Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 16 de 16
Filtrar
1.
J Vasc Interv Radiol ; 26(4): 573-82, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25680281

RESUMO

PURPOSE: To compare the complications, stent patency, and patient survival with self-expandable metal stents (SEMSs) placed above or across the sphincter of Oddi in malignant biliary obstruction. MATERIALS AND METHODS: From January 2008 to December 2012, 155 patients were treated with percutaneous transhepatic SEMS placement. Seventy-four patients underwent suprapapillary stent placement (group A), and 81 patients underwent transpapillary stent placement (group B). Complications rates, stent patency, and patient survival were evaluated and analyzed for potential predictors. RESULTS: In group A, 68 covered and 28 uncovered SEMSs were placed, and, in group B, 78 covered and 19 uncovered SEMSs were placed. Thirty-six stent-related early complications were observed in a total of 154 patients (23.4%): pancreatitis (n = 23), cholangitis (n = 12), and cholecystitis (n = 1). The early complication rates for groups A and B were 14.9% (11 of 74) and 31.3% (25 of 80), respectively (P = .016). Pancreatitis occurred in three patients (4.1%) in group A and 20 patients (25.0%) in group B (P = .001). Stent location was a single independent predictor of pancreatitis (P < .001). Stent occlusions by tumor growth was more frequently observed in group A than in group B (P = .007), whereas stent occlusion by sludge incrustation was more frequently found in group B than in group A (P = .007). There was no significant difference in cumulative stent patency (P = .401) or patient survival (P = .792) between groups. CONCLUSIONS: To decrease the incidence of pancreatitis, suprapapillary placement of SEMSs is recommended for malignant biliary obstruction, but not in the lower 2 cm of the common bile duct.


Assuntos
Neoplasias dos Ductos Biliares/mortalidade , Neoplasias dos Ductos Biliares/cirurgia , Colestase/mortalidade , Colestase/cirurgia , Implantação de Prótese/mortalidade , Stents/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Causalidade , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Implantação de Prótese/métodos , Infecções Relacionadas à Prótese/mortalidade , República da Coreia/epidemiologia , Taxa de Sobrevida
3.
J Vasc Interv Radiol ; 21(7): 1038-44, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20537915

RESUMO

PURPOSE: To evaluate risk factors for the recurrence of biliary stones after a percutaneous transhepatic biliary stone extraction. MATERIALS AND METHODS: The procedures were performed on 339 patients between July 2004 and December 2008 (54 months). Medical records and images were retrospectively reviewed for 135 patients (mean age, 66.4 years; 83 men and 52 women) who had undergone follow-up for a mean of 13.2 months (range, 3-37 months). To evaluate risk factors for the recurrence of biliary stones, variables were evaluated with univariate and multivariate analyses. Variables included sex, age, stone location, number of stones, stone size, presence of a peripapillary diverticulum, application of antegrade sphincteroplasty, presence of a biliary stricture, largest biliary diameter before the procedure, and gallbladder status. RESULTS: Thirty-three of the 135 patients (24%) had recurrent symptomatic biliary stones and underwent an additional extraction. The mean time to recurrence was 17.2 months +/- 8.7. Univariate analysis of risk factors for recurrence of biliary stones demonstrated that location, number of stones, stone size, application of antegrade sphincteroplasty, presence of a biliary stricture, and biliary diameter were significant factors (P < .05). With use of multivariate analysis, the number of stones (> or =6; relative risk, 64.8; 95% confidence interval: 5.8, 717.6) and stone size (> or =14 mm; relative risk, 3.8; 95% confidence interval: 1.138, 13.231) were determined to be significant risk factors. CONCLUSIONS: The independent risk factors for recurrence of symptomatic biliary stones after percutaneous transhepatic biliary stone extraction were a stone size of at least 14 mm and the presence of at least six stones.


