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At least 577 records · Page 32Linked to original sources
PubMed2005

Development of rhinovirus study model using organ culture of turbinate mucosa.

To better understand the pathophysiology of rhinovirus (RV) infection, a development of a study model using organ culture of turbinate mucosa was sought. Inferior turbinate mucosal tissues were cultured using air-liquid interface methods, on a support of gelfoam soaked in culture media. RV-16 was applied to the mucosal surface and washed off, and histological changes were evaluated. The success of RV infection was assayed by semi-nested RT-PCR of the mucosal surface fluid taken 48h after incubation. Intracellular RVs were visualized by in situ hybridization (ISH). Secretion of the cytokines, IL-6 and IL-8, into the culture media was quantitated by ELISA. After 7 days of culture, the turbinate mucosae did not show significant damage. A PCR product indicating successful RV infection was detected in 5 out of 10 mucosal tissues. ISH showed a very small number of positively stained cells focally located in the epithelial layer. In the beginning 24h after infection, secretion of IL-6 and IL-8 into the culture media of infected mucosae was significantly greater than into the media of control mucosae. Our results indicate that the air-liquid interface organ culture of turbinate mucosa could serve as an acceptable in vitro model for studying RV infection.

Adolescent↗
PubMedDate not supplied

Evaluation of hyaluronic acid sheet for the prevention of postlaminectomy adhesions.

BACKGROUND CONTEXT: Various materials have been tested for their ability to maintain a barrier between muscles and epidural space in order to physically or chemically inhibit scar ingrowths. Hyaluronic acid (HA) solution and gel have been reported to be effective in preventing adhesions postlaminectomy; however, neither has been used clinically after spinal surgery. PURPOSE: To determine the efficacy of HA sheet for the prevention of postlaminectomy adhesions compared with that of HA gel or another sheet. STUDY DESIGN/SETTING: An animal model of lumbar laminectomy in rabbits was used to study postoperative scar tissue formation around the spinal cord. The histologic effects of HA sheet were compared with those of Gelfoam (GF) and further evaluated by an inflammation model using rhTNF-alpha. PATIENT SAMPLE: Rabbit. OUTCOME MEASURES: Histologic examination. METHODS: Five rabbits were killed at 2, 4, 8, and 24 weeks after laminectomy, respectively. Another 18 rabbits were examined in an environment of active inflammation experimentally induced by rhTNF-alpha to compare the effects of HA sheet with those of GF or HA gel. Histologic examination was performed to quantitatively assess invasive scar formation or inflammation postlaminectomy, and then, the histologic effects of HA sheet were compared with those of GF or HA gel. RESULTS: In the HA group, significantly, the area of subarachnoid space was larger, distance from the surface of dura to scar tissues was greater, the number of inflammatory cells in the scar tissues at the site of laminectomy was less, and enlargement of dura was suppressed. Using an inflammation model, we also demonstrated the efficacy of HA sheet treatment. CONCLUSIONS: In an experimental laminectomy model, HA sheet formed a solid interpositional membrane barrier and exhibited anti-inflammatory activity. Further investigations will be needed for HA sheet to be used clinically.

Animals↗
PubMed2004

Role of interventional radiology in the management of vascular complications after liver transplantation.

The purpose of this study is to review the role of the percutaneous interventional procedures in the treatment of vascular complications after orthotopic liver transplantations (OLT). Vascular complications, such as arterial stenosis and venous thrombosis, which occur in approximately 1% to 10% of liver transplant patients, are associated with a higher risk of graft dysfunction. Percutaneous interventional procedures, including angioplasty, local thrombolysis, and embolization, are useful to manage these complications. A reduced blood loss and a low incidence of procedural complications allow for rapid recovery. Hepatic arterial and portal vein anastomotic stenosis can be treated effectively by means of balloon dilation; stenting has also been proposed, particularly for venous complications. Infusional local thrombolysis may be useful in venous thrombosis. Arteriovenous fistulas, occurring at the level of the anastomosis or after liver biopsy, require intraarterial embolization using microcoils or gelfoam. Timing of the intervention for the treatment of ischemic complications is of outmost importance to guarantee liver functional recovery and avoid irreversible parenchymal injuries. Other interventional procedures may be extremely useful to manage portal hypertension after OLT; for example, by creation of transjugular portosystemic shunts, or, in the case of associated hypersplenism, transarterial embolization of the splenic artery. Finally, in patients with recurrent hepatitis, the transjugular approach has been shown to be safe and effective for liver biopsy, whereas transarterial chemoembolization may be extremely useful to treat recurrent hepatocarcinoma.

