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At least 649 records · Page 36Linked to original sources
PubMed1985

Hepatic haemobilia: non-operative management in eight cases.

Eight cases of major haemobilia have been seen by the Surgical Hepatobiliary service at Westmead Hospital between 1979 and 1984. Two occurred following blunt abdominal trauma, three after percutaneous biliary drainage or liver biopsy, two in association with postoperative haemorrhagic pancreatitis and one because of an abscess complicating hepatic hydatid disease. Coeliac and superior mesenteric angiography were carried out in all patients, and false aneurysms were demonstrated in seven of the eight. A marked coagulopathy was present in the remaining patient, in whom bleeding stopped without intervention when the coagulopathy was reversed. Those with false aneurysms were treated by radiologically controlled transarterial embolization with gelfoam, acrylate or Gianturco coils, and bleeding was controlled in all. There was one death from overwhelming sepsis in the patient with the hepatic abscess. It is concluded that percutaneous radiologically controlled embolization is the treatment of choice for most cases of haemobilia, except when there is major hepatic sepsis.

Acute Disease↗
PubMed1986

Mediastinal carcinoid tumour: pre-operative arterial embolisation.

Carcinoid tumours of the mediastinum are very rare. They are frequently malignant and run a quite different course from that of the more benign thymomas. We report a 70 year old man with an anterior mediastinal tumour which was initially diagnosed as a thymoma but which was subsequently shown to be a carcinoid tumour. Surgical extirpation was greatly enhanced by pre-operative angiography and arterial embolisation of the tumour. Early and aggressive diagnostic attempts, pre-operative angiography, with or without arterial embolisation, and complete surgical excision offer the best hope of a cure for these malignant tumours.

Aged↗
PubMed1982

Arterial embolisation in renal carcinoma: a useful procedure?

Twenty-eight patients underwent embolisation over a 2-year period. III effects followed embolisation in 16 (57%), 2 of whom died. Attention is drawn to the intolerance of many patients to the length of the procedure. Of 24 patients undergoing operation, one case was inoperable and difficulty was encountered in 9. No perirenal plane of oedema was identified. No specimen examined histologically showed complete infarction. The tumour tissue was more resistant to infarction than normal kidney and 8 tumours (35%) appeared to have escaped completely. It is concluded that the role of embolisation is limited and that a combination of methods for achieving adequate arterial occlusion must be used for the optimum effect.

Embolization, Therapeutic↗
PubMed2005

Local radiotherapy as a complement to incomplete transcatheter arterial chemoembolization in locally advanced hepatocellular carcinoma.

PURPOSE: In order to determine the effect of additional radiotherapy (RT) after an incomplete transcatheter arterial chemoembolization (TACE) in an unresectable hepatocellular carcinoma (HCC), the treatment results of patients receiving TACE plus RT were analyzed and compared with those treated with TACE alone. MATERIALS AND METHODS: One hundred and five patients with an unresectable HCC were treated with TACE from January 1992 to December 2002. In 73 of these patients, the TACE was incomplete. Among them, TACE was repeatedly performed in 35 patients (TACE group), and the remaining 38 patients were also treated with local RT (TACERT group). The patients were either in stage III or IVa, Eastern Cooperative Oncology Group 2 or less, and Child-Pugh class A or B. The average frequency of TACE prior to RT was 2 and the RT was started within 7-10 days after the TACE. RESULTS: The 2-year survival rate was significantly higher in the TACERT than in the TACE group (36.8 % vs. 14.3%, P=0.001). According to the tumor size, the 2-year survival rates in the TACERT and TACE groups were 63% vs. 42% in 5-7 cm (P=0.22), 50% vs. 0% in 8-10 cm (P=0.03), and 17% vs. 0% in larger than 10 cm (P=0.0002) respectively. CONCLUSION: There was a significantly improved survival rate in the TACERT group of unresectable HCC patients than in the TACE group, particularly in case of tumors > or =8 cm in diameter. Therefore, RT in addition to TACE is strongly recommended for patients with an unresectable HCC.

Antibiotics, Antineoplastic↗
PubMed2005

A three-dimensional in vitro model system to study the adaptation of craniofacial skeletal muscle following mechanostimulation.

