bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful treatment of left main coronary artery total occlusion combined with cardiogenic shock
Authors: Yu Xing , Zheng Jian-Yi , Zhu Gui-Ping
Published: July 2019

Acute myocardial infarction (AMI) caused by total occlusion of the left main coronary artery (LMCA) is a catastrophic event. However, the clinical features and appropriate treatment of patients with this condition remain unclear. We report a man with total occlusion of the LMCA presenting with AMI combined with cardiogenic shock. He was successfully treated with angioplasty and drug-eluting stent implantation assisted by an intra-aortic balloon pump (IABP). This case suggests that percutaneous coronary intervention may be an optional therapeutic strategy in these patients, and that IABP implantation could improve clinical outcomes. A dominant right coronary artery and enhanced collateral circulation were considered to be key features related to the patient’s survival.
Laboratory laparoscopy: Nephroureterectomy, pelvic lymphadenectomy and orchiectomy
Authors: Trinchieri A. , Zanetti G. , Maggioni A. , Montanari E. , Colombo F. , Rovera F. , Taverna G.L. , Dell'Orto P. , Russo R. , Dellino E. , Pisani E.
Published: July 2019

Recent developments in technology have resulted in the application of laparoscopy in several areas of urology. To develop the technique different procedures were performed in 22 male pigs weighing 25–30 kilograms. The types of procedure included: pelvic lymphadenectomy, nephroureterectomy, orchiectomy of cryptorchid testicle.
The treatment of male impotence with HCG and PGE-1
Authors: Pastorini S. , Griffa D. , Brigato R. , Surleti D. , Cocimano V.
Published: July 2019

In the present work we have studied the success of HCG-PG-1 association in the treatment of male impotence. We recruited (January-June 1990) 60 patients suffering from impotence for at least six months, selected by means of appropriate inclusion criteria. They were subdivided into three groups after standard diagnostic screening. In the first group we employed therapy with HCG 5.000 U.l. a week for four months. In the second group we have made intracavernous pharmaco-therapie weekly with PGE-1 for the same period. In the third group we did both above - mentioned therapies associated. Anamnesics qualitative-quantitative criteria for numeral results determination were adopted. This association produced a better therapeutic result as regards single therapy, with rapid and durable progress and very good follow-up.
Magnetic resonance imaging in studying pathologies of the scrotum
Authors: Bellorofonte B. , Tombolini P. , Ruoppolo M. , Belleggia F. , Tagliaferri A. , Ferri P.M. , Yamak R.
Published: July 2019

The importance of high-resolution magnetic resonance (MR) imaging in studying a pathologic disease of the scrotum was assessed. In this study we had evaluated twenty-nine patients with testicular tumor, hydrocele, epididymitis, epididymal simple cyst. The final diagnosis was established surgically in twenty patients and clinically in nine. MR imaging made it possible to discriminate intratesticular from extratesticular processes and their extent, whether a lesion was cystic or solid. Lastly MR imaging, in comparison with US scanning, seemed to have more sensitivity in the characterization of intratesticular lesions.
Autotransfusion methods in urology: Cost-benefit analysis
Authors: Martinelli A. , Turci A. , Santarelli R.
Published: July 2019

The use of homologous blood in surgical practice gives rise to heavy risk of transmission of infectious diseases, particularly viral hepatitis and A.I.D.S. Blood transfusion, in the form of predeposit and intra-operative recovery, avoids these risks, as well as to improving operating conditions complying furthermore with the recent provision of the law about blood transfusion. At our urological department, in the period 1986–1992 more than 400 blood pre-deposits have been performed. Since 1990 intraoperative blood recovery has been used in addition to the pre-deposit technique, recovering blood from TURP washing fluid by means of a cellular separator, at first experimentally and then in surgical routine. The Authors report their experience and many considerations concerning economical, sanitary and forensic points of view.
Interactive multimediality system on personal computer for teaching in urology
Authors: Orlando G. , Marandola P. , Macchi R. , Cremaschi E. , Trinchieri A. , Speroni A.
Published: July 2019

The multimediality systems are specifically informatics procedures. These allow the contemporary presentation and the active interaction on the monitor of a personal computer of texts, dias, videomovies, animations. Our study presents an interactive-multimediality system for the training of the urologist in medical school. The object of the development at this moment is the presentation and illustration of the urethrocystoscopic procedure. The graphic interface allows the user the choice of modality, e.g. text, animation, videomovie or dia; the user “clicks” on the icon and the system starts; the modality can be changed at any time to have a better visualization of the problem. The user can choose to read or hear the text. The development of the system will be a complete teaching media for endourologic diagnostic and therapeutic methods. In the future the virtual reality will be very interesting: the student will be able to read, see and verify the pathologies and the therapeutic methods on the computer before real application on the human body.
HPV and cryotherapy male lesions
Authors: Borsa R. , Polledro P. , Cordara G. , Fontana G. , Abrate M.
Published: July 2019

