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A Radomized Trial of Bronchial Arterial Infusion (BAI), Traditional Vein Chemotherapy and BAI plus Vein Chemotherapy Sequential Therapy in the Treatment of Advanced and Late NSCLC  [cached]
Xiaoying HUANG,Chang YU,Liangxing WANG,Weizhong ZHOU
Chinese Journal of Lung Cancer , 2008,
Abstract: Background and Objective Many patients always late disease when they diagnozed with lung cancer, the therapeutic effect of late lung-cancer was very poor, the aim of this study is to compare therapeutic effect among bronchial arterial infusion (BAI), traditional vein chemotherapy and BAI plus vein chemotherapy sequential therapy, for late NSCLC, and find a better way to treat late lung cancer. Methods One hundred and seven patients with advanced NSCLC were randomly treated by BAI, traditional vein chemotherapy and BAI plus vein chemotherapy sequential therapy. Results Primary lesion's total response rate (RR) of BAI group, traditional vein chemotherapy group and sequential therapy group were: 59.22%, 30.23% and 69.05%, respectively。RR of primary lesion in BAI group was significantly higher than that in traditional vein chemotherapy group (P<0.01), sequential therapy group was much higher than that in traditional vein chemotherapy group (P<0.01), there was no differences between BAI group and sequential therapy group (P>0.05). Metastasis's total response rate (RR) in BAI group, traditional vein chemotherapy group and sequential therapy group were: 18.19%, 53.58%, 60.00%, respectively. RR in metastasis BAI group was significantly lower than that in traditional vein chemotherapy group (P<0.05), sequential therapy group was much higher than that in BAI group (P<0.01), there was no remarkable differences between traditional vein chemotherapy group and sequential therapy group (P>0.05). Conclusion BAI plus vein chemotherapy sequential therapy has good response on both NSCLC primary lesion and metastasis.
Bronchial stump reinforcement with an azygous vein flap
Faisal Al-Mufarrej, Marc Margolis, Eric Strother, Barbara Tempesta, Farid Gharagozloo
Journal of Cardiothoracic Surgery , 2009, DOI: 10.1186/1749-8090-4-22
Abstract: A bronchopleural fistula is a serious complication of lobectomies and, more commonly, pneumonectomies. It can lead to persistent empyemas that require open drainage, frequent debridements, and prolonged hospitalization. While many patient, disease and technical risk factors for the development of bronchopleural fistulas have been identified, bronchial stump reinforcement has been shown to significantly reduce the incidence of this complication. Various coverage techniques have been described in the literature, with intercostal, diaphragmatic, and pericardial flaps being the most widely studied. While the azygous vein flap is an easy, safe and effective reinforcement option for right-sided bronchial stumps, the flap is not widely adopted, with little mention in the literature, partly due to surgeons' uneasiness with the technique. In this report, we describe an easy-to-adopt approach to azygous vein bronchial reinforcement.Upon completing a right-sided, high-risk lobectomy or a right pneumonectomy, the azygous vein is dissected off the posterior chest wall between the point where the right superior intercostal vein drains into it and where it drains into the superior vena cava. The right superior intercostal vein (draining the second, third, and fourth posterior intercostal veins) is then ligated and divided. With the aid of a vascular endoscopic gastrointestinal anastamosis (Endo-GIA Roticulator 45) stapler, the azygous vein is stapled and divided close to where it drains into the superior vena cava. The azygous vein is then mobilized until enough length is obtained (Figure 1). The fifth and, rarely, subsequent posterior intercostal veins may need to be ligated and divided to gain some length on the azygous flap. Using a linear stapler (TA-30), the azygous vein is stapled across its most proximal end (Figure 2). The posterior aspect of the azygous vein, between the two staple lines, is then opened up longitudinally, creating a flap that can cover the stapled or sutu
Efficacy of 5-Fluorouracil and High-Concentration Cisplatin Suspended in Lipiodol by Short-Term Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis  [PDF]
Yutaka Yata, Masashi Namikawa, Tatsuya Ohyama, Takashi Ohsaki, Daisuke Kanda, Takeshi Hatanaka, Kei Shibuya, Jun Kubota, Hitoshi Takagi, Terumi Takahara, Teruo Yoshinaga
Journal of Cancer Therapy (JCT) , 2015, DOI: 10.4236/jct.2015.613125
