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101.
Marzio Angelo Zullo Alfonso Ruggiero Roberto Montera Francesco Plotti Ludovico Muzii Roberto Angioli Pierluigi Benedetti Panici 《Maturitas》2010
Objective
To evaluate use of bulking agents (polydimethylsiloxane) as an alternative treatment of female stress urinary incontinence (SUI) in older patients.Study design
Prospective cohort study.Main outcome measures
Women with age >75 years old, affected by stress urinary incontinence, presenting to our institution between January 2005 and January 2008 were considered for eligibility in this prospective study. All patients were submitted to transurethral implantation using Macroplastique Implantation System (MIS) (Uroplasty, Minneapolis, Minnesota). Cure of SUI was defined as the resolution of SUI symptoms. Objective cure rate was assessed by urogynecological physical examination and urodynamic assessment performed at 6 and 12 months after surgery respectively. Subjective cure rate was assessed during the interview of the 12th month with a visual analogue scale (VAS) for quantification of SUI severity and a standardized question about the repeatability of the procedure.Results
A total of 27 consecutive patients were enrolled in this study. After 12 months of surgery the objective cure rate was 44% (12 of 27 patients), the improvement rate was 33% (9 of 27) and the failure rate was 22% (6 of 27). The overall success rate was 77% (12 patients cured and 9 improved). 23 (85%) patients would like to repeat this surgical procedure if necessary.Conclusion
Transurethral implantation of bulking agents should be considered as alternative treatment of SUI in complicated older patients. 相似文献102.
Panici PB Plotti F Zullo MA Muzii L Manci N Palaia I Ruggiero A Angioli R 《Gynecologic oncology》2006,103(3):859-864
OBJECTIVE: To compare transperitoneal, extraperitoneal and laparoscopic pelvic lymphadenectomy in terms of feasibility and morbidity in patients affected by cervical cancer undergoing radical hysterectomy. METHODS: Consecutive patients affected by stage IB-IIB cervical carcinoma scheduled for radical surgery entered the study. Patients were randomly assigned to transperitoneal (TPL), extraperitoneal (EPL) or laparoscopic pelvic lymphadenectomy (LPL). All patients underwent classical radical hysterectomy. Perioperative data were recorded. Follow up examinations were performed at the 15th, 30th and 60th day after surgery. RESULTS: 168 patients entered the study. The mean operative times were: 63+/-7.6, 54+/-6.7 and 75+/-8.4 min (TPL vs EPL P<0.001; EPL vs LPL P<0.001; TPL vs LPL P<0.001) for TPL, EPL and LPL respectively. The feasibility of the procedures, analyzed on an intention-to-treat basis, was 96%, 93% and 95% for TPL, EPL and LPL group respectively (P=ns). The average hospitalizations were: 5.6+/-0.9, 3.2+/-0.4 and 3.1+/-0.3 days (TPL vs EPL P<0.001; TPL vs LPL P<0.001) for TPL, EPL and LPL respectively. CONCLUSIONS: EPL and LPL are as feasible and effective as TPL and can be adequately performed with a reasonable complication rate. LPL showed a statistically significant longer operative time. However, both EPL and LPL can minimize some postoperative complications reducing length of stay. 相似文献
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Maurizio Pompili Claudio Maurizio Pacella Giampiero Francica Mario Angelico Giuseppe Tisone Paolo Craboledda Erica Nicolardi Gian Ludovico Rapaccini Giovanni Gasbarrini 《European journal of radiology》2010,74(3):e6
Objective
The aim of this study was to determine the effectiveness and safety of percutaneous laser ablation for the treatment of cirrhotic patients with hepatocellular carcinoma awaiting liver transplantation.Materials and methods
The data of 9 male cirrhotic patients (mean age 50 years, range 45-60 years) with 12 biopsy proven nodules of hepatocellular carcinoma (mean diameter 2.0 cm, range 1.0-3.0 cm) treated by laser ablation before liver transplantation between June 2000 and January 2006 were retrospectively reviewed. Laser ablation was carried out by inserting 300 nm optical fibers through 21-Gauge needles (from two to four) positioned under ultrasound guidance into the target lesions. A continuous wave Neodymium:Yttrium Aluminium Garnet laser was used. Transarterial chemoembolization prior to liver transplantation was performed in two incompletely ablated tumors.Results
No procedure-related major complications were recorded. During the waiting time to liver transplantation local tumor progression after ablation occurred in 3 nodules (25%). At histological examination of the explanted livers complete necrosis was found in 8 nodules (66.7%, all treated exclusively with laser ablation), partial necrosis >50% in 3 nodules (25%), and partial necrosis <50% in 1 nodule.Conclusion
In patients with cirrhotic livers awaiting liver transplantation, percutaneous laser ablation is safe and effective for the management of small hepatocellular carcinoma. 相似文献106.
