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At least 73 records · Page 4Linked to original sources

Duodenal infarction after therapeutic Gelfoam embolization of a bleeding duodenal ulcer.

A patient is presented who sustained a duodenal infarction after therapeutic Gelfoam embolization of the gastroduodenal artery for hemorrhage from a duodenal ulcer. Factors that may have contributed to this previously unreported complication included underlying vascular disease, recent surgery, and an associated arteritis possibly related to the Gelfoam. Although ischemic injury of the duodenum has been considered unlikely because of its dual vascular supply, our case suggests that the technique of therapeutic embolization may carry an increased risk in patients with underlying vascular disease or previous surgery within the area of the vascular bed to be embolized.

Aged↗

Palliative chemoembolization of hepatocellular carcinoma with mitoxantrone, Lipiodol, and Gelfoam. A phase II study.

Transcatheter chemoembolization, in conjunction with various drugs, has been widely used for palliative treatment of hepatocellular carcinoma. A phase II study was carried out on mitoxantrone chemoembolization. High risk cirrhotic patients were excluded from this study. Fourteen mg/m2 mitoxantrone and up to 20 ml Lipiodol were injected, followed by Gelfoam embolization as indicated. Thirty-seven patients (33 with cirrhosis) were treated. Sixty-nine cycles were delivered, with mean (+/-SD) Lipiodol and emulsified mitoxantrone doses of 11.3+/-3.8 ml and 11.8+/-5.2 mg, respectively. Thirteen, 16, and 8 patients received one, two, and three cycles, respectively, with time intervals of 123+/-60 days. Thirty patients received Gelfoam embolization at the first cycle, 9 at the second and 4 at the third. No treatment-related deaths occurred. Complications were mild and transient, including nausea/vomiting in most cases, fever over 38 degrees C 67%, pain 74%, ascites 8%, jaundice 3%, bleeding 3%, pancreatitis 3%, myelosuppression 44%, diarrhea 5%. Treatment response rate was 49% (including 16% minor responses) with 16% early progressions. With a median follow-up of 12 months, the 12-month response duration and survival rates were 56% and 79% respectively. Transcatheter chemoembolization with mitoxantrone appears to be a promising method for the palliation of advanced hepatocellular carcinoma, and deserves to be evaluated in well controlled randomized studies.

Antineoplastic Agents↗

Gelfoam embolization of a distal coronary artery guidewire perforation.

A guidewire-induced distal coronary artery perforation presenting with cardiac tamponade was occluded by distal Gelfoam embolization via an infusion catheter. This extends the treatment options for this rare complication of coronary interventional procedures. Cathet. Cardiovasc. Intervent. 49:214-217, 2000.

Aged↗

A morphological and immunohistochemical study of human retinal pigment epithelial cells, retinal glia, and fibroblasts grown on Gelfoam matrix in an organ culture system. A comparison of structural and nonstructural proteins and their application to cell type identification.

Retinal pigment epithelial (RPE) cells, retinal glia, and fibroblasts undergo marked phenotypical change when outside their usual microenvironment, as occurs in epiretinal membrane formation. To explore their phenotypic potential without the influence of other cell types, each was cultured on Gelfoam matrix and assessed immunohistochemically and ultrastructurally. All cell types demonstrated vimentin and a universal beta-tubulin epitope, TU27. RPE and retinal glial cells were positive for cytokeratin, Leu 7, and neuron-specific (gamma gamma) enolase, as were glia and fibroblasts for S-100 protein and RPE cells and fibroblasts for glutamine synthetase. RPE cells alone showed positivity for class III beta-tubulin and retinal S-antigen (monolayer cultures only); occasional retinal glia, which immunohistochemical findings suggest are Müller cell derived, demonstrated GFA protein. Therefore, class III beta-tubulin may be useful in distinguishing RPE cells from retinal glia and fibroblasts, and Leu-7 may help to identify RPE cells and fibroblasts; these cell types are difficult to distinguish in clinical material using more traditional morphological criteria.

Cells, Cultured↗

Blood supply of experimental liver tumors after intraarterial embolization with gelfoam powder and absolute ethanol.

