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At least 919 records · Page 51Linked to original sources
PubMed2005

[MRI evidence of exogenous vascular endothelial growth factor-enhanced transport across inner ear barriers in guinea pigs].

OBJECTIVE: Increased vascular endothelial growth factor (VEGF) and VEGF receptor expression is the important biological response under shear stress, ischemia and hypoxia conditions. Mechanical vibration induced cochlea shear stress and trauma obviously upregulate VEGF and VEGF receptor 2 (VEGFR2) expression in the cochlea. To evaluate the possibility of VEGF varying the transport in blood-labyrinth barrier and blood-perilymphatic barrier. METHODS: Eleven guinea pigs, male and female, weighing from 300 g to 900 g were kept under general anaesthesia with xylazine (16 mg/kg) and ketamine (60 mg/kg) for both drug delivery and MRI measurement. VEGF (6 ears) and phosphate-buffered saline (PBS, 5 ears) were delivered to the inner ear via the round window membrane (soaked in gelfoam). The T1 contrast agent gadodiamide (Gd-DTPA-BMA) chelated bound paramagnetic gadolinium was used as the inner ear barrier transportation tracer. A Bruker Biospec Avance 47/40 experimental MRI system with a magnetic field strength of 4. 7 Tesla and a 40 cm bore was used for the 2-dimensional cochlea MRI evaluation. The Paravision software was used for image intensity measurement and the Adobe Photoshop 6.0 software was used for image presentation. RESULTS: VEGF induced significant Gd uptake in the scala tympani and scala vestibuli, but had little effect on the uptake of Gd in the scala media. CONCLUSIONS: VEGF significantly increased the transportation of blood-perilymphatic barrier and adapted the inner ear for compensation and repair.

Animals↗
PubMed2005

Selective portal vein embolization as introduction in major surgery.

In the period between the December 2000 and September 2004, altogether 13 patients underwent preoperative portal vein embolization (PPVE); 9 patients with colorectal metastases and 4 patients with hepatocellular carcinoma. The indirect splenic portography was performed after catheter was introduced into superior mesenteric artery via femoral artery approach. The portal vein was punctured percutaneously transhepatic under fluoroscopy. Following portography, selected portal vein segments were embolized by injecting polyvinil alcohol (PVA) particles until stasis of blood flow was achieved. Proximal parts of branches and the channel in the liver parenchyma were occluded with Gelfoam particles. The increase of the remnant liver parenchyma was measured by magnetic resonance imaging. iTwo patients experienced post-embolization syndrome and another one had subcapsular hematoma. The volume of the liver parenchyma increased minimally for 8% and maximally for 109%. Altogether, 10 patients underwent surgical resection. In two patients, the disease progressed and carcinoma spread to the previously healthy liver lobe and in one there was no hypertrophy and we decided for artery chemoembolization (AC). The results show that PPVE triggers a strong regenerative response resulting in hypertrophy of normal liver parenchyma and expand possibilities of curative surgery for patients who would not otherwise have been candidates for extended resection.

Carcinoma, Hepatocellular↗
PubMed2005

Clinical application of laparoscopic spleen-preserving operation in traumatic spleen rupture.

OBJECTIVE: To evaluate the effect of laparoscopic spleen-preserving operation for traumatic spleen rupture. METHODS: From 1997 to 2003, 15 cases of traumatic spleen rupture were treated with laparoscopic spleen-preserving operation in our hospital. Nine cases had operation history in the middle and lower abdomen. ZT binding, electrocoagulation, fibrin and gelfoam tamping and suture repairing were used in patients with spleen rupture of grade I and grade II. Combined hemostasis was used for spleen rupture of grade III. RESULTS: All patients did not need laparotomy during operation and no postoperative bleeding occurred. They were all cured and followed up for 3-12 months. Determination of immunoglobulins after operation showed normal, and spleen ultrasonic examination, CT and body state evaluations were all satisfactory. CONCLUSIONS: Laparoscopy in the management of spleen trauma can be used in confirmed diagnosis and in determining the degree of spleen injury. For patients with stable vital signs laparoscopic spleen-preserving operation can be used. The laparoscopic spleen-preserving operation is safe in the treatment of traumatic spleen rupture.

