence of previous radiotherapy, time of treatment, and site, kind and length of the ureteric injury on treatment outcome was studied in 137 injuries. The length of the injury was found to be the most important prognosticator of treatment outcome, probably because extensive injuries required diversions involving a high failure rate. Previous radiotherapy and late treatment also had negative prognostic significance, probably due to their frequent association with injury length. The feasibility and efficacy of endourological treatment were studied in 30 injuries. Attempt to perform endoscopic ureteric stenting failed in 14 cases. In the 16 successful ones, restoration of normal urinary tract and good long-term results were accomplished in all cases. Endourological treatment appeared to be particularly indicated for short injuries diagnosed early after the trauma. A new bladder elongation technique involving a particular Z-shaped incision of the bladder was studied in sheep. This bladder Z-plasty provided an average of 5.8 cm greater bladder elongation than the bladder psoas-hitch, with no complications or changes in bladder capacity. The effects of various double-J stent materials on pressure conditions in the upper urinary tract, on the urothelium, on urine precipitation (encrustation), and on urinary infection were investigated in vivo, in pig ureters, and in vitro, by cell cultures and bacterial adhesion assays. Pure polyurethane stents were found to cause long-lasting changes of renal pelvic dynamics and, consequently, to have deleterious effects on renal function. Stents made of "modified polyurethane" were found to be cytotoxic in vitro. Silicone and Hydro-Plus stents appeared to be the safest overall, as they caused less superficial epithelial destruction and host reaction than the others. Silicone stents, however, were found to be more prone than Hydro-Plus stents to encrustation.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1994

The effects of various indwelling JJ stents on renal pelvic pressure and renal parenchymal thickness in the pig.

OBJECTIVE: To determine whether indwelling JJ stents significantly alter renal pelvic pressure and consequently have deleterious effects on renal function. MATERIALS AND METHODS: Thirteen piglets were used totalling 26 renal units. Using an open, sterile surgical procedure, 23 renal units were stented with 6 F JJ catheters of eight different types: three renal units were not stented and served as controls. Intra-pelvic pressure values during diuretic stress were measured before and after 6 weeks of intubation. The kidneys were then removed and sent for pathological evaluation of renal parenchymal thickness. RESULTS: A marked increase in intra-pelvic pressure values was found in two of the 19 stented renal units suitable for this measurement. A significant reduction (more than one third with respect to the control values) in renal parenchymal thickness was found in six of the 21 stented renal units suitable for this measurement, three of which had been intubated with a Cook polyurethane stent and three with an Angiomed Puroflex stent. CONCLUSION: In the present experimental study some JJ stents seemed to cause long-lasting changes in renal pelvic pressure and consequently to have deleterious effects on renal function. Although experimental findings are not always fully related to clinical practice, a knowledge of the potential effects of these prostheses is essential to minimize complications related to their use.

Animals↗
PubMed1994

Pain sensation in transurethral microwave thermotherapy for benign prostatic hyperplasia: the rationale for prophylactic sedation.

Transurethral microwave thermotherapy (TUMT) can be painful. Pain sensation limits treatment tolerance and consequently also treatment efficacy. Of our population of patients treated with TUMT, 22% (63/288) needed intravenous analgesia and, nevertheless, 6% (17/288) needed definitive treatment interruption. The aim of this study was to identify the mechanism of pain sensation during TUMT and to verify whether the prophylactic use of a sedative drug would improve treatment tolerance. Eighty-three patients undergoing TUMT treatment for benign prostatic hyperplasia at our department entered a prospective, randomized, single-blinded study. Thirty minutes before treatment, 40 patients (group A) received 960 mg cotrimoxazole orally while 43 patients (group B) received 960 mg cotrimoxazole and 10 mg oxazepam, both orally. Statistically significant improvement in treatment tolerance in group B in comparison with group A was found. Pain sensation during TUMT seemed to be mostly due to anxiety. It is concluded that the prophylactic use of a sedative drug is advisable in patients undergoing TUMT in order to improve treatment tolerance.

Analgesia↗
PubMed1994

Penile necrosis in a diabetic with renal disease and clean intermittent catheterization for recurrent urethral stricture. Case report.

In a patient with diabetic microangiopathy and renal disease, penile necrosis occurred in connection with clean intermittent catheterization. Microangiopathy of the urethral and penile arteries presumably lowered the local defences, so that the catheterization initiated penile necrotic changes by introducing bacteria and traumatizing the poorly vascularized urethral epithelium.

