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Isolated limb infusion

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https://www.readbyqxmd.com/read/27897028/a-single-center-experience-with-isolated-limb-infusion-an-interventional-oncology-opportunity
#1
Adam DeFoe, Andrew Heckman, Dick Slater, Edibaldo Silva-Lopez, Jason Foster, Thom Bowden, Christopher Vargo
OBJECTIVE: This retrospective review details our experience with isolated limb infusion for the treatment of melanoma, squamous cell carcinoma, and sarcoma in-transit metastases performed entirely in the interventional radiology suite. Eleven patients were treated over a 3-year period. Treatment response was assessed clinically and with PET/CT. CONCLUSION: Eight patients had either complete or partial response, giving an overall response rate of 72%. Isolated limb infusion can efficiently be performed entirely in the interventional radiology suite...
November 29, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27859767/mechanisms-for-the-control-of-local-tissue-blood-flow-during-thermal-interventions-influence-of-temperature-dependent-atp-release-from-human-blood-and-endothelial-cells
#2
Kameljit K Kalsi, Scott T Chiesa, Steven J Trangmar, Leena Ali, Makrand D Lotlikar, José González-Alonso
Local tissue perfusion changes with alterations in temperature during heating and cooling, but the thermosensitivity of the vascular ATP signalling mechanisms for control of blood flow during thermal interventions remains unknown. Here we tested the hypotheses that the release of the vasodilator mediator ATP from human erythrocytes, but not from endothelial cells or other blood constituents, is sensitive to both increases and reductions in temperature and that increasing intravascular ATP availability with ATP infusion would potentiate thermal hyperaemia in limb tissues...
November 17, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27680682/preclinical-validation-of-a-single-treatment-infusion-modality-that-can-eradicate-extremity-melanomas
#3
Minhyung Kim, Nickolay Neznanov, Chandler D Wilfong, Daria I Fleyshman, Andrei A Purmal, Gary Haderski, Patricia Stanhope-Baker, Catherine A Burkhart, Katerina V Gurova, Andrei V Gudkov, Joseph J Skitzki
Isolated limb perfusion (ILP) with the chemotherapeutic agent melphalan is an effective treatment option for extremity in-transit melanoma but is toxic and technically challenging to deliver locoregionally. CBL0137 is an experimental clinical drug with broad anticancer activity in animal models, owing to its ability to bind DNA in a nongenotoxic manner and inactivate the FACT chromatin modulator essential for tumor cell viability. Here, we report that CBL0137 delivered by ILP in a murine melanoma model is as efficacious as melphalan, displaying antitumor activity at doses corresponding to only a fraction of the systemic MTD of CBL0137...
September 28, 2016: Cancer Research
https://www.readbyqxmd.com/read/27664339/quiescent-pluripotent-stem-cells-reside-within-murine-peripheral-nerves-that-can-be-stimulated-to-proliferate-by-recombinant-human-bone-morphogenic-protein-2-or-by-nerve-trauma
#4
Michael H Heggeness, Nora Strong, Paul H Wooley, Shang-You Yang
BACKGROUND: The clinical use of recombinant human bone morphogenic protein 2 (rhBMP-2, Infuse) has been associated with nerve-related complications including new-onset sciatica, and retrograde ejaculation. PURPOSE: To better understand the interaction of rhBMP-2 and peripheral nerves with the intent of making procedures safer. STUDY DESIGN/SETTING: Using a mouse model to examine the direct effect of diluted rhBMP-2 (Infuse) on murine sciatic nerves...
September 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27600523/reconstituted-high-density-lipoproteins-promote-wound-repair-and-blood-flow-recovery-in-response-to-ischemia-in-aged-mice
#5
Tania Tsatralis, Anisyah Ridiandries, Stacy Robertson, Laura Z Vanags, Yuen Ting Lam, Joanne T M Tan, Martin K C Ng, Christina A Bursill
BACKGROUND: The average population age is increasing and the incidence of age-related vascular complications is rising in parallel. Impaired wound healing and disordered ischemia-mediated angiogenesis are key contributors to age-impaired vascular complications that can lead to amputation. High-density lipoproteins (HDL) have vasculo-protective properties and augment ischemia-driven angiogenesis in young animals. We aimed to determine the effect of reconstituted HDL (rHDL) on aged mice in a murine wound healing model and the hindlimb ischemia (HLI) model...