HPV are the etiologic agents in condylomas. Serotypes 6-11-16 cause flat or esophytic lesions. A colposcope is used in our Centre, after applying acetic acid, for revealing otherwise invisible male genital lesions from HPV. Our case histories refer to 21 patients with condylomatosis, treated as follows: 13 underwent cryotherapy by means of a device using expanding nitric oxide through a suitable probe; 8 underwent surgical abscission. In all cases beta-interferon was used locally. After a minimum of 3 to a maximum of 16 months, patients are disease free. Our experience with cryotherapy is therefore extremely positive, confirming statements by the Center for Disease Control in Atlanta to the effect that cryotherapy should be considered the preferential treatment for HPV lesions.
Correlation between prostatic echographic study and male infertility
Authors: Dopinto F. , Marcello G. , Fiordelise S. , Valentino R.V.
Published: July 2019

Studies in echography have proved to be of extreme value in screening male infertility. During recent years proposals have been put forward for man screening programmes in association with spermiogram. The prostate gland is a fundamental organ in reproduction, occupying an important position with regard to the seminal canal and prostatic secretion is responsible for 30% of seminal plasma volume.
R.M.N. in the local staging of prostate cancer. Comparison of digital rectal examination, transrectal ultrasonography, CT-scan and pathological results
Authors: Faggiano L , Maccatrozzo L. , Merlo F. , Fandella A. , Checchin P. , Tuccitto G. , Mangano M. , Mbajo P. , Anselmo G.
Published: July 2019

Accurate preoperative staging is important for selection of patients for radical retropubic prostatectomy. Twenty-two men with cyto-histological diagnosis of prostate adenocarcinoma were evaluated for local diffusion of the neoplasia prior to radical prostatectomy. Tumors confined to the prostate gland (no capsular penetration, no seminal vesical invasion and negative lynphonode) were determined by digital rectal examination (DRE), transrectal ultrasonography (TRUS), pelvic CT-scan, and MRI and then compared to the pathological results. Correct T-staging and predictive value for tumor confinement were better for TRUS: 77% and 69,2% respectively. Statistically it was not much different from T-staging accuracy and predictive value for tumor confinement of CT-scan and MRI, but DRE proved to be the least accurate. All examinations cannot identify the microscopic extent of the tumor.
Extracorporeal lithotripsy to remove ureteral stent calcifications
Authors: Curti P. , Massolini G. , Cavalleri S. , Carluccio G. , D'Amico A. , Beltrami P. , Bianchi G.
Published: July 2019

In this report the Authors present their experience regarding two cases of calcification of the renal end of a ureteral double J catheter treated by ESWL. The shock waves can easily fragment this type of calcification: for this reason ESWL represents the treatment of choice of such complications.
Chronic lymphatic leukemia with renal localization: Case report
Authors: Frigola M. , Cortecchia V. , D'Amato G. , Bertaccini A. , Irianni G. , Beghelli R. , Cigno M. Lo , Zaganelli S. , Russo L. Lo
Published: July 2019

Chronic lymphatic leukemia is a lymphoproliferative disease typical in adult age. It is characterized by a proliferation in the peripheral blood and bone marrow of mature lymphocytes progressively permeating the lymphonodes, spleen, liver and more rarely the uro-genital apparatus. This case report concerns a man suffering from C.L.L. since 1972, treated with medical therapy; from 1991 onwards the patient reported a pain in the right lumbar area. Radiological examinations showed a subcapsular corpuscular mass 3.3 cm thick with no change in the kidney parenchyma. Examination of the blood showed hyperleucocytosis. The patient underwent right nephrectomy after biopsy; the histological examination showed leukemic infiltration compatible with C.L.L. The patient then underwent therapy with Fludarabine and is at present in good condition.
Hemorrhagic pseudocysts of the adrenal gland: Case description
Authors: Comunale L. , Motta L. , Baldassarre R. , Pianon R. , Novella G. , Schiavone D.
Published: July 2019

Cysts of the suprarenal gland, classified as parasitical cysts, epithelial cysts, endothelial cysts and pseudocysts are uncommon. We report a case of pseudocysts of the suprarenal gland. Clinical signs consisted of flank pain and palpable mass. Urography, ultrasonography and computed tomography were essential for diagnosis. Treatment consisted of surgical extirpation, as percutaneous needle aspiration entails high rate of recurrences.
Prolapsed orthotopic ureterocele in an adult: Case report
Authors: Manca G.P. , Martina G. , Piras P. , D'Alpaos M. , Andressi F.
Published: July 2019

The Authors describe the clinical presentation of a rare case of prolapsed orthotopic ureterocele in an adult. A ureterocele prolapse is relatively rare and becomes exceptional in the orthotopic ureterocele of the adult (only two cases in literature). In the case that we present, the prolapse happened in a 64-year-old woman after a cystoscopic search, that allowed the diagnosis of orthotopic ureterocele. Successive reduction was possible only after evacuative puncture, that reduced the mass and avoided strangulation and allowed non-urgent surgery correction. The therapy was a resection of the ureterocelic sac and successive reimplantation of the ureter with an antireflux technique.
Clinical staging of prostatic carcinoma by prostatic mapping
Authors: Casolari E. , Rossi-Cesolari R. , Spatafora S. , Cavazza A. , Leoni S.
Published: July 2019

