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Biomedical subjects

G B Ratto

Publications and source records attributed to G B Ratto.

At least 91 records · Page 5Linked to original sources
PubMed1976

[Use of a new water-soluble aldosterone-antagonist in surgery. Early clinical results].

A new i.v., water-soluble aldosterone antagonist (potassium canrenoate) was employed for the first time in a series of patients operated for various forms of abdominal disease. The pharmacological and clinical effects of the drug were constantly reproduced and a marked anti-aldosterone activity was noted. The drug is felt to be specifically indicated in the management of secondary hyperaldosteronism typical of the immediate postoperative period.

Adult↗
PubMedDate not supplied

Adoptive immunotherapy of advanced solid tumors: an eight year clinical experience.

BACKGROUND: Adoptive immunotherapy (AI) of cancer, based upon the injection of in vitro manipulated autologous lymphocytes is still in an experimental phase. Our group started different clinical trials of AI in early 1990, and, at present, some specific targets for this approach seem to have been identified. PATIENTS AND METHODS: 296 patients with solid tumors (melanoma, kidney carcinoma, non-small-cell lung cancer, mesothelioma, neoplastic pleural effusion, and liver cancer) were treated with either locoregional or systemic adoptive immunotherapy (AI) using both LAK and TIL cells in combination with s.c. rIL-2. RESULTS: The surgery/AI combination resulted in good clinical results, characterized by enhanced survival and long lasting disease free periods in a significant number of patients. CONCLUSIONS: AI seems to be efficacious in the treatment of melanoma, lung and hepatic cancers. Further studies will expand the application of the treatment to other malignancies.

Clinical Trials as Topic↗
PubMedDate not supplied

Phase II study of neoadjuvant chemotherapy in patients with surgically-proven, unresectable stage III non-small cell lung cancer.

BACKGROUND: The aim of this study was to assess whether patients with truly unresectable (bulky extracapsular N2, T4 for tracheobronchial angle or mediastinal organ invasion) stage III non-small cell lung cancer (NSCLC), as proven by cervical mediastinoscopy supplemented or not by left anterior mediastinoscopy and fiberoptic bronchoscopy or thoracotomy, could become resectable after induction cisplatin-containing chemotherapy. In addition, we studied the value of preoperatory magnetic resonance imaging (MRI), in evaluating the probability of achieving a radical resection after neoadjuvant chemotherapy. PATIENTS AND METHODS: Sixteen consecutive untreated stage III NSCLC patients were enrolled in the study. All the patients received two cycles of combination chemotherapy including cisplatin 100-120 mg/m2 intravenously (i.v.) days 1 and 22 and vinorelbine 30 mg/m2 i.v. days 1, 8, 15, 22 and 28 or vinblastine 5 mg/m2 i.v. days 1, 8, 15, 22 and 28. Thoracotomy was planned, after chemotherapy, for all non-progressive patients. No other treatment after surgery was devised following radical resection and patients with residual disease after surgery received standard post-operative radiotherapy. Response to treatment was evaluated by thorax CT and MRI two weeks after the last administration of chemotherapy. RESULTS: The overall complete resection rate was 38% (6 out of 16 patients). MRI was predictive of complete resectability in 80% of cases. In fact, 6 patients judged resectable were completely resected, 3 patients judged unresectable underwent only explorative thoracotomy or incomplete resection while MRI was unpredictive only in one case. The most important chemotherapy-related toxicity was hematological: eight patients (50%) had grades III-IV leukopenia. CONCLUSION: These results indicate that preoperative second generation cisplatin-based chemotherapy can make resectable truly unresectable stage III NSCLC patients in only 38% of cases and that MRI is a reliable tool for assessment of radical resection probability after neoadjuvant chemotherapy.

Aged↗
PubMedDate not supplied

An experimental study to examine the patency and tissue response of two types of biosynthetic graft used as a replacement for porcine inferior vena cava.

This experimental study has been carried out to evaluate biosynthetic grafts as vascular substitutes. Tubular segments of 35 x 8 mm made of (1) tanned ovine collagen and integral polyester mesh, either of the first (Omniflow I) or second generation (Omniflow II), or (2) polytetrafluoroethylene (e-PTFE), have been sutured in the infrarenal inferior vena cava of pigs, and removed 1 hour, 7, 14, 28, 56 and 112 days after implantation. The patency rate of biosynthetic grafts was higher than that of e-PTFE grafts (p < 0.01). There was no significant difference between the patency of the first generation and second generation collagen grafts. These results indicate that biosynthetic prostheses may be suitable vascular substitutes in low flow and low pressure systems. Improvements in the collagen inner cover structure (Omniflow II vs. Omniflow I), producing greater mechanical endurance, did not enhance long-term patency or the healing patterns of biosynthetic grafts.

Animals↗
PubMedDate not supplied

Complications of surgery in the treatment of lung cancer: their relationship with the extent of resection and preoperative respiratory function tests.

We reviewed our experience with the surgical treatment of lung cancer, in order to investigate if the extent of the pulmonary resection and preoperative respiratory function tests correlate with the frequency of postoperative complications. The records of 292 patients who underwent lobectomy and of 64 who had pneumonectomy were analyzed. Postoperative complications developed in 148 patients. The incidence of bronchopleural fistula and cardiac rhythm disturbances was significantly higher after pneumonectomy than after lobectomy. A significant relationship was found between the preoperative ventilatory function tests and the postoperative frequency of intrapleural air spaces or atelectasis. The 30 day operative mortality was significantly related to the extent of the resection; postoperative deaths due to cardiorespiratory insufficiency were also associated to the severity of the obstructive pulmonary disease.

