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Enhanced in vitro hair growth at the air-liquid interface: minoxidil preserves the root sheath in cultured whisker follicles.

Inasmuch as hair follicles are difficult to maintain in culture, the study of hair biology using cultured hair follicles has met with only limited success. In our attempts to solve the problem of follicle degeneration, we cultured follicles at the air-surface interface on a modified collagen matrix (Gelfoam). In follicles cultured at the air-surface or submerged, we examined follicular morphology, hair shaft growth, sulfotransferase levels, cysteine incorporation, an expression of a tissue inhibitor of metalloproteinase (TIMP), and ultra-high sulfur keratin (UHSK). Follicles cultured at the air-liquid interface produced a 2.7-fold increase in hair growth and maintained an anagen-like morphology. Substrates such as nylon mesh seeded with fibroblasts, Full Thickness Skin, or 5-microns polycarbonate filter also supported hair growth, whereas Gelfilm, GF-A glass filter, filter paper, or 1-micron polycarbonate filter did not. The UHSK expression was significantly higher in the air-liquid interface cultures compared to the submerged culture. Several potassium channel openers, including minoxidil, a minoxidil analog, and the pinacidil analog (P-1075), all stimulated significant cysteine incorporation in follicles. Minoxidil and its analog specifically preserved the follicular root sheath, in contrast to P-1075 which did not, indicating a difference in the two drug types. The preservation of the root sheath was measured by increased TIMP expression and sulfotransferase activity and indicates that the root sheath is a target tissue for minoxidil. Our results show that follicles cultured at the air-liquid interface maintain a better morphology and produced greater hair growth than follicles cultured on tissue culture plastic.

Air↗

Transcatheter arterial embolization as a method of cisplatin-retention enhancement on the VX2 tumor uterus transplants.

PURPOSE: Enhanced cisplatin (Pt) retention using transcatheter arterial chemoembolization (TAE) with Gelfoam particles was studied in rabbit uterine tumors. METHODS: Ten rabbit uteri were inoculated with 5 x 10(7) cells of VX2 carcinoma. Three to four weeks later cisplatin, 1 mg/kg, was injected, either with (TAE group) or without (IA group) being mixed with small Gelfoam particles, into the aortic bifurcation over 5 s. Blood and tissue concentration of cisplatin were determined. RESULTS: Slower arterial blood clearance of Pt was observed in the TAE group compared with the IA group, whereas the venous blood Pt clearance curves were similar for both groups. The uterine tumor Pt concentration at 80 min was found to be 2.52-fold higher after TAE compared with IA (p < 0.01). In the pelvic metastatic lymph nodes, the Pt concentration was 4.63 times higher after TAE than after IA (p < 0.01). CONCLUSION: These data indicate that TAE is an effective means of increasing tissue concentration in uterine tumors.

Animals↗

[Comparative study on the long-term effect of permanent embolization of hepatic artery with Bletilla striata in patients with primary liver cancer].

From May, 1990 to Sept., 1993 106 cases of primary liver cancer were treated by temporary or permanent hepatic arterial embolization with Bletilla striata powders (permanent, 56 cases) or gelfoam powders (temporary, 50 cases) under controlled technical conditions, in term of degree of tumor necrosis, revascularization of tumor, and long-term effect, the results of Bletilla striata group were better as compared with those of gelfoam group. The 1, 2 and 3 year survival rates were 44.9%, 33.6% and 33.6% in Beltilla striata group while the rates were 48.9%, 31.1% and 16.0% in gelfoam group, suggesting that Bletilla striata is superior to gelfoam as an embolizing agent for hepatic carcinoma.

Antineoplastic Agents, Phytogenic↗

Application of anticancer agent embolism in Miles' operation.

Presented in this paper is a report of the prospective studies on rectal cancer. By using the method of anticancer agent gelatin sponge to form embolism and by ligating the bilateral arteria iliaca internal, we performed Miles' operation on 64 cases of rectal cancer. Only 24 cases in the control group had Miles' operation. The amount of blood transfused during operation, duration of operation, days of hospitalization, infection rate of incision on the peritoneum, and relapse rate in treated group were significantly different from those in the control group (P < 0.05).

Adult↗

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↗

Technique and complications of renal carcinoma infarction.

The technique of renal arterial embolization in 150 patients with renal carcinoma using Gelfoam, Ivalon particles, and coils is described. The complications of the procedure and the morbidity and mortality following embolization are presented. The details of the postinfarction syndrome in the first 100 patients are analyzed. The prevention of these complications is discussed.

Embolization, Therapeutic↗

Palliative embolization of renal tumors: follow-up of 19 cases.

Palliative renal artery embolization (without subsequent nephrectomy) was performed in 19 patients with renal carcinoma, and the follow-up is presented. Seventeen of the patients had metastatic disease at the time of embolization. Three patients were alive 11, 52, and 56 months after embolization. Gross hematuria was eliminated in 5 patients. Temporary remission of suspected pulmonary metastases was seen in 2 patients. It is concluded that transcatheter embolization alone is not curable and in this series did not affect the overall survival rate; however, local tumor symptoms may be palliated by this method.

