Biomedical subjects

F Bertoni

Publications and source records attributed to F Bertoni.

313 records · Page 18Linked to original sources

PubMedDate not supplied

Neoadjuvant chemotherapy for the treatment of osteosarcoma of the extremities: excellent response of the primary tumor to preoperative treatment with methotrexate, cisplatin, adriamycin, and ifosfamide. Preliminary results.

A total of 48 patients with non-metastatic osteosarcoma of the extremities were treated with a new neoadjuvant chemotherapy protocol which, prior to surgery, included the use of high dose methotrexate, cisplatin, adriamycin and ifosfamide. Cisplatin was administered intra-arterially, whereas the other drugs were given intravenously. In all of the cases response to this chemotherapy protocol was very good, allowing for conservative treatment in 46 out of 48 patients. Histological evaluation of chemotherapy response showed good (> 90%) and total necrosis in 87 and 54% of the cases, respectively. Drug toxicity was acceptable. Results were significantly better than those previously obtained in our and in other institutes when only three drugs were used (methotrexate, cisplatin, and adriamycin) in the preoperative treatment scheme. Since it has been demonstrated that grade of histological response to preoperative chemotherapy, and prognosis are closely related in osteosarcoma of the extremities treated with neoadjuvant chemotherapy, in addition to allowing for the use of conservative surgery in the majority of cases, this new protocol may also lead to a significant increase in the patient cure rate.

Adolescent↗

PubMedDate not supplied

[Evaluation of experimental data obtained using new-generation CO2 laser in surgery].

In order to study the interaction between the laser and biological tissues, we realized an experimental "in vivo" model using 12 Wistar male adult rats (mean b.w. 300 gr.). On the animals, during general anesthesia and after an accurate shearing of the back, we performed a cutaneous lozenge in order to value the characteristics and the possibilities of a last generation laser. It concerns of a CO2 laser (EASY LASER SP5, CLASS IV F.D.A.) with the possibility of employing of different variables. During this study were evaluated the most interesting variables: frequency, power and duty cycle. Among the variables we identified the frequency of the application range of the superpulse effect and the selective photothermolysis. The histological and morphological studies performed on the cutaneous specimens after laser treatment, showed that the correct application of this kind of laser can be an effective help for the surgeon during clinical practice.

Animals↗

PubMedDate not supplied

Recurrent lumbar disc herniation: what recurs? (A morphological study of recurrent disc herniation).

A morphological study was conducted on disc material obtained during surgical discectomy in 20 patients. The series was divided into 4 groups. Group I: 3 patients who had never been operated on before; group II: 3 patients who had already been submitted to discectomy but at a level which differed from that of the disc examined; group III: 4 patients treated surgically for contralateral herniation; group IV: 10 patients with true recurrent disc herniation, that is, already submitted to surgery for the treatment of homolateral herniation of the same disc. All of the cases submitted to surgery had been operated on more than a year previously. Moreover, the disc material obtained during autopsy in a patient operated 15 years before for disc herniation was studied. A morphological study of the cases and the data reported in the literature reveals that the fibrocartilaginous tissue of recurrences differs from that of primary herniation because of the presence of large collagen bundles associated with fibrillar framework. This aspect suggests the hypothesis that is also supported by the autoptic material examined that recurrent disc herniation is formed by repair tissue that substitutes the part of the disc that is operated on, and that recurrent herniation is caused by mechanical collapse of the repair tissue. From a surgical point of view, a distinction may be made in terms of early recurrences, which appear within one year of surgery and are formed by disc tissue which is identical to that of primary herniation, and late recurrences, the subject of this morphological study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Role of lactose, arginine and lysine combination in fracture healing (an experimental study)].

L-arginine and L-lysine are essential amino acids which seem to possess some properties able to influence bone fractures healing. In fact, they seem to be involved not only in the increase of intestinal calcium adsorption but also in collagen synthesis, in insulin and growth hormone secretion and in osteoblastic activation. So, an experimental in vivo model was carried out by using 50 adult rabbits which, under general anaesthesia, were submitted to an osteotomy of the left fibula. Animals were divided into 5 groups and were daily treated with a mixture of lactose, L-arginine and L-lysine or with the only lactose (control group) at the same dosage as recommended for humans. They were sacrificed after 15, 30, 40, 50 and 60 days for radiological and histological studies. The results of the study showed that the pharmacological mixture containing L-arginine and L-lysine accelerates and ameliorates the healing processes and this positive effect was particularly evident from the 30th day after the osteotomy. We think that these results are linked not only to calcium metabolism but also to different biological properties which positively contribute to a good healing of bone fractures.

Animals↗

PubMedDate not supplied

Neoadjuvant chemotherapy for malignant fibrous histiocytoma of bone and for osteosarcoma of the limbs: a comparison between the results obtained for 21 and 144 patients, respectively, treated during the same period with the same chemotherapy protocol.

