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At least 487 records · Page 27Linked to original sources
PubMed1996

[Diagnosis and therapy for metastatic liver cancer].

Hepatic metastases occur frequently in patients with colorectal cancer. Patients with advanced cancer should be followed carefully after curative resection of the primary lesions for the early detection of the recurrence. If hepatic metastasis is suspected on the basis of rising CEA levels, more sophisticated imaging techniques, such as ultrasound, computed tomography, magnetic resonance imaging and hepatic angiography should be employed for the diagnosis. However, these tests are not cost-effective and not warranted on a routine follow-up basis. To be more cost-effective, a relatively simple and sensitive test or group of tests should be used. The authors have proposed that the basement membrane producibility of the primary lesion yields the most important information predicting a liver metastasis; the basement membrane producing cancer highly metastasizes to the liver. In contrast, more than 90% of non-producing cancer does not metastasize to the liver. The basement membrane producibility is easily examined by laminin staining. In the treatment of hepatic metastases, hepatic resection is the preferred approach when the metastases are located in a resectable segment or can be encompassed by as many as five wedge resections, but these scenarios are relatively uncommon. For unresectable disease, chemotherapy and intravenous and/or intra-arterial embolization are viable alternatives. Loco-regional treatment may offer a pharmacological advantage since a liver metastasis is almost exclusively fed by the hepatic artery. A pilot study we conducted on hepatic infusion chemotherapy combined with interleukin-2 (IL-2.MF) revealed very encouraging results (response rate: 76%), and further study in a prospective randomized trial confirmed this high response rate. Adjuvant IL-2.MF infusion therapy after curative resection of liver metastases is also effective for the prevention of recurrence in the residual liver. Based on the data, we conclude that multimodal treatments of hepatic resection and loco-regional infusion of immuno-chemotherapy (IL-2.MF) make it possible to control both resectable and unresectable liver metastases.

Animals↗
PubMedDate not supplied

Combination therapy of percutaneous mitoxantrone injection, percutaneous ethanol injection, and transcatheter arterial embolization for intrahepatic hepatocellular carcinoma and adrenal metastasis.

We treated a 63-year-old man who had recurrent large hepatocellular carcinomas (> 5 cm in diameter) and left adrenal metastasis with the combination approach of percutaneous intratumoral chemotherapy with mitoxantrone, percutaneous ethanol injection, and transcatheter arterial embolization. He received repeated transcatheter arterial embolization and percutaneous ethanol injection combination therapy for intrahepatic hepatocellular carcinomas, which controlled his disease for 6 months from the first treatment. After that, left adrenal metastasis was detected by biopsy specimen. Therefore, we repeated more transcatheter arterial embolization and percutaneous ethanol injection to the liver and left adrenal gland, but this combination therapy could not control the hepatocellular carcinomas in these organs. With the patient's consent, he was treated with the combination approach of percutaneous intratumoral chemotherapy with mitoxantrone, percutaneous ethanol injection, and transcatheter arterial embolization for hepatocellular carcinomas of the liver and left adrenal gland. After this combination therapy, we followed-up the viable lesions by color Doppler ultrasonography and computed tomography examination. However, we could not detect these viable lesions of hepatocellular carcinomas in his body until one month before he died. When the degree of hepatic failure worsened due to the natural course of cirrhosis, this combination therapy was stopped 7 months before he died. He died of pulmonary tumor emboli from metastasis of inferior vena cava 24 months after the combination therapy started. However, on autopsy there was almost no remaining hepatocellular carcinoma found in the main lesions of liver and left adrenal gland. We suggest that a combination approach of percutaneous intratumoral chemotherapy with mitoxantrone, percutaneous ethanol injection, and transcatheter arterial embolization may be indicated in elderly cases of intrahepatic large hepatocellular carcinoma and adrenal metastasis, which are not under control only by transcatheter arterial embolization and percutaneous ethanol injection.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Color vision testing to assist in diagnosis of digoxin toxicity.

