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Biomedical subjects

E Belgrano

Publications and source records attributed to E Belgrano.

At least 37 records · Page 2Linked to original sources
PubMed2000

A renal metastasis from primary peripheral chondrosarcoma presenting as spontaneous retroperitoneal hematoma.

The authors describe a case of renal metastasis from chondrosarcoma originating from the rib, with acute clinical onset characterised by serious anaemia secondary to retroperitoneal perineal haemorrhage. No similar cases have been reported in the literature. The interest of this case lies in both the symptoms of onset and in the metastatic site. From a diagnostic point of view an intraoperative ultrasound scan was useful, revealing the presence of a roundish neoformation, irregularly hypogenic, with a different appearance from anything observed by the authors in the other intraoperative ultrasound examinations of renal masses.

Aged↗
PubMed2000

[Transrectal ultrasound-guided biopsy of the prostate].

The early detection of prostatic neoplasm is nowadays a primary need in the urological field. The availability of transrectal ultrasound equipment alongside with bioptic tools made possible that transrectal ultrasound-guided biopsy of the prostate became the standard procedure to achieve this goal. With this work we would like to confirm the efficacy of this method which is also associated with a good tolerance and low complications rate. 82 patients that came to our Department between 1997 and 1999 were submitted to this procedure, 25 resulted positive for prostatic adenocarcinoma. Only 2 of them did not tolerate the procedure while all the others referred only mild discomfort at the moment of the puncture; 9 patients afterwards had to be admitted to the hospital due to fever (1 patient), acute retention of urine (3 patients) and persistent macroscopic hematuria (5 patients). Transrectal ultrasound-guided biopsy of the prostate reveals to be a safe and accurate method to obtain tissue samples of the prostate along with high tolerance and low incidence of serious complications.

Biopsy, Needle↗
PubMed2000

[Minimally invasive treatment of intraprostatic cysts].

Prostatic cysts are rare; they are to be considered in the evaluation of obstructive azoospermia. A correct diagnosis is based on transrectal ultrasound of the prostate. Herein we describe our experience with perineal ultrasound cyst aspiration. During the last 10 years, 21 infertile patients underwent ultrasound puncture of an intraprostatic cyst. Patients were placed in the lithotomy position, a 16 G needle was adopted; by means of ultrasound was possible to follow the needle entering the cyst. The content was aspirated and, if no spermatozoa were detected in the cystic liquid, sclerosing agents were introduced. The technique was performed successfully in all patients with symptomatic cyst within the prostate. Follow-up prostatic ultrasound and semen analysis were performed in 17 patients. There was 1 recurrence that was aspirated again. In 12 cases an increase in sperms number and motility was obtained, in 3 cases oligoastenospermia remained unchanged and 2 patients are still azoospermic. In 3 cases the partners become pregnant.

Cysts↗
PubMed1999

The usefulness of the somatosensory evoked potentials of the pudendal nerve in diagnosis of probable multiple sclerosis.

STUDY DESIGN: The aim of the study was to evaluate the sensitivity of pSEP in patients affected by probable MS. OBJECTIVES: Bladder dysfunction is the presenting symptom in 2% of patients affected by multiple sclerosis (MS) and may be present in up to 78% of them. Abnormalities of somatosensory evoked potentials of the pudendal nerve (pSEP) have been found by many authors in patients affected by clinically defined MS, but little is known of diagnostic reliability of pSEP in early stage of MS. METHODS: Sixteen patients, eleven females and five males, aged between 18 and 45 years old (mean age 28.9), affected by clinically probable MS, were studied. Six of them reported retention or urge incontinence. pSEP with P1 (P40) scalp wave was analyzed. All patients also underwent visual evoked potentials (VEP), SEP of median and tibial nerves (mSEP, tSEP), brainstem acoustic evoked potentials (BAEPs), MRI of the brain and cerebrospinal fluid (CSF) evaluation. Urodynamic study with simultaneous measurement of intravesical, intraurethral and abdominal pressures with external sphincter electromyography was performed. RESULTS: Abnormalities of the evoked potentials were found in all patients. Abnormalities of the pSEP were observed in all the symptomatic cases and in eight of the remaining ten patients; ten showed no responses from the scalp and four showed P1 increased latency. Urodynamic abnormalities were found in 12 patients and MRI showed demyelinating lesions in 13 patients and oligoclonal bands were found in eight of them. CONCLUSION: pSEP can be worthwhile as part of the initial diagnostic evaluation in patients affected by MS. It provides information of diagnostic relevance and plays a role in screening patients for urodynamic testing, which, however, is more specific for detecting urethrovesical dysfunctions and preventing urological complications.

Adolescent↗
PubMed1999

Diagnostic testicular biopsy and cryopreservation of testicular tissue as an alternative to repeated surgical openings in the treatment of azoospermic men.

