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Isolated limb perfusion

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https://www.readbyqxmd.com/read/29209518/diagnosis-and-treatment-of-soft-tissue-sarcomas-of-the-extremities-and-trunk
#1
Maria Anna Smolle, Dimosthenis Andreou, Per-Ulf Tunn, Joanna Szkandera, Bernadette Liegl-Atzwanger, Andreas Leithner
The relatively low incidence and often atypical clinical presentation of soft-tissue sarcomas (STS) impedes early and adequate diagnosis. Patients may report on recently enlarged soft-tissue swellings, infrequently complain of painful lesions, or even have no symptoms at all.A thorough diagnostic work-up is essential in order to distinguish between benign soft-tissue tumours and STSs. Patient history, clinical features and radiological findings all help in assessing the underlying pathology. 'Worrying' features such as recent increase in size, deep location relative to the fascia, a tumour exceeding 4 cm in size, and invasive growth patterns seen on imaging should prompt verification by biopsy...
October 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29142747/clinical-characteristics-of-critically-ill-cancer-patients-who-are-undergoing-isolated-limb-perfusion
#2
Silvio A Ñamendys-Silva, Arturo M Ruiz-Beltran, Mireya Barragán-Dessavre, Andoreni R Bautista-Ocampo, Abelardo Meneses-García, Octavio González-Chon, Angel Herrera-Gómez
The aim of the present study was to investigate the incidence of organ dysfunction, and to describe the clinical characteristics and intensive care unit (ICU) outcomes of critically ill cancer patients who were admitted to an oncological ICU during the isolated limb perfusion post-operative period. The present study was an observational investigation of 42 critically ill cancer patients who were admitted to the ICU of the Instituto Nacional de Cancerología, during the isolated limb perfusion post-operative period, between July 2010 and February 2016...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29022281/isolated-limb-perfusion-and-infusion-for-extremity-soft-tissue-sarcoma-a-contemporary-systematic-review-and-meta-analysis
#3
Madalyn G Neuwirth, Yun Song, Andrew J Sinnamon, Douglas L Fraker, Jonathan S Zager, Giorgos C Karakousis
BACKGROUND: Isolated limb perfusion (ILP) and isolated limb infusion (ILI) have been variably used in recent years for the treatment of locally advanced or marginally resectable extremity soft tissue sarcomas (STSs). We performed a systematic review and meta-analysis of contemporary studies to further characterize treatment patterns and outcomes. METHODS: PubMed was queried for articles published in or after the year 2000, in the English language, with > 10 patients, and with adequate outcome data following ILP/ILI...
December 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28978662/fractalkine-induces-angiogenic-potential-in-cx3cr1-expressing-monocytes
#4
Youngrok Park, Joon Lee, Jae-Yong Kwak, Kyoungmi Noh, Eunjung Yim, Hyun-Kyung Kim, Young June Kim, Hal E Broxmeyer, Jeong-A Kim
We report the unique role of CX3CL1 (or fractalkine) on CD11b(+) myelomonocytic cells expressing CX3CR1, the only known receptor for CX3CL1, in promoting blood perfusion recovery. In a mouse ischemic hind-limb model, CD11b(+)CX3CR1(+) cells migrated to ischemic femoral muscles through CX3CL1-mediated chemotaxis. CD11b(+)CX3CR1(+) macrophages isolated from ischemic tissues [tissue (T)-CD11b(+)CX3CR1(+)] of muscle exert a proangiogenic effect through platelet factor-4 (CXCL4; PF-4) production. PF-4 does not promote angiogenesis by itself but, instead, increases VEGF-mediated angiogenesis...
October 4, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28971992/diuretic-state-affects-ascending-thin-limb-tight-junctions
#5
Svenja Rebecca Sonntag, Annalisa Ziemens, Vera Christine Wulfmeyer, Susanne Milatz, Markus Bleich, Nina Himmerkus
The nephron segments in the inner medulla are part of the urine concentrating mechanism. Depending on the diuretic state they are facing a large range of extracellular osmolality. We investigated whether water homeostasis affects tubular transport and permeability properties in inner medullary descending thin limb (IMdTL) and ascending thin limb (IMaTL). Three experimental groups of rats under different diuretic states were investigated on metabolic cages: waterload, furosemide induced diuresis and control (antidiuresis)...
