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V Coppola

Publications and source records attributed to V Coppola.

67 records · Page 4Linked to original sources
PubMedDate not supplied

[Assessment of microvascularization around the plaques in Peyronie's disease with Doppler color ultrasonography, power Doppler and ultrasonography contrast media].

INTRODUCTION: The origin of Peyronie's disease remains obscure although the first report of this condition dates back to 1743. The disease prevalence in 388.6 in 100,000 population and little physiopathologic information is available. Repeated microtrauma to the tunica albuginea appears to favor the onset of inflammatory phenomena which result in fibrosis and calcification. The disease activity produces a microvascularization around the fibrocalcific plaques. We studied the evolution of the inflammatory process in Peyronie's disease relative to clinical symptoms, in order to optimize treatment follow-up. MATERIAL AND METHODS: We examined 20 patients with Peyronie's disease aged 34 to 56 years using a GE Sonora Logic 500 MD US scanner with linear probes of 7.5 and 13 MHz. The microvascularization around the plaques was studied with color and power Doppler investigations before contrast agent administration and with combined color and power Doppler after contrast agent administration. We injected Levovist (300 mg/mL) and 10 micrograms prostglandin E1 (PGE1). Examinations were repeated after 2-4 months in the patients with evidence of microvascularization around the plaques. RESULTS: US demonstrated fibrocalcific plaques in all the patients. The microvascularization around the plaques was seen with color Doppler in 3 cases (15%), with power Doppler in 5 cases (25%) and with contrast-enhanced color and power Doppler in 7 cases (35%). At 2-4 months' follow-up, we observed slight plaque enlargement and worsened symptoms in 5 of 7 patients (71%) with evidence of some microvascularization around the plaque. CONCLUSIONS: The plaque presence allows to define the condition and the microvascularization provides information on its evolution. The disease activity can be distinguished into 3 stages which can be related to the painful symptoms. US exhibits a better cost/benefit ratio than contrast-enhanced MRI.

Adult↗
PubMedDate not supplied

Criteria for planning radiologic equipment replacement.

INTRODUCTION: The correct procedure for acquiring new radiologic equipment includes technology assessment, the analysis of needs, equipment purchasing/renting, room setting, equipment installation, management, and planned replacement. Therefore we need a simple, independent and objective procedure to analyze the technical and economic need of replacing a piece of radiologic equipment. We report on a simple evaluation method permitting to judge radiologic equipment acceptability, as stated by the relevant Italian laws. MATERIAL AND METHODS: Our system is adapted from similar business applications; it analyzes five main parameters, namely: support services (equipment age and working age, maintenance charges and the availability of spare parts), equipment function (life-supporting, diagnostic or treatment units; in an emergency department), the cost/benefit ratio, clinical efficacy and overall safety. If needed, another parameter can be added: accessibility by patients, involving such issues as time and ease of access to the examination/equipment and its location. The different criteria of radiologic equipment acceptability can be used to calculate the acceptability index (AI), as follows: AI = 0.4 (a + b + c + d) + 0.2 (e + f + g) + (h) where: (a) = unit's age, (b) = maintenance charges, (c) = non-use times, (d) = availability of spare parts, (e) = equipment function, (f) = operational analysis, (g) = diagnostic efficacy, (h) = safety. Each parameter is given a score according to the existing situation. RESULTS: Four scenarios can result from the analysis: 1) the equipment needs not be replaced; 2) replacement is not urgent and another check is scheduled within 12 months; 3) replacement must be scheduled; 4) the equipment must be urgently replaced (within 12 months). In the latter case, the unit should be disconnected at once if safety measures are violated irremediable. CONCLUSIONS: Our method is easy to use and a valid tool also for radioprotection purposes: the main difficulty is collaborating with the administrative offices in charge of equipment purchasing and maintenance. The facility's head radiologist can use the analysis to provide economic (and thus objective and indisputable) data about the need to replace, supplement, update, or repair pieces of diagnostic imaging equipment. Also, maintenance form and terms could be renegotiated and radioprotection improved. The Italian Society of Medical Radiology (SIRM) might suggest this method to the Italian Ministry of Health as the basis of the parliamentary bill on radiologic equipment replacement.

Diagnostic Equipment↗
PubMedDate not supplied

[Cystic dilatation of the seminal vesicles: which diagnostic approach?].

PURPOSE: We investigated the frequency, clinical features, diagnostic course and therapy of congenital and acquired seminal vesicle cysts. MATERIAL AND METHODS: Seven vesicular cysts were found in adult subjects in 1995-1996. All diagnoses were made with suprapubic and transrectal US, CT and MRI. Vesiculo-deferentography was never used for diagnosis. Patient age and symptoms, cyst site, structure and dysembryogenetic associations were considered for diagnosis. RESULTS: All the patients were adult and all but one fertile. Age ranges were IV (43%), III and V (28.5%) decades. The cyst was congenital in 5 patients, associated with other dysplasias in 60% of them, and acquired in 2 patients. 57% of patients had urogenital symptoms and 2 patients (28.5%) had no clinical signs. US was performed for fertility tests in one patient. The left gland was always and exclusively involved; its size ranged 3.2 to 5.8 cm and its shape was characteristic only in 2 acquired cysts. DISCUSSION: Both abdominal and rectal US examinations were always performed and always reliably showed cyst site, origin, size and components. CT confirmed local findings and was also used to study the abdomen assessing renal presence and function. MRI permitted the best anatomical study with the multiplanar demonstration of the relationships between small pelvis structures. CONCLUSIONS: Congenital cysts and acquired distension of the seminal vesicles are uncommon findings also because they are difficult to diagnose. Diagnostic imaging reliably differentiates vesicular cysts from other cystic collections in that region, providing enough information to distinguish acquired from congenital forms, the former curable with drug treatment and the latter requiring more invasive therapy. Relative to site prevalence (100% in the left gland), we do not know if this was an aleatory finding or it indicated an actual congenital predisposition. US yields the indispensable diagnostic findings, but MRI should be always performed to ensure diagnosis, to study the abdomen and to plan possible surgery.

Adult↗