Between May 1996 and May 1998, 64 azoospermic patients underwent an investigative testicular biopsy combined with the cryopreservation of spermatozoa which were retrieved from a simultaneously examined fresh sample. Testicular tissue cryopreservation was carried out in 43 cases (67%) for late intracytoplasmic sperm injection (ICSI) attempts. In all, 23 couples underwent 26 assisted conception cycles; the fertilization rate was 64% with spermatozoa (139/218, 24 cycles), 40% with round spermatids (2/5, one cycle), and 69% with elongated spermatids (9/13, one cycle). The embryo cleavage rate was 84%. A mean number of 2.7 +/- 0.7 embryos were replaced in 24 patients. In two cases, embryo quality was very poor and they were not transferred. Eight clinical pregnancies resulted (35% per patient and 33% per transferred cycle) with an implantation rate of 14.1%: two patients have already delivered and six are ongoing. In conclusion, the cryopreservation of testicular tissue during the first diagnostic biopsy is an alternative to repeated surgical openings and permits patients to initiate an ovarian stimulation cycle with the certitude of having spermatozoa available. Moreover, since only one straw is routinely used for each ICSI cycle, the frozen tissue remains as a sperm source for multiple attempts.

Adult↗
PubMed1999

AMS 800 artificial sphincter: an unusual case of circumscribed peritonitis due to prosthetic reservoir infection.

OBJECTIVES: Male urinary incontinence is nowadays a rare event in patients submitted to radical prostatectomy. In these cases, insertion on a hydraulic prosthesis is often the only therapeutical solution. Complications following this type of surgery are rare and when they occur, generally depend on the bacterial contamination of the device which will be "rejected". The cuff is generally the first cause of infection and its prompt removal should solve the problem in the majority of the cases. METHODS: Herein we report the case of a patient submitted to cuff removal three years earlier who consulted for a symptomless circumscribed peritonitis due to bacterial contamination of the intraperitoneal reservoir. RESULTS AND CONCLUSION: This report emphasizes the need to re-examine the indications for intraperitoneal implantation of the reservoir. Moreover, in case of a three-component prosthetic device, the external components (pump, cylinders and/or cuff) should be removed in a single step, at the same time, in order to avoid future contamination of the internal components.

Aged↗
PubMed1999

Scleroembolization techniques in the treatment of varicocele.

Varicocele is a common finding in adolescents and adult men. Its association with male infertility has been well documented: varicoceles are reported to be present in 20% to 40% of infertile men. It has been demonstrated that varicocele correction leads to an improvement in the quality of semen in most cases. Percutaneous sclerotization is an established method for treatment of varicocele performed on an outpatient basis. In our report we intend to review our experience in venographic study and transcatheter sclerotherapy based on 560 cases of infertile patients with varicocele. Our study confirms that percutaneous therapy of varicocele may lead to improved spermatogenesis in the majority of patients.

Adolescent↗
PubMed1997

Laparoscopically assisted penile revascularization for vasculogenic impotence: 2 additional cases.

PURPOSE: Microsurgical revascularization of the penis in vasculogenic impotence is an accepted surgical procedure in young men with a history of blunt pelvic or perineal trauma. Most penile revascularization techniques use the inferior epigastric artery in direct artery-to-artery revascularization or dorsal vein arterialization procedures. To obviate the wide pararectal incision laparoscopic mobilization of the inferior epigastric vessels has been recently proposed. We present 2 cases of successful laparoscopically assisted penile revascularization. MATERIALS AND METHODS: With the patient under general anesthesia the first trocar was inserted in the umbilical region and pneumoperitoneum was induced. Two other trocars were positioned laterally. As soon as the inferior epigastric vessels were accessed, dissection was initiated below the level of the arcuate line. The vessels were dissected cephalad en bloc to a point of bifurcation of the inferior epigastric artery above the umbilical level. The inferior epigastric pedicle was ligated with clips and transected at the cephalad edge of the dissection. It was then mobilized and tunneled through an infrapubic incision at the base of the penis for subsequent microvascular anastomosis with the penile vessels. RESULTS: The anastomosis was patent and hemostasis was satisfactory. Operative time in the 2 cases was 4.3 and 5.2 hours, respectively. At 3 months both patients reported complete erections. CONCLUSIONS: Our experience confirms the extremely practical use of laparoscopy which, due to its magnification power, makes it possible to perform fast, accurate excision of the epigastric bundle. Moreover, a wide pararectal incision, which is a frequent cause of postoperative complications, is avoided.

Humans↗
PubMed1996

Preliminary reports on morphological and ultrastructural changes in the corpora cavernosa of the rat after chronic arterial obstruction.

