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Biomedical subjects

M Gil

Publications and source records attributed to M Gil.

At least 127 records · Page 7Linked to original sources

Twelve years of experience with cytotoxic therapy in malignant tumors of the neck and head.

Since 1968 we have treated with antiblastic drugs 164 malignant tumors recurrent or incurable by surgery or radiotherapy in 151 cases. Different therapeutic methods were employed. Today we have the possibility of selecting alternative options with incipient or relatively delimited carcinomas, principally the substitution of radical surgery by initial associated physical and chemical treatment, so that if there is a cure the consequences of radical surgery can be avoided. We emphasize the curve of two primary cancers of the uvula with 300 mg bleomycin exclusively and the results observed in oropharyngeal and laryngeal carcinomas by using three intermittent Schabel cycles and 4,000 rad Telecobalt, avoiding a radical surgery.

Antineoplastic Agents↗

Preliminary results of chemoradiotherapy followed (or not ) by active immunotherapy of stage III and IV lymphosarcoma and reticulosarcoma: correlation of the results with WHO categorization.

One hundred and one patients with advanced (stage III and IV) LS and RS at the first presentation of the disease or on relapse were treated with a regimen combining initial chemotherapy, complementary radiotherapy on "icebergs," supplementary chemotherapy, and finally, active immunotherapy. The overall complete remission rate was about 79% for LS and 73% for RS. About 50% of the patients were still in remission for both diseases after 2 years; 60% with LS were still alive after 2 years and 44% with Rs. This study shows the useful prognostic value of the WHO classification for LS and RS: the prognosis of prolymphocytic (centrofollicular) LS is far better than that of the lymphoblastic type, which is itself better than that of the very poor prognostic immunoblastic type. The prognosis of RS is intermediate between that of the best prognostic type and that of the poorest prognostic type of LS.

Adolescent↗

Preliminary results of chemo-radiotherapy followed or not by active immunotherapy of stage III and IV lymphosarcoma and reticulosarcoma. Correlation of the results with WHO categorisation.

We treated 101 patients with advanced (stage III and IV) lymphosarcoma and reticulosarcoma at first presentation of the disease or in relapse according to a protocol combining initial chemotherapy, complementary radiotherapy on icebergs, supplementary chemotherapy, and, finally, active immunotherapy. The overall complete remission rate was about 79% for lymphosarcoma and 73% for reticulosarcoma. About 50% of the patients were still in remission in each of the two diseases at 2 years; 60% of lymphosarcoma and 44% of reticulosarcoma patients achieved 2-year survival. This study shows the prognostic value of the WHO classification for lymphosarcoma and reticulosarcoma: the prognosis of prolymphocytic (centrofollicular) lymphosarcoma is far better than that of the lymphoblastic type, which is in turn better than that of the very poor prognosis of the immunoblastic type. The prognosis of reticulosarcoma is intermediate between that of the best-prognosis and that of the poorest-prognosis type of lymphosarcoma.

Adolescent↗

Myocardial ultrastructural changes during extracorporeal circulation wtih anoxic cardiac arrest and its prevention by coronary perfusion. Experimental study.

This experimental work has been carried out with the aim of studying the ultrastructural myocardial changes caused by prolonged anoxic cardiac arrest during cardiopulmonary bypass, and their prevention by means of two different techniques of coronary perfusion--systemic-pressure continuous and low-pressure intermittent perfusion. After 30 minutes of cardiac anoxia, the ultrastructural changes of the myocardial cell were reverted to normal by coronary perfusion; when anoxic cardiac arrest was prolonged up to 60 minutes there was severe myocardial damage, with marked mitochondrial changes and dehiscence of intercalated discs, which persisted in spite of restoring coronary flow. These morphological data were in accordance with the fact that no dog which underwent anoxic cardiac arrest for 60 minutes recovered. Both intermittent and continuous coronary perfusion were effective in preventing anoxic damage; cardiac muscle cells were better preserved by low-pressure intermittent perfusion than by systemic-pressure continuous perfusion, which caused intracellular and intramitochondrial oedema.

Animals↗

[Simultaneous location of non-palpable breast neoplasms and sentinel node (SN) study by radioisotopic techniques].

