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Biomedical subjects

Marco Carini

Publications and source records attributed to Marco Carini.

23 records · Page 2Linked to original sources
PubMed2004

Orthotopic ileal neobladder giant stone in a female.

This article describes an unexpected case of a giant neobladder stone in a female that was diagnosed incidentally for a concurrent ovarian disease, without clinical or instrumental evidence of neobladder over distension. In July 1989, M.A., woman, 39-years old, underwent radical cystectomy, saving the uterus and the ovaries, and orthotopic ileal bladder substitution. Twelve years later she had symptoms of diffuse abdominal discomfort for about one month, without noticeable urinary symptoms or urinary retention. Enhanced CT and a subsequent MRI showed the presence of a 10 x 12.5 x 19 cm capsulated ovaric mass with sharp edges and associated obstructive bilateral hydroureteronephrosis, and an oval-shaped stone with a 10 cm longitudinal diameter, which occupied the majority of the neobladder cavity. The patient underwent surgical operation to remove the ovaric mass (fibrotecoma) and to extract the giant floating stone by a neocystotomy. Its dimensions were 10.5 x 7 x 7 cm, weighing 760 g. The stone was triple phosphate on chemical-physical analysis. The case reveals that neobladder stones can be associated with very few symptoms and if an appropriate follow-up is not performed they can become of remarkable dimensions.

Adult↗
PubMed2003

Gemcitabine plus cisplatin in adjuvant regimen for bladder cancer. Toxicity evaluation.

OBJECTIVE: To evaluate the toxicity of gemcitabine and cisplatin combination therapy in adjuvant regimen after radical cystectomy for muscle invasive bladder cancer. PATIENTS AND METHODS: Forty patients underwent radical cystectomy for pT2b-pT4 N0-N2 transitional cell carcinoma of the urinary bladder. They had not received prior systemic chemotherapy and were scheduled to receive gemcitabine 1,000 mg/m(2) on days 1, 8, and 15 and cisplatin 70 mg/m(2) on day 1 of a 28-day cycle, for 4 cycles. All toxicities were evaluated by World Health Organization toxicity criteria. RESULTS: No toxic deaths occurred. All patients experienced transitory alopecia. 12/40 (30%) patients did not experience any toxicity except for alopecia. 23/40 (57.5%) had hematologic toxicity; 1/40 (2.5%) thrombocytopenia grade 4, and 3/40 (7.5%) granulocytopenia grade 3. All nonhematologic toxicities (21/40, 52.5%), including neurotoxicity, constipation and diarrhea, nausea and vomiting were less than grade 3. CONCLUSIONS: Gemcitabine plus cisplatin is a well-tolerated combination therapy with a good clinical safety profile, ethically justifiable in adjuvant regimen for bladder cancer.

Adult↗
PubMed2002

ET(B) receptor in renal medulla is enhanced by local sodium during low salt intake.

Renal endothelin-1 participates in sodium and water handling, and its urinary excretion is increased in sodium-retentive states. We compared the cortical and medullary renal expression of prepro-endothelin-1, endothelin-converting enzyme-1, and endothelin type A and type B receptors in patients who underwent nephrectomy after normal (108 mmol/d NaCl; n=6) or low (20 mmol/d NaCl; n=6) sodium diet and investigated whether sodium exerts a direct role on endothelin receptor binding in vitro. With normal sodium diet prepro-endothelin-1 mRNA was 3-fold higher in renal medulla than in cortex (P<0.01), whereas endothelin-converting enzyme-1 mRNA was equally distributed. Endothelin-1 receptor density was 2-fold higher in renal medulla than in cortex (P<0.05). Type B was the main receptor subtype in both regions. In the renal cortex, low sodium diet caused a 194% increase in prepro-endothelin-1 mRNA (P<0.05), whereas endothelin-converting enzyme-1 type B and type A receptors remained unchanged. In contrast, in the renal medulla the increase in prepro-endothelin-1 mRNA (+30%, P<0.05) was associated with a selective increase in type B receptor for both mRNA expression (+37%, P<0.05) and binding density (+55%, P<0.05). Increasing in vitro sodium concentrations between 154 and 308 mmol/L significantly enhanced type B receptor density (P<0.05) and affinity (P<0.05). In conclusion, during low sodium diet, renal prepro-endothelin-1 synthesis increases mainly in the renal cortex (where no changes in receptors occur), whereas type B receptor is selectively enhanced in the renal medulla. The range of sodium concentrations that are physiologically present in vivo in the renal medulla selectively modulate type B receptor density and affinity.

Aspartic Acid Endopeptidases↗