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Biomedical subjects

E Pisani

Publications and source records attributed to E Pisani.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Ileal neobladder in women: Milano's technique].

In the female patient with transitional cell carcinoma the risk of urethral recurrence is very low, when the bladder neck is histologically free of tumour. On the other hand urinary continence can be maintained if the lower half of the urethra together with the nerve supply is preserved. On this basis orthotopic bladder reconstruction was applied also in a female patient. In order to preserve urinary continence minimal dissection was performed anterior to the proximal urethra; in addition pubourethral ligaments were left intact. On the other hand to prevent chronic urinary retention arising from downward displacement of the reservoir a colposacropexy was performed. At 3 weeks the filling cystogram demonstrated a well shaped and compliant reservoir. No downward displacement of the reservoir was observed in upright position. Neither reflux nor residual urine could be demonstrated by voiding cystourethrogram. The woman achieved diurnal and nocturnal continence at 3 month.

Carcinoma, Transitional Cell↗
PubMed1996

[Nonsurgical and endoscopic therapy in obstructive azoospermia].

The endoscopic therapy has an elective role in the distal obstructive azoospermia for urogenital carrefour pathologies both organics and functional and differently in the resection and/or aspiration with sperm recovery forms. Resolutely attends to the symptomatology and positively to the fertility re-establishment, in front of a short sickness-rate. The Authors describe the different techniques with relative indications, results and complications. Instead medical therapy has a role in the obstructive above all post infection and post inflammatory lesions prevention. Furthermore propose to oneself the goal to improve the seminal quality by the improvement of the semen fertilization capacity and to reduce the affections symptomatology. Finally concurs with the sperm selection techniques to fertility potential wealth.

Endoscopy↗
PubMed1995

[Multicenter clinical study of the effects of once daily administration of mepartricin 150.000 U. in benign prostatic hypertrophy].

The effects of partricin methyl ester, administered to 481 BPH patients at the dose of 150.000 U as a single administration at night for 90 days were studied in the course of a multicentre study. The favourable evolution of the objective and subjective symptomatologic parameters taken into consideration confirmed the efficacy of the substance used even by this mode of administration. The size of the patient sample ensured that reliable findings were obtained as regards the excellent safety of this form of dosage.

Adult↗
PubMed1995

Andrological laparoscopy.

The laparoscopic technique has well defined indications for some andrological procedures such as the diagnosis and the treatment of cryptorchidism, but its role remains controversial in varix ligation for which laparoscopy is however the newest development. At the Institute of Urology of the University of Milan from January 1992 to June 1994 five adults patients with undescended and unpalpable testis underwent laparoscopy. In 4 cases laparoscopic orchiopexy (2 direct and 2 staged procedures) and in one case laparoscopic orchiectomy have been performed. In the same period 20 cases of varicocele (6 bilateral) have been observed and treated by laparoscopic varix ligation. For cryptorchidism after the identification of the testis we decide on the basis of parenchimal trophism wheter to perform orchidopexy or orchiectomy. A single step laparoscopic orchiopexy can be performed if the undescended testis is located proximal to the internal inguinal ring and if the mobilization of the spermatic vessels allows it. A Fowler-Stephens staged orchiopexy is indicated for intra abdominal testicle with short spermatic vessels. In the first stage the spermatic vessels are isolated and divided relying on the compensation offered by the deferential and extrafunicular vessels. After six months, once the testis trophism has been ascertained, the testis can be placed in the scrotum. For varicocelectomy the peritoneum is incised at the projection of the spermatic cord from the internal inguinal ring. A blunt and gentle dissection prepares the spermatic vascular bundle, the spermatic artery is identified and isolated and the vein are clipped and divided.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Urology.

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Humans↗
PubMed1995

Laparoscopy of the kidney and the adrenal gland.

