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Biomedical subjects

A M Granov

Publications and source records attributed to A M Granov.

At least 19 recordsLinked to original sources
PubMed2005

[Radiopaque oil chemical arterial embolization in treatment of pancreatic cancer].

The article is dedicated to a new method of treatment of pancreatic cancer, developed by researchers of St. Petersburg Research Institute of Roentgenology and Radiotherapy. The method consists in slowing down blood flow in the tumor by means of selective embolization of its arteries using a mixture of the chemiotherapeutic agent gemcitabine (Gemzar) in the oily radio-paque medium Lipodol Ultrafluid. Upon entering microcirculatory vessels, the agent diffuses into pancreatic tissue. This tumor chemoinfiltration provides prolonged contact between tumor tissue and the chemoembolization agent, thus allowing strong antitumor effect without high systemic toxicity. Experimental studies on 12 dogs have proved that oil arterial chemoembolization with lipiodol does not cause morphological changes in the pancreas, and is only manifested by short and reversible hyperenzymemia.

Angiography↗
PubMed2005

[Positron emission tomography in oncourology].

The authors present the results of the examination of 61 patients with genitourinary space-occupying lesions, using 18F- fluorodeoxyglucose positron emission tomography (PET) in whole body mode. In all cases the diagnosis was verified morphologically. The results demonstrated high diagnostic accuracy of PET, including possibility to determine the extent of oncourological cancer. However, the method displays poor efficacy in cases of hypernephroid cancer due to low level of glycolysis in this type of tumor.

Adolescent↗
PubMed2003

[Modern technologies of diagnosis and combined surgical treatment in liver tumors].

Modern technologies used at St. Petersburg Central Research Institute of Roentgenology and Radiotherapy of Russia's Ministry of Health in the diagnosis and treatment of malignant and benign liver cancers are surveyed in the paper. Apart from routine examinations, like ultrasound scanning, computer tomography, MRT, angiography, the below new technologies were widely used: multi-stratum spiral computer tomography, special MRT techniques and positron-emission tomography. The new methods enabled us to diagnose the tumor and its extension, to choose an optimal intervention technique, to make an objective assessment of the results and to correct the treatment strategy. Preoperative embolization of the portal-vein branches in the damaged hepatic lobe and postoperative adjuvant local chemotherapy of the hepatic artery and portal vein belong to the new combined surgical treatment scheme. The method of combined arterial-portal chemoembolization, used in unresectable malignant hepatic pathologies, extends the survival of patients by 3-5 times. Ferromagnetic embolization presupposes the administration of ferromagnetic, through the arterial bed or direct puncture, into the tumor with a subsequent SHF-current treatment which brings about a selective tumor hyperthermia without heating the normal hepatic parenchyma. Arterial embolization combined with local injection sclerotherapy in hemangiomas of the liver provides for a complete regeneration of benign tumors and can be regarded as a low-trauma alternative to liver resection. The use of new methods of diagnosis and treatment expands the possibilities of surgical care for patients with hepatic neoplasms and essentially improves the treatment results.

Angiography↗
PubMed2003

[The role of positron emission tomography with C18-Fluorodeoxyglucose in clinical oncology].

The study was concerned with evaluation of the diagnostic potential of positron emission tomography (PET) with 18-FDG in clinical oncology and elucidation of its role in assessing therapy effectiveness. The Ecat Exact 47 and Ecat Exat HR+ (Siemens) insatllations were used to examine 674 patients, with Whole Body protocol used in 585. PET with 18-FDG proved highly effective in diagnosing malignancies of the breast, lung, liver, pancreas, testis, brain and lymphoma as well as evaluating the efficacy of therapy.

Brain Neoplasms↗
PubMed2001

[Critical state medicine. Surfactant therapy of adult respiratory distress syndrome (results of multicenter studies)].

The paper provides evidence for the pathogenetic approach to treating acute lung lesion (ALL) and adult respiratory distress syndrome (ARDS). An algorithm of the use of Russian lung surfactant preparations: CT-HL and CT-BL has been developed. In involves earlier (the first days following the onset of respiratory failure) use of surfactant, its combined bolus intratracheal or intrabronchial administration in doses of 200-400 mg/m2, followed by continuous (5-day) aerosol inhalation in doses of 20-30 mg/h for children and 30-75 mg/h for adults until pronounced clinical and X-ray effects are shown. Fifty three patients were found to develop ALL and ARDS in the presence of severe pneumonia, postperfusion lung disorders, reperfusion syndrome, pulmonary embolism, long-term artificial ventilation, combined car accident injury and gunshot wounds of the chest, heroine intoxication, septic shock, sepsis, postoperative sequels in cancer patients, and after hepatic transplantation or massive aspiration of gastric contents. Fifty patients were overcome their critical status, 44 survived. The duration of artificial ventilation (AV) ranged from 1 to 6 days. Earlier use of the drugs made it possible to transfer patients to safe AV regimens and to eliminate ALL and ARDS rapidly and to significantly reduce mortality due to critical states.

