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Biomedical subjects

G Guazzoni

Publications and source records attributed to G Guazzoni.

At least 73 records · Page 4Linked to original sources
PubMed1993

Morphodynamic assessment of penile circulation in impotent patients: the role of duplex and color Doppler sonography.

Duplex and color Doppler sonography were used to assess the vascular status of 240 impotent patients. The tests were performed before and after intracorporal injection of a standard dose of a vasoactive mixture and measurements were done both at the crura and at the midshaft of the penis. Particular care was taken in the evaluation of cavernosal arteries diameter, wall pulsatility, morphology of spectral waveform, blood flow acceleration, systolic and diastolic flow velocity and flow volume. Resistance and pulsatility indexes of the cavernosal arteries were also measured. Flow along the deep dorsal vein was quantified when possible. Cavernosal artery peak systolic flow velocity, flow volume and acceleration were the best indicators of arterial penile circulation. Persistently elevated (> 10 cm/s) diastolic flow in the cavernosal arteries positively correlated with a diagnosis of venogenic impotence obtained by dynamic infusion cavernosometry--cavernosography in almost 80% of cases. Duplex and color Doppler sonography permit to thoroughly evaluate cavernosal arteries function and seem to have a promising role in the study of the veno-occlusive mechanism of the corpora cavernosa.

Blood Flow Velocity↗
PubMed1993

Bladder outflow after radical prostatectomy.

Postoperative bladder outflow was assessed in 150 patients subjected to radical retropubic prostatectomy for clinically localized prostate cancer. The overall mean (+/- S.E.M.) postoperative peak flow rates and residual urine volumes were 16.9 +/- 1.3 ml/s and 11.4 +/- 2.1 ml. According to flow nomograms, 22% of the patients were still obstructed postoperatively due to stricture of either the anastomosis or the urethra (12%), or to partial bladder denervation (10%). Scoring of subjective symptoms was not reliable in detecting postoperative outflow obstruction, while uroflowmetry with flow nomograms identified all obstructed cases. Radical retropubic prostatectomy can induce both mechanical and functional alterations of the distal urinary tract and a strict assessment of postoperative bladder outflow is recommended.

Adenocarcinoma↗
PubMed1993

[Echo-guided transperineal and transrectal prostatic biopsy: complications of the 2 methods].

We evaluated the complications of transrectal and transperineal ultrasound-guided prostatic biopsy in 280 patients. All patients underwent antibiotic prophylaxis with a different scheme according to the approach for the biopsy. Urine culture and, in some patients, blood culture have been collected after biopsy. We have reported the same rate of complications for the two modalities except for a lower rate of positive urine culture and blood culture in the group of patients submitted to transperineal biopsy; this type of approach, then, should be considered of first choice in some patients with a higher risk of infections.

Aged↗
PubMed1993

[Doppler color echography in the diagnosis of impotence].

This study reports the experience achieved with duplex and color Doppler ultrasonography in 120 impotent patients. The following morphodynamic parameters of the cavernosal arteries were studies before and after intracorporal injection of a mixture of vasoactive drugs: arterial diameter, wall pulsatility, morphology of the spectral waveform, peak systolic velocity, end diastolic velocity and flow volume. The veno-occlusive mechanism of the corpora cavernosa was studied directly by determination of flow along the deep dorsal vein of the penis and indirectly by serial evaluation of the diastolic flow of the cavernous arteries.

Adult↗
PubMed1992

Transrectal microwave hyperthermia for benign prostatic hyperplasia: long-term clinical, pathological and ultrastructural patterns.

Transrectal microwave hyperthermia of the prostate was administered to 191 patients with bladder outlet obstruction due to benign prostatic hyperplasia who were either at poor operative risk or who refused surgery. Patients were divided in 2 groups according to age and they underwent either 5 or 10, 60-minute sessions of hyperthermia, with a calculated intraprostatic temperature of 42.5 plus or minus 0.5C. Light and electron microscopy showed no irreversible damage at the glandular epithelium but did demonstrate a significant increase in neoformed intraprostatic capillary-like vessels. At 1, 12 and 24 months residual urine volume was significantly decreased in the majority of patients but only a minor amelioration of urinary flow rates and subjective symptoms was observed. According to maximum flow nomograms all patients were still obstructed postoperatively. Transrectal hyperthermia cannot be considered a genuine alternative to surgery for patients with bladder outlet obstruction due to benign prostatic hyperplasia.

Aged↗
PubMed1992

Transrectal microwave hyperthermia for advanced prostate cancer: long-term clinical results.