Biopsy↗
PubMed2006

Biopsy-related hemorrhage of renal allografts treated by percutaneous superselective segmental renal artery embolization.

INTRODUCTION: Biopsy-related vascular injuries in renal transplants are rare, but they can lead to dramatic clinical symptoms prompting immediate treatment. Transcatheter embolization is a minimally invasive technique used to treat some forms of arterial bleeding. This study evaluated the efficacy of this technique in iatrogenic biopsy-related vascular lesions in renal allografts. MATERIALS AND METHODS: Over the last eight years, six patients with severe renal hemorrhage were admitted to the angiography department of our hospital for evaluation and possible further treatment. All of them had a history of previous biopsy of a transplanted kidney. They all presented with clinical signs of hemodynamic instability. Angiographic investigation of the kidneys preceded further intervention in all cases. All underwent hyperselective embolization of the specific bleeding vessel with the use of microcoils and/or gelfoam particles. RESULTS: Successful embolization of the feeding artery could be performed in all patients. Superselective segmental renal artery embolization had a successful outcome concerning a steady renal function and a stable clinical course. No complications occurred. CONCLUSION: Transcatheter embolization is a safe and efficient endovascular technique to treat biopsy-related vascular injuries in renal transplants. Immediate clinical success and significant benefit in renal function can be obtained, and the longevity of the allograft after successful embolization mainly depends on the natural outcome.

Adolescent↗
PubMed2006

Perioperative management of a patient with Bernard-Soulier syndrome for third molar surgery.

Bernard-Soulier Syndrome (BSS) is a disease characterized by prolonged bleeding time, thrombocytopenia, and extremely large platelets and has a prevalence of less than 1 in 1,000,000. Patients with disorders of coagulation and bleeding can be among the most difficult surgical patients to manage. Perioperative hemorrhage can contribute to life-threatening complications in even the most routine surgical procedures. Because of the rarity of BSS, there are no well-defined protocols for the management of perioperative bleeding associated with this condition. Treatment with preoperative and intraoperative systemic aminocaproic acid, HLA-matched platelets, and topical gelfoam and thrombin resulted in sustained hemostasis and a durable healing response. For those rare few afflicted with this disease, we present a combined systemic and topical approach that may be helpful in the control and prevention of perioperative hemorrhage in this and other similar platelet disorders.

Adolescent↗
PubMed1985

Malignant rectal carcinoid: a sequential multidisciplinary approach for successful treatment of hepatic metastases.

A malignant rectal carcinoid metastatic to the liver presents a formidable challenge. The uniformly fatal course in patients with liver metastases (average survival of 2 years) justifies an aggressive approach. Although in an occasional patient the tumor is resectable, most are managed by chemotherapy, which generally is of limited effectiveness. Although certain drug combinations such as 5-fluorouracil and streptozotocin have achieved higher response rates, these responses are often brief (3 to 4 months) and poorly documented. Surgical hepatic dearterialization and, more recently, hepatic intraarterial embolization are quite effective in inducing regression in a variety of hepatic neoplasms, including metastatic carcinoids, but these are usually temporary. We have been timely instructed on the value of combined therapy by a patient who is a long-term survivor of a metastatic carcinoid to the liver. She is the only survivor among a group of 14 patients who had an average survival of 17 months. This patient emphasizes the benefit of combined hepatic dearterialization and chemotherapy in patients with metastatic carcinoid to the liver. She initially had intrahepatic infusion of 5-fluorouracil and streptozotocin through the surgically placed hepatic artery and portal vein catheters, but this was curtailed after 2 months because of catheter sepsis. She then had four sequential selective hepatic intraarterial embolizations with Gelfoam over a 16 month period. She also received systemic therapy with 5-fluorouracil and streptozotocin during a major portion of this period (10 months). Significant tumor regression was documented radiologically. Although she had another trial with intrahepatic chemotherapy infusion using surgically placed catheters, this was again discontinued because of catheter sepsis, and systemic chemotherapy was resumed. Currently, the patient is asymptomatic, has excellent performance status, and continues to show objective tumor regression on a program of systemic therapy with fluorodeoxyuridine and doxorubicin. She has survived more than 7 years with liver metastases from a rectal carcinoid.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Pulmonary artery pseudoaneurysm after tube thoracostomy.

