Biomedical subjects

G Mentha

Publications and source records attributed to G Mentha.

169 records · Page 10Linked to original sources

PubMedDate not supplied

Enhancement of liver hemangiomas on T1-weighted MR SE images by superparamagnetic iron oxide particles.

OBJECTIVE: Superparamagnetic iron oxide (SPIO) particles are phagocytosed by cells of the macrophage-monocytic phagocytic system. They are usually used in MRI as a negative contrast agent, because of their strong T2* effect, to improve detection of tumors in the liver and spleen. However, they also have a potent T1 relaxivity. In the current study, we describe this T1 effect in liver hemangiomas. MATERIALS AND METHODS: Twelve patients (nine women and three men, aged from 38 to 76 years) with liver hemangiomas were examined by means of MRI at 1.5 T before and after intravenous administration of SPIO particles at a dose of 15 mumol Fe/kg body wt. Signal intensity was measured from regions of interest. RESULTS: Whereas on postcontrast T2-weighted SE images the hemangiomas showed on average a signal drop of 20% (p = 0.011) and 49% (p = 0.001) (first and second echo, respectively), their signal increased by 106% (p = 0.001) on postcontrast T1-weighted SE images. CONCLUSION: The T1 effect (signal enhancement) we observed in liver hemangiomas after infusion of SPIO particles could prove to be a useful new diagnostic feature that would help characterize these common lesions and differentiate them from other liver tumors.

Adult↗

PubMedDate not supplied

Reliable bioelectrical impedance analysis estimate of fat-free mass in liver, lung, and heart transplant patients.

BACKGROUND: Bioelectrical impedance analysis (BIA) can be valuable in evaluating the fat-free (FFM) and fat masses (FM) in patients, provided that the BIA equation is valid in the subjects studied. The purpose of the clinical evaluation was to evaluate the applicability of a single BIA equation to predict FFM in pre- and posttransplant patients and to compare FFM and FM in transplant patients with healthy controls. METHODS: Pre- and posttransplant liver, lung, and heart patients (159 men, 86 women) were measured by two methods-50-kHz BIA-derived FFM (FFM(BIA)) by Xitron instrument and DXA-derived FFM (FFM(DXA)) by Hologic QDR-4500 instrument-and compared with healthy controls (196 men, 129 women), aged 20 to 79 years. RESULTS: The high correlation coefficient (r = .974), small bias (0.3 +/- 2.3 kg), and small SEE (2.3 kg) suggest that BIA using the GENEVA equation is able to predict FFM in pre- and posttransplant patients. The study shows that the lower weight seen in transplant men and women than in controls was due to lower FFM, which was partially offset by higher FM in men but not in women. Furthermore, the higher weights in posttransplant than in pretransplant patients were due to higher FM and % FM that was confirmed by lower FFM/FM ratio in posttransplant patients. CONCLUSIONS: Single 50-kHz frequency BIA permits measurement of FFM in pre- and posttransplant patients.

Absorptiometry, Photon↗

PubMedDate not supplied

Long-term results after surgical management of chronic pancreatitis.

BACKGROUND/AIMS: Long-term outcome in surgery for chronic pancreatitis remains relatively unknown. METHODOLOGY: Between 1963 and 1993, we performed 123 pancreatic resections and 35 drainage procedures for severe chronic pancreatitis. We reviewed 131 patients with a mean follow-up of 48 months (4 months to 18 years). RESULTS: Actual 10-year survival was 82% for nonalcoholic patients and 51% for alcoholic pancreatitis. Pain was successfully treated in 71% with pancreatic resection and in 42% with drainage procedures (p<0.01). Although post-operative diabetes mellitus occurred in 56% of patients after pancreatic resection, long-term nutritional status was similar after pancreatic resection and drainage procedures. Weight gain could be observed in 75 patients (47%) and quality-of-life was good to excellent in 97 patients (74%). CONCLUSIONS: In conclusion, long-term survival was mainly conditioned by the etiology of the disease. Pancreatic resections were more successful in treating intractable pain than drainage and required fewer re-interventions. As presumed, resections were associated with a higher rate of diabetes mellitus, but this, however, had no impact on long-term nutritional status and quality-of-life.

Adult↗

PubMedDate not supplied

Do aneurysms and pseudoaneurysms of the splenic artery require different surgical strategy?