September 27, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28918185/isolated-limb-perfusion-for-locally-advanced-angiosarcoma-in-extremities-a-multi-centre-study
#6
MULTICENTER STUDY
E A Huis In 't Veld, D J Grünhagen, C Verhoef, H G Smith, A C J van Akkooi, R Jones, F van Coevorden, A J Hayes, W J van Houdt
BACKGROUND: Angiosarcomas are rare and aggressive soft-tissue sarcomas. The only potential curative treatment is complete surgical excision. This study reports the outcome of isolated limb perfusion (ILP) with high-dose melphalan and tumour necrosis factor α for locally advanced angiosarcoma. MATERIAL AND METHODS: All patients who underwent an ILP for angiosarcomas between 1991 and 2016 in three tertiary referral centres were identified from prospectively maintained databases...
November 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28802661/efficacy-of-isolated-limb-perfusion-ilp-in-patients-with-merkel-cell-carcinoma-mcc-a-multicenter-experience
#7
L M van Veenendaal, M F Madu, M E T Tesselaar, C Verhoef, D J Grünhagen, A C J van Akkooi
BACKGROUND: Merkel cell carcinoma (MCC) is a rare and potentially aggressive neuroendocrine tumor of the skin, with a propensity for locoregional metastases. In two expert referral centers, isolated limb perfusion (ILP) is used to obtain locoregional control in selected locoregionally advanced MCC patients. This study describes our experience. METHOD: Patients who underwent ILP for MCC were analyzed. ILP was performed with melphalan and tumor necrosis factor (TNF) combination therapy...
August 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28754400/isolated-limb-perfusion-with-cytostatic-drug-leakage
#8
M Zarazua, P Paredes, F Gahete-Santiago, R Rull, A Blasi, J Balust
Isolated limb perfusion is the treatment of stage III melanoma with in-transit metastasis. This technique allows the administration of cytostatics at an effective concentration and temperature, which could not be administered systemically because of their toxicity. The toxicity due to leakage of the chemotherapy agent from the limb into the systemic circulation is the most serious short-term complication, and is manifested by a systemic inflammatory response syndrome in the immediate post-intervention period...
July 25, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28717603/isolated-limb-perfusion-electrochemotherapy-for-the-treatment-of-an-advanced-squamous-cell-carcinoma-of-the-hoof-in-a-mare
#9
Enrico Pierluigi Spugnini, Carlo Bolaffio, Licia Scacco, Alfonso Baldi
A twenty-year-old female saddle horse was referred for evaluation of a seven month, non-healing erosive lesion of the right hind hoof with proliferation and bleeding of the underlying soft tissues. This lesion had been twice surgically treated as a canker but rapidly recurred. Histological examination of the second excision revealed a well-differentiated squamous cell carcinoma. At presentation, the horse was mildly depressed, lame and partially non-weight-bearing on the right hind leg, which exhibited a 10 x 10 cm erosive and proliferative lesion remodeling the hoof...
2017: Open Veterinary Journal
https://www.readbyqxmd.com/read/28624225/inhibition-of-mef2a-enhances-neovascularization-via-post-transcriptional-regulation-of-14q32-micrornas-mir-329-and-mir-494
#10
Sabine M J Welten, Margreet R de Vries, Erna A B Peters, Sudhir Agrawal, Paul H A Quax, A Yaël Nossent
Improving the efficacy of neovascularization is a promising strategy to restore perfusion of ischemic tissues in patients with peripheral arterial disease. The 14q32 microRNA cluster is highly involved in neovascularization. The Mef2a transcription factor has been shown to induce transcription of the microRNAs within this cluster. We inhibited expression of Mef2a using gene-silencing oligonucleotides (GSOs) in an in vivo hind limb ischemia model. Treatment with GSO-Mef2a clearly improved blood flow recovery within 3 days (44% recovery versus 25% recovery in control) and persisted until 14 days after ischemia induction (80% recovery versus 60% recovery in control)...
