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Biomedical subjects

G Carmignani

Publications and source records attributed to G Carmignani.

At least 73 records · Page 4Linked to original sources

Correlation between liver cirrhosis and benign prostatic hyperplasia: a morphological study.

In elderly males hormonal changes occur, that are believed to cause benign prostatic hyperplasia (BPH). These are decreased testosterone production, an increased testosterone SHBG and a slightly increased estradiol production. Liver cirrhosis in males causes similar endocrine changes. We carried out a post mortem study evaluating the prostates of 51 men who died with liver cirrhosis compared with a similar group without any hepatic disease. The occurrence of BPH in cirrhotic subjects was diminished and delayed compared to total population. Furthermore in cirrhotic men BPH is more common as early nodular hyperplasia (early stage) or stromal hyperplasia (suggesting estrogenic prevalence), while in the general population stromal and epithelial hyperplasia (androgenic stimulation), were almost equally present.

Adult↗

Cavernous artery revascularization in vasculogenic impotence: new simplified technique.

A new simplified technique of cavernous artery revascularization is presented. The arterial inflow to the corpora is obtained through a counterflow end-to-end anastomosis of the inferior epigastric artery to the proximal stump of the transected dorsal penile artery. The revascularization of the cavernous artery occurs through the common penile artery. This operation is particularly suitable for patients showing pudendal or common penile artery obstruction at arteriography. Optimal distal perfusion is obtained by a cross end-to-side anastomosis of the distal stump of the dorsal artery to the contralateral dorsal penile artery. To date 5 patients have been operated on using this method with good functional results in 80 per cent.

Erectile Dysfunction↗

Comparison of algorithms for determining the end-point of the forced vital capacity maneuver.

The criteria of the American Thoracic Society (ATS) for determining the end-point of the forced vital capacity (FVC) maneuver were compared with an algorithm employed by a computer system (Hewlett-Packard), which yields a later end-point. The 150 subjects tested were divided into five groups of 30 on the basis of the following spirometric diagnoses: normal; small airways' obstruction (SAO); mild airways' obstruction (MAO); severe chronic obstructive pulmonary disease (COPD); or restrictive disease. The subjects performed a minimum of three maneuvers according to ATS standards, and the flow-volume curves with the greatest sum of FVC and forced expiratory volume in one second (FEV) were chosen for analysis by the two algorithms. Hewlett-Packard (HP) values for FVC and FVC time were always higher than the corresponding ATS values, and the HP values for flows were always lower than the corresponding ATS values. The higher differences were observed in the SAO group. In the group with severe COPD, high FVC differences and low flow differences were observed; on the contrary, in the restrictive group, low FVC differences and high flow differences were present. These results, in addition to the different location of the FVC end point, may be explained by the different morphology of the flow-volume curves. In conclusion, the ATS algorithm caused a systematic underevaluation of FVC and a systematic overevaluation of flows, which cause practical consequences only in the SAO group. In fact, 28 percent (17/60) of the subjects with SAO characteristics were considered "normal" using ATS criteria for the end-point.

Adult↗

A new technique for end-to-end ureterostomy in the rat, using an indwelling reabsorbable stent.

The restoration of the continuity of the urinary tract represents one of the major problems in rat renal transplantation. End-to-end ureterostomy is the most physiologically effective technique; however, it involves noteworthy technical difficulties because of the extremely thin caliber of the ureter in the rat and the high incidence of postoperative hydronephrosis. We describe a new technique for end-to-end ureterostomy in the rat, where the use of an absorbable ureteral stent is recommended. A 5-0 plain catgut thread is used as a stent. The anastomosis is performed under an operating microscope at X 25-40 magnification with interrupted sutures of 11-0 Vicryl. The use of the indwelling stent facilitates the performance of the anastomosis and yields optimal results. The macroscopical, radiological, and histological controls in a group of rats operated on with this technique showed a very high percentage of success with no complications, a result undoubtedly superior to that obtained with conventional methods.

Animals↗

Experimental varicocele in the rat--a new experimental model. I. Effect on testicular structure.

A new experimental model of a varicoele in the rat is proposed. The study has been carried out on the Wistar rat in which the gonadal vein enters into the iliac vein. A varicocoele was induced in different ways: by complete or incomplete ligature of the iliac vein medial to the entry of the gonadal bein (Group I and II); by creating a venous compression by positioning the iliac artery in front of the vein, thus reproducing the so called "nut cracker" phenomenon (Group III); by creation of a small arterio-venous fistula by means of a side-to-side anastomosis between the iliac artery and vein. The results were studied macroscopically and histologically. The damage was most evident in Group III and significant in Group IV, but the absence of damage to the contralateral testis remains unexplained.

Animals↗

Experimental varicocoele in the rat - a new experimental model. II. Effect on impregnating ability.

In this paper the impregnating ability of rats in whom a varicocoele was induced according to principles described in a previous work was assessed. The animals, 20 adult male Wistar rats, were subdivided into 4 groups and treated as follows. In Group 1 a varicocoele was produced by partial ligature of the iliac vein proximal to the entry of the testicular vein. Group 2: same as Group 1 but incomplete ligature. In Group 3 an anterior transposition of the common iliac artery to the vein was carried out. In Group 4 a small side-to-side fistula between the common iliac artery and vein was created. The impregnating ability was evaluated by caging each operated animal with two fertile female rats. Only two animals, one belonging to Group 1 the other to Group 2, were unable to impregnate their partners.

