Search PubMed⌕ Search

Biomedical subjects

G Vespasiani

Publications and source records attributed to G Vespasiani.

At least 19 recordsLinked to original sources
PubMed1997

Electromotive delivery of mitomycin C into human bladder wall.

The aim of this investigation was to establish an appropriate tissue pharmacokinetic model to compare concentrations of mitomycin C (MMC) in the human bladder wall after either passive delivery or electromotive administration (EMDA) and to evaluate the effects of EMDA on tissue morphology and MMC structure. Tissue sections of human bladder were inserted into two chamber cells with urothelium exposed to donor compartments containing MMC (10 mg in 100 ml of 0.24% NaCl solution) and an anode and with serosa exposed to receptor compartments containing 100 ml of 0.9% NaCl solution and a cathode. Fourteen paired experiments ("current 5 mA/no current") were conducted over 15 min; MMC tissue content was assessed by high-pressure liquid chromatography. Tissue viability and morphology and MMC stability were assessed by trypan blue exclusion test, tissue pH, histological analysis, and mass spectrometry analysis. MMC concentrations were increased, and variability in drug delivery rate was reduced in all tissue in samples exposed to electric current. Tissues were viable and undamaged histologically, and no MMC structural modification was observed. In conclusion, EMDA enhances administration of MMC into viable bladder wall tissue and reduces the variability in drug delivery rates.

Administration, Intravesical↗
PubMed1997

Voiding dysfunction in patients with spinal cord lesions at the thoracolumbar vertebral junction.

Neurogenic voiding dysfunction invariably follows a complete spinal cord lesion. With spinal shock urodynamic investigation will show an areflexic bladder if the sacral spinal cord has been damaged, otherwise, if the lesion involves the suprasacral cord, an overactive bladder will result. There are some exceptions to this rule, particularly in those with lesions of the thoracolumbar vertebral junction, where the sacral cord is located, it may be difficult to predict urodynamic dysfunction merely on the basis of the vertebral body involved. 46 patients with a complete SCI neurological lesion at the thoraco-lumbar vertebral junction underwent a neurourological evaluation including multi-channel urodynamic studies. Overall in 20 to 36% of the patients the urodynamic pattern was different from what one would have expected considering the anatomical level of the vertebral body involved. Urodynamic study is confirmed as an essential tool in the correct diagnostic and therapeutic approach to the voiding dysfunction in these type of patients.

Adolescent↗
PubMed1996

Autologous adrenal medullary transplant in Parkinson's disease: critical review of our results in 13 patients.

Autotransplantation of the adrenal medullary to the caudate nucleus has been proposed for severe Parkinson's disease (PD). We describe our experience in 13 patients using a transperitoneal approach to the medullary and craniotomy for the implant: the neurosurgical equipe's decision to opt for craniotomy made quick removal of the medullary with minimal morbidity more difficult. The surgical technique are discussed. We evaluated also the impact of the procedure on urinary symptoms and sexual disturbances associated with PD. Results were disappointing. Four patients died post-operatively. The neurological pattern improved in three men and one woman. No significant improvement was observed in the urological and sexual dysfunctions.

Adrenal Medulla↗
PubMed1996

Validation of a computerised measurement system for guided routine evaluation of cardiovascular autonomic neuropathy.

A study for evaluating the use of the Cardionomic system was conducted in six Italian Centres for Diabetes. Cardionomic is a portable computerised system that is used for a guided step-by-step performance of several cardiovascular tests for autonomic neuropathy (heart rate and blood pressure). It has been compared to the traditional method using an electrocardiograph. In this study, which involved 74 diabetic patients, 392 cardiovascular tests were conducted with the electrocardiograph and 392 were done using the portable system. The results were compared to the results obtained with the ECG assuming the latter as the standard ones. All the indices of validity that were investigated (sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio) indicate that the proposed system is reliable. Because it saves a considerable amount of time and is also easy to use, it represents a valid alternative for the routine screening of autonomic neuropathy.

Adult↗
PubMed1996

Endoscopic ballistic lithotripsy in the treatment of bladder calculi in patients with neurogenic voiding dysfunction.

Bladder stones represent a troublesome complication in patients suffering from neurogenic voiding dysfunction, in whom prompt and effective therapy is required. A variety of endoscopic lithotripsy methods are available; however, current devices can be tedious to use. We have treated 17 patients affected by bladder calculi and spinal cord injury or multiple sclerosis by means of the ballistic lithotripter EMS Swiss Lithoclast. The mean diameter of the stones was 2.7 cm. The mean operative time was 27 minutes. There were five intraoperative complications, including crises of autonomic dysreflexia (three patients) and light hematuria (two patients). There was no malfunction of the lithotripter and no long-term complications. All the patients were stone free at 6 months postoperatively. In conclusion, endoscopic lithotripsy with the ballistic lithotripter proved to be a very effective, rapid, and safe method for treating bladder calculi in patients with neurogenic bladders.