BACKGROUND/AIMS: Although aneurysms and pseudoaneurysms of the splenic artery may result in life-threatening hemorrhage, their etiology, mode of presentation, and surgical strategy seem to differ. In an attempt to clarify their management, we reviewed our experience with aneurysms and pseudoaneurysms of the splenic artery. METHODOLOGY: Between 1977 and 1997, 10 patients were operated on for true aneurysm and 6 for pseudoaneurysm of the splenic artery. RESULTS: True aneurysms required resection because of rupture (n=7), size (n=2), and anticipated pregnancy (n=1). They remained asymptomatic unless rupture had occurred. Treatment consisted in aneurysmectomy with preservation of the pancreas and spleen when asymptomatic and required splenectomy or splenopancreatectomy when ruptured. Pseudoaneurysms were always associated with chronic pancreatitis and symptoms had lasted from several hours to 4 weeks prior to hospitalization. Caudal splenopancreatectomy was required in all but one case. CONCLUSIONS: To contrast true aneurysms, pseudoaneurysms most often present with massive or intermittent bleeding. While the spleen and pancreas should be preserved when treating asymptomatic true aneurysms, management of ruptured aneurysms and pseudoaneurysms of the splenic artery usually consists of splenectomy or splenopancreatectomy.

Adult↗

PubMedDate not supplied

Surgical presentation of abdominal tuberculosis: a protean disease.

BACKGROUND/AIMS: The incidence of tuberculosis is rising again in the Western world, due to the emergence of new groups of patients at risk. This paper intends to describe the various patterns of surgical presentation of abdominal tuberculosis in an industrialized country. METHODOLOGY: A retrospective study was made of all patients admitted to our surgical institution, and in whom a diagnosis of abdominal tuberculosis was established. Eleven patients were identified. Ten of them were migrants from countries endemic for tuberculosis. RESULTS: Six patients presented with acute abdominal pain (3 in right lower quadrant) and had surgery in emergency. Two patients had elective surgery for diagnostic purposes. Two patients underwent other invasive diagnostic and/or therapeutic procedures. One patient was treated conservatively. Unusual presentations included 2 patients with periportal lymphadenitis and compressive features on the main bile duct and/or the portal vein, and 1 patient with acute duodenal tuberculous perforation. The main localization of disease was lymph nodes for 5 patients, intestinal for 4 and peritoneal for 2. CONCLUSIONS: Surgeons must be aware of the wide clinical spectrum of abdominal tuberculosis and have a high index of suspicion when confronted with patients from an endemic area and presenting with unclear abdominal symptoms.

Adult↗

PubMedDate not supplied

Treatment of hepatocellular carcinoma at the dawn of the third millennium: liver transplantation and its alternatives.

Hepatocellular carcinoma is one of the most frequent tumors worldwide, and its frequency is increasing. The management of hepatocellular carcinoma has changed in recent years, this because screening allows to discover tumors at an earlier stage, and because of effective treatments are available, such as liver transplantation, liver resection, percutaneous ablation and transarterial chemoembolization. Each one of these treatments has its own advantages and drawbacks, and range of application according to the stage of the tumor and of the underlying liver disease. This review summarizes the recent progress in the management of HCC and the practice in our unit.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Risk factors influencing the outcome of portal and mesenteric vein thrombosis.

BACKGROUND/AIMS: This study analyzes risk factors that influence the course and outcome of portal and superior mesenteric vein thrombosis (PMVT). METHODOLOGY: We retrospectively reviewed 45 patients who were admitted to our institution over a 17-year period with a diagnosis of PMVT. Patients were classified according to three etiological groups, namely: cirrhosis (47%), pancreatitis (22%), and other causes (33%), with 1 patient belonging to two different groups. RESULTS: Over the course of the disease, rupture of gastric or esophageal varices was more frequent (p<0.005) in cirrhotics (75%) than non-cirrhotics (17%). Sclerotherapy was always the first treatment for variceal bleeding, with a success rate of 73% but a rate of recurrence of 56%. Surgical procedures were performed on 22% of patients. Actuarial survival was 43% at 5 years, but survival was significantly increased for idiopathic cases (p=0.005) and decreased in the presence of cirrhosis (p<0.001), malignancy (p<0.0001) or hematemesis (p<0.005). Gastrointestinal bleeding and terminal malignancies were responsible for 50% of deaths. CONCLUSIONS: Cirrhotic patients experience a detrimental outcome with an increased risk of gastrointestinal bleeding, which is the first cause of mortality in PMVT. Non-cirrhotic patients, especially idiopathic cases, enjoy a longer survival rate and seldom bleed, which allows for the use of anticoagulative therapy.

Adult↗