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1.
Eur J Radiol ; 89: 277-283, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27908612

ABSTRACT

PURPOSE: To evaluate the safety and efficacy of polyvinyl alcohol (PVA) terminal chemoembolization and to identify the prognostic factors associated with survival in hepatocellular carcinoma (HCC) patients with hepatic arteriovenous shunts (HAVS). MATERIALS AND METHODS: Of 133 patients' managements were retrospectively analyzed. HAVS was classified into three types: slow-flow, intermediate-flow and high-flow. The size of the PVA used was determined following the scheme: slow-flow HAVS: 300-500µm PVA; intermediate-flow HAVS: 500-710µm PVA; high-flow HAVS: 710-1000µm PVA. The HCCs with slow-flow and intermediate-flow HAVS were embolized by PVA plus chemotherapeutic agents lipiodol emulsion, while the high-flow HAVS were treated by PVA with chemotherapeutic agents. Survival curves were calculated by Kaplan-Meier method and compared by log-rank test. The influence of possible prognostic factors on survival were analyzed by multivariate Cox proportional-hazards method. RESULTS: The median overall survival (OS) of 133 patients was 9.1 months. The median OS of the slow-flow type, intermediate-flow type and high-flow type patients were 10.8, 9.1 and 7.3 months, respectively. There was no statistically significant difference among different HAVS types (P=0.239). The 30-day mortality was 3.8%. Cox multivariate survival analysis revealed that initial preoperative AFP value≥400ng/ml (HR=2.105, P=0.006) was an independent risk factor. While multiple embolization (HR=0.482, P=0.011), tumor remission (HR=0.431, P=0.041) and multimodality therapy (HR=0.416, P=0.004) were independent protection factors. CONCLUSION: It is safe and effective for HCCs with HAVS treated by terminal chemoembolization therapy with PVA plus chemotherapeutic agents lipiodol emulsion (or PVA plus chemotherapeutic agents). The HCCs with HAVS achieves good prognosis with multiple embolization, tumor remission and multimodality therapy, while achieves poor prognosis with inital preoperative high AFP value (≥400ng/ml).


Subject(s)
Antineoplastic Agents/administration & dosage , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Liver Neoplasms/therapy , Polyvinyl Alcohol/administration & dosage , Adult , Aged , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/pathology , Chemoembolization, Therapeutic/mortality , Ethiodized Oil/administration & dosage , Female , Humans , Kaplan-Meier Estimate , Liver Neoplasms/mortality , Liver Neoplasms/pathology , Male , Middle Aged , Portasystemic Shunt, Surgical/mortality , Prognosis , Retrospective Studies , Risk Factors , Treatment Outcome
2.
J Vasc Interv Radiol ; 22(8): 1216-20, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21801998

ABSTRACT

This study describes fluoroscopy-guided percutaneous intratumoral injection therapy (PIIT) with a pingyangmycin lipiodol emulsion in the management of recurrent sacrococcygeal chordomas after surgical excision. Seven patients underwent a total of 22 treatment sessions (3-4 sessions per patient); treatment responses were evaluated clinically, and lesion size was determined using computed tomography (CT). Over 10-26 months of follow-up, tumor sizes and visual analogue scale (VAS) scores of all patients were decreased. No patients had complications during the follow-up period. Preliminary results showed that PIIT with pingyangmycin lipiodol emulsion under fluoroscopic guidance is effective and safe and may be considered as a treatment option.


Subject(s)
Antibiotics, Antineoplastic/administration & dosage , Bleomycin/analogs & derivatives , Chordoma/drug therapy , Ethiodized Oil/administration & dosage , Spinal Neoplasms/drug therapy , Adult , Aged , Bleomycin/administration & dosage , Contrast Media/administration & dosage , Emulsions , Female , Fluoroscopy , Humans , Injections, Intralesional , Iopamidol/administration & dosage , Male , Middle Aged , Neoplasm Recurrence, Local , Pain Measurement , Radiography, Interventional , Retrospective Studies , Sacrococcygeal Region , Treatment Outcome
3.
Nan Fang Yi Ke Da Xue Xue Bao ; 29(12): 2504-5, 2509, 2009 Dec.
Article in Chinese | MEDLINE | ID: mdl-20034914

ABSTRACT

OBJECTIVE: To summarize our 10-year experience with percutaneous fluoroscopically guided removal (PFGR) of metallic foreign body (MFB) in the soft tissue. METHODS: PFGR was performed in 65 patients for removing a total of 368 MFBs from the soft tissues. The MFBs ranged from 0.2 to 0.3 cm in length embedded in the soft tissue for 7 days to 8 years. For superficial MFBs, the MFBs were removed directly with curved forceps under real time fluoroscopy. For deep MFBs, trocar technique was applied using the instruments for percutaneous diskectomy, with the outer cannula inserted toward the foreign body under real-time fluoroscopy followed by MFB removal by grasping forceps. RESULTS: A total of 346 MFBs were successfully removed without any serious complications (success rate 94.0%), including 154 removed directly and 192 MFBs with trocal technique. The time of the procedures and radiation exposure for MFB removal was 30 s to 20 min and 1-6 min, respectively. CONCLUSION: PGFR of MFBs in the soft tissue under fluoroscope is safe and effective. Direct removal using curved forceps is suitable for MFBs in superficial soft tissues, while trocal techniques needs to be utilized for deep MFBs.


