Biomedical subjects

A Nemcek

Publications and source records attributed to A Nemcek.

15 recordsLinked to original sources

PubMed2001

Failed primary management of iatrogenic biliary injury: incidence and significance of concomitant hepatic arterial disruption.

BACKGROUND: Vasculobiliary injury (VBI) is a well-recognized complication of laparoscopic cholecystectomy (LC). In patients with failed primary management of bile duct injury (BDI), an assessment of the hepatic arterial system may be important to determine the presence of VBI. This study was conducted to determine the incidence of VBI in patients with failed primary management of LC-related BDI and to establish a potential correlation between the level of BDI and the incidence of VBI. METHODS: A retrospective review was conducted on 18 patients referred for failed primary management of LC-related BDI who underwent prospective arteriography as part of the preoperative work-up. RESULTS: Of the 18 patients who sustained BDI, Bismuth level 4 lesions were found in 7 patients (39%), level 3 in 8 patients (44%), and level 2 in 3 patients (17%). VBI was identified on arteriography in 11 patients (61%). VBI was present in 71% of patients with level 4 lesions, 63% of patients with level 3 lesions, and 33% of patients with level 2 lesions. The time interval from primary management to its failure was longer in VBI than in BDI alone. CONCLUSIONS: We have observed a high incidence of VBI in patients with failed primary management of LC-related BDI. Arterial disruption may affect the outcome of primary management of BDI.

Adult↗

PubMed2001

Indications and results of liver resection and hepatic chemoembolization for metastatic gastrointestinal neuroendocrine tumors.

BACKGROUND: We reviewed 36 patients with liver metastases from islet cell tumors of the pancreas (n = 18) and carcinoid tumors (n = 18) who were treated with surgical resection (n = 16) or hepatic chemoembolization (n = 20). METHODS: All resections were complete and included 4 lobectomies, 6 segmental resections, and 6 wedge resections. There were no operative deaths. RESULTS: Median survival has not yet been reached, and the actuarial 5-year survival rate is 70%. Prognostic variables associated with improved disease-free survival included prior resection of the primary tumor and 4 or fewer metastases resected (P <.05). With an average of 3 chemoembolization procedures per patient, 17 of 20 patients (90%) demonstrated either a significant radiographic response (n = 5), stabilization of tumor mass (n = 2), or improvement of clinical symptoms (n = 10). Factors related to a sustained response (more then 1 year) included surgical resection of the primary tumor, 4 or more chemoembolization procedures, and liver metastases of 5 cm or smaller. Median survival after treatment was 32 months (range, 7-63 months), and the actuarial 5-year survival rate was 40%. CONCLUSIONS: Surgical resection of metastatic neuroendocrine tumors provides the best chance for extended survival. Chemoembolization effectively improves clinical symptoms and, in selected patients, may provide sustained tumor control.

Adenoma, Islet Cell↗

PubMed2000

Intrahepatic portal-hepatic venous anastomosis: a portal-systemic shunt with neurological repercussions.

Intrahepatic shunts are rarely diagnosed as a cause of neurocognitive abnormality. A complaint of fatigue led to the diagnosis of a right portal vein-hepatic vein aneurysmal communication in a 23-yr-old, otherwise healthy woman. Neuropsychological testing, imaging, and MR spectroscopy revealed changes similar to those described in patients with cirrhosis and subclinical hepatic encephalopathy. T1-weighted MRI showed a hyperintense globus pallidus, a feature seen in subjects with and without portal-encephalopathy. Portal-systemic shunting in the absence of parenchymal liver disease reproduces neurological features described in cirrhosis.

Adult↗

PubMed2000

Peliosis hepatis with intrahepatic hemorrhage: successful embolization of the hepatic artery.

Peliosis hepatis is defined as the appearance of blood filled lakes in the hepatic parenchyma. It has been associated with various pharmacological agents and infections. Treatment has been primarily symptomatic and includes discontinuation of offending medications, partial hepatectomy or occasionally liver transplantation. We report a 58 year old white female on hormone replacement therapy who developed symptomatic peliosis hepatis and underwent successful superselective hepatic artery embolization with control of bleeding.

Embolization, Therapeutic↗

PubMed1997

Sarcoma arising from an abdominal aortic aneurysm.

