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https://www.readbyqxmd.com/read/29352698/gastric-varices-bleed-at-lower-portosystemic-pressure-gradients-than-esophageal-varices
#1
Joseph D Morrison, Nasya Mendoza-Elias, Andrew J Lipnik, R Peter Lokken, James T Bui, Charles E Ray, Ron C Gaba
PURPOSE: To quantify and compare portosystemic pressure gradients (PSGs) between bleeding esophageal varices (EV) and gastric varices (GV). MATERIALS AND METHODS: In a single-center, retrospective study, 149 patients with variceal bleeding (90 men, 59 women, mean age 52 y) with EV (n = 69; 46%) or GV (n = 80; 54%) were selected from 320 consecutive patients who underwent successful transjugular intrahepatic portosystemic shunt (TIPS) creation from 1998 to 2016...
January 15, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29352618/point-shear-wave-elastography-of-the-spleen-its-role-in-patients-with-portal-hypertension
#2
Natalie Lucchina, Chiara Recaldini, Monica Macchi, Valeria Molinelli, Mario Montanari, Sergio Segato, Raffaele Novario, Carlo Fugazzola
The goals of the study described here were to evaluate the feasibility and reproducibility of measuring spleen stiffness (SS) using point shear wave elastography in a series of cirrhotic patients and to investigate whether SS, liver stiffness (LS) and other non-invasive parameters are correlated with the presence of esophagogastric varices (EVs). Fifty-four cirrhotic patients with low-grade EVs or without EVs at esophago-gastro-duodenoscopy were enrolled. They underwent abdominal ultrasound and Doppler ultrasound of hepatic vessels simultaneously with p-SWE of the liver and spleen...
January 15, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29351804/a-metastasized-hepatocellular-carcinoma-in-the-capsule-of-an-undescended-testis-in-the-right-inguinal-area-report-of-a-rare-case
#3
Qianhui Li, Xiuying Shi, Chuifeng Fan
BACKGROUND: Hepatocellular Carcinoma (HCC) is the most common primary carcinoma of the liver, which mainly metastasizes through the portal vein system. CASE PRESENTATION: Here, we report an extremely rare case in which HCC metastasized to the capsule of an undescended testis in the right inguinal area of the patient. A tumor approximately 8.8 × 7.0 cm in size was found in the patient's liver during a health check-up. Initially, it was considered a metastatic tumor because the patient was found to have cryptorchidism, which had been left untreated before he presented to our hospital...
January 19, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29350831/randomized-trial-on-extended-versus-modified-right-lobe-grafts-in-live-donor-liver-transplantation
#4
Christi Titus Varghese, Viju Kumar Bharathan, Unnikrishnan Gopalakrishnan, Dinesh Balakrishnan, Ramachandran N Menon, Othiyil Vayoth Sudheer, Puneet Dhar, Sudhindran Surendran
Despite advances in the practice of live donor liver transplantation (LDLT), the optimum surgical approach with respect to the middle hepatic vein (MHV) in right lobe LDLT remains undefined. We designed a randomized trial to compare the early postoperative outcomes in recipients and donors between extended right lobe grafts (ERG: transection plane was maintained to the left of MHV, and division of MHV performed beyond the segment VIII vein) and modified right lobe grafts (MRG: transection plane was maintained to the right of MHV, the segment V and VIII drainage was reconstructed using a conduit of recipient portal vein)...
January 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29350513/racial-ethnic-variation-in-devices-used-to-access-patient-portals
#5
Eva Chang, Katherine Blondon, Courtney R Lyles, Luesa Jordan, James D Ralston
OBJECTIVES: We examined racial/ethnic variation in the devices used by patients to access medical records through an online patient portal. STUDY DESIGN: Retrospective, cross-sectional analysis. METHODS: Using data from 318,700 adults enrolled in an integrated delivery system between December 2012 and November 2013, we examined: 1) online patient portal use that directly engages the electronic health record and 2) portal use over desktops/laptops only, mobile devices only, or both device types...
January 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29350267/modern-work-up-and-extended-resection-in-perihilar-cholangiocarcinoma-the-amc-experience
#6
REVIEW
F Rassam, E Roos, K P van Lienden, J E van Hooft, H J Klümpen, G van Tienhoven, R J Bennink, M R Engelbrecht, A Schoorlemmer, U H W Beuers, J Verheij, M G Besselink, O R Busch, T M van Gulik
AIM: Perihilar cholangiocarcinoma (PHC) is a challenging disease and requires aggressive surgical treatment in order to achieve curation. The assessment and work-up of patients with presumed PHC is multidisciplinary, complex and requires extensive experience. The aim of this paper is to review current aspects of diagnosis, preoperative work-up and extended resection in patients with PHC from the perspective of our own institutional experience with this complex tumor. METHODS: We provided a review of applied modalities in the diagnosis and work-up of PHC according to current literature...