The exact preoperative stage of prostatic cancer is the major problem involved in the indications for radical retropubic prostatectomy. A personal technique of prostatic mapping (PM) by means of strategic transrectal ultrasound guided core biopsies is presented as an effort to improve the staging of clinically localized prostatic cancer. PM is able “to photograph” intraprostatic neoplastic spread revealing infiltration of the apex and of the seminal vesicle beaks. Our hope is that, if our results are confirmed, PM will become an important tool in preoperative prostatic cancer staging.
Relazione su: “La prostatectomia radicale oggi: Problematiche attuali e nuove terapie alternative”
Authors: Guaitoli P. , Bertè R. , Callari S. , Zappalà L. , Mazza G.
Published: July 2019

The Authors present a report about 107 patients treated by radical retropubic prostatectomy over a period of 6 years in the Urologic Department of Gorizia Hospital. They compare their data with those given in the latest scientific articles, results being similar. Noticing that many cases are still understaged, they emphasize the opportunity of a joint contribution by surgeon and oncologist in fighting the disease.
La prostatectomia radicale: Ruolo del Patologo nella valutazione “a posteriori” degli indici prognostici tissutali
Authors: Colonna A.
Published: July 2019

Tissue prognosticators in radical prostatectomy specimens are studied. In general the morphological features of histologic grade, pathologic stage and tumour extension are universally accepted. New prognostic tissue markers are being developed. It will be interesting to know if there is independent prognostic significance in direct multivariate analyses to develop fast and inexpensive methods. An essential review of literature is presented.
L'uso delle protesi endoprostatiche nella terapia dell'IPB
Authors: Morgia G. , Motta M.
Published: July 2019

Endoscopic or open surgery is still today the choice therapy for benign prostatic hypertrophy. However, in those cases where the temporary or absolute general condition of the patient advises against an operation, an alternative and less invasive therapy is needed. Endoprostatic stents have by now been on sale for several years and in the meantime have reached a good technological level, allowing excellent results to be obtained. These prostheses can be divided into two groups: the first is distinguished by the temporary nature of the implant, in that it is reversible (Prostakath, Variospire, Prostacoil, luc, Memokath), while the second group consists of permanent prostheses (Urolume, Asi, Memotherm) which can only be removed by particularly complex techniques. This study analyses the features of the various types of stents in relation to the positioning techniques, their characteristics, results, their therapeutic efficacy, complications and last but not least the cost. In conclusion the authors make some comments about their experience with a few of the stents.
Rottura dei corpi cavernosi: Nostra esperienza
Authors: Pirritano D. , Scalfari A. , Gemelli R. , Catuogno C. , Ielapi V. , Martino L.F. , Ventrice G.A. , Lanza P.
Published: July 2019

The Authors report their experience on traumatic rupture of the corpora cavernosa. The importance of immediate surgery, in order to fully repair the lesions and avoid complications, is underlined.
L'adenoma nefrogenico della vescica. Caso clinico
Authors: Cammarata C. , Paola Q. , Panarisi S. , Barbera M. , Solazzo G. , Curto G.
Published: July 2019

The Authors report a case of nephrogenic adenoma of the bladder in an 8-year-old girl. The diagnostic and therapeutic management are described and the various histogenetic theories are discussed.
Frozen section accuracy in the lymph node staging of prostatic carcinoma
Authors: Terrone C. , Pelucelli G. , Bellei L. , Rossetti S. Rocca , Valente G.
Published: July 2019

— We investigated the accuracy of frozen sections in the detection of pelvic lymph node metastases in prostatic carcinoma. A group of 77 patients with clinical stage B or C prostatic cancer underwent staging pelvic lymphadenectomy followed by radical prostatectomy in 71 cases. Frozen section examination was performed in 46 cases because of the presence of suspicious lymph nodes. The accuracy of frozen section was 95.5% with 5.4% false negative results. Out of 24 patients with lymph node metastases confirmed by paraffin sections, 20 had frozen sections: 9 positive for cancer, 2 false negatives and 9 true negatives. Of the 31 patients from whom frozen sections were not obtained, 4 were found to have lymph node metastases on paraffin sections. In these 4 cases and in the presence of true negative frozen sections, nodal disease was minimal in 75% of patients. The results suggest that frozen sections are a useful tool to detect lymph node metastases. The accuracy depends on the experience of the histopathologist and the volume of the metastases.
Perioperative complications and quality of life after radical retropubic prostatectomy
Authors: Merlo F. , Mangano M. , Checchin P. , Maccatrozzo L. , Fandella A. , Anselmo G.
Published: July 2019

— The Authors report their experience with perioperative complications in 128 patients after radical retropubic prostatectomy preceding bilateral pelvic lymphadenectomy for prostatic cancer. Patients were classified by anatomo-pathological stage; 25% were stage D1. Data relating to homologous transfusions (22%), intraoperative complications (1.6%), minor (16%) or major (7%) early complications and late complications (0.8%) are analysed. The latest group of patients has also been assessed from a sexual, psychological and social point of view. 84% of patients reported an erectile deficit, but only 4% suffered a psychological worsening reflecting on their social life.
Diagnostic-therapeutic protocol in interstitial cystitis: Our initial experience
Authors: Randone D.F. , Caccia P. , Giargia E. , Giacomelli G. , Pasquale M.
Published: July 2019

