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PubMed2004

Use of D-STAT to prevent bleeding following percutaneous transhepatic intraportal islet transplantation.

An infrequent but nevertheless concerning complication associated with percutaneous transhepatic islet transplantation is bleeding. Historically in 61 procedures at this institution, we experienced four bleeding complications in three patients (6.6%), two requiring blood transfusion (3.3%) and two asymptomatic intraperitoneal bleeds detected sonographically at 24 h postprocedure (3.3%). It is suggested that the source of the majority of these bleeds is the liver parenchymal tract following removal of the infusion catheter combined with a significant dose of heparin administered to prevent portal vein thrombosis. Various techniques have been used to reduce the risk of tract bleeding, including gelfoam, intravascular coils, and cautery. In our experience gelfoam alone has been used to plug the catheter tract (n = 47); however, in the aforementioned three patients, this technique failed, either due to dislodgement of, or bleeding peripheral to, the plug. This article describes the use of D-Stat, a collagen/thrombin paste that is injected into the peripheral tract. In five consecutive cases performed using D-Stat, there has been no bleeding or thromboses detected. D-Stat combined with a single gelfoam plug offers a quick, easy, efficacious way of sealing the entire catheter tract without leaving any permanent hardware in the liver. This new method may simplify tract closure and reduce bleeding complications in islet transplantation.

Animals↗
PubMed1999

New method for packing the external auditory canal, middle ear space, and mastoid cavities after otologic surgery.

Since its introduction in 1945, an absorbable gelatin sponge, Gelfoam, has long been a staple used for packing in otologic surgery. The present method commonly employed at the University of Manitoba teaching hospitals requires that operating room nurses carefully prepare extremely small pieces of both compressed and noncompressed Gelfoam. These pieces are then selectively soaked in an antibiotic solution and carefully placed, one by one, into the appropriate position. We describe a new paste preparation of Gelfoam powder, Thrombostat, acetic acid, and Bacitracin ointment, which can very quickly be injected from a syringe into the operated cavity. Our preliminary study indicates that this preparation reduces operating time, while making the process of packing easier for the surgeon. In addition, it ensures a more evenly packed cavity while still fulfilling the requirements of middle ear packing. Postoperatively, it was found to be easier to debride from the operative cavity in the office, decreasing patient discomfort and procedure time. Reported below is a preliminary clinical patient series report comparing this new method to the old method.

Acetic Acid↗
PubMedDate not supplied

Hepatic artery chemoembolization for advanced stage HCC: experience of 650 patients.

UNLABELLED: Hepatic artery chemotherapy using cisplatin in various protocols was examined in 650 patients. Overall objective tumor response rate (PR) was 65%. Average survival was 7.5 mo in patients with tumor progression, 18.0 mo for tumor stability and 32.0 mo for PR. 1- and 2-yr survival was 70% and 40% in responders, 20% and 0% in progressors. Prognostic factors were examined in 155 patients treated with cisplatin and gelfoam chemo-occlusion. In survival groups of > 24 mo, 4-24 mo and < 4 mo, similar numbers had cirrhosis, hepatitis B virus, hepatitis C virus and alcoholism. Decreased survival was associated with abnormal bilirubin, albumin and prothrombin time. Tumor vascularity and response to chemotherapy were associated with prolonged survival. Tumor vascularity seemed important for tumor response. Portal vein thrombosis occurred in all groups. Lesion number, bilobarity and maximum size had no correlation with response or survival. We analyzed the cause of death in 425 patients. No evidence of hepatocellular carcinoma progression, judged by absence of change in CT scan or tumor marker in the last 4 months of life, was found in 42%. A group of 57 patients were treated with cisplatin in dose range 125-200 mg/m2 alone or with gelfoam. In both groups, responders survived longer than non-responders: cisplatin alone responder mean survival, 29.0 mo, non-responder 11.1 mo, P < 0.0001. There was a strong effect of dose density on median survival for cisplatin alone, but not for cisplatin and gelfoam. CONCLUSIONS: A large experience of single-agent cisplatin chemo-occlusion is summarized. Good liver function and tumor vascularity are associated with response to chemotherapy, which in turn is associated with enhanced survival. Many deaths are due to cirrhosis and not hepatocellular carcinoma.