2016: Lipids in Health and Disease
https://www.readbyqxmd.com/read/27570911/codelivery-of-infusion-decellularized-skeletal-muscle-with-minced-muscle-autografts-improved-recovery-from-volumetric-muscle-loss-injury-in-a-rat-model
#6
Benjamin Kasukonis, John Kim, Lemuel Brown, Jake Jones, Shahryar Ahmadi, Tyrone Washington, Jeffrey Wolchok
Skeletal muscle is capable of robust self-repair following mild trauma, yet in cases of traumatic volumetric muscle loss (VML), where more than 20% of a muscle's mass is lost, this capacity is overwhelmed. Current autogenic whole muscle transfer techniques are imperfect, which has motivated the exploration of implantable scaffolding strategies. In this study, the use of an allogeneic decellularized skeletal muscle (DSM) scaffold with and without the addition of minced muscle (MM) autograft tissue was explored as a repair strategy using a lower-limb VML injury model (n = 8/sample group)...
October 2016: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/27540361/netupitant-a-potent-and-highly-selective-nk1-receptor-antagonist-alleviates-acetic-acid-induced-bladder-overactivity-in-anesthetized-guinea-pigs
#7
Stefano Palea, Véronique Guilloteau, Moéz Rekik, Emanuela Lovati, Marc Guerard, Maria-Alba Guardia, Philippe Lluel, Claudio Pietra, Mitsuharu Yoshiyama
Introduction. Tachykinins potently contract the isolated urinary bladder from a number of animal species and play an important role in the regulation of the micturition reflex. On the guinea-pig isolated urinary bladder we examined the effects of a new potent and selective NK1 receptor antagonist (netupitant) on the contractions induced by a selective NK1 receptor agonist, SP-methylester (SP-OMe). Moreover, the effects of netupitant and another selective NK1 antagonist (L-733,060) were studied in anesthetized guinea-pigs using two experimental models, the isovolumetric bladder contractions and a model of bladder overactivity induced by intravesical administration of acetic acid (AA)...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27237868/intralesional-pv-10-for-in-transit-melanoma-a-single-center-experience
#8
Jocelyn Lippey, Rhiannon Bousounis, Cori Behrenbruch, Bartholomew McKay, John Spillane, Michael A Henderson, David Speakman, David E Gyorki
BACKGROUND AND OBJECTIVES: Patients with in-transit melanoma metastasis have longer median survival than patients with distant metastatic disease. Furthermore, local disease control is an important endpoint for symptom management. The treatment of unresectable loco-regional recurrence or in-transit disease has been historically managed with a combination of treatments including surgery, radiotherapy, isolated limb infusion or perfusion as well as systemic therapies. Intralesional PV-10 has been used at Peter MacCallum Cancer Centre since 2010, and the current report presents a retrospective analysis of patient outcomes, reporting the response rates, durability of responses, and observed toxicities...
September 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/26926481/clinical-response-and-regional-toxicity-following-isolated-limb-infusion-compared-with-isolated-limb-perfusion-for-in-transit-melanoma
#9
Lesly A Dossett, Ilan Ben-Shabat, Roger Olofsson Bagge, Jonathan S Zager
BACKGROUND: Isolated limb perfusion (ILP) and infusion (ILI) are therapeutic modalities for the treatment of in transit melanoma. METHODS: A retrospective review of all patients undergoing first-time ILI or ILP for in-transit melanoma metastases between 2007 and 2015 was performed. Demographic and clinical characteristics included age, sex, nodal status at the time of ILI/ILP (N-stage), and burden of disease (BOD). Regional toxicity was categorized by the Wieberdink classification...