Adolescent↗
PubMed2005

[Management of intractable epistaxis and bleeding points localization].

OBJECTIVE: To investigate the common nasal bleeding points and the management of intractable epistaxis. METHODS: The bleeding points and its correlation with age distribution, surgical techniques as well as its effects were studied retrospectively in 92 patients, in whom the bleeding points were not found by routine nasal endoscopy and the hemorrhage was not controlled with standard nasal packing. RESULTS: The bleeding points were found in the following different sites: superior wall of inferior nasal meatus (56.5%, 52/92), olfactory cleft of nasal septum (27.2%, 25/92), posterosuperior wall of middle nasal meatus (8.7%, 8/92) and uncertain (7.6%, 7/92). The results showed that the bleeding points had correlation with age. Epistaxis was well controlled by electrocoagulation in 83 cases, gelfoam packing in 8 cases, and transcatheter maxillary artery embolization in 1 case. There were no complications during a followed-up for 1 - 3 months after management. Among the 92 cases, the numbers of treatment needed to stop bleeding were 82 cases (89.1%) after 1 time of treatment, 9 cases (9.8%) after 2 times and in one case (1.1%) after 4 times. CONCLUSIONS: Endoscopy combined with displacement of the middle and inferior turbinate gives good visualization and direct management of the deeply-sited bleeding points, which were difficult in localization. The combined method provides an effective and safe way to control intractable epistaxis.

Adolescent↗
PubMed1992

Therapeutic embolization of post-cholecystectomy hepatic artery aneurysm.

A "sandwich" technique employing steel coils and gelfoam embolization was applied in two cases of hepatic artery aneurysms. Immediate cessation of the bleeding was evident clinically and the post-embolization angiogram showed occlusion of the vascular lesion. Cholecystectomy is one of the most common abdominal operations and it is generally well tolerated, particularly in young and middle-aged patients. Morbidity rates of 5% to 32% and mortality rates of 0.4% to 2.5% have been reported, depending on such factors as age, underlying illness, etc. (1-4). The most frequent complications of cholecystectomy are wound infection, abscess, ductal injury or ligation, and bleeding. This paper describes two cases of hepatic pseudoaneurysm following iatrogenic damage during cholecystectomy which was treated with transarterial embolization.

Aneurysm↗
PubMed2006

Inadvertent foreign body embolization in diagnostic and therapeutic cerebral angiography.

BACKGROUND AND PURPOSE: Inadvertent foreign body embolization is a rarely diagnosed and neglected complication of cerebral angiography that has not been studied systematically. METHODS: We undertook a comprehensive 5-year retrospective study of all available postmortem cases of postangiographic neurologic complications, as well as a comprehensive histologic examination of all surgically resected central nervous system arteriovenous malformations, at our institution. RESULTS: Among the autopsy series, we found 3 patients for whom cerebral infarction, sometimes catastrophic, is attributable to inadvertent cotton fiber, Gelfoam, or polyvinyl alcohol particulate emboli during cerebral angiography. All cases described had concurrent atherosclerotic vascular disease. Particulate embolization, which is usually cotton fiber, is present in as many as 25% of resected arteriovenous malformations: the risk of finding such emboli is in part dependent on a history of prior interventional (as opposed to diagnostic) angiographic procedures. It is not surprising that the amount of tissue examined also increases the risk of finding such emboli. CONCLUSIONS: Unintentional foreign body emboli remain common in modern angiographic practice and are probably underappreciated clinically. Although such emboli are usually asymptomatic, they can be clinically devastating, and a high index of suspicion is required for diagnosis. Foreign body emboli should be included in the differential diagnosis of postangiographic ischemia or infarction.

Cerebral Angiography↗
PubMedDate not supplied

Transcatheter oily chemoembolization for the treatment of large hepatocellular carcinoma with an accompanying tumor thrombus in the right main branch of the portal vein and arterioportal shunting: report of one patient still surviving after more than seven years.