Antineoplastic Agents↗
PubMed2002

Experimentally induced rhinosinusitis in rabbits.

OBJECTIVE: The purpose of this study was to develop an experimental rhinosinusitis model by using bacteria-added absorbable material for temporary ostial obstruction. METHOD: Absorbable gelatin sponge was inserted between the endoturbinals and the ostium of the sinus. In the first group, the effects of surgical procedure and Gelfoam on ostial mucosa were examined macroscopically. In the second group Gelfoam was moistened with Staphylococcus aureus (ATCC 25923). The sinuses of rabbits were examined by coronal com puted tomography before each surgical procedure and sacrifice. The animals were sacrificed at the first, second, fourth eighth, and tenth weeks. Histologic and microbiologic examinations were performed. RESULTS: In the first group, fibrotic bands and adhesions were observed between the ostium of the maxillary sinus and the endoturbinals in the first and second week. In the second group, a thick purulent discharge that invariably filled the sinuses of the inoculated side was seen after the first week of induction, and opacity, which was determined radiologically, did not disappear until the end of the study. CONCLUSION: In this study, an experimental rhinosinusitis model was accomplished. It is currently believed that obstruction of the ostium with mucosal edema, polyps, or tumour leads to maxillary sinusitis. In this model, the pathogenesis of human sinusitis was imitated by temporary occlusion of the ostium with bacteria-added Gelfoam. This model can be used in further studies to explore the role of the ostium in the pathogenesis of sinusitis.

Animals↗
PubMed2005

[Dexamethasone pharmacokinetics in perilymph of guinea pig after different topical administrations].

OBJECTIVE: To determine pharmacokinetics profiles of dexamethasone (DEX) in perilymph of guinea pig with different intratympanic administrations, and to provide experimental evidence for clinical choice about administration. METHOD: Two different topical administrations placing a granule gelfoam soaked with DEX (10 g/L) in the niche of round window of guinea pig and infusing tympanic bulb with DEX solution (10 g/L) were conducted. Perilymph of the scala tympani was sampled 1-6 h after administration. DEX in the samples was assayed with high-performance liquid chromatography. RESULT: The concentrations of DEX in perilymph after placing a granule gel-foam soaked with DEX in the niche of round window were significantly higher than that after intratympanic infusing. The half-life time of DEX after placing a granule gelfoam was longer. CONCLUSION: DEX could effectively penetrate round window membrane into perilymph after different intratympanic administrations, and the method of placing a granule gelfoam soaked with DEX in the niche of round window is more effective than that of intratympanic infusing.

Administration, Topical↗
PubMed2005

[The change of pulmonary surfactant associated protein A in acute pulmonary embolism].

OBJECTIVE: To study the changes of pulmonary surfactant associated protein A (SPA) of lung tissue in acute pulmonary embolism (PE). METHODS: Male SD rats were injected with medical gelfoam microspheres via jugular vein to induce the PE model. Thirty-two rats were randomized into four groups: a control group (n = 8) and three groups of embolism for 24 h (n = 8), 1 week (n = 8) and 2 weeks (n = 8), respectively. The rats were sacrificed at the time of 2 weeks, 24 h, 1 week and 2 weeks. Pulmonary artery pressure, heart rate and respiratory rate were measured by right heart catheterization and artery blood gas was analyzed at the time of sacrifice. Lung tissues were sliced and stained with HE to observe the embolism of pulmonary arteries. RT-PCR and Western blot were used to study the changes of SPA mRNA and SPA protein in lung tissues. RESULTS: In the embolism rats, the pulmonary arterial pressure (mm Hg) increased significantly; the mean pulmonary arterial pressures of the 4 groups were 14.2 +/- 4.1, 26.1 +/- 7.5, 26.1 +/- 6.8 and 29.0 +/- 8.2, respectively (P < 0.05). The heart rate (per/minute) also increased significantly, 415 +/- 15, 451 +/- 35, 463 +/- 29 and 446 +/- 14, respectively in the 4 groups (P < 0.05). The arterial partial pressure of oxygen (mm Hg) decreased significantly, 94.1 +/- 8.8, 80.5 +/- 5.8, 80.4 +/- 13.8 and 73.4 +/- 14.3, respectively in the 4 groups (P < 0.05). After 24 h of embolism, pulmonary arteries were shown to be embolized with gelfoam, and later the gelfoam was resolved at week 2. The expression of SPA mRNA and protein in lung tissues decreased significantly after embolism; the mRNA level was 1.43 +/- 0.51, 0.83 +/- 0.33, 0.91 +/- 0.33 and 0.87 +/- 0.35 respectively in the 4 groups (P < 0.05); the protein level was, 1.00 +/- 0.00, 0.44 +/- 0.18, 0.44 +/- 0.33, and 0.52 +/- 0.32, respectively (P < 0.05). CONCLUSION: The SPA level decreases significantly in acute pulmonary embolism, which may play an important role in hypoxemia in pulmonary embolism.