Pulmonary artery pseudoaneurysm has been described as a complication of Swan-Ganz catheterization and right heart catheterization. Isolated cases of this condition occurring in blunt and penetrating chest trauma have been reported. In this communication, we describe the case of a patient with intracranial hemorrhage who required positive-pressure ventilation and in whom subsequent pneumothorax developed, necessitating tube thoracostomy. A persistent opacification of the lung field resulted in evaluation with computed chest tomography and color-flow Doppler ultrasonography. A pseudoaneurysm of the lingular segmental artery was identified and successfully obliterated by Gelfoam coil embolization.

Aneurysm, False↗
PubMed1991

Embolization in traumatic intrarenal vascular injuries.

A retrospective study was made of 42 patients who had traumatic intrarenal false aneurysms or arteriovenous fistulae. Forty of these patients were treated by embolization. The majority of patients had renal stab wounds (23), while the other main causes were blunt injury (9), and iatrogenic injury following renal biopsy (7). Forty patients presented with persistent or recurrent haematuria and two with high output cardiac failure due to large arteriovenous fistulae. Embolization was performed using gelfoam and coils and was successful in 35 (87.5%) with complete resolution of haematuria. Re-embolization in the remaining five patients proved successful in four cases and a failure in only one. Complications included renal intimal dissection in three, ectopic coil placement and contrast extravasation each involving three patients while post-embolization pyrexia occurred in one patient. No patients developed hypertension after the procedure. Embolization was shown to provide a safe and effective form of treatment of intra-renal vascular injuries.

Aneurysm↗
PubMed1980

Per catheter control of haemorrhage from the superior and inferior mesenteric arteries.

The relevant findings in 11 cases of per catheter control of haemorrhage from different sites in the large and small bowel are presented together with a description of the techniques and some of the possible complications of vasopressin infusion and gelfoam embolisation. In six of these cases vasopressin infusion was sus achieved by embolisation, three following the failure of vasopressin therapy. In one case embolisation of the ileo-colic artery produced a caecal infarct. Important differences in the vascular supply to the large and small bowel and their practical significance in embolisation are discussed.

Adult↗
PubMed1980

Hypernephroma embolisation--is it worthwhile?

Transcatheter embolisation was performed in 16 patients with hypernephroma, using either Oxycel, Gelfoam, or steel wire coil(s). Thirteen patients proceeded to early nephrectomy. Surgery was facilitated in four patients with large hypervascular tumours, three of whom had vena caval occlusion. Patients with small, or only moderately vascular tumours, did not benefit from the technique as assessed at nephrectomy. The technique was used as a palliative procedure in three patients, haematuria stopped in two, and abolition of high-output heart failure was achieved in one. Owing to the danger of this technique, it is suggested that its use be restricted to (a) rendering patients with large hypervascular tumours more suitable for surgery, and (b) in palliation of inoperable patients who have symptoms such as severe haematuria. The effect of the technique on survival time remains uncertain.

Adenocarcinoma↗
PubMed1984

Therapeutic arterial embolisation: report of five years' experience.

Therapeutic arterial embolisation was performed in 48 patients. Gelfoam, Oxycel, Bucrylate, Gianturco wire coils and lyophilised dura mater were used. Indications included control of acute haemorrhage, pre-operative vascular reduction, palliation of inoperable lesions, or to render such lesions operable, and elective definitive treatment. The technique was not considered to be of significant value as a pre-operative measure but was successful for the control of haemorrhage, the management of inoperable lesions and as an elective definitive treatment for various unusual lesions. One patient died and three had complications. The choice of occlusive material is discussed and depends upon the nature and vascularity of the lesion and whether short- or long-term occlusion is required.

Acute Disease↗
PubMedDate not supplied

Bleeding following endoscopic sphincterotomy: angiographic management by transcatheter embolization.