Diseases of the kidney and of the adrenal gland can be managed surgically by the laparoscopic approach. Laparoscopic nephrectomy, nephroureterectomy, renal cyst resection and adrenalectomy have been reported. This paper describes our early experience with the laparoscopic approach for the treatment of diseases of the kidney and of the adrenal gland. Since June we have performed 4 nephrectomies, 14 renal cyst excisions and one adrenalectomy. Postoperative recovery and need for pain medication were reduced. Complications have been rare. At the present time laparoscopic nephrectomy for benign renal diseases, laparoscopic excision of recurrent renal cysts and laparoscopic adrenalectomy for functioning renal tumours should be considered. The role of laparoscopic approach for treatment of malignant diseases of the kidney and of the adrenal gland is still debatable.

Adrenal Gland Diseases↗
PubMed1995

[Stress urinary incontinence after perineal radical prostatectomy].

22 pts treated by radical perineal prostatectomy have been submitted to pelvic floor training soon after catheter removal, in order to assess faster continence reappraisal than that normally described in literature. 18 pts resulted dry within 4 months from surgical care. 2 pts resulted with stabilized mild stress incontinence due to daytime activity within 6 months from prostatectomy. 2 pts complained strong stress urinary incontinence over a period of more 9 months from surgery, but none resulted affected from continuous leakage. In this pts we observed a maximum time of continence reappraisal of 6 months with a minimum of 1 and an average of 4. An high perineal test has been found statistically correlated in the first three months from surgery with nocturnal continence reappraisal and the begging of diurnal micturion events (p < 0.005). Pelvic floor exercises has been found useful in the treatment of post radical perineal prostatectomy stress urinary incontinence.

Aged↗
PubMed1994

Benign, borderline, and well-differentiated malignant intestinal mucinous tumors of the ovary: a clinicopathologic, histochemical, immunohistochemical, and nuclear quantitative study of 57 cases.

Mucinous ovarian tumors are still a subject of controversy because they can show either intestinal or endocervical differentiation. Morphologic distinction between borderline and malignant tumors is sometimes difficult, and their clinical behavior has not been definitively ascertained. We selected 10 mucinous cystadenomas (MCAs), 32 intestinal mucinous borderline tumors (IMBTs), and 15 well-differentiated mucinous carcinomas (MCCs), all with goblet cells, at least focally. In all cases, we studied the clinicopathologic features, mucin content, intermediate filament expression, and some nuclear quantitative features, namely, the volume-corrected mitotic index (M/Vi), percentage of nucleolated nuclei, mean number of nucleoli per nucleus, percentage of nucleoli touching the nuclear membrane, and mean nuclear area. The quantitative nuclear study included cytometric DNA analysis and the results were expressed as relative mean ploidy value (RMPV) and as diploid-tetraploid or aneuploid histograms. The results of the quantitative study were evaluated statistically. All patients had stage IA tumors, had received surgical therapy only, and were alive and well after a follow-up of more than 5 years. Light microscopic examination revealed that destructive stromal invasion was not present in any MCCs and that IMBTs and MCCs were easily recognizable using the Hart and Norris criteria, later expanded by Hart. Mucin histochemistry and intermediate filament immunohistochemistry failed to detect substantial differences between the diagnostic categories. DNA analysis demonstrated an increase in aneuploid tumors going from IMBTs to MCCs, but these differences were not statistically significant. On the other hand, nuclear quantitative morphology showed significant differences among the three groups of tumors for all features considered. Forward stepwise discriminant analysis highlighted that MCAs, IMBTs, and MCCs were contiguous but different categories. These data support the separation of IMBTs and MCCs into morphologically different categories as underlined by the results of quantitative nuclear morphologic analysis. The favorable outcome of all patients confirms the excellent prognosis of stage I IMBTs and suggests that well-differentiated MCCs without destructive stromal invasion at stage IA could be assimilated, in terms of prognosis and therapy, into stage I IMBTs.

Adenocarcinoma, Mucinous↗
PubMed1994

Steadiness of amyotrophic lateral sclerosis in the province of Parma, Italy, 1960-1990.

