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Biomedical subjects

J Aquino

Publications and source records attributed to J Aquino.

15 recordsLinked to original sources

Günther Tulip filter: preliminary clinical experience with retrieval.

PURPOSE: The Günther Tulip filter is a permanent filter that has a hook to permit retrieval. The authors report their preliminary clinical evaluation of the filter with regard to feasibility and safety of retrieval. MATERIALS AND METHODS: Nine men and six women who ranged in age from 17 to 79 years (mean, 51 years) underwent treatment with use of the Günther Tulip filter. Patients judged to require caval interruption for < 14 days were selected to receive the filter and retrieval was planned for all patients. Indications for filter placement were: recent pulmonary embolism (PE) or proximal deep vein thrombosis (DVT) with a contraindication to anticoagulation (11 patients), massive PE treated with thrombolytic therapy (one patient), PE with heparin-induced thrombocytopenia (one patient), and prophylaxis after major trauma (two patients). Patients were followed for inferior vena cava (IVC) thrombosis, bleeding, and recurrent DVT or PE. RESULTS: In all nine patients in whom it was attempted, the filter was successfully snared and retrieved via a jugular approach. The mean implantation period was 8.6 days (range, 5-13 days). Retrieval required 2.2-13 minutes (mean 5.3 minutes) of fluoroscopy. No caval injuries occurred as a result of retrieval. All retrieved filters had strands of organized thrombus on the filter struts. The patients were followed for 52-285 days (mean, 115 days) after retrieval. One patient developed a recurrent DVT 230 days after retrieval. No other patients developed a recurrent DVT and no patients developed IVC thrombosis, bleeding, or PE. Six filters were not retrieved: five because of an ongoing contraindication to anticoagulation and one because the patient died of causes unrelated to the filter. CONCLUSION: This preliminary study confirms the feasibility and safety of retrieval of the Günther Tulip filter up to 13 days after implantation.

Adolescent↗

Outpatient percutaneous transluminal renal artery angioplasty: a Canadian experience.

PURPOSE: The authors performed a retrospective study of their experience and complication rate while performing outpatient percutaneous transluminal renal artery angioplasty (PTRA) during a 5-year period. MATERIALS AND METHODS: From July 1992 to July 1997, 87 PTRAs were performed. Of these, 62 PTRA procedures were performed on 53 outpatients. In total, 66 arteries were dilated in 62 PTRA sessions using standard, established techniques. During the same period, only 25 PTRAs were performed on inpatients. Angioplasties were performed on those patients with demonstrated renal artery stenosis and poorly controlled hypertension and/or renal failure. Patients chosen for PTRA were picked by a team that included a vascular surgeon, a nephrologist, and a radiologist. Patients who were deemed suitable for an outpatient procedure were recommended by a nephrologist. Radiological input was sought at that time. Specific guidelines were used to select these patients who were otherwise healthy, well-orientated, and able to respond to an emergency situation. None of the subjects had significant risk factors. All were accompanied by an adult for the first 24 hours and all lived no more than an hour's travel time from a hospital. All were stable on discharge and were seen within 24 hours by a nephrologist. RESULTS: The technical success rate, defined as a residual stenosis on imaging of less than 30% and/or by a pressure gradient of less than 10 mm Hg across the stenosis, was 85%. The early complication rate was 5.6%, including two patients who developed a localized hematoma. In all, four patients were admitted to the hospital rather than being discharged to home after an average of 4.2 hours of observation. The late complication rate was 3% and involved two patients. One patient, who reported pain after balloon deflation, was readmitted 6 hours after discharge with hypotension, and a diagnosis of renal artery rupture was confirmed with computed tomography. Another patient developed peripheral atheroemboli 20 days after the procedure. CONCLUSION: Outpatient PTRA can be performed on selected patients. In this study, late complications occurred in only 3% of patients. Early complications were readily recognized in 5.6% of patients, and these patients were admitted for observation after the procedure.

Adult↗

Oversized inferior vena cava: use of a single Vena Tech--LGM filter.

The authors describe placement of the LG-Medical filter (B. Braun/Vena Tech, Evanston, Ill.) in four patients with an oversized inferior vena cava. The corrected caval diameter at the level of the most inferior renal vein was greater than 28 mm in each patient. However, in each case the vena cava tapered inferiorly to a segment with a diameter less than 28 mm, and the filter was placed at this site. Filter placement was accomplished without difficulty or complication in all cases. One patient died of underlying disease. The three surviving patients were followed for 119 to 374 (mean 276) days. There was no evidence of filter migration, recurrent pulmonary embolism, occlusion of the venacava, access-site thrombosis or other complication. The authors concluded that placement of bi-iliac filters can be avoided by this technique.

Constriction, Pathologic↗

Tumor localization of monoclonal antibodies against human renal carcinoma in a xenograft model.