Adenocarcinoma↗
PubMedDate not supplied

Multiple aneurysmal dilatations in a knitted dacron velour graft.

The formation of multiple aneurysms in the midportion of Dacron grafts has been reported only twice in the surgical literature. In the present case, three aneurysmal dilatations developed 6 years following an orto-femoral Dacron graft implantation. Multiple structural defects in the Dacron prosthesis appear to be the most likely cause of the graft failure.

Blood Vessel Prosthesis↗
PubMedDate not supplied

Our eight-year experience with human umbilical vein grafts.

From 1977 through 1984, 58 arterial reconstructions using glutaraldehyde-tanned human umbilical vein (H.U.V.) grafts were carried out: 41 femoropopliteal, 4 composite aortopopliteal (a Dacron graft was inserted proximally), 5 femorotibial, 6 axillofemoral, 1 femorofemoral, and 1 iliofemoral bypass. Autogenous saphenous vein was absent or inadequate in all patients. Limb salvage was the primary indication for surgery (89.7%). Five and 8 years cumulative patency rates were 42.8% and 35.1% respectively for all H.U.V. by-passes and 52.4% and 41.9% respectively for femoropopliteal by-passes. Four out of the 5 femorotibial by-passes failed during the first month following surgery. Two of the 6 axillofemoral and 3 of the 4 composite aortopopliteal by-passes thrombosed within 1 and 3 years after surgery, respectively. Perioperative mortality was 5.1%, while overall mortality was 17.2%. The following conclusions can be drawn from these results: H.U.V. grafts did not achieve cumulative patency rates superior to those reported with autogenous saphenous vein, in limb salvage situations, when the saphenous vein is not available, the H.U.V. graft offers acceptable salvage rates, results from the 8-year follow-up period demonstrate the durability and long-term patency of H.U.V. grafts.

Aged↗
PubMedDate not supplied

Effects of colon to antrum transposition on gastrin release and antral G-cell proliferation.

To investigate the effects of colonic mucosa on antral G-cell activity and proliferation, a colonic patch was transposed to the antrum. Thirty-nine rats were divided into 3 equal groups and underwent the following surgical procedures: Group 1: sham operation. Group 2: a standard portion (1 cm2) of the anterior surface of the antrum, including the pyloric sphincter, was removed and the defect was closed using a 10 mm segment of transverse colon shaped as a patch. Group 3 (control group): an identical procedure was carried out, closing the gastric defect with a gastro-duodenal suture. Three months after surgery, serum gastrin levels were determined by radioimmunoassay, both in fasting and freely fed animals. The antrum was then removed and examined for: counts of antral G-cell number by an immunoperoxidase method; evaluation of the cytoplasmic G-cell granule distribution (assumed as an index of gastrin turnover) by transmission electron microscopy investigation. The colon to antrum transposition significantly increased the antral G-cell density. By contrast, fasting serum gastrin levels and gastrin turnover were reduced after colon to antrum transposition, as compared with the relevant control procedure.

Animals↗
PubMedDate not supplied

The effects on colonic mucosa of transposition to the stomach.

In order to investigate the morphological and functional changes produced in the colonic mucosa after prolonged exposure to gastric juices, 24 colonic patches were implanted on the gastric body and the gastric antrum. The specimens were removed, two, four or six months after surgery, and several morpho-functional changes were observed. These included a gastric-like transformation of the superficial epithelial cells, the presence, exclusively in the colonic patches implanted in the gastric body, of cells with large osmiophilic cytoplasmic granules and a progressive increase in sialomucin secretion with an almost complete disappearance of sulfomucins.

Animals↗
PubMedDate not supplied

[Significance of cardiopulmonary resuscitation in thoracic surgery].

45 patients admitted in the thoracic non-cardiac surgery service of the U.L.B. between 1966 and 1983 (17 yrs) were short- or longterm survivors of cardiopulmonary resuscitation. In november 1979 the traditional system was supplanted by a mobile unit with reduction of the interval between cardiopulmonary arrest and resuscitation to 1 minute. The obtained results are as follows: A mobile thoracic wall or intra-thoracic visceral lesions or displacement of thoracic content secondary to a recent thoracic intervention or serious injury do not constitute a contra-indication. Closed chest massage was mainly applied. Displacement of the heart secondary to chronic tuberculosis or pneumonectomy or serious thoracic injury are not formal contra-indications. Open cardiac massage was applied during surgical interventions or with hypovolemic shock secondary to massive intra-thoracic hemorrhage or cardiac tamponade. Pulmonary resuscitation with extra-corporeal circulation was only applied when mechanical ventilation did not suffice. All patients succumbed due to an associated lung involvement with destruction of the pulmonary parenchyma. The use of a mobile unit increased the number of successful resuscitations but did not change at all the duration of survival of the patients nor the number of neurological deficits. The survival time was only affected by 2 factors; the primary disease for which the patient was hospitalized and the presumed cause of arrest. All the other factors had no influence on the duration of survival; a. type of intervention; b. place of C.P. arrest and c. method of resuscitation.

Adolescent↗