— As the greatest obstacle to the study of interstitial cystitis is the lack of agreement regarding its aetiology, we set up a diagnostic-therapeutic protocol based on clinical findings, physical examination, urodynamics, Parson's test, cystoscopic evaluation with hydrodistension and biopsy. 12 patients with interstitial cystitis and 10 controls were evaluated. 60% therapeutic success was obtained after only hydrodistension and antidepressant therapy.
Preliminary comparative considerations about urinary cytology and the Bard BTA test in the diagnosis and follow-up of superficial bladder cancer
Authors: Boccafoschi C. , Montefiore F. , Treffiletti S. , Signorello D. , Langé A.
Published: July 2019

— The value of urinary cytology in the diagnosis and follow-up of superficial transitional cell carcinoma of the bladder is well known. Results of traditional cytologic examinations may be affected by the different methods of urine collection, preservation, manipulation and observation of the samples so that more objective tools are desirable. The aim of this study in to compare the traditional cytologic examinations with a new diagnostic in-vitro test (Bard BTA test), which can detect antigen complexes in the urine due to the contact of the tumour cells with the basement membrane. The Bard BTA test is a latex agglutination assay which identifies the bladder tumour antigens in the urine. The result of the agglutination reaction (positive or negative) may be visually distinguished by the variation in colour of special strips of testing paper. The Authors report on a preliminary experience in the follow-up of patients with previous superficial transitional cell carcinoma of the bladder: they compare the results of traditional cytology, the Bard BTA test and cystoscopy and have found agreement in 70% of the cases.
Incidence and treatment of the “steinstrasse” after in situ extracorporeal shock wave lithotripsy (ESWL)
Authors: Merlo F. , Cicerello E. , Checchin P. , Faggiano L. , Anselmo G.
Published: July 2019

— The aim of this work has been to check the frequency and to assess which manoeuvres are necessary in treating the steinstrasse after ESWL. 1779 patients (1360 with renal and 419 with ureteral stones) underwent in-situ ESWL. 68 patients developed a steinstrasse in the immediate 24 hours following treatment. In 85% of the cases (58/68) there was dilation of the urinary tract. In 39 patients the steinstrasse was spontaneously eliminated within 10 days, while in the remaning 29 an auxiliary manoeuvre was necessary. These manoeuvres required further admittance to hospital or prolungation of stay, but created no statistically significant differences in the stone free rate 2 months after treatment (96 and 97% respectively, p< 0.001). Our experience would indicate that the incidence of steinstrasse after ESWL in situ is quite low (3.8%) and the necessity for auxiliary manoeuvres is extremely rare (1.6%).
Sacral root neuromodulation in chronic lower urinary tract dysfunction: Preliminary reports on our clinical experience
Authors: Cappellano F. , Catanzaro F. , Torelli F. , Pizzoccaro M. , Baruffi M. , Morte E. Della , Sironi D.
Published: July 2019

— Chronic lower urinary tract dysfunction not responsive to conventional therapies can be treated by sacral root neuromodulation. Before implantation of a permanent stimulator, the effect is tested by temporary implantation of a wire electrode connected to an external stimulator (PNE). We report our experience with 19 PNE and 2 permanent implants with a follow-up of 12 and 6 months, very good results and no serious side effects. A short excursus follows about PNE and the permanent implant technique and above all indications of this technique and patient selection. From our clinical experience and data, patients with excellent response to PNE, who have urethral or detrusorial instability, would appear to respond best after permanent implant.
MC (cisplatin and methotrexate) adjuvant chemotherapy after cystectomy versus MC neoadjuvant chemotherapy following cystectomy in locally advanced bladder cancer: Results after 10 years of experience
Authors: Rigoni L , Scattoni V. , Rovellini P. , Pavia G. , Bottanelli A. , Baroni G.P. , Sciaraffia G. , Toia G. , Martignoni G. , Marcelli G.
Published: July 2019

— We report the results of a retrospective study of two groups of patients affected by locally advanced bladder cancer: the first group was submitted to adjuvant chemotherapy with Cisplatin and Methotrexate after cystectomy and the second group was submitted to neoadjuvant chemotherapy with the same scheme following radical cystectomy. The validity of the study is given by the homogeneity of the two groups for period of recruitment, number of patients, patient's age, stage of disease and treatment. The overall survival of 5 years in the first group was 30%, while the 5-year survival rate of the second group was 38%, 63% and 17% for all the patients, the responders and the nonresponders respectively. No significant difference in terms of survival was found between the two groups, but the results of the neoadjuvant approach may be influenced by clinical staging errors. The chemosensitivity, that can be assessed only with the neoadjuvant treatment, is the main prognostic factor.
Occupational factors and development of bladder cancer in Lecco (North-West Italy). Preliminary results
Authors: Invernizzi S. , Locatelli G. , Cappoli S. , Butti A. , Librizzi A. , Pozza D. , Ferraresi I. , Pisati G.
Published: July 2019

— To examine whether occupational factors can be related to the development of bladder cancer, we investigated the occupational histories of patients with bladder transitional cell carcinoma, living in the province of Lecco (North-West Italy) and compared the distribution of their occupations and that of all residents in the same area. A standardized questionnaire (covering family, medical, occupational and residential history, socioeconomics factors and various dietary factors) constituted the study instrument. 358 subjects, of whom 48 at first diagnosis were studied. Tobacco smoking, employment in the transport and communications and in the services sectors were found as possible factors of increased risk in developing bladder cancer. To obtain more definite information a hospital-based case-control study on bladder cancer incidence will be conducted.
Ectopic “blind ureterocele”: Report of 2 cases
Authors: Bondavalli C. , Pegoraro C. , Schiavon L. , Dall'Oglio B. , Luciano M. , Parma A.
Published: July 2019