Twenty rats with implanted liver tumor were studied. Following baseline angiography, the hepatic artery was embolized with Gelfoam powder or ethanol (n = 12) while the controls (n = 8) did not undergo embolization. Postmortem Microfil perfusion was performed in all livers. Filling of tumor lakes from the portal vein was seen more often in embolized animals than in controls, indicating the potential role of the portal venous system in the supply of dearterialized hepatic tumors. We discuss the possible clinical implication of our results.

Animals↗

Transcatheter hepatic segmental arterial embolization using lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma.

Transcatheter hepatic segmental arterial chemoembolization using Lipiodol mixed with an anticancer drug followed by the injection of Gelfoam particles, introduced into the tumor-bearing hepatic segment as the target area (segmental Lipiodol-TAE), was carried out in 54 patients with hepatocellular carcinoma (HCC), 7 of whom were later resected. In 5 of the resected 7 cases, complete necrosis was histologically verified. No death due to HCC was encountered in 47 nonoperated cases, and better therapeutic results were obtained with segmental Lipiodol-TAE. It was concluded that this technique does not adversely affect normal tissues, and it does reinforce the effect of TAE.

Carcinoma, Hepatocellular↗

Transcatheter gelfoam embolization in intractable prostatic bleeding.

The authors describe a case in which protracted bleeding after a transurethral prostatic resection could not be controlled with repeated fulguration and resection. Hemostasis was obtained with transcatheter arterial Gelfoam embolization of both hypogastric arteries.

Aged↗

Striatal implants of fetal striatum or gelfoam protect against quinolinic acid lesions of the striatum.

Previous studies in our laboratory have shown that intrastriatal implants of fetal striatum significantly attenuate excitotoxic damage resulting from a 240 nmol quinolinic acid (QA) challenge delivered 7 days later. In contrast, animals with intrastriatal implants of other tissue types (adipose tissue, peripheral nerve or adrenal medulla) demonstrate a more limited, but consistent trend in protection from QA excitotoxicity. The present study was designed to test the hypothesis that partial striatal protection found in animals receiving peripheral tissue grafts is due to the transplantation procedure eliciting a host response which attenuates excitotoxicity. Adult female Long-Evans rats received either cellular (fetal striatum) or acellular (gelfoam) implants followed 1 week later by a unilateral injection of 240 nmol QA into the grafted striatum. Animals were tested for rotational asymmetries before grafting, post-implantation, and after lesioning. Compared to baseline rotational behavior, rats which received implants did not show changes in ipsilateral turning after QA lesions. This protective effect was not limited to rotational behavior since improvements in spontaneous locomotor activity were evident. In addition, the adipsia and aphagia often associated with striatal lesions were ameliorated in both groups of grafted animals. Morphometric analysis demonstrated that endogenous dopaminergic, cholinergic and enkephalinergic systems in the two transplanted groups sustained less excitotoxic damage than in the QA lesioned, non-grafted animals. These results are consistent with the hypothesis that a host generated response activated by the implantation procedure provides a protective effect against QA excitotoxicity.

Animals↗

Myospherulosis of the alveolus secondary to the use of Terra-Cortril and Gelfoam. Report of a case.

Myospherulosis is a recently discovered disease apparently caused by the placement of mineral oil- or petrolatum-based products into various tissues. Terra-Cortril (a tetracycline/steroid ointment in a petrolatum base) on Gelfoam has been placed in the sockets of surgically removed third molars in an attempt to eliminate the occurrence of dry sockets. The case report presented here documents the radiographic progress of the disease for 6 years, showing an attempt by the bone to repair itself. A surgical procedure was performed to remove the affected tissue, and photographs were taken to illustrate the clinical appearance of the disease. The specimen consisted of a black, tarlike material which was completely encased in bone. Histologic examination was consistent with a diagnosis of myospherulosis.

Administration, Topical↗

Widespread dissemination of gelfoam particles complicating occlusion of renal circulation.

Embolization of renal circulation by Gelfoam particles in a thirty-two-year-old man with renal carcinoma was followed by retrograde regurgitation of the injected particles upstream, with resultant occlusion of the celiac trunk and the superior mesenteric artery. This was followed by a stormy clinical course, which the patient survived. Several possible explanations are offered for the occurrence of this complication.

