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Epidermolysis bullosa (EB) is a very rare inherited disease featured with skin blistering resulting from minor trauma. Sometimes the esophageal mucosa could also be involved, which leads to esophageal strictures. Here we report two cases of EB-related esophageal strictures who were successfully treated with esophageal balloon dilations. The two cases with EB had severe dysphagia. Clinical examination showed signs of malnutrition, skin blisters and loss of toenails due to EB. They underwent careful fluoroscopic balloon dilation with 10- and 16-mm-sized balloon catheters, respectively. They could ingest soft and some solid foods after the procedure and maintained during the 20 months and 16 months follow-up periods.
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Cloque , Cathéters , Sténose pathologique , Troubles de la déglutition , Épidermolyse bulleuse , Sténose de l'oesophage , Études de suivi , Malnutrition , Muqueuse , Ongles , PeauRésumé
Objective To discuss the application of MRI in making early assessment of the coagulation extent of liver tumor after microwave ablation(MWA).Methods From January 1,2015 to January 31,2016,CT-guided percutaneous MWA was employed in 46 patients with liver tumor.A total of 55 hepatic lesions were detected in the 46 patients,the mean diameter of the lesion was (26.0±5.3) mm.On the second day after MWA,MRI was performed to evaluate the ablation effect,the ablated extent (long axis×short axis) was calculated,the results were compared with the referential data provided by manufacturer.The MWA-related complications,including inadequate ablation and excessive ablation,were recorded and analyzed.Results MRI performed on the second day after MWA showed that successful MWA treatment was obtained in all the 55 hepatic lesions,and no serious complications occurred immediately after ablation.The used parameter settings of microwave energy included 60 W-5 min (n=4),60 W-8 min (n=4),60 W-10 min (n=14),70 W-8 min (n=40),70 W-10 min (n=11) and 80 W-10 min (n=18);the corresponding ablated extents produced by the above parameter settings were 41.3 mm×31.2 mm,52.0 mm×36.3 mm,51.5 mm×34.3 mm,52.9 mm×35.5 mm,56.8 mm×36.1 mm and 64.0 min×44.0 mm respectively;all the above actual ablated values were larger than the referential data provided by manufacturer,and among them the real ablated extent of 80 W-10 min group carried the biggest difference with that provided by manufacturer (64.0 mm×44.0 mm vs.54.0 mm×37.0 mm,P<0.01).No inadequate ablation of lesion was observed,and excessive ablation was seen in 12 lesions,presenting as the involvement of the hepatic capsule or even the subcutaneous muscle layer.Conclusion Early MRI examination after MWA can precisely evaluate the ablation extent.The results of this study indicate that the actual ablated value is bigger than the referential value provided by manufacturer.Accurate prediction of ablation range before MWA is helpful in ensuring a complete ablation as well as in improving the safety of MWA.
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<p><b>BACKGROUND</b>Acute massive pulmonary embolism (PE) is a clinical emergency requiring rapid and supportive measures. Percutanous mechanical thrombectomy is considered as a treatment option. The purpose of this study was to evaluate the clinical efficacy and safety of peructaneous mechanical catheter fragmentation in the management of acute massive PE.</p><p><b>METHODS</b>From January 2003 to June 2007, 28 patients (20 men, 8 women; mean age 64 years) with acute massive PE initially diagnosed by computed tomography and confirmed by pulmonary angiography were treated with inferior vena caval filter placement and percutaneous catheter fragmentation. Twenty-six patients received thrombolytic agents after embolus fragmentation.</p><p><b>RESULTS</b>Technical success was achieved in all patients. The improvement of clinical status and restoration of blood flow in the main branches of the pulmonary artery were seen in 27 patients. Only one case did not benefit from the percutaneous therapy and died from the failure of the surgery. Oxygen saturation increased from (86.2 +/- 4.5)% to (96.1 +/- 3.2)% (P < 0.001) after the interventional procedure. The post-procedure mean pulmonary artery pressure decreased from (34.2 +/- 4.8) mmHg to (25.2 +/- 5.1) mmHg (P < 0.001). During clinical follow-up (range, 1 - 5 years), no patients had recurrence of PE.</p><p><b>CONCLUSION</b>Percutaneous catheter fragmentation combined with thrombolysis is an effective and safe therapy in the clinical management of acute massive PE.</p>
Sujets)
Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Cathétérisme , Méthodes , Embolie pulmonaire , Imagerie diagnostique , Thérapeutique , Études rétrospectives , Traitement thrombolytique , Méthodes , Tomodensitométrie , Filtres cavesRésumé
In addition to the common complications involving hepatic artery, hepatic vein and biliary tract, which have already been mentioned and discussed in the preceding parts of this article, there are some uncommon complications which have been reported in the medical literature as the case report or as the case- series analysis. This paper sums up these uncommon complications. Part of these uncommon complications can be treated with interventional therapy. It is very important for interventional radiologists to make a further understanding of the different etiology of these uncommon complications occurred after liver transplantation so as to get a comprehensive knowledge about the complications after liver transplantation.
