Radiofrequency ablation of subcapsular hepatocellular carcinoma: single center experience.

PURPOSE: To present a single center results, regarding radiofrequency ablation (RFA) of subcapsular hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Forty patients with subcapsular HCC were treated with RFA under CT guidance for fifty-two discrete lesions in our institution. Twenty-eight patients underwent ablation of a solitary tumor and twelve patients underwent RFA of two tumors. Six patients had a subcapsular HCC with an exofitic location. All lesions had a diameter of <4 cm. We used two types of generators and electrodes: spiral electrode and expandable electrode. Needle track ablation was performed in all cases. Follow-up consisted of an abdomen computed tomography (CT) scan after contrast administration immediately after each session and then after one, three, six, and twelve months. RESULTS: In forty-eight lesions complete tumor ablation was depicted at the one month CT scan. In four lesions with residual viable tumor, a second session was performed. After the second ablation no residual tumor was observed in any patient. No major complications occurred in any of our patients. Fever with a temperature up to 39 °C was documented during the first days as part of the post-ablation syndrome in thirteen patients (32.2%). Seeding along the needle track was observed in none of our patients. Local tumor progression, was observed in ten lesions (19.25%) and in all cases a second RFA session was performed with optimal results. CONCLUSION: Subcapsular location should not be considered as a contraindication for liver RFA.

CT-guided percutaneous drainage of infected collections due to gastric leak after sleeve gastrectomy for morbid obesity: initial experience.

This study was designed to evaluate the efficacy and safety of computed tomography (CT)-guided drainage in treating infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity. From January 2007 to June 2009, 21 patients (9 men and 12 women; mean age, 39.2 (range, 26-52) years) with infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity underwent image-guided percutaneous drainage. All procedures were performed using CT guidance and 8- to 12-Fr pigtail drainage catheters. Immediate technical success was achieved in all 21 infected collections. In 18 of 21 collections, we obtained progressive shrinkage of the collection with consequent clinical success (success rate 86%). In three cases, the abdominal fluid collection was not resolved, and the patients were reoperated. Among the 18 patients who avoided surgery, 2 needed replacement of the catheter due to obstruction. No major complications occurred during the procedure. The results of our study support that CT-guided percutaneous drainage is an effective and safe method to treat infected abdominal fluid collections due to gastric leak in patients who had previously underwent laparoscopic sleeve gastrectomy for morbid obesity. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.

Knowledge and general consideration about Pap test screening among women from Finland and Greece.

It seems that lack of regular Pap smear screening is a risk factor for cervical cancer. Since women started having Pap smears the number of deaths from cervical cancer has dropped dramatically. The purpose of this study was to investigate the knowledge of women about the essential and basic parameters related to the Pap test in the general population of two European countries: Finland and Greece. The same percentages (> 50%) of women in Athens and Helsinki had good knowledge of the Pap test. Comparing country populations, greater numbers of Finnish women had a better level of Pap test knowledge. Additionally, older women in Finland were more educated and informed about the usage of Pap testing due to the good health service information in this country.

Synthesis and pharmacochemistry of some new aminoketones with local anaesthetic activity.

The synthesis of some new 1-indane- and 1-(1',2',3',4'-tetrahydronaphthalene-1-spiro-3''-ryrrolidino-2'',5 ''- dione)-3-amino-substituted-butanones-2, having the structural characteristics for local anaesthetic activity, is reported. These aminoketones were synthesized using a modified Mannich reaction. The structure of the intermediate and final products were identified by elemental and spectroscopic analyses (IR, 1H-NMR, MS). The physicochemical parametres pKa and logP were determined experimentally, and they were also calculated using the appropriate Taft's equation and the Rekker's hydrophobic fragmental constants, respectively. The local anaesthetic activity of the synthesized compounds was determined in vitro on isolated frog's nerve, using an improved evoked action potential technique. The biological results were expressed as relative activities (RA) to procaine, used as reference compound. These RA of the investigated compounds were found to lie between 0.50-0.85. An attempt was made to correlate the local anaesthetic activity with the values of the investigated physicochemical parameters.

Pharmacochemistry of novel aminoketone phthalimide, delta 4-tetrahydrophthalimide, and arylsuccinimide derivatives with local anaesthetic activity.

A number of aminoketones with prospective local anaesthetic activity were prepared. The structure of the synthesized compounds was confirmed by spectroscopic and elemental analyses. The physiochemical parameters (pka and logP) were also investigated. The local anaesthetic activity was determined in vitro on sciatic frog's nerve by the compound action potential technique: the phthalimide derivatives possess considerable local anaesthetic activity equal to that of lidocaine and higher than that of procaine.

Antiinflammatory activity of aminoketone derivatives of 2,4-disubstituted thiazoles.

A group of nine aminoketones, 2,4-disubstituted thiazole derivatives were tested in vivo in order to evaluate their biological activity. Antiinflammatory activity was studied by means of the carrageenin-induced mouse paw edema. Writhing induced by acetic acid in rats used to evaluate the analgesic activity. The results are discussed from the view of structure activity relationship.

Influence of pindolol on asthmatics and effect of bronchodilators.

Bronchospasm is a known side effect of the administration of beta-blockers to asthmatics. The purpose of this study was to investigate the frequency of bronchospasm caused by the administration of relatively low doses (2.5-7.5 mg) of pindolol, a beta-blocker with intrinsic sympathetic activity (ISA) to asthmatics, the severity of the bronchospasm and its reversibility and the probable correlations of bronchial asthma (BA) characteristics (severity, duration, allergy and airway hyperreactivity) with existing or nonexisting bronchospasm. Seventeen asthmatic patients: 10 men and 7 women, with a mean age of 44 +/- 10 years, participated in this study. The duration and severity of BA, the presence of allergy determined by skin tests and the bronchial hyperreactivity to methacholine inhalation challenge were observed on the first day of study. On the following days, the respiratory function parameters forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), and the pulse rate were measured before and 30, 60 and 90 min after the administration of placebo and pindolol. Then salbutamol was administered by a dosimetric aerosol (DA) at the usual dosage (200 micrograms) and the change in FEV1 was observed at 60 min; thereafter 40 micrograms of ipratropium bromide (IB) were administered by DA and FEV1 was measured after 60 min. Pindolol was administered gradually by mouth (2.5 mg every 30 min), the maximal total dose being 7.5 mg. Administration of pindolol caused a significant fall of FEV1 of 12 +/- 11% compared to placebo. A significant total decrease of FEV1 (greater than or equal to 20% of baseline) was observed in 9 patients.(ABSTRACT TRUNCATED AT 250 WORDS)