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Biomedical subjects

M Zanini

Publications and source records attributed to M Zanini.

48 records · Page 3Linked to original sources
PubMed1982

Follow-up of pathological stage I and IIA supradiaphragmatic Hodgkin's disease primarily treated with radiotherapy.

One hundred and fifty-five consecutive previously untreated adult patients with supradiaphragmatic pathologic stage IA (71) and IIA (84) Hodgkin's disease treated only with radiotherapy (RT) at the Istituto Nazionale Tumori of Milano from 1970 to 1978 were reviewed. Staging procedures included lymphangiography and laparotomy in all cases. Most patients were irradiated with a conventional cobalt machine. Mantle fields were adopted for 36.8% of cases, mainly at stage I, whereas 63.2% received mantle plus paraaortal irradiation. Doses were above 40 Gy for involved sites and 35-40 Gy for prophylactically irradiated nodes. Minimum and median follow-up were 30 months and 6 years, respectively. All patients achieved complete remission at the end of RT. As of June 1981, 89 of 155 patients (57.5%) were alive and free from progression, 60.6% at stage I, and 54.8% at stage II. Relapses occurred in 54 of 155 cases (35%) after a median free interval of 21 months. Marginal recurrences accounted for 5.8%, true recurrences for 9%, nodal extensions for 8.4%, and extranodal extensions for 11.6%. Males older than 40 years and mediastinal involvement were correlated with higher relapse rates. Salvage treatment consisted of RT alone in 8 patients and chemotherapy plus or minus RT in 44, whereas 2 patients died before a new treatment could start. As of June 1981, 38 of 54 relapsed patients (70.4%) were alive and disease free, whereas 2 were alive with evidence of disease. Actuarial overall survival at 6 years was 90.3% for all cases, 97.1% for stage I, and 84.8% for stage II. Treatment toxicity was analyzed, and problems concerning surgical staging procedures, optimal RT and role of chemotherapy as primary or salvage treatment were discussed.

Actuarial Analysis↗
PubMed1982

[Right atrial-right ventricular anastomosis for correction of tricuspid atresia].

Primary correction of type 1 b tricuspid atresia with a right atrial-right ventricular anastomosis has been performed on a 23-month-old baby with excellent clinical and hemodynamic results. This type of operation, which has been described for the first time by Björk et al. in 3 patients aged 8, 9 and 12 years respectively, does not require any conduit or prosthesis since it employs the right atrial appendage and a patch of autologous pericardium. The authors review the surgical anatomy of tricuspid atresia, the various operative techniques so far employed for its correction, as well as other congenital heart diseases which could benefit from this surgical procedure. Moreover they underline the advantage of the latter technique which avoids the employment of any foreign material, can be performed in early infancy, and can be considered definitive since it obviates the need for initial palliative procedures.

Heart Atria↗
PubMed1980

[A new rare earth intensifying screen: lanthanum oxybromide (Quanta III - Dupont): relative speed, resolution and image quality (author's transl)].

Some physical and diagnostic characteristics of a new rare earth screen (lanthanum oxybromide: Quanta III) were evaluated and compared to those of conventional calcium tungstate (Hi-Plus-Dupont). The speed, resolution and clinical acceptance were analyzed using the same film (Cronex 4 - Dupont). This new system allows a significant X-ray exposure reduction with little or no loss of overall diagnostic performance.

Calcium↗
PubMedDate not supplied

Lymphographic evaluation in bone and soft tissue sarcomas.

A group of 79 patients with soft tissue sarcomas and 46 with primary malignant bone tumors underwent lymphangiography as part of the initial diagnostic workup. In the group of soft tissue sarcomas, the overall incidence of metastases was 22 of 79 (28%). According to the site of origin, the highest incidence was found in tumors originating from the buttocks (57%), followed by those from the inferior limbs (31%). Considering the histology, the incidence ranges from 50% in anaplastic sarcoma, to 43% in rhabdomyosarcoma, to 23% for liposarcoma and fibrosarcoma. The incidence of lymphographically proven metastases in bone tumors was 8 to 46 (17%), with 1 out of 4 in reticulum cell sarcoma, 1/1 in chordoma, and 22% in Ewing's sarcoma. A radiographic/histologic correlation on the lymph nodes was obtained in 19/79 (24%) soft tissue sarcomas and in 4/46 (9%) bone tumors. In the 12 radiographically negative and 11 radiographically positive cases, this correlation was always correct. The results of this study suggest a larger use of lymphography in these tumors.

Bone Neoplasms↗
PubMedDate not supplied

Long-term results of an intensive regimen: VEBEP plus involved-field radiotherapy in advanced Hodgkin's disease.