Adenocarcinoma↗

Effectiveness of collagen-gentamicin implant for treatment of "dirty" abdominal wounds.

The purpose of this work was to compare the efficacy and safety of the collagen-gentamicin sponge with conventional treatment (wound open, maintaining a close observation, and cleaning it daily with antiseptics) for the prophylaxis of infection in "dirty" abdominal wounds. Seventy-three patients with dirty abdominal wounds caused by gastrointestinal tract surgery were studied. The patients were randomized in two groups: group A, open wounds, treated with local cleansing, metronidazole 20 to 40 mg/kg/day IV and gentamicin 5 mg/kg/day IV for 7 days. Group B, primary closure with collagen-gentamicin implant plus metronidazole 20 to 40 mg/kg/day IV for 7 days. Surgical wound infections were significantly reduced by the collagen-gentamicin implant. Polymicrobial infections were observed in group A, whereas the infections were caused only by a single organism in group B. In conclusion, the collagen-gentamicin implant is effective and well tolerated in the treatment of "dirty" surgical abdominal wounds because it significantly reduces the wound infection rate (p < 0.01) and shortens healing time (p < 0.001) and the period of disability.

Adolescent↗

Preoperative transcatheter arterial chemoembolization and prognosis of patients with hepatocellular carcinomas: retrospective analysis of 120 cases.

To clarify whether preoperative transcatheter arterial chemoembolization (TAE) improves the prognosis of patients with hepatocellular carcinoma (HCC) after surgery, 120 patients who had undergone hepatectomy for HCC from 1988 to 1994 and satisfied the criteria of stages II and III were enrolled in this study. Forty-four patients underwent preoperative TAE (group A) and 76 patients did not (group B). No significant differences in the outcomes were observed between these two groups. To rectify the comparison, patients with tumors 2 to 8 cm were assigned to groups A1 (n = 24) and B1 (n = 57), and those with tumors > 8 cm were assigned to groups A2 (n = 20) and B2 (n = 19), respectively. Although no significant differences in survival between groups A1 and B1 were found, group A2 presented superior 1-, 2-, and 3-year tumor-free survival rates of 80%, 55%, and 32% and 1-, 3-, and 5-year cumulative survival rates of 90%, 53%, and 42%. These figures are in comparison with the tumor-free survival rates of 50%, 22%, and 11% (p = 0.06), and the cumulative survival rates of 72%, 33%, and 11% (p = 0.01) during the same periods for group B2, respectively. The Cox regression model revealed that for patients with tumors > 8 cm, the relative risk of preoperative TAE for overall survival was 0.38 (p = 0.017), indicating that preoperative TAE might benefit patients with tumors > 8 cm but not those with tumors 2 to 8 cm.

Adult↗

[Preoperative angiographic embolization of carotid glomus tumors. A method for improving operability].

During surgical resections carotid body tumors may bleed profusely due to their vascularity. Preoperative angiographic embolization of tumor-supplying arteries has reduced intraoperative blood loss significantly. The present study reviews our clinical experiences with 13 paragangliomas of the carotid bifurcation in 12 patients during the past 5 years. In 6 patients (46.1%) computed tomography and magnetic resonance imaging demonstrated extensive spread of the tumor up to the base of the skull. Tumors of this size were initially assessed as being inoperable but curative surgical resections were performed after embolization of tumor-supplying arteries by intravascular injections of Gelfoam and implantations of microcoils. Vascular reconstruction of the internal carotid artery by a saphenous vein graft was required in 4 patients (30.7%). In 3 malignant paragangliomas (23.0%) adjuvant radiotherapy of 50-60 Gy was administered to the tumor site after surgery. During an average follow-up of 29 months, one malignant paraganglioma was found to have recurred locally 13 months after initial therapy.

Adult↗

[Improvement of hemostasis in laparoscopic and open partial nephrectomy with gelatin thrombin matrix (FloSeal)].

Long-term follow-up studies have demonstrated that effective local tumor control and long-term tumor-free progression rates can be achieved by nephron-sparing surgery. However, hemostasis is a major issue and the lack of effective means of hemostasis has limited a wider use of the laparoscopic approach to nephron-sparing surgery. Between January 2001 and August 2002, a total of 36 patients with renal cell carcinomas were treated by partial nephrectomies using a two-component tissue sealant (FloSeal). The median age was 55.2 years (range: 34-71 years). Follow-up time was 1-18 months (median: 5.5 months). The tumor diameter ranged from 2 to 5 cm (median: 2.9 cm). Open retroperitoneal surgery was performed in 17 cases and laparoscopic partial nephrectomy in 19 cases. The two-component tissue sealant (consisting of a gelatin matrix with granular and thrombin components) was applied after resection of the tumor and before perfusion of the kidney. The following parameters were recorded: (1) time until complete hemostasis was achieved, (2) decrease in postoperative hemoglobin level, (3) postoperative bleeding, and (4) presence or absence of a perirenal hematoma 24 h and 10 days postoperatively by ultrasound. After application of the tissue sealant for 1-2 min to the moist resection site, hemostasis was immediate in all cases. During the laparoscopic partial nephrectomies, a laparoscopic applicator was used that avoided wasting the tissue sealant within the dead space of the instrument. When reperfusion of the kidney was established, hemostasis was maintained. The decrease in postoperative hemoglobin level ranged from 0.3 to 1.2 points (median: 0.8 points). None of the patients required blood transfusions. There were no cases of postoperative bleeding. An ultrasound examination 24 h and 10 days postoperatively demonstrated the absence of a significant perirenal hematoma. The two-component tissue sealant FloSeal provided immediate and durable hemostasis in open and laparoscopic partial nephrectomies. The tissue sealant may provide a tool to expand the possibilities of laparoscopic nephron-sparing surgery.

