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https://www.readbyqxmd.com/read/28333016/predictors-of-liver-toxicity-following-stereotactic-body-radiation-therapy-for-hepatocellular-carcinoma
#1
Michael Velec, Carol R Haddad, Tim Craig, Lisa Wang, Patricia Lindsay, James Brierley, Anthony Brade, Jolie Ringash, Rebecca Wong, John Kim, Laura A Dawson
PURPOSE: To identify risk factors associated with a decline in liver function after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma. METHODS AND MATERIALS: Data were analyzed from patients with hepatocellular carcinoma treated on clinical trials of 6-fraction SBRT. Liver toxicity was defined as an increase in Child-Pugh (CP) score ≥2 three months after SBRT. Clinical factors, SBRT details, and liver dose-volume histogram (DVH) parameters were tested for association with toxicity using logistic regression...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28331452/balloon-occlusion-technique-for-managing-portal-vein-hemorrhage-in-liver-transplantation
#2
John B Seal, Humberto Bohorquez, Naren Battula, Lucia DeGregorio, Emily Bugeaud, David S Bruce, Ian C Carmody, Ari J Cohen, George E Loss
BACKGROUND: Portal vein thrombosis (PVT) is relatively common among candidates for liver transplantation and can present significant intraoperative challenges. Depending on the extent of PVT, thromboendovenectomy (TEV), portal bypass, or systemic inflow may be required to restore portal inflow. While TEV is the most commonly used approach to restore anatomic portal inflow, portal vein injury and life-threatening hemorrhage are risks with this technique. CASE REPORT: We present a salvage technique for managing portal vein injury during TEV using intraluminal balloon occlusion of the portal vein during portal vein repair and reconstruction...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331142/usefulness-of-color-coding-resected-samples-from-a-pancreaticoduodenectomy-with-tissue-marking-dyes-for-a-detailed-examination-of-surgical-margin-surrounding-the-uncinate-process-of-the-pancreas
#3
Satoshi Mizutani, Hideyuki Suzuki, Takayuki Aimoto, Seiji Yamagishi, Keisuke Mishima, Masanori Watanabe, Yasuhiko Kitayama, Norio Motoda, Saiko Isshiki, Eiji Uchida
BACKGROUND: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy. The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28330599/impact-of-graft-preservation-solutions-for-liver-transplantation-on-early-cytokine-release-and-postoperative-organ-dysfunctions-a-pilot-study
#4
H Brisson, C Arbelot, A Monsel, C Parisot, M Girard, E Savier, C Vezinet, Q Lu, J-C Vaillant, J-L Golmard, G Gorochov, O Langeron, J-J Rouby
INTRODUCTION: During liver transplantation, graft ischemia-reperfusion injury leads to a systemic inflammatory response producing postoperative organ dysfunctions. The aim of this observational and prospective study was to compare the impact of Solution de conservation des organes et tissus (SCOT) 15 and University of Wisconsin (UW) preservation solutions on early cytokine release, postreperfusion syndrome and postoperative organ dysfunctions. METHODS: Thirty-seven liver transplantations were included: 21 in UW Group and 16 in SCOT 15 group...
March 15, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28328234/quantification-of-basal-insulin-peglispro-and-human-insulin-in-adipose-tissue-interstitial-fluid-by-open-flow-microperfusion
#5
Katrin Tiffner, Beate Boulgaropoulos, Christian Höfferer, Thomas Birngruber, Niels Porksen, Helle Linnebjerg, Parag Garhyan, Eric Chen Quin Lam, Mary Pat Knadler, Thomas R Pieber, Frank Sinner
BACKGROUND: Restoration of the physiologic hepatic-to-peripheral insulin gradient may be achieved by either portal vein administration or altering insulin structure to increase hepatic specificity or restrict peripheral access. Basal insulin peglispro (BIL) is a novel, PEGylated basal insulin with a flat pharmacokinetic and glucodynamic profile and altered hepatic-to-peripheral action gradient. We hypothesized reduced BIL exposure in peripheral tissues explains the latter, and in this study assessed the adipose tissue interstitial fluid (ISF) concentrations of BIL compared with human insulin (HI)...
March 22, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28324324/prognostic-factors-of-sorafenib-therapy-in-hepatocellular-carcinoma-patients-with-failure-of-transarterial-chemoembolization
#6
Sangheun Lee, Jung Hyun Kang, Do Young Kim, Sang Hoon Ahn, Jun Yong Park, Beom Kyung Kim, Seung Up Kim, Kwang-Hyub Han
BACKGROUND: There is no approved therapy for patients with failed transarterial chemoembolization (TACE) and progression of hepatocellular carcinoma. We aimed to investigate the efficacy and prognostic factors in patients with TACE failure who received sorafenib rescue therapy. METHODS: We investigated 54 patients who met the criteria of TACE failure as defined by the international guidelines of Europe and Japan. Sorafenib was used as a rescue therapy. Overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier methods, and multivariate analysis was performed to find prognostic factors...
