Biomedical subjects
Publications and source records attributed to L Miano.
The authors report their preliminary results using allopurinol as prophylactic treatment in 30 patients suffering from recurrent calcium oxalate renal stones. The results obtained were generally good, but a longer follow-up period and a larger patient population are required before definite conclusions can be drawn.
Litholytic and prophylactic medical treatment of cystine lithiasis in 42 patients over a 5-year period is reported. Treatment consists of administration of urinary alkalizing agents and alpha-mercaptopropionylglycine. Successful results were obtained in a high percentage of cases.
Homolateral pelvic ureteroureterostomies were performed in 25 patients presenting with complete duplication of the pyeloureteric tract. The procedure was performed in 16 cases of ureteroceles, in 7 cases of reflux in duplicated ureters, in 1 case of ectopic ureter and in 1 postoperative stenosis of one segment of a double ureter. According to the authors' experience this is the surgical treatment of choice in conservative surgical treatment.
We found increased levels of catecholamines in some patients who had high-renin hypertension. To study relations between angiotensin and the sympathetic nerves further, we infused saralasin, a blocker of angiotensin II, into 11 hypertensive patients being evaluated for renovascular hypertension. There were variable responses of mean arterial pressure, plasma renin activity, and norepinephrine levels. When high-renin hypertensive patients with increased levels of norepinephrine were compared with those having high renin and normal levels of norepinephrine, they showed a lesser decrease in mean arterial pressure--5 +/- 5% versus 14 +/- 4%, P less than 0.05--a decrease in plasma renin activity of 20 +/- 17% versus an increase of 77 +/- 24% (P less than 0.01), and a decrease in norepinephrine levels of 42 +/- 7% versus an increase of 10 +/- 23% (P less than 0.05) (means +/- SE). The evidence suggests that patients with high-renin levels are heterogeneous and that the primary mediator of the hypertension is sympathetic tone hyperactivity in those with increased levels of norepinephrine and angiotensin excess in those with normal levels of norepinephrine.
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To test whether central neurogenic factors participate in blood pressure elevation in primary hypertension, we studied the concentrations of: norepinephrine, epinephrine and dopamine-beta-hydroxylase (DBH) in cerebrospinal fluid (CSF); and norepinephrine, epinephrine, DBH and plasma renin activity (PRA) in plasma of 22 subjects (seven with primary hypertension, 11 normotensive patients with non-systemic neurological disorders, and four with secondary hypertension). Plasma and CSF norepinephrine (NE) were increased in primary hypertensives compared to normotensives. Cerebrospinal fluid norepinephrine was related to diastolic blood pressure, and systolic blood pressure when normotensive and primary hypertensives were taken together. The CSF norepinephrine of primary hypertensive patients was correlated with natural log PRA. The CSF norepinephrine was correlated inversely with age in primary hypertensive patients but not in the normotensive subjects. The low CSF norepinephrine and epinephrine, despite markedly increased plasma NE and epinephrine, in two patients with pheochromocytoma, indicate a blood-brain barrier for these neurohormones. The observations support the view that the central sympathetic nervous system is involved in the pathogenesis of primary hypertension, particularly in younger patients.
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The authors report the results about the staging of renal carcinoma using "angio-CT". The diagnostic accuracy, the sensibility, the specificity, in 42 patients, have been evaluated and compared with the subsequent operative or authoptic diagnosis. The meaning of this study is the comparison of the results obtained by this method in front of other examinations, especially artheriography.
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A randomized, double blind, placebo-controlled study (placebo and Finasteride 1 or 5 mg/die) was carried out in 34 patients with benign prostatic hyperplasia (BPH). After 12 months of treatment all patients received Finasteride 5 mg/die. Follow-up ranges from 18 to 36 months. One year after treatment, patients receiving Finasteride 1 or 5 mg/die, showed significant decrease (one-way ANOVA) of serum dihydrotestosterone (-70.1% and -69.6%, respectively), serum prostate specific antigen (-50% and -50.8%, respectively) and prostate volume (-36.3% and -31.8%, respectively). Comparable modifications of such parameters were observed in the placebo group only during the second year of the study when they were shifted to Finasteride treatment (5 mg/die). No increase of serum testosterone was observed in any group. Maximum urinary flow rate increased on the average, after one year, by 2.6 and 3.6 ml/s in patients receiving Finasteride 1 and 5 mg/die, respectively; a 1.3 ml/s increase occurred in the placebo group. The total urinary symptom score (Boyarsky) decreased in all three patient groups. Results of this study show that a few months are necessary to exert a significant therapeutic effect. The drug is well tolerated and does not decrease the patient's sexual activity. Finasteride certainly opens new perspectives in the treatment of BPH.