Assuntos
Cálculos Biliares/epidemiologia , Cálculos Biliares/cirurgia , Idoso , Feminino , Cálculos Biliares/prevenção & controle , Humanos , Masculino , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Prevenção Secundária , Resultado do Tratamento
4.
Front Genet ; 11: 134, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32211021

RESUMO

Genomic prediction is an effective way to estimate the genomic breeding values from genetic information based on statistical methods such as best linear unbiased prediction (BLUP). The used of haplotype, clusters of linked single nucleotide polymorphism (SNP) as markers instead of individual SNPs can improve the accuracy of genomic prediction. Since the probability of a quantitative trait loci to be in strong linkage disequilibrium (LD) with a cluster of markers is higher compared to an individual marker. To make haplotypes efficient in genomic prediction, finding optimal ways to define haplotypes is essential. In this study, 770K or 50K SNP chip data was collected from Hanwoo (Korean cattle) population consisted of 3,498 cattle. Using SNP chip data, haplotype was defined in three different ways based on 1) the number of SNPs included, 2) length of haplotypes (bp), and 3) agglomerative hierarchical clustering based on LD. To compare the methods in parallel, haplotypes defined by all methods were set to have comparable sizes; 5, 10, 20 or 50 SNPs on average per haplotype. A linear mixed model using haplotype to calculated the covariance matrix was applied for testing the prediction accuracy of each haplotype size. Also, conventional SNP-based linear mixed model was tested to evaluate the performance of the haplotype sets on genomic prediction. Carcass weight (CWT), eye muscle area (EMA) and backfat thickness (BFT) were used as the phenotypes. This study reveals that using haplotypes generally showed increased accuracy compared to conventional SNP-based model for CWT and EMA, but found to be small or no increase in accuracy for BFT. LD clustering-based haplotypes specifically the five SNPs size showed the highest prediction accuracy for CWT and EMA. Meanwhile, the highest accuracy was obtained when length-based haplotypes with five SNPs were used for BFT. The maximum gain in accuracy was 1.3% from cross-validation and 4.6% from forward validation for EMA, suggesting that genomic prediction accuracy can be increased by using haplotypes. However, the improvement from using haplotypes may depend on the trait of interest. In addition, when the number of alleles generated by each haplotype defining methods was compared, clustering by LD generated the least number of alleles, thereby reducing computational costs. Therefore, finding optimal ways to define haplotypes and using the haplotype alleles as markers can improve the accuracy of genomic prediction.

5.
Mol Ther ; 16(9): 1637-42, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18628758

RESUMO

JX-594 is a targeted oncolytic poxvirus that is designed to eradicate cancer cells having cell-cycle defects, through replication, cell lysis, and spread within tumors; oncolysis-induced tumor vascular shutdown and immunostimulation are augmented by granulocyte monocyte-colony-stimulating factor (GM-CSF) transgene expression. We have previously shown, in animal models of hepatocellular carcinoma (HCC), that JX-594 is a promising anticancer agent. We tested JX-594 in three patients with advanced refractory hepatitis B virus (HBV)-associated HCC through intratumoral administration. JX-594 treatment was well-tolerated and resulted in antitumoral efficacy in all three patients, despite the presence of high levels of neutralizing antibodies. JX-594 replication, its release into the circulation, distant tumor targeting were demonstrated. JX-594 administration resulted in the induction of antivascular cytokines, and was associated with tumor vascular shutdown. We also showed, for the first time, that oncolytic virotherapy can suppress underlying HBV replication in HCC patients, and that tumor tissue could be the primary source of acute HBV replication and acute post-treatment HBV release. JX-594 treatment in HBV-associated HCC warrants further clinical testing; a Phase II trial is underway.