Animals↗
PubMed1990

[Effects on blood coagulation-fibrinolytic system after transcatheter hepatic arterial therapy in cases of hepatocellular carcinoma analyzed by plasma levels of plasmin-alpha 2-PI complex, D dimer and thrombin-ATIII complex].

To clarify the effects on blood coagulation-fibrinolytic system after transcatheter hepatic arterial therapy for cases of hepatocellular carcinoma (HCC), plasma levels of Plasmin-alpha 2PI complex (PIC), Ddimer and Thrombin-ATIII (TAT) before and after therapy were measured by EIA, in addition to other conventional coagulofibrinolytic parameters. In the group (9 cases) treated with intra-arterial injection of adriamycin, there were no significant changes of coagulofibrinolytic parameters except for Ddimer (P less than 0.05) which was elevated 1-2 days after therapy. However, only two cases in whom plasma PIC, Ddimer and TAT levels were clearly elevated before therapy, showed further marked elevation of those parameters after therapy. In the group (29 cases) treated with intra-arterial injection of adriamycin-lipiodol suspension, whether or not embolized with gelfoam, plasma PIC, Ddimer and TAT levels were significantly elevated (P less than 0.01) after therapy, as well as other conventional coagulofibrinolytic parameters. These results indicate that hypercoagulable and hyperfibrinolytic states were induced by treatment. Moreover, the secondary hyperfibrinolytic state tended to persist longer than the hypercoagulable state. The 14 cases embolized with gelfoam seemed to have more apparent effects on blood coagulation-fibrinolytic system than cases not treated with gelfoam. Therefore, we conclude that caution and prophylaxis for the occurrence of disseminated intravascular coagulation are necessary for transcatheter arterial therapy for cases of HCC.

Antithrombin III↗
PubMed1989

[Limitation of oily chemoembolization against hepatocellular carcinoma and arterioportal segmental chemoembolization].

Emulsion of adriamycin and lipiodol added with Gelfoam has been used for the transcatheter oily chemoembolization against hepatocellular carcinomas. This therapy resulted in significantly increased cumulative survival as compared with chemoembolization therapy using anti-cancer drugs and Gelfoam. However, it was revealed to have the following limitations: Insufficient efficacy against micrometastases and extracapsular invasion; impossible to perform sufficient treatment for patients with severe hepatic disorders; and there were cases in which lipiodol was hardly retained. In order to overcome the limitations described above, we have performed segmental hepatic chemoembolization simultaneously from the hepatic artery embolization simultaneously from the hepatic artery and portal vein. This method works on the basis of the fact that excess amount of lipiodol emulsion infused from the hepatic artery flows into the portal vein. Gelfoam embolization is also added in this method. Though subjects appropriate for this newly developed method are restricted, all the tumors in the objective segment of the liver can undergo necrosis. The efficacy is comparable to the effects of hepatectomy. In addition, since the other segments of the liver are able to be kept in reserve, this method is able to be applied to patients with severe hepatic disorders.

Aged↗
PubMed1979

Stapes surgery at the Otologic Medical Group.

We reviewed the records of 498 primary stapedectomy cases in regard to duration of disease, age at surgery, oval window pathology, hearing results, dizziness, and tinnitus. Ninety percent of the cases in which a tissue graft had been used as an oval window covering obtained a postoperative hearing level within 10 dB of the preoperative bone conduction. Postoperative sensorineural hearing impairment occurred infrequently and was two to three times more common in cases in which Gelfoam had been used as an oval window covering as compared to tissue grafts. Postoperative dizziness of one degree or another persisted at four months in 2 percent of the cases and was a problem for the patient in two cases (0.4%). This dizziness was likewise more common in Gelfoam cases. We concluded that tissue grafts are a better covering for the oval window than Gelfoam both in regard to hearing improvement and lack of postoperative complications.