A patient having a large hepatocellular carcinoma with an accompanying tumor thrombus in the right main branch of the portal vein and arterioportal shunting was treated with transcatheter oily chemoembolization with adriamycin emulsion in Lipiodol plus Gelfoam. The whole right hepatic lobe regressed together with the tumor, and the tumor thrombus in the portal vein disappeared. The patient is still alive more than seven years after the treatment, with normal levels of alpha-fetoprotein. The response of this patient is interesting in discussing potential indications for therapy.

Atrophy↗
PubMedDate not supplied

Biloma following transcatheter oily chemoembolization.

Hepatic biloma (bile cyst) developed in a patient after transcatheter oily chemoembolization (TOCE) with Lipiodol for hepatocellular carcinoma. The patient was treated conservatively and underwent the next TOCE uneventfully. An inappropriately large dose of Lipiodol, anticancer agent, and Gelfoam can induce biloma; however, it is not reasonable to abstain from TOCE for hepatocellular carcinoma in fear of biloma.

Bile↗
PubMed2006

Cochlear function after selective spiral ganglion cells degeneration induced by ouabain.

BACKGROUND: Ouabain, a cardiac glycoside that specifically binds to Na/K-ATPase and inhibits its activity, was applied to gerbils to develop a method for studying auditory neuropathy. METHODS: Ouabain was applied to the round window of the cochlea in each gerbil by using a piece of gelfoam with 3 microl or 24 microl (1 mmol/L) ouabain solution. The changes of the threshold of auditory brainstem response, cochlear function round window electrocochleography, as well as the morphological changes of the spiral ganglion cells of the cochlea were observed after application of ouabain for 24 hours or 96 hours. RESULTS: In ouabain treated gerbils, auditory brainstem response and compound action potential thresholds showed either elevation or no response at all. However, the thresholds of cochlear microphonic and distortion product otoacoustic emissions were not affected. Degeneration and necrosis of some spiral ganglion cells in ears with applications of ouabain (24 hours, 3 microl, 1 mmol/L; 96 hours, 24 microl, 1 mmol/L ouabain). The number of spiral ganglion cells was decreased (24 hours, 3 microl, 1 mmol/L ouabain) or near to a total loss (96 hours, 24 microl, 1 mmol/L ouabain). CONCLUSIONS: These results indicate a high degree of independence between the spiral ganglion cells and the outer hair cell systems in the cochlear transduction mechanism. The method used in this study would provide a valuable tool for studying auditory neuropathy.

Action Potentials↗
PubMedDate not supplied

[Blunt trauma in kidney transplant with preservation of renal function].

A 35-year-old male received a living related kidney transplant. At 184 months posttransplantation he suffered a direct right iliac fossa blunt trauma while working on a machine in a steel factory. Graft pain, dysuria and gross hematuria were observed and CT showed a periallograft hematoma. Because of his anemia and graft function deterioration, surgical exploration was warranted. A 500-cc perigraft hematoma was compressing the kidney and ureter, a 5-cm long, 5-mm in depth linear laceration in the lateral aspect of the superior pole of the graft and a 15-mm long, 2-mm in depth linear laceration in the medial aspect of the superior pole were actively bleeding. Major renal arteries and veins were not injured. Both lacerations were closed by suturing the renal parenchyma over gelfoam pledgets with absorbable suture in a buttress fashion. The kidney was salvaged. Serum creatinine was maintained at 1.5 mg/dl during follow-up. A review of the literature showed that few cases of traumatic renal graft rupture with kidney salvage have been reported. Our case is one of them.

Adult↗
PubMed2006

Angiographic findings and endovascular embolization in Dieulafoy disease: a case report and literature review.

Dieulafoy disease is an unusual cause of gastrointestinal (GI) hemorrhage that can be fatal. It arises from an abnormally large eroded submucosal artery commonly located in the proximal stomach. Since this disease first described in 1884, it has been rarely discussed in radiology literature. We describe a case of an elderly patient with multiple medical problems presented with upper and lower GI hemorrhage. Repeated upper GI endoscopies revealed a large fundal clot but otherwise were unremarkable. Angiography showed anomalous short gastric artery originating normally from the splenic artery. The latter was embolized with microcoils and Gelfoam. Following embolization, the frequency and amount of bleeding decreased although did not totally stop and the patient underwent elective partial gastrectomy. The diagnosis was made histologically. Therefore, Dieulafoy disease can represent a diagnostic and therapeutic challenge. It should be suspected if a patient with GI hemorrhage is found to have extravasation from a dilated tortuous artery that appears normal otherwise with no associated large draining veins. Transcatheter selective arterial embolization has a reported role in the literature as a less invasive therapeutic option compared to surgery.