This report describes an initial step in the process of determining whether color vision changes might form the basis for testing to assist in diagnosis of digoxin toxicity. The research questions concerned the types of color vision deficiencies found in people with elevated digoxin levels, the types of color vision tests that could help identify color vision changes in these people, and the relationship between serum digoxin level and subjects' responses to color vision tests. Three groups of subjects with a minimum of one week on maintenance digoxin therapy were tested. Two groups who were free of selected known causes of abnormal color vision participated in a single test session: clinic women (N = 19) and hospitalized women (N = 30). A third group (N = 10) was initially tested at a time of elevated serum digoxin levels (greater than or equal to 2.5 ng/ml) and retested at therapeutic levels. The Farnsworth-Munsell 100-Hue Test was performed on the clinic women. All subjects were tested with the Ishihara; the Hardy, Rand, and Rittler (HRR) plates; and the Farnsworth Panel D-15. The 49 women who had a single test session demonstrated a positive relationship between digoxin level and failing the Ishihara (p less than .05). On retest at therapeutic levels, the group with initial high digoxin levels had a significant reduction in the number of Ishihara (p .005) and HRR (p less than .005) errors. The Panel D-15 lacked sensitivity. Most subjects with high digoxin levels would not have been able to perform a reliable 100-Hue test. Red-green deficiency was the most common defect.

Adult↗
PubMed1978

Teaching retarded women a clothing selection skill using community norms.

Five institutionalized retarded women were taught a clothing selection skill to coincide with popular fashion. Normative data concerning popular styles of color-coordinated clothing were collected through observations of women's apparel in a local community. Using a puzzle simulation of a woman with alternative pieces of colored clothing, color coordination training was conducted using modelling, instructions, practice, praise, and feedback to teach popular selections of color combinations. A generalization training component with actual clothing was also included. Training was accompanied by large increases in percentage of popular color selections with the puzzle and actual clothing. The increases maintained over a seven- to 14-week followup period. Time efficiency measures supported the use of the simulation procedure as opposed to total reliance on actual clothing. The results underscore the utility of local norms in community preparation programs and the efficacy of instructional procedures for severely and profoundly retarded persons as part of their participation in the deinstitutionalization movement.

Adult↗
PubMed2001

Multiparameter flow cytometry of bacteria: implications for diagnostics and therapeutics.

BACKGROUND: Flow cytometric studies of antibiotic susceptibilities of bacteria have typically measured a single fluorescence parameter, such as membrane potential (indicating viability), or permeability to nucleic acid stains such as propidium (indicating nonviability). Cytometry of bacteria stained simultaneously with a membrane potential dye and a permeability indicator reveals unanticipated complexity. METHODS: Aliquots of cultures of three bacterial species were stained with the potential-sensitive dye hexamethylindocarbocyanine [DiIC1(3)] and the permeability indicator TO-PRO-3, in the presence and absence of a proton ionophore which collapses the potential gradient. They were analyzed using a dual-laser flow cytometer. RESULTS: Cultures grown under suboptimal conditions appear to contain cells that take up TO-PRO-3 while maintaining membrane potential, although some events showing both high DiIC1(3) fluorescence and high TO-PRO-3 fluorescence may represent clumps. CONCLUSIONS: Variations in metabolic patterns between species and within organisms under suboptimal culture conditions or following antibiotic exposure may make it difficult to develop flow cytometric clinical assays for antibiotic susceptibility. However, transient permeabilization of otherwise resistant organisms by sublethal doses of antibiotics may make it possible to treat infections by such organisms with suitably derivatized, otherwise toxic molecules; multiparameter cytometry should be useful in pursuing this approach to therapy.

Carbocyanines↗
PubMed1993

[Color-coded duplex sonography (angiodynography) in comparison with phlebography].

To verify the suspected diagnosis of deep thrombosis in the pelvic and/or the leg veins or to clarify the causes of pulmonary embolism, 84 patients were examined prospectively by color-coded duplex-sonography. The findings in the 103 legs examined were subsequently compared to those of an ascending phlebography. The deep veins from the region of the vena iliaca communis down to the lower leg were visualized, and blood flow, lumen and compressibility were checked. This procedure enabled the identification of totally occluding thrombi as well as partial thrombi with the circumfluent blood. The sensitivity of thrombus identification was 92.9%, the specificity was about 97% in the different segments. The results show that color-coded duplex sonography is a sensitive diagnostic instrument for follow-up in conservative therapy. Also, in postthrombotic changes, fresh clots can be identified for the most part. Color-coded duplex sonography can replace phlebography in most cases, if special attention is paid to regions which are difficult to visualize, such as the pelvic veins, the Hunter's channel and the veins of the lower leg.