Adult↗
PubMed1994

[Urethral diverticuli in patients with spinal cord injury: echographic study].

Urethral diverticula, a not infrequent complication in patients with spinal cord injuries, usually involve the bulbous urethra which is particularly exposed to the trauma of catheterism. Indeed, the frequent association of urethral trauma and infection is often the cause of diverticula in these patients. Diagnosis is made by ascending urethrogram, voiding cystourethrogram and urethroscopy. Eight patients between 20 and 45 years of age with spinal cord injuries who had used an indwelling catheter for periods ranging from 1 to 18 months and who presented urethral diverticula at conventional investigation, underwent transperineal and penile contact ultrasonography using 3.5 and 7.5 MhZ real-time scanners. Ultrasonography was performed during intraurethral injection of saline solution through a catheter positioned near the external urethral meatus. Before the scan all patients had undergone a neuro-urological physical examination, urine analysis and culture, renal and bladder ultrasonography, ascending urethrogram and voiding cystourethrogram, urethroscopy and urodynamic investigation. Ultrasonography identified all urethral diverticula, defined them morphologically, visualized the diverticula filling and emptying phases and evaluated urethral wall and periurethral tissue characteristics, without exposing patients to any dangerous gonadal irradiation. Ultrasonography cannot replace radiological investigation but is a valid alternative in cases of contrast medium allergy, when monitoring inoperable diverticula and in postoperative follow-ups.

Adult↗
PubMed1994

[Echography in prostatitis].

In many infertile patients abnormalities in sperm are due to prostatic inflammatory disease. In the male reproductive system temporary episodes of inflammation, caused by newly discovered micro-organisms such as Chlamydia Trachomatis and Ureaplasma Urealyticum, may occur frequently and cause sub-clinical inflammation. This rapidly became chronic and induce the development of anti-spermatozoon antibodies. This latent clinical pattern and lack of symptoms often means diagnosis is late and medical treatment inadequate. In recent years attention has been focused on transrectal ultrasonography as a possible gold standard for diagnosing prostatic inflammatory disease. Widespread use of technologically advanced instruments has significantly improved the quality and definition of prostatic images. This paper discusses the current role of transrectal ultrasonography in the diagnosis of prostatic inflammatory disease. Abnormalities in the ultrasound pattern, caused by infection, are analyzed in detail and discussed critically in order to assess their role as markers of prostatic inflammation.

Humans↗
PubMed1993

Intralesional alpha interferon therapy in papillary superficial transitional cell carcinoma of the bladder. A pilot study.

The tolerability, toxicity and therapeutic efficacy of recombinant interferon alpha-2a (rIFN alpha-2a), administered by intralesional injection, were evaluated in 15 patients with papillary superficial transitional cell carcinoma of the bladder, rIFN alpha-2a was delivered endoscopically in a single weekly dose of 3 x 10(6) IU for 4 weeks (total 12 x 10(6) IU). Transurethral resection of residual tumours was then performed. The response to treatment was assessed according to ultrasonographic, endoscopic and pathological findings. One patient achieved complete remission, 6 partial remission, 6 minor remission and 2 stabilisation of disease. All patients completed the course of treatment. A mild, transient, flu-like syndrome was documented after every injection. Immunological findings suggest that the antitumour effects of rIFN alpha 2a are not mediated through the immune system.

Aged↗
PubMed1992

[Ultrasonography in the follow-up of patients after extracorporeal shockwave lithotripsy].

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized treatment of urinary stones, but created new clinical situations and problems in the interpretation of which x-rays and ultrasonography have proved invaluable. This paper defined the role of ultrasound in the follow-up of patients who had undergone ESWL and assessed its advantages and limitations in evaluating the efficacy of this form of therapy and in monitoring the elimination of stone fragments. The utility of ultrasound in the diagnosis and monitoring of the complications due to ESWL has been emphasized. Finally ultrasound is a valid tool when performing those echo-guided procedures which are essential for the treatment of obstructive complications secondary to ESWL.

Follow-Up Studies↗
PubMed1991

Evaluation of new computerized method for recording 7-day food intake in IDDM patients.