Assuntos
Carcinoma Hepatocelular/irrigação sanguínea , Carcinoma Hepatocelular/terapia , Chordopoxvirinae/genética , Hepatite B/terapia , Terapia Viral Oncolítica , Replicação Viral , Idoso , Carcinoma Hepatocelular/secundário , Citocinas/genética , Citocinas/imunologia , Citocinas/metabolismo , DNA Viral/genética , Fator Estimulador de Colônias de Granulócitos e Macrófagos/genética , Fator Estimulador de Colônias de Granulócitos e Macrófagos/imunologia , Fator Estimulador de Colônias de Granulócitos e Macrófagos/metabolismo , Hepatite B/imunologia , Hepatite B/virologia , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/metabolismo , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/metabolismo
6.
Lancet Oncol ; 9(6): 533-42, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18495536

RESUMO

BACKGROUND: JX-594 is a targeted oncolytic poxvirus designed to selectively replicate in and destroy cancer cells with cell-cycle abnormalities and epidermal growth factor receptor (EGFR)-ras pathway activation. Direct oncolysis plus granulocyte-macrophage colony-stimulating factor (GM-CSF) expression also stimulates shutdown of tumour vasculature and antitumoral immunity. We aimed to assess intratumoral injection of JX-594 in patients with refractory primary or metastatic liver cancer. METHODS: Between Jan 4, 2006, and July 4, 2007, 14 patients with histologically confirmed refractory primary or metastatic liver tumours (up to 10.9 cm total diameter) that were amenable to image-guided intratumoral injections were enrolled into this non-comparative, open-label, phase I dose-escalation trial (standard 3x3 design; two to six patients for each dose with 12-18 estimated total patients). Patients received one of four doses of intratumoral JX-594 (10(8) plaque-forming units [pfu], 3x10(8) pfu, 10(9) pfu, or 3x10(9) pfu) every 3 weeks at Dong-A University Hospital (Busan, South Korea). Patients were monitored after treatment for at least 48 h in hospital and for at least 4 weeks as out-patients. Adverse event-monitoring according to the National Cancer Institute Common Toxicity Criteria (version 3) and standard laboratory toxicity grading for haematology, liver and renal function, coagulation studies, serum chemistry, and urinalysis were done. The primary aims were to ascertain the maximum-tolerated dose (MTD) and safety of JX-594 treatment. Data were also collected on pharmacokinetics, pharmacodynamics, and efficacy. Analysis was per protocol. This study is registered with ClinicalTrials.gov, number NCT00629759. FINDINGS: Of 22 patients with liver tumours who were assessed for eligibility, eight patients did not meet inclusion criteria. Therefore, 14 patients, including those with hepatocellular, colorectal, melanoma, and lung cancer, were enrolled. Patients were heavily pretreated (5.6 previous treatments, SD 2.8, range 2.0-12.0) and had large tumours (7.0 cm diameter, SD 2.7, range 1.8-10.9). Patients received a mean of 3.4 (SD 2.2, range 1.0-8.0) cycles of JX-594. All patients were evaluable for toxicity. All patients experienced grade I-III flu-like symptoms, and four had transient grade I-III dose-related thrombocytopenia. Grade III hyperbilirubinaemia was dose-limiting in both patients at the highest dose; the MTD was therefore 1x10(9) pfu. JX-594 replication-dependent dissemination in blood was shown, with resultant infection of non-injected tumour sites. GM-CSF expression resulted in grade I-III increases in neutrophil counts in four of six patients at the MTD. Tumour responses were shown in injected and non-injected tumours. Ten patients were radiographically evaluable for objective responses; non-evaluable patients had contraindications to contrast medium (n=2) or no post-treatment scans (n=2). According to Response Evaluation Criteria in Solid Tumors (RECIST), three patients had partial response, six had stable disease, and one had progressive disease. INTERPRETATION: Intratumoral injection of JX-594 into primary or metastatic liver tumours was generally well-tolerated. Direct hyperbilirubinaemia was the dose-limiting toxicity. Safety was acceptable in the context of JX-594 replication, GM-CSF expression, systemic dissemination, and JX-594 had anti-tumoral effects against several refractory carcinomas. Phase II trials are now underway.


