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Biomedical subjects

M Piergiovanni

Publications and source records attributed to M Piergiovanni.

7 recordsLinked to original sources
PubMed1994

Ureteral and bladder lesions after ballistic, ultrasonic, electrohydraulic, or laser lithotripsy.

Four techniques of intracorporeal lithotripsy are now available: ballistic, ultrasonic, electrohydraulic, and laser. Their therapeutic efficacies have generally been evaluated and compared, but very few data have been available on their relative risks of iatrogenic trauma to the urothelial wall. We conducted a comparative analysis of this risk by testing the pig ureteral and bladder wall with the EMS Lithoclast, Olympus ultrasonic lithotripter, Walz Lithotron EL 23, and Versa Pulse Ho:YAG Coherent Laser. We measured the number of shockwaves or the energy required to perforate the ureter and bladder by delivering shocks perpendicular to the walls. Ureteral perforation was impossible with the 1.0-mm Lithoclast transducer and the 1.5-mm ultrasound transducer. Perforation was induced after 250 shocks with the 0.8-mm Lithoclast transducer, after 110 shocks with the 3F electrohydraulic electrode, and after 0.02 kJ with the laser. Bladder perforation was impossible with the 2.0-mm Lithoclast device and the 3.4-mm ultrasound transducer but was induced after 0.04 kJ had been delivered with the laser. We evaluated the iatrogenic risk under normal conditions of use by delivering the shocks tangentially to the ureteral wall and perpendicular to the bladder wall. We sacrificed animals on days 0, 1, and 6. The immediate histologic lesions induced by the Lithoclast and the ultrasound lithotripter were similar, consisting of a moderate reduction of the epithelial layers or intraepithelial detachments. Electrohydraulic shocks induced almost complete abrasion of the urothelium, and the laser induced extensive lesions of partial or complete necrosis of the urothelial wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Exploration and endoscopic treatment of unilateral primary haematuria: is non-specific diffuse pyelitis a real entity?

Chronic unilateral primary haematuria is rare and raises difficult problems of diagnosis and treatment as most of the knowledge in this field has been based on a very limited number of patients. This clinical entity needs critical reevaluation as recent progress in endourological investigations has revealed that lesions other than the classical submucosal haemangioma are just as frequently responsible for unilateral primary haematuria. These endoscopic lesions have generally been poorly defined up to now and our data based on a retrospective review of 8 patients emphasises the persistent gaps in our understanding of the pathophysiology of this disease. Among the lesions responsible for unilateral primary haematuria, diffuse petachiae of the renal pelvis and cavities represent the most frequent endoscopic lesion described in our experience (50% of cases). Histologically, these diffuse lesions correspond to non-specific pyelitis, consisting of simple oedema of the lamina propria. In addition to its diagnostic role, endoscopy can also be used to effectively treat the lesions responsible for unilateral primary haematuria, using either electrocoagulation or nitrate cautery, provided a retrograde approach can be completed by a percutaneous approach, with an overall success rate of 75% of cases with a mean follow-up of 16 months.

Electrocoagulation↗
PubMed1994

Endourological treatment of lumbar and iliac ureteral stones. A comparative study of 49 cases.

The efficacy of the Lithoclast has been described extensively in the recent literature. However, to our knowledge, few articles have dealt with the safety of this technique. We present a retrospective study of 49 patients with stones of the lumbar and iliac ureter treated between 1989 and 1992 either by means of the Lithoclast (17 patients), by electrohydraulic shock waves (16 patients), or by trapping the stones in a wire stone basket (16 patients). The success rates were 88% for the Lithoclast and wire stone baskets and 62% for electorhydraulic shock waves. The mean dimensions of the stones were 10 mm for the Lithoclast and electrohydraulic shock wave groups, and 7 mm for the wire stone basket group. Complications consisted of 7 ureteral lesions (2 cases with the Lithoclast, 4 cases with electrohydraulic shock waves and 1 case with the wire stone basket) and 1 stripping of the lower ureter following stone extraction with a wire stone basket, which required open reimplantation. This study demonstrates the efficacy and safety of the Lithoclast for the treatment of large stones of the lumbar and iliac ureter.

Adolescent↗
PubMed1993

The Swiss Lithoclast: a new device for endoscopic stone disintegration.

Even in the presence of extracorporeal shock wave lithotripsy there is still the need for endourological treatment of stones in the urinary tract. Stone fragmentation usually is achieved with either ultrasonic, electrohydraulic or laser lithotripsy. We report our early experience with a new, simply constructed machine at a reasonable cost for endoscopic stone disintegration--the Swiss Lithoclast. The principle of this lithotriptor is based on pneumatic shock waves induced by the central compressed air system of a hospital or by a compressor. This device was used to treat 151 patients with stones in the kidney, ureter, bladder or a Kock pouch continent urinary diversion. Endoscopic fragmentation was successful in all patients. Independent of the composition, all stones were disintegrated within a short period, indicating that the device may well represent an attractive alternative to standard endoscopic lithotriptors.

Adolescent↗
PubMed1991

[Urinary catheterization: transurethral or suprapubic approach?].

75 patients, needing a bladder drainage for nonurological indications and having sterile urines were studied after randomization into two groups. In the first group, drained with an urethral catheter, urinary infection took place in 12 (= 30%) patients, while it was detected in 4 (= 11%) drained with a suprapubic catheter. In this latter group, patients felt more comfortable, had less pain; the duration of urinary drainage and hospital stay was shorter.

Aged↗
PubMed1977

[Anthropometric state of nutrition in students of various elementary and secondary schools in Ancona].

An anthropometric assessment was made of the nutritional state of children from Ancona elementary and middle schools. It was found that the girls had more body fat than the boys, though the latter, too, displayed values above those reported in U.S. and Italian studies. The view is expressed that this excess fat requires counteraction through nutritional education. Diet and physical exercise are known to be important in the prevention of degenerative diseases of a metabolic nature. Such prevention must be undertaken as soon as possible.

Adipose Tissue↗