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Biomedical subjects

L Giuliani

Publications and source records attributed to L Giuliani.

At least 145 records · Page 8Linked to original sources
PubMed1981

Infrarenal cavectomy and microsurgical reconstruction of an accidentally sectioned aberrant renal vessel in a patient with renal cell carcinoma.

A case of renal cell carcinoma invading the surrounding organs and extending into the infrarenal vena cava, treated by enlarged nephrectomy, splenectomy, resection of the diaphragm and extended resection of vena cava, is presented. Special attention is paid to the diagnostic angiographic approach, to the surgical solution adopted and to the microvascular reconstruction of an injured aberrant vessel of the contralateral kidney.

Adenocarcinoma↗
PubMed1981

Surgical hyperparathyroidism in calcium stone formers. A retrospective study of 20 cases.

Urinary lithiasis, hypercalciuria and hyperparathyroidism are strictly related diseases, and the urologist diagnoses primary hyperparathyroidism (PHP) in the majority of cases. Herein we retrospectively analyze our experience of 20 cases of surgically proved PHP, operated on in the last 4 years. Hypercalcemia was the keystone for the diagnosis of all our cases PTH radioimmunoassay on selectivity sampled blood revealed a fundamental tool in the management of patients with suspicious or certain hyperparathyroidism. It confirmed the diagnosis in all the cases and gave the preoperative localization of parathyroid adenomas in 70% of the cases. Besides, it made it possible to discriminate between parathyroid adenomas and diffuse hyperplasia preoperatively, so offering a considerable aid to the surgeon in deciding between the conservative and liberal approach to parathyroid surgery. At follow-up, 3 out of 14 cases revealed renal hypercalciuria, which could have been the cause of hyperparathyroidism, as proposed by Reiss and associates previously. The relationship between hypercalciuria and hyperparathyroidism and the problem of a new classification of parathyroid hyperfunction are discussed.

Adenoma↗
PubMed1981

Prolactin secretion in benign prostatic hypertrophy.

Prolactin secretion was evaluated in 22 patients with benign prostatic hypertrophy, before and after thyrotropin-releasing hormone stimulation. Increased prolactin reserve was found. In 11 patients, in whom the test was performed twice, the prolactin response after surgery was higher than in the pre-surgical test. The possible role of prolactin in the genesis of benign prostatic hypertrophy is discussed.

Aged↗
PubMed1981

Parathyroid autotransplantation.

7 patients with diffuse parathyroid hyperplasia underwent total parathyroidectomy and microsurgical autotransplantation for diffuse parathyroid hyperplasia. 5 of 7 patients showed good function of the grafted parathyroid tissue, as checked by the separate PTH assay from the grafted versus not grafted forearm. In 1 patient parathyroid stimulation test with EDTA infusion and suppression test with calcium infusion were also performed.

Adult↗
PubMed1981

[Testis autotransplantation in the abdominal cryptorchidism (author's transl)].

Testis autotransplantation represents an elegant and safe surgical procedure in the complex problem of the abdominal cryptorchidism. The authors report 2 cases of testis autotransplantation, in a child and in a young adult. the technique is strictly microsurgical, using the operative microscope, the microsurgical instruments and microsutures. For the control, the use of Doppler sound has proven its efficacy. The first results are encouraging and the authors conclude that such an intervention deserves to be taken into consideration when the decision to conserve an abdominal testicle is considered.

Adult↗
PubMed1981

[Brisk postoperative bleeding in a solitary kidney successfully treated by temporary clot embolization (author's transl)].

The so called temporary embolization by percutaneous injection of autologous clot can be envisaged as the method of choice in selected cases of massive renal bleeding. The goals of this technique are to occlude the bleeding vessels until a satisfactory hemostasis is achieved and to preserve as far as possible the renal parenchyma by adopting a completely reabsorbable embolic material as the autologous clot. After a review of the literature a case is presented where a temporary embolization was performed in a young woman with brisk postoperative bleeding in a solitary kidney. The procedure was successful and the renal function was not impaired.

Adult↗
PubMed1981

[Sub-costal xypho-umbilico flap. A new approach to the neoplastic kidney (author's transl)].

The authors suggest a new approach to the kidney tumors: the xypho-umbilical-subcostal flap incision. This incision offers the advantages of the transversal as well as of the longitudinal approaches and gives a very satisfactory exposition of the surgical field. The authors report 52 cases of renal tumors operated on with this approach in the last 5 years: because of the optimal view it allows and of the lack of complications they suggest this incision as a method of choice in the majority of the cases of renal tumor.

Humans↗
PubMed1980

[Renal adenocarcinoma with neoplastic thrombus in the inferior vena cava. Prognosis and operative risk].

10 cases of renal adenocarcinoma invading the lower vena cava and subjected at the Genoa urology clinic to radical nephrectomy and cavotomy, with thrombectomy or resection of the vena cava, are reviewed. Of 5 patients who did not present long-term metastasis, 2 are alive and in good condition at 30 and 64 months, one died from myocardial infarction after 34 months, and two died in the postoperative course from respectively renal insufficiency and myocardial infarction. In patients presenting long-term metastasis at the moment of surgery, results were poor: four patients died from 4 to 7 months later and only one patient, with bone metastasis, is alive after 33 months.