July 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/26797898/use-patterns-and-costs-of-isolated-limb-perfusion-and-infusion-in-the-treatment-of-regional-metastatic-melanoma-a-retrospective-database-analysis
#10
Qiufei Ma, Zhongyun Zhao, Beth L Barber, Mark Shilkrut
INTRODUCTION: Isolated limb perfusion and infusion (ILP/ILI) are therapies for regional metastatic melanoma that allow high doses of anticancer drugs to be delivered directly into the circulation of an affected limb, thereby minimizing systemic drug toxicity. This procedure can lead to high response rates and is recommended in patients with Stage III unresectable metastatic melanoma. However, limited information is available on patterns of use and costs. This study examined patterns of ILP/ILI use and associated costs in patients with melanoma in the United States (US)...
February 2016: Advances in Therapy
https://www.readbyqxmd.com/read/26768512/neoadjuvant-use-of-ipilimumab-in-locally-advanced-melanoma
#11
Lynn J Howie, Douglas S Tyler, April K S Salama
Recent advances in immune modulating therapies show great promise for patients with advanced melanoma, however optimal strategies for achieving long-term disease control in locally advanced melanoma are unclear. We present two cases of neoadjuvant ipilimumab, one case in combination with isolated limb infusion (ILI) followed by surgical resection and one followed by surgery alone. Both patients have had durable responses. These cases highlight the ongoing need for prospective trials in the neoadjuvant setting...
December 2015: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/26686469/local-and-systemic-vasodilatory-effects-of-low-molecular-weight-s-nitrosothiols
#12
Taiming Liu, Hobe J Schroeder, Sean M Wilson, Michael H Terry, Monica Romero, Lawrence D Longo, Gordon G Power, Arlin B Blood
S-nitrosothiols (SNOs) such as S-nitroso-L-cysteine (L-cysNO) are endogenous compounds with potent vasodilatory activity. During circulation in the blood, the NO moiety can be exchanged among various thiol-containing compounds by S-transnitrosylation, resulting in SNOs with differing capacities to enter the cell (membrane permeability). To determine whether the vasodilating potency of SNOs is dependent upon membrane permeability, membrane-permeable L-cysNO and impermeable S-nitroso-D-cysteine (D-cysNO) and S-nitroso-glutathione (GSNO) were infused into one femoral artery of anesthetized adult sheep while measuring bilateral femoral and systemic vascular conductances...
February 2016: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/26601864/chemotherapy-for-melanoma
#13
REVIEW
Melissa A Wilson, Lynn M Schuchter
Prior to the recent therapeutic advances, chemotherapy was the mainstay of treatment options for advanced-stage melanoma. A number of studies have investigated various chemotherapy combinations in order to expand on the clinical responses achieved with single-agent dacarbazine, but these have not demonstrated an improvement in overall survival. Similar objective responses were observed with the combination of carboplatin and paclitaxel as were seen with single-agent dacarbazine. The combination of chemotherapy and immunotherapy, known as biochemo-therapy, has shown high clinical responses; however, biochemo-therapy has not been shown to improve overall survival and resulted in increased toxicities...
2016: Cancer Treatment and Research
https://www.readbyqxmd.com/read/26581203/australian-multicenter-study-of-isolated-limb-infusion-for-melanoma
#14
Hidde M Kroon, Brendon J Coventry, Mitchell H Giles, Michael A Henderson, David Speakman, Mark Wall, Andrew Barbour, Jonathan Serpell, Paul Paddle, Alexander G J Coventry, Thomas Sullivan, Bernard Mark Smithers, John F Thompson
PURPOSE: Isolated limb infusion (ILI) offers a less invasive alternative to isolated limb perfusion (ILP) for the treatment of locally advanced extremity melanoma. In Australia, ILI has essentially completely replaced ILP. The aim of this study was to collect and evaluate the results of ILI in an Australian multicenter setting. PATIENTS AND METHODS: The results of 316 first ILI procedures, performed between 1992 and 2008 in five Australian institutions, were collectively analyzed, with all five institutions using the same protocol...
April 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/26382102/the-role-of-regional-chemotherapy-in-the-management-of-extremity-soft-tissue-malignancies
#15
REVIEW
H G Smith, A J Hayes
BACKGROUND: Regional chemotherapy involves the targeted delivery of high dose chemotherapy to an affected area. In the limbs, the two main methods employed are isolated limb perfusion (ILP) and isolated limb infusion (ILI), with advantages and disadvantages to each technique. The aim of this review was to clarify the roles of each technique in the management of locally advanced soft tissue malignancies of the extremities. METHODS: Relevant articles were identified from a comprehensive literature search using the PubMed database...