Adolescent↗
PubMed2001

Tattoo darkening and nonresponse after laser treatment: a possible role for titanium dioxide.

OBJECTIVE: To examine relationships between chemical composition, biopsy findings, and clinical outcome in laser-treated tattoos. DESIGN: Observational nonblinded retrospective study. SETTINGS: University-based dermatology clinic and private practice. PARTICIPANTS: Twenty patients who underwent biopsy of laser-treated tattoos. MAIN OUTCOME MEASURES: Biopsy specimens were analyzed after laser treatment, and the depths of changed particles were recorded. Ultrastructure of the changed particles was examined by electron microscopy. Presence of inorganic chemicals was determined by x-ray diffraction. Correlation between x-ray diffraction, microscopy, and clinical response was attempted. RESULTS: Of the 20 tattoos, 7 lightened, 9 failed to change, and 4 darkened after laser treatment. There was a significant association between presence of titanium dioxide and poor response to laser therapy. Microscopic studies showed variable changes in the ink particles, but there was a trend toward residual deep green pigment in the resistant tattoos. Also, round dark stippling was observed superficially in the darkened specimens. CONCLUSIONS: Titanium is overrepresented in tattoos that respond poorly to laser treatment. Further studies are necessary to show whether this metal is the primary cause of this poor response.

Coloring Agents↗
PubMed1996

Treatment of nevus Ota: combined skin abrasion and carbon dioxide snow method.

Thirty-seven patients with nevus Ota were treated by skin abrasion-carbon dioxide snow therapy. Data obtained from 24 patients (including 5 infants) who completed treatment were analyzed to determine the number of treatment courses and to assess the outcome by color and histologic type. The 5 infants completing treatment received a mean of 10 courses of carbon dioxide snow therapy. Excluding these infants, the mean number of treatment courses was 3 for skin abrasion and 16 for carbon dioxide snow therapy. The therapeutic outcome was satisfactory, being graded as "excellent" in 6 patients, "excellent to good" in 6 patients, "good" in 10 Patients, and "fair" in 2 patients. None of the patients had a "poor" outcome. Darker lesions were generally less responsive to treatment. Lesions with melanocytes in the superficial dermis showed a better response with fewer courses of treatment. Those with melanocytes throughout the whole dermis generally had a poorer outcome. The results confirm that the benefits of this procedure are limited by the associated pain and the need for great skill and a long treatment duration.

Adolescent↗
PubMedDate not supplied

Some recent advances in the clinical aspects of multiple sclerosis.

UNLABELLED: Recent work on the clinical aspects of multiple sclerosis is reviewed with particular regard to symptomatology: New approaches to clinical symptoms and the identification of more subtle impairments are illustrated by recent studies of visual function in M.S. patients; pathophysiology: It is now widely appreciated that the dysfunction observed in patients is not determined solely by histologically demonstrable demyelination. The function of the demyelinated neuron is highly variable, being dependent upon factors which may change from day to day. Recent ideas about 'neuro-electric blocking factors' and other factors that may influence demyelinated neurons and hence symptoms are discussed; diagnosis: tests on C.S.F., electro-physiological and psychophysiological tests and computer tomography as aids to diagnosis and the controversy over 'specific' blood tests are reviewed; course and prognosis: Long term follow-up studies confirm that, in a significant proportion of cases, the course of M.S. may be benign and have identified some early prognostic indices; TREATMENT: The results of trials of symptomatic (spinal cord stimulation) and would-be curative therapies (such as dietary supplementation with poly-unsaturated fatty acids and immunosuppression) are briefly discussed.

Body Temperature↗
PubMed2001

Objective evaluation of treatment effects on port-wine stains using L*a*b* color coordinates.

