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P Cortellini

Publications and source records attributed to P Cortellini.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Buschke-Löwenstein tumor: report of 2 clinical cases].

In our department two cases of Buschke-Löwenstein tumor were up to day observed. The first case, a man 51 years old, showed a big exophytic growth all over the glans, plus some similar lesions all along the shaft of the penis, besides a bilateral inguinal lymphoadenopathy. The second case was that of a man 70 years old, presenting a single exophytic growth on the glans. Both cases underwent a surgical excision of the lesions. The first patient had a local relapse after one year and a second one after further four months, which were both surgically exsected. Today, both patients are disease-free, being elapsed twelve years and sixteen months respectively. Surgical excision seems therefore to answer well the clinical problem, as for as the rarity of distant spread, the feasibility of conservative removal or reiteration, should it the case, are concerned.

Aged↗
PubMed2000

[Interstitial laser therapy in benign prostatic hyperplasia].

The interstitial laser therapy is a low invasivity system for prostatic benign hyperplasia. We report our experience with Indigo 830e new system where diode laser and optical temperature sensor warrant a laser-induced interstitial thermal therapy able to continuously adjust energy delivery to the tissue.

Aged↗
PubMed2000

[Unusual case of mesothelioma of the tunica vaginalis associated with prostatic adenocarcinoma].

Malignant mesothelioma of the tunica vaginalis testis, is a very rare neoplasm with highly aggressive biological behaviour. It usually occurs in patients aged between 55 and 75 years. A testicular mass is always observed, often accompanied with hydrocele. The response to chemotherapy and radiotherapy is poor. Initial aggressive surgery is necessary. The median survival, without surgical treatment is 23 months. A rare case of malignant mesothelioma of the tunica vaginalis testis, observed in a patient affected by prostate neoplasm is reported. A radical retropubic prostatectomy was performed. The patient was suffering from dysuria and there was a suspect area at the digital examination. Rectal ultrasonography and biopsy showed an adenocarcinoma at T1c clinical stage. A radical prostatectomy was carried out and histology showed an adenocarcinoma, Gleason score 7 pT3bN0M0. Surgery was followed by radiation therapy. After three years, a pleural seroma, a cutaneous mass and testicular nodule were observed and cytological examination showed endothelial cells. Scrotal orchiectomy was performed, because he was suffering from emphysema. Cytological examination confirmed malignant mesothelioma of the tunica vaginalis testis. Only 73 cases of this tumour have been reported in the last 30 years. The therapeutic options for this aggressive neoplasm are discussed. Since chemotherapy and radiation therapy had poor results, a rapid surgical treatment, by radical orchiectomy, is important.

Adenocarcinoma↗
PubMed1999

Long-term clinical outcomes of abutments treated with guided tissue regeneration.

STATEMENT OF PROBLEM: Guided tissue regeneration (GTR) is an efficacious and predictable treatment modality for deep intrabony defects around natural teeth and abutments. However, long-term prognosis of abutments treated with regeneration has to be proven. PURPOSE: This study investigated the long-term stability of clinical outcomes obtained with regeneration in strategically important abutments. MATERIAL AND METHODS: Sixteen deep intrabony defects around strategically important abutments in 16 patients were treated according to the principles of GTR. After completion of initial periodontal therapy and placement of long-term provisional fixed partial dentures, nonresorbable membranes were applied. Membranes were removed after 6 weeks. All patients remained in a supervised recall program. Final fixed partial dentures were placed 1 year after surgery. Clinical outcomes were evaluated at 1 year and then 4 to 8 years after surgery. RESULTS: Clinical attachment level gains of 5.3 +/- 1.8 mm, reductions in pocket depth (6.1 +/- 2 mm), and increases in the percentage of radiographic bone support (31% +/- 18%) were observed at 1 year. At long-term follow-up visits, clinical attachment levels remained stable with respect to 1 year (-0.1 +/- 0.6 mm; P =.4). The percentage of radiographic bone support slightly increased as compared with 1 year (1% +/- 3%, P =. 04), and pocket depths (0.8 +/- 0.8 mm, P =.004). CONCLUSIONS: This study indicated that tooth support can be gained with GTR and maintained over time in patients recalled regularly.

