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M Ruoppolo

Publications and source records attributed to M Ruoppolo.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Neoadjuvant chemotherapy of locally advanced tumors of the bladder: preliminary experience].

From february 1988 to march 1989, 6 patients with locally advanced bladder cancer (T3b-T4, N0-N1, M0) were treated with 4 courses of neoadjuvant MP chemotherapy (methotrexate 300 mg/mq. + cisplatinum 100 mg/mq). In two patients chemotherapy was stopped because minimal or no response after two courses. Partial response (RP) was achieved in three patients (50%). Two patients died 2 and 5 month later. One patients developed metastases at 11 month. The remaining three cases showed NED at 3, 4 and 15 months of follow-up. In the same period 4 patients with metastatic bladder tumor were treated with M-VAC chemotherapy according to Yagoda before the cystectomy. M-VAC obtained a complete response in one case, and PR in 3 cases. All the metastases showed evidence of objective tumor regression. Reduction of bone pain was observed in one case. One patient died 15 months later with bone massive involvement. Another patient developed invasive tumor at 13 months. Two patients were disease-free at 3 and 5 months, respectively. Toxicity was more frequent in patient treated with M-VAC than with MP chemotherapy. M-VAC, we believe, represents a reliable neoadjuvant treatment of advanced metastatic bladder cancer.

Aged↗
PubMed1990

[Complications of percutaneous litholapaxy].

Percutaneous nephrolithotomy has been proved an efficient management of renal calculi. We report, in present review, the complications of PCNL procedure referred by several authors and our casistic since 1985. Major complications occurred in 3-6% of treated patients: severe bleeding, arteriovenosal fistulas, haematoma perirenal, water syndrome, sepsis, DIC, etc.). Nephrectomy was necessary in less than 1% of reported cases. 5 patients died for complications related to PCNL. Early complications occurred during the percutaneous puncture, tract dilation and lithotripsy. Postoperatively bleeding at the time of nephrostomic tube removal was reported in 0.5-1% of cases. Late sequelae of PCNL: stricture, fistulas, renal damage, renal function loss, high lithiasis recurrence rate were reported rarely. We, herein, believe PCNL is a safe and effective procedure with minimal rate of complications and late effects, according to other important authors.

Humans↗
PubMed1990

[Complications and limitations of transurethral prostatic resection: retrospective study of 366 patients].

In present paper we report our experience on 366 patients underwent to transurethral resection of prostate from January 1988 to January 1990. All patients were controlled by uroflowmetry and retrograde plus minctional urethrography, with evaluation of the possible immediate and latest complications. Among the latest complications, the most representative had been urethral stricture, occurred in 24 patients (6.5%) according with international literature. We considered also various iatrogenics factors (operator experience, endoscopic time, catheter section, catheter permanence time, use of lubricator, presence of catheter before TURp, preventive Otis urethrotomy). From our study rises out that the most important risk factors are: a) catheter permanence time; b) TURp without preventive Otis urethrotomy.

Humans↗
PubMed1989

[Extracorporeal lithotripsy with low pressure shockwaves using a modified Dornier HM3 lithotriptor: preliminary results].

Extracorporeal shock wave lithotripsy is a well established procedure for the treatment of the renal and ureteral calculi. The technical innovations of the low-pressure generator with a modified ellipsoid installed into the Dornier HM3 lithotripter leads to decrease the pressure in the second focus F2 lowering the painful sensation linked to the treatment and allowing to perform lithotripsy without general or epidural anae sthesia. From January to March 1988 132 patients underwent 144 treatment by modified Dornier Lithotripter HM3, we performed the treatments under a combination of anxiolytic and analgesic drugs in 125 patients (94.6%), only 7 patients needed the general or epidural anaesthesia, because of complex endoscopic pretreatment instrumentations. An average of 2150 Shock waves was applied with a range of 500 to 3800, the shock wave energy was administered at an average 20 Kvolts (16-26 Kv). Stone fragmentation had a success rate of 94.6%. The average postoperative stay was 4.5 days. After a month of follow-up 50.9% of the patients was free of stones, 27.8% had sand or spontaneously passable fragments and 11.1% had residual fragments larger than 4 mm. The treatment was judged as free of pain or with tolerable pain in 60% of the patients, 40% of the patients needed additional medication. The number of secondary treatment was, in our review, 9% but it could increase because we observed after a month of follow-up that 11% of the patients treated presents fragments larger than 4 mm.

Equipment Design↗
PubMed1989

[The Wolf piezolith 2300 lithotriptor: a technical note].

In the Piezolith Wolf 2300 lithotripter, shock waves are generated by about 3000 piezoceramic elements aligned on a self-focusing spherical disk. No ECG-recording is required. Stone localization is obtained by two 4.5 MHz sector ultrasound scanners. Acoustic coupling is performed by a partial water bath. The focal region (pressure higher than P + 12) is only 11 X 3 mm. The positive peak pressure ranges by 300 two 1050 bar. The large exposure of the shock front causes low pressure at the skin level and gives quite painless treatment.