— Ureterocele without corresponding renal tissue has been called blind ureterocele. We observed this rare malformation in two cases: a 17-year-old youth with the ureteral orifice located at the seminal vesicle and a 25-year-old woman with the orifice at the bladder neck. In both cases the proximal ureter ended in the lumbar fossa without renal parenchyma. The etiology of this ureterocele is unclear. Functioning renal tissue is supposed to be necessary for the development of a ureterocele: in blind ureterocele the renal parenchyma could subsequently disappear.
Biological prognostic factors in renal cell carcinoma
Authors: Monica B. , Barbieri A. , Cortellini P.
Published: July 2019

– The authors have reviewed literature regarding the main contributions of molecular biology to renal cell carcinoma characterisation. The progress made in the analysis of chromosomal alterations, oncogenes, p53 protein, proliferation indices and adhesion molecules are described. The authors conclude that molecular biology, especially the analysis of chromosomal alterations and proliferation indices, may contribute to renal cell carcinoma diagnosis and to the understanding of its pathogenesis and prognosis.
Prognostic factors in renal cell carcinoma: Effect on prognosis of neoadjuvant and adjuvant treatments
Authors: Castagnetti G. , Ferrari G. , Dotti A. , Ferrari P.
Published: July 2019

– Medical treatment of metastatic renal cell carcinoma has undergone many changes since the eighties when therapeutical interest shifted to immunotherapy, due to description of spontaneous regression of pulmonary metastasis after nephrectomy and the fact that the illness was refractory to chemotherapy and radiotherapy. First reports of complete response and partial response (about 20%) obtained by interferon led to research resulting in the discovery and use of new drugs (interleukine) and immunocompetent cells (LAK and TIL cells) capable of increasing the percentage of response, but with very serious side effects (IL-2 i.v.). The association of interferon-interleukine administered subcutaneously is the most common and most effective therapy. The association between these drugs (IFN, IL-2) and immunocompentent cells (LAK and TIL cells) will have to be assessed in the future because, even if the first experiences are favourable, follow-up periods and patient numbers are still too small.
The physic-pathology of continence and anti-reflux mechanisms
Authors: Bercovich E. , Deriu M.
Published: July 2019

– When performing a heterotopic continent urinary diversion there are some crucial moments from a physiopathological point of view, such as the reconfiguration of the low-pressure reservoir, the uretero-enteric anastomoses and making the valve for continence. The low-pressure reservoir is achieved by detubularising an intestinal segment, chosen for its natural characteristics of peristalsis, the possibility of residual contractions and the tensive-elastic features of the tract used. It is traditionally thought that it is the shape given to the neo-reservoir rather than the length of intestinal tract which influences compliance. In turn the uretero-enteric anastomoses should not be assessed purely surgically, but also physiologically for their capacity to preserve renal functionality and prevent reflux. Correctly performed anastomoses adapted to the single techniques of continent diversion are extremely important, bearing in mind parameters such as the length of the intramural tract and the calibre of the ureters. The linchpin, however, is the continence mechanism, achieved by using valves that are physiologically present (ileocecal valve) or by constructing valves from intestinal segments. Careful evaluation of the various methods for this purpose, from the flutter valve to Mitrofanoff's principle, highlights the diversity of these mechanisms, due to different pressor balances, and of their validity and reliability, both physiopathologically and with regard to long-term continence. The outcome is that the choice of intestinal segment to be used, the type of reconfiguration, the uretero-entero anastomosis and the valvular mechanism techniques are not casual and/or preferential, but based each time on pressure factors present in the type of urinary diversion.
Modified Indiana Pouch: Surgical technique and preliminary results
Authors: Muto G. , Moroni M. , Leoni S. , Spatafora E. , Bardari F.
Published: July 2019

– Two modified continent Indiana Pouch techniques are presented, one of which using gastrointestinal anastomosis (GIA) staplers. The authors describe their experience with 88 patients who underwent the above operation at the Divisions of Urology in the Maria Vittoria Hospital of Turin and S. Maria Nuova Hospital of Reggio Emilia. Mean follow-up is 18 months (range 4-26). A total of 24 post-operative complications are described: 2 bowel obstructions, 4 strictures of the stoma, 3 parastomal hernias, 1 pouchitis and 1 acute pyelonephritis, 2 cases of incontinence, 2 of over-distension of the pouch, 5 ureteral obstructions and 4 cases of diarrhoea. Neither stones of the pouch nor metabolic acidosis were observed. Using GIA staplers for tailoring the pouch saves 120 minutes operating time for an additional cost of about 600 $.
Massa emorragica paravescicale. Presentazione di un caso: Haemorrhagic paravesical mass. Case report
Authors: Pavone C. , Liberti P. , Canizzaro F. , Barbiera F. , Aragona F.
Published: July 2019