Acute Disease↗
PubMed1999

[Arterial embolization in treatment of hepatic cavernous hemangioma].

Clinical and radiologic results of hepatic artery embolization (HAE) were retrospectively analyzed in 32 patients with cavernous hemangioma of the liver. Embolization was the only method of treatment of the hemangioma in 25 of 32 patients. HAE was effective for improvement of symptoms such as abdominal pain, anemia, rapid tumor enlargement, portal or systemic hypertension due to intratumoral arterioportal or arteriovenous fistulas. On the other hand, symptoms of hepatic tumor improved in only two patients but became worse in four of 14 patients with non-severe disease. During one to five years of follow-up, reduction of arterial supply of hemangioma was seen in all the patients, but the tumor size decreased in only 1/3 of them. It is concluded that individual approach to the use of HAE and other treatment modalities should be preferred in patients with hepatic cavernous hemangioma.

Adult↗
PubMed1998

[Results of endovascular interventions (embolization and chemoembolization) in the treatment of operable and extensive kidney cancer].

The results of an all-round examination and complex treatment of 323 patients with renal cell carcinoma were evaluated. Locally advanced tumors were diagnosed in 143 (44.3%) and extended ones--in 180 (66.7%). In patients with locally advanced tumor who had undergone nephrectomy after embolization or chemoembolization, 12-, 24- and 36-month survival rates showed no significant difference. In patients with extended renal carcinoma, 2- and 3-year survival was significantly higher after chemoembolization than after standard embolization of the renal artery.

Adult↗
PubMed1995

[Combined radio-endovascular and percutaneous procedures in the treatment of liver hemangioma].

A spectrum of roentgenoendovascular and percutaneous procedures of hepatic hemangioma treatment is considered for situations in which resection of the liver is not justified. Stage I of therapy involved embolisation of hepatic artery and its branches. At stage II, ultrasonography and roentgenoscopy-controlled aiming percutaneous puncture and sclerosation of hemangioma were conducted. Said procedure was used in treatment of 12 patients. The results were evaluated using scintigraphy, ultrasonography, computed tomography and aiming puncture biopsies.

Administration, Cutaneous↗
PubMed1992

Arterioportal fistulas (APF) in liver tumors: prognosis in relation to treatment.

Prognosis of 16 patients with hepatic tumors and angiographically proven arterioportal fistulas was analysed in relation to treatment. Six patients received only conservative therapy; they all died of variceal bleeding in the course of two months after angiography. Hepatic resection was performed in four patients; three of them are still alive 13-52 months later including two free of both the tumor and portal hypertension. Hepatic artery embolization was carried out in six patients. All of them died in 2-36 months after the procedure, but only two from gastroesophageal hemorrhage. It is concluded that prognosis of arterioportal fistulae in liver neoplasms is poor due to hyperkinetic portal hypertension and following variceal bleeding. Hepatic resection of both the tumor and the fistula is the treatment of choice. In unresectable cases hepatic artery embolization will decrease the risk of variceal hemorrhage.

Arteriovenous Fistula↗
PubMed1992

[A differential approach to the surgical treatment of liver hemangiomas].

Treatment results and indications for surgery were analysed in 50 cases of hepatic hemangioma versus pattern of hemangiomatosis and size, site and extent of tumor. Surgery was performed in 41 (82%) patients. Radical surgery was possible and justified in as few as one-third of them. Palliative treatment including ligation and roentgen-endovascular occlusion of the hepatic artery and its branches, local ferromagnetic embolization of tumor and suturing and sclerotherapy of hemangioma were performed in 28 cases. End results were analysed in 33 cases followed up to as long as 8 years posttreatment. The extent and type of surgery for hepatic hemangioma should be different for each of the four patterns of the disease identified.

Adult↗
PubMed1991

[Embolization of the hepatic artery in the treatment of malignant tumors of the liver].