June 16, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28612619/-isolated-perfusion-of-the-upper-extremity-with-tnf-%C3%AE-double-venous-cannulation
#11
M Špaček, P Mitáš, M Vočka, L Lacina, G Hodková, R Špunda, O Kodet, I Krajsová, L Petruželka, J Trnka, J Kubinyi, Z Matějovský, L Lambert, J Lindner
BACKGROUND: The authors present a technical variation of the standard cannulation for cardiopulmonary bypass perfusion during hyperthermic isolated limb perfusion (ILP) procedures in selected patients with unresectable soft tissue sarcoma or malignant melanoma. PATIENTS: Of 55 ILP procedures performed at our institution since the procedure was established in 2009, nine were performed at the upper extremity. Standard single venous cannulation was used in five cases, and extended, double venous cannulation in the last four...
December 0: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28607127/role-of-the-primary-cilia-on-the-macula-densa-and-thick-ascending-limbs-in-regulation-of-sodium-excretion-and-hemodynamics
#12
Jiangping Song, Lei Wang, Fan Fan, Jin Wei, Jie Zhang, Yan Lu, Yiling Fu, Shaohui Wang, Luis A Juncos, Ruisheng Liu
We investigated the significance of the primary cilia on the macula densa and thick ascending limb (TAL) in regulation of renal hemodynamics, sodium excretion, and blood pressure in this study. A tissue-specific primary cilia knock-out (KO) mouse line was generated by crossing NKCC2-Cre mice with IFT88-Δ/flox mice (NKCC2(CRE); IFT88Δ(/flox)), in which the primary cilia were deleted from the macula densa and TAL. NO generation was measured with a fluorescent dye (4,5-diaminofluorescein diacetate) in isolated perfused juxtaglomerular apparatus...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28601307/hyperthermic-isolated-limb-perfusion-the-switch-from-steinmann-pins-to-omni-tract-assisted-isolation
#13
COMPARATIVE STUDY
Dimitrios Stamatiou, Christos V Ioannou, Nikolaos Kontopodis, Dimosthenis Michelakis, Konstantinos Perisinakis, Konstantinos Lasithiotakis, Odysseas Zoras
BACKGROUND: Hyperthermic isolated limb perfusion (HILP) represents an alternative to amputation for patients with either in-transit melanoma or unresectable soft tissue sarcoma, entailing delivery of high-dose chemotherapy after isolation of the extremity, under hyperthermic conditions. Stabilization of the Esmarch elastic bandage is so far performed with the use of Steinmann pins. In this study, we presented our experience with HILP and demonstrated an alternative technique for limb isolation using an Omni-tract retractor instead of the traditional Steinmann pin, while comparing the two methods...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28599085/exploring-the-putative-role-of-trpv1-dependent-cgrp-release-in-remote-hind-preconditioning-induced-cardioprotection
#14
Puneet Kaur Randhawa, Amteshwar Singh Jaggi
Remote ischemic preconditioning (RIPC) is a phenomenon whereby transient non-lethal ischemia and reperfusion episodes confer protection against prolonged ischemia-reperfusion-induced injury. However, the underlying intracellular signaling has not been extensively explored. The present study aims to inspect the putative involvement of TRPV1 -dependent CGRP release in mediating remote hind limb preconditioning-induced cardioprotection. In the present study, remote hind limb preconditioning stimulus was delivered (4 consecutive episodes of 5 minutes of ischemia-reperfusion) using a blood pressure cuff tied at the inguinal level of the rat...
June 9, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28549963/the-role-of-the-profundoplasty-in-the-modern-management-of-patient-with-peripheral-vascular-disease
#15
Maurizio Taurino, Francesca Persiani, Roberta Ficarelli, Federico Filippi, Raffaele Dito, Luigi Rizzo
BACKGROUND: The occlusion of superficial femoris artery (SFA) is a common feature in peripheral vascular disease, so the profunda femoris artery (PFA) is a crucial collateral pathway for the perfusion of the lower limb. The purpose of this study is to discuss the safety, clinical, and hemodynamic efficacy of profundoplasty on the basis of limb salvage, patency, and freedom from reintervention rates. Furthermore, this study aims to identify the risk factors linked to the failure of the procedure...
