Patients with primary and secondary liver cancers generally have a poor prognosis with limited potentially curative options. Liver-directed, intra-arterial therapies such as selective internal radiotherapy (SIRT) and trans-arterial chemoembolization (TACE) are taking a larger role in the management of these patients. The current standard of therapy is for delivery of SIRT or TACE particles through an end-hole microcatheter.
View Article and Find Full Text PDFPurpose: We sought to report outcomes and toxicity in patients with hepatocellular carcinoma (HCC) who received resin yttrium-90 selective internal radiation therapy ((90)Y-SIRT) and to identify factors associated with declining liver function.
Methods: Patients treated with (90)Y-SIRT were retrospectively evaluated. Radiographic response was assessed using RECIST 1.
Purpose: The aim of this study was to determine if early recognition and treatment of delayed gastric emptying (DGE) can augment postoperative outcomes in patients undergoing pancreatectomy.
Methods: The International Study Group of Pancreatic Surgery definition of DGE was used to identify patients at Indiana University Hospital who required supplemental nutrition for DGE after pancreatectomy. Outcomes were compared between those without DGE, those with DGE who received supplemental nutrition within 10 days after pancreatectomy (early intervention), and those treated after 10 days (late intervention).
Nine cancer patients were treated with adoptive cell therapy using autologous anti-MAGE-A3 T-cell receptors (TCR)-engineered T cells. Five patients experienced clinical regression of their cancers including 2 on-going responders. Beginning 1-2 days postinfusion, 3 patients (#'s 5, 7, and 8) experienced mental status changes, and 2 patients (5 and 8) lapsed into comas and subsequently died.
View Article and Find Full Text PDFCardiopulmonary bypass (CPB) circuits are frequently necessary in the repair of congenital heart defects in infants and children. Although advances in technology and operative technique have decreased the mortality associated with cardiac procedures requiring CPB, post-operative neuro-cognitive outcome and the role of the CPB circuit in post-operative morbidity remains a significant concern. There are several factors that have been suggested to play a significant role in general post-operative outcome, including intraoperative inflammatory responses caused by the interaction of blood with circuit component surfaces, selection of appropriate perfusion mode to optimize organ function during CPB, and the introduction of gaseous microemboli into the patient's systemic circulation through circuit manipulations and modifications.
View Article and Find Full Text PDFThe objective of this study was to evaluate the effect of flow rate and perfusion mode on the delivery of gaseous microemboli in a simulated pediatric cardiopulmonary bypass (CPB) circuit with an open arterial filter purge line using a novel ultrasound detection system. The circuit was primed with 450 ml fresh, heparinized bovine blood plus 200 ml Lactated Ringer's solution (total volume 650 ml, corrected Hct 25%). After the injection of 5 ml air into the venous line, an Emboli Detection and Classification (EDAC) Quantifier (Luna Innovations, Inc.
View Article and Find Full Text PDFThe purpose of this study was to evaluate the effect of different flow rates and pressures on the degree of shunting of blood flow by the arterial filter purge line in a simulated neonatal cardiopulmonary bypass circuit. The circuit was primed with heparinized bovine blood (hematocrit 24%) and postfilter pressure was varied from 60-180 mm Hg (20 mm Hg increments) using a Hoffman clamp. Trials were conducted at flow rates ranging from 200-600 ml/min (100 ml/min increments).
View Article and Find Full Text PDFLevetiracetam (LEV) is effective for treating localisation-related epilepsy, but it is uncertain whether it is effective for treating idiopathic generalised epilepsy. We compared 12-week baseline and LEV treatment periods for patients with generalised seizure types-myoclonic, tonic-clonic and absence seizures--who had failed other anticonvulsants. The majority of 55 patients (76%) had >50% seizure reduction with LEV therapy, 40% became seizure-free; 15% discontinued LEV due to adverse events, mostly sedation.
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