The results of therapeutic hepatic artery embolization (HAE) in 25 patients with malignant unresectable tumors of the liver are discussed. The proximal segments of the hepatic artery were occluded by metal spirals. Thrombosis of the portal vein was accepted as an absolute contraindication for HAE, and a tumor involving more than 50% of the volume of the liver and chronic hepatic insufficiency were considered relative contraindications. After the intervention signs of subjective improvement were noted in 73.9% and signs of objective improvement in 65.2% of cases. The mortality after HAE was 4.2%. The obtained results are evidence of the efficacy of proximal HAE as a method for the treatment of inoperable malignant tumors of the liver.

Adenoma, Bile Duct↗
PubMed1991

[Long-term results of the embolization of the hepatic and splenic arteries in liver cirrhosis].

The authors studied the long-term results of portal hypertension correction in patients with far-advanced stages of cirrhosis of the liver. Embolization of the hepatic and/or splenic arteries was performed in 231 patients (147 males and 84 females) aged from 17 to 70 years. Sixty-seven patients are alive at present, the average duration of the follow-up period is 57.9 +/- 19.8 months. Four patients were not followed up; 160 patients died, 18 (7.8%) of them within 30 days after an endovascular manipulation. The mean survival of patients who were discharged from the clinic was 21.1 +/- 17.4 months. Survival was higher among patients treated by successive embolization of the hepatic and splenic arteries than in those treated by occlusion of one of these vessels. Comparative analysis showed that embolization of arteries of the hepatolienal zone prolongs the life of patients with complicated forms of portal hypertension in cirrhosis of the liver.

Adolescent↗
PubMed1990

[Stage-by-stage arterial embolization in large-size malignant tumors of the liver].

A new method of embolization of the hepatic artery (EHA) is proposed for malignant tumors of great volume. The method is realized in two steps: at the first step a reduction is fulfilled, at the second step (2-8 weeks later)--complete interruption of the arterial blood flow of the liver. The method was used in 5 patients with spreaded tumors of the liver. No complications were noted. A conclusion was made that volume of the tumor more than 70% of the organ should not be taken as the absolute contra-indication to EHA. The latter should be fulfilled by the proposed method in such cases.

Adolescent↗
PubMed1990

[The preoperative embolization of the hepatic artery in patients with malignant liver tumors].

Hepatic artery embolization (HAE) was performed in 4 patients with liver tumors 5-60 days prior to radical resection. No adverse effects of HAE on the liver or gallbladder were observed at surgery. Intraoperative blood loss was reduced in 2 patients. Surgery was completed with intraportal chemotherapy. At 6-26 months post-surgery, all the patients were alive with no evidence of disease. It was concluded that preoperative HAE may be used in treatment of liver malignancies.

Adult↗
PubMed1990

[Clinical aspects of diagnosis and treatment of aneurysms of the splenic artery].

Literature data and original clinical evidence are reviewed concerning diagnostic and treatment aspects of splenic artery aneurysms (SAA). Five cases of aneurysms of the splenic artery trunk in 4 females and 1 male aged 23-54 are described. There was a case of a false SAA due to previous abdominal trauma and consequent pancreatitis. In another case SAA combined with cavernous hepatic hemangioma. Portal hypertension resultant from hepatic cirrhosis was seen in 3 out of 5 SAA cases. Two patients underwent embolization of the artery trunk proximally from SAA, three patients--ligation of the splenic artery with removal of the SAA and the spleen. Current methods of investigation are believed capable of SAA diagnosis before fatal complications, with differential approach to SAA evaluation warranting definition of surgical treatment scope.

Adult↗
PubMed1990

[Prognostic value and possibilities of the treatment of arterio-portal fistula in tumors of the liver].

Angiograms demonstrated arterio-portal shunts in tumors of the liver in 15 patients. Five patients received symptomatic therapy, all of them died from hemorrhage from varicose esophageal veins in the immediate 2 months. Resection of the liver was performed in 4 patients, 3 of them are alive and in a state of remission. Esophageal hemorrhage developed only in 2 of 6 patients who underwent embolization of the hepatic artery. It is concluded that the prognosis is extremely unfavourable in untreated patients with marked arterio-portal shunting in the hepatic tumor. Such patients must be treated surgically or, if inoperable, by radiologically-guided intervention, which makes it possible to normalize portal hemodynamics in most cases and avoid fatal hemorrhage.

Adult↗