BACKGROUND: Computed tomographic fluoroscopy (CTF), also called real-time CT, is increasingly used in interventional radiology but has not yet been recommended to guide percutaneous transhepatic biliary decompression (PTBD). We report our early clinical experiences with CTF-guided PTBD. METHODS: Sixteen consecutive patients underwent PTBD under CTF guidance because of obstructive jaundice caused by malignant tumor (11 cases of carcinoma of the bile duct, four cases of pancreatic cancer, and one case of metastasis). CTF-guided PTBD was performed on a helical CT scanner and a surgical C arm. Main target parameters were the success and complication rates, the number of necessary punctures, the time needed for successful puncture of a suitable bile duct, and the patients' radiation exposure. RESULTS: CTF-guided punctures of the bile duct for PTBD were successful on the first trial in 10 cases; in six patients, two hits were necessary. The time needed to hit a suitable bile duct was 6-21 s (median = 13 s). Therefore, the radiation exposure (skin) was 27-94.5 mSv. The additional implantation and stenting of the bile duct by means of the surgical C arm was uneventful in 15 cases. In one case, only external drainage could be achieved. Complications did not occur. CONCLUSION: CTF enables good visualization of the most suitable duct for puncture. Therefore, subsequent recanalization seems to be easier than other methods.

Bile Duct Neoplasms↗

PubMedDate not supplied

A comparative study of CT fluoroscopy combined with fluoroscopy versus fluoroscopy alone for percutaneous transhepatic biliary drainage.

PURPOSE: We compared CT fluoroscopy (CTF) for the initial puncture of bile ducts with conventional fluoroscopic guidance in patients with malignant jaundice in whom percutaneous transhepatic biliary drainage (PTBD) was planned. METHODS: Forty consecutive patients were randomized to two study groups: group A underwent PTBD under CTF and fluoroscopic guidance, group B underwent PTBD under fluoroscopic guidance alone. CTF-guided PTBD was performed using a combination of a helical CT scanner of the latest generation and a mobile C-arm; conventional PTBD was performed under fluoroscopic guidance in the angiographic unit. End points of the study were the success (a puncture that enabled safe placement of a guidewire in a suitable bile duct) and the complication rate (hemobilia, bile fistula, biliary peritonitis), the number of punctures required, the time needed for successful puncture of a suitable bile duct, and the patient's radiation exposure. RESULTS: CTF-guided puncture of peripheral bile ducts suitable for PTBD was successful at the first attempt in 16 cases, under conventional fluoroscopic guidance, in only two cases. We found a significantly different number of punctures (1.2 in group A vs 2.9 in group B), a significantly shorter time for puncture in group A (mean 39 sec), but also a significantly higher skin exposure dosage in group A (mean 49.5 mSv surface dosage). There was no significant difference regarding the total procedure time. Only one complication occurred in group B (portobiliary fistula). CONCLUSION: CTF-guided initial puncture of bile ducts allowed a significantly reduced number of punctures and puncture times compared with puncture under conventional fluoroscopic guidance for placement of percutaneous transhepatic biliary drainage catheters.

Adult↗

PubMedDate not supplied

Systemic administration of recombinant transforming growth factor beta 2 (rTGF-beta 2) stimulates parameters of cancellous bone formation in juvenile and adult rats.

Transforming growth factor beta is a multifunctional protein with known actions on bone and bone cells. The ability of TGF-beta to stimulate osteogenic parameters in vitro and osteogenesis adjacent to injection sites in vivo is well established. The purpose of this study was to determine if systemic administration of recombinant TGF-beta 2 (rTGF-beta 2) could stimulate bone formation in rats of different ages. Juvenile (25-day-old) and adult (160-day-old) rats were treated daily for 5 days and 14 days, respectively, with rTGF-beta 2 given by subcutaneous injection. Bone formation was measured in cancellous bone of the lumbar vertebrae in juvenile rats and the femoral epiphysis in adult rats. Endochondral bone growth rates were measured in the distal femurs from both juvenile and adult rats using histomorphometric methods. Systemic administration of rTGF-beta 2 resulted in substantial increases in bone formation rates (both surface and volume referent) in both juvenile and adult rats. In the juvenile rats, rTGF-beta 2 increased the percent double labeled surface and the mineral appositional rate. In the adult rats, TGF-beta 2 treatment increased the double labeled surface and also endochondral (longitudinal) growth parameters without changing the number of osteoclasts or the number of osteoclast nuclei per cell. These results demonstrate that short-term systemic administration of rTGF-beta 2 substantially increases cancellous bone formation rate in rats.

Aging↗

PubMedDate not supplied

The apparent digestibility of 'complete diet' cubes given to Thoroughbred horses and the use of chromic oxide as an inert faecal marker.

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Animal Feed↗

PubMedDate not supplied

Successful treatment of intimal hyperplasia in renal arteries by endovascular brachytherapy.

PURPOSE: The present study shows the possibility of preventing restenosis of renal arteries by endovascular brachytherapy. METHODS AND MATERIALS: We present a patient suffering from rapid restenosis of both renal arteries with decreasing renal function. Percutaneous transluminal angioplasty (PTA) and stent implantation were unable to stop hypertension and to stabilize renal function. Both renal arteries and the right pole artery were treated by endovascular brachytherapy in one session. RESULTS: Six months after intervention, intraarterial digital subtraction angiography (DSA) showed no evidence of recurrence, and the blood pressure remained normal without medical treatment. CONCLUSION: Endovascular brachytherapy can help to prevent restenosis in renal arteries. It is possible to treat both renal arteries and one pole artery in one session without any disadvantage.

Angiography, Digital Subtraction↗