March 21, 2017: Hepatology International
https://www.readbyqxmd.com/read/28324163/new-macroscopic-classification-and-back-flow-thrombectomy-for-advanced-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus-invading-the-contralateral-second-portal-branch
#7
Takumi Fukumoto, Masahiro Kido, Atsushi Takebe, Motofumi Tanaka, Hisoka Kinoshita, Kaori Kuramitsu, Shohei Komatsu, Daisuke Tsugawa, Tadahiro Goto, Sadaki Asari, Hirochika Toyama, Tetsuo Ajiki, Yonson Ku
PURPOSE: Patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) invading the portal trunk (Vp4) are poor surgical candidates because of the technical difficulties involved. To overcome the limitations, we developed a technique of back-flow thrombectomy (BFT) based on the inherent portal hemodynamics and the macroscopic form of PVTT. METHODS: Forty-six patients with multiple HCC and Vp4 PVTT underwent hepatectomy with tumor thrombectomy...
March 21, 2017: Surgery Today
https://www.readbyqxmd.com/read/28322103/segmental-portal-superior-mesenteric-vein-resection-and-reconstruction-with-the-iliac-vein-after-pancreatoduodenectomy
#8
Xin Zhao, Li-Xin Li, Hua Fan, Jian-Tao Kou, Xian-Liang Li, Ren Lang, Qiang He
Objective The results of segmental venous resection (VR) combined with pancreatoduodenectomy (PD) are controversial but may be promising. Few studies have described reconstruction of the portal/superior mesenteric vein (PV/SMV) with the iliac vein harvested from donation after cardiac death (DCD). Methods From January 2014 to April 2016, PD combined with segmental excision of the PV/SMV (VR group) was performed in 21 patients with adenocarcinoma of the head of the pancreas (ADHP). The authors established a new technique of venous reconstruction using the iliac vein from DCD and analysed patients' long-term survival...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28321158/porcine-model-characterizing-various-parameters-assessing-the-outcome-after-acetaminophen-intoxication-induced-acute-liver-failure
#9
Karolin Thiel, Wilfried Klingert, Kathrin Klingert, Matthias H Morgalla, Martin U Schuhmann, Pamela Leckie, Yalda Sharifi, Nathan A Davies, Rajiv Jalan, Andreas Peter, Christian Grasshoff, Alfred Königsrainer, Martin Schenk, Christian Thiel
AIM: To investigate the changes of hemodynamic and laboratory parameters during the course of acute liver failure following acetaminophen overdose. METHODS: Eight pigs underwent a midline laparotomy following jejunal catheter placement for further acetaminophen intoxication and positioning of a portal vein Doppler flow-probe. Acute liver failure was realized by intrajejunal acetaminophen administration in six animals, two animals were sham operated. All animals were invasively monitored and received standardized intensive care support throughout the study...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28320514/eus-guided-portal-vein-interventions
#10
Guru Trikudanathan, Rahul Pannala, Manoop S Bhutani, Joshua Melson, Udayakumar Navaneethan, Mansour A Parsi, Nirav Thosani, Arvind J Trindade, Rabindra R Watson, John T Maple
No abstract text is available yet for this article.
March 17, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28319252/physiologic-reduction-of-hepatic-venous-blood-flow-by-the-valsalva-maneuver-decreases-liver-stiffness
#11
Selcan Ipek-Ugay, Heiko Tzschätzsch, Jürgen Braun, Thomas Fischer, Ingolf Sack
OBJECTIVES: Liver stiffness increases after intake of food or water, suggesting that hepatic venous blood flow affects the results of elastographic measurements. This study investigated the correlation between in vivo liver stiffness and hepatic blood flow using the Valsalva maneuver for reducing intrahepatic venous blood flow. METHODS: Intrahepatic changes in venous blood flow were assessed by sonography based on the pulsed wave Doppler velocity, vessel diameter assessment, and blood flow volume measurements in the portal vein and right hepatic vein...
March 20, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28319148/the-incremental-benefit-of-eus-for-identifying-unresectable-disease-among-adults-with-pancreatic-adenocarcinoma-a-meta-analysis
#12
Paul D James, Zhao Wu Meng, Mei Zhang, Paul J Belletrutti, Rachid Mohamed, William Ghali, Derek J Roberts, Guillaume Martel, Steven J Heitman
BACKGROUND AND STUDY AIMS: It is unclear to what extent EUS influences the surgical management of patients with pancreatic adenocarcinoma. This systematic review sought to determine if EUS evaluation improves the identification of unresectable disease among adults with pancreatic adenocarcinoma. PATIENTS AND METHODS: We searched MEDLINE, EMBASE, bibliographies of included articles and conference proceedings for studies reporting original data regarding surgical management and/or survival among patients with pancreatic adenocarcinoma, from inception to January 7th 2017...