May 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28540806/laparoscopic-hyperthermic-isolated-limb-perfusion-a-new-minimally-invasive-approach-for-hilp
#16
N Solari, F Sucameli, M Gipponi, F De Cian, F Cafiero
BACKGROUND: Hyperthermic isolated limb perfusion (HILP) represents a limb-sparing treatment for unresectable soft tissue sarcoma (STS) of the extremities with substantial complete response rates. HILP often provides good functional limb preservation, hence a significant improvement also in terms of quality of life of the patient. Notwithstanding these clear advantages, the traditional technique is still hindered by relatively high post-operative morbidity. METHOD: We treated a 78-year-old female with unresectable angiosarcoma of the left leg using a new surgical approach: an entirely laparoscopic HILP...
April 24, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540796/myoglobin-does-not-predict-local-toxicity-in-isolated-limb-perfusion
#17
Andreas Nyström Wendt, Jan Mattsson, Roger Olofsson Bagge
INTRODUCTION: Isolated limb perfusion (ILP) is a treatment option for patients with in-transit metastases of malignant melanoma in the extremities, as well as locally advanced sarcoma. ILP allows for a delivery of high-dose chemotherapy to an isolated extremity with minimal systemic toxicity. However, local toxicity like oedema, blistering, nerve damage and compartment syndrome can occur. Myoglobin measurements have been used as a screening method to predict the most severe cases of local toxicity...
April 10, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28515994/in-vivo-reflectance-confocal-microscopy-a-useful-non-invasive-tool-to-assess-the-response-to-isolated-limb-perfusion-for-superficial-pigmented-melanoma-in-transit-metastatic-disease-report-of-a-case
#18
Rastine Merat, Wolf-Henning Boehncke, Gürkan Kaya
Complete response can be difficult to assess after isolated limb perfusion (ILP) for metastatic in-transit melanoma, especially when numerous and unresectable post-necrotic persisting pigmented lesions occur. These residual lesions are mainly seen in the more superficial and pigmented types of metastatic disease and correspond to the residual melanophage granuloma that persists after tumor tissues undergo complete necrosis. Reflectance confocal microscopy (RCM) is a non-invasive technique that allows the exploration of the superficial dermis...
April 2017: Dermatology Practical & Conceptual
https://www.readbyqxmd.com/read/28470333/extracorporeal-perfusion-of-isolated-organs-of-large-animals-bridging-the-gap-between-in-vitro-and-in-vivo-studies
#19
Carola R Daniel, Raphael Labens, David Argyle, Theresia F Licka
Since the early 20th century extracorporeal perfusion of large animal organs has been used to investigate a broad variety of research questions, thereby overcoming common draw backs of in vitro studies without suffering from ethical concerns associated with live animal research. The technique is in accordance with the 3R principles and represents an excellent opportunity to investigate in detail the physiology of organs under standardised conditions. It is also suitable for the translation of basic pre-clinical research into a more relevant arena prior to or avoiding altogether live animal research...
May 3, 2017: ALTEX
https://www.readbyqxmd.com/read/28444128/low-dose-ionizing-radiation-induces-therapeutic-neovascularization-in-a-pre-clinical-model-of-hindlimb-ischemia
#20
Augusto Ministro, Paula de Oliveira, Raquel J Nunes, André Dos Santos Rocha, Adriana Correia, Tânia Carvalho, José Rino, Pedro Faísca, Jorg D Becker, João Goyri-O'Neill, Filomena Pina, Esmeralda Poli, Bruno Silva-Santos, Fausto Pinto, Marc Mareel, Karine Serre, Susana Constantino Rosa Santos
Aims: We have previously shown that low-dose ionizing radiation (LDIR) induces angiogenesis but there is no evidence that it induces neovascularization in the setting of peripheral arterial disease. Here, we investigated the use of LDIR as an innovative and non-invasive strategy to stimulate therapeutic neovascularization using a model of experimentally induced hindlimb ischemia (HLI). Methods and results: After surgical induction of unilateral HLI, both hindlimbs of female C57BL/6 mice were sham-irradiated or irradiated with four daily fractions of 0...
June 1, 2017: Cardiovascular Research
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