Wide variations in port-wine stains and their responses to various therapies pose a need for the development of an objective method to evaluate the effects of treatment. Several techniques such as laser Doppler, reflectance spectrometry, and tristimulus colorimetry have been used to evaluate the color of port-wine stains, but these techniques are limited by cost, small test size area, and other factors. Therefore, we developed a simple and cost-effective method of evaluating treatment results on port-wine stains using the L*a*b* color coordinate system in combination with a personal computer. For 22 patients with port-wine stains, the slide photographs were digitized using a slide scanner. L*a*b* color differences of the normal control and port-wine stain sites were obtained before and after treatment, and treatment effect (percent) was calculated. By calculating each color difference between the lesion and normal skin both before and after treatment, problems arising from different illuminating conditions during photography were minimized. The results were compared with the visual evaluation conducted by three experienced plastic surgeons. The treatment effects analyzed by L*a*b* color coordinate ranged from 4 to 95 percent, with a mean of 48.1 percent, whereas treatment effects evaluated by the plastic surgeons ranged from 15 to 92 percent, with a mean of 51.1 percent. The subjective clinical grades correlated well with the treatment effects obtained by the proposed color analysis system (correlation coefficient, 0.89). The maximum difference in the effect of treatment for a patient evaluated by the three clinicians was up to 60 percent, which means that visual judgment is very subjective and variable. The color analysis system proposed as a result of this study is very easy, objective, quantitative, cost-effective, and can be useful for the evaluation of treatment effects on colored skin lesions such as port-wine stains.

Color↗
PubMed1992

Prevention of initial variceal hemorrhage.

Results from prospective controlled trials do not justify the use of either prophylactic shunt surgery or sclerotherapy for the prevention of initial variceal bleeding. Use of nonselective beta-adrenergic blockers has been shown to reduce significantly the risk of first variceal hemorrhage, but their effect on survival is marginal. Because only 25% to 40% of patients with cirrhosis and varices experience variceal bleeding, is it justified to place all patients with varices on beta-blocker therapy? The answer lies in the identification of a high-risk population (i.e., patients with large varices and endoscopic red color signs) and patients who can tolerate and will be compliant with therapy. The duration of therapy required is unknown and perhaps requires a lifetime commitment. Future research will involve the use of combinations of pharmacologic agents to reduce further portal pressure and perhaps the use of pharmacologic agents and sclerotherapy. The goal of a significant improvement in survival is yet to be obtained.

Adrenergic beta-Antagonists↗
PubMed1999

Shock waves (SW) noninvasive extracorporeal thrombolysis treatment (NISWT).

A group of 24 patients were considered for noninvasive shock waves thrombolysis (NISWT). Of these, 15 patients gave their informed consent. NISWT was attempted in eight patients (while seven patients were randomized for follow-up only). NISWT was possible in six of seven patients. In one patient randomized for NISWT, local inguinal scarring, due to previous surgery, made impossible the visualization of the femoral vein, and therefore focusing of shock waves (SWs). No side effects were reported in the days after SWs administration during the 4-month follow-up. In patients treated with NISWT it was possible to observe just after the SWs session the presence of echolucent "acoustic holes" and flow (by color and power Doppler) within the "holes." All "echolucent holes" produced at the first session were still present at 4 months, and color flow imaging also detected new flow channels in echogenic areas of thrombi previously not visible. In one patient thrombolysis was achieved after the first treatment, but at 3 and 4 months the thrombus was completely avascular. In conclusion, thrombolysis using SWs was obtained in selected cases and it was still persisting at 4 months in six of the seven treated patients. NISWT appears feasible and promising. These results should be confirmed by larger, prospective trials.

Adult↗
PubMed1994

The current status of ultrasound and color Doppler imaging in screening for ovarian cancer.

The lack of significant improvement in ovarian cancer survival in over 3 decades has focused interest on early disease detection as well as the development of more effective therapies. Ultrasound's ability to discern alterations in ovarian architecture and color doppler's ability to recognize malignancy-associated angiogenesis have resulted in the application of these techniques to ovarian cancer screening. Morphology scoring systems have been developed to quantitate the anatomic alterations seen on ultrasound. Prospective ovarian cancer ultrasound screening trials involving 11,283 women were evaluated: 486 participants underwent surgical exploration and 19 ovarian cancers were diagnosed. Thirteen cases were stage I where the impact of screening on disease survival is thought to be maximal; 5/13 were invasive epithelial malignancies, 7/13 were borderline tumors, and 1/13 was a granulosa cell tumor. Overall, 32 surgeries (95% CI = 20-58) were required to diagnose one stage I ovarian cancer; if only those women with a family history of ovarian cancer are included in the analysis, then 17 surgeries (95% CI = 14-41) would be required. Potential clinical implications of these results are discussed, as well as future directions for screening.

Adolescent↗
PubMed2003

Red ink tattoo reactions: successful treatment with the Q-switched 532 nm Nd:YAG laser.