Adult↗
PubMed1999

Peyronie's disease--incision and dorsal vein grafting combined with contralateral plication in straightening the penis.

OBJECTIVES: To evaluate the effectiveness of incisions of Peyronie's plaque and vein grafting combined with contralateral plication to straightening the penis. PATIENTS AND METHODS: Twenty-four patients with Peyronie's disease were treated surgically with a vein patch grafting technique to correct penile curvature. Median penile deviation was 70 degrees (range 60-90 degrees ), in 1 patient curvature was 30 degrees and all were unable to have normal sexual intercourse. The deep dorsal vein was excised and opened longitudinally. Transverse relaxing incisions about 1-2 cm long were made on the plaques at the point of maximal curvature, then, two other lateral incisions were made on both ends at 3 and 9 o'clock. The endothelial side of the harvested vein was placed in contact with the cavernous tissue to cover the defect created. Application of the contralateral surface of the tunica albuginea was performed in 21 cases to straighten the penis. RESULTS: After a median follow-up of 24 months, 19 patients were able to perform sexual intercourse, 3 patients who required intracavernous injection to maintain erection presented pre-operative adverse factors affecting erectile function. One patient returned to baseline pre-operative curvature. Twelve patients reported penile shortening, although only 5 patients were concerned about it. None of the patients permanently lost sensation in the glans of the penis. Palpable knots on the site of plication were reported in 5 patients. CONCLUSIONS: Plaque incision and placement of a deep dorsal vein patch graft, combined with contralateral corporeal plication, is a relatively simple, safe and effective alternative to correct angulations greater than 60 degrees.

Adult↗
PubMed1999

Histological adaptation of orthotopic ileal neobladder mucosa: 4-year follow-up of 30 patients.

OBJECTIVE: For 4 years we have monitored the histological evolution of ileal neobladders in a single cohort of 30 patients in order to systematically describe the histological changes occurring after surgery. The aim of the study was to evaluate the long-term evolution of many histological parameters with functional relevance as to the metabolic outcome of the reservoirs. METHODS: Ileal samples were collected during surgery and by random biopsies during cystoscopy 6, 12, 18, 24, 36 and 48 months later. At each step qualitative and quantitative assessment of the histological and cytological conditions of the samples was carried out. RESULTS: Morphological changes develop relatively early but the situation tends to level out in about 1 year. The morphological changes are topographically uneven and, although mucosal flattening becomes progressively prevalent, areas with shortened villi persist indefinitely. Goblet cells prevail over enterocytes and the secretive pattern shifts towards sialomucins. The overall replication rate decreases initially but tends to restore in 1 year. Dysplasia or atrophy were never recorded. CONCLUSIONS: The 4-year systematic follow-up revealed a typical histological adaptation pattern in the ileal neobladder without signs of dysplasia. The changes seem to be induced by the aggressive environment and develop in the time lag required for functional adaptation of the epithelium.

Adult↗
PubMed1999

Coronally advanced flap procedure for root coverage. Treatment of root surface: root planning versus polishing.