A clinical and epidemiological study on amyotrophic lateral sclerosis (ALS) was conducted in the province of Parma, Italy, from 1960-1990. A total of 121 cases were collected from hospital records. The average annual incidence was 0.98 per 100,000 inhabitants, with a male/female ratio of 1.1. Age-specific incidence was maximal in the age group 60-69 years. No difference between rural and urban areas was found. Prevalence on October 26th, 1981 was 2.5 per 100,000. Mean age at onset was 60 years, with no significant sex difference. Mean duration of the disease was 30 (sd 21.4) months. Bulbar forms were significantly (p < 0.05) shorter than conventional forms, with a mean duration of 23.4 (sd 21.4) months. Age at onset did not influence prognosis. A comparison of three decades was made, to verify whether possible variations of the disease had occurred with time. From our data a definite stability was found in such epidemiological parameters as incidence, prevalence, mean duration and mortality of ALS in the period.

Adult↗
PubMed1994

[Erectile function and ablative surgery of penile tumors].

The Authors try to show the possibility to combine radical excision with minimal invasiveness in the surgery of penile cancer. The focal point of every therapeutic decision is correct clinical staging. Unfortunately there's some confusion in the two international staging systems (TNM and Jackson's classification). In fact it's not clear the anatomical difference between epithelioma of the glans infiltrating corpus spongiosum and subcoronary epithelioma of the shaft infiltrating the corpora cavernosa. It's obvious that the infiltration of the corpora cavernosa is a far more aggressive oncological manifestation than that of tumour infiltrating the corpus spongiosum. So we consider Jackson's classification more congenial. In terms of surgery this anatomical independence makes it easy to consider the corpora cavernosa as a distinct entity, so they remain perfectly functional when separated from the glandulo-spongio-urethral unit with its vasculo-nervous bundle. This makes conservation of the erectile function, when clinical staging show us that the tumour is not infiltrating the corpora cavernosa. The Authors show their results, which seem to be rather good.

Humans↗
PubMed1994

[Renal calculi].

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Humans↗
PubMed1993

Prostatic intra-epithelial neoplasia: expression and location of proliferating cell nuclear antigen in epithelial, endothelial and stromal nuclei.

The expression and location of proliferating cell nuclear antigen (PCNA) immunostaining in epithelial, endothelial and stromal nuclei were assessed in prostatic intra-epithelial neoplasia (PIN). It was then compared with patterns in benign lesions and in invasive adenocarcinomas of the prostate. The PCNA-positive nuclei showed homogeneous or granular types of staining, or a mixture of both, and a gradation in the intensity of staining. Nuclei with granular and mixed patterns appeared lighter brown than those with a homogeneous pattern, which are darker and more often noted in PIN and invasive adenocarcinomas than in benign lesions. For epithelial PCNA-stained nuclei, the proportions in the two grades of PIN were greater than in benign prostatic hyperplasia (mean 3.16%, SE 0.31%) and prostatic atrophic ducts and acini (mean 0.56%, SE 0.09%), the values decreasing from the nuclei in the basal position towards those in the luminal layer. In grade 1, the category mean values were 9.51% (SE 1.14%) in the basal, 7.02% (SE 1.27%) in the intermediate and 6.02% (SE 0.90%) in the luminal position. In grade 2, the category mean values were 13.81% (SE 1.42%) in the basal position, 10.99% (SE 1.17%) in the intermediate and 7.91% (SE 1.43%) in the luminal position. In small and large acinar adenocarcinomas, the proportions of positive nuclei were 8.66% (SE 0.30%) and 9.06% (SE 0.30%), respectively. The category mean values in the cribriform adenocarcinomas were 14.40% (SE 0.61%) in the basal position, 11.84% (SE 1.30%) in the intermediate and 9.26% (SE 0.66%) in the luminal position. As in PIN, the proportions of immunostained nuclei in the adenocarcinoma with cribriform pattern decreased from the basal towards the luminal layer. In the solid/trabecular adenocarcinomas, the category mean value in the cell layer adjacent to the stroma was 17.60% (SE 2.92%), whereas in the other cell layers it was lower than that in the cells adjacent the stroma (mean 13.88%, SE 1.71%). For capillary endothelial and stromal cells, the percentages of PCNA-stained nuclei were much lower than those in the epithelial component. The lowest mean values were obtained in benign lesions, whereas the highest were in invasive adenocarcinomas, the percentages in PIN being intermediate.

