Biomedical subjects
Publications and source records attributed to B Cola.
Authors present the results of an experimental research to evaluate the effectiveness of a slow resorbable suture (Polyglactyn 910) in arterial microsurgery. Healing of vascular wall, histologically evaluated, showed good reliability, compared to other suture materials.
70 cases of carcinoma of the anus are described in a retrospective study. All patients had been operated, since surgical treatment was regarded as the method of choice at that time. Our work therefore consists in assessing the role of surgery in the treatment of such carcinomas. In the initial forms, extended sphincter saving exeresis allowed excellent results (100% survival over a 1- to 10-year follow-up). In more advanced lesions, treated with abdominoperineal resection, the survival rate was 50% after 5 years. The same figure was obtained in case of extension to the female genital organs (the invasion of which is not a pejorative sign), while the prognosis was considerably worsened for the patients who had had lymph node resection due to invasion of inguinal nodes (20% survived after 5 years). Local surgical exeresis currently is as valuable as radiation therapy, but the latter is clearly indicated for advanced carcinomas, for which mutilating surgery has not demonstrated its superiority.
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The high hepatic clearance of the new doxorubicin analogue epirubicin (4'-epidoxorubicin, epiDX) suggests a possible use of this drug in local and regional therapy where a first pass through the liver is required before the drug can reach systemic circulation. EpiDX pharmacokinetics was followed in advanced cancer patients with liver metastases or a primary tumour after single bolus administration in the hepatic artery, through a surgically implanted catheter and subcutaneous access port. The first-pass effect through the liver was appreciable and only a relatively low fraction of the drug reached systemic circulation. Mild leucopenia and alopecia were observed only in a patient with a hepatopulmonary shunt; this subject was actually exposed to higher epiDX plasma levels. Low intraperitoneal doses of epiDX were administered in a weekly schedule to advanced cancer patients with peritoneal metastases and ascites. Drug concentrations were monitored in the ascitic effusion and in plasma. A high concentration gradient was present between the peritoneal cavity and peripheral circulation. No relevant local or systemic toxicity was observed.
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Between 1972 and 1985, 107 patients with chronic Idiopathic Thrombocytopenic Purpura underwent splenectomy. Platelet life span and sites of sequestration were studied with labelled platelets and external scanning. Medical treatment was always of scarce and transient effectiveness and had considerable side effects. Splenectomy had minimal complications and mortality and caused no hazard of overwhelming sepsis in adults. The results of splenectomy were very satisfying, especially when platelet sequestration was mainly splenic (remission in about 90% of patients). Surgical treatment is at present the most effective in patients with chronic ITP.
A case of polypoid carcinoma of the lower oesophagus in a 52 yr old man is reported. The tumour presented the histological features of spindle-cell squamous carcinoma and oat-cell carcinoma. The histogenesis of these tumours is considered.
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