We investigated the localization of intravenously injected DAL K45 and DAL K29, two monoclonal antibodies (MABs) against human renal cell carcinoma (RCC), and their F(ab)2 fragments in nude mice bearing intrarenal transplants of the RCC line Caki-1. More of the MABs or their F(ab)2s specifically localized in the tumor than in any normal tissue with the exception of blood. Compared to parent MABs, F(ab)2s were cleared faster from all tissues. In serum, the MABs and F(ab)2s showed a single radioactive peak retaining partial immunoreactivity. DAL K45-F(ab)2 showed the highest tumor:normal tissue localization ratios and the most distinct gamma-camera image at 24 h.

Adult↗

Radionuclide imaging of metastases from renal-cell carcinoma by 131I-labeled antitumor antibody.

On immunofluorescence assay, goat antisera reacted with renal-cell carcinomas from 20 patients, but not with adult normal human tissues (including patient's normal kidney). After in travenous injection, the 131I-labeled antibody localized preferentially in metastatic renal carcinoma in 6 consecutive patients. Labeled antitumor antibodies may have the specificity for tumor imagining which current radiopharmaceuticals lack.

Adenocarcinoma↗

Radionuclide imaging of primary renal-cell carcinoma by I-131-labeled antitumor antibody.

A goat antibody against human renal-cell carcinoma reacted on immunofluorescence with renal-cell carcinomas from 20 patients, but not with normal adult human tissues, including kidney. After i.v. administration the I-131-linked antibody showed preferential tumor localization in six of seven patients with primary renal carcinoma. Labeled antitumor antibodies may have the specificity for tumor imaging that current radiopharmaceuticals lack.

Adenocarcinoma↗

Antibody as carrier of 131I in cancer diagnosis and treatment.

Cell-surface localizing heterologous antibodies against mouse EL4 lymphoma, Ehrlich ascites carcinoma, and several human malignant tumors could be bound to varying amounts of 131I without interfering with the reactivity of these antibodies with their respective tumor cells. Exposure of the mouse tumor cells to radio-iodinated antitumor antibodies in vitro, or the injection of radio-iodinated antitumor antibodies into mice preinoculated with tumor cells resulted in either partial or complete tumor inhibition depending upon the amount of 131I activity carried by the antibodies. Injection of comparable amounts of the immunoglobulin alone or of 131I bound to normal globulin did not cause any tumor inhibition. Intraperitoneally injected radio-iodinated anti-EL4 antibody was found to localize preferentially in the subcutaneous transplants of EL4 lymphoma. Similar localization of intravenously injected radio-iodinated antibodies was observed in the metastases of two cancer patients.

Animals↗

Tumor localization of 131-I-labeled antibodies by radionuclide inaging.

Intravenous injections of 131-I-labeled anti-EL4 lymphoma antibodies showed progressive localization of radioactivity in EL4 transplants but not in B16 melanoma in mice carrying both tumors. Normal rabbit globulin labeled with 131-I did not localize in either tumor and cleared more slowly from the internal organs. Metastatic localization of intravenous 131-I-labeled anti-tumor antibodies was also observed in 2 cancer patients.

Animals↗

LGM (Vena Tech) vena caval filter: experience at a single institution.

PURPOSE: The authors describe their experience with LG-Medical (LGM [Vena Tech]) filter placement and follow-up. PATIENTS AND METHODS: LGM vena cava filters were placed in 63 patients. Follow-up was obtained by means of duplex sonography of the introduction vein and inferior vena cava (IVC) and abdominal radiography in 50 patients, and by means of autopsy in an additional four patients. In eight, only clinical follow-up was obtained and one patient was lost to follow-up. RESULTS: Major complications of placement occurred in three patients, all when the right internal jugular vein was used for introduction: In one patient a filter was inadvertently placed in the right renal vein and in two the filter failed to open fully. No serious complications of placement occurred when either the right or left common femoral veins were used. Pulmonary embolism (PE) recurred in four patients (6%) and was fatal in one. Septicemia from an infected filter was the probable cause of death in another patient. Introduction vein thrombosis occurred in five patients (8%) and was symptomatic in two (3%). Occlusion of the IVC occurred in 15 patients (24% of the total patient group, but 28% of those with objective follow-up) and was symptomatic in 12 (19%). Two patients with IVC occlusion had recurrent PE. CONCLUSION: These data suggest that the rate of IVC occlusion is higher than most previous reports have suggested and that IVC occlusion may be a potentially serious complication.

Equipment Design↗

Antibody response to anti-A/New Jersey/76 vaccines.

Experimental inactivated influenza vaccines prepared with strain X 53, derived from A/New Jersey/76 virus were injected to several groups of subjects. Different compositions of vaccine were used and the subjects were selected from different age groups. Antibody responses were measured 15 days after vaccination; it was then possible to evaluate the conversion rates, the percentages of subjects showing a protective level of antibodies and the average level of antibodies. The results show that a very small dose of antigen, probably acting as a booster, gives very good results in the older age group. On the other hand, young adults (below 23) react to a much lower degree to the vaccine. The results are discussed in relation to the age distribution of preexisting antibodies in the experimental groups and in the general population in France.

Adult↗