January 19, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29350048/triple-split-bolus-versus-single-bolus-ct-in-abdominal-trauma-patients-a-comparative-study
#7
Johannes Clemens Godt, Torsten Eken, Anselm Schulz, Cathrine K Johansen, Anette Aarsnes, Johann Baptist Dormagen
Background Split-bolus computed tomography (CT) is a recent development in trauma imaging. Instead of multiple scans in different contrast phases after a single contrast bolus, split-bolus protocols consist of one single scan of the thorax and abdomen after two or three contrast injections at different points of time. Purpose To evaluate and compare image quality and injury findings of a new triple-split-bolus CT (TS-CT) protocol of thorax and abdomen with those of a portal venous phase CT (PV-CT) in the same patient group...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29349020/an-arthroscopic-humeral-medializing-repair-of-the-supraspinatus
#8
Amir Ghazanfari, Daniel J H Henderson, Geoffroy Nourissat
Posterosuperior repair of the rotator cuff is one of the most frequently performed surgical procedures in the shoulder. Its aim is to fix the tendon back to the bone to restore anatomy, improve shoulder function, and prevent progression of cuff tear arthropathy and attendant muscle degeneration. Despite technical advances in this procedure, in some cases, the tendon cannot be fixed back to the footprint without excessive tension on the repair. In young patients or in patients with low-grade muscle atrophy and fatty degeneration (Goutallier grade 1 or 2), it is mandatory to attempt fixation of the tendon to restore functional anatomy and prevent further muscle degeneration...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349009/arthroscopic-repair-of-type-ii-slap-tears-using-suture-anchor-technique
#9
Mathew Hamula, Siddharth A Mahure, Daniel J Kaplan, Brent Mollon, Joseph D Zuckerman, Young W Kwon, Andrew S Rokito
Arthroscopic SLAP tear repair has become an increasingly used treatment for patients presenting with symptomatic SLAP tears after failed nonoperative management. Debridement, SLAP repair, and open or arthroscopic biceps tenodesis or tenotomy have been used for the treatment of SLAP tears. Various techniques for repair have been described, and furthermore, there is a high incidence of concomitant pathology of the shoulder. Repair remains an excellent option in isolated SLAP tears amenable to repair, with excellent outcomes in well-indicated patients...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29348397/placement-of-an-aortohepatic-conduit-as-an-alternative-to-standard-arterial-anastomosis-in-liver-transplantation
#10
Dong-Hwan Jung, Cheon-Soo Park, Tae-Yong Ha, Gi-Won Song, Gil-Chun Park, Yong-Pil Cho, Sung-Gyu Lee
BACKGROUND The aim of this study was to assess the impact of placement of an aortohepatic conduit on graft and patient survival after liver transplantation (LT) in selected patients with an inadequate recipient hepatic artery (HA) for a standard arterial anastomosis. MATERIAL AND METHODS Of 331 patients who underwent deceased donor LT, 25 (7.6%) who received placement of an aortohepatic conduit at the time of transplantation were included. Clinical characteristics and outcomes, including postoperative complications, conduit patency, and graft and patient survival rates, were analyzed...
January 19, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29348286/portal-vein-embolisation-in-a-patient-with-situs-inversus
#11
Igor Faria, Roberto Romulo Souza, Roberto Fuser Prosperi, Jose Hugo M Luz
Portal vein embolisation (PVE) is a well-established technique used for patients who require major hepatic resections without sufficient volume of future remnant liver (FRL). We describe a case of PVE in a patient with situs inversus. Computed Tomography (CT) 4 weeks after the procedure demonstrated significant hypertrophy of the FRL. However, the surgical procedure was aborted due to signs of extrahepatic progression.
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29346805/mesenteric-vessel-patency-following-hifu-therapy-in-patients-with-locally-invasive-pancreatic-cancer
#12
Holger M Strunk, Caroline Lützow, Jana Henseler, Martin Mücke, Maximilian Rauch, Christian Marx, Hans H Schild, Milka Marinova
PURPOSE:  To evaluate the effects of HIFU therapy on visceral vessel patency in patients with inoperable locally invasive pancreatic cancer. MATERIALS AND METHODS:  50 pancreatic cancer patients (26 men, 24 women) aged 41 - 82 years (65.0 ± 10.2) underwent ultrasonography (US) and computed tomography (CT) examinations before and within one day after HIFU treatment, as well as at follow-up at six weeks, three months and six months. Evaluation and grading were performed by two experienced independent radiologists according to a classification scheme based on vessel involvement, vessel diameter, patency, and defects in flow...
January 18, 2018: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/29346573/the-addition-of-bevacizumab-to-oxaliplatin-based-chemotherapy-impact-upon-hepatic-sinusoidal-injury-and-thrombocytopenia
#13
Michael J Overman, Renata Ferrarotto, Kanwal Raghav, Binsah George, Wei Qiao, Karime K Machado, Leonard B Saltz, Thibault Mazard, J N Vauthey, Paulo M Hoff, Brian Hobbs, Evelyn M Loyer, Scott Kopetz
Background: Oxaliplatin-based chemotherapy can cause hepatic sinusoidal injury (HSI), portal hypertension, and splenic sequestration of platelets. Evidence suggests that bevacizumab may protect against HSI. Methods: Two cohorts of metastatic colorectal cancer (CRC) were analyzed: a nonrandomized exploratory cohort of 184 patients treated at a single institution from 2003 to 2010 and a confirmatory cohort of 200 patients from a multi-institutional randomized trial (NO16966)...