This clinical study was designed to determine if mechanical instrumentation (root planing) of the exposed root is useful in treating gingival recession caused by traumatic toothbrushing following a coronally advanced flap (CAF). Ten patients with high levels of oral hygiene (full-mouth plaque score <20%), from 25 to 57 years of age, were selected for the study. Each patient showed 2 bilateral Class I or II maxillary recessions. A total of 20 recessions were treated. The difference in the recessions was < or =1 mm. In each patient, one recession was randomly assigned to the test group and the contralateral one to the control group. In the test group, the exposed root surface was polished at slow speed with a rubber cup and prophylaxis paste for 60 seconds. In the control group, the exposed root surface was planed with a sharp curet. In both test and control groups, a trapezoidal full- and partial-thickness flap was elevated, coronally displaced, and sutured to cover the treated root surface. Before treatment, the mean recession depth in the test group (polishing) was 3.1+/-1.1 mm; and in the control group (root planing), 2.9+/-1.0 mm. Three months after the described procedures, the test group (polishing) showed a mean recession reduction of 2.6+/-0.6 mm; mean percent root coverage was 89+/-14%. In the control group (root planing), the mean recession reduction was 2.3+/-0.7 mm and mean percent root coverage was 83+/-16%. The difference of recession reduction between the test and control group was not statistically significant (P = 0.1405), even though the test group showed slightly better clinical results in terms of root coverage. This prospective clinical, controlled, randomized study shows that mechanical instrumentation (root planing) of the exposed root surfaces is not necessary when shallow recessions caused by traumatic toothbrushing are treated using a coronally advanced flap (CAF) in patients with high levels of oral hygiene.

Adult↗
PubMed1999

Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage? A 19-case series.

This clinical study was designed to determine whether the thickness of the flap can influence root coverage when gingival recessions associated with traumatic toothbrushing are treated using a coronally advanced flap (CAF). Nineteen patients, aged from 25 to 57 years, with high levels of oral hygiene (full-mouth plaque scores <20%) were selected for the study. Each patient contributed with one Miller Class I or II maxillary or mandibular recession. A total of 19 recessions > or =2 mm were treated. After local anesthesia and before flap elevation, the exposed root surface was planed with a sharp curet. A trapezoidal full- and partial-thickness flap was then elevated, displaced coronally, and sutured to cover the treated root surface. Before suturing, flap thickness was measured in the alveolar mucosa with a gauge. After surgery, all patients were recalled for control and professional prophylaxis once a week during the first month and monthly up to the third month. The mean initial recession depth was 3.0+/-0.9 mm. Mean flap thickness (FT) was 0.7+/-0.2 mm. Three months later, mean recession depth was 0.6+/-0.6 (P <0.0001) and mean recession reduction was 2.4+/-0.7 mm. Mean root coverage was 82+/-17%. Flap thickness >0.8 mm was associated with 100% of root coverage. The results of this study indicate that there is a direct relation between flap thickness and recession reduction (P <0.0001).

Adult↗
PubMed1999

[Sarcomatoid carcinoma of the bladder].

Two cases of bladder sarcomatoid carcinoma, a rare tumor (0.3% of all bladder histotypes) are described and the difficult histological diagnosis and the utility of immunoassay markers analysed. Moreover, clinical observations are shortly discussed.

Aged↗
PubMed1999

The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures.

A novel surgical procedure specifically designed to access interdental spaces in the regenerative treatment of deep intrabony defects is presented. This procedure (simplified papilla preservation flap, SPPF) was designed to provide surgical access to interproximal bony defects while preserving interdental soft tissues, even in narrow interdental spaces and posterior teeth. A modified mattress suture allows coronal positioning of the buccal flap and primary closure of the interdental space without tension. The modified mattress suture minimizes the collapse of the membrane into the defect. An experimental population of 18 patients in good general health who presented with one intrabony defect each was selected for this clinical study. The application of the SPPF in combination with bioresorbable membranes resulted in clinical attachment level (CAL) gains of 4.9 +/- 1.8 mm at 1 year. The difference between baseline CAL and 1 year CAL was highly clinically and statistically significant. The residual pockets at 1 year measured 3.6 +/- 1.2 mm. A slight increase in gingival recession was noted. Primary closure of the flap in the interdental space over the membrane was obtained in 100% of the cases after completion of surgery and maintained in 67% of the cases during the healing period. The application of SPPF in combination with bioresorbable barrier membranes allowed primary closure of the interdental space in most of the treated sites and resulted in consistent CAL gains at 1 year.

Absorbable Implants↗
PubMed1998

Treatment of deep and shallow intrabony defects. A multicenter randomized controlled clinical trial.