Adult↗
PubMed1995

Calbindin-D28k in subsets of medulloblastomas and in the human medulloblastoma cell line D283 Med.

OBJECTIVE: To evaluate the antigenic expression of calbindin-D28k in surgically resected cerebellar medulloblastomas and the human medulloblastoma cell line D283 Med in relation to glial neoplasms, the human glioblastoma (U-251 MG) and rat glioma (C-6) cell lines, and other primary and metastatic brain tumors. DESIGN: Immunohistochemical staining was performed using an antiserum and a monoclonal antibody against calbindin-D28k on (1) formalin-fixed, paraffin-embedded human, predominantly posterior fossa, brain tumor specimens (49 medulloblastomas, 59 glial and mesenchymal primary central nervous system tumors, 1 posterior fossa rhabdoid tumor, and 34 metastatic tumors); (2) formalin-70% alcohol-, or Bouin's-fixed tumor cell lines (D283 Med, U-251 MG, and C-6) maintained in a three-dimensional gelatin foam (Gelfoam matrix) system, with or without treatment with dibutyryl cyclic adenosine monophosphate; and (3) formalin-fixed, paraffin-embedded C-6 glioma cells transplanted intracerebrally to rats. RESULTS: Calbindin-D28k immunohistochemical staining was detected in 20 of 49 cerebellar medulloblastomas and in cells of the human medulloblastoma cell line D283 Med grown in gelatin Gelfoam matrices, with or without treatment with dibutyryl cyclic adenosine monophosphate. In surgical resection specimens, calbindin-D28k reactivity was evident in populations of poorly differentiated cells of classic (non-nodular) medulloblastomas (16/20) and in mature Purkinje neuronlike phenotypes in medulloblastomas with ganglion cells (4/6) but was absent in desmoplastic medulloblastomas, including in areas of neoplastic neuritogenesis ("pale islands") (0/23). Calbindin-D28k staining was also present in D283 Med explants for up to 29 days in vitro. Reactivity was more widespread in dibutyryl cyclic adenosine monophosphate-treated cultures, coinciding with neuronal morphologic alterations of cultured cells. Focal calbindin-D28k stainig was present in neural-like cells of an embryonal cerebellar tumor with divergent mesenchymal, epithelial, and neuroectodermal/neuroendocrine differentiation suggestive of a malignant rhabdoid tumor. No calbindin-D28k staining was obtained in primary glial and mesenchymal (intra- and extra-axial) brain tumors (0/59), in explants of human glioblastoma cell line U-251 MG, or in the rat glioma line C-6 maintained in Gelfoam matrices or transplanted intracerebrally. Among 34 epithelial and mesenchymal tumors metastatic to the posterior fossa, only subpopulations of cells in two small-cell (neuroendocrine) carcinomas originating in the lung were calbindin positive. CONCLUSION: Calbindin-D28k expression in classic medulloblastomas, medulloblastomas with ganglion cells, and in the human medulloblastoma cell line D283 Med (which was derived from a metastatic classic medulloblastoma) suggests a phenotypic kinship between subsets of this tumor and neuronal progeny of the ventricular neuroepithelium, thus conferring additional support for its neuroblastic nature.

Animals↗
PubMed1994

Chemoembolization in liver malignant involvement. Experiences on 17 cases.

