A male patient underwent conventional transcatheter chemoembolization for advanced recurrent hepatocellular carcinoma(HCC). Even after the injection of 7 m L of lipiodol followed by gelatin sponge particles, the flow ...A male patient underwent conventional transcatheter chemoembolization for advanced recurrent hepatocellular carcinoma(HCC). Even after the injection of 7 m L of lipiodol followed by gelatin sponge particles, the flow of feeding arteries did not slow down. A repeat angiography revealed a newly developed vascular lake draining into systemic veins; however, embolization was continued without taking noticing of the vascular lake. The patient's level of consciousness deteriorated immediately after the procedure, and non-contrast computed tomography revealed pulmonary and cerebral lipiodol embolisms. The patient's level of consciousness gradually improved after 8 wk in intensive care. In this case, a vascular lake emerged during chemoembolization and drained into systemic veins, offering a pathway carrying lipiodol to pulmonary vessels, the most likely cause of this serious complication. We should be aware that vascular lakes in HCC may drain into systemic veins and can cause intratumoral arteriovenous shunts.展开更多
OBJECTIVE: To investigate the therapeutic effect of Astragali on sodium and water retention in aortocaval fistula-caused experimental congestive heart failure and its involved mechanisms. METHODS: In aortocaval fistul...OBJECTIVE: To investigate the therapeutic effect of Astragali on sodium and water retention in aortocaval fistula-caused experimental congestive heart failure and its involved mechanisms. METHODS: In aortocaval fistula-caused chronic (5 wk), heart failure rats treated with and without Astragali 1.0 g/day intraperitoneally, changes of cardiac and renal function, renal response to atrial natriuretic peptide (ANP) were examined. Dot blot analysis was used to determine the effect of Astragali on hypothalamic arginine vasopresin (AVP) mRNA expression, and mRNA expressions of aortic and renal AVP V1a receptor, renal AVP V2 receptor and aquaporin-2 (AQP2) were simultaneously detected by RT-PCR method. RESULTS: Rats with aortocaval fistula impaired cardiac and renal functions evidenced by higher right atrial pressure (RAP), left ventricular end-diastolic pressure (LVEDP), lower + dP/dtmax of left ventricle, glomerular filtration rate (GFR), renal plasma flow (RPF), urine volume (UV), urinary sodium excretion (UNaV) and free water clearance (CH2O) compared with sham-operated control (P展开更多
目的:探讨动静脉内瘘(AVF)失功后介入手术的治疗方法,评估其治疗效果及应用价值。方法:回顾性分析自2006年4月—2015年1月行介入手术治疗的20例自体AVF失功患者的临床资料。结果:20例患者中,16例经静脉端造影,4例经股动脉-主动脉-腋动...目的:探讨动静脉内瘘(AVF)失功后介入手术的治疗方法,评估其治疗效果及应用价值。方法:回顾性分析自2006年4月—2015年1月行介入手术治疗的20例自体AVF失功患者的临床资料。结果:20例患者中,16例经静脉端造影,4例经股动脉-主动脉-腋动脉路径造影;单纯吻合口狭窄4例,行球囊扩张后狭窄明显改善;吻合口狭窄伴血栓形成有5例,切开取栓后再行球囊扩张治疗;静脉端血栓形成3例,切开取栓后返血良好;静脉端狭窄合并血栓形成7例,行切开取栓后再行球囊扩张治疗;头静脉长段闭塞1例,改用人工血管行AVF术。术后全部患者经该血管通路恢复透析治疗,透析时流量均>200 m L/min。共17例患者获得随访,平均随访时间13.2个月,12个月通畅率为47.1%。结论:介入导管技术在治疗AVF失功方面是安全、有效的。展开更多
BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2...BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.展开更多
文摘A male patient underwent conventional transcatheter chemoembolization for advanced recurrent hepatocellular carcinoma(HCC). Even after the injection of 7 m L of lipiodol followed by gelatin sponge particles, the flow of feeding arteries did not slow down. A repeat angiography revealed a newly developed vascular lake draining into systemic veins; however, embolization was continued without taking noticing of the vascular lake. The patient's level of consciousness deteriorated immediately after the procedure, and non-contrast computed tomography revealed pulmonary and cerebral lipiodol embolisms. The patient's level of consciousness gradually improved after 8 wk in intensive care. In this case, a vascular lake emerged during chemoembolization and drained into systemic veins, offering a pathway carrying lipiodol to pulmonary vessels, the most likely cause of this serious complication. We should be aware that vascular lakes in HCC may drain into systemic veins and can cause intratumoral arteriovenous shunts.
文摘OBJECTIVE: To investigate the therapeutic effect of Astragali on sodium and water retention in aortocaval fistula-caused experimental congestive heart failure and its involved mechanisms. METHODS: In aortocaval fistula-caused chronic (5 wk), heart failure rats treated with and without Astragali 1.0 g/day intraperitoneally, changes of cardiac and renal function, renal response to atrial natriuretic peptide (ANP) were examined. Dot blot analysis was used to determine the effect of Astragali on hypothalamic arginine vasopresin (AVP) mRNA expression, and mRNA expressions of aortic and renal AVP V1a receptor, renal AVP V2 receptor and aquaporin-2 (AQP2) were simultaneously detected by RT-PCR method. RESULTS: Rats with aortocaval fistula impaired cardiac and renal functions evidenced by higher right atrial pressure (RAP), left ventricular end-diastolic pressure (LVEDP), lower + dP/dtmax of left ventricle, glomerular filtration rate (GFR), renal plasma flow (RPF), urine volume (UV), urinary sodium excretion (UNaV) and free water clearance (CH2O) compared with sham-operated control (P
文摘目的:探讨动静脉内瘘(AVF)失功后介入手术的治疗方法,评估其治疗效果及应用价值。方法:回顾性分析自2006年4月—2015年1月行介入手术治疗的20例自体AVF失功患者的临床资料。结果:20例患者中,16例经静脉端造影,4例经股动脉-主动脉-腋动脉路径造影;单纯吻合口狭窄4例,行球囊扩张后狭窄明显改善;吻合口狭窄伴血栓形成有5例,切开取栓后再行球囊扩张治疗;静脉端血栓形成3例,切开取栓后返血良好;静脉端狭窄合并血栓形成7例,行切开取栓后再行球囊扩张治疗;头静脉长段闭塞1例,改用人工血管行AVF术。术后全部患者经该血管通路恢复透析治疗,透析时流量均>200 m L/min。共17例患者获得随访,平均随访时间13.2个月,12个月通畅率为47.1%。结论:介入导管技术在治疗AVF失功方面是安全、有效的。
基金the National Research Foundation of Korea Grant funded by the Korean government(MSIT)(2020R1A2C1100891 and 2021R1G1A1008337)the Soonchunhyang University Research Fund.
文摘BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.