Transrectal microwave hyperthermia was applied to 46 stages D1 and D2 prostate cancer patients to treat urinary symptoms and local pain unrelieved by total androgen ablation therapy. Hyperthermia was administered in 10, 60-minute sessions twice a week for 5 weeks. A calculated intraprostatic temperature of 43.5 +/- 0.5C was maintained throughout the treatment. At 2 years the mean residual urine volume was significantly decreased (p less than 0.05), while the mean peak flow rate and maximum flow nomogram were improved but not significantly. The majority of patients reported a notable amelioration of subjective symptoms and quality of life. The only complication was a prostatorectal fistula that was cured by leaving a urethral catheter in place for 4 weeks. Prostatic hyperthermia is a safe and effective palliative procedure for bladder outlet obstruction due to advanced prostate cancer.

Aged↗
PubMed1992

Transrectal hyperthermia-induced histological and ultrastructural changes of human benign prostatic hyperplasia tissue.

This prospective study evaluated the tissutal, cellular and intracellular effects of transrectal microwave hyperthermia on human benign prostatic hyperplasia. Forty-eight patients with benign prostatic hyperplasia underwent ten 60-min-long sessions of transrectal hyperthermia with an intraprostatic calculated temperature of 42 +/- 0.5 degrees C. Ultrasound-guided transperineal biopsies of the prostate were taken before and 1 month after completion of treatment. Postoperatively, morphometric analysis of bioptic specimens showed a statistically significant (p < 0.01) increase in the number of intraprostatic arterioles and capillary-like vessels. Diffused inflammatory infiltrates were also noted. Postoperative integrity of intracellular organelles and cellular membranes was evidenced by transmission electron microscopy. Our regimen of transrectal prostatic hyperthermia did not cause any irreversible histological or ultrastructural damage to the prostatic tissue. Hyperthermia-induced increase in blood flow could enhance drug delivery to the prostate gland.

Humans↗
PubMed1992

[Long-term results of treatment of benign prostatic hypertrophy by trans-rectal prostatic hyperthermia].

From November 1987, 250 patients with symptomatic benign prostatic hyperplasia underwent transrectal prostatic hyperthermia. Forty-six patients had an indwelling catheter while 204 patients were obstructed but could still void spontaneously. Hyperthermia was administered in 5 or 10 sixty-minute sessions, with a calculated intraprostatic temperature of 42.5 or 43 degrees C. At the two-year follow-up, residual urine volume was significantly decreased while peak flow rate, maximum flow nomogram and subjective symptoms were only slightly improved, i.e. patients were still obstructed postoperatively. Transrectal prostatic hyperthermia cannot be considered as a first choice therapy for symptomatic benign hyperplasia but it can be offered only to carefully selected patients who cannot undergo any alternative therapeutic procedure.

Aged↗
PubMed1992

[Use of ultrasonography in morphofunctional evaluation of orthotopic neo-bladder].

Seventeen patients submitted to radical cystectomy and orthotopic bladder replacement according to Reddy's technique were studied at the 1, 3, 6 and 12-month, then annually follow-up by physical examination, intravenous pyelogram, cystourethrography, suprapubic and transrectal ultrasonography and complete urodynamics. Sixteen patients (94%) reported day-time urinary continence and twelve patients (70%) day-time and nocturnal continence. Cysto-manometry showed a mean bladder capacity of 450 cc with a maximal endocavitary pressure of 40 cm. H2O and satisfactory peak flow rate. Vesico-ureteral reflux was never detected at roentgenography. Ultrasonography may be useful in the study of a possible reflux or stenosis of the neovesico-ureteral junction by detecting renal scars or dilatation of the renal cavities. Sovrapubic ultrasonography can quantify the capacity of the neo-bladder (300-600 cc), study its shape, walls and contractions that do not cause the involuntary opening of the neo-bladder neck. Transrectal ultrasonography studies the bladder neck shape and its dynamic function. Residual urine volume never exceeded 50 cc. Ultrasonography demonstrated its effectiveness and reliability and limited the application of more invasive roentgenographic procedures.

Cystectomy↗
PubMed1991

Multimodal therapy for stones in pelvic kidneys.

Stones located in pelvic kidneys can be successfully treated by extracorporeal lithotripsy, either alone or in combination with endourology and open surgery. A multimodal approach was used in 16 patients with pelvic kidney stone disease and a 87.5% stone-free rate was achieved. The proper positioning of the patient on the lithotripter apparatus and the correct integration of the different therapeutic procedures were the real clues for obtaining a remarkable success rate with a minimally invasive approach.

Adult↗
PubMed1991

Long term experience with the prostatic spiral for urinary retention due to benign prostatic hyperplasia.

Twenty high risk patients with benign prostatic hyperplasia and urinary retention were treated by insertion of an intraprostatic spiral. The device was positioned under fluoroscopic guidance using a technique developed by us. The procedure required only local anaesthesia and successfully relieved the obstruction in all patients. At the six-month follow-up full continence had been achieved in 15 patients (75%). Three patients (15%) complained of mild stress incontinence but this was not severe enough to require removal and repositioning of the spiral. A 92-year-old patient reported severe incontinence despite correct positioning of the spiral. Removal of the spiral was necessary in one of the continent patients who was receiving anti-coagulant drugs because of sudden, severe macrohaematuria with subsequent acute urinary retention. The spiral became displaced and required repositioning in one patient. Median residual urine volume was constantly lower than 50 ml and the median maximal flow rate at six-month follow-up was 13.2 ml/s. Our long term follow-up study shows the effectiveness and safety of the prostatic spiral as an alternative treatment for selected patients with urinary retention caused by benign prostatic hyperplasia.