Twenty-one patients affected with malignant fibrous histiocytoma localized in the limbs were treated by pre- and postoperative chemotherapy (neoadjuvant). Preoperatively methotrexate (i.v.), cisplatinum (i.a.), and adriamycin (i.v.) were administered. Postoperatively the same drugs (in patients who responded well) or with the addition of ifosfamide and VP 16 (in those who responded poorly) were administered. Twenty resections and 1 amputation followed. The response to chemotherapy was good in 7 patients, and poor in 14. At a mean follow-up of 6.3 years 15 patients were disease-free and 6 had relapses. These results appear to be comparable to those for 144 patients affected with osteosarcoma of the limbs treated at the same time with the same protocol. The percentage of good responses and pulmonary metastases was higher in cases of osteosarcoma. Pre- and postoperative chemotherapy increases the percentage of healing in malignant fibrous histiocytoma. The lower percentage of good responses and the different type of relapse as compared to osteosarcoma indicate that preoperatively chemotherapy different from that used for osteosarcoma should be conducted.

Adult↗

PubMedDate not supplied

The effect of intra-arterial versus intravenous cisplatinum in the neoadjuvant treatment of osteosarcoma of the limbs: the experience at the Rizzoli Institute.

The effect of intra-arterial versus intravenous infusion of cisplatinum on the histological response of osteosarcoma of the limbs was evaluated based on the results of three studies in which CDP was preoperatively associated with MTX and ADM (1st study), and with MTX, ADM, and IFO (2nd and 3rd studies). In the chemotherapeutic protocol that involved 3 drugs the percentage of "good histological responses to chemotherapy" (defined as tumor necrosis > 90%) was significantly higher in the 40 patients who were administered CDP by intra-arterial infusion as compared to that observed in the 39 patients treated with CDP by intravenous route (78% versus 46%: P .004). In the two sequential studies where 4 drugs were used, the percentage of good histological responses was essentially the same for patients treated with CDP administered intravenously, and for those treated with CDP administered intra-arterially (78% versus 84%). Regardless of the route of infusion used to administer cisplatinum the percentage of "good" histological responses was significantly higher in the 109 patients treated with the 4-drug protocol as compared to the 79 patients treated with the 3-drug protocol (82% vs 62%; P .04). This difference may essentially be attributed to the higher percentage of good responses observed in the 4-drug protocol in patients treated with CDP administered intravenously (78% vs 46% for patients treated i.v. with the 3-drug protocol; P .006). For the patients instead treated with CDP administered intra-arterially the percentage of good responses was essentially the same with the 4-drug protocol and with the 3-drug protocol (84% vs 78%; P ns). These data lead us to conclude that in the neoadjuvant treatment of osteosarcoma of the limbs a preoperative 4-drug protocol (MTX, CDP, ADM, IFO) is more effective than a 3-drug protocol (MTX, CDP, ADM), and that in a 4-drug preoperative chemotherapy protocol intra-arterial infusion of CDP does not offer particular advantages as compared to intravenous infusion.

Adolescent↗

PubMedDate not supplied

[Local recurrence after surgical or surgical-chemotherapeutic treatment of osteosarcoma of the limbs. Incidence, risk factors and prognosis].

METHODS: Local recidivation (incidence, risk factors an prognosis) was analysed retrospectively in 765 patients with non-metastatic osteosarcoma of the extremities treated between 1972 and 1992 either with surgery alone (78 cases) or with surgery and associated adjuvant (258 cases) and neoadjuvant chemotherapy (429 cases). RESULTS: The local recurrence of the disease, which was documented in 26 patients (3.4%), was significantly related to the type of surgery performed (1.1% in 344 amputated patients vs 5.2% in 422 patients treated with resection; p < 0.003) and with surgical margins (0.6% in 700 radical or extensive operations vs 22.7% in 66 marginal or intralesional interventions; p = 0.0001). In patients treated with neoadjuvant chemotherapy, the incidence of local recidivation was also correlated with the type of histological response to chemotherapy (2.9% in 274 cases with a "good" response vs 8.4% in 154 cases with a "poor" response; p < 0.021). In all 26 patients local recidivation was associated with metastases occurring before (16 cases), after (3 cases) or in concomitance (7 cases) with the local recurrence of neoplasia. In spite of treatment performed at the start of recidivation, 25 patients (96.1%) died from the tumour whereas the mortality rate in those patients with metastases but no local recidivation was only 72.1% (261 out of 362 cases). This difference was also statistically significant (p < 0.01). CONCLUSIONS: The results obtained appear to justify the current trend of minimising demolitive surgery in osteosarcoma of the extremities. Surgery should only be performed in these patients by centres able to make an adequate evaluation of surgical margins and the histological response to preoperative chemotherapy. In view of the fatal prognosis linked to recidivation and the high probability of its onset in cases with inadequate surgical margins and a poor response to chemotherapy, the authors propose that subsequent amputation should be performed immediately in those patients undergoing resection who present both these conditions.

Bone Neoplasms↗