OBJECTIVE: To obtain correct location of non-palpable breast lesions, with high suspicion of malignancy and detection of SN by radiosotopic techniques. MATERIAL AND METHODS: Thirty-one patients whose ages ranged from 35 to 79 years, with non-palpable breast lesions detected by mammography and/or ultrasonography were studied. All the patients were diagnosed of breast cancer and treated with primary chemotherapy. All the patients underwent total axillary dissection. At 24 hours of the intervention, all patients received one dose of 37 MBq (1 mCi) of 99mTc labeled macroaggregated albumin (MAA) in the center of the lesion by ultrasonographic guide. Scintigraphic images were performed in anterior and lateral projections (in prone decubitus with hanging breast) to verify the correct location of the radiopharmaceutical. After, a study of the SN was performed by subdermal administration of an 18 MBq (0.5 mCi) dose of 99mTc labeled nanocolloid. The SN site was labeled on the skin with indelible ink. The intrasurgical site of the breast lesion and SN was performed using a gamma detector probe. Correct placement of the intralesional radiopharmaceutical, existence of disease free borders and histological study of SN were performed by the pathologist in the surgical act. The differed pathology study was performed with hematoxilin-eosin and immunohistochemistry. RESULT: In 29 of the 31 lesion sites, there was good placement of the radiotracer (93.5 %). There was 1 case of contamination of the needle pathway and another that did not coincide with the lesion, due to poor placement. Location of the SN was 96 % in the axilla and 4 % in axilla and internal mammary chain. The SN was located in surgery in 28/31 patients (90 %). CONCLUSION: Simultaneous radioguided location of the hidden breast lesions and sentinel node is a simple method, which is well tolerated by the patients and can be done in a single operation act.

Adult↗

[Treatment of supraventricular paroxysmal tachycardia and auricular flutter by auricular stimulation].

Although the management of supraventricular tachycardias (SVT) and atrial flutter (AF1) with drugs or cardioversion is usually effective, their use in the high risk patient commonly digitalized, may be dangerous. Since the availability of an alternate therapeutic method is desirable, the usefulness of atrial pacing was evaluated in 31 episodes of tachyarrhythmia in 31 patients with varied heart conditions. The arrhythmia diagnosis and the stimulation were done through a right atrial electrode. In most cases the rate of stimulation was higher than that of the atria (up to 400 stimuli per min). Of 17 cases with SVT (four with preexcitation syndrome), pacing led to sinus rhythm (SR) in all, even though it was transient in two. SR was obtained in six of eleven cases of AF1, through a short lasting atrial fibrillation (AF) in three of them. Four patients with paroxysmal atrial tachycardia with A-V block changed to AF. SR was achieved shortly after termination of the procedure in two of the latter. It is concluded that atrial pacing is a valuable therapeutic method since it is effective, it has very low risk specially in digitalized patients, its does not require anesthesia and because it may be used repeatedly in case of recurrence. The technique of atrial pacing permits, in some cases, the identification of the mechanism responsible for the arrhythmia.

Adolescent↗

[Correlation between exercise test and coronariography].

In order to evaluate the sensibility and specificity of the maximal treadmill exercise-stress test, a correlation was made, in fifty patients, of the resus of the test and the findings at selective coronary arteriography. None of the patients had received cardioactive drugs previous to the study. Among twenty-nine patients with proven coronary disease, three had false negative exercise tests. The remaining twenty-six cases had positive tests. The sensitivity of the method (reliability in identifying the presence of disease) was 89.7%. Twelve of twenty-one subjects with normal coronary arteries had negative exercise tests. In eight patients without coronary artery lesions, the exercise test was positive (false positive tests). An additional patient had an equivocal response and is included among the false positive responses. These nine-patients form a special group since they had severe heart disease, even though it was not due to atherosclerosis of the major coronary vessels. The specificity of the test (reliability in identifying the absence of disease) was 57.1%. However, in the absence of other heart disease, none of the subjects with normal coronary arteries had a false positive response. An analysis is made of the possible causes of these false negative and false positive responses. It was also shown in this study that the patients with coronary artery disease and positive treadmill tests had a definite functional aerobic impairment as well as a significant reduction in such indices of myocardial oxygen consumption as the heart rate and the double product (pressure-pulse), when compared to the subjects with normal coronary vessels and negative tests. In the group of patients with false positive responses, these parameters were not significantly different from the normals. The exercise-stress test protocol used in this study appears to have an adequate sensibility and an acceptable specificity.

Adult↗