2017: PloS One
https://www.readbyqxmd.com/read/28317586/strategies-to-improve-local-control-of-resected-pancreas-adenocarcinoma
#13
Paul H Sugarbaker
BACKGROUND: Only approximately one in ten pancreas cancer patients is a candidate for potentially curative resection of this disease. Even this small fraction of patients has a poor prognosis following pancreatico-duodenectomy. The disease has an anatomic location that makes it difficult for the surgeon to maintain adequate margins of resection and prevent tumor spillage at the time of resection. Also, the disease is biologically aggressive and even with a complete visible resection of the disease, micrometastases are likely to remain behind...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28317585/meta-analysis-and-cost-effective-analysis-of-portal-superior-mesenteric-vein-resection-during-pancreatoduodenectomy-impact-on-margin-status-and-survival
#14
REVIEW
Richard Bell, Braden Te Ao, Natasha Ironside, Adam Bartlett, John A Windsor, Sanjay Pandanaboyana
INTRODUCTION: The benefit of portal-superior mesenteric vein resection (PSMVR) with pancreatoduodenectomy (PD) remains controversial. This study assesses the impact of PSMVR on resection margin status and survival. METHOD: An electronic search was performed to identify relevant articles. Pooled odds ratios were calculated for outcomes using the fixed or random-effects models for meta-analysis. A decision analytical model was developed for estimating cost effectiveness...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28316856/giant-splenorenal-shunt-in-a-young-patient-with-autoimmune-hepatitis-primary-biliary-cholangitis-overlap-syndrome-and-portal-vein-thrombosis
#15
F Chegai, A U Cavallo, M Forcina, V Giuricin, F Castellani, L Greco, M Manuelli, T M Manzia, G Sergiacomi
We present a case of giant Splenorenal Shunt (SRS) associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensive calcified thrombosis causing complete occlusion of the portal vein lumen and partially occluding the origin of the superior mesenteric vein was present and a small calcified thrombus in the Splenic Vein lumen was also evident...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/28316323/a-rare-cause-of-upper-gastrointestinal-hemorrhage-chronic-thrombosis-of-the-splenic-artery
#16
Sevtap Arslan, Mehmet Ruhi Onur, Erhan Akpınar
Upper gastrointestinal bleeding (UGIB) represents one of the most serious conditions of the gastrointestinal tract with a mortality rate of 10%. The main cause of UGIB is peptic ulcer, accounting for 28%-59% of cases. A rare cause of UGIB is submucosal arterial collaterals, which develop after splenic artery thrombosis. UGIB secondary to gastric submucosal collateral arteries should be considered in patients with endoscopic appearance of varicose veins in the absence of portal hypertension. Computed tomography angiography (CTA) is the only fast and noninvasive definitive imaging technique for such patients...
March 17, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#17
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28315648/morphologic-and-doppler-findings-from-hepatic-ultrasonography-of-normal-cynomolgus-monkeys-macaca-fascicularis
#18
Kyo Won Lee, Chan Woo Cho, Ji Eun Lee, Hyojun Park, Gyu-Seong Choi, Woo Kyoung Jeong, Jae Berm Park, Sungjoo Kim
The present study evaluated the anatomic and ultrasonographic features of the liver in normal cynomolgus monkeys (Macaca fascicularis). Healthy, male, cynomolgus monkeys from Cambodia (n = 25; mean age, 58.1 mo) were sedated with ketamine (7 mg/kg) and examined by using 2D and Doppler ultrasonography. We measured the diameters of the vascular structures and bile duct, determined the velocities of the hepatic artery and portal vein, and calculated the resistance index of the hepatic artery. Vessel diameters were: proper hepatic artery, 1...
March 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28315061/external-validation-of-the-simplified-preoperative-assessment-for-low-grade-mucinous-adenocarcinoma-of-the-appendix
#19
Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim Gushchin
BACKGROUND: MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for appendix tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the appendix, based on preoperative CT scans. This study independently evaluates the tool's performance. METHODS: Seventy-six preoperative CT scans of LGMA patients were evaluated by two surgeons unfamiliar with the patients' medical history...
March 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28302230/distal-duodenal-varices-first-presentation-of-upper-gastrointestinal-bleeding
#20
Inam -Ul- Haq, Amir Ali Shah, S Chandramohan
Varices are abnormal dilated veins which result from increased pressure in the portal circulation. Although the oesophagus and stomach are the most common sites for varices to develop, they may also occur as ectopic varices in the duodenum, rectum, and retroperitoneal areas. Isolated duodenal varices involving distal duodenum, particularly the fourth part of the duodenum, are extremely rare. However, such ectopic varices are associated with an increased risk of bleeding and mortality. Not only are they a diagnostic challenge, particularly if they present as a first manifestation of portal hypertension, they are also very difficult to treat due to their location...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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