ABSTRACT
The authors studied the remote results of 27 endovascular catheter atherectomies performed in 25 patients. All patients had lesions of arteries of the femoropopliteal segment according to the TASC II classification. The duration of follow up varied from 6 to 34 months. Endovascular catheter atherectomy was carried out by means of the SilverHawk EV3 system with protection of the distal bed from embolism using Spider EV3. Our findings prove that catheter atherectomy with the SilverHawk system is most efficient it treatment of short stenotic lesions, lesions localizing in the zone of increased dynamic activity, multi-level lesions of arteries of the femoropopliteal segment, as well as short lesions in patients suffering from diabetes mellitus.
Subject(s)
Arterial Occlusive Diseases/surgery , Atherectomy/instrumentation , Endovascular Procedures/instrumentation , Femoral Artery , Popliteal Artery , Surgical Equipment , Aged , Angiography, Digital Subtraction , Arterial Occlusive Diseases/diagnosis , Equipment Design , Female , Follow-Up Studies , Humans , Male , Middle Aged , Multidetector Computed Tomography , Ultrasonography, Doppler, DuplexABSTRACT
Endovascular target catheter atherectomy (ETCA) - method of artery patency allowing to obtain occlusion substrate. Given the high destructive effect of atherectome's elements on tissue the objective was determination possibility of histological and electron microscopic investigation of this substrate after atherectomy. The research included 8 patients who underwent ETCA of legs arteries. It was observed substrate removal from broken stent in 1 case. 2 of 8 patients had diabetes. Obtained substrate was available for histological and electron microscopic investigation. Atherosclerosis was confirmed in all cases. It was not observed substrate significant morphological changes in patients with presence or absence of diabetes. Microscopic investigation of substrate from broken stent shows pronounced development of granulation tissue that was regarded as special form of reparative regeneration. Finding internal elastic membrane during microscopic investigation in some cases proves radical intervention. The authors consider that microscopic investigation of substrate after ETCA may be used for diagnosis verification, thorough analysis of morphological changes in lesion area and radicalism of atherectomy.
Subject(s)
Arteries/pathology , Atherectomy/methods , Atherosclerosis , Lower Extremity/blood supply , Peripheral Arterial Disease , Aged , Atherosclerosis/complications , Atherosclerosis/pathology , Female , Humans , Male , Microscopy/methods , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/etiology , Peripheral Arterial Disease/physiopathology , Peripheral Arterial Disease/surgery , Treatment OutcomeSubject(s)
Bone Neoplasms , Giant Cell Tumor of Bone , Lung Neoplasms , Mediastinal Neoplasms , Sternum , Thoracoplasty/methods , Biopsy , Bone Neoplasms/diagnosis , Bone Neoplasms/surgery , Female , Giant Cell Tumor of Bone/diagnosis , Giant Cell Tumor of Bone/surgery , Humans , Lung Neoplasms/pathology , Lung Neoplasms/secondary , Lung Neoplasms/surgery , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/secondary , Mediastinal Neoplasms/surgery , Middle Aged , Osteotomy/methods , Pneumonectomy/methods , Sternum/diagnostic imaging , Sternum/pathology , Sternum/surgery , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
Clinical cases of patients with rare forms of ductal pancreatic carcinoma are described. Difficulties of preoperative radiologic verification of ostheoclast-like giantcell tumor and cricoids-cell carcinoma of the pancreas are described. Morphologigic and immunohistochemical features of these tumors are highlighted. One of the clinical cases demonstrate the aggressive tumor behavior, led to liver metastases 4 months after the radical operation. Literature review highlights historical aspects and the state-of-art of diagnostics and treatment of rare forms of the ductal carcinoma of the pancreas.