This prospective multicenter intra-individual randomized controlled clinical trial was designed to compare the efficacy of guided tissue regeneration (GTR) with bioresorbable barrier membranes versus access flap surgery, in intrabony defects. 2 similar defects were selected in each of 23 patients and randomly assigned to 1 of the 2 treatments. Surgery consisted of an identical procedure except for the omission of the barrier membrane in the flap control sites. At 1-year, probing pocket depth reductions were 4.3+/-2.3 mm in GTR treated sites and 3.0+/-1.5 mm in the flap control sites (p=0.02, paired t-test). Clinical attachment level (CAL) gains were 3.0+/-1.7 mm in the GTR sites and 1.6+/-1.8 mm in the control sites (p=0.009, paired t-test). A subset analysis, performed according to the initial depth of the intrabony component of the defects (INFRA), indicated that in shallow defects (INFRA < or =3 mm) treated with the access flap alone, CAL gains were 1+/-1.5 mm, while in deep ones (INFRA > or =4 mm) they were consistently greater (1.9+/-1.9 mm). The % CAL gains, calculated as the % of the baseline intrabony component depth, however, were almost identical in the 2 subpopulations (45.8+/-64.7% in shallow and 43.8+/-37.6% in deep defects). Similarly, in the GTR sites, linear CAL gains were greater in deep (3.7+/-1.7 mm) than in shallow defects (2.2+/-1.3 mm), but no differences were observed in terms of % CAL gains (76.7+/-27.7% and 75.8+/-45%, respectively). The frequency distribution of CAL changes expressed as %s of the baseline INFRA indicates that most of the sites treated with GTR (73% in shallow and 92% in deep defects) gained 50% or more CAL. Furthermore, many defects (64% of shallow and 33% of deep defects) reached 100% of CAL gain. The present study demonstrated that: (i) GTR with bioresorbable barrier membranes resulted in a significant added benefit in comparison with access flap alone; (ii) the linear amounts of CAL gains were greater in deep than in shallow defects; (iii) CAL gains expressed as %s of the baseline depths of the intrabony component, were similar in shallow and deep defects; (iii) the regenerative procedure tested in the present study resulted in CAL gains equal to the depth of the intrabony component of the defect in some, but not in most of the instances.

Absorbable Implants↗
PubMed1998

A controlled multicenter study of adjunctive use of tetracycline periodontal fibers in mandibular class II furcations with persistent bleeding.

The aim of this randomized single-blind multicenter controlled clinical trial was to clinically evaluate the effectiveness of adjunctive local controlled drug delivery in the control of bleeding on probing in mandibular class II furcations during maintenance care. 127 patients presenting with a class II mandibular furcation with bleeding on probing were included in the study. They had been previously treated for periodontitis and were participating in supportive care programs in periodontal specialty practices. Treatments consisted of scaling and root planing with oral hygiene instructions (control) and scaling and root planing and oral hygiene combined with local controlled drug delivery with tetracycline fibers (test). The following outcomes were evaluated at baseline and 3 and 6 months after therapy at the furcation site: bleeding on controlled force probing (BOP), probing pocket depth (PD) and clinical attachment levels (CAL). Levels of oral hygiene and smoking status were also assessed. Both test and controls resulted in significant improvements of BOP and PD at 3 and 6 months. The test treatment, however, resulted in significantly better improvements: BOP decreased by 52% in the control group and by 70% in the test group at 3 months; at 6 months, however, the difference was no longer significant. The test treatment resulted in a 0.5 mm greater reduction of PD than the control at 3 months, the improvement was highly significant but its duration did not extend until the 6 months evaluation. No differences were observed in terms of changes in CAL. These data indicate that addition of tetracycline fibers to mechanical therapy alone resulted in improved control of periodontal parameters during periodontal maintenance of class II mandibular furcations. Short duration of the effect, however, requires further investigations to optimize conservative treatment of these challenging defects.

Adult↗
PubMed1998

Generalizability of the added benefits of guided tissue regeneration in the treatment of deep intrabony defects. Evaluation in a multi-center randomized controlled clinical trial.