PURPOSE: This pilot study was conducted to evaluate the efficacy and toxicity of a new intensive drug regimen, combined with involved-nodal-field radiotherapy, in advanced Hodgkin's disease not treated by chemotherapy. PATIENTS AND METHODS: From September 1990 to March 1993, 73 evaluable patients with newly diagnosed stage IIB, III (A and B), and IV (A and B) Hodgkin's disease or who were relapsing after primary subtotal or total nodal irradiation were treated with eight cycles of etoposide, epirubicin, bleomycin, cyclophosphamide, and prednisolone (VEBEP) followed by radiotherapy (30-36 Gy) to the nodal site or sites of pretreatment disease. The median duration of follow-up was 68 months. RESULTS: The complete remission rate was 94% (95% CI: 86-98). At 6 years, freedom from progression and overall survival rates were 78% (95% CI: 68-88) and 82% (95% CI: 73-91), respectively. There was one episode of fatal sepsis after bone marrow aplasia that occurred after VEBEP and extended-field irradiation. Hematologic toxicity during chemotherapy was acceptable; without the support of growth factors, grade IV leukopenia and grade IV neutropenia, as determined within cycles, occurred in 38% and 85% of patients, respectively, but was reversible in the vast majority of patients by the day of treatment recycle. No episodes of epidoxorubicin-related cardiomyopathy or symptomatic pulmonary toxicity were documented. Overt and/or subclinical hypothyroidism occurred in 38% of cases. Gonadal damage was evident in the large majority of male patients but reversible in half of them, whereas permanent sterility was observed in females at least 35 years of age. No secondary leukemia has been so far detected. DISCUSSION: VEBEP followed by involved-nodal-field radiotherapy is an effective treatment for chemotherapy-naive Hodgkin's disease and is associated to acceptable rates of acute and intermediate-term toxicity. This intensive regimen, which does not routinely require the support of hematopoietic growth factors and can be delivered in an outpatient setting, warrants a prospective comparison in a randomized trial versus one of the more effective standard-combination regimens.

Adolescent↗
PubMedDate not supplied

Aortic insufficiency. A multivariate analysis of incremental risk factors for operative mortality and functional results.

The object of this study was to establish which of four chosen preoperative parameters, namely NYHA functional Class, cardio-thoracic ratio (CTR), left ventricular end-diastolic pressure (LVEDP) and ejection fraction (EF), might affect, singly or in combination, the operative risk in isolated, chronic aortic insufficiency (AI). To this purpose we reviewed the records of all adult patients consecutively operated upon in our Department for isolated chronic AI, from 1979 to 1985. Patients with associated cardiac disease, transvalvular aortic gradient, recent endocarditis of a malfunctioning bioprosthesis were excluded from the study, leaving 89 consecutive patients (mean age 47.2 years) for evaluation. St. Jude or Duromedics mechanical prostheses were exclusively used for aortic valve replacement (AVR). Post-operatively all patients received long term anticoagulation. Follow up period ranged from 24 to 109 months (mean 61.8 months). The method of analysis was designed as follows: a) each patient was allocated a positive (+) or a negative (-) variable for the value of each parameter, b) five patient groups were formed on the basis of the free association of parameter variables, c) single variables and their association with early and late mortality, functional results as NYHA Class were compared by statistical methods (chi 2, Student's Test, Wilcoxon Test). The results of the study show: a) only EF significantly influenced early mortality (P less than 0.05), b) late mortality was significantly influenced (P less than 0.001) by NYHA Class and CTR, c) single parameter variables (+ or -) and or their association significantly conditioned functional results.

Aortic Valve↗
PubMedDate not supplied

Late pulmonary toxicity after treatment for Hodgkin's disease.

The combination of mediastinal radiotherapy (RT) with chemotherapy (CT) including bleomycin is associated with an increased risk of pulmonary toxicity. The aim of the present investigation was to evaluate late pulmonary effects of RT plus CT consisting of the ABVD regimen in patients suffering from early stage Hodgkin's disease. For this purpose pulmonary function was serially evaluated before, at the end and at least 1 year after therapy in 32 patients (median age 28 years) with Hodgkin's disease stages IA,B-IIA. Treatment consisted of four cycles of ABVD chemotherapy followed by mediastinal irradiation at the median dose of 36 Gy (range 30.6-43.2). At the end of treatment, resting mean pulmonary function tests showed a significant decline of forced expiratory volume in 1 second (FEV1), forced expiratory flow at 25-75%, (FEF25-75%), total lung capacity (TLC), vital capacity (VC) and carbon monoxide diffusing capacity (DLCO). The decline of TLC, VC and DLCO, indicative of a pulmonary defect of restrictive type, persisted 1 year from the end of therapy. Only seven patients developed symptoms of cough and mild shortness of breath with effort. These data confirm that RT combined with short term ABVD result in pulmonary dysfunction that does not seem to have clinical significance.

Adolescent↗