Adenocarcinoma↗
PubMed1980

Transcatheter embilization of the hypogastric arteries in cases of bladder hemorrhage from advanced pelvic cancers: followup in 9 cases.

Bilateral transcatheter embolization of the hypogastric arteries is effective hemostatic treatment for patients with chronic life-threatening bladder hemorrhage from advanced pelvic cancers. We reviewed 9 cases in which this procedure had been done to investigate the immediate results, clinical effects, complications and late results. The minimum followup is 1 year except for 4 patients who were followed until death, which occurred in less than 1 year. Bleeding relapse occurred in only 2 cases and another embolization procedure was done in 1 case without major complications. A considerable decrease in the size of the tumor was noted in 1 patient after the bilateral hypogastric arterial embolization procedure. A rare complication, the Brown-Séquard's-like syndrome, is discussed.

Aged↗
PubMed1980

[Transcatheter hypogastric embolization in life-threatening bladder hemorrages: immediate and long-term results (author's transl)].

Transcatheter embolization of the hypogastric arteries has become a more and more largely used therapeutic approach in mastering unrestrainable hemorrages in bladder cancer patients. In this paper the Authors report their experience with this method based on 9 cases, which could be followed for 1 year or until patient's death. The immediate and long-term results are presented and discussed. The Authors conclude that transcatheter hypogastric embolization is the best non-invasive method to handle neoplastic pelvic hemorrages.

Aged↗
PubMed1980

Hydroxyurea in the management of chronic urea-splitting urinary infections.

The aim in the management of struvite stones is to remove all of the stones and to treat urinary infection. The bacterial species which are known to cause struvite stones produce the enzyme urease, which increases urinary pH by splitting urea and consequently causes urinary supersaturation with respect to struvite and hydroxyapatite. The use of bacterial urease inhibitors with antibiotics is a new and interesting aid in the management of chronic urea-splitting infections. We describe our experience with the use of hydroxyurea in 15 patients with chronic urea-splitting infections.

Adolescent↗
PubMed1980

Treatment of advanced prostatic carcinoma with cyproterone acetate and orchiectomy--5-year follow-up.

We report the results from 106 patients with extracapsular (stage C) or widespread (stage D) prostatic cancer, who were treated with cyproterone acetate and orchiectomy and followed for 5 years. As controls we used 40 patients, chosen at random, with stage C and stage D cancer of the prostate gland who were treated with stilbestrol and orchiectomy. The survival rate is improved in patients treated with cyproterone acetate and orchiectomy compared to the patients treated with stilbestrol and orchiectomy. Treatment with cyproterone seems more effective in those patients with low-stage and low-grade prostatic cancer. The side effects of this therapy are less and milder than those described in estrogenic treatment alone or with orchiectomy.

Adult↗
PubMed1980

The effect of cyproterone acetate and orchiectomy on metastases from prostatic cancer.

We have studied 38 patients with previously untreated, widespread prostatic cancer, who were submitted to therapy with cyproterone acetate and orchiectomy. 70% of patients with symptoms have shown subjective improvement. Moreover, it was possible to observe the regression, stabilization or progression of metastases in 32, 50 and 18% of the cases, respectively. We conclude that such therapy is effective in the initial treatment of metastatic prostate cancer and can be continued under radiographic control until the appearance of new metastases. At this point radiotherapy and alkylating agents may be effective.

Adult↗
PubMed1980

Radical economic surgery and antiandrogenic therapy in management of prostatic cancer.

The treatment of early stage prostatic cancer with retropubic radical prostatectomy, pelvic lymphadenectomy and antiandrogenic therapy is reported. Out of 22 patients operated in the past 9 years, none died because of the tumor and metastases appeared in 1 patient only. The latter showed a microscopic seminal vesicle invasion and was considered as a P3 stage. Excluding impotence which is generally the rule, urinary incontinence was the most common complication: it was complete in 1 case but successfully treated surgically and mild in 6 cases without, however, requiring surgical intervention or collection device.

Aged↗
PubMed1979

Value of selective parathormone radioimmunoassay in primary hyperparathyroidism.

Nine cases of primary hyperparathyroidism (PHP) in patients with urinary calculi are reported and discussed. Selective venous catheterization and parathormone (PTH) radioimmunoassay confirmed the diagnosis in all cases, preoperatively discriminated between adenoma and diffuse parathyroid hyperplasia, and permitted exact preoperative localization of 5 of 7 adenomas. The interest of the urologist in PHP and the usefulness of selective PTH radioimmunoassay are discussed and emphasized.

Adenoma↗
PubMed1979

Bivalve nephrolithotomy in kidneys with ileal ureter.

We describe the surgical management of 2 patients with staghorn stones in kidneys previously operated upon and an ileal ureter. Bivalve nephrolithotomy was accomplished in situ using local hypothermia and anatrophic nephrotomy. This approach seemed to be the most suitable in these cases because other procedures could have been difficult and risky for the pelvioileo-anastomosis.

Adult↗