Subject(s)
Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Metals , Radiography, Interventional , Adolescent , Adult , Child , Female , Fluoroscopy/methods , Humans , Lower Extremity , Male , Young Adult
4.
Cardiovasc Intervent Radiol ; 31(6): 1133-40, 2008.
Article in English | MEDLINE | ID: mdl-18584240

ABSTRACT

Our purpose was to study necrosis and apoptosis of hepatocellular carcinoma (HCC) cells after preoperative transcatheter arterial chemoembolization (TACE) with use of low-dose and high-dose anticancer drugs in HCCs. Fifty-four patients with advanced but surgically resectable HCC were studied. Thirty-four patients who elected to undergo preoperative superselective TACE were randomized to low- and high-dose TACE. Patients in group A (n = 16) received low-dose anticancer drugs: 2 mg mitomycin C (MMC), 10 mg epirubicin (EPI), and 100 mg carboplatin (CBP). Patients in group B (n = 18) were given high doses of anticancer drugs (10 mg MMC, 40 mg EPI, and 300 mg CBP). Hepatic resection was subsequently performed. Group C comprised 20 patients who underwent resection without TACE. In all patients the necrosis rates and apoptosis index of tumor cells were evaluated by pathologic examinations and terminal deoxynucleotidyl transferase-mediated nick-end labeling assay. There was no significant difference between group A and group B in tumor response (p [ 0.05) after TACE. Necrosis rates in groups A, B, and C were 88.4 +/- 11.1%, 87.1 +/- 12.5%, and 7.3 +/- 3.5%, respectively. There was no significant difference between group A and group B (p [ 0.05), while statistical difference was found between group A and group C (p \ 0.001) and between group B and group C (p \ 0.001). Apoptosis indexes in the three groups were 11.0 +/- 4.0%, 10.7 +/- 3.9%, and 5.6 +/- 2.6%, respectively. Statistical difference exhibited between group A and group C (p \ 0.001) and group B versus group C (p \ 0.001). No significant difference was observed between group A and group B (p [ 0.05). In conclusion, superselective TACE with low- and high-dose chemotherapeutic agents induced similar degrees of cellular apoptosis and necrosis.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Liver Neoplasms/therapy , Adult , Aged , Analysis of Variance , Apoptosis , Biomarkers, Tumor/analysis , Carboplatin/administration & dosage , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/surgery , Chi-Square Distribution , Combined Modality Therapy , Disease Progression , Dose-Response Relationship, Drug , Epirubicin/administration & dosage , Female , Humans , Liver Function Tests , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Male , Middle Aged , Mitomycin/administration & dosage , Necrosis , Statistics, Nonparametric , Treatment Outcome
5.
Chin Med J (Engl) ; 121(2): 143-6, 2008 Jan 20.
Article in English | MEDLINE | ID: mdl-18272041

ABSTRACT

BACKGROUND: Endothelial progenitor cells (EPCs) derived from bone marrow may differentiate into endothelial cells and participate in endothelial repair. These cells can be mobilized into peripheral blood by cytokines, including granulocyte colony-stimulating factor (G-CSF). In the present study, we investigated the effects of G-CSF on neointimal formation and restenosis in a canine model of arterial balloon injury. METHODS: Sixteen male beagle dogs were injected subcutaneously with 20 microg x kg(-1) x d(-1) recombinant human G-CSF (n = 8) or normal saline (n = 8) for 1 week. On the fifth day of treatment, the dogs underwent renal arterial angioplasty. At 8 weeks after arterial balloon injury, angiographic observations were made and injured arteries were processed for morphometric analysis of neointimal formation. RESULTS: Peripheral white blood cell counts were increased by 3.34-fold compared to baseline on the fifth day of administration of G-CSF. Angiographies revealed that one stenosis had occurred among the eight injured renal arteries from dogs treated with G-CSF, whereas all injured renal arteries from dogs treated with normal saline remained patent. The mean extent of stenosis among injured arteries was 18.3% +/- 17.9% in the G-CSF treated group compared to 12.5% +/- 7.6% in the saline treated control group (P = 0.10). G-CSF treatment slightly increased neointimal thickness (0.42 +/- 0.15 mm vs 0.25 +/- 0.06 mm, P = 0.08) with an intima to media ratio of 0.83 +/- 0.49 vs 0.54 +/- 0.18 (P = 0.11). CONCLUSIONS: G-CSF treatment does not attenuate neointimal hyperplasia and restenosis formation in a canine model of renal arterial injury, suggesting that the therapeutic strategy for preventing restenosis by stem cell mobilization should be investigated further.