Subject(s)
Carcinoma, Pancreatic Ductal , Digestive System Surgical Procedures/methods , Pancreas/surgery , Pancreatic Neoplasms , Carcinoma, Pancreatic Ductal/diagnosis , Carcinoma, Pancreatic Ductal/metabolism , Carcinoma, Pancreatic Ductal/physiopathology , Carcinoma, Pancreatic Ductal/therapy , Combined Modality Therapy , Diagnosis, Differential , Drug Therapy/methods , Female , Humans , Immunohistochemistry , Liver Neoplasms/secondary , Male , Middle Aged , Neoplasm Staging/methods , Pancreas/pathology , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/metabolism , Pancreatic Neoplasms/physiopathology , Pancreatic Neoplasms/therapy , Prognosis , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography/methodsSubject(s)
Arteries/pathology , Gastrinoma/surgery , Multiple Endocrine Neoplasia Type 1/surgery , Neoplasm Invasiveness , Pancreatectomy/methods , Pancreatic Neoplasms/surgery , Vascular Neoplasms/pathology , Adult , Female , Follow-Up Studies , Gastrinoma/diagnosis , Gastrinoma/secondary , Humans , Multiple Endocrine Neoplasia Type 1/diagnosis , Multiple Endocrine Neoplasia Type 1/secondary , Pancreatic Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
23 pancreatectomies were made on the reason of various tumors of the pancreas during the period of 2009-2012yy. 15 patients had duct adenocarcinoma, 4 - neuroendocrine neoplasia, 2 - intraductal papillary-mucinous tumor, 1 had metastase of renal-cell carcinoma and 1 was diagnosed with serous cystadenoma. Pancreatectomy was indicated in case of invasion of the whole pancreas or in case of multiple tumor focuses. By adenocarcinoma the pancreatecomy was abstained in case of large vessels (a. mesenterica suoerior, truncus coeliacus and hepatic arteries) invasion or remote metastases presense or impossibility of R0 resection. Metastases and vessel invasion were not considered as contraindication to pancreatectomy in patients with neuroendocrine lesions. 10 (43.5%) patients had postoperative complications; 2 patients died. The survival median was 7 months for the duct adenocarcinoma. Postoperative life duration for patients with other pancreatic tumors was 6-36 months.
Subject(s)
Decision Making , Pancreatectomy/methods , Pancreatic Neoplasms/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Pancreatic Neoplasms/mortality , Retrospective Studies , Russia/epidemiology , Survival Rate/trends , Treatment OutcomeABSTRACT
The influence of various factors on the physico-chemical characteristics and complexation of glucose with a mutant form of D-glucose/D-galactose-binding protein which can be regarded as a sensor of the glucometer, namely the protein GGBP/H152C with solvatochromic dye BADAN attached to the cysteine residue Cys 152, has been investigated. The point mutation His 152Cys and attaching BADAN reduced the affinity of the mutant form GGBP/H152C to glucose more than 8-fold compared to the wild type protein. This allows using this mutant for the determination of sugar content in biological fluids extracted by transdermal technologies. Sufficiently rapid complexation of GGBP/H152C with glucose (the time of protein-glucose complex formation is not more than three seconds even in solutions with a viscosity of 4 cP) provides timely monitoring changes in the concentration of sugar. The changes of ionic strength and pH within the physiological range of values of these variables do not have significant influence on fluorescent characteristics of GGBP/H152C-BADAN. At acidic pH, (see symbol) some of the molecules GGBP/H152C is in the unfolded state. It has been shown that mutant form GGBP/H152C has relatively low resistance to guanidine hydrochloride denaturing effects. This result indicates the need for more stable proteins to create a sensor for glucose biosensor system.
Subject(s)
2-Naphthylamine/analogs & derivatives , Biosensing Techniques , Escherichia coli Proteins/chemistry , Glucose/isolation & purification , Monosaccharide Transport Proteins/chemistry , 2-Naphthylamine/chemistry , Blood Glucose/isolation & purification , Escherichia coli/genetics , Escherichia coli Proteins/genetics , Guanidine/chemistry , Humans , Monosaccharide Transport Proteins/genetics , Mutation , Protein ConformationABSTRACT
4 clinical cases of metastatic invasion of pancreas by renal cancer were analyzed. The main features were the late metastatic revealance and the absence of specific clinical picture. The radiodiagnostics showed signs similar to neuroendocrine tumors of the pancreas, which complicated the diagnosis. All the patients were operated on - the resection of the pancreas was performed.