Adult↗

Phagocytosis of myelin by astrocytes in explants of adult rabbit cerebral white matter maintained on Gelfoam matrix.

The role of astrocytes in the process of demyelination has been controversial. A culture system in which explants of adult cerebral rabbit white matter were maintained on a Gelfoam matrix was used for evaluating the phagocytosis of myelin by astrocytes without an influx of phagocytic cells derived from actively circulating blood-borne cells. Adult neurons were not viable for more than a few days in these explant cultures, thus resulting in empty myelin sheaths following loss of their axons. After 7 days in vitro, astrocytes, recognized by positivity for glial fibrillary acidic protein by electron microscopic immunocytochemistry, contained numerous membrane-bound vesicles filled with myelin in various stages of degradation. Although the majority of macrophage-like cells were negative for glial fibrillary acidic protein, a minority were positive, in spite of the lack of bundles of intermediate filaments, and were interpreted as astrocytic. Astrocytes were also often positive for glutamine synthetase. This study presents evidence suggesting that astrocytes may actively participate in the phagocytosis and degradation of myelin, a function generally attributed to reactive macrophages.

Animals↗

A versatile permanent planar implant technique utilizing iodine-125 seeds imbedded in gelfoam.

Tumors attached or adjacent to critical structures can often not be completely resected or resected with adequate surgical margins. Sites involving major blood vessels, the vertebral column or the brain with small residual tumors or suspicious margins often present technical difficulties for standard I-125 or Ir-192 implants. A relatively simple, accurate and inexpensive implant method is described using I-125 seeds imbedded in gelfoam to implant permanently into small residual tumors or suspicious margins where standard implant techniques may be unsatisfactory. A method for planning the treatment dose for such an implant is described. Cases involving paraspinal and brain tumors are reported to illustrate the technique.

Adolescent↗

Renal artery embolization with ethanol and gelfoam for the treatment of ureteric fistulae with one year follow-up.

Two patients with ureteric fistulae who were unfit for reconstructive surgery were treated by renal ablation using intra-arterial ethanol, gelfoam fragments and in one case coils. In both cases the fistulae dried-up on the same day and both patients are well and normotensive a year later. Our conclusion is that renal ablation by arterial embolization with ethanol can be a valuable alternative to surgery to treat ureteric fistulae in patients who are poor surgical risks.

Embolization, Therapeutic↗

Comparison of avitene, topical thrombin, and gelfoam as sole hemostatic agent in tuboplasties.

Forty-eight virgin guinea pigs were subjected to bilateral sectioning of the uterine horn and cuff type salpingostomy. Avitene, Topical Thrombin, or Gelfoam was used as the sole hemostatic agent in each of three study groups. Bipolar cauterization was used in a control series. These agents were compared with regard to ease of application, degree of adhesion formation, net surface area, and microscopic evaluation of degree of fibrosis and inflammatory reaction. The results revealed no statistically significant differences among the various methods of hemostasis. Data were evaluated by uni- and multivariate analyses. Several trends in the data were noted: the greatest amount of fibrosis was associated with Topical Thrombin and Avitene, and the greatest inflammatory response was associated with Avitene. These agents show no superiority to currently used cautery methods of obtaining hemostasis.

Animals↗

Controlled delivery of pilocarpine. 1. In vitro characterization of Gelfoam matrices.

The potential of Gelfoam absorbable gelatin sponge as a carrier for ophthalmic delivery of pilocarpine was examined. Prolonged in vitro release of pilocarpine was achieved through pharmaceutical modification of the device by embedding a retardant in the pores. The device embedded with cetyl ester wax released pilocarpine in a zero-order pattern (release exponent = 0.93 +/- 0.04) for up to 5 hr. This result corresponded well with a linear penetrant uptake by this device. The device impregnated with polyethylene glycol 400 monostearate exhibited anomalous drug transport with a release exponent of 0.63 +/- 0.02. The absorption of water by this retardant and the formation of a gel layer on the surface slowed the penetration of the release medium into the deeper sections of the matrix, as well as the rapid outward diffusion of drug, resulting in a prolonged release of pilocarpine.

Chromatography, High Pressure Liquid↗