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At least 775 records · Page 43Linked to original sources
PubMed1983

Successful embolization for uterine hemorrhage in a patient with acute promyelocytic leukemia.

A successful embolization for life-threatening uterine hemorrhage is described in a patient with acute promyelocytic leukemia and disseminated intravascular coagulation. On admission the patient was in the 6th week of gestation with incomplete abortion and uterine hemorrhage. In addition to combination chemotherapy and anticoagulant therapy, dilatation and curettage were also performed. After the operation the uterine hemorrhage was progressively increased in amount and was not responsive to usual measures. Embolization of bilateral uterine arteries using Gelfoam was performed with a dramatic improvement of the hemorrhage.

Abortion, Incomplete↗
PubMed1976

[Extirpation of nasopharyngeal fibromas after selective preoperative angiographic embolization].

The gross amount of bleeding during surgical removal of nasopharyngeal angiofibromas is feared. An excellent method to reduce this amount is the preoperative selective embolization of the feeding vessels of these tumors under angiographic control. The advances in selective angiography of the branches of the external carotid artery by femoral catheterization make it possible to applicate Gelfoam emboli in the very arteries which are to be embolized. There is a case report about two young men who have been pretreated in this manner. The intraoperative bleeding was minimal.

Embolization, Therapeutic↗
PubMed1999

Survival and function of bioengineered cardiac grafts.

INTRODUCTION: Patients with congenital heart disease frequently require graft material for repair of cardiac defects. However, currently available grafts lack growth potential and are noncontractile and thrombogenic. We have developed a viable cardiac graft that contracts spontaneously in tissue culture by seeding cells derived from fetal rat ventricular muscle into a biodegradable material. We report our investigations of the in vitro and in vivo survival and function of this bioengineered cardiac graft. METHODS AND RESULTS: A cardiomyocyte-enriched cell inoculum derived from fetal rat ventricular muscle was seeded into a piece of Gelfoam (Upjohn, Ontario, Canada), a biodegradable gelatin mesh, to form the graft. For in vitro studies, growth patterns of the cells within the graft were evaluated by constructing growth curves and by histologic examination; in in vivo studies, the graft was cultured for 7 days and then implanted either into the subcutaneous tissue of adult rat legs or onto myocardial scar tissue in a cryoinjured rat heart. Five weeks later, the graft was studied histologically. The inoculated cells attached to the gelatin mesh and grew in 3 dimensions in tissue culture, forming a beating cardiac graft. In both the subcutaneous tissue and the myocardial scar, blood vessels grew into the graft from the surrounding tissue. The graft implanted into the subcutaneous tissue contracted regularly and spontaneously. When implanted onto myocardial scar tissue, the cells within the graft survived and formed junctions with the recipient heart cells. CONCLUSIONS: Fetal rat ventricular cells can grow 3-dimensionally in a gelatin mesh. The cells in the graft formed cardiac tissue and survived and contracted spontaneously both in tissue culture and after subcutaneous implantation. Future versions of this bioengineered cardiac graft may eventually be used to repair cardiac defects.

Animals↗
PubMed1999

Endothelial implants inhibit intimal hyperplasia after porcine angioplasty.

The perivascular implantation of tissue-engineered endothelial cells around injured arteries offers an opportunity to study fundamental vascular physiology as well as restore and improve tissue function. Cell source is an important issue because the ability to implant either xenogeneic or allogeneic cells would greatly enhance the clinical applications of tissue-engineered grafts. We investigated the biological and immunological responses to endothelial cell xenografts and allografts in pigs 4 weeks after angioplasty of the carotid arteries. Porcine or bovine aortic endothelial cells were cultured within Gelfoam matrices and implanted in the perivascular space of 42 injured arteries. Both porcine and bovine endothelial cell grafts reduced the restenosis index compared with control by 54% and 46%, respectively. Perivascular heparin release devices, formulated to release heparin at twice the rate of release of heparan sulfate proteoglycan from endothelial cell implants, produced no significant reduction in the restenosis index. Endothelial cell implants also reduced occlusive thrombosis compared with control and heparin release devices. Host immune responses to endothelial implants were investigated by immunohistochemical examination of explanted devices and by immunocytochemistry of serum samples. The bovine cell grafts displayed infiltration of leukocytes, consisting primarily of lymphocytes, and caused an increase in antibodies detected in serum samples. Reduced cellular infiltration and no humoral response were detected in animals that received allografts. Despite the difference in immune response, the biological effects of xenografts or allografts did not differ significantly.