– The authors report an exceptional case of haemorrhagic paravesical mass with chronic granulomatosis and haemosiderinic deposit in a 23-year-old man. Symptomatology, diagnostic procedure, treatment and pathological appearance of the mass are described. Literature on the subject is reviewed.
Bladder neck cysts: Report on 2 cases
Authors: La Rosa P. , Rotondo S. , Maccarrone G. , Molino F. , Basilicò C. , Aragona C.
Published: July 2019

– Bladder neck cysts arise from a central degeneration of von Brunn nidi and are found casually during ultrasound, explaining obstructive symptomatology of which the patient sometimes complains. Endorectal ultrasound is essential for identifying this pathology and for a differential diagnosis between the various cystic formations of the prostate and the urogenital sinus. This paper reports two recent clinical cases related to this pathology.
Interstitial cystitis: Clinical and therapeutic aspects
Authors: Almasi J. , D'Alessandro M. , Salvia L. , Gambera G.M. , Salvia G. , Nuciforo G. , Nicolosi D.
Published: July 2019

– Although the number of findings are increasing, interstitial cystitis is still not a very frequent chronic disease, making its diagnosis and treatment difficult. In reviewing the etiopathogenetic theories, diagnostic criteria and therapies, often still empirical and based on ex adjuvantibus standards, the authors emphasise how interstitial cystitis may, in the more advanced stages, result in highly invalidating clinical forms and even renal failure. The fact that it is more frequently detected abroad (twice the number compared to Italy) suggests that examinations in our country may be incorrect and incomplete.
Ultrasound measurement of detrusor thickness in bladder instability in women
Authors: Lamartina M. , Rizzo M. , Di Girolamo A. , Camilleri G. , Bianco A. Lo , Ferraro G. , Ascoli R.
Published: July 2019

– Ultrasound was used to measure the detrusor thickness in 20 women with urodynamically-proved detrusorial instability. In 95% of the cases, detrusor thickness is greater than or equal to 5 mm. Comparison with a control group confirms the reliability of these results.
Valutazione clinico patologica di una popolazione anziana maschile con disfunzione erettile
Authors: Toia G. , Baroni G. , Bianchi A. , Bottanelli A. , Rovellini P. , Sciaraffia G. , Marcelli G.
Published: July 2019

The predicted increase in the future of the number of elderly people requires an in-depth study of their characteristics. Answers are also needed regarding their sexual life, which remains one of the basic needs of healthy elderly men. The sexual characteristics of a population between 60 and 75 years old are summed up in this study.
Elettrovaporizzazione endoscopica della prostata (TVP): Esperienza su 112 casi
Authors: Berti G.L. , Leidi G.L , Raimoldi A. , Veneroni L. , Giola V. , Longoni E. , Bacchioni A.M.
Published: July 2019

Transurethral electrovaporisation of the prostate (TVP) is one of the most recent techniques utilised as an alternative to TURP for the treatment of benign prostatic hyperplasia (BPH). This study reports our experience with TVP on 112 patients affected by BPH. All the patients had an adenoma equal or less than 40 grams in weight, maximum flow rate less than 10 ml per second or urine retention and PSA less than 4 mcg per litre. In all cases TVP was carried out without any complications during the operation (mean time 32 minutes) with no bleeding. 102 patients had the catheter removed after two days and 10 after 4 days. The maximum flow rate increased from 6.7 ml per second before the operation to 25.1 ml per second post operation. In 7 patients (6.2%) with unsatisfactory flow and/or with adenoma residue, it was necessary to perform a second TVP. 8 patients had temporary stress incontinence for 3 months after the operation, while one patient had permanent orthostatic incontinence. We can conclude that TVP is an easy technique to learn and has given the same clinical and urodynamic results as TURP, with negligible bleeding. The complication of temporary post operative incontinence in 7 patients and permanent incontinence in one patient, requires further studies to understand whether this is due to the surgical technique or to the actual method.
Le biopsie prostatiche random nei tumori prostatici allo stadio T1C: Confronto fra la tecnica a 6 sestanti vs quella a 10 sestanti
Authors: Consonni P. , Scattoni V. , Nava L , Trimboli F. , Broglia L. , Spalmero M. , Bua L , Bocciardi A. , Rigatti P.
Published: July 2019

It is still controversial which prostatic biopsy technique can provide the highest positive rate, complications, prostatic volume and PSA levels being equal. 656 consecutive patients (mean age 62.2 years) were submitted to biopsies using two similar transrectal techniques differing only in the number of biopsies: the “classic” six-sextant and a tensextant technique (adding 4 paraurethral biopsies). Every suspicious or hypoechoic area was also biopsied. Nine per cent (8/89) and 14% (6/42) of the patients subjected to 6-sextant and 10-sextant biopsies respectively, with a PSA level between 4.0-10.0 ng/ml had prostatic cancer. The positive rate increased to 24% (12/49) with sextant plus directed biopsies and to 33% (33/99) with directed biopsies only. Overall, 21% (52/279) of the patients with the above PSA level had a prostatic tumour. The 10-sextant biopsy technique does not seem to be significantly superior to the classic 6-sextant approach.
Chemioterapia primaria e trattamento delle masse residue nei tumori germinali non seminomatosi del testicolo. La nostra esperienza
Authors: Micheli E. , Belussi D. , Hurle R. , Losa A. , Ranieri A. , Manzetti A. , Lembo A. , Sarti E.
Published: July 2019