INTRODUCTION: Liver invasion is the major cause of organ failure in patients with primary liver cancer and metastatic large bowel cancer. Furthermore it causes high morbidity in many other carcinomas. The normal liver presents a double circulation: 75% from portal circulation and 25% from hepatic artery. In malignant primary and secondary lesions the blood support is given by hepatic artery. Antineoplastic drugs mixed to selectively injecting embolic particles, such as polyvinyl alcohol and gelatin powder (Gelfoam), can be injected to infarct tumors and to obtain a therapeutical advantage. Chemoembolization using an emulsion of Lipiodol ultra-fluid (LUF) and drugs is a recent tool in liver regional therapy. LUF has been shown to be taken up hepatocellular carcinoma and retained for a long period of time in the tumor bed. Chemoembolization causes massive shrinkage due to ischemia and increasing the local drug intensity and drug exposure. Our study reports the results of multi-agents chemoembolization (MACHEM) in 17 patients bearing massive liver involvement. MATERIAL AND METHODS: From January 1988 we treated 17 patients (5 HCCs, 7 large bowell carcinomas, 1 gastric cancer, 1 ocular melanoma, 1 pancreas, 1 soft tissue sarcoma, 1 carcinoid) using a transfemoral approach to cannulate the celiac axis and then the hepatic artery. The catheter was advanced into the vessel responsible for the majority of the tumor blood supply and a mixture of Gelfoam, radiopaque contrast media, followed by chemotherapy (mitomycin 10 mg/sqm, cisplatin 20 mg/sqm, epirubicin 20 mg/sqm) mixed to LUF was injected until vascular stasis occurred. After chemoembolization, analgesics and anti-pyretics were administered. Liver function tests were monitored daily. RESULTS: Objective tumor regression was observed in 11 out 15 full evaluable patients; the median duration of survival was 9.5 months. Within 8 weeks shrinkage, due to development of necrosis, appeared in the tumors. One patient with high levels of 5-HIAA due to carcinoid, demonstrated more than 75% decreasing in urinary excretion. In 6 patients out 8 with CEA elevation a clear reduction was documented as well in 2 HCCs out 5 with alfa-fetoprotein elevation. DISCUSSION: The palliation of HCC and metastatic liver disease have been extremely disappointing. Systemic chemotherapy produces in HCC a response rate of no more than 20% and does not increase the median survival. Venook obtained 24% of PRs and liquefaction in 35 out 50 HCC treated with chemoembolization. Some results have been also demonstrated in the treatment of metastatic liver tumors by Carrasco, Daniels and Modiano. Moertel stressed that chemoembolization could be incorporated in the initial management of carcinoid. Because of the difference in chemoembolization protocols it is difficult to compare the relative efficacy of this tool, although encouraging response rates have been reported in palliation of bulky tumors. In our study Gelfoam given before LUF and antineoplastic agents mixture produce a distal arteriolar occlusion and this would facilitate the migration of the polychemotherapy emulsion toward the tumor. Our MACHEM program has been shown to have significant activity even in heavily pretreated patients with an acceptable toxicity. We conclude that hepatic arterial chemoembolization will be improved by mean of better combination of chemotherapy with embolizing agents in well selected patients.

Adult↗
PubMed1998

Neurotrophin-3 prevents death of axotomized Clarke's nucleus neurons in adult rat.

In the present investigation, we studied whether neurotrophin-3 (NT-3) contributes to the rescue of axotomized Clarke's nucleus (CN) neurons in adult rats. A significant (24%) loss of CN neurons occurred at L-1 ipsilateral to T-8 hemisection by 14 days, which reached 31% at 2 months and then stabilized. Axotomized CN neurons had also atrophied by 14 days, but mean cell size did not decrease further. Animals that received gelfoam soaked in nerve growth factor, brain derived neurotrophic factor, or ciliary neurotrophic factor at the lesion site also showed a 30% neuron loss at 2 months, and a 40% reduction in average cell area. Rats receiving NT-3 showed a 15% neuron loss, which was not improved by additional neurotrophins in combination with NT-3. None of the treatments prevented neuron atrophy. Bioassay of the gelfoam showed that NT-3 bioactivity remained at 5 days after surgery but not at 14 days. Additional rats with hemisections that received NT-3 continuously via mini-pump for 2 months showed a 15% neuron loss, the same as with NT-3 given via gelfoam. These results indicate that even limited exposure of axotomized CN neurons to NT-3 produces permanent rescue of 50% of the neurons. The virtually complete rescue that we had previously observed with transplants of fetal central nervous system (CNS) tissues may, therefore, be due at least in part to NT-3, but the exogenous administration of a single neurotrophic factor or a combination of neurotrophic factors is less effective than transplants in producing long-term survival of axotomized CNS neurons.