Angioplasty↗
PubMed1999

Fibrinogen and vascular smooth muscle cell grafts promote healing of experimental aneurysms treated by embolization.

BACKGROUND AND PURPOSE: Residual necks and recurrences frequently occur after endovascular treatment of cerebral aneurysms. Addition of fibrinogen and vascular smooth muscle cells (VSMCs) to the embolic material may promote healing of embolized aneurysms by increasing neointima formation at the neck. METHODS: Bilateral carotid aneurysms were constructed with venous pouches in 31 dogs. Aneurysms were packed intraoperatively with bare Gelfoam sponges, sponges treated with fibrinogen, or fibrinogen sponges seeded with the animal's own VSMCs or peripheral blood mononuclear cells. Animals were killed after angiography at 3 weeks, and morphometric studies were performed to measure the thickness of the neointima at the neck of treated lesions. Angiographic results and mean thickness of neointimas were compared using ANOVA. In 8 animals, 1 aneurysm was embolized with sponge seeded with VSMCs transduced by adenoviral infection to express a fluorescent protein (green fluorescent protein), and gene expression was monitored for 4, 7, 14, and 21 days by fluorescent microscopy. RESULTS: Aneurysms treated with sponges seeded with VSMCs had significantly thicker neointimas and were more completely obliterated at 3 weeks than control aneurysms treated with fibrinogen sponges. Peripheral blood mononuclear cells could not reproduce these findings. Sponges treated with fibrinogen alone promoted formation of a thicker neointima than bare sponges. Transduced cells transplanted into in vivo aneurysms still expressed green fluorescent protein at 3 weeks. CONCLUSIONS: VMSC grafts can improve healing of experimental aneurysms treated by embolization. Transplantation of cells transduced to express a foreign gene opens the way for in situ gene therapy for cerebral aneurysms.

Adenoviridae↗
PubMed2006

Collagen matrices enhance survival of transplanted cardiomyoblasts and contribute to functional improvement of ischemic rat hearts.

BACKGROUND: Cardiac cell transplantation is limited by poor graft viability. We aimed to enhance the survival of transplanted cardiomyoblasts using growth factor-supplemented collagen matrices. METHODS AND RESULTS: H9c2 cardiomyoblasts were lentivirally transduced to express firefly luciferase and green fluorescent protein (GFP). Lewis rats underwent ligation of the left anterior descending artery (LAD) ligation to induce an anterior wall myocardial infarction. Hearts (n=9/group) were harvested and restored ex vivo with 1 x 10(6) genetically labeled H9c2 cells either in (1) saline-suspension, or seeded onto (2) collagen-matrix (Gelfoam [GF];), (3) GF/Matrigel (GF/MG), (4) GF/MG/VEGF (10 microg/mL), or (5) GF/MG/FGF (10 microg/mL). Hearts were then abdominally transplanted into syngeneic recipients (working heart model). Controls (n=6/group) underwent infarction followed by GF implantation or saline injection. Cell survival was evaluated using optical bioluminescence on days 1, 5, 8, 14, and 28 postoperatively. At 4 weeks, fractional shortening and ejection fraction were determined using echocardiography and magnetic resonance imaging, respectively. Graft characteristics were assessed by immunohistology. Bioluminescence signals on days 5, 8, and 14 were higher for GF-based grafts compared with plain H9c2 injections (P<0.03). Signals were higher for GF/MG grafts compared with GF alone (P<0.02). GFP-positive, spindle-shaped H9c2 cells were found integrated in the infarct border zones at day 28. Left ventricular (LV) function of hearts implanted with collagen-based grafts was better compared with controls (P<0.05). Vascular endothelial growth factor or fibroblast growth factor did not further improve graft survival or heart function. CONCLUSIONS: Collagen matrices enhance early survival of H9c2 cardiomyoblasts after transplantation into ischemic hearts and lead to improved LV function. Further optimization of the graft design should make restoration of large myocardial infarctions by tissue engineering approaches effective.