BACKGROUND: Several studies have shown that GTR therapy of intrabony defects results in significantly better outcomes than access flap alone. Most of the available data, however, have been produced in highly controlled research environments by a small group of investigators. Generalizability of results to different clinicians and different subject populations has not been evaluated so far. METHODS: This parallel group study involved 143 patients recruited in a practice-based research network of 11 offices in 7 countries. It was designed to evaluate: 1) the applicability of the documented added benefits of GTR in the treatment of intrabony defects to different populations, and 2) the generalizability of the expected results to different clinicians. GTR was compared to access flap alone. Defects, one in each patient, were accessed with a previously described papilla preservation flap in both the test and control group. In addition, GTR sites received application of a bioabsorbable poly-D,L-lactide-co-glycolide membrane. A stringent plaque control regimen was enforced in all patients during the 1-year observation period. Outcomes included gains in clinical attachment (CAL) and reductions in probing depth. RESULTS: Observed gains in CAL were 2.18 +/- 1.46 mm for access flap and 3.04 +/- 1.64 mm for the GTR-treated group. The treatment-associated difference was statistically significant (P = 0.03) after correcting for both center effect and defect anatomy. Among the various centers, a 1.73 mm difference in CAL gain was observed. This is a clinically relevant amount, which underlines the significance of center variability in the outcome of periodontal surgical procedures. A frequency distribution analysis of the obtained CAL gains indicated that GTR treatment of deep intrabony defects decreased, with respect to the access flap control, the probability of obtaining only a modest attachment gain at 1 year. Conversely, CAL gains of 4 mm or more were observed in more than 40% of GTR-treated defects and in less than 20% of the controls (P < 0.0001). CONCLUSIONS: These data indicate that GTR therapy of deep intrabony defects performed by different clinicians on various patient populations resulted in both greater amounts and improved predictability of CAL gains than access flap alone.

Absorbable Implants↗
PubMed1998

[The use of early enteral nutrition (EEN) after major urologic surgery].

PURPOSE: To evaluate the efficacy of early enteral nutrition in management of patients operated by major urologic surgery and to demonstrate her advantages versus total parenteral nutrition. MATERIALS AND METHODS: 20 patients, operated by radical cystectomy and urinary diversion by ureteroileocutaneostomy, Padua ileal bladder or ureterosigmoidostomy are inserted in our study: 12 were treated by early enteral nutrition for 8 days and eight by total parenteral nutrition for the same period: in each group nutritional and immunological parameters at day -1, +3 and +7, the length of postoperatory stay, the incidence of complications, with particular respect for infections have been evaluated and correlated one to each other. RESULTS: We have no death in each group; in the first group no gastroenteric allergy to the nutrient, less incidence of venous catheter and surgical wound infections (respectively p < 0.01 and p < 0.005); we have no significant decrease of postoperatory stay length; the effective problem in this group was the incidence of diarrhea, that in one case have made necessary the suspension of enteral nutrition. Enteral nutrition costs were about half of those of total parenteral nutrition. CONCLUSIONS: We believe that early enteral nutrition is an effective and safe nutrition method in patients operated by major urologic surgery: with this is possible a better nutrition, that reduce the incidence of postoperative complications, mainly infections, and maybe the length of postoperatory stay (our champion is too small for statistical evaluation), that may lead to a decrease in management costs of these patients.

Aged↗
PubMed1998

[Repair of vesicovaginal fistula by the Martius technique].

Vesico-vaginal fistula (VVF) is still an unpleasant complication of female genital system surgery. We report the case of a 57-years-old woman undergone to neoadjuvant radiotherapy and afterwards abdomino-perineal resection who developed after one months a VVF.

Adenocarcinoma↗
PubMed1998

[Ileal conduit: our experience].

In the last 100 year, many progresses have been done in the ileal urinary diversion after cystectomy. Although the interest for the continent urinary diversion has increased enormously in the last ten years, the ileal conduit still represents the golden standard. We report our experience.

Adult↗