A rare case of retroperitoneal sarcoma arising from an aneurysm sac is diagnosed in a patient following tube graft repair of the abdominal aortic aneurysm. The radiographic studies illustrate the characteristics of malignancy which are distinguishable from more common vascular complications. Malignancy should be considered in the differential diagnosis of retroperitoneal masses during radiographic follow-up of patients after aortic surgery. Sarcoma is optimally treated with complete excision, sometimes requiring concomitant vascular reconstruction. Radical en bloc resection was not attempted in this case due to extensive involvement of the aorta and inferior vena cava.

Aged↗

PubMed1997

Transcatheter embolization of a ruptured superior gluteal artery aneurysm: case report and review of the literature.

PURPOSE: To report the successful coil embolization of a true gluteal artery aneurysm and review therapeutic options for this rare condition. METHODS AND RESULTS: A ruptured superior gluteal artery aneurysm in a symptomatic 80-year-old man was successfully thrombosed by embolization using a combination of Gianturco coils and helical platinum microcoils. Six-month computed tomography demonstrated persistent thrombosis of the aneurysm and resolution of the perivascular blood. CONCLUSIONS: This report offers support for the use of catheter-based techniques as an alternative to standard surgical repair of gluteal artery aneurysms.

Aged↗

PubMed1994

Assessment of complete remission after 2-chlorodeoxyadenosine for hairy cell leukemia: utility of marrow immunostaining and measurement of splenic index.

2-Chlorodeoxyadenosine (2-CdA) yields high complete remission (CR) rates in patients with hairy cell leukemia (HCL) Two approaches were used to detect minimal residual disease. We studied two B-lineage antibodies, L26 and MB2, and a T-lineage antibody, UCHL-1, in fixed marrow core biopsies from 34 patients with HCL before and after 2-CdA to detect minimal residual in the marrow. In addition, the splenic index was calculated before and after treatment to detect residual splenomegaly. Prior to therapy, hairy cells exhibited intense cytoplasmic membrane reactivity with L26 and strong intracytoplasmic reactivity with MB2. UCHL-1 did not react with hairy cells. Thirty-one patients were assessable 3 months after therapy. Five of 24 (21%) patients in CR by routine evaluation had residual HCL detected by immunostaining. Four of these 5 patients have been reevaluated at 1 year. One patient relapsed by routine evaluation, 2 remained positive by immunostaining alone, and 1 patient became negative by immunostaining. A total of 19 patients have been evaluated at 1 year and 17 remain in CR. Three of these 17 were positive by immunostaining, 2 of whom had been positive at 3 months and 1 additional patient who became positive by immunostaining at 1 year. Of 9 patients evaluated at 2 years, an additional 2 of 3 patients with minimal residual disease detected previously by immunostaining at 3 months relapsed by routine morphology and 1 had persistent positive immunostaining. Only 1 patient in remission by morphology and immunostaining has relapsed.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies↗

PubMed1989

Granulosa cell tumor of the adult testis: ultrastructural and ultrasonographic characteristics.

We report a case of a granulosa cell tumor of the testis. The ultrastructural characteristics of this rare tumor were compared to its homologue in the ovary and they were similar.

Adult↗

PubMed1986

Vertebral-body collapse in focal and diffuse disease: patterns of pathologic processes.

The radiographic patterns of vertebral-body collapse and/or endplate deformity were examined in 99 autopsy specimens of the thoracolumbar spine with benign and malignant disease. Angling of endplates was found to be highly predictive of underlying malignancy, whereas concavity was more suggestive of benign disease, for both individual vertebral bodies and intact spines (P less than .001). Diffuse-concave, diffuse-angled, and focal-angled patterns were more useful (P less than .001) than the focal-concave pattern (P = .07) in distinguishing between benign and malignant disease for superior endplates, whereas all were equally useful (P less than .025) in inferior endplates. Condition of the adjacent disks, location within the spine, and position of the apex of collapse were not predictive. Although these results and subsequent blinded testing suggest that reliable distinction between benign and malignant vertebral collapse is possible, extrapolation to clinical practice may be inappropriate because of population bias in the study and differences in radiographic quality between autopsy specimens and live subjects.

Adult↗

PubMedDate not supplied