OBJECTIVES: Various authors have investigated the pathological findings of penile tissue after chronic arterial obstruction, but the significance of these changes in the corpora cavernosa remains unclear. In order to evaluate the possible damages in the erectile tissue after chronic arterial obstruction at different levels, we utilized an experimental model in rats to determine the changes in smooth muscle cells and elastic fibers of the erectile tissue by microscopic immunohistochemical and ultrastructural studies. METHODS: Twelve adult male Wistar rats were employed in this study. Ten were used for the experiments and two as control. The rats were anaesthetized with ether and intraperitoneal 10% chloral hydrate. Microsurgical isolation of the involved vessels was performed with the aid of a Zeiss dissecting microscope. Partial stenosis was achieved with 11/0 nylon and amputation of the penis was performed at previously established time periods. The partial stenosis was carried out at the level of the aortic below the renal vessels (Group A), the common iliac artery on both sides (Group B) and the hypogastric artery on the left side (Group C). Arterial obstruction was maintained in each group for 50, 40 and 25 days, respectively. RESULTS/CONCLUSIONS: In comparison with normal controls, the histological findings revealed discrete and diffuse interstitial hyalinosis with reducted elastic fibers, while dilated vascular lacunae were also present on TEM (Transmission Electron Microscope) and SEM (Scanning Electron Microscope) examination. The greatest ultrastructural damages were observed in the group with obstruction of the common iliac artery on both sides. The foregoing confirms that an eventual chronic obstruction of these arteries does not allow the formation of collateral vessels for the corpora cavernosa.

Animals↗
PubMed1996

[Effect of imipramine hydrochloride on urinary function and serum parameters in enuretic children: preliminary study].

We still do not know whether Imipramine works exactly as an antidiuretic. The aim of this study was to investigate any existing urinary or serum factor differences between 9 children with primary nocturnal enuresis and six age and sex matched controls and to see if therapy with Imipramine could modify these parameters. All subjects underwent an evaluation of daily and nightly urinary volume, daily fluid intake, morning plasma and urine osmolality, plasma aldosterone, electrolytes, blood urea nitrogen and plasma glucose. The results, using a one-way ANOVA, would suggest the following: 1) enuretic children have a higher 24 urinary volume with a reduced osmolality compared to controls; 2) Aldosterone does not seem to be involved in the pathogenesis of enuresis; 3) Imipramine HCL therapy does reduce the volume of urine lost in diapers, and its efficiency can be documented objectively; 4) Imipramine HCL's mechanism appears to be related to an increased renal water resorption.

Analysis of Variance↗
PubMed1996

[Calcifying giant-cell Sertoli tumor: description of a case with atypical echographic presentation].

Large cell calcifying Sertoli cell tumor of the testis is an extremely rare type of sex cord tumor with low malignant potential that occurs in the first and second ecades of life. Twenty-eight cases have been reported in the literature and, to our knowledge, only 2 had an aggressive behaviour. Patient age, tumor size, histological malignant patterns such as pleomorphism and high mitotic rate seem to heavy influence the future neoplasm malignancy. Ultrasonography imaging of the large cell calcifying has described in only 6 cases. We report an experience with a large cell calcifying Seroli cell tumor of the testis and point out the unusual sonographic findings. Moreover, if histologic examination suggests no malignant features, we suggest local excision as ideal therapy for the preservation of testicular parenchyma.

Adolescent↗
PubMed1996

[Color Doppler echographic monitoring of retrograde and anterograde sclero-embolization of a left varicocele: report of 76 cases].

Varicocele, which is the most common cause of infertility in man, is detected by means physical examination and color Doppler sonography. We analyzed the results of percutaneous sclerotherapy of the spermatic veins in 76 out of 103 patients with varicocele: antegrade sclerotherapy was performed in 11 patients while 92 men underwent retrograde scleroembolization. Color Doppler sonography was performed one month later and showed persistence of varicocele in 3 patients who underwent retrograde sclerotherapy. Retrograde percutaneous sclerotherapy of the spermatic vein represents, in our opinion, the gold standard in the treatment of primitive and recurrent left varicocele, because of its efficacy and minimal invasive nature. Antegrade sclerotherapy is an effective alternative treatment when retrograde access is not possible.

Adolescent↗
PubMed1996

[Echographic, MRI and CT features in a case of bladder endometriosis].

Endometriosis is relatively frequent in females of menstrual age and consists in the appearance of active endometrial tissue at site other than uterine cavity. Endometrial tissue has been described to colonise the urinary system, particularly the urinary bladder. The most common clinical features of vesical endometriosis are urgency and frequency, hypogastric pain and hematuria. We report on a case of vesical endometriosis whose presenting features were dysmenorrhea, stranguria and pelvic pain. MRI and CT did not provide different or more precise information than ultrasound scan: these findings were indistinguishable from an intrauterine lesion. On the contrary endovaginal sonography was more sensitivity than MRI and CT. Cystoscopy was negative. Nondiagnostic laparoscopy was performed. Patient underwent laparotomy and partial cystectomy. Histopatological findings demonstrated an endometriosis of the muscle layer of the bladder. The rarity of this condition prompted us to report on the problems encountered in making the differential diagnosis.

Adult↗