Aged↗
PubMed1991

Acceleration of human prostate cancer growth in vivo by factors produced by prostate and bone fibroblasts.

Prostate cancer, the most prevalent cancer affecting men, frequently metastasizes to the axial skeleton where it produces osteoblastic lesions with growth rates often exceeding that of the primary tumor. To evaluate the role of tumor cell-host stromal interaction and stromal specific growth factors (GFs) in prostate cancer growth and progression, we coinoculated athymic mice with human prostate cancer cells (LNCaP) and various nontumorigenic fibroblasts s.c. LNCaP tumor formation was most consistently induced by human bone (MS) fibroblasts (62%), followed by embryonic rat urogenital sinus mesenchymal (rUGM) cells (31%) and Noble rat prostatic fibroblasts (17%), but not by NIH-3T3, normal rat kidney, or human lung CCD16 fibroblasts. Carcinomas formed preferentially in male hosts, demonstrating in vivo androgen sensitivity. The human prostate component of these tumors was confirmed with immunohistochemical staining for prostate-specific antigen (PSA), Northern analysis for PSA expression, and Southern analysis for human repetitive Alu sequences. Elevations in serum PSA paralleled the histomorphological and biochemical findings. LNCaP and fibroblast cell-conditioned media (CM) was used to determine whether autocrine and paracrine mitogenic pathways exist between LNCaP and fibroblast cells in vitro, and various defined GFs were tested to identify possible active factors. Mitogenic assays revealed a 200-300% bidirectional stimulation between LNCaP and bone or prostate fibroblast-derived CM. Lung, normal rat kidney, and 3T3 fibroblast CM were not mitogenic for LNCaP cells. Among the purified GFs tested basic fibroblast growth factor (bFGF) was the most potent mitogen, stimulating LNCaP growth 180% in a concentration-dependent manner. Transforming growth factor alpha and epidermal growth factor were both minimally mitogenic. Coinoculation of LNCaP cells with a slowly absorbed matrix (Gelfoam) absorbed with bFGF or dialyzed and concentrated rUGM or MS CM was also capable of inducing LNCaP tumor formation in vivo. These observations illustrate that fibroblasts differentially modulate prostate cancer growth through the release of paracrine-mediated GFs, possibly including bFGF, and that tumor-stromal cell interactions play an important role in prostate cancer growth and progression.

Androgens↗
PubMed2006

[Intermediate and long term clinical effects of uterine arterial embolization in treatment of adenomyosis].

OBJECTIVE: To assess the intermediate and long term clinical effectiveness of uterine arterial embolization (UAE) in treatment of adenomyosis. METHODS: The standard UAE was performed in 189 patients with adenomyosis in our hospital from Jun 1999 to Jun 2004. The fresh gelfoam particles or polyvinyl alcohol particles (PVA) or sodium alginate microspheres for vascular embolization (KMG) mixed with antibiotics were used to embolize the arteries. The degree of dysmenorrhea and amount of menorrhea after the operation were investigated. RESULTS: (1) The number of the cases completely followed up was 168, with a ratio of 88.9%, and a follow-up time of (50 +/- 15) months. (2) The symptom of dysmenorrhea: in all 168 patients, 159 had dysmenorrhea before the operation. Clinical effectiveness was observed in 82.4% (131/159) of patients after the operation, but in 17.6% (28/159) of patients there was no clinical effectiveness, and in 5.0% (8/159) of patients the dysmenorrhea recurred after the operation. (3) The clinical effectiveness between the patients with adenomyosis with and without myoma or between the patients with local and diffuse adenomyosis had no significant difference (P > 0.05). (4) The amount of menorrhea: in the 93 patients with hypermenorrhea, the amount of menorrhea returned to normal in 83.9% (78/93), oligomenorrhea occurred in 10.8% (10/93), the menorrhea of 2 patients was rare, transient amenorrhea occurred in one case, and the amount of menorrhea did not change in two patients. Among the 74 patients with normal menorrhea, the menorrhea amount did not change in 77.0% (57/74), oligomenorrhea occurred in 20.3% (15/74), uterine amenorrhea occurred in two patients. The menorrhea amount of one patient with oligomenorrhea returned to normal after the UAE therapy. (5) Nine patients accepted hysterectomy due to reoccurrence of dysmenorrhea or ineffectiveness or hypermenorrhea. CONCLUSION: UAE has a good intermediate and long term effectiveness in treatment of adenomyosis.