Assuntos
Neoplasias Hepáticas/terapia , Terapia Viral Oncolítica , Vírus Oncolíticos , Vaccinia virus , Adulto , Idoso , Feminino , Fator Estimulador de Colônias de Granulócitos e Macrófagos/biossíntese , Fator Estimulador de Colônias de Granulócitos e Macrófagos/genética , Humanos , Hiperbilirrubinemia/etiologia , Imuno-Histoquímica , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Terapia Viral Oncolítica/efeitos adversos , Vírus Oncolíticos/genética , Vírus Oncolíticos/crescimento & desenvolvimento , Vírus Oncolíticos/metabolismo , Tomografia por Emissão de Pósitrons , Infecções por Poxviridae/etiologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Falha de Tratamento , Resultado do Tratamento , Vaccinia virus/genética , Vaccinia virus/crescimento & desenvolvimento , Vaccinia virus/metabolismo , Replicação Viral
7.
Cancer Gene Ther ; 12(2): 116-21, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15578067

RESUMO

Transcatheter hepatic arterial chemoembolization using emulsions composed of anticancer agents and gelatin sponges (GS) has been an efficient and safe palliative treatment for inoperable hepatocellular carcinoma (HCC). We employed catheter-mediated left hepatic arterial embolization (CHAE) to increase transduction efficiency of adenoviral vector in canine hepatocytes. The emulsion was prepared by mixing pieces of GSP and adenoviral vectors expressing recombinant beta-galactosidase (Ad.LacZ) or human hepatocyte growth factor (Ad.hHGF). After the left hepatic artery was catheterized under angiography, CHAE with Ad.LacZ or Ad.hHGF was performed. Livers were removed and stained for LacZ activity on day 7. The expression pattern of LacZ staining was either scarce or patchy around the central hilum of the hepatic artery, or was homogeneously distributed in whole lobes, depending on whether large or small pieces of GSP were used. Hematological and serum biochemical changes during CHAE exhibited only a few effects. The chronological measurement of serum HGF concentration showed that the duration of transgene expression was greater after CHAE with Ad.hHGF. A similar pattern of transgene expression was observed in a rat model after hepatic arterial embolization with differential doses of Ad.hHGF soaked in GSP. These results suggest that hepatic arterial embolization by transcatheter mediated infusion with a mixture of adenovirus-GSP could be used for human HCC.


Assuntos
Adenoviridae/genética , Desoxicitidina/análogos & derivados , Esponja de Gelatina Absorvível , Vetores Genéticos/administração & dosagem , Fator de Crescimento de Hepatócito/genética , Hepatócitos/metabolismo , beta-Galactosidase/genética , Animais , Antimetabólitos Antineoplásicos/uso terapêutico , Desoxicitidina/uso terapêutico , Cães , Artéria Hepática , Fator de Crescimento de Hepatócito/metabolismo , Humanos , Infusões Intra-Arteriais , Fígado/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Transdução Genética , Transgenes/fisiologia , beta-Galactosidase/metabolismo , Gencitabina
8.
Phlebology ; 30(8): 549-56, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25096757

RESUMO

OBJECTIVES: To evaluate the complications of the temporary implanted inferior vena cava (IVC) filter and the feasibility of double-loop technique for removal of complicated IVC filters. METHODS: From January 2012 to December 2013, a total of 25 patients with IVC filter were referred for IVC filter retrieval. There were 20 Celect®, 3 OptEase®, and 2 Günther-Tulip® filters. All of the patients were evaluated with a pre-procedural CT scan to identify any complications. The IVC filters which had failed to be retrieved by the conventional method were evaluated, and retrieval was attempted with double loop technique. RESULTS: Sixteen of 25 (64%) filters had complications; IVC wall penetration (n = 11, 44%), tilted within IVC (n = 6, 24%), embedded struts (n = 3, 12%), and fracture of the strut (n = 1, 4%). The complications were overlapped in five patients. Two of them (8%) had also complained of filter-related pain. The success rate of IVC filter retrieval by double-loop technique was 14/16 (87.5%). There was no major filter retrieval-related complications. CONCLUSIONS: The double-loop technique is a safe and feasible method for complicated IVC filter retrieval.


