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Biomedical subjects

C Servadio

Publications and source records attributed to C Servadio.

At least 55 records · Page 3Linked to original sources
PubMed1991

Local hyperthermia for prostate cancer.

Hyperthermia for treatment of cancer is known to be beneficial both in itself and in conjunction with other forms of treatment, particularly radiotherapy. We have developed a new machine for local hyperthermia (41-44 degrees C) to the prostate, by transmission of microwaves (915 MHz) via a rectal probe. Patients were treated on an outpatient basis and did not require any anesthesia or sedation. There were no complications. Good results, measured by local control, disappearance of malignancy, relief of obstructive symptoms and pain, have been obtained in a series of 44 cases. More studies with this promising new modality are in progress.

Aged↗
PubMed1991

The effect of intravesical bacillus Calmette-Guerin therapy on the upper urinary tract.

A total of 66 patients with low grade, low stage transitional cell carcinoma of the bladder who were treated with intravesical bacillus Calmette-Guerin (BCG) underwent cystourethrography to detect vesicoureteral reflux. BCG was instilled weekly for 6 weeks and monthly thereafter for up to 24 months. Whenever vesicoureteral reflux was found or morphological abnormalities were detected on excretory urography (IVP) an isotope renal scan was performed to evaluate the relative renal function. Vesicoureteral reflux was found in 13 patients (19.7%): 10 had grades 1 and 2A, and 3 had grade 2B reflux. The number of BCG instillations ranged from 8 to 22. IVPs were normal in 11 patients. In 2 patients mild unilateral dilatation was present before BCG instillations, and this remained unchanged during and after therapy. None of the 13 patients with vesicoureteral reflux had IVP features suggestive of urinary tuberculosis. In 11 patients the refluxing renal systems had normal relative renal function (50 to 55%). Two patients had a decrease to 40% of the relative renal function with normal IVPs, suggesting a nonBCG related cause. We conclude that BCG therapy is safe in patients with minimal reflux.

Aged↗
PubMed1991

Severe sepsis following extracorporeal shock wave lithotripsy.

A patient with life-threatening sepsis following extracorporeal shock wave lithotripsy (ESWL*) is described. The urosepsis was complicated by meningitis and diffuse metastatic endophthalmitis necessitating enucleation of the right eye. Retinal detachment occurred in the left eye following focal endophthalmitis and the operation yielded a poor functional result. The patient was discharged from the hospital 3 months after the ESWL therapy, free of urinary stones. The etiology, treatment and prophylaxis of this serious problem are discussed.

Aged↗
PubMed1991

Chronic abacterial prostatitis and hyperthermia. A possible new treatment?

A group of 45 patients with chronic abacterial prostatitis or prostatodynia underwent 6 weekly, 1-hour sessions of local deep microwave hyperthermia (42.5 +/- 0.5 degrees C) to the prostate. All patients had a long history of symptoms typical of the condition. They all failed to respond to a variety of conventional treatments administered over several years by various specialists. Each patient served as his own control before and after the hyperthermic treatment. The results of this study are encouraging: 25% showed a sustained and complete loss of symptoms and 50% had a partial response; the remaining 25% reported no improvement. These results open up new possibilities in the treatment of this condition, which has so far responded poorly to conventional therapy.

Adult↗
PubMed1991

Immunocytochemistry of epithelial markers in citral-induced prostate hyperplasia in rats.

Immunocytochemical characterization of several epithelial markers using the PAP technique was analyzed during different stages of induced prostatic hyperplasia in rats. Intact adolescent rats (42 days old) were treated with citral (3,7 dimethyl-2,6 octadienal) for 10, 30 and 100 days and their ventral prostate compared to untreated, matched-age animals. Among the epithelial markers studied the prostatic specific acid phosphatase was present in hyperplastic prostates of rats. The immunoreaction showed a fair correlation with the severity of lesion and duration of treatment. The prostatic specific antigen showed equally immunoreactive in both control and treated rats. The hyperplastic and normal rat prostates did not show immunoreactivity towards the other epithelial cell markers such as epithelial membrane antigen, carcinoembrionic antingen and alpha-fetoprotein antisera. It is concluded that prostatic specific acid phosphatase, and to a lesser extent prostatic specific antigen, might represent valuable markers for comparative studies of prostatic hyperplasia in rodents.