Aged↗
PubMed1993

Dose dependent effects of protracted ingestion of small amounts of gliadin in coeliac disease children: a clinical and jejunal morphometric study.

This study aimed to investigate the effects of chronic ingestion of small amounts of gliadin on children with coeliac disease. A four week challenge was performed on 20 children who had been on a gluten free diet for mean (SD) 14 (3) months. They were given a daily dose of either 100 mg (group A, n = 10, mean age 4 (2) years) or 500 mg of gliadin (group B, mean age 5 (3) years). The effects of the gliadin were monitored by morphometric study of the jejunal mucosa, intestinal permeability test with cellobiose/mannitol, and serum antigliadin antibody test. After the challenge, group A patients showed a significant increase in the mean intraepithelial lymphocyte count (before challenge 11 (3), afterwards 19 (6)) and a decrease in the villous height/crypt depth ratio (beforehand 1.5 (0.1), afterwards 1.3 (0.2)), while the intestinal permeability test remained normal and the IgA-antigliadin antibody increased in four of 10 children. After the challenge group B showed more pronounced histological changes, an increase in the mean urinary cellobiose/mannitol % (beforehand 0.028 (0.020), afterwards 0.058 (0.028)), and IgA-antigliadin antibody positivity in six of eight subjects. The discriminant analysis function showed that the pretreatment group, group A after challenge, and group B after challenge were correctly classified in 90% of cases by functions based on the individual intraepithelial lymphocyte count and the villous height/crypt depth ratio. This study shows that chronic ingestion of small amounts of gluten causes dose-dependent damage to the small intestinal mucosa in children with coeliac disease. The predictive value of laboratory tests, such as the antigliadin antibody test and the intestinal permeability test seems to be lower in treated patients than in those with active coeliac disease.

Celiac Disease↗
PubMed1993

Prostatic intra-epithelial neoplasia. Qualitative and quantitative analyses of the blood capillary architecture on thin tissue sections.

The aim of our study was to qualitatively and quantitatively investigate the capillary architecture on lectin Ulex Europaeus agglutinin I-stained histological section in prostatic intra-epithelial neoplasia. The capillaries appeared as small, short or elongated vessels with either a smooth or undulated external contour and either virtual or visible lumen, sometimes with a clearly identifiable endothelial nucleus/i. In the benign prostatic hyperplasia and prostatic intra-epithelial neoplasia categories, the capillaries appeared located in close contact with (i.e. touching) or in proximity to the basement membrane of ducts and acini. In the invasive adenocarcinoma category, on the contrary, the capillaries in general appeared interspersed within the tumour stroma and septa. Our quantitative studies of the capillary architecture showed that, going from benign prostatic hyperplasia through prostatic intra-epithelial neoplasia up to invasive adenocarcinoma, an increasing proportion of capillaries becomes shorter, with open lumen and undulated external contour and with a greater number of endothelial cells. The highest proportion of touching capillaries was seen in benign prostatic hyperplasia, while the lowest was in invasive adenocarcinoma, being intermediate in prostatic intra-epithelial neoplasia. When the prostatic intra-epithelial neoplasia samples were divided into low-grade and high-grade, the feature values in the low-grade approached those in benign prostatic hyperplasia, whereas in the high-grade they were close to invasive adenocarcinoma. Half of the benign prostatic hyperplasia samples were taken from total prostatectomies because of the preoperative diagnosis of prostatic adenocarcinoma. The feature values in this subcategory were close to those of prostatic intra-epithelial neoplasia of low grade.

Adenocarcinoma↗
PubMed1993

[Orchiopexy].

The Authors illustrate their experience in the treatment of a case of left criptorchidism using laparoscopic technique associated with traditional surgery (Fowler-Stephens technique) without important complications during and after the procedure. The non palpable testis was located in the peritoneal cavity. The first step consists in a laparoscopic clip ligation of the spermatic vessels with the intent of improve the vasal collateral blood flow. After a 6 months interval, the patient underwent laparoscopic orchidopexy.

Adult↗