Abstract: Background: Since advanced hepatocellular carcinoma (HCC) is potentially fatal, and patients’ quality of life (QOL) often deteriorates during their treatment, improving the prognosis and QOL of patients given chemotherapy is very important. In addition, cost-effective treatments are highly desirable when chemotherapy must be given repeatedly. The aim of this study was to evaluate the efficacy and usefulness of 5-fluorouracil (5-FU) and high-concentration cisplatin by short-term hepatic arterial infusion chemotherapy (3-day FPL) in advanced HCC patients. Methods: Thirty patients with unresectable advanced HCC were enrolled. The patients underwent hepatic arterial infusion chemotherapy via the implanted port system with 5-FU on days 1 - 3 and a fine-powder formulation of cisplatin in suspended pre-warmed lipiodol on day 2 every 4 to 10 weeks. Tumor response was assessed one month later with CT. Results: All patients had evidence of portal vein invasion (Vp2-4). Four patients achieved a complete response (CR), 8 patients achieved a partial response (PR), and 7 patients had stable disease (SD). The median progression-free survival (PFS) and overall survival (OS) were 198 days and 452 days, respectively. The OS was significantly longer in the successful disease control group (CR, PR, and SD) than in the progressive disease group (P < 0.005). Conclusions: Three-day FPL was effective and tolerable in advanced HCC patients due to its shorter time of administration than conventional FP therapy. Therefore, repetitive 3-day FPL appears useful and contributes to improving the prognosis and QOL of patients with advanced HCC. In addition, this protocol is a cost-effective treatment.
Treatment of Deep Vein Thrombosis with Continuous IV Infusion of LMWH: A Retrospective Study in 32 Children  [PDF]
Veronika Fiamoli,Jan Blatny,Ondrej Zapletal,Svetlana Kohlerova,Eva Janousova
Thrombosis , 2011, DOI: 10.1155/2011/981497
Abstract: Thirty-two consecutive children aged 0–18 years with VTE treated with LMWH administered as a continuous infusion (CI) were identified at the Children's University Hospital Brno. The treatment led to at least partial resolution of the thrombus within two weeks in 85% of patients. There were no adverse events or increased bleeding reported in any patients. No recurrences were observed during a followup period of 6 months. Although continuous infusion should not replace subcutaneous (SC) administration of LMWH, CI appeared to be safe and efficient and may provide an alternate method of administering LMWH in a subset of the paediatric population where SC administration may not be feasible. Further prospective studies are needed to support the promising findings of our pilot clinical observation. 1. Introduction The incidence of VTE-venous thromboembolism (deep vein thrombosis, pulmonary embolism) is age dependent with the lowest risk occurring in children [1–3]. The estimated incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in the general paediatric population is 0.07/10 000 and 5.3/10 000 among hospital admissions, respectively [4–7]. In the last decade, however, the incidence of VTE in children appears to be increasing probably because of increased awareness of the problem and improved diagnostic methods [8, 9]. DVT/PE develops in children often as a secondary complication of other underlying disorders. These prothrombotic risk factors can be either inherited or acquired. Inherited prothrombotic risk factors are responsible for only 5–7% of VTE in children [6, 7]. Idiopathic VTE occurs in less than 1% of newborns, and in less than 5% of children compared to approximately 40% of adults [6, 7, 10, 11]. Children less than one year of age and teenagers appear to be at a higher risk for developing secondary VTE [6, 10–12]. Low molecular weight heparins (LMWHs) are currently the standard of treatment for DVT in children for its more predictable pharmacokinetics and better bioavailability than unfractionated heparin [13]. It is also associated with lower risk of heparin-induced thrombocytopenia (HIT), bleeding, and osteoporosis [14]. Other alternatives include, coumarins, pentasaccharides, and under specific circumstances, thrombolytics. The standard method of LMWH administration is via the subcutaneous (SC) route. It enables home treatment, and in the vast majority of patients, it does not need frequent monitoring once a therapeutic and safe level has been achieved. However, there may be a subset of children, in whom the benefits of SC
Architectural Optimization and VLSI Implementation of CIKS Encryption Algorithm
N. Sklavos,B. V. Izotov
Asian Journal of Information Technology , 2012,
Abstract: Data Dependent Permutations (DDP) attracted the interest of cryptographers last years. CIKS-1 is a latest published block cipher based on DDP transformations. In this paper, an area optimized architecture and the FPGA implementation of this cipher are proposed. The proposed architecture introduces an area-optimized combination of the different encryption and decryption schemes of CIKS-1 algorithm. The comparisons of the introduced design with the conventional architecture prove that the proposed architecture allocates 20-30% less area and it is better by about 14% in the Area-Delay product. The Performance/Area ratio proves that the proposed architecture is superior to the conventional by about 25%. Detailed performance analysis results are presented. The proposed implementation is designed on a pipelined architecture and reaches throughput value up to 2.5 Gbps. The achieved high throughput ensures fast encryption and it is suitable for networks with hard performance demands.