Acyclic Monoterpenes↗
PubMed1990

[Laser treatment for transitional cell cancer of the bladder].

The neodymium (ND):YAG laser has become popular among urologists during the past 10 years. Laser irradiation can be used for the treatment of superficial transitional cell carcinoma of the bladder. The ND:YAG laser rays have 3 properties that make them particularly suited to urology: a 4-6 mm depth of penetration, transmissibility via quartz fibers, and non-absorbability by water. 7 men and 4 women, aged 55-77 years (mean 73), underwent ND:YAG laser irradiation of recurrent low-stage tumors as outpatients, under local anesthesia. Catheters were not left in and the patients were discharged about 30 minutes after treatment. In a short follow-up of 2-6 months there were no recurrences; cystoscopic follow-up continues.

Aged↗
PubMed1990

Local hyperthermia to canine prostate. A pilot study.

Repeated treatments of localized deep microwave hyperthermia were given to a series of dogs by means of a 915 MHz, water-cooled skirt-type applicator. The applicator was inserted into the rectum and directed toward the prostate in order to heat it by means of the absorbed microwaves while keeping the rectal wall at a lower temperature by surface cooling of the applicator itself. Sessions were given for different lengths of time ranging between ninety minutes and five hours, during which the prostate temperature was kept at 42.5 degrees C (+/- 0.5 degrees C) or 44.5 degrees C (+/- 0.5 degrees C). Three-dimensional temperature distributions in the prostate were measured accurately and verified by a Luxtron Fluoroptic Unit. Temperatures were constantly monitored in the rectal wall and in the prostatic urethra. Thorough and systemic follow-up was done before, during, and after each treatment, and the observations are reported. Two interesting preliminary observations were made: (1) differential blood counts showed significantly monocytosis following the treatments and lasted for at least one week, and (2) values of creatinine phosphokinase (CPK) and serum glutamic oxaloacetic transaminase (SGOT) were found to rise irreversibly in those animals which were later found to have definite histopathologic evidence of localized necrotic damage.

Animals↗
PubMed1990

Clinical and pathological findings in prostates following intravesical bacillus Calmette-Guerin instillations.

The prostates of 36 patients who were treated with intravesical bacillus Calmette-Guerin were evaluated by digital rectal examination and transrectal ultrasonography. When abnormal palpatory and/or ultrasonographic findings were detected, core needle biopsies from the suspicious areas were performed. Of the 36 patients 20 underwent biopsies of the prostate. Pathological findings revealed typical granulomas in 8 patients (3 caseating and 5 noncaseating multifocal granulomas). Nonspecific chronic prostatitis was noted in 4 patients and benign prostatic hyperplasia was noted in 8. The number of bacillus Calmette-Guerin instillations ranged from 6 to 19. The interval from initiation of therapy to biopsy ranged from 1.5 to 14.5 months. Caseating granulomas were found during the early course of bacillus Calmette-Guerin instillations (1.5 to 3.0 months), whereas noncaseating granulomas were detected at later stages (4 to 14.5 months). These findings present a high incidence of granuloma formation in patients treated with intravesical bacillus Calmette-Guerin. The duration of therapy is a determinant factor in the induction of granuloma type.

Administration, Intravesical↗
PubMed1990

Local hyperthermia of the prostate gland for the treatment of benign prostatic hypertrophy and urinary retention.

Local hyperthermia of the prostate was used to treat 72 patients who had an indwelling catheter because of urinary retention caused by benign prostatic hypertrophy. One month after completion of treatment 50% of patients were able to dispense with the catheter and 1 year later 40% remained catheter-free. The best results were achieved in patients who underwent 6 to 10 treatment sessions in conjunction with cyproterone acetate 50 mg tid administered during the treatment period only.

Aged↗
PubMed1990

Comparison between short-course high-dose preoperative irradiation with immediate radical cystectomy and salvage cystectomy after full-dose irradiation.