Sara Cecchini Donatella Sarti Stefano Ricci Ludovico Delle Vergini Manuela Sallei Stefano Serresi Giuseppe Ricotti Luca Mulazzani Fabrizia Lattanzio Giammaria Fiorentini 《World journal of clinical oncology》2015,6(4):57-63
AIM: To better define the efficacy and the safety of intra-arterial infusion performed with or without hemofiltration for recurrent limb melanoma.METHODS: Patients with the following characteristics were included in the study: recurrent limb melanoma not indicated for surgical resection, measurable disease in the extremity, > 18 years, performances status (Eastern Cooperative Oncology Group ) was 0-1 and life expectancy of at least 6 mo. Twenty nine consecutive patients were enrolled in the study. Patients underwent fluoroscopic placement of angiographic arterial and venous catheters to infuse the drug in the artery [isolated limb infusion (ILI)], and to stop the out flow (venous). Melphalan was rapidly infused into the isolated limb via the arterial catheter after the inflation of venous balloon catheter. Then the circulation of the limb was completely blocked with a pneumatic cuff at the root of the limb. Haemofiltration (HF) was available only in the main center, and was performed with an extracorporeal perfusion system, in order to reduce high systemic toxic peaks of drug.RESULTS: Thirty seven ILI were done in 29 cases (31 ILI-HF and 6 ILI) between 2001 and 2014 at Ancona and Pesaro Hospitals, Italy. Clinical outcomes were monitored 30 d after treatment. Eleven patients (38%) received infusion of melphalan alone, 7 (24%) melphalan associated to mitomicin C and 7 (24%) melphalan associated to cisplatin, the remaining 4 were treated with cisplatin, melphalan and epirubicin or cisplatin and mitomicin C. The overall response rate was 66%, in particular, 3 patients (10%) were complete responders and 16 (56%) were partial responders; whereas 7 patients (24%) had stable disease, and 3 (10%) showed progressive disease. Limb toxicity was assessed adopting Wieberdink scale, with evidence of 90% of low grade (I and II) toxicity.CONCLUSION: ILI-HF and ILI are effective and safe treatments for recurrent non-resectable limb melanoma. They present evidence of favorable clinical benefit and is effective in delaying progression. 相似文献
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Immunohistochemical study of epidermal nerve fibres in involved and uninvolved psoriatic skin using confocal laser scanning microscopy 总被引:2,自引:0,他引:2
Simona Pergolizzi M. Vaccaro Ludovico Magaudda Maria Rita Mondello Alba Arco Placido Bramanti Serafinella Patrizia Cannavò Biagio Guarneri 《Archives of dermatological research》1998,290(9):483-489
Abstract Psoriasis is a typical hyperproliferative epidermal disease whose aetiopathogenesis is still to be defined. One of the most
likely hypotheses is that it has a neurogenic origin correlated with an altered release of some neuropeptides by sensitive
cutaneous nerves via antidromic pathways. As there are conflicting reports about the existence of cutaneous nerve alterations
in psoriasis, we carried out an immunolocalization study using the protein gene product 9.5 as a marker for neuronal structures
observed by confocal laser scanning microscopy in order to determine the pattern of sensory nerves in psoriatic skin. The
investigation was carried out on cutaneous biopsies taken from involved (mature and long-established lesions) and uninvolved
skin of ten patients with extensive chronic plaque psoriasis. In uninvolved psoriatic skin a significant decrease in epidermal
nerve fibres was found, a further decrease was observed in mature lesions and almost a complete lack of epidermal nerve fibres
in long-established psoriatic lesions. The reduction in epidermal nerve fibres and the consequent loss of relationship between
these nerve structures and the skin immunocompetent cells (antigen-presenting cells, Langerhans cells, keratinocytes) might
be a factor of fundamental importance in the self-maintenance of the disease.
Received: 26 May 1997 相似文献
110.