The aim of this study was to investigate the in vitro response of human craniofacial muscle-derived myotubes (primitive/nascent muscle fibres), in three-dimensional constructs, to strain in vitro to mimic clinical scenarios, using expression of the mechanoresponsive gene gelatinase-A/matrix metalloproteinase-2 (MMP-2) as a marker of remodelling of muscle extracellular matrix. Three-dimensional (3D) constructs of cells derived from explants of human masseter muscle (human craniofacial muscle-derived cells; hCMDC) in collagen sponges were subjected to mechanical, uniaxial strain using the Bio-Stretch system. 3D myotube constructs were exposed to the strain regimes of rapid ramp stretch (RRS) or cyclical ramp strain (CRS) with 7.5% and 15% strain. The activity of MMP-2 was assessed by zymography of construct-conditioned medium, whilst lysates of the constructs were used to measure creatine phosphokinase (CPK) activity to confirm the presence of myotubes in the strained constructs. Scanning electron microscopy of the collagen sponges and the CPK assays confirmed the presence of myotubes. MMP-2 was expressed by all the samples and controls, but expression was found to be significantly higher in those cultures strained continuously (RRS), compared to cyclical strain (CRS), and in those strained at 15% compared to 7.5%. Thus, MMP-2 expression, and hence extracellular matrix remodelling, is up-regulated in response to strain and is dependent upon the amount and type of strain to which the muscle is subjected.

Adaptation, Physiological↗
PubMedDate not supplied

Managing patients on warfarin therapy: a case report.

Coagulotherapy is a common therapeutic regimen most frequently utilizing warfarin. This therapy may have important dental ramifications. An understanding of the mechanisms of action and drug interactions may help avoid problems. Questions commonly arise as to what dental procedures may be safely considered when a patient is on anticoagulant therapy. The coagutherapy level is measured in values of the International Normalized Ratio (INR). Any question about the appropriateness of dental procedures should be referred to the physician prescriber of the anticoagulant therapy. Generally, controlling bleeding is less of a problem than the management of thrombi and vascular occlusion from decreased coagutherapy. A case is presented in which the INR reached a critical value as the result of drug interactions and miscommunication.

Anti-Bacterial Agents↗
PubMed1981

Peroperative protection of cornea and conjunctiva.

In 221 consecutive cataract extractions the peroperative epithelial damage was assessed by vital staining with 1% lissamine green, using logarithmic grading (grade 5 more than 10 000 stained dots) on cornea and on the superior, medial, lateral, and inferior conjunctiva. Evenly spread dots were seen on the cornea in 63 per cent of the eyes not subjected to protective treatment. In 35 per cent we observed staining caused by taut suturing of cornea and/or conjunctiva, in 10 per cent horizontal lines due to corneal bending during the extraction. The cornea was protected most effectively by healon (1% instilled once). Saline (4 or 5 instillations during the operation sufficed) protected equally well as gelatin sponge, methylcellulose, polyvinyl alcohol, and a soft contact lens. The inferior conjunctiva was protected only by healon, the superior also by saline, gelatin sponge, and polyvinyl alcohol.

Adult↗
PubMed2005

Sealing effectiveness of materials used in furcation perforation in vitro.

OBJECTIVES: In this study the sealing ability of various materials used to repair furcation perforations was evaluated. DESIGN: Ninety human molars were endodontically treated and a perforation was made in the pulp chamber floor using a round bur. The teeth were inserted into a moistened flower sponge and perforation sites were sealed with one of the following materials: Mineral Trioxide Aggregate (ProRootM), Super-EBA, Vitremer, Hemarcol together with Super-EBA, Hemarcol together with Vitremer, Tricalcium phosphate together with AH26, Cavit W and amalgam. After eight months, the sealing effectiveness of the materials was evaluated in a double-blinded trial under a video-microscope by detecting the penetration of silver nitrate solution (50%w/w) in longitudinal tooth sections. RESULTS: Perforation sites filled with Hemarcol together with Vitremer or with MTA exhibited statistically less silver stain penetration while Cavit W or Tricalcium phosphate together with AH26 sealer failed to effectively seal the perforation sites. CONCLUSIONS: MTA alone or Vitremer in combination with a collagen sponge can be used effectively in the treatment of perforations in a furcation area.

Aluminum Compounds↗
PubMed1974

Gel-foam granuloma in the brain.

A case is recorded in which a large giant cell reaction to gel-foam is noted after its use in neurosurgery. This caused blockage to the flow of cerebrospinal fluid and also thrombosis of superficial vessels of the brain with subsequent infarction. We recognize the value of gel-foam as a haemostatic agent in neurosurgery but wish to warn against its use too close to viable cerebral tissue, as it can induce a marked giant cell granulomatous reaction.

Adult↗
PubMed1997

Solitary ileocolic arteriovenous malformation: spongostan and silk therapeutic embolisation.

A debilitated patient with liver cirrhosis and poor haemostasis had a severe lower gastrointestinal haemorrhage. A superior mesenteric arteriogram revealed an early persistent and promiment draining vein in the ileocolic artery. Two fragments of Spongostan and silk were used to embolise the bleeding artery and the haemorhage ceased immediately. No infarction of the embolised area was observed and the bleeding was controlled.

Arteriovenous Malformations↗