Between 1976 and 1983, 70 patients who underwent cystectomy for transitional cell carcinoma (TCC) of the bladder were retrospectively divided into two groups: 39 patients were treated by a protocol using 2,000 rad of radiation over a period of 5 days followed by immediate cystectomy (group 1); 31 patients who failed to be cured by definitive radiotherapy of 6,000 rad were treated by salvage cystectomy (group 2). The 5-year disease-specific survival rate was not significantly different in the two groups of patients (64.5 and 65.5%). The postoperative early complication rates were similar as well (36.8% in group 1 and 35.5% in group 2). One patient of the group treated with 2,000 rad died 19 days after surgery, giving an operative mortality of 1.4%. We conclude that there is a continuing role for salvage cystectomy after irradiation failure. One-stage salvage cystectomy has a relatively low morbidity and should be performed early after failure of definitive irradiation.

Aged↗
PubMed1990

Re-orchiopexy: advantages and disadvantages.

Re-orchiopexy was performed in 33 boys (42 testes) in order to place an undescended testis in the scrotum after failure of the initial operation. Success was achieved in 80.9%. Seven of the 10 testes, reported to have short spermatic vessels at the first surgery, had no elongation of the vessels and only 1 of these resulted in a high scrotal location of the testis. It appears that most orchiopexy failures are the result of technical failures of the initial procedure. Standard orchiopexy with extensive mobilization of the spermatic vessels and testis can successfully correct most of the undescended testes. However, the preferred management for the intra-abdominal testis with short vessels may be transection of the spermatic vessels rather than a planned two-stage technique.

Adolescent↗
PubMed1990

Local thermotherapy of the benign prostate: a 1-year follow-up.

Local hyperthermia to the prostate has initially been found to be of considerable beneficial value in cancer of the gland and later also in benign prostatic hypertrophy (BPH) and in chronic prostatitis. The Prostathermer has been especially developed and used for this purpose. 124 patients with BPH, who have been treated by this method, were reevaluated after 1 year. This thermotherapy was well tolerated, and no noticeable complications were encountered. A sustained definite improvement in objective and subjective obstructive symptoms and signs was seen in 51% of the cases. Such definite and persistent improvement was best obtained when treatments were performed twice weekly for 60 min over a period of 3 weeks. Those patients with the more severe obstructive symptoms fared best. A full explanation for the effectiveness of this treatment of BPH has yet to be found. Although local hyperthermia cannot, at this stage, be considered as a radical form of treatment of BPH, it may offer definite relief to about 50% of the cases, particularly to those unwilling or unsuitable for surgery.

Androgen Antagonists↗
PubMed1990

Extracorporeal shock wave lithotripsy: our experimental and clinical experience with the Direx machine.

The Direx Tripter X-1 is a modular extracorporeal shock wave system that uses underwater spark gaps as its source for lithotripsy. Experience with 712 treatments in 541 patients has given a fragmentation rate of 99%. Of these patients, 27% had stones larger than 2 cm or multiple stones. A stone free situation at 3 months follow-up was achieved in 75% of the cases. Seventeen percent had small fragments less than 4 mm and 8% had fragments greater than 4 mm. Auxiliary procedures following ESWL were required in 7%. No major complications were seen. The advantages of this system are: modularity, mobility, flexibility, and low cost.

Adolescent↗
PubMed1990

Klebsiella metastatic endophthalmitis--a complication of shock wave lithotripsy.

A 70-year-old man suffering from nephrolithiasis developed acute pyelonephritis following extracorporeal shock wave lithotripsy of renal stones. After 10 days, urosepsis complicated by meningitis was diagnosed, and 72 hours later he developed right panophthalmitis with perforation of the globe, which was treated by enucleation. A week later, while on cefotaxime and cefuroxime, a focal infectious process developed in the retina of the left eye's posterior pole, spreading into the vitreous and causing retinal detachment. The patient was treated by vitrectomy and retinal detachment surgery, with good anatomical results. The functional result, however, was poor. Endophthalmitis is a possible complication, through rare, of urosepsis in patients undergoing shock wave lithotripsy.

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