Assuntos
Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/métodos , Filtros de Veia Cava , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
Korean J Radiol ; 3(2): 98-104, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12087199

RESUMO

OBJECTIVE: To determine the heating characteristics of needle-shaped duplex stainless steel thermoseeds, and to evaluate their effectiveness in the induction of hyperthermia in rabbit liver. MATERIALS AND METHODS: Thermoseeds of the two different shapes, L-shaped for single doses of hyperthermia and I-shaped for in-vitro study and repeated hyperthermic induction, were prepared. For the in-vitro study, an I-shaped thermoseed 0.23 mm in diameter and 25 mm long was placed inside a plastic tube filled with water. Heat was applied for 30 minutes within an induction magnetic field, and during this time changes in temperature were recorded using three thermocouples. For the in-vivo study, fifteen New Zealand white rabbits were divided into five equal groups. An I-shaped or L-shaped thermoseed was inserted in each rabbit's liver, and then placed within the center of the magnetic induction coil during a 30-minute period of hyperthermia. The rabbits in the first group were sacrificed immediately after hyperthermia was induced once, while those in the other groups were sacrificed at 1, 3, and 7 days, respectively, also after one induction. The remaining three rabbits were sacrificed 4 days after three consecutive daily treatment sessions. The resected segments of liver were subsequently evaluated histopathologically for the extent of coagulation necrosis caused by heating of the thermoseed. RESULTS: The in-vitro study demonstrated that the temperature in the thermoseed, which was 25.9 degrees C before heating and 54.8 degrees C after heating, rose rapidly at first but progressively less rapidly as time elapsed. Light microscopic examination of the rabbits' livers revealed coagulation necrosis and infiltration by inflammatory cells around the insertion site of the thermoseed. The maximum diameter of coagulation necrosis was 2.81+/-1.68 mm, and this occurred in the rabbits that were sacrificed 7 days after heat induction. CONCLUSION: Needle-shaped duplex stainless steel thermoseeds show temperature-dependent-type heating characteristics, and in rabbit liver, induced coagulation necrosis of surrounding tissues after heat is applied for 30 minutes. These thermoseeds may thus be useful for the induction of interstitial hyperthermia.


Assuntos
Temperatura Corporal , Hipertermia Induzida/instrumentação , Fígado/fisiologia , Animais , Fígado/patologia , Necrose , Coelhos , Aço Inoxidável
11.
Korean J Intern Med ; 28(3): 322-9, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23682226

RESUMO

BACKGROUND/AIMS: The bedside index of severity in acute pancreatitis (BISAP) is a new, convenient, prognostic multifactorial scoring system. As more data are needed before clinical application, we compared BISAP, the serum procalcitonin (PCT), and other multifactorial scoring systems simultaneously. METHODS: Fifty consecutive acute pancreatitis patients were enrolled prospectively. Blood samples were obtained at admission and after 48 hours and imaging studies were performed within 48 hours of admission. The BISAP score was compared with the serum PCT, Ranson's score, and the acute physiology and chronic health examination (APACHE)-II, Glasgow, and Balthazar computed tomography severity index (BCTSI) scores. Acute pancreatitis was graded using the Atlanta criteria. The predictive accuracy of the scoring systems was measured using the area under the receiver-operating curve (AUC). RESULTS: The accuracy of BISAP (≥ 2) at predicting severe acute pancreatitis was 84% and was superior to the serum PCT (≥ 3.29 ng/mL, 76%) which was similar to the APACHE-II score. The best cutoff value of BISAP was 2 (AUC, 0.873; 95% confidence interval, 0.770 to 0.976; p < 0.001). In logistic regression analysis, BISAP had greater statistical significance than serum PCT. CONCLUSIONS: BISAP is more accurate for predicting the severity of acute pancreatitis than the serum PCT, APACHE-II, Glasgow, and BCTSI scores.


