Biomedical subjects
Publications and source records attributed to F Aragona.
The foetuses of 10 women at 9-12 weeks gestation were irradiated with ultrasound under typical diagnostic exposure conditions immediately prior to abortion. Electron microscopy of liver fragments revealed neither morphological nor structural changes.
The authors describe a rare case of inverted papilloma of the renal pelvis. A pathological, clinical and epidemiological review of this lesion is given. Up-to-date diagnostic work-up is outlined.
We report on the familial occurrence of congenital bulbar urethral stricture in 2 brothers. Embryological mechanisms are briefly discussed and the literature reviewed.
A case report of arterial hypertension which occurred 5 years after a blunt renal trauma is presented. The physiopathology of this type of hypertension along with the diagnostic features and the therapeutic aspects are extensively discussed. The sudden appearance of hypertension in a young patient following trauma must suggest a Page kidney as one of the diagnostic possibilities.
Bladder angiosarcoma is an extremely rare neoplasia whose aggressive biological behavior follows that of other angiosarcomas. The second case of primary angiosarcoma of the bladder is reported pointing out the immunohistochemical characteristics of these neoplasias. Using immunoperoxidase staining techniques, Ulex lectin has proved to be a more sensitive marker for endothelial cells than factor VIII-related antigen, and it should be used as an additional marker for endothelial cell-derived tumors.
Injectable bovine collagen has found extensive applications as soft tissue substitute and, more recently, in the primary treatment of vesico-ureteral reflux. Reactions to the material have been reported to be temporary, of low incidence and self-limiting. However, animal collagen is still an immunogen that is capable of eliciting an immune response. Elevated anti-collagen antibody levels have been detected in patients treated with clinical doses of injectable collagen, even in the absence of adverse cutaneous reactions. These antibodies have not yet been shown to be cross-reactive with human collagen and it is presumable that for most patients biologic exposure to collagen does not pose any health hazard. Nevertheless, the long-term significance of these antibodies is unknown and, until the nature of the immune response to bovine collagen is better understood, it would be advisable to avoid collagen implants in patients with a long life-expectancy or when other therapeutic modalities are available.
The effects of monopolar and bipolar diathermy systems were studied in 12 male Sprague-Dawley rats. Fulguration was achieved by application of a standard current (13 W for 1 s) on the foreskin. Tissue damage was assessed by light microscopy. Results suggest that bipolar probe causes less tissue damage than its monopolar counterpart. It has proved to be of value in plastic and paediatric procedures and is recommended for the urologist's armamentarium.
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Xanthogranulomatous cholecystitis (XC) is a chronic inflammatory lesion of the gallbladder histologically characterized by the presence of varying amounts of foamy histiocytes in the inflammatory infiltrate. In this study a review of 63 cases selected from 1207 surgically removed gallbladder is presented; the percentage found (5.2%) is slightly higher than that of previous reports showing that XC is less uncommon than generally believed. A detailed microscopic study is performed: the authors observed according to the histological features particularly the different patterns of distribution of the inflammatory infiltrate and postulate the existence of three subtypes of XC: multinodular, focal and diffuse XC. Finally, the main etiopathogenetic hypotheses are briefly discussed.
The authors reviewed the records of 160 patients with neurogenic bladder secondary to myelomeningocele (MMC) treated at the Urology Department of the University of Padua during 1977-1988. All patients had been evaluated by excretory urography, urethrocystography and videocystomannometry (VCM). Urodynamic studies are fundamental in determining vesicosphincteric dysfunction and patients who are at high risk for early renal lesions. For this reason, the authors recommend urodynamic evaluation from the first year of the infant's life in order to institute treatment early. The therapeutic approach should aim at a) preserving renal function, b) achieving a socially acceptable degree of urinary continence, and c) protecting sexual function.
The preliminary results of a randomized ongoing study performed in order to evaluate the efficacy and the relative toxicity of a low dose (75 mg). BCG regimen in the treatment of superficial bladder cancer were considered. Ninety-eight patients (58 patients for prophylaxis of the recurrences of Ta-T1 papillary tumors; 40 patients for therapy of carcinoma in situ) received a 6-weeks course of 75 mg. BCG Pasteur vaccine. An additional course was given to non-responders. A maintenance therapy was administered in complete responders monthly for the first year and quarterly for the second. The prophylaxis group (TUR + BCG) was randomized vs TUR alone (40 patients = control group). Complete response in evaluated patients of the prophylaxis, control and therapy groups achieved 86%, 17% and 78%, respectively, after 18 months; 5%, 20% and 9% of patients, respectively, experienced tumor progression. As regards the toxicity, irritative disturbances (27%) and fever (16%) appeared significantly decreased in comparison with those reported in the literature. No major complications were experienced. In conclusion, the low dose (75 mg.) Pasteur BCG regimen used in our trial was effective as a prophylaxis against recurrent superficial papillary tumors and as a treatment of carcinoma in situ, with a significant decrease in toxicity.
The authors describe a case of liposarcoma of the renal sinus, a relatively uncommon tumor site. We briefly review its pathogenesis and underscore the importance of the preoperative differential diagnosis, particularly from other tumor masses that are often difficult to distinguish.
A contracted noncompliant bladder is an infrequent but severe complication of cutaneous ureterostomy. Recently, we effected a significant increase in bladder capacity by long-term, gentle hydraulic dilation with saline solution plus an anticholinergic drug (emepronium bromide). Based on this experience, we suggest a conservative approach like this before electing a patient for bladder augmentation or permanent diversion for any child with vesical contracture.
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To distinguish prostatic dysplasia (or adenosis) from well differentiated adenocarcinoma on transrectal needle biopsy, a morphometric study was conducted on 20 cases of adenosis and 20 cases of well differentiated adenocarcinoma of the prostate. About 100 cells for each patient were analyzed by means of a computerized image analyzer, and mean nuclear diameter, mean nuclear area, mean form factor and number of cells in eight classes of nuclear diameter were studied. The best predictors of malignancy (evaluated by means of Receiver Operating Characteristics curves) were mean nuclear area greater than 28 mu2, presence of more than 5% of cells with nuclear diameter greater than 6.15 mu, and mean nuclear diameter greater than 5 mu. Using these diagnostic criteria the probability of malignancy for a positive specimen rises from 14% (pre-test) to 75% (post-test).
A case of stone formation within a female urethral diverticulum is presented together with a brief literature review. Clinical diagnosis may be suspected if a stony hard mass is palpable on the floor of the urethra. The definitive diagnosis depends upon a plain X-ray film and a retrograde positive pressure urethrogram. Surgical excision of the diverticulum together with the calculus is best performed by the vaginal route.
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