Animals↗
PubMed1978

Esophagogastric variceal hemorrhage: its treatment by percutaneous transephatic coronary vein occlusion.

The angiographic technique percutaneous transhepatic coronary vein occlusion was used to treat esophagogastric variceal bleeding in 38 patients. There were two categories of patients: those actively bleeding who had not been controlled by continuous vasopressin infusion and/or Blakemore tube tamponade, and those with portal hypertension who were not actively bleeding at the time of transhepatic portal venography but who were at high risk for recurrent variceal hemorrhage. Coronary vein occlusion was achieved in 33 patients by (1) metal clip and cotton devices(one); (2) balloon catheter occlusion (two); (3) heat-treated autogenous clot and powdered absorbable gelatin sponge (Gelfoam) (13); and (4) Gelfoam strips soaked in sodium tetradecyl sulfate (17). Percutaneous coronary vein occlusion was effective in controlling 81% of the patients with actively bleeding varices. In patients who were not actively bleeding, percutaneous transhepatic coronary vein occlusion seemed to afford good protection for recurrent variceal hemorrhage.

Coronary Vessels↗
PubMed1997

Tibial segmental defect repair: chondrogenesis and biomechanical strength modulated by basic fibroblast growth factor.

BACKGROUND: The effect of recombinant human basic fibroblast growth factor (bFGF) on cartilage development and bone biomechanical strength during healing of a tibial segmental defect was studied in the rat. Two reports on the effect of basic FGF administration during fracture healing and several reports on the effects of acidic FGF have documented different responses of callus cartilage to this important growth factor. This is the first report of the effect of bFGF on cartilage formation in the healing of a grafted segmental defect in the rat. METHODS: The tibiae of 80 male rats underwent segmental resection of the mid-diaphyseal region. One-half of this group consisted of controls that received insertion of an intramedullary wire with a coralline hydroxyapatite graft and Gelfoam without bFGF. The tibiae of the other half were treated identically but had the Gelfoam impregnated with 1 microgram bFGF. Animals were killed at 2, 4, and 8 weeks postoperatively. Histological sections were stained with toluidine blue to differentiate the cartilage. Areas of metachromatically stained extracellular matrix, cell areas, cell size, and cellularity were quantified by using image analysis. Unfixed treated and control tibiae were tested for bone failure strength by using four-point bending on an Instron machine. RESULTS: Control bone failure strength was significantly greater than bFGF-treated bones at 2 weeks and energy-to-failure was significantly decreased in treated bones at 2 weeks. Although strength increased with time in all groups, treated groups at 4 and 8 weeks did not differ from controls. Basic FGF treatment promoted an increase in the development of normal hyaline cartilage and vasculogenesis at 2 weeks as compared with controls. Total cartilage declined over time in all groups. Average cell size and cell number did not change with either treatment or time. Bone formation and healing was equivalent in treated and control groups at 8 weeks. CONCLUSIONS: The results indicate that bFGF released directly and initially but not continuously exerts a transient positive effect on hyaline cartilage formation at the expense of repair site strength and does not accelerate healing.

Animals↗
PubMed1994

Transcatheter arterial embolization with or without cisplatin treatment of hepatocellular carcinoma. A randomized controlled study.

BACKGROUND: This randomized controlled study was objectively designed to evaluate the utility cisplatin (50 mg) in transcatheter arterial embolization (TAE) for treatment of hepatocellular carcinoma (HCC). METHODS: From May 1991 to July 1993, 46 patients were included in the study. All had a pathologic verification of HCC. Clinically, all of the patients were considered inoperable. However, these patients satisfied eligibility criteria for TAE. The patients were divided into two groups by random sampling. In group I, 22 patients received TAE with the regimen of cisplatin (50 mg) mixed with Lipiodol 5-15 ml followed by gelfoam pieces. In group II, 24 patients, as a controlled group, used the regimen of Lipiodol and gelfoam (Spongostan Film, Ferrosan, Denmark) pieces only, without adding any anticancer drug. The two groups were evaluated by a series of imaging studies and various clinical examinations before and after TAE. Subsequently, TAE was performed every 2 or 3 months for all patients until there was no visible tumor, or the patient could not sustain further TAE, or the patient died. RESULTS: In group I, TAE was administered 61 times (average 28 times for each patient), and in group II, 73 times (average 3 times for each patient). The 1-year and 2-year survival rates of group I were 52.5% and 26.2%, and group II were 72.5% and 39.5%. Statistically, there was no significant difference in survival curves and survival rates between these two groups. Tumor response rate of group I was 68% (15/22) and group II was 67% (16/24). There was no significant difference in tumor response between these two groups. The liver and renal function studies after TAE also showed no significant difference between these two groups. CONCLUSIONS: Based on this controlled study, the authors conclude that the addition of cisplatin does not enhance the therapeutic effect of TAE for treatment of HCC.