BACKGROUND: In the South-west Thames region there were an unprecedented number of lichenoid tattoo reactions to red ink in patients who had visited a local tattoo parlour. The red ink was found to contain mercuric sulphide, a compound known to cause allergic reactions. Topical Dermovate (clobetasol propionate 0.05%, GlaxoWellcome) ointment alone had little impact. OBJECTIVES: To investigate whether the Q-switched 532 nm Nd:YAG laser could produce permanent flattening of the reaction. METHODS: This was an open nonrandomized clinical trial. Biopsies were taken from the lichenoid areas within the tattoos. Subjects were patch tested to 1% ammoniated mercury in petrolatum prior to treatment with the Q-switched 532 nm Nd:YAG laser. Laser treatments were delivered at 6-weekly intervals by a single operator. Patients also applied topical Dermovate between treatments. Therapy was discontinued when the lesions flattened. Clinical photographs were assessed at baseline and prior to each laser treatment. RESULTS: Seven patients with Fitzpatrick skin types I-III were enrolled in the study (four females, three males, mean age 39 years). All patients completed the trial. Patch testing to mercury was universally negative at 48 and 96 h. Substantial flattening and depigmentation of the red ink within the tattoos was noted after six laser treatments. No adverse effects were recorded. CONCLUSIONS: The Q-switched 532 nm Nd:YAG laser in combination with topical Dermovate ointment is a safe and effective method of treating red ink tattoo reactions.

Administration, Topical↗
PubMed2000

Expression of estrogen receptors in desquamative gingivitis.

BACKGROUND: Most cases of chronic desquamative gingivitis (CDG) are shown by direct immunofluorescence (DIF) to be immune mediated diseases. Some patients present with similar clinical and microscopic findings as CDG but DIF staining is negative. It has been suggested that those cases of CDG may be hormone (estrogen) mediated and may be treated with estrogens with favorable results. METHODS: Gingival tissue from 24 cases of CDG and one case of ordinary gingivitis were studied for estrogen receptor (ER) expression using immunohistochemical techniques. Twenty-four of the 25 cases were female. Using standard DIF analysis, 11 of the CDG cases were diagnosed as benign mucous membrane pemphigoid, 10 as lichen planus or lichenoid mucositis (LP), and one as pemphigus. The remaining 3 cases were not diagnostic for a specific disorder (idiopathic). Five of the females had a history of estrogen substitute therapy. RESULTS: Twenty-two of 23 female CDG cases were positive for ER, although the degree of staining varied. A 32-year-old female with ordinary gingivitis, whose gingivitis varied with her menstrual cycle, did not stain for ER. A 50-year-old male and a 76-year-old female, both with gingival LP, also had negative staining for ER. CONCLUSIONS: There appears to be no correlation between diagnosed diseases (immunological versus idiopathic) and expression of ER in CDG gingiva. ER expression in the gingiva is probably not related to the presence or absence of estrogen supplementation. The results of this study do not support the use of estrogen in the treatment of idiopathic CDG.

Adult↗
PubMed2003

Effect of electrical stimulation on HIV-1-infected HeLa cells cultured on an electrode surface.

Acquired immunodeficiency syndrome (AIDS) is a disease caused by infection with the human immunodeficiency virus (HIV). Although drug therapy for AIDS is available, problems such as side effects associated with drug therapy and the appearance of resistant HIV strains have arisen. Therefore, therapies based on new principles other than drug treatment are required. In the present study, the effect of electrical stimulation on HIV-1(LAI) chronically infected HeLa (P6 HeLa/HIV-1(LAI)) cells cultured on an electrode surface was examined. The results indicated that sensitivity to electrical stimulation was much higher in P6 HeLa/HIV-1(LAI) cells than in uninfected P6 HeLa cells. When electrical stimulation was applied at 1.0 V (vs. Ag/AgCl) for 20 min, the proportion of damage to cell membrane among P6 HeLa/HIV-1(LAI) cells, as evaluated by Trypan blue staining, was approximately 4 times higher than that for uninfected P6 HeLa cells. Furthermore, in comparison with uninfected P6 HeLa cells, the proliferation of P6 HeLa/HIV-1(LAI) cells was significantly suppressed after electrical stimulation. This technique was proven to selectively kill P6 HeLa/HIV-1(LAI) cells, when compared with uninfected control cells.

Cell Death↗