Interventional Management of a Renal Cell Carcinoma by Radiofrequency Ablation with Tagging and Cooling

Over the last few years, percutaneous radiofrequency (RF) ablation has been successfully established as a viable treatment modality for small peripheral renal cell carcinoma (RCC). This technique is limited by central tumor location and tumor size. We report the interventional management of a 5.3 cm mixed RCC with central and exophytic parts by combining the RF ablation with embolization, tagging, and retrograde, as well as anterograde cooling. The potential pitfalls of complex hybrid interventions for treating RCC are discussed.

The Current Practice of Transarterial Chemoembolization for the Treatment of Hepatocellular Carcinoma

Despite remarkable advancement in the surveillance and treatment of hepatocellular carcinoma (HCC) and the availability of novel curative options, a great proportion of HCC patients are still not eligible for curative treatment due to an advanced tumor stage or poor hepatic functional reserve. Therefore, there is a continuing need for effective palliative treatments. Although practiced widely, it has only recently been demonstrated that the use of transarterial chemoembolization (TACE) provides a survival benefit based on randomized controlled studies. Hence, TACE has become standard treatment in selected patients. TACE combines the effect of targeted chemotherapy with the effect of ischemic necrosis induced by arterial embolization. Most of the TACE procedures have been based on iodized oil utilizing the microembolic and drug-carrying characteristic of iodized oil. Recently, there have been efforts to improve the delivery of chemotherapeutic agents to a tumor. In this review, the basic principles, technical issues and complications of TACE are reviewed and recent advancement in TACE technique and clinical applicability are briefed.

Caffeine clearance in patients with hepatocellular carcinoma after transcatheter oily chemoembolization treatment.

BACKGROUND: Hepatocellular carcinoma (HCC) is a common neoplasm worldwide, particularly in Asia, with a grave prognosis. Transcatheter Oily Chemoembolization (TOCE) is now universally accepted as the method of choice for the treatment of inoperable HCC. The purpose ofthis study was to evaluate caffeine clearance, a quantitative liver function assessment, in HCC patients before and after treatment with TOCE. METHOD: Both conventional liver function test (LFT) and caffeine clearance were evaluated in twelve patients. Each patient took a 3.5 mg/kg single oral dose of caffeine solution before TOCE, 1 day and 5 weeks after treatment. Blood samples were subsequently collected at 0.5, 1.5, 3, 5, 10 and 24 hours after each dose of caffeine administration and assayed for serum caffeine level by the HPLC technique. Clearance (Cl) was calculated using the equation of Cl = Kel x Vd (Kel = elimination rate constant, Vd = volume of distribution) and half-life was determined using pharmacokinetic analysis. RESULTS: The mean caffeine clearance 1 day after TOCE (0.51 +/- 0.096) and 5 weeks after TOCE treatment (0.43 +/- 0.07) was significantly reduced compared with the mean caffeine clearance before treatment (0.79 . 0.2 ml/min x kg) with the p = 0.06 and p = 0.03, respectively. No significant changes (p > 0.05) in most conventional LFT were observed 5 weeks after treatment. CONCLUSIONS: In the present study, the authors found that caffeine clearance was reduced after TOCE in patients with HCC inspite of no changes in conventional LFT. Thus, the determination of caffeine clearance can serve as a useful parameter for the assessment of hepatic functional reserve in HCC patients post TOCE treatment.

Quimioembolización selectiva con adriamicina-urografin-lipiodol, en el tratamiento del hepatocarcinoma / Embolization with adriamycin-urographin-lipiodol in patients with liver carcinoma

Various methods of regional chemotherapy have been used in patients with non ressectable hepatic carcinoma. We report our preliminary experience with embolization using adrimycin-urographin-lipiodol in 2 patients with this cancer in whom a considerable reduction of tumoral mass was observed. The pertinent literature is briefly commented

Experiencia personal en el uso del lipiodol ultrafluido en las fístulas urogenitales iatrogénicas: nueva modalidad de tratamiento / Personal experience in the use of ultrafluid lipiodol in iatrogenic genitourinary fistulas: a new treatment modality

Apoyados en la propiedad que tiene el lipiodol de estimular la granulación de los tejidos, se utiliza con resultados exitosos en el tratamiento de las fístulas urogenitales, secuelas de accidentes quirúrgicos y obstétricos, lo cual queda corroborado por los casos curados mediante la instilación vesical del mismo. Con este nuevo procedimiento, se evita realizar una nueva intervención quirúrgica a estas pacientes con pocas posibilidades de curación mediante la cirugía

Estudo histomorfológico do tecido conjuntivo subcutâneo do rato ao implante de pastas à base de hidróxido de cálcio, contidas em tubos de dentina humana / Histomorphologic study of the subcutaneous connective tissue reactions of rat, due to the implantation of calcium hydroxide pastes contained in human dentin tubes

Foram utilizados 36 ratos, albinos, machos, adultos jovens, divididos em 3 grupos, de 12 animais cada, agrupados inicialmente em gaiolas para 3 indivíduos. Os animais receberam implantes de tubos de dentina humana contendo as seguintes pastas: Grupo I - Hidróxido de cálcio + Polietileno glicol 400; Grupo II - Hidróxido de cálcio + Lipiodol (ultrafluido) e Grupo III - Hidróxido de cálcio + Paramonoclorofenol canforado 2,5:7,5. Decorridos os períodos de 30, 60, 90 e 120 dias, os animais foram recuperados e as áreas circunjacentes aos implantes, removidas e preparadas para estudo histológico. Os resultados microscópicos mostraram que as misturas correspondentes aos Grupos I, II e III, comportaram-se como irritantes de tecido conjuntivo subcutâneo do rato, possibilitando no entanto cápsula em colagenizaçäo progressiva no decorrer dos períodos