Adult↗
PubMed1993

Native astrocytes do not migrate de novo or after local trauma.

While transplanted astrocytes migrate in specific patterns in the recipient brains, it is not known whether native astrocytes behave similarly. The ability of normal astrocytes to migrate under non-transplant conditions was therefore explored. Native astrocytes were labelled in situ with fluorescent latex beads. These latex spheres were actively endocytosed by astrocytes in vitro, and it was therefore anticipated that these spheres would also be endocytosed by native astrocytes exposed to them. Labelling was accomplished by dissecting the pia mater away from a small region of the cerebral cortex and overlaying the area with Gelfoam containing fluorescent beads. After 2-4 h, the Gelfoam was removed and the wound was closed. At the end of 2-4 weeks, manipulated brains were harvested for fluorescence microscopy. In this analysis, fluorescent polyspheres had been taken up by both pial fibroblasts and astrocytes at the pial-glial margin. Labelled astrocytes [identified by glial fibrillary acidic protein (GFAP) staining] were neither hyperplastic nor hypertrophic. They were confined to the area of the original labelling site, and did not migrate either laterally across the pial margin or ventrally into the cortical layers. Knife wounding at the time of label application, either in the region of the label or distant from it, produced reactive astrocytes that were hypertrophic. These cells also did not migrate from the label site. These results suggest that astrocytes labelled by this method do not migrate in the absence of some transplant-derived stimulus even when stimulated by local wounding.

Animals↗
PubMed1994

Leukemia inhibitory factor prevents the death of axotomised sensory neurons in the dorsal root ganglia of the neonatal rat.

Leukemia inhibitory factor (LIF) has several characteristics of a neurotrophic factor for sensory neurons. Here we have investigated whether LIF also supports the survival of axotomised sensory neurons in vivo. Newborn rat pups received a unilateral sciatic nerve transection and the injury site was treated with gelfoam soaked in phosphate buffered saline (PBS), nerve growth factor (NGF), or LIF. Neuronal nucleoli in the L5 dorsal root ganglia were counted, appropriate corrections applied, and the resultant neuronal loss expressed as a percentage of the contralateral intact side. In animals where LIF was administered neuronal loss was significantly reduced: 2 days after LIF treatment neuronal loss was 19.5% compared to 43% in PBS-treated animals; 3 days after LIF treatment neuronal loss was 20.4% compared to 40.2% in PBS-treated animals; however, 7 days after LIF treatment there was no significant reduction in the number of neurons lost. The degree of rescue of sensory neurons in vivo by LIF was found to be similar to NGF, which was not surprising as both factors supported the survival of a similar population of sensory neurons in vitro. Rescue was not observed when LIF-containing gelfoam was placed away from the axotomised nerve, suggesting that LIF's action may be associated with its retrograde transport or direct signalling at the site of nerve injury.

Animals↗
PubMed1979

Percutaneous embolization to control intractable epistaxis.

Recurrent epistaxis is a common manifestation of patients with a bleeding diathesis. Two patients with epistaxis secondary to a bleeding diathesis managed by local conservative techniques are reviewed. (A case of polycythemia vera and a case of liver failure secondary to hepatoma are reviewed.) Recently bilateral, percutaneous carotid angiography examination was performed on a patient with a bleeding diathesis and intractable epistaxis. At the time of the angiographic examination, embolization of both internal maxillary arteries with Gelfoam particles was accomplished and dramatic control of the epistaxis was achieved. In a patient with severe epistaxis secondary to a bleeding diathesis that is unresponsive to local measures, percutaneous Gelfoam embolization offers substantial advantages over surgical intervention.

Adult↗