Adult↗
PubMed1991

Hemostatic agents. Adjuncts to control bleeding.

1. Allergic reactions can occur with the use of topical hemostatic agents. 2. Some hemostatic agents may be used in combination to provide more effective hemostasis (eg, thrombin and Gelfoam). 3. Documentation should be made of any hemostatic agent left in situ at the time of closure. 4. Use of topical hemostatic agents is generally contraindicated in contaminated wounds.

Education, Nursing, Continuing↗
PubMed1991

[Microsurgical treatment of trigeminal neuralgia].

129 cases of trigeminal neuralgia were treated microsurgically. The roots of trigeminal nerves were found to be affected by arteries in 96 cases, by veins in 23, and by both arteries and veins in 10. According to these relations, the disease was divided into 3 types: (1) contiguous type (49 cases, 37.9%), vessels 1 mm close to the nerves without any compression; (2) compressive type (42, 32.5%), vessels close to the nerves with compression; (3) adhesive type (38, 29.5%), vessels and nerves adhered to each other. A piece of dacron was used to wrap the nerve root and fixed by gelfoam and silver clip. Pain relieved immediately after operation in 123 cases with an effective rate of 98.4%.

Adult↗
PubMed1991

[Bile lake: a complication of transcatheter hepatic arterial infusion and embolization therapy (TAI, TAE)].

A 74-year-old man with hepatocellular carcinoma developed cholangitis and bile lake in the liver after repeated TAI (anticancer drug-lipiodol suspension) and gelfoam TAE. Despite percutaneous transhepatic drainage, he died of hepatic failure 34 months after the first TAI and TAE. We speculate that cholangitis and bile lake were caused by chemical toxicity of highly concentrated anticancer drug to the bile duct and compression of the proximal bile duct by the tumor.

Aged↗
PubMed1991

[Arterial embolization of an arteriovenous fistula with hemobilia after blind liver puncture].

Five days after percutaneous liver biopsy we observed in a 42-year-old man with alcoholic liver cirrhosis severe hemobilia requiring transfusions of packed red cells. By means of super-selective arterial embolization, using gelfoam, the bleeding source, an av-fistula, was successfully occluded. Iatrogenic hemobilia, although seen after percutaneous liver biopsy only in app. 0.005% of the cases, is today the most important cause of biliary bleeding, mainly as a complication (app. 3% of the cases) of the widespread use of interventional procedures of the biliary tree (e.g. PTCD). Therapeutically arterial embolization should be considered first if possible.

Adult↗
PubMed1991

[Stapes decompression].

Footplate decompression, which has been described in Lyon in 1965, can be easily performed under local anesthesia. The surgical procedure consists of a 8/10 mm diameter stapedotomy followed by an obturation with spongel, gelfoam or a piece of thin fascia. The operation is not a labyrinthectomy or a sacculotomy but aims to decompress endolymphatic hydrops in Ménière's disease. It must be realised only in case of typical unilateral Ménière's disease with disabling vertigo and very poor residual hearing. More than two hundred cases have been operated on. Vertigo has been relieved in 90% of the operated cases, tinnitus less severe in 50% of cases and hearing sometimes worse but often unchanged. In patients suffering from a unilateral Ménière's disease with disabling vertigo and poor residual hearing, footplate decompression appears to be one of the most simple safe and effective surgical procedures.

Humans↗