Assuntos
Calcitonina/sangue , Pancreatite/diagnóstico , Precursores de Proteínas/sangue , Índice de Gravidade de Doença , Biomarcadores/sangue , Peptídeo Relacionado com Gene de Calcitonina , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pancreatite/sangue , Prognóstico , Estudos Prospectivos , Curva ROC
12.
Sci Transl Med ; 5(185): 185ra63, 2013 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-23677592

RESUMO

Oncolytic viruses cause direct cytolysis and cancer-specific immunity in preclinical models. The goal of this study was to demonstrate induction of functional anticancer immunity that can lyse target cancer cells in humans. Pexa-Vec (pexastimogene devacirepvec; JX-594) is a targeted oncolytic and immunotherapeutic vaccinia virus engineered to express human granulocyte-macrophage colony-stimulating factor (GM-CSF). Pexa-Vec demonstrated replication, GM-CSF expression, and tumor responses in previous phase 1 trials. We now evaluated whether Pexa-Vec induced functional anticancer immunity both in the rabbit VX2 tumor model and in patients with diverse solid tumor types in phase 1. Antibody-mediated complement-dependent cancer cell cytotoxicity (CDC) was induced by intravenous Pexa-Vec in rabbits; transfer of serum from Pexa-Vec-treated animals to tumor-bearing animals resulted in tumor necrosis and improved survival. In patients with diverse tumor types treated on a phase 1 trial, CDC developed within 4 to 8 weeks in most patients; normal cells were resistant to the cytotoxic effects. T lymphocyte activation in patients was evidenced by antibody class switching. We determined that patients with the longest survival duration had the highest CDC activity, and identified candidate target tumor cell antigens. Thus, we demonstrated that Pexa-Vec induced polyclonal antibody-mediated CDC against multiple tumor antigens both in rabbits and in patients with diverse solid tumor types.


Assuntos
Citotoxicidade Celular Dependente de Anticorpos/imunologia , Proteínas do Sistema Complemento/imunologia , Imunoterapia , Neoplasias/imunologia , Terapia Viral Oncolítica , Vírus Oncolíticos/imunologia , Vaccinia virus/imunologia , Animais , Antígenos de Neoplasias/imunologia , Antineoplásicos/metabolismo , Sobrevivência Celular , Modelos Animais de Doenças , Humanos , Necrose , Neoplasias/patologia , Neoplasias/terapia , Coelhos , Soro/metabolismo , Análise de Sobrevida
13.
Int J Cardiovasc Imaging ; 28 Suppl 1: 7-13, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22618435

RESUMO

The purpose of this study was to investigate the image quality and radiation dose of triple rule-out computed tomography (TROCT) using a 320-row-detector volume CT system to compare the wide-volume and helical modes of this CT system. Sixty-four patients with noncritical chest pain were allocated to one of 2 groups according to the type of CT examination mode used. Group 1 patients were examined using the wide-volume (non-spiral) mode and group 2 patients were examined using the 160-detector row helical mode, with the same contrast injection protocol in both methods [biphasic injection protocol; injection rate of 4 ml/s, median volume, 70 ml (range 65-100 ml)]. Attenuations of the pulmonary trunk, ascending aorta, and coronary arteries were measured in Hounsfield units; a subjective overall patient-based image quality score of 1-3 was awarded to each study. Effective doses, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Average effective dose was significantly lower in group 1 than group 2 (9.7 ± 5.1 vs. 16 ± 5.9 mSv, P < 0.001). The mean attenuation of the main pulmonary trunk was significantly higher in group 1 than group 2 (P = 0.04) and mean attenuations in other vessels were not significant different. SNR and CNR were not significantly different between the groups. The proportion of diagnostic image qualities for chest CT angiography (CTA) was similar between the groups (93.5 vs. 93.9 %). In coronary CTA, group 1 showed a higher proportion of diagnostic image qualities than group 2 (100 vs. 87.9 %). The use of wide-volume mode of 320-detector CT reduces the overall effective radiation dose and results in similar attenuation and image quality for TROCT as compared with the helical mode.