Diabetes Mellitus, Type 1↗
PubMed1994

Prognostic factors in the management of ureteric injuries.

The outcome of 137 ureteric injuries was analysed with respect to previous radiotherapy, site, type and length of the injury and time of treatment, to evaluate the prognostic significance of each of these factors. The length of the injury was the most important prognosticator of treatment outcome (P = < 0.0005). Previous radiotherapy and timing of treatment had prognostic significance (P = < 0.05) but the predictive value seemed to be linked to the frequent association with injury length. The site and the type of injury had no prognostic significance. The unfavourable prognostic significance of extensive injury length appeared to be related to the treatment procedures (urinary diversions) which in themselves carry a high failure rate. Knowledge of the impact of these factors on the outcome of ureteric injuries is valuable in choosing the best treatment option for each patient.

Female↗
PubMed1993

Toxicity and immediate allergenicity of latex gloves.

Surgical latex gloves and a natural rubber latex (NRL) catheter were evaluated for biocompatibility by cell culture methods and Type I allergic reactions in operating room personnel using latex gloves. The prevalence of relevant immediate allergy to NRL was 5.2% when using eluates made from different latex gloves as allergens and the skin-prick test methodology. The reliability of a questionnaire in detecting the sensitized persons was limited. Weak positive skin test reactions to surgical latex glove eluates were found to be unreliable as compared with challenging with the corresponding glove. Latex gloves exhibited more toxicity in cell culture than non latex gloves, but, inversely, the toxic catheter gave weak positive skin-prick test reaction in only one sensitized person, confirming that the allergenicity and toxicity of natural rubber products do not refer to the same properties of the products. Catheters exhibiting toxicity in cell culture have earlier been found to cause significant clinical symptoms in operated patients, but in the case of surgical gloves this relationship is not clear. One glove brand with a low content of known sensitizing rubber chemicals caused clear toxicity in cell culture but was well tolerated by the hospital personnel.

Allergens↗
PubMed1993

Endourological treatment of ureteric injuries.

Over the last 8 years, 30 patients with ureteric injuries underwent endoscopic treatment. There were 14 failures, 5 because of blockage or diversion of the catheter in the fistulous gap and 9 because it was impossible to penetrate the stenotic tract. All failures occurred when treatment was attempted more than 3 weeks after the trauma. Sixteen lesions were successfully treated by placing a 6 to 10 F double pigtail catheter in the damaged ureter and leaving it for at least 3 months. Patients were followed up for 24 months. No recurrences were seen and good long-term results were achieved in all cases. In our experience, endourological treatment can be recommended for recent strictures < 2 cm in length, or for small fistulas in which continuity of the ureteric wall is still partially preserved. Despite the risk of failure, especially following late treatment of an injury, it should be considered a safe and effective procedure that is accepted well by the patients and that avoids the need for open surgery and its possible complications.

Cutaneous Fistula↗
PubMed1993

Bladder Z-plasty for the repair of ureteric injuries. Experimental study in sheep.

There is general acceptance that the best substitute for a damaged distal ureter is an elongated bladder and that the bladder psoas hitch is the most reliable procedure. Nevertheless, it is not always sufficient to bridge a long ureteric gap. In order to obtain an equally safe but wider bladder elongation than the psoas hitch can provide, we have previously studied the effect of several Z-shaped incisions on isolated pig bladders. The aim of the present study was to verify, in vivo, the efficacy and safety of the new technique. Five sheep underwent the psoas hitch procedure and 6 the Z-plasty procedure. The results showed that Z-plasty provides an equally safe but longer bladder elongation than the psoas hitch procedure.

Animals↗
PubMed1993

Management of bilateral ureteric injuries after gynaecological and obstetric procedures.

The outcome of 24 patients affected by bilateral injuries of the ureter after gynaecological and obstetric procedures was analyzed. Five patients were not treated because they were asymptomatic, while 19 patients underwent different kinds of surgical procedures. Ureteric stenting was performed in 4 patients, reconstructive procedures in 9, internal diversions in 2 and external diversions in 4. Good results were achieved in 14 (74%) of the 19 treated patients. The success rate, however, was remarkably higher (85%) in the group of patients treated with ureteric stenting or reconstructive procedures than in those treated with diversions (50%). Ureteric stenting and bilateral reconstructive procedures, when feasible, constitute the simplest and safest way to repair short ureteric injuries. In the management of extensive injuries nephrostomy represents a safe and valid alternative to open surgical diversions which do not improve the quality of life and may even be life-threatening.

Female↗
PubMed1993

Pharmacotesting with high dose prostaglandin E1 in impotence.

The diagnostic value of pharmacotesting in impotence is controversial. The results of high dose prostaglandin pharmacotesting were compared with those of colour duplex Doppler scanning and pharmacocavernometry in 82 impotent patients and 10 control subjects. Based on the results of 10 control subjects, the prostaglandin test was defined as positive if intracavernous pressure 200 minutes after injection of 40 micrograms prostaglandin E1 was > or = 42 mm Hg and negative if intracavernous pressure was < 42 mmHg. The test was repeated in 29 subjects and classified results were consistent in 24 subjects (86%, k = 0.65). The test was negative in 52 out of 56 patients (sensitivity 93%) with vasculogenic impotence (arteriogenic and/or cavernovenous factor involved) and the test was positive in 21 out of 26 patients (specificity 81%) with non-vasculogenic impotence (arteriogenic or cavernovenous factor not involved). The majority, 27 out of 31 patients (87%) with arteriogenic impotence showed simultaneous dysfunction of cavernovenous occlusion mechanism. In conclusion, pharmacotesting with high dose prostaglandin is a useful screening test of vasculogenic impotence.

Alprostadil↗
PubMed1992

Oral prophylaxis with fosfomycin trometamol in transurethral prostatectomy and urological maneuvers: literature review and personal experience.

In the literature there are three comparative and two open studies in which 1,395 patients received 3 g of fosfomycin trometamol per os 12 or three hours before and 24 hours after surgery: 625 patients received control substances or placebo. In the comparative studies the incidence of postoperative bacteriuria in patients treated with fosfomycin trometamol ranged from 2.9 to 7.6% at one week and from 1.2 to 3.2% at two to four weeks follow-up, and was lower than in patients treated with reference drugs or placebo. In the open study, postoperative bacteriuria ranged from 2.9 to 6.0% at one week follow-up. In our open study, 70 patients were evaluable. Four out of 70 (5.7%) developed fever > or = 38 degrees C, with positive urine culture, during the first three postoperative days. At two weeks follow-up another 5.7% showed a symptomatic urinary tract infection with a cumulative infection rate of 11.4%. In all cases, the bacteria were resistant to fosfomycin trometamol. A low incidence, 4.2%, of side effects, mainly related to the gastrointestinal tract, was observed. Fosfomycin trometamol proved to be effective with the advantage of no risk of cross resistance, practical pharmaceutical formulation with good patient compliance, good safety profile with few side effects and a satisfactory cost/benefit ratio.

Aged↗
PubMedDate not supplied

Vasoactive intestinal polypeptide (VIP) is not an androgen-dependent neuromediator of penile erection.

The effects of castration on vasoactive intestinal polypeptide (VIP) immunostaining in human corpus cavernosum (CC) and the relationship between VIP immunostaining and erectile function were studied in patients with localised prostate cancer who had (Group 1 = castrated) or had not (Group 2 = control) undergone 3-month neoadjuvant chemical castration before radical prostatectomy. Evaluation of erectile function included medical and sexual history, physical examination, and measurement of total serum testosterone. CC biopsies were taken at the end of radical prostatectomy and samples immunostained with anti-human VIP antibody. Specific staining was quantified by image analysis and expressed in arbitrary units (AU). Chemical castration induced erectile function deterioration in 70% of patients due to loss of sexual interest and confidence in the ability of having an erection rather than reduced ability of obtaining sexually induced erections. Average VIP content was 34.5 AU in Group 1 and 39 AU in Group 2 and this difference was not statistically significant. Chemical castration does not influence VIP immunostaining of human CC, suggesting that VIP is not an androgen-dependent neuromediator of penile erection and that it can be responsible for sexually induced erections in castrated patients.

Aged↗
PubMedDate not supplied

Combined adrenal adenoma and myelolipoma in a patient with Conn syndrome. Case report.

Adrenal myelolipoma is an uncommon benign tumor usually discovered by chance in patients with hypertension, obesity, arteriosclerosis or cancer. The association with adrenocortical endocrine dysfunctions is rare. We report herein an unusual case, the second in the literature to the best of our knowledge, of combined adrenal adenoma and myelolipoma in a patient with Conn syndrome.

Adenoma↗