[Cancerization of the gastric stump in patients subjected to surgical operation for benign gastroduodenal ulcer].
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Aged↗
Biomedical subjects
G Bonanni
Publications and source records attributed to G Bonanni.
[Reiter's syndrome].
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Arthritis, Reactive↗
Achievement of spermatogenesis and genital tract maturation in hypogonadotropic hypogonadic subjects during long term treatment with gonadotropins or LHRH.
15 subjects with Hypogonadotropic Hypogonadism (HH) were treated with either gonadotropins (13 cases) or pulsatile subcutaneous Luteinizing Hormone Releasing Hormone (LHRH) (2 cases) for up to 42 months, to study the effects of therapy step by step. The following results were obtained: (A) In postpubertal HH (5 cases = Group A), therapy brought about onset of spermatogenesis within 3 months and its normalization within 6 months. In HH of prepubertal onset (10 cases = Group B), spermatogenesis started within 9 to 21 months and became normal in only 3 cases after at least 18 months. The best sperm counts were obtained in Group A in the third month of treatment (41.75 +/- 43.68 mil./ml) and in Group B in the 36th month (14.87 +/- 17.06 mil./ml). Sperm motility was normal in the majority of the cases in Group A from the beginning but did not become normal in Group B. (B) Seminal fructose and zinc were normal from the beginning of therapy in 66% of the cases in both groups. Zinc became normal in 100% within 3 months in Group A, in Group B within 18. Carnitine was normal in 50% of cases in both groups, contemporaneous with sperm appearance. Transferrin was normal in Group A after appearance of spermatozoa, but in Group B never became normal. (C) We hypothesize that the recovery of fertility passes through the following stages: (1) Functional recovery of Leydig cells, followed by seminal vesicles and prostate. (2) Recovery of epididymal function, which probably implies beginning of the tubular function. Recovery of Sertoli cell function occurs with more difficulty.
Adult↗
[Results of laparoscopic bilateral varicocelectomy].
Left varicocele (LV) is a common clinical condition that is present in approximately 15% of the general male population. Bilateral varicocele (BV) is an association of clinical LV and subclinical or ultrasound diagnosed right varicocele. Recent diagnostic technology suggests that BV is much more common than previously suspected varying from 15 to 57%. The laparoscopic technique offers the possibility of planning bilateral varix ligation but only a few reports are currently available. The aim of this study was to evaluate the outcome of contemporary bilateral correction of BV on spermatogenesis. From 1992 January to 1998 December a total of 207 patients with clinical left varicocele and a pathological sperm count were studied. Scrotal sonography was performed and in 96 patients (group A) subclinical right varicocele was diagnosed while 111 patients (group B) only had LV. 84 patients were married and had tried unsuccesfully for a pregnancy for at least one year before evaluation. All patients underwent laparoscopic varicocelectomy, performed under general anesthesia with a three trocar technique with application of clips to the spermatic vein and resection. Patients with right reflux received bilateral varix ligation. Operating time averaged 28 minutes for unilateral cases and 42 minutes for bilateral legatures. No significant differences were found in age distribution or preoperative seminal paramenters between the two groups. Postoperative hospital stay was 1.2 and 1.3 days respectively. 168 patients underwent sperm count four to six months after surgery. Both groups showed improvements in number (group A 41 millions, group b 27 millions), 2nd hour motility (group A 32%, group B 19%) and morphology (group A 52%, group B 51%). 95 patients achieved normalization of seminal parameters, 40 (63%) in group A and 37 (30%) in group B, and there was a statistically significant difference between the two groups. The pregnancy rate was calculated on married population after one year; it was 41% in total. The role of the subclinical right varicocele associated to clinical left varicocele is uncertain and there are few papers concerning this argument. In this serie normalization of seminal parameters and the pregnancy rate were significantly higher in patients with bilateral correction of reflux. In conclusion our data confirm that subclinical right reflux also has a detrimental effect on spermatogenesis and we suggest that it must be corrected contemporary when associated with clinical left varicocele.
Adolescent↗
[Physiopathological and nutritional changes in hemodialysis patients and in those who have undergone renal transplantation].
The paper examines the complex metabolic behaviour of patients undergoing hemodialysis and renal transplantation. It underlines the importance of the metabolic and nutritional status of these patients since inadequate nutritional therapy may result in the failure of hemodialysis and/or surgery. Given the complexity of the metabolic syndrome and its bronchopulmonary, cardiovascular and septic complications, it is necessary to monitor the various chemical and clinical parameters in these patients in order to guarantee an optimal recovery and satisfactory survival rate. Fortunately today, by replacing the use of Azathioprine, Cyclosporin--irrespective of its collateral and/or secondary effects--has replaced the use of corticosteroids whose immunodepressive action made it obligatory to start simultaneous prophylactic antibiotic treatment and/or chemotherapy in order to avoid the development of other chance disease. The paper also reports the findings of a retrospective study (1976-1986) which evaluated various physiopathological and metabolic parameters and compared them to data reported in the literature.
Combined Modality Therapy↗
A case of subprimary suprarenal tuberculosis.