OBJECTIVE: To evaluate a new computerized method for recording 7-day food intake. RESEARCH DESIGN AND METHODS: Randomized crossover trial was conducted with patients recording the amount and type of every food and drink consumed during a week by either a computerized device (Food-meter) or recording the data in a diary. Each method was applied twice. Twenty-one insulin-dependent diabetic patients (mean +/- SD age 25 +/- 9 yr) were studied. RESULTS: The two methods showed very good agreement in the evaluation of the patients' diets (1792 +/- 408 vs. 1764 +/- 436 kcal/day, 84 +/- 19 vs. 82 +/- 21 g/day protein, 68 +/- 22 vs. 67 +/- 23 g/day fat, 210 +/- 60 vs. 207 +/- 58 g/day carbohydrate with the conventional and computerized methods, respectively). The variability between the methods and the variability within each method were of similar magnitude. CONCLUSIONS: The Food-meter represents a useful tool for computerizing the 7-day food record. The method is easy, reliable, and time saving. Moreover, it minimizes the risk of transcriptional errors.

Adult↗
PubMed1991

[Ultrasonically guided access to the kidney].

Ultrasonography is an ideal procedure to guide and control the diagnostic and therapeutical percutaneous renal puncture. Some procedures considered in pre-echographic period, long, complicated and not free from risks and complications, were transformed in routine manoeuvres by the advent of ultrasound. Nowadays, thanks to the ultrasound guide, is possible to perform a rapid, accurate, safe and without anesthesia puncture of the kidney and of the upper urinary tract. Several procedures contemplating the renal puncture, can be performed in out-patients.

Biopsy↗
PubMed1991

[Echography in andrological emergencies].

Ultrasonography is the first imaging method to undertake in all acute andrological disorders. It gives an accurate diagnostic picture in a high percentage of cases and is extremely useful for following patients during therapy and after surgery. The forms of acute andrological disorders, of both medical and surgical pertinence, that can be evaluated ultrasonographically include many prostate, seminal vesicle and external genital afflictions. Among the prostate and seminal vesicle disorders, of particular importance are acute prostate vesiculitis and prostatic abscess. Ultrasonography can be used to advantage in the latter as a guide to percutaneous transperineal drainage. The acute penis disorders that can be assessed by are essentially vascular affections (priapism and thrombosis of the corpus cavernosum). Ultrasonography, however, find its widest field of application in acute scrotum disorders. Ultrasonography is the most valid diagnostic aid for confirming clinical data in all forms of these disorders. It allow these that need medical treatment to be differentiated from those requiring surgery. Ultrasonography has good specificity in the differential diagnosis of spermatic cord and Morgagni's hydatid torsion, an acute scrotal affliction not uncommon in childhood, which is often self-limiting and, therefore, does not necessitate emergency surgery. Finally, ultrasonography is useful for distinguishing minor scrotal trauma which can be treated medically from major scrotal trauma which requires surgical intervention.

Acute Disease↗
PubMed1990

Partial gastrectomy and mineral metabolism: effects on gastrin-calcitonin release.

Bone mineral metabolism was studied in 20 male patients, between 8 and 18 years, after surgical treatment for peptic ulcer (ten Billroth 1 and ten Billroth 2 gastrectomies) and in 16 sex- and aged-matched healthy controls. The bone mineral content was statistically reduced only in the Billroth 2 group. Serum 25(OH)D was lower in all patients, but fractional calcium absorption was similar to the control value. This may be due to increases in 1,25(OH)2D and parathyroid activity (particularly in Billroth 2). Serum osteocalcin levels and hydroxyproline excretion were higher than in the controls. A positive linear correlation emerged not only between serum 1,25(OH)2D and PTH levels but also between each of these and serum osteocalcin and urine hydroxyproline. Both PTH and calcitriol were inversely correlated with the bone mineral mass in Billroth 2, confirming a trend observed in Billroth 1. Although calcitonin values were normal, basal gastrin levels were severely impaired in all patients. In response to a mixed meal, increases in gastrin and calcitonin were significantly lower than in the controls. The calcitonin response to intravenous calcium and pentagastrin infusion was not significantly different to the controls. The percentage increase in gastrin and calcitonin responses to oral calcium correlated positively with the reduction in bone mineral content only in the Billroth 2 group, suggesting a reduction in calcitonin release may contribute to gastric surgery osteopenia in these patients.

Adolescent↗
PubMed1990

Diuretic ultrasound. A non-invasive technique for the assessment of upper tract obstruction.

A study was made of the diagnostic reliability of renal ultrasound with a diuretic in the evaluation of upper tract obstruction. The test comprised an initial renal ultrasound examination followed by the intravenous injection of 250 ml physiological saline with 40 mg frusemide; further ultrasound scans were carried out from 5 to 150 minutes later. A total of 67 patients was studied and the results were compared with those of diuretic intravenous urography, diuretic renography and, in some cases, the Whitaker test. Dynamic ultrasound with a diuretic showed a sensitivity of 94%, specificity of 94%, positive predictive value of 91% (obstructive), negative predictive value of 96% (non-obstruction) and a total diagnostic capacity of 94%.

Adolescent↗