Aged↗
PubMed1991

[Comparison of rectal examination, transrectal echography, CAT and MRI in the local staging of prostatic carcinoma].

From January 1978 to June 1990, 120 prostate cancer patients were submitted to radical retropubic prostatectomy. Local pathological staging evidenced 70 patients (58%) in stage B of disease (intraprostatic disease) and 50 patients (42%) in stage C of disease (extraprostatic disease). Sensitivity of rectal examination, transrectal ultrasonography, CT or NMR for stage B was 61%, 75%, 54% respectively and for stage C 61%, 70%, 50%. This study underscores the effectiveness of transrectal ultrasonography in the diagnosis of prostate cancer non evidenced at rectal examination. CT and NMR are not valuable for local staging and are now used only in patients at risk for extraprostatic or systemic disease.

Evaluation Studies as Topic↗
PubMed1990

[Local prostatic hyperthermia in the therapy of urinary obstruction caused by prostatic adenoma. Experimental, clinico histologic and structural findings].

A specifically designed system of selective prostate heating was used to treat 197 patients with prostatic diseases: 164 benign prostatic hypertrophy cases, 14 prostatic adenocarcinoma cases, 19 chronic abacterial prostatitis cases. Ninety-one benign prostatic hypertrophy patients could be evaluated at the three month follow-up date. Sixty-eight patients complained of severe obstructive symptoms and 23 had an indwelling catheter. Prostates were heated up to 42 +/- 0.5 degrees C during 60 minute long sessions, once or twice a week for five weeks. Local prostatic hyperthermia determined a marked amelioration of the clinical picture in 67% of patients who presented without an indwelling catheter. Sixteen patients (70%) were weaned off the catheter. Major complications were not encountered.

Aged↗
PubMed1990

Morphodynamic and biochemical assessment of seminal plasma in patients who underwent local prostatic hyperthermia.

Fourteen young and sexually active patients with chronic abacterial prostatitis who failed to respond to conventional medical therapy underwent four 60 minute sessions of local prostatic hyperthermia. Calculated prostatic temperature was 42 +/- 0.5 degrees C. Analysis of seminal plasma was performed pre- and postoperatively and included: number, motility, and morphology of spermatozoa; zinc, citric acid, D-fructose, and free testosterone content. Preoperative semen analysis was normal in five patients and abnormal in nine. Morphodynamic and biochemical patterns of seminal plasma were not significantly altered by thermotherapy. Local prostatic hyperthermia can be safely used in patients with chronic abacterial prostatis not responding to conventional medical therapy and desiring to preserve their reproductive potential.

Adult↗
PubMed1990

Adult nephroblastoma induced erythrocytosis. Report of a case and review of the literature.

We report a 32-year-old white male with nephroblastoma induced erythrocytosis. Serum erythropoietin levels were elevated preoperatively and normalized after surgical eradication of the renal mass causing the complete disappearance of the erythrocytosis. The erythropoietic hormone was demonstrated in the neoplastic mass confirming the nephroblastoma as the site of hormone synthesis. After surgery, the patient underwent a course of chemotherapy with actinomycin D (AMD) and vincristine (VCR) and is currently free of disease.

Adult↗
PubMed1990

Local bacillus Calmette-Guerin therapy for superficial bladder cancer: clinical, histological and ultrastructural patterns.

The effectiveness of intravesical administration of bacillus Calmette-Guerin as a prophylaxis of superficial bladder cancer has been definitely demonstrated. On the other hand, therapeutic regimens, duration effects, efficacy of either maintenance cycles or repeated courses of therapy in case of failures are still controversial. We report the results achieved in 15 cases of carcinoma in situ of the bladder and in 48 cases of superficial bladder cancer (Ta-T1 stage of disease) with bacillus Calmette-Guerin immunotherapy. Our patients underwent an initial six week cycle and a following maintenance cycle with monthly administrations for one year. Median follow-up was 19 months (range 18-21 months). Patients with carcinoma in situ are now free of disease; on the contrary, patients with Ta-T1 tumors experienced 18 recurrences (28%). There was a marked decrease of recurrence rate when compared to previous local chemotherapy. We report in detail the adverse effects encountered and both histologic and ultrastructural findings observed after immunotherapy. Bacillus Calmette-Guerin therapy can influence positively the natural history of the disease but possible adverse effects should always be considered before starting the treatment.

Administration, Intravesical↗