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Biomedical subjects

F Giunta

Publications and source records attributed to F Giunta.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

High-dose-rate brachytherapy for poor-prognosis, high-grade glioma: (phase II) preliminary results.

AIMS AND BACKGROUND: The purpose of this study was to investigate the palliative effectiveness of an interstitial fractionated high-dose-rate (HDR) brachytherapy regimen in patients with poor-prognosis, high-grade glioma. METHODS: An after-remote-loading microSelectron HDR lr-192 370 GBq unit was used. A unique coaxial after-loading catheter was stereotactically inserted through the center of the target volume. The treatment schedule was: 5 fractions, 5 Gy per fraction, or alternatively 7 fractions, 3.85 Gy per fraction, at the dose specification surface, 2 fractions per day. Twenty-four patients have been treated: in 17 of them (T1 G3-4) the catheter was implanted during stereotactic biopsy procedure; in the other 7 cases (T2 G3-4), subjected to partial resection and reduced to yT1, the catheter was implanted following surgery with a mean delay of 15 days. RESULTS: The treatment was feasible and well tolerated. The complete course takes no more than 7 days. The acute complication rate (2/24) seems to be acceptable. The median survival was 8 months. No less than 45% of the patients had a WHO grade 2 score or better at any time of follow-up. At 4 months of follow-up, functional status, assessed using a verbally administered Barthel index, had improved from the pretreatment level in 29.1% of the 18 surviving patients and remained stable in another 22.2%. A minimal response or stable disease, according to CT scan, was obtained in about half of the assessable survivors at any time of follow-up. CONCLUSIONS: The short course of brachytherapy provides a good palliation in terms of functional improvement in a high proportion of patients, with low and acceptable toxicity.

Actuarial Analysis↗
PubMedDate not supplied

Single versus multiple drug therapy in the combined treatment of malignant gliomas. A multicenter study.

The best treatment of malignant gliomas has been considered to be surgery followed by irradiation and chemotherapy with nitrosourea compounds. Our controlled and randomized trial was designed in 1982 to analyze the effectiveness of multiple-drug versus single-drug therapy in patients bearing malignant gliomas. After 3 weeks from surgery and histopathological diagnosis 173 patients were randomly assigned to receive one of the three chemotherapy regimens: CCNU alone, CCNU plus VM-26 or CCNU plus VM-26 plus 5-FU. Radiotherapy was administered whole-brain (40-45 Gy) and coned-down focal (15-20 Gy) irradiation for a total of 60 Gy (1700 rets) in conjunction with the first course of chemotherapy. 150/173 patients are evaluable. Statistical analysis of results shows a better quality of life and survival for patients treated with polychemotherapy using a three drug combination than two drug or single drug therapy (13.8 vs 14.7 vs 18.2 months MST; P less than 0.01) but with a higher incidence of toxicity problems. An analysis of prognostic factors and their distribution in each arm of the protocol will be made in the near future.

Adolescent↗
PubMedDate not supplied

Third ventricle intrinsic craniopharingioma. Case report.

A case of craniopharingioma developed and situated in the cavity of the third ventricle with no connections with the base of the skull is reported. The patient was a thirty-year-old man, who within a few months had developed a diencephalic syndrome followed by psychic disorders and intracranial hypertension. Cerebral scan: large area of accumulation in the supra and retrosellar region. Bilateral carotid angiogram: no pathological staining but the venous angle and the internal cerebral vein were elevated and shifted posteriorly. Pneumoencephalogram: free and normal basal cisterns; the third ventrical is almost totally filled by a mass; small dilatation of the lateral ventricles. Operation: right trans ventricular approach to the third ventricle. The tumour was the size of an apricot encapsulated with a smooth surface, and adherent to the wall of the third ventricle only in the region of the infundibulum. There was little bleeding and no cystic component. Total removal was performed except for a few millimeters of capsule in the infundibular region. The postoperative course was complicated by an irreversible diencephalic insufficiency with death on the 27th postoperative day. Autopsy clearly showed that the inferior surface of the brain in the diencephalic region was not involved by the mass which hystologically was doubtless a craniopharingioma. Only two other cases of craniopharingioma of the third ventricle were so far reported in the literature by Cashion and Young in 1971.

Adult↗
PubMedDate not supplied

Critical evaluation of the hemispheric perfusion brain scanning using Tc99m labeled human albumin microspheres in cerebral ischemic disorders. Preliminary report.

Twentytwo patients, 11 with Completed Stroke and 11 with Transitory Ischemic Attacks, were submitted to the Perfusional Brain Scanning (PBS). In all cases the PBS demonstred a pathologic pattern. The test explored the conditions of the arteriolar tree and acquainted us with the degree of the ischemic damage and the functional value of the interhemispheric arterial collateral circle. Further informations on the morphology, site and extension of the lesion were obtained. The pathophysiologic aspects of the procedure are discussed and its safety assessed.

Brain Ischemia↗
PubMedDate not supplied

Intramedullary spinal cord metastases.

The authors report 5 cases of intramedullary metastases, observed in the last 5 years. In 2 cases, the way of spreading was via the CSF, in 2 cases via the systemic circulation, and in 1 case along the perineural sheaths. A comparison with similar studies in the literature is followed by a brief discussion on treatment and prognosis.

Adenocarcinoma↗
PubMedDate not supplied

Esophagogastric anastomotic leakage.

Anastomotic leakage of esophagogastric anastomoses can be prevented by administering adequate preoperative nutritional support and by employing mechanical circular staplers. In a series of 299 intrathoracic anastomoses, 35 leakages were observed, 11 of which gave asymptomatic radiological findings. In a series of 46 cervical anastomoses, nine leakages were observed. In the majority of cases conservative treatment was adopted. This is based upon external drainage of septic collections, gastric emptying, antibiotics and intensive nutritional care. The mortality rate in cases of anastomotic fistulas was 1.74% (6 patients) in the patients with esophagogastric anastomoses.

Cardia↗
PubMedDate not supplied

Critical evaluation of a new water soluble contrast medium (Iopamidolo) in cervical myelograms.

The Authors report the preliminary results in 96 cervical myelograms performed by percutaneous subarachnoid injection at the level C1-C2 of a new water soluble contrast medium (Iopamidolo*). Compared to other water soluble contrast media Iopamidolo offers some advantages: (1) it is a time stable solution ready for immediate use; (2) it gives an ideal density for the study of the cervical spinal canal; (3) it provides high quality radiograms suitable for magnification of anatomical details which give a more accurate surgical diagnosis; (4) it is well tolerated without significant sequelae; no delayed complications were reported up to 15 months. This contrast medium gives valuable results also in myelograms performed by lumbar route.

Humans↗