Adult↗

[Post-traumatic priapism in a 10-year-old boy].

The case of a 10-year-old boy with post-traumatic priapism after perineal trauma is presented. Interdisciplinary treatment using angiography and selective catheter embolization for juvenile high-flow priapism is demonstrated. The literature and the diagnostic possibilities resulting from color duplex sonography are discussed.

Arteriovenous Fistula↗

Super-selective angiographic embolisation of a branch of the anterior pudendal artery for the treatment of intractable post-operative bleeding.

We describe a case of post-operative bleeding after a posterior fascial defect repair. This was refractive to exploration and vaginal packing so laparotomy would have been necessary. Superselective cannulation demonstrated bleeding from a branch of the anterior pudendal artery which had crossed the midline making identification difficult during vaginal exploration. The bleeding vessel was embolised using a mixture of PVA300 and Spongistan gel foam and the bleeding ceased. The use of embolisation in the peri-operative phase is discussed.

Angiography↗

Arterial embolization to control renal hemorrhage in patients with percutaneous nephrostomy.

Two patients with renal hemorrhage treated by arterial embolization are reported. In one patient, one kidney was injured and the another had poor function. The other patient had one kidney. Although both patients had hematuria and underwent percutaneous nephrostomy, the bleeding location was not detected angiographically. Repeated embolization and irrigations through a nephrostomy catheter following each embolization arrested the bleeding.

Adult↗

Embolization of large aneurysms with long wire coils.

The authors report the experience of using long coils of 2 m length in the management of large aneurysms. Knowledge of the characteristics of these coils is of value for correct placement. These coils are safe and cost-effective for excluding large aneurysms.

Aged↗

Embolization for hemoptysis: a six -year review.

PURPOSE: To review our method of embolization for hemoptysis. METHODS: Between 1993 and 1999, 134 patients were treated in our department for hemoptysis. One hundred and sixteen patients were followed up (18 were lost to follow-up) over a period ranging from 1 to 66 months (median 9.5 months, SD 14.81 months). Most cases were due to tuberculosis (83.6%) and malignancy (9.5%). One hundred and three required embolization. Vascular access was obtained via the femoral route but two cases required a brachial approach for abnormal branches of the subclavian artery. All abnormal vessels found were embolized using polyvinyl alcohol particles alone or in combination with gelfoam. RESULTS: Bronchial artery hypertrophy was found in 88.3% of cases; about a third of which had a nonbronchial systemic contribution. No angiographic abnormalities were found in 11.2%. Our failure rate was 18.4% (58% required surgery while 42% died from massive hemoptysis). Sixteen cases required multiple embolization sessions. No major complications were encountered. CONCLUSION: Embolization is effective for treatment of moderate to massive hemoptysis. The majority of our cases were due to tuberculosis. Approximately one third had nonbronchial systemic artery contributions, indicating that a concerted search for these is mandatory.

Angiography↗

Transcatheter arterial chemoembolization of liver tumors: effects of embolization protocol on injectable volume of chemotherapy and subsequent arterial patency.

The purpose of this study was to determine whether transcatheter arterial chemoembolization (TACE) protocol affects the total volume of chemotherapy injected into the liver as well as subsequent arterial patency. A total of 160 patients with primary or secondary liver cancer were treated with 3 different chemoembolization protocols at a single institution. Data were analyzed retrospectively. Group 1 (n = 36) consisted of slurry of chemotherapy, oil and polyvinyl alcohol particles (PVA), group 2 (n = 91), chemotherapy and oil followed by PVA, and group 3 (n = 33), chemotherapy and oil followed by Gelfoam pledgets. The total volume of chemotherapy injected into the liver was recorded. Arterial patency was determined during subsequent chemoembolizations. The mean percentage of total intended chemotherapy dose administered was 54.6% for group 1, 75.3% for group 2, and 80.6% for group 3. Arterial patency at follow-up angiography was 56% for group 1, 74% for group 2, and 81% for group 3. The slurry protocol (group 1) significantly reduced arterial patency and injectable volume of chemotherapy during TACE.

Angiography, Digital Subtraction↗