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Objective To observe the therapeutic response of liver tumors by arterial embolization hyperthermia with Nano Superparamagnetic Iodized Oil(NSIO)using rabbit VX2 liver tumor model.Methods A total 24 rabbits containing experimental hepatic tumors were randomly assigned to one of four groups as follows:NSIO embolization hyperthermia group(group A),Lipidol embolization group(group B),NSIO embolization group(group C),and contronl group(group D),each groups contain 6 VX2 rabbits.Fourteen days after implantation of the experimental hepatic tumor,VX2 rabbits were treated.In group A group B and group C,the rabbits hepatic proper artery were selectively catheterized by 3 Fr microcatheters via right femoral artery under fluoroscopic guidance.10% NSIO 0.5 ml(group A and group C)or Lipidol 0.5 ml(group B)infused into proper hepatic artery.Three days after embolization,the rabbits in group A and group B were exposed to gap-type alternating magnetic field for 30 minutes,while rabbits in group C and group D have not been exposed to alternating magnetic field.The liver tumor size were measured by CT scanning before and 14 days after treatment then the animals were sacrificed,the liver,lung,heart spleen and kidney were harvested for histopathology examination,the liver tumor size were detected directly. Results All subjects experienced uneventful 14 days surivials,on the biochemical examination,there were no changes about the function of liver and renal in each group 14 days after treatment compare to pre- treatment.Fourteen days after treatment,the tumor size decreased by 8.09% in group A,but increased by 9.72% and 13.00%(P<0.05)in group B and group C respectively,in group D,the tumor size increased by 57.50%(P<0.01).In histopathology examination,the tumor necrosis in three treatment groups were manifest,particular in group A.Conclusion Arterial embolization hyperthermia with NSIO has obvious therapeutic response to experimental hepatic tumors,it encourages further development of this technology for the treatment of liver cancer in humans.
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Objective To evaluate the safety and clinical efficacy of system thrombolysis combined with percutaneous catheter thrombus fragmentation and thrombectomy for acute massive pulmonary embolism. Methods Ninteen patients with acute massive pulmonary embolism were treated with IVC filter placement, percutaneous catheter thrombus fragmentation and system thrombolysis combined with anticoangulation using low-molecular-weight heparin.Four of 19 patients underwent adjuvant Stranb Rotarex catheter thrombectomy.Results Twenty-one procedures were performed in 19 patients.Improvement of pulmonary artery patency and initial relief of symptoms immediately occurred in 18 of 19 patients after interventional therapy.The oxygen saturation increased from 86% to 97%.Pulmonary artery pressure decreased from 33? 5mm Hg(1mm Hg=0.133kPa)to 25?5mmHg after interventional therapy(t=13.2,P
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One endophytic stain SS02 was isolated from the underground stems of Paris polyphylla var. Chinensis franch. The ferments of SS02 showed antibiosis activities against 13 kinds of the crop causes germs. The characteristics of morphology,physiological and biochemical showed that SS02 belonged to Bacillus sp. The 16S rDNA of SS02 was PCR and sequenced. The accession of GenBank is AY842144. The one 16S rDNA phylogenetic tree was constructed by comparing with the published 16S rDNA sequences of the relative bacteria species. In the phylogenetic tree SS02 and Paenibacillus daejeonensis was the closest relative with 97.7% sequence similarity. According to the phylogenetic analysis it was identified as Paenibacillus daejeonensis SS02.