Clinical Application of Newborn Umbilical Vein Catheterization Combining with PICC  [PDF]
Patiman Tuerhong
Journal of Biosciences and Medicines (JBM) , 2017, DOI: 10.4236/jbm.2017.55001
Abstract: Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN checked in our hospital’s ICU are selected and divided into combination group (n = 30) and PICC group (n = 30) according to the random number table. Combination of UVC and PICC is applied on newborn of combination group while only PICC is applied on newborn of PICC group. These two groups’ newborn’s PICC catheterization operation time, PICC indwelling time, weight gain, hospital stays, hospital infection, planned extubation, successful single puncture, adverse events and other indexes are observed. Result: Newborns in combination group have less PICC catheterization operation time and less hospital stays than newborns in PICC group while newborns in combination group have longer PICC indwelling time and greater weight gain than newborns in PICC group. The difference here has statistical significance (p < 0.05). Combination group’s hospital infection ratio (3.33%) is lower than that of PICC group (23.33%). The difference here has statistical significance (p < 0.05). Newborns in combination group have a planned extubation rate of 93.33% and a successful single puncture rate of 93.33%, which are greater than those of newborn in PICC group (respectively 73.33% and 70.00%). The difference here has statistical significance (p < 0.05). Newborns in combination group have an adverse event occurrence rate of 43.33%, lower than that of PICC group (70.00%). The difference here has statistical significance (p < 0.05). Conclusion: Application of combination of UVC and PICC on VLBWN can greatly improve PICC catheterization efficiency and newborn patients’ nutriture and reduce rate of complications, thus, it is worthy of clinical application.
Fetal tachyarrhythmia with 1:1 atrioventricular conduction. Adenosine infusion in the umbilical vein as a diagnostic test
Leiria, Tiago L. L.;Lima, Gustavo G. de;Dillenburg, Rejane F.;Zielinsky, Paulo;
Arquivos Brasileiros de Cardiologia , 2000, DOI: 10.1590/S0066-782X2000000700007
Abstract: this is the report of a case of fetal tachyarrhythmia with 1:1 atrioventricular conduction detected by pre-natal echocardiography in a fetus at 25-weeks gestation. adenosine infusion via cordocentesis was performed as a diagnostic test to differentiate between atrioventricular nodal reentrant supraventricular tachyarrhythmia and atrial flutter. after infusion, transient 2:1 atrioventricular dissociation was obtained and the diagnosis of atrial flutter was made. transplacental therapy with digoxin and amiodarone was then successfully used.
