Growth rates of pulmonary metastases after liver transplantation for unresectable colorectal liver metastases.

Background: The previously reported SECA study demonstrated a dramatic 5-year survival improvement in patients with unresectable colorectal liver metastases (CLM) treated with liver transplantation (LT) compared with chemotherapy. The objective of this study was to assess whether immunosuppressive therapy accelerates the growth of pulmonary metastases in patients transplanted for unresectable CLM.

Methods: Chest CT scans from 11 patients in the SECA study resected for 18 pulmonary metastases were reviewed retrospectively.

Patterns of recurrence after liver transplantation for nonresectable liver metastases from colorectal cancer.

Background: Surgical resection is the only curative modality for colorectal liver metastases (CLM), and the pattern of recurrences after resection affects survival. In a prospective study of liver transplantation (Lt) for nonresectable CLM we have shown a 5-year overall survival rate of 60 %, but 19 of 21 experienced recurrence. This study reports the pattern of recurrences after Lt for CLM and the effect on survival.

Liver transplantation for nonresectable liver metastases from colorectal cancer.

Objective: The objective of this pilot study was to investigate the potential for long-term overall survival (OS) after liver transplantation for colorectal liver metastases (CLMs).

Background: Patients with nonresectable CLMs have poor prognosis, and few survive beyond 5 years. CLMs are currently considered an absolute contraindication for liver transplantation, although liver transplantation for primary and some secondary liver malignancies shows excellent outcome in selected patients.

Evaluation of patients after treatment of arterial priapism with selective micro-embolization.

Objective: Arterial (high-flow) priapism is characterized by a prolonged non-painful erection without sexual arousal as a result of unregulated inflow of blood to the corpus cavernosum. Treatment is based on decreasing this elevated inflow, primarily by means of selective arteriography and embolization. The aim of this study was to evaluate the treatment of patients with arterial priapism.

Doppler examination of the allografted kidney.

A comprehensive ultrasound examination of the transplanted kidney includes a Doppler examination. Duplex Doppler, color Doppler and power Doppler can all reveal important information. In addition, calculation of the resistance and pulsatility indices to quantify changes in the spectral Doppler waveform can be of great help, particularly in the first weeks and months following a transplantation.

Is a prolonged bleeding time associated with an increased risk of hemorrhage after liver biopsy?

Bleeding time determination is not advised as a general preoperative hemostasis screening test, but it might be useful in some patient groups. Patients referred for liver biopsy frequently have coagulation disturbances and are at risk of hemorrhage. In this prospective study 219 liver biopsies were carried out regardless of a prolonged bleeding time, but with minimum requirements for hemoglobin concentration, platelet count, and tests of the internal and external coagulation pathways.

Effect of ultrasound contrast medium in color Doppler and power Doppler visualization of blood flow in canine kidneys.

Purpose: To examine the effect of an ultrasound contrast medium (UCM) in the visualization of parenchymal blood flow by means of color Doppler and power Doppler sonography.

Material And Methods: Nonenhanced and UCM-enhanced Doppler images of canine kidneys were obtained in a transversal plane during various states of flow reduction in the anterior branch of the renal artery. The UCM consisted of air-filled shell-stabilized microballoons (half-life approximately 2 min).

[Hepatic vein thrombosis. Diagnostic and therapeutic difficulties].

Budd Chiari syndrome (liver vein thrombosis) may be a diagnostic and therapeutic problem. On the basis of four different cases we review the major diagnostic and therapeutic principles involved. Imaging techniques are necessary in order to establish the diagnosis.

Use of sonicated albumin (Infoson) to enhance arterial spectral and color Doppler imaging.

Purpose: To examine the effect of an ultrasound contrast medium (UCM), Infoson, on Doppler examination of stenotic arteries.

Methods: Stenoses were created in the common carotid artery of six piglets, and examined with spectral Doppler and color Doppler imaging during UCM infusion in the left ventricle.

Results: UCM caused a mean increase in recorded maximal systolic and end-diastolic velocities of 5% and 6%, respectively, while blood flow remained constant.

Spirometrically controlled high resolution computed tomography - quantitative assessment of density distribution in patients with diffuse fibrosing alveolitis.

Study Objective: Lung density assessed by high resolution computed tomography (HRCT) is sufficiently sensitive for the diagnosis of interstitial lung disease, but may be hampered by uneven disease distribution. We determined the mean and subpleural density values in patients with diffuse fibrosing alveolitis (FA) and evaluated the diagnostic accuracy of both parameters, expressed as post-test odds ratios.

Materials And Methods: Pulmonary HRCT was performed on 21 FA patients and compared to scans of 27 healthy volunteers.

Ex vivo ras peptide vaccination in patients with advanced pancreatic cancer: results of a phase I/II study.

In a pilot I/II study we have tested synthetic ras peptides used as a cancer vaccine in 5 patients with advanced pancreatic carcinoma. The treatment principle used was based on loading professional antigen-presenting cells (APCs) from peripheral blood with a synthetic ras peptide corresponding to the ras mutation found in tumour tissue from the patient. Peptide loading was performed ex vivo and the next day APCs were re-injected into the patients after washing to remove unbound peptide.

Arterial high flow priapism role of radiology in diagnosis and treatment.

Radiological methods for diagnosis and treatment of arterial high flow priapism are described based on experience with 7 patients, 6 with lesions of the cavernous and 1 with a lesion of the spongious body and glans. Arteriography (7 patients) and cavernosography (6 patients) indicated the site of the lesion in all cases. Color Doppler was useful in the two patients examined.

Reproducibility of quantitative, spirometrically controlled CT.

Quantitative spirometrically controlled computed tomography (with 1-mm-thick sections) was performed twice (with a 5-minute break) in 24 adult patients with pulmonary disease to objectively evaluate parenchymal changes in the lung. Twelve measurements of attenuation were made on apical, carinal, and basal scans (right, left, total of each level, total right, total left, total of all three scans), obtained at 50% vital capacity. Since differences in measurements between the first and second examination were not significant, the method provides highly reproducible results.

Dysfunctional labor after external cephalic version.

Objective: To determine whether there is a greater occurrence of dysfunctional labor or a higher incidence of cesarean delivery for failure to progress in women who have undergone a successful version for breech presentation.

Methods: Using a retrospective case-control design, 76 women who had undergone a successful version from January 1988 through July 1993 were identified and their medical records reviewed. The control population was matched for delivery date, parity, and gestational age.

Isolated cavernous bodies.

Corpus cavernosography in a patient with erectile dysfunction revealed absence of communication between the 2 cavernous bodies. No similar case was found in a review of 100 consecutive cavernosograms or in the literature. The abnormality may be a source of error in pressure recordings or in intravenous injection of pharmaceutical agents.

Reconstruction of the lateral ligamentous structures of the ankle with a modified Watson-Jones procedure.

A modified Watson-Jones tenodesis using a split of the peroneus longus for correction of chronic lateral ankle instability has been used in a series of 43 ankles. The range of follow-up varied between 2 and 10 years (median 56 months). Functional stability was achieved in most cases.