Subject(s)
Granulocyte Colony-Stimulating Factor/pharmacology , Hematopoietic Stem Cell Mobilization , Renal Artery/injuries , Animals , Dogs , Hyperplasia , Male , Recombinant Proteins , Renal Artery/pathology , Tunica Intima/pathology
6.
Nan Fang Yi Ke Da Xue Xue Bao ; 28(2): 293-5, 2008 Feb.
Article in Chinese | MEDLINE | ID: mdl-18250067

ABSTRACT

OBJECTIVE: To assess value of endovascular graft exclusion (EVGE) with digital subtraction angiography (DSA) in the treatment of Stanford type B aortic dissection (AD). METHODS: On the basis of diagnosis with multi-slice spiral CT (MSCT), DSA was performed in 20 Stanford B AD cases for further diagnostic confirmation and EVGE was conducted for treatment. The DSA findings of the cases and the therapeutic effect of EVGE were evaluated. RESULTS: In the 20 cases of Stanford type B AD, altogether 22 stents were implanted during EVGF with a stent release success rate of 100%. Postoperative examination revealed no obvious leakage or false lumen in 15 cases, and death occurred in 1 case 6 days after the operation due to right renal hemorrhage and infection, and the rest 19 patients were cured and discharged. Follow-up of the patients demonstrated improvement in the clinical symptoms, and MSCT showed that all the dissections were sealed successfully. No severe complications were observed 3 months after the treatment in these patients. CONCLUSION: DSA can identify the fine anatomy of AD and allowed intraoperative monitoring in EVGE, which is an effective and safe means for treatment of Stanford type B AD.


Subject(s)
Angiography, Digital Subtraction/methods , Aortic Aneurysm/diagnostic imaging , Aortic Aneurysm/surgery , Aortic Dissection/diagnostic imaging , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation/methods , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Stents , Tomography, Spiral Computed , Treatment Outcome
7.
Nan Fang Yi Ke Da Xue Xue Bao ; 27(9): 1391-5, 2007 Sep.
Article in Chinese | MEDLINE | ID: mdl-17884786

ABSTRACT

OBJECTIVE: To investigate the changes of ataxia-telangiectasia mutated (ATM) phosphorylation in HepG(2) cells in relation to HepG(2) cell survival under continuous low dose-rate irradiation. METHODS: HepG(2) cells were exposed to equivalent irradiation doses delivered at either a continuous low dose-rate (7.76 cGy/h) or a high dose-rate (4500 cGy/h), and the phosphorylated ATM proteins and surviving fraction of HepG(2) cells after the exposures were compared. RESULTS: The phosphorylation of ATM protein was maximal at 0.5 Gy irradiation delivered at either a high doserate or a continuous low doserate. As the radiation dose increased, ATM protein phosphorylation decreased under continuous low dose-rate irradiation, but remained stable under high dose-rate irradiation. With comparable ATM protein phosphorylation induced by continuous low dose-rate irradiation and high dose-rate irradiation, there was no significant difference in the surviving fraction of HepG(2) cells (P>0.05), but at a significantly lower ATM protein phosphorylation level than that induced by high dose-rate irradiation, continuous low dose-rate irradiation resulted in increased cell killing (P<0.01). CONCLUSION: Continuous low dose-rate irradiation increases HepG(2) cells radiosensitivity as compared with high dose-rate irradiation. Increased cell killing following continuous low dose-rate irradiation is associated with reduced phosphorylated ATM protein, and inhibition of ATM phosphorylation may increase the radiosensitivity of HepG(2) cells.


Subject(s)
Cell Cycle Proteins/metabolism , DNA-Binding Proteins/metabolism , Protein Serine-Threonine Kinases/metabolism , Radiation Tolerance/radiation effects , Tumor Suppressor Proteins/metabolism , Animals , Ataxia Telangiectasia Mutated Proteins , Cell Line, Tumor , Cell Survival/radiation effects , Dose-Response Relationship, Radiation , Humans , Mice , Phosphorylation/radiation effects , Time Factors
8.
Nan Fang Yi Ke Da Xue Xue Bao ; 27(5): 675-8, 2007 May.
Article in Chinese | MEDLINE | ID: mdl-17545087