Assuntos
Angina Pectoris/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Tomografia Computadorizada Espiral , Adulto , Idoso , Idoso de 80 Anos ou mais , Angina Pectoris/etiologia , Distribuição de Qui-Quadrado , Meios de Contraste , Doença da Artéria Coronariana/complicações , Feminino , Humanos , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Doses de Radiação , República da Coreia , Adulto Jovem
14.
World J Gastroenterol ; 18(26): 3426-34, 2012 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-22807613

RESUMO

AIM: To investigate the efficacy of hepatic arterial infusion chemotherapy (HAIC) using floxuridine (FUDR) in patients with advanced hepatocellular carcinoma (HCC) confined to the liver. METHODS: Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at our hospital between March 2005 and May 2008. Among the 34 patients, 9 patients were classified as Child class C, and 18 patients had portal vein tumor thrombus (PVTT). One course of chemotherapy consisted of continuous infusion of FUDR (0.3 mg/kg during day 1-14) and dexamethasone (10 mg on day 1, 4, 7 and 11), and this treatment was repeated every 28 d. RESULTS: Two patients (5.9%) displayed a complete response, and 12 patients (35.3%) had a partial response. The tumor control rate was 61.8%. The median overall survival times were 15.3 mo, 12.4 mo and 4.3 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0392). The progression-free survival was 12.9 mo, 7.7 mo and 2.6 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0443). The cumulative survival differed significantly according to the Child-Pugh classification and the presence of PVTT. In addition to hepatic reserve capacity and PVTT, the extent of HCC was an independent factor in determining a poor prognosis. The most common adverse reactions to HAIC were mucositis, diarrhea and peptic ulcer disease, but most of these complications were improved by medical treatment and/or a delay of HAIC. CONCLUSION: The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities, even in patients with advanced cirrhosis.


Assuntos
Carcinoma Hepatocelular/tratamento farmacológico , Infusões Intra-Arteriais/métodos , Neoplasias Hepáticas/tratamento farmacológico , Idoso , Dexametasona/uso terapêutico , Intervalo Livre de Doença , Feminino , Floxuridina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Veia Porta/patologia , Fatores de Tempo , Resultado do Tratamento
15.
J Thorac Oncol ; 4(2): 263-5, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19179907

RESUMO

An aortoesophageal fistula (AEF) is uncommon but is frequently fatal. Most cases are attributable to a thoracic aortic aneurysm. Other common causes include malignant intrathoracic neoplasm, foreign body ingestion, endovascular stent graft repair for thoracic aortic disease, and esophageal surgery. We report a case of an AEF that developed after chemo-irradiation and subsequent esophageal stent implantation in patient with non-small cell lung cancer. The patient underwent self expanding metallic esophageal stent implantation for an esophageal stricture after chemotherapy and radiotherapy. However, 1 month later, he presented with hematemesis. Chest computed tomography and aortography revealed a fistula from the descending thoracic aorta to the stented esophagus. The patient expired 36 hours after initial hematemesis. To our knowledge, this is the first confirmed report of an AEF in patient with a nonesophageal malignancy that had undergone chemo-irradiation and subsequent esophageal stent implantation. We recommend that special caution be exercised when performing esophageal stent implantation in patients who have received prior radiotherapy to the thorax including the esophagus.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/terapia , Fístula Esofágica/etiologia , Hematemese/etiologia , Neoplasias Pulmonares/terapia , Stents/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Terapia Combinada , Fístula Esofágica/patologia , Evolução Fatal , Hematemese/patologia , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
16.
Cardiovasc Intervent Radiol ; 32(3): 577-80, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-18797964

RESUMO

Amyloidosis is characterized by the extracellular deposition of amyloid protein in various organs. Gastrointestinal involvement in amyloidosis is common, but a diagnosis of amyloidosis is often delayed. Severe gastrointestinal hemorrhage in amyloidosis is rare but can be fatal in some cases. We experienced a case of a 49-year-old man who presented with recurrent massive hematochezia. Although embolization was performed eight times for bleeding from different sites of the small intestine, hematochezia did not cease. We report the case, with a review of the literature.


Assuntos
Amiloidose/cirurgia , Gastroenteropatias/cirurgia , Hemorragia Gastrointestinal/cirurgia , Amiloidose/complicações , Amiloidose/diagnóstico por imagem , Angiografia , Meios de Contraste , Embolização Terapêutica , Evolução Fatal , Gastroenteropatias/complicações , Gastroenteropatias/diagnóstico por imagem , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA