Biomedical subjects
Publications and source records attributed to R Ponchietti.
A 6-year experience with omentoplasty is presented. During this period pedicled omentum was used in 145 procedures of reconstructive urologic surgery. On the basis of this experience the authors conclude that omentoplasty is an essential part in urological reconstructive surgery.
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The purpose of this research has been to value the importance of chronic inflammation of the prostatovesicular apparatus in sterile patients. The authors wish to underline the high incidence of chronic inflammation if this apparatus in such patients, the low incidence of bacterial forms and the high frequence of association with bradycinesia. The therapy of such forms gives excellent results.
A rare case of male internal pseudohermaphroditism is described. The patient had normal external male sexual characteristics but unilateral cryptorchidism. Three of his brothers had also cryptorchidism. The patient's parents were cousins. The patient's karyotype was normal.
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We are reporting the first case of priapism due to a sacrococcygeal chordoma metastasis treated with radiation therapy as palliative treatment.
The human prostatic urethra has been investigated by means of scanning electron microscopy. On the posterior wall of the urethra, the seminal colliculus with the orifices of the ejaculatory ducts is clearly detectable. The upper portion of the prostatic urethra shows a typical transitional epithelium with large superficial cells of a ruffled appearance. In the lower portion of the organ (underneath the openings of the ejaculatory ducts), the apical pattern of the cells varies considerably. Four main aspects are recognizable: apices provided with microvilli, dome-shaped apices with an almost smooth surface, large apices with labyrinthic microplicae and ciliated apices. Also, apices showing intermediate characteristics can be noted. The functional significance of the morphological patterns as well as the possibility of a transition among the various types of surface structures are discussed.
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Combination chemotherapy with newer, more active drugs in patients with advanced and/or metastatic bladder cancer might show improved response rate and survival. Gemcitabine (GEM) and Epidoxorubicin (EPI) have demonstrated activity in this disease. In addition, experimental studies in vitro have shown that the two agents have additive-synergistic effects when used in combination. Our prior phase I dose-finding study in previously untreated patients with advanced or metastatic bladder cancer defined recommended doses for further trials of GEM 1000 mg/m2 and EPI 25 mg/m2 on days 1, 8 and 15 every 28 days. A phase II trial at this dose level was initiated in previously untreated patients to assess efficacy and toxicity. Eligible patients had measurable disease; Karnofsky performance status (PS) of > 40; no prior chemotherapy; and adequate bone marrow reserve, cardiac, hepatic and renal function. Thirty- one patients (22 males, 9 females) with median age of 64 (range 44-75) and median PS of 80 were accrued, and all were eligible. Twelve patients had T4N1-2 M0, 8 had lymph node only metastases, while 11 had visceral metastases (liver, bone, lung). A total of 181 cycles was administered (range 3-7 per patient). Major toxicities (WHO grade > or = 3) were: neutropenia in 5 patients, thrombocytopenia in 2 patients, and anemia in 2 patients. Three patients had febrile neutropenic episodes and only 3 patients required dose reduction. Grade 1-2 non-hematological toxicities included nausea/vomiting, stomatitis and alopecia. No cardiac toxicity was observed. Of the 30 response evaluable patients, 17 (57%) demonstrated a major response (3 complete and 14 partial) (95% CI: 39%-75%), 7 had stable disease (23%) and 6 progressed (20%). These preliminary results confirm the phase I observation that the combination of GEM--EPI is highly active in the treatment of advanced and metastatic bladder cancer with a favourable toxicity profile.
A review of published series about 56 cases with unilateral nonvisualization on excretory urography after external trauma have been described: the renal injury causing the nonvisualization was contusion in 8 patients, laceration in 13, rupture in 12 and renal pedicle in 19. The acquisition of the most important methods has allowed a total view as about minimal lesions (contusion, laceration), as rupture or fragmentation of the kidney and renal pedicle. We have evaluated 32 cases of renal traumatic injuries and we have studied one case with unilateral nonvisualization stressing the diagnostic, etiopathogenetic and therapeutic problems.
Testicular maldescent adversely affects spermatogenesis, therefore the primary purpose of its correction is to preserve subsequent fertility. However, many patients, even with unilateral cryptorchidism, are infertile in spite of successful prepubertal orchidopexy. Out of our 104 patients treated for unilateral cryptorchidism before puberty, a decreased sperm density (spermatic concentration less than 20 X 10(6)/ml) was observed in 64 cases (61.54%), a normal sperm count in 32 cases (30.77%) and azoospermia in the remaining 8 cases (7.69%). Both congenital and acquired abnormalities may be associated with development of bilateral testicular impairment in unilateral cryptorchid males.
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Testicular biopsies from 25 boys, aged 11-17, with left clinically evident varicocele were studied. Electron microscopic observations documented diffuse histological changes of smooth endoplasmic reticulum, Golgi apparatus and mitochondria of Leydig cells. Ultrastructural modifications of these subcellular structures related to steroid hormone synthesis may impede the normal growth and maturation of the testis and impair fertility potential.
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Twenty-four boys age 11-17 with moderate to large sized varicocele were studied. The duration of varicocele ranged from 11 to 20 months prior to surgery. Histological and ultrastructural studies of testicular specimens demonstrated bilateral abnormalities and the detrimental effect of varicocele on the future fertility of these young patients. These findings strongly support the necessity of an early surgical treatment of varicocele.
Pudendal-pudendal and pelvic-pudendal sacral evoked potentials (ESP) were studied in 40 patients complaining of erectile impotence. Electromyographic results allowed us to recognize the organic cause of impotence in 4 men with visceral neuropathies. Sacral evoked responses extend our diagnostic possibilities in evaluating erectile impairment secondary to subclinical neurological abnormalities.
Seminal plasma, Zinc, Magnesium and Calcium concentrations were evaluated in 15 infertile men with chronic prostatitis and in 10 controls. Highly significant difference (p less than 0,01) was observed in Calcium concentration only in the group of bacterial prostatitis with respect to the controls. The possible significance of these data is suggested.