Thanks to the introduction of new chemotherapeutic agents, treatment of non-seminomatous germinal cell tumours (NSGCT) has dramatically improved during the last two decades. The association of chemotherapy and surgery has further increased the therapeutic success rate. The authors report their experience on this subject over the last ten years. Although the number of patients is relatively small and statistically insignificant, the results compare well with those of large centres dealing with this pathology.
La nostra esperienza nella correzione del varicocele mediante sclerotizzazione anterograda: Risultati e analisi dei costi
Authors: Rolle L , Del Noce G. , Ceruti C. , Tamagnone A. , Ragni F. , Carbone P. , Fontana D.
Published: July 2019

The antegrade sclerotherapy of spermatic veins suggested by R. Tauber in 1988 is one of the most interesting methods for treating varicocele. This technique consists of isolating and cannulating a dilated spermatic vein and then injecting a sclerosing mixture. The procedure is carried out under local anaesthesia and through a small scrotal incision. Antegrade sclerotheraphy is relatively cheap, easy and quick to perform and seems as reliable as surgical ligation and section of the spermatic veins, which is why, in our opinion, antegrade sclerotherapy plays an important role in treating varicocele. This paper describes our preliminary results.
Il trattamento endoscopio dei diverticoli vescicali
Authors: Ferrara V. , Beatrici V. , Cicetti A. , Gabrielloni G. , Sagrini D.
Published: July 2019

The finding of bladder diverticula is often casual during investigations due to bladder outlet obstruction symptoms. The presence of infection, stones, tumours are usually the reference parameters for surgical treatment. From 1992 to 1997 we performed endoscopic diverticulectomy on 12 male patients aged between 20 and 76 years, with bladder acquired diverticula. We made the diverticulum neck incision with a Collins loop at the 4 cardinal points and then all the diverticulum surface was coagulated with a rollerball. In our experience endoscopic diverticulectomy has proved to be an effective technique with total disappearance of diverticula and residual urine.
Risk and prognostic factors in testicular tumours: 3 emblematic observations
Authors: Gemelli R. , Sicuro O. , Zagordi A. , Martino L.F. , Scalfari A.
Published: July 2019

The authors report 3 clinical cases of testicular tumour considered emblematic regarding genesis and development, and highlight the close connection between testicular tumours and some of the known risk and prognostic factors.
Negative results in adulthood after surgery for hypospadias
Authors: Palminteri E. , Barbagli G. , Mottola A. , Rizzo M.
Published: July 2019

Many techniques have been used for correcting hypospadias over the years, passing from surgery in several stages and with scrotal flaps to single sessions with preputial island flaps. The authors reviewed the cases of 33 patients who, between 1942–94, underwent multi-stage urethroplasty, in order to assess results. The most frequent complications were: stenosis of the urethra, residual curvature, aesthetic deficit, hypospadic meatus, stenosis of the meatus, fistulas, hairs in the neourethra, urethrocele, HXO urethral calculosis. Two or more complications were present in 81.8% of patients, while 18.2% had just one. A retrospective evaluation of these patients leads to the conclusion that hypospadias repair with multi-stage techniques in the long term gives a high percentage of negative results. All patients underwent further surgery as adults to correct the results of the previous surgery, with considerable psychological problems. Despite having a reconstructed meatus in the glans, 42.4% of the patients had a residual curvature of the penis due to asymmetry of the corpora cavernosa. Hypospadias was considered for years as an isolated disease of the urethra and not of the penis as a whole. Over the last few years the concept of hypospadic penis has been accepted with consequent development in reconstructional techniques and an improvement in aesthetic-functional results.
Non-urological pathology with urinary symptoms: Our experience
Authors: Salvia G. , Amuso G. , Bartolotta S. , Caizzone F. , Savoca F. , Nicolosi D.
Published: July 2019

It is uncommon in a Urology Department to have patients with urological symptoms which prove to be caused by non-urological pathologies, as seen in our department over the last 15 years. In outlining their experience, the authors discuss some methodological and clinical aspects of the most common diseases encountered.
Clinical features of urinary tuberculosis today
Authors: Fontana D. , Porpiglia F. , Toffola A. Della , Morra I. , Boario L. , Destefanis P.
Published: July 2019

Over the last few years an increase of tuberculosis in the urogenital forms has also been noted. The authors decided to investigate whether the clinical features of the disease have changed in time. Data taken from literature were compared with the case histories of the San Luigi Hospital from the last 5 years. At onset, symptoms have remained practically the same. Some data emerged, however, which have given food for thought: diagnosis was made on average 6–8 months after the first symptoms appeared and the lesions were often found in the advanced stage, thus requiring a greater number of radical and reconstructive operations.
Medical treatment
Authors: Pozzi E. , Galietti F.
Published: July 2019