Transcatheter embolization is a well-established and effective method for the control of bleeding from the upper gastrointestinal tract and often represents the preferred alternative to more invasive surgical management. The applications of this technique for the management of bleeding following endoscopic sphincterotomy have not been reported previously. Of five patients referred for arteriography with life-threatening postsphincterotomy bleeding, active bleeding from branches of the gastroduodenal artery was demonstrated in four. Embolization of this vessel with Gelfoam controlled the bleeding in all three patients in whom it was attempted. Arterial stenosis and spasm precluded such treatment in one patient. The fifth patient was not bleeding at the time of arteriography. There were no complications from these procedures. Our experience shows that postsphincterotomy bleeding can be safely and effectively controlled by transcatheter embolization, thereby avoiding surgery which is associated with significant morbidity and mortality in this setting.

Adult↗
PubMed1998

Successful right trisegmentectomy for ruptured hepatoblastoma with preoperative transcatheter arterial embolization.

This is the first report of the successful use of percutaneous transcatheter arterial embolization (TAE) in controlling hemorrhage from ruptured hepatoblastoma, allowing early major hepatic resection to be performed safely in a young infant. A 6-month-old girl presented with a huge abdominal mass and was found to have a hepatoblastoma that measured 15 x 10 x 12 cm and arose from the right lobe of her liver on computed tomography (CT) scan examination. The tumor spontaneously ruptured, and she went into shock. TAE with gelfoam cube particles successfully arrested the tumor bleeding and allowed stabilization of her blood pressure with blood transfusion. Right trisegmentectomy was performed 12 hours later. The postoperative course was uneventful. With three courses of cisplatin, vincristine, and 5-fluorouracil after the hepatectomy, the serum alpha-fetoprotein level returned to normal, and the patient has remained well 4 months postoperation.

Angiography↗
PubMed1998

Transcatheter arterial chemoembolization in the treatment of hepatoblastoma.

BACKGROUND: The prognosis of hepatoblastoma is poor unless the tumor is completely resected. Various types of chemotherapy have been developed to increase its resectability. Recently, transcatheter arterial chemoembolization (TACE) has been developed for the treatment of unresectable adult hepatoma with favorable results. The authors applied this procedure to hepatoblastoma in infants and children. METHODS: TACE was performed in eight hepatoblastoma cases. After an intraarterial catheter was inserted into the main feeding artery of the tumor, injection of adriamycin or THP-adriamycin (20 to 30 mg/m2) dispersed in lipiodol and cisplatin (40 to 60 mg/m2) followed by embolization using Gelfoam pieces was performed. Effects of TACE were evaluated according to shrinkage of tumor mass on imaging examinations, alpha-fetoprotein (AFP) levels, and pathological findings of the surgical specimens 4 weeks after TACE. RESULTS: A marked reduction in tumor size associated with a decrease in AFP level occurred 1 month after the treatment. Tumor shrinkage ranged from 0.9% to 45.0% with a mean value of 25.8%. AFP levels decreased by 0.2% to 11.9% with a mean level of 4.6% from initial levels. In addition, there was no marked chemotherapeutic agent-induced toxicity noted during the observation period. Resection of the tumors was performed safely after TACE in all cases. Pathological examination showed massive necrosis in the surgical specimens, and the mean percentage of necrotic area within the tumor was 71.1%. Two patients died of extensive lung metastasis 2 months and 3 years after the operation, respectively. The remaining six were doing well and free of disease at a mean follow-up period of 50 months. CONCLUSION: TACE is an effective, safe, and useful method for the initial treatment of hepatoblastoma.

Antibiotics, Antineoplastic↗
PubMed1999

Successful transumbilical embolization of congenitally ruptured hepatoblastoma.

To avoid a high-risk operation on a moribund neonate with a ruptured hepatic tumor, transumbilical embolization of the bleeding tumor was attempted in a 2-day-old neonate. A 3F microferret catheter was advanced through the right umbilical artery. After identifying the left hepatic artery feeding the bleeding tumor, Gelfoam (Upjohn, Kalamazoo, MI) particles were injected. Bleeding was successfully controlled. The infant was able to tolerate enteral feeding when stable. Seventeen days after embolization, elective left hepatic lobectomy was performed. Histological examination showed a fetal epithelial type hepatoblastoma. The baby is 13 months old now and is receiving chemotherapy.