Abdominal Cavity↗
PubMedDate not supplied

Preoperative embolization of juvenile angiofibromas of the nasopharynx.

The juvenile nasopharyngeal angiofibroma is a vascular tumor. Careful and complete removal is challenging because of the brisk bleeding during surgery. The means applied to reduce this blood loss have included preoperative estrogens, ligation of feeding vessels, silicone embolization of feeding vessels, and cryosurgery. We have used preoperative Gelfoam embolization of the internal maxillary artery in seven patients. Our clinical impression of significant reduction in loss of blood was confirmed by comparison with 16 previous patients. The average amount of blood lost in the embolized group was half that of the control group. A study of this type comprises many variables; however, the results do suggest that preoperative embolization of the internal maxillary artery is of advantage in the surgical treatment of juvenile angiofibromas.

Adolescent↗
PubMedDate not supplied

Glomus jugulare and vagale.

The therapeutic results in 72 patients with glomus jugulare and nine with glomus vagale have indicated a surgical cure rate of 80% in the former and 100% in the latter. Radiotherapy demonstrated a 65% tumor response rate and a 25% cure rate histologically and clinically. Embolization with Gelfoam beads in seven patients resulted in diminished tumor size and arterial circulation from the external carotid system. However, in all cases the tumor persisted. Embolization diminished intraoperative bleeding. Nevertheless, the use of embolization as a palliative modality demonstrated significant symptomatic relief in aged, debilitated patients and in all patients with large inoperable glomus jugulare tumors.

Adolescent↗
PubMedDate not supplied

Stapedectomy. Postmortem findings.

Histological studies were made of 16 temporal bones of 13 subjects who had stapedectomy operations. Photographs of the prostheses in situ are a special feature of the studies. It was found that prostheses which overlap the margins of the oval window cause incomplete closure of the air-bone gaps. Fibrous adhesions were a common consequence of trauma to the mucous membrane of the middle ear. Gelfoam implantation promotes the formation of thin oval window membranes which tend to bulge out of the oval window. Most incudes show small areas of cortical bone resorption. In at least half the cases the surgical technique of stapedectomy, as judged from these studies, was less than ideal. Surgeons who perform stapedectomy should be cognizant of the relevant surgical pathology and adopt methods which will optimize functional results and minimize complications.

Adult↗
PubMedDate not supplied

Selective lesions of the vestibular labyrinth.

In attempts to decrease gentamicin ototoxicity, the round windows of guinea pigs were covered with fat before gentamicin was given through the middle ear cavity. Although ototoxicity to the cochlea was reduced, the desired effect on the vestibular sense organs also was reduced, because of the oval window's resistance to drug penetration. In another series of guinea pigs, simple opening of the lateral semicircular canal and covering it with a pledget of Gelfoam soaked with gentamicin was an excellent method for producing a selective vestibular lesion. It is expected to reduce the function of all vestibular sense organs without impairing cochlear function.

Adipose Tissue↗
PubMed1990

Epidermal growth factor binding and action on tympanic membranes.

A significant percentage of tympanic membrane (TM) perforations require some form of therapy to heal. Topical application of epidermal growth factor (EGF), a potent mitogen for epidermal and mesodermal cells, promotes healing of injuries in tissues histologically similar to TM, such as cornea and skin. We evaluated TM as a target tissue for EGF action. Specific, high affinity receptors for EGF were detected in TM (Kd = 3.1 nM, 150 fmol receptor/mg protein). Autoradiography of iodine 125-EGF binding to intact TMs revealed that EGF receptors were present on cells in the stratified squamous epithelial layer and in the stromal/mucoepithelial layer. Repetitive treatment of perforated cat TMs with 20 micrograms of EGF formulated in saline induced substantial hyperplasia of epithelial and stromal layers compared to paired TMs treated with saline. A single treatment of perforated cat TMs with 50 micrograms of EGF formulated in a hydrogel or in shredded Gelfoam produced significantly (p less than .05) smaller perforations at 6 days following the operation compared to paired TMs treated with vehicles. These results demonstrate that TM is a target tissue for EGF and that topical treatment with EGF stimulates healing of TM perforations.

Animals↗
PubMed1990

Middle ear gas generation in myringoplasties.