In spite of the current availability of new and more up-to-date methods of prevention, diagnosis and therapy, specific forms in general and the ability to perform rapid, efficacious and resolutory operations, a number of cases of subprimary or secondary tuberculosis still exist which are most probably the result of delayed diagnosis, contagious episodes or the failure to adhere to recommended treatment protocols and, often, less than optimum medical therapy. A rare case of adrenal tuberculosis diagnosed in a patient hospitalized for left renal calculosis is reported. Routine tests indicated a specific form of diagnosis, and during surgery for left renal calculosis the patient underwent left adrenalectomy. Histological tests confirmed the initial diagnosis. For 180 days after the operation the patient received pharmacological treatment directed specifically against Koch's bacillus.
Adrenal Gland Diseases↗
[The current physiopathological, diagnostic, clinical and therapeutic considerations of peptic ulcer. A comparison between traditional and modern therapeutic methods].
The authors, keeping in mind their clinical, diagnostic and therapeutic experience on ulcerous gastric and duodenal pathology, underline the effectiveness of the traditional antacids as well as that of the modern up-to-date antisecretory and cytoprotective agents. After having put into evidence the causes that can provoke peptic ulcer not excluding that of iatrogenic and their probable aetiopathogenetic mechanism and having hinted at another pathology that uses the same therapeutic remedies, the gastro-oesophagus reflux, they discuss in detail the active principles used in the gastric or duodenal pathology, the possible side and/or secondary effects that in the long run are determined when using only the modern therapy with the usual antacids. Therefore, they hope that these therapies are used after carefully considering the general clinical and anatomicopathologic situation of the lesion that must be created.
Antacids↗
[Treatment of male hypogonadotropic hypogonadism].
Males affected by hypogonadotropic hypogonadism can be treated with androgen replacement therapy, if they do not wish fertility. In order to limit or avoid androgen toxicity on the liver, it is possible to use testosterone undecanoate (which is absorbed in the gut by lymphatic system) at the dose of 160-240 mg/die or testosterone esters administered intramuscolarly at the dose of 250 mg/month. Estradiol and DHT derived from testosterone catabolism can be in excess therefore they can be provoke toxic phenomena, even if slight, such as gynecomastia or prostatic diseases. If patients wish fertility, they must be treated with gonadotropins or pulsatile LHRH. Therapeutic effects are very different depending on the different origin of the hypogonadism. In postpubertal onset hypogonadotropic hypogonadism, the response is constant and rapid; sperm count normalization can be reached within 6 months with the only hCG. Prepubertal onset hypogonadotropic hypogonadal men need hu-FSH too and longer treatment (18-24 months); sperm count normalization can be reached in less than half case. Nevertheless fertility can be reached even in oligozoospermic stage. Negative prognostic factors are: pan-hypopituitarism, cryptorchidism, how old are the patients at the beginning of the treatment and small testis volume. It is not yet clear if pulsatile LHRH therapy is profitable in terms of therapeutic results.
Gonadotropins↗
CT demonstration of capsuloligamentous lesions of the knee joint.
Direct CT of the knee joint was performed on 45 patients who subsequently underwent surgery for clinically suspected capsuloligamentous lesions. It was possible to perform a complete examination on all patients, even those immobilized in a cast or with acute clinical symptoms. Computed tomography correctly differentiated 32 lesions of the anterior cruciate ligament, five lesions of the posterior cruciate ligament, 16 lesions of the collateral ligaments, and 43 associated meniscal lesions. In five cases surgery disproved the CT diagnosis. Our experience permitted us to identify direct CT signs that not only indicate the presence of a capsuloligamentous lesion but also determine its site, extent, and seriousness.
Adolescent↗
[Therapy of thalassemia major with transplant of the bone marrow. Our experience with the busulfan, cyclophosphamide, cyclosporin, and acyclovir protocol].
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Acyclovir↗
[Computerized axial tomography and electromyography in vertebral and spinal cord pathology].
Fifty patients with lumbar spinal disease, 47 of them with disk herniation, were studied preoperatively using both electromyography and computerized tomography (CT), in order to verify the mutual diagnostic significance and accuracy of these techniques. Electromyographic studies provided correct informations regarding the level of the lesion in 41 patients with 1 mistaken level and 8 false negatives, without indicating the nature of involved pathologies. The specific nature of the lesions was correctly indicated by CT studies in 43 patients with 4 incorrect diagnoses and 3 false negatives, without defining the functional loss produced by the lesions. Using electromyography and CT together, first electromyographic studies to establish the spinal level to investigate principally with CT, the diagnostic accuracy can improve because of the decrease of the false negatives.
Adult↗
Concomitant ceco-appendicular and urinary tuberculosis. Description of two rare cases: physiopathological and diagnostic remarks.
Two cases of specific tubercular processes in the ceco-appendicular zone and the urinary system in men aged 25 and 30 years are described. Both patients reported abdominal pain and persistent fever that did not respond to treatment. Surgery revealed ulcerated appendix, intraperitoneal serous exudate, ascitic liquid, peritoneal ulcerocaseous nodules, and fibrous adhesions. Histological sections revealed a tubercular puchet in the ceco-appendicular zone. Subsequent x-ray test in response to reports of frequent painful urination showed specific lesions in the papillae and renal ureteral ampullae, and urine cultures were positive for Koch's bacillus. Treatment with streptomycin, followed by isoniazid, rifampicin, ethambutol, and morinamid for 2 years, was effective.
Adult↗