Animals↗

Microsurgical testis autotransplantation. A critical review.

Abdominal testes represent 15 to 25% of all cases of cryptorchidism. In 5% the testis is so high in the abdomen that it is impossible to perform a conventional orchidopexy. The authors report an experience of 5 cases of testicular autotransplantation achieved by temporarily severing the testicular vessels and then reanastomosing them to the inferior epigastric vessels using a microsurgical technique with an operating microscope at 25 times magnification. Compared to traditional methods, autotransplantation permits an easy replacement of an ectopic testis into the scrotum and a more physiological blood supply to the testis. The authors discuss surgical and microsurgical techniques, testicular ischemia time and follow-up of patients who have undergone autotransplantation.

Child, Preschool↗

Transcatheter embolization with autologous clot in the treatment of renal bleeding.

Six cases of renal bleeding which were successfully treated by transcatheter embolization with autologous clot are described and illustrated. The problems of clot lysis and consequent vessel recanalization are discussed both from an experimental and clinical point of view. It is concluded that clot embolization is suitable treatment for renal bleeding and, in selected cases, is preferable to open surgery.

Accidents, Traffic↗

Microsurgical one-stage repair of hypospadias with a rectangular transverse dorsal preputial vascularized skin flap.

A microsurgical technique for one-stage repair of hypospadias using a rectangular transverse dorsal preputial island skin flap is presented. The use of optical magnification, atraumatic technique, and microsurgical instruments allows a vascularized preputial skin flap to be raised and isolated on the dorsum of the penis and then rotated ventrally and tubulized into a neourethral channel. The meatus of the new urethral channel lies at the tip of the glans. Cover for the penis is simply obtained and does not require a longitudinal row of sutures. The need to remove the distal stenotic portion of the urethra and to correct any degree of chordee is outlined and emphasized. Good cosmetic and functional results demonstrate the efficacy of such a technique.

Child↗

Temporary embolization in urological practice: myth or reality?

Clot embolization through percutaneous transcatheter technique has proved to be a highly effective and reliable method for stopping bleeding from renal or pelvic areas. The recanalization of the embolized vessels is constant and the recovery of the renal function quite satisfactory. In case of priapism temporary embolization may be very useful in selected cases.

Adolescent↗

PTH radioimmunoassay and loading tests in the diagnosis of patients with primary hyperparathyroidism.

PTH radioimmunoassay today represents an unreplaceable tool in the diagnosis of primary hyperparathyroidism. However, the diagnostic importance of its dosage on selective venous samples is still discussed. Herein, we report our experience of 47 patients operated on for primary hyperparathyroidism. The catheterization of neck veins was performed according to Doppman and co-workers. The PTH assay was carried out with COOH- and NH2-specific antisera. (In 5 cases an inhibition test with CaCl2 infusion was practiced during selective catheterization to preoperatively discriminate between adenoma and hyperplasia.) In 8 cases loading tests with EDTA and in 6 cases with CaCl2 were also performed in association with peripheral venous sampling, in an attempt to improve its sensibility. The 47 cases operated upon showed the following results: the peripheral PTH values were significantly raised in 60% of the cases; the selective PTH dosage with COOH-specific antiserum showed a parathyroid hyperfunction in 100% of the surgically confirmed cases, whereas with the NH2-specific antiserum an increased PTH rate was found only in 84%. A right preoperative localization was obtained in 73%. The value of loading tests is more difficult to evaluate and is discussed in detail.

Adult↗

[Parathyroid gland autotransplantation: long-term results and direct test of the function of the implant by selective parathyroid hormone determination and stress test].

The precision of PTH measurement and the location of the implant allow the functioning of the transplanted tissue to be easily checked by separately measuring the PTH concentration in the arm bearing the transplant in comparison with the other side. In 10 of the 13 patients operated on by us it was observed that the transplant had grown and was functioning satisfactorily. In 2 further patients, in whom the PTH concentration alone gave no clear information on the functioning of the transplanted tissue, the tolerance test was for this purpose decisive. In fact the transplanted parathyroid tissue showed a rapid and clear response to pharmacodynamic stimulus, which demonstrated the viability of the transplant. We therefore venture to say that pharmacodynamic investigation is of a certain use in postoperative examinations of these patients, especially in doubtful cases. Unfortunately we have had no opportunity to perform a histological investigation of the implanted endocrine tissue, but this has already been reported on in print.

Adult↗

Long-term results with autogenous microvascular grafts in various experimental models in rats.

Autogenous arterial and venous grafts were used to bridge defects in the femoral arteries, aortas, and renal arteries of 40 Wistar rats in an effort to determine the feasibility of using such grafts in the treatment of renovascular hypertension. The long-term results indicated that arterial grafts would be the most suitable in such a situation, but further study is needed before the technique can be applied clinically.

Animals↗

Usefulness of preoperative transcatheter embolization in kidney tumors.

In recent years preoperative transcatheter embolization has been used widely in the management of kidney tumors. However, the effective clinical usefulness of this method has not yet been proved. Forty cases of kidney tumors treated by preoperative embolization and radical nephrectomy are reviewed and compared with a homogeneous group of patients who did not undergo preoperative embolization. Intraoperative blood loss, postoperative complication, and survival rate were statistically evaluated according to tumor stage. Advantages and disadvantages of preoperative transcatheter embolization of kidney tumors are reviewed.

Adenocarcinoma↗