January 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/26288004/myoepithelial-carcinoma-of-the-extremity-response-to-isolated-limb-infusion
#16
COMPARATIVE STUDY
Michael J Fitzgerald, Klaus Busam, Edward Athanasian, Mary S Brady
We report our experience with two patients with myoepithelial carcinoma (MEC) of the extremity. An 83-year-old male and a 35-year-old female were treated with standard isolated limb infusion (ILI), using melphalan and dactinomycin. The first patient had a complete response (CR) that was sustained for two and a half years, until he developed a regional lymph node metastasis. The second patient had a 4.7 cm tumor located on her left hand with metastasis to the ipsilateral axillary lymph nodes. Initial treatment consisted of ILI and left axillary lymphadenectomy...
October 2015: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/26266102/isolated-limb-infusion-chemotherapy-with-or-without-hemofiltration-for-recurrent-limb-melanoma
#17
Sara Cecchini, Donatella Sarti, Stefano Ricci, Ludovico Delle Vergini, Manuela Sallei, Stefano Serresi, Giuseppe Ricotti, Luca Mulazzani, Fabrizia Lattanzio, Giammaria Fiorentini
AIM: To better define the efficacy and the safety of intra-arterial infusion performed with or without hemofiltration for recurrent limb melanoma. METHODS: Patients with the following characteristics were included in the study: recurrent limb melanoma not indicated for surgical resection, measurable disease in the extremity, > 18 years, performances status (Eastern Cooperative Oncology Group ) was 0-1 and life expectancy of at least 6 mo. Twenty nine consecutive patients were enrolled in the study...
August 10, 2015: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/26256710/a-multicenter-retrospective-study-of-the-effectiveness-of-the-trellis-8-system-in-the-treatment-of-proximal-lower-extremity-deep-vein-thrombosis
#18
MULTICENTER STUDY
Paul Gagne, Thomas Khoury, Barry J Zadeh, Hiranya A Rajasinghe
BACKGROUND: Deep vein thrombosis (DVT) occurs in up to 600,000 patients in the United States annually and can lead to long-term morbidity because of the post-thrombotic syndrome. The multicenter isolated-pharmacomechanical thrombolysis device (ISOL-8) study was designed to determine the safety and efficacy of the Trellis™-8 peripheral infusion system when used as the primary intervention to achieve DVT thrombolysis in patients with proximal lower-extremity occlusive DVT, and track the incidence and severity of the post-thrombotic syndrome (PTS) symptoms in patients 2 years after treatment...
November 2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26140669/the-role-of-regional-therapies-for-in-transit-melanoma-in-the-era-of-improved-systemic-options
#19
REVIEW
Emmanuel Gabriel, Joseph Skitzki
The incidence of melanoma has been increasing at a rapid rate, with 4%-11% of all melanoma recurrences presenting as in-transit disease. Treatments for in-transit melanoma of the extremity are varied and include surgical excision, lesional injection, regional techniques and systemic therapies. Excision to clear margins is preferred; however, in cases of widespread disease, this may not be practical. Historically, intralesional therapies were generally not curative and were often used for palliation or as adjuncts to other therapies, but recent advances in oncolytic viruses may change this paradigm...
July 1, 2015: Cancers
https://www.readbyqxmd.com/read/26037985/assessment-of-elevated-compartment-pressures-by-pressure-related-ultrasound-a-cadaveric-model
#20
R M Sellei, S J Hingmann, C Weber, S Jeromin, F Zimmermann, J Turner, F Hildebrand, H-C Pape
PURPOSE: There is a risk of misinterpreting the clinical signs of acute compartment syndrome of the lower limb resulting in delayed fasciotomy. Up to date, the diagnosis of compartment syndrome is based on clinical assessment and of invasive needle pressure measurement in uncertain cases. Close monitoring is necessary for early recognition of raising compartment pressures. Clinical assessment of muscle firmness by the physician's palpation alone is unreliable. Thus, a device objectifying this assessment would be beneficial...
December 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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