The main anti-tuberculous drugs are currently Rifampicin, Isoniazid, Ethambutol, Pyrazinamide and Streptomycin. Chemoantibiotic treatment aims at clinical-radiological recovery by the elimination of the metabolically active mycobacterial population, which is shown by the negativization of the microbiological examinations. Since the mycobacteria in a host reach the proliferative stage, when they are most vulnerable to the chemoantibiotics, at different times, the drugs must be administered for months. Several drugs must be associated to forestall mycobacterial resistance. The tendency today is mainly for short 6-month treatments. Most forms of urogenital tuberculosis are treated as follows: chemoantibiotic therapy with 4 drugs for the first month, if necessary associated with corticotherapy; subsequent radical or reconstructive surgery; chemoantibiotic therapy for at least another 5 months with 2 drugs.
Comprehension Instruction for Tier 2 Early Learners: A Scaffolded Apprenticeship for Close Reading of Informational Text
Authors: Mariage Troy V. , Englert Carol Sue , Mariage Mary F.
Published: July 2019

This exploratory case study used a mixed-methods pre-/post-intervention design to study the impact of an intervention on reading comprehension, annotation, and discussion quality. Five third-grade struggling readers who were part of a Tier 2 reading comprehension group were apprenticed into holding close-reading discussions of informational text. The teacher utilized an apprenticeship approach to provide explicit instruction and scaffolding to support four phases of close reading (discussion norms, main ideas, annotating text, discussion). Curriculum-based probes indicated that students improved their comprehension as measured by the total number of accurate main ideas recalled, the number of correct responses on quizzes, and the number and breadth of annotations. A standardized, norm-referenced measure of fluency (Reading Curriculum–Based Measurement [R-CBM]) and comprehension (MAZE) also showed improvements from fall to spring, with four of five participants changing levels from the winter to spring administration on the MAZE measure of comprehension. Discourse analysis revealed changes in discussion quality.
The effect of vibration characteristics of an automotive seating system on ride comfort – A finite element study
Authors: Ramalingam M , Jebaseelan D Davidson
Published: July 2019

The Automotive Seating System (ASS) is an important sub-system in a car for increasing the ride comfort of driver/occupant and hence the need for a systematic study on the vibration characteristics of ASS is of importance. The present study finds out the vibration characteristics of four models of automotive seating system, with and without dummy mass using finite element analysis. The vibration mode shapes such as lateral, fore-aft and twisting of automotive seating system found in the frequency range 0-80 Hz for the four models of automotive seating system and correlated with experimental results found in the literature. The natural frequency of the seat with dummy mass was found to be in the human discomfort zone of the spinal column (10–12 Hz) and abdomen (4–8 Hz). The vibration transfer to occupant body was studied at 11 positions, with unit acceleration given at four mounting locations of automotive seating system in three directions separately. The vibration transmissibility was found to be higher than one in seat backrest. The random vibration analysis was carried out to identify the acceleration level of automotive seating system, subjected to smooth and rough road excitations. In the case of rough road random excitations, the results of root mean square acceleration values in automotive seating system show that the driver/passenger feels “fairly comfortable”. This study emphasizes the importance of the ride comfort of driver/occupant. To enhance the ride comfort, the stiffness of seat structure has to be modified and suspension system has to be introduced.
Nanomedicine-based Curcumin Approach Improved ROS Damage in Best Dystrophy-specific Induced Pluripotent Stem Cells
Authors: Lin Tai-Chi , Lin Yi-Ying , Hsu Chih-Chen , Yang Yi-Ping , Yang Chang-Hao , Hwang De-Kuang , Wang Chien-Ying , Liu Yung-Yang , Lo Wen-Liang , Chiou Shih-Hwa , Peng Chi-Hsien , Chen Shih-Jen , Chang Yuh-Lih
Published: July 2019

Best dystrophy (BD), also termed best vitelliform macular dystrophy (BVMD), is a juvenile-onset form of macular degeneration and can cause central visual loss. Unfortunately, there is no clear definite therapy for BD or improving the visual function on this progressive disease. The human induced pluripotent stem cell (iPSC) system has been recently applied as an effective tool for genetic consultation and chemical drug screening. In this study, we developed patient-specific induced pluripotent stem cells (BD-iPSCs) from BD patient-derived dental pulp stromal cells and then differentiated BD-iPSCs into retinal pigment epithelial cells (BD-RPEs). BD-RPEs were used as an expandable platform for in vitro candidate drug screening. Compared with unaffected sibling-derived iPSC-derived RPE cells (Ctrl-RPEs), BD-RPEs exhibited typical RPE-specific markers with a lower expression of the tight junction protein ZO-1 and Bestrophin-1 (BEST1), as well as reduced phagocytic capabilities. Notably, among all candidate drugs, curcumin was the most effective for upregulating both the BEST1 and ZO-1 genes in BD-RPEs. Using the iPSC-based drug-screening platform, we further found that curcumin can significantly improve the mRNA expression levels of Best gene in BD-iPSC-derived RPEs. Importantly, we demonstrated that curcumin-loaded PLGA nanoparticles (Cur-NPs) were efficiently internalized by BD-RPEs. The Cur-NPs-based controlled release formulation further increased the expression of ZO-1 and Bestrophin-1, and promoted the function of phagocytosis and voltage-dependent calcium channels in BD-iPSC-derived RPEs. We further demonstrated that Cur-NPs enhanced the expression of antioxidant enzymes with a decrease in intracellular ROS production and hydrogen peroxide-induced oxidative stress. Collectively, these data supported that Cur-NPs provide a potential cytoprotective effect by regulating the anti-oxidative abilities of degenerated RPEs. In addition, the application of patient-specific iPSCs provides an effective platform for drug screening and personalized medicine in incurable diseases.