Fetal tachyarrhythmia with 1:1 atrioventricular conduction. Adenosine infusion in the umbilical vein as a diagnostic test  [cached]
Leiria Tiago L. L.,Lima Gustavo G. de,Dillenburg Rejane F.,Zielinsky Paulo
Arquivos Brasileiros de Cardiologia , 2000,
Abstract: This is the report of a case of fetal tachyarrhythmia with 1:1 atrioventricular conduction detected by pre-natal echocardiography in a fetus at 25-weeks gestation. Adenosine infusion via cordocentesis was performed as a diagnostic test to differentiate between atrioventricular nodal reentrant supraventricular tachyarrhythmia and atrial flutter. After infusion, transient 2:1 atrioventricular dissociation was obtained and the diagnosis of atrial flutter was made. Transplacental therapy with digoxin and amiodarone was then successfully used.
A rare case of fatal hepatic veno-occlusive disease and rupture of the spleen vein and artery after Gemtuzumab Ozogamicin (Mylotarg?) infusion
Massumoto, Celso M.;Pinheiro, Ronald F.;Pinheiro Júnior, Edilson D.;Baiocchi, Otávio C.;Alves, Adelson;
Revista Brasileira de Hematologia e Hemoterapia , 2004, DOI: 10.1590/S1516-84842004000300013
Abstract: gemtuzumab ozogamicin (mylotarg?) targets leukemia cells expressing the cd 33 receptor by means of a monoclonal antibody conjugated to a cytotoxic agent, calicheamicin. it was approved for use in elderly patients with relapsed or refractory acute myeloid leukemia and reversible hepatotoxicity is common after administration. the first case of hepatic veno-occlusive disease was reported after gemtuzumab ozogamicin infusion in a patient who had been submitted to hematopoietic stem cell transplantation 8 months earlier. three phase 2 studies with 188 patients with acute myeloid leukemia in first relapse that used gemtuzumab ozogamicin were analysed and the incidence of fatal hepatic veno-occlusive disease in these studies was < 1%, and prior hematopoietic stem cell transplantation was the most significant risk factor. the aim of this paper is to report a rare fatal case of hepatic veno-occlusive disease with rupture of the spleen vein and artery in a 68-year-old patient that had received gemtuzumab ozogamicin. to the best of our knowledge, it is the first case report of hepatic veno-occlusive disease with rupture of the spleen vein and artery related to gemtuzumab ozogamicin.
Application of chemosensitivity test in regional chemotherapy for hepatocellular carcinoma via hepatic artery and portal vein  [cached]
NIE Lei
Journal of Clinical Hepatology , 2013,
Abstract: ObjectiveTo evaluate the chemosensitivities of hepatocellular carcinoma (HCC) to different chemotherapy drugs by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H tetrazolium bromide (MTT) assay and to provide guidance for individualized chemotherapy regimen in regional chemotherapy via the hepatic artery and portal vein. MethodsForty-two HCC samples were selected. Primary culture of HCC cells combined with MTT assay were used to evaluate the chemosensitivities of HCC to 5-fluorouracil (5-FU), cisplatin (DDP), mitomycin C (MMC), adriamycin (ADM), hydroxycamptothecine (HCPT), gemcitabine (Gemzar), and oxaliplatin (OXA). Individualized chemotherapy regimens were developed according to the chemosensitivity test results to guide regional chemotherapy via the hepatic artery and portal vein in 24 of these patients (as an individualized chemotherapy group). The therapeutic efficacy was compared with that of transcatheter arterial infusion performed in 20 patients (as a control group). The chi-square test was used for comparison of sensitivity rate, and the rank-sum test was used for comparison of time to progression (TTP). ResultsThe sensitivity rates of HCC were 64.3% to OXA, 45.2% to HCPT, 40.5% to DDP, 38.1% to Gemzar, 33.3% to ADM, 21.4% to 5-FU, and 16.7% to MMC. Compared with the control group, the individualized chemotherapy group had a significantly higher objective response rate (500% vs 200%, P= 0039), a significantly higher disease control rate (708% vs 350%, P = 0017), and a significantly longer TTP ((47±29)m vs(26±13)m, P = 0032) ConclusionIn vitro chemosensitivity test based on MTT assay may be used to screen out the chemotherapy drugs in individualized chemotherapy for HCC and provide guidance for regional chemotherapy via the hepatic artery and portal vein, so as to improve the effect of chemotherapy
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