No Gelfoam was used to support the vein in 10 simple underlay vein graft myringoplasties. Computed tomographic studies 24 hours postoperatively showed gas filling 75% to 100% of the middle ears in three ears. The epitympanum and mastoid were also evaluated. Apparently, in some ears the middle ear generates gas in the immediate postoperative period to support fresh vein grafts.

Blood Vessel Prosthesis↗
PubMed1995

Long-term result of vocal cord augmentation with autogenous fat.

The use of autogenous fat for augmentation of the paralyzed vocal fold is a promising substitute for alternate injectable material such as Teflon (polytef paste, polytetrafluoroethylene; Ethicon) and Gelfoam (absorbable gelatin sponge; Upjohn). Long-term histologic evaluation of fat grafts to the larynx has not previously been reported in the literature. We present a case report of autogenous fat augmentation of a paralyzed vocal fold with documentation of persistent fat graft present 5 months after transplant.

Adipose Tissue↗
PubMed1997

Control of tubercular haemoptysis by bronchial artery embolization.

Thirty-seven patients presenting with massive or recurrent haemoptysis secondary to tuberculous aetiology were subjected to bronchial artery angiography. Of these, failure, to catheterize the bleeding vessel occurred in two patients while embolization was withheld in two patients due to the presence of anterior spinal artery arising from a common intercosto-bronchial trunk. Immediate arrest of bleeding was performed in the remaining 33 patients by selective embolization of the abnormal bronchial arteries with a resorbable material (Gelfoam). Regular follow up for a duration of 6 months after the procedure revealed relapse of haemoptysis in four patients; three were treated by re-embolization of the abnormal bleeding vessels while one patient died due to aspiration immediately on admission. No recurrence of bleeding was seen in the remaining 29 patients. It is concluded that bronchial artery embolization is an effective treatment for immediate control of life-threatening haemoptysis.

Acute Disease↗
PubMed1984

Stapedectomy revision following sensorineural hearing loss.

This study analyzes 71 stapedectomies that resulted in a sensorineural hearing loss, followed by a revision stapedectomy on the suspicion of an oval window fistula. The cases were divided between two primary stapedectomy techniques: a stainless steel Robinson prosthesis on a vein graft and a wire prosthesis with Gelfoam. The major differences between the surgical findings of the two groups were the fistula rate with the wire prosthesis was 10 times that with the Robinson prosthesis; the wire prosthesis was longer than necessary in 21% of the cases in which it was used; there was no finding of excess length with the Robinson prosthesis; and after revision stapedectomy, dizziness was lessened in 20% of the patients in the Robinson prosthesis group, in 60% of those in the wire prosthesis group, and in 75% of those with fistula. Surgical directions are given for revision stapedectomy following a sensorineural hearing loss.

Cochlear Implants↗
PubMed1977

Superselective arterial embolization for the control of postsurgical bleeding.

Superselective catheterization and Gelfoam embolization of a muscular branch of the deep femoral artery was successfully performed; a profuse postsurgical bleeding requiring repeated transfusion of blood was stopped. The time of persistence, advantages and disadvantages of commonly used embolic materials are discussed. It is concluded that embolization is an effective method to stop bleeding in selected patients.

Adult↗
PubMed1979

Transcatheter arterial embolization of experimental hepatic tumours in the rat.

After transcatheter arterial embolization with Spongostan (99.3% gelatin-similar to gelfoam) in a group of rats with experimental hepatic tumours, the angiographic and microscopic findings were compared with those in a group of rats with non-embolized liver tumours. Partial recanalization of the hepatic artery was demonstrated already after 2 to 6 days. Reduced vascularization of tumours could be demonstrated after embolization and in a few animals even decrease in tumour size. Microscopy revealed a significantly greater extent of tumour necrosis in embolized tumours of large size. Necrosis of normal liver tissue was found to a varying degree in the embolized rats, while no ischemic injury was evident in livers of most non-embolized animals.

Animals↗
PubMed1979

Transcatheter arterial embolisation in nasopharyngeal angiofibroma.

Transcatheter arterial embolisation using gelfoam particles has been used in 4 young male patients with nasopharyngeal angiofibroma. The procedure proved to be extremely useful preoperatively in controlling and limiting profuse bleeding during surgery, allowing total excision of the tumor.

Adolescent↗