January 15, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29344520/did-the-international-alpps-meeting-2015-have-an-impact-on-daily-practice-the-hamburg-barmbek-experience-of-58-cases
#14
Gregor A Stavrou, Marcello Donati, Mohammad H Fard-Aghaie, Martin Zeile, Tessa M Huber, Axel Stang, Karl J Oldhafer
Background: ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) was introduced only 10 years ago and has gained wide acceptance as a variation of staged procedures in liver surgery. It has been criticized for its high morbidity and mortality, which all centers reported in their initial series. Methods: After a world expert meeting in Hamburg in 2015 where all experts in the field met to discuss this method, caveats were extracted and formulated...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29344518/current-modalities-for-the-assessment-of-future-remnant-liver-function
#15
REVIEW
Fadi Rassam, Pim B Olthof, Roelof J Bennink, Thomas M van Gulik
While imaging studies such as computed tomography or magnetic resonance imaging allow the volumetric assessment of the liver segments, only indirect information is provided concerning the quality of the liver parenchyma and its actual functional capacity. Assessment of liver function is therefore crucial in the preoperative workup of patients who require extensive liver resection and in whom portal vein embolization is considered. This review deals with the modalities currently available for the measurement of liver function...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29344517/a-comparison-of-pitfalls-after-alpps-stage-1-or-portal-vein-embolization-in-small-for-size-setting-hepatectomies
#16
REVIEW
Andreas A Schnitzbauer
Background: Portal vein embolization (PVE) followed by resection and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) are tools to enable liver resections in small-for-size settings. Methods: A systematic review of the literature and comparison of pitfalls between PVE and resection and after ALPPS stage 1 were performed. Results: Evidence levels were as low as 4 for both procedures. 20 publications were identified with reports on post-PVE or post-ALPPS stage 1 pitfalls...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29344515/portal-vein-embolization-state-of-the-art-technique-and-options-to-improve-liver-hypertrophy
#17
REVIEW
Steven Y Huang, Thomas A Aloia
Portal vein embolization (PVE) is associated with a high technical and clinical success rate for induction of future liver remnant hypertrophy prior to surgical resection. The degree of hypertrophy is variable and depends on multiple factors, including technical aspects of the procedure and underlying chronic liver disease. For patients with insufficient liver volume following PVE, adjunctive techniques, such as intra-portal administration of stem cells, dietary supplementation, transarterial embolization, and hepatic vein embolization, are available...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29344514/portal-vein-embolization-history-and-current-indications
#18
REVIEW
Hiroji Shinkawa, Shigekazu Takemura, Shogo Tanaka, Shoji Kubo
Portal vein embolization (PVE) was first adapted for patients undergoing major hepatectomy for hepatocellular carcinoma (HCC). In these patients, PVE caused hypertrophy of the unaffected liver and increased the volumetric ratio of future liver remnant (FLR) to total liver volume. 99mTechnetium-galactosyl human serum albumin (99mTc-GSA) scintigraphy revealed that PVE also induced a shift in hepatic function from the embolized part to the nonembolized part of the liver. Various hepatobiliary malignancies can be treated using PVE, and PVE is increasingly being used to expand the indication for major hepatectomy in patients with initially insufficient FLR volume or function...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29344199/expression-and-prognostic-significance-of-doublecortin-like-kinase-1-in-patients-with-hepatocellular-carcinoma
#19
Mengjiao Fan, Niansong Qian, Guanghai Dai
Doublecortin-like kinase 1 (DCLK1), a putative cancer stem cell marker in intestinal and pancreatic tumors, is associated with tumor pathogenesis and progression, and poor survival outcomes in numerous types of cancer. However, DCLK1 expression and its prognostic value remain unclear in hepatocellular carcinoma (HCC). In the present study, the expression of DCLK1 was assessed using immunohistochemistry in 96 resected HCC and 68 adjacent tissue specimens. The staining intensity and the percentage of stained cells were scored on a scale of 0-3 and 0-4, respectively...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29340282/should-vasoconstrictors-be-considered-in-a-cirrhotic-patient-with-acute-non-variceal-upper-gastrointestinal-bleeding
#20
Xingshun Qi, Hongyu Li, Xiaodong Shao, Zhendong Liang, Xia Zhang, Ji Feng, Hao Lin, Xiaozhong Guo
Varices manifest as a major etiology of upper gastrointestinal bleeding in patients with chronic liver diseases, such as liver cirrhosis and hepatocellular carcinoma. By contrast, non-variceal upper gastrointestinal bleeding is rare. Pharmacological treatment differs between patients with variceal and non-variceal bleeding. Vasoconstrictors are recommended for the treatment of variceal bleeding, rather than non-variceal bleeding. In contrast, pump proton inhibitors are recommended for the treatment of non-variceal bleeding, rather than variceal bleeding...
December 2017: Journal of Translational Internal Medicine
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