Equipment Design↗
PubMed1989

[The Wolf piezolith 2300: lights and shadows].

Extracorporeal piezoceramic Wolf lithotripter was developed in West Germany by Ziegler and Associates in collaboration with Wolf GmbH. Piezolith 2300 has no cumbersome water tube and it was constructed as a mobile unit. It requires no patient irradiation, a special room adaptation, a electrodes replacement or any auxiliary staff. From February 1988 up to May 1989 a total of 230 stones in 218 patients, 18 to 79 years old, was treated with Piezolith 2300, in our Center. Ultrasound localization failed in 7 more cases of ureteral stones. Treatment resulted quite painless. Auxiliary measures before EPL, were performed in 12 cases, only (5%). 15 pts were managed with combined procedures: ESWL + EPL, PCNL + EPL, surgery + EPL. The mean of SW was 3000 (800-6500) for each piezoelectric session. In 27 pts (12%), 4 or more EPL sessions were performed. A successful disintegration was achieved in 210 cases (90.2%). Out of 20 unsuccessful cases, 15 were managed by Dornier HM3 mod lithotripter and 4 by ULL. Post EPL ancillary procedures were required in 4 pts (1.8%). No major complications were observed in our series. At the 30-days follow-up, 57.3% of the patients were stone free. At preliminary 3-month follow-up in 120 pts the rate of the entire success raised to 75%. We think, according to others authors, that EPL is the treatment of first choice in 70% of reno-ureteral stones.

Adolescent↗
PubMed1989

[Urinary excretion of N-acetyl-glucosaminidase after extracorporeal shockwave lithotripsy: a marker of renal tubule injury].

The major complications of extracorporeal shock wave lithotripsy (ESWL) are perirenal hematomas for an incidence of less than 1 per cent. However in animal experiments histopathological effects of focused electrohydraulic shock waves on renal parenchyma have been reported, the most significant of which are hemorrhagic foci healing rapidly by cicatrization. Furthermore imaging studies have demonstrated morphological changes limited to the area of the kidney exposed to shock waves. Liver, skeletal muscle and pancreatic enzyme changes have been documented after ESWL. In our experience the urinary ratio of NAG (N-acetyl-glucosaminidase) to creatinine, a good marker of renal tubular damage, increased after treatment with both the original and the modified spark gap Dornier HM3 lithotripters and with the piezoelectric Wolf Piezolith 2200. Particularly the threshold of pathological urinary NAG excretion were 2,000 and 2,600 shocks respectively using the original and the modified Dornier HM3 and 7,000 shocks using the Wolf Piezolith 2200. The functional significance of the changes is not known, however in clinical practice it would seem prudent to avoid excessive exposure to shock waves.

Acetylglucosaminidase↗
PubMed1989

[Possibility of using the piezoelectric lithotriptor in the treatment of severe cavernous fibrosis].

The treatment of serious cavernous corpora fibrosis due to priapism, a prosthesis explantation, iatrogenic causes, or Peyronie's disease, is by now still uncertain. Therefore we tried, when medical and physical therapy failed, to find out the possibility of extracorporeal lithotripter to treat such a complicated cases. From February 88 until now 16 patients underwent extracorporal shock waves treatment, out of 16, 9 had a serious Peronie's disease (a), in 3 fibrosis was a consequence of priapism (b), in 3 of prosthesis explantation (c), 1 patient of cavernosography (d). The treatment was performed by Wolf piezoelectric lithotripter (Piezolith 2300), the patients were treated once a week for 6 weeks. (800 SW; power ranged between 40 and 100 Mpa, frequency between 1 and 2.5 Hertz). In all the patients an orally steroid drugs was administered and a ionophoresis therapy associated. After one year of follow up a penile ultrasound scan, artificial erection tests, rigidometry. None side effects was noted but local ecchimosis. The were done results obtained might support our effort and suggest further studies.

Adult↗
PubMed1988

Renal tubular damage after renal stone treatment.

50 patients were studied with respect to renal tubular damage related to open operative, percutaneous and extracorporeal shock wave treatment of renal stones. Preoperative and postoperative urinary N-acetyl-glucosaminidase (NAG) levels were measured as a marker of renal damage. There was no significant evidence of renal tubular damage in patients who underwent a conventional or percutaneous nephrolithotomy; urinary NAG excretion was significantly increased after ischaemic surgery. After extracorporeal shock wave lithotripsy (ESWL) serum NAG levels increased, probably because a damage of the white blood cells in cutaneous and renal circulation, but a slight increase of urinary NAG excretion could suggest a mild renal tubular damage especially in case of more than 2,000 shocks.

Acetylglucosaminidase↗