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Biologic evaluation of SPAD. I. A comparison between the tissue reactions to SPAD, Gelfoam, and silver amalgam.

The biologic properties of Traitement SPAD, a material suggested for filling root canals and the periapical region in cases of periapical involvement, were tested and compared with those of Gelfoam and silver amalgam. Empty polyethylene tubes were used as a negative control. The reactions of the subcutaneous tissues of rats to the test and to the control materials are reported. The initial tissue reaction to SPAD was very mild. However, this reaction increased with time to become moderate and persisted throughout the period of the study with no signs of absorption of the material. The inflammatory response to Gelfoam was initially greater. However, it decreased with time and the material was removed by the macrophages with subsequent reduction in the size of the surgical gap. The greatest inflammatory reaction was recorded after the use of silver amalgam, with the formation of capsules around the specimens, indicating that the material was extremely irritant before it had set. The longer the silver amalgam remained in situ, the milder the tissue reaction became.

Animals↗

An evaluation of 9-aminoacridine/Gelfoam to reduce dry socket formation.

This clinical study was undertaken to evaluate the effectiveness of locally applied 9-aminoacridine in Gelfoam in reducing the incidence of dry socket formation after third molar extractions. Results indicated that this technique was not effective. The incidence of dry socket formation in smokers and nonsmokers was compared. Also, the influence of surgical trauma on dry socket formation was examined.

Aminacrine↗

Postoperative radiographic appearance of intracranial hemostatic gelatin sponge.

Hemostatic gelatin sponges were placed in hemispheric defects created in four dogs which were then periodically scanned by computed tomography to determine the postoperative appearance of the sponges. The hemostatic sponges appeared as low attenuation regions for 7-10 days. The attenuation value of these Gelfoam cavities was intermediate between fat and air. Subsequently, clinical cases were selected in which the location of gelatin sponges were known to demonstrate the appearance of the material in patients. In addition to enhancing the accuracy of computed tomographic interpretation, we have found that the gelatin sponge can be useful as a transient computed tomography marker for localization of surgical activity.

Adolescent↗

Percutaneous transfemoral renal artery occlusion in patients with renal carcinoma. Preliminary report.

Twenty-four patients have undergone percutaneous transfemoral selective renal artery occlusion as part of their management for renal carcinoma. Preoperative infarction was performed in 7 cases. This facilitated surgery by eliminating the major blood supply to the tumor and resulted in collapse of the large collateral veins and created edema within the perirenal tissue. In 17 patients with visceral metastases, tumor infarction was performed in lieu of nephrectomy for control of the primary lesion and in hopes of stimulating an autoimmune response. The current status of this procedure s discussed in light of its indications, complications, and preliminary results.

Acute Kidney Injury↗

Transcatheter embolization of renal arteriovenous fistula.

A patient with malignant hypertension and acute renal failure underwent percutaneous renal biopsy which resulted in the creation of an arteriovenous fistula that communicated with the renal pelvis. Successful segmental embolization with gelatin sponge (Gelfoam) was achieved via a transcatheter approach.

Adult↗

Transcatheter angiographic control of bleeding.

The therapeutic uses of transcatheter angiographic techniques are reviewed, and the applications in various organ systems are described. Recent experiences in the urinary tract are discussed as well as our experience in a case of radiation cystitis and recurrent bladder tumor.

Aged↗

Widespread dissemination of gelfoam particles complicating occlusion of renal circulation.

Embolization of renal circulation by Gelfoam particles in a thirty-two-year-old man with renal carcinoma was followed by retrograde regurgitation of the injected particles upstream, with resultant occlusion of the celiac trunk and the superior mesenteric artery. This was followed by a stormy clinical course, which the patient survived. Several possible explanations are offered for the occurrence of this complication.

Adult↗

Fibroblast growth on a porous collagen sponge containing hyaluronic acid and fibronectin.

We have previously shown that the presence of fibronectin (FN) and/or hyaluronic acid (HA) in a 3-dimensional type I collagen sponge enhances wound healing in vivo. In the present study the same material was used as a support for growth of fibroblasts in vitro. Using radiochemical techniques, scanning electron and light microscopy, the properties of fibroblasts cultured on the collagen sponge or on the sponge containing HA or FN have been compared with cultures grown on plastic dishes. Fibroblast replication and collagen synthesis were higher on plastic than on the collagen sponge. In the presence of HA or FN the entire thickness of the sponge was infiltrated by fibroblasts which rapidly replicated. The presence of HA or FN increased synthesis of collagen which was largely deposited around cells.

Animals↗

Phagocytosis of myelin by astrocytes in explants of adult rabbit cerebral white matter maintained on Gelfoam matrix.

The role of astrocytes in the process of demyelination has been controversial. A culture system in which explants of adult cerebral rabbit white matter were maintained on a Gelfoam matrix was used for evaluating the phagocytosis of myelin by astrocytes without an influx of phagocytic cells derived from actively circulating blood-borne cells. Adult neurons were not viable for more than a few days in these explant cultures, thus resulting in empty myelin sheaths following loss of their axons. After 7 days in vitro, astrocytes, recognized by positivity for glial fibrillary acidic protein by electron microscopic immunocytochemistry, contained numerous membrane-bound vesicles filled with myelin in various stages of degradation. Although the majority of macrophage-like cells were negative for glial fibrillary acidic protein, a minority were positive, in spite of the lack of bundles of intermediate filaments, and were interpreted as astrocytic. Astrocytes were also often positive for glutamine synthetase. This study presents evidence suggesting that astrocytes may actively participate in the phagocytosis and degradation of myelin, a function generally attributed to reactive macrophages.

Animals↗

A randomized trial of hepatic arterial chemoembolization in patients with unresectable hepatocellular carcinoma.

A randomized trial of hepatic arterial chemoembolization was conducted in 42 patients with unresectable hepatocellular carcinoma. These patients represented 41% of patients with hepatocellular carcinoma seen during the inclusion period. In the remaining 59%, 9% had resectable tumours and 50% had unresectable tumours with contraindication for chemoembolization. Patients received either repeated chemoembolization with gelfoam powder and doxorubicin (group 1) or symptomatic treatment (group 2). There was no difference in age, prevalence of cirrhosis or staging according to Okuda between the two groups of patients. A complete tumour response (assessed by arteriography, ultrasonography and serum alphafetoprotein) was observed in four patients, and a partial response in three other patients from group 1. Actuarial survival rates were 33 and 24% in group 1 and 52 and 31% in group 2 at 6 and 12 months, respectively (differences were not significant--logrank test). With the treatment used in our study, chemoembolization did not prolong the survival time of patients with unresectable hepatocellular carcinoma. There were, however, some complete or partial responses. The high spontaneous 1-year survival rate of untreated patients was probably due to the exclusion of the most severely ill patients. Our results do not support the use of this method of chemoembolization in the treatment of hepatocellular carcinoma.

Adult↗