Embolization, Therapeutic↗
PubMed1996

Vocal cord medialization for unilateral paralysis associated with intrathoracic malignancies.

Patients with unilateral vocal cord paralysis from intrathoracic malignancies may have significant dysfunctions of speech, swallowing, ventilation, and effective coughing as a result of inadequate compensation of the nonparalyzed cord. In patients with already compromised pulmonary function, aspiration can be a life-threatening event. Sixty-three patients with intrathoracic malignancies required surgical correction of vocal cord paralysis. Primary pathology included lung cancer (49), esophageal cancer (nine), and miscellaneous tumors (five). Symptoms included hoarseness (62), dyspnea (21), aspiration (26), weight loss (19), dysphagia (14), and pneumonia (14). The surgical procedures included medial displacement of the vocal cord with silicone elastomer (48), temporary Gelfoam injection (seven), and Teflon (polytetrafluoroethylene) injection (eight) to move the affected cord to a medial position. In 11 patients, the operation was performed in the acute postoperative setting to improve pulmonary toilet. Symptomatic improvement was noted in the following proportions of affected patients: hoarseness, 92%; dyspnea, 90%; dysphagia, 93%; aspiration, 92%; pneumonia, 93%; and weight loss, 47%. Overall success rate of the intervention was 57 of 63 patients (90%). All 11 patients treated in the acute setting had immediate improvement. A variety of complications occurred in 17% of patients. Surgical management of vocal cord paralysis in patients with intrathoracic malignancies prevents life-threatening pulmonary complications in the acute postoperative setting. In chronic situations, it provides patients with improved speech, swallowing, and pulmonary function, resulting in improved quality of life, even for patients not cured of their disease.

Adult↗
PubMed1992

Prostate and bone fibroblasts induce human prostate cancer growth in vivo: implications for bidirectional tumor-stromal cell interaction in prostate carcinoma growth and metastasis.

Prostate cancer selectively metastasizes to the axial skeleton to produce osteoblastic lesions, which suggests that bidirectional paracrine interactions exist between prostate cancer and bone cells. To evaluate the role of tumor-stromal cell interaction and stromal-specific growth factors in prostate cancer growth and dissemination, we coinoculated nontumorigenic human prostate cancer cells (LNCaP) and various tissue-specific fibroblasts subcutaneously in athymic mice. LNCaP tumors were induced most consistently by human bone fibroblasts (62%), followed by two prostate fibroblast cell lines (31% and 17%), but not by lung, kidney, or embryonic 3T3 fibroblasts. Carcinomas formed preferentially in male hosts, demonstrating in vivo androgen sensitivity. Immunohistochemical and biochemical techniques confirmed the human prostate component of these tumors and were paralleled by elevations in serum prostate specific antigen. In vitro mitogenic assays revealed a two-to three-fold bidirectional stimulation between LNCaP and bone or prostate fibroblast conditioned media, but not lung, kidney, or 3T3 fibroblast conditioned media. A novel method developed to deliver concentrated bone or prostate fibroblast conditioned media in vivo using a slowly absorbed matrix (gelfoam) also induced tumor formation, emphasizing the importance of fibroblast growth factors in LNCaP tumor formation. Northern analysis identified the stromal compartment as the primary source of extracellular matrix (collagen, fibronectin), while only LNCaP cells expressed transforming growth factor alpha. Although LNCaP and stromal cells express basic fibroblast growth factor (bFGF), the bidirectional paracrine-mediated mitogenic activity between these cells is not inhibited by anti-bFGF antibodies, suggesting that other undefined growth factors may be involved in stimulating LNCaP growth. These observations illustrate the importance of stromal-epithelial interaction in prostate tumor growth and suggest that extracellular matrix and paracrine-mediated growth factors play a role in prostate cancer growth and metastasis.

Androgens↗
PubMed1976

Preoperative vascular embolization as an adjunct to successful resection of large retroperitoneal hemangiopericytoma.

A large retroperitoneal hemangiopericytoma was resected successfully with the aid of preoperative control of the blood supply of the lesion with percutaneous intra-arterial gelfoam and ferromagnetic silicone embolization. We believe that this resection would not have been possible without this adjuvant technique. Future application of this combined technique will enable more aggressive surgical intervention in unresectable vascular tumors and arteriovenous malformations.

Adult↗