ABSTRACT

OBJECTIVE: To evaluate the safety of iodine-125 seed implantation in the liver. METHODS: Twenty New Zealand rabbits were divided into control and treatment groups and in the latter, iodine-125 seeds of 37 MBq were implanted into the liver under CT guidance whereas nonradioactive seeds were implanted in the control rabbits. Four weeks after implantation, white blood cell count, liver functions, and renal functions were measured or evaluated for comparison with those before implantation. The rabbits were then anesthetized to collect the liver tissue for pathological examination with HE staining and cell apoptosis assay. RESULTS: Obvious hepatic tissue necrosis was observed around the radioactive seeds in the treatment group. At a 5 mm distance to the seeds, a distinct boundary occurred between the necrotic hepatic cells and normal cells. The control rabbits, however, had normal liver structure around the seeds implanted. In situ cell apoptosis examination showed a distinct band of apoptotic cells in the liver tissue of rabbits in the treatment group, which was not found in the control group. Two weeks after iodine-125 irradiation, alanine aminotransferase significantly increased in the treatment group (t=6.285, P<0.001), but recovered two weeks later (t=2.002, P=0.06). No significant alterations occurred in aspartate aminotransferase, blood urea nitrogen, serum creatinine, hemoglobin, serum total bilirubin, white blood cell count, or platelet count after the seed implantation. CONCLUSION: Iodine-125 seed implantation in the liver results in conformal irradiation dose distribution without obvious effects on the vital organs, demonstrating iodine-125 seed implantation as a safe and minimally invasive technique for hepatic cancer treatment.


Subject(s)
Iodine Radioisotopes/adverse effects , Liver/radiation effects , Radiation Injuries, Experimental/etiology , Alanine Transaminase/blood , Animals , Apoptosis/radiation effects , Dose-Response Relationship, Radiation , In Situ Nick-End Labeling , Liver/pathology , Liver/physiopathology , Male , Rabbits , Radiation Injuries, Experimental/blood , Radiation Injuries, Experimental/pathology , Random Allocation , Time Factors
9.
Nan Fang Yi Ke Da Xue Xue Bao ; 27(3): 384-6, 2007 Mar.
Article in Chinese | MEDLINE | ID: mdl-17426000

ABSTRACT

OBJECTIVE: To evaluate the feasibility of no antibiotic administration to prevent infection during the perioperative period of percutaneous intradiscal ozone-injection for treatment of lumbar disc herniation. METHODS: Seventy-two patients with lumbar disc herniation but normal body temperature as well as normal results of three routine tests (blood, urine, stool) and C-reactive protein (CRP) level were randomly divided into two groups. The patients in prophylaxis group were given cephalothin V(2.0 g) intravenous 30 min before the operation, and the control group did not use any antibiotics. All the patients were injected with 6-10 ml ozone (40 microg/ml) for medical use into the discs with 21G needles under fluoroscopic guidance, followed by 10 ml ozone into the paravertebral space. Three days later the general examinations and CRP measurement were repeated. RESULTS: No infection was found in these patients, nor were any significant differences noted in the results of the examinations between the two groups after controlling in patients with above-normal white blood cell count, neutrophil percentage and CRP level. CONCLUSION: Prophylaxis antibiotics is not necessary during the perioperative period of percutaneous intradiscal ozone injection for lumbar disc herniation.


Subject(s)
Intervertebral Disc Displacement/drug therapy , Lumbar Vertebrae , Oxygen/administration & dosage , Ozone/administration & dosage , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Cefazolin/therapeutic use , Drug Therapy, Combination , Female , Humans , Injections, Intralesional , Intervertebral Disc Displacement/diagnostic imaging , Male , Middle Aged , Perioperative Care , Radiography
10.
Di Yi Jun Yi Da Xue Xue Bao ; 24(2): 232-4, 2004 Feb.
Article in English | MEDLINE | ID: mdl-14965839

ABSTRACT

OBJECTIVE: To explore the diagnostic value of angiography in small kidney patients. METHODS: Angiographies were performed in 32 patients with small kidney of unknown etiology or with suspected renal arterial stenosis (RAS). RESULTS: Twelve cases of renal atrophy due to RAS were diagnosed by angiography, which demonstrated renal artery stenoses or occlusions. Angiography of 17 patients with nephrogenic renal atrophy displayed homogeneous shrinkage of the renal arteries except in the ostium. In 3 patients with renal hypoplasia, angiography showed narrowed renal arteries and tiny renal arterial branches. CONCLUSION: Renal artery angiography is of important values in the differential diagnosis between renal atrophy due to RAS, nephrogenic renal atrophy and non-renovascular renal atrophy, and renal hypoplasia.


Subject(s)
Kidney/abnormalities , Kidney/pathology , Renal Artery/diagnostic imaging , Adult , Aged , Atrophy , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Radiography , Renal Artery Obstruction/diagnostic imaging , Retrospective Studies
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