Multidisciplinary Taiwan consensus for the use of conventional TACE in hepatocellular carcinoma treatment.

Developed in early 1980s, transarterial chemoembolization (TACE) with Lipiodol was adopted globally after large-scale randomized control trials and meta-analyses proving its effectiveness were completed. Also known as "conventional TACE" (cTACE), TACE is currently the first-line treatment for patients with unresectable intermediate stage hepatocellular carcinoma (HCC) and delivers both ischemic and cytotoxic effects to targeted tumors. Although new technology and clinical studies have contributed to a more comprehensive understanding of when and how to apply this widely-adopted therapeutic modality, some of these new findings and techniques have yet to be incorporated into a guideline appropriate for Taiwan.

Ten-year follow-up of renal adenomatosis with magnetic resonance imaging: a case report.

Background: Renal adenomatosis is a rare disease that presents as multiple papillary adenomas in the bilateral kidneys. Moreover, papillary adenoma is considered a precursor to papillary renal cell carcinoma. Therefore, patients with renal adenomatosis may have higher risk of developing malignancy than patients without this benign condition.

Percutaneous Transcollateral Retrograde Recanalization of Isolated Dissection of the Superior Mesenteric Artery.

Endovascular stent placement (ESP) for patient with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) is a widely accepted treatment option. However, failed percutaneous ESP is not uncommon and is one of the leading causes for laparotomy. We report a case of 63-year-old man with SIDSMA encountered failed antegrade recanalization via conventional transfemoral approach.

Multidisciplinary Taiwan Consensus Recommendations for the Use of DEBDOX-TACE in Hepatocellular Carcinoma Treatment.

Transarterial chemoembolization (TACE) is the first-line treatment in patients with unresectable hepatocellular carcinoma (HCC). In recent years, there has been increasing clinical evidence that drug-eluting beads provide a combined ischemic and cytotoxic effect that may be superior to conventional TACE, with low systemic toxicity. The therapeutic value of TACE performed using the embolic microsphere DC Bead loaded with doxorubicin (drug-eluting bead doxorubicin [DEBDOX]) has been shown by several randomized controlled trials.

Regorafenib diminishes the expression and secretion of angiogenesis and metastasis associated proteins and inhibits cell invasion via NF-κB inactivation in SK-Hep1 cells.

The aim of the present study was to investigate the effects of regorafenib on the nuclear factor κ-light-chain-enhancer of activated B cells (NF)-κB-modulated expression of angiogenesis- and metastasis-associated proteins and cell invasion in human hepatocellular carcinoma SK-Hep1 cells. The SK-Hep1 cells were treated with different concentrations of NF-κB inhibitor 4-N-[2-(4-phenoxyphenyl) ethyl] quinazoline-4,6-diamine (QNZ) or regorafenib for 24 or 48 h. The effects of QNZ and regorafenib on cell viability, NF-κB activation, expression and secretion levels of angiogenesis- and metastasis-associated proteins and cell invasion were evaluated with MTT assays, western blotting, ELISA, gelatin zymography and cell invasion assays.

Hepatic artery infusion catheter implantation without embolization of the gastroduodenal artery in cases of retrograde blood flow.

Between January 2007 and January 2008, a port/catheter system for hepatic arterial infusion chemotherapy was implanted in seven patients with retrograde blood flow in the gastroduodenal artery (GDA). The GDA was not coil-embolized when the catheter tip was positioned in the right gastroepiploic artery. In all cases, implantation of the port/catheter system was successful, and there were no complications.

Prediction of mortality after emergent transjugular intrahepatic portosystemic shunt placement: use of APACHE II, Child-Pugh and MELD scores in Asian patients with refractory variceal hemorrhage.

Objective: This study was designed to determine if existing methods of grading liver function that have been developed in non-Asian patients with cirrhosis can be used to predict mortality in Asian patients treated for refractory variceal hemorrhage by the use of the transjugular intrahepatic portosystemic shunt (TIPS) procedure.

Materials And Methods: Data for 107 consecutive patients who underwent an emergency TIPS procedure were retrospectively analyzed. Acute physiology and chronic health evaluation (APACHE II), Child-Pugh and model for end-stage liver disease (MELD) scores were calculated.

A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm.

Purpose: To characterize imaging findings from computed tomography, magnetic resonance imaging, and angiogram in patients with infected aortic aneurysm.

Methods: We retrospectively reviewed the records of 21 patients (men, 17; women, 4) with proven infected aortic aneurysms and compared the imaging findings (computed tomography scans, n = 21; magnetic resonance images, n = 2; and angiograms, n = 2).

Results: Aneurysms were located in the descending thoracic aorta (n = 10; 47.

Ionic versus nonionic contrast media solvents used with an epirubicin-based agent for transarterial chemoembolization of hepatocellular carcinoma.

Purpose: To compare the stability of epirubicin-iodized oil emulsions prepared with ionic or nonionic contrast medium and to compare the efficacy of these emulsions in a prospective, randomized, controlled trial of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

Materials And Methods: Epirubicin-iodized oil emulsions prepared with ionic and nonionic contrast media was evaluated for stability with light microscopy and magnetic resonance imaging. One hundred ninety-seven patients with inoperable HCC were randomized to receive TACE with epirubicin, prepared either with ionic (control group, n = 99) or nonionic (experimental group, n = 98) contrast medium.

Clinical significance of poor CT enhancement of the thickened small-bowel wall in patients with acute abdominal pain.

Objective: Our purpose was to compare clinical outcomes in patients with acute abdominal pain and inner-layer enhancement of a thickened small-bowel wall, as shown on CT, with outcomes in similar patients without such enhancement.

Materials And Methods: We retrospectively studied outcomes in 126 patients with acute abdominal pain and small-bowel wall thickening on CT: 84 with inner-layer enhancement and 42 without this enhancement. We compared the surgical, small-bowel resection, small-bowel necrosis, and mortality rates between the two groups using the chi-square test.

Prophylactic residual aneurysmal sac embolization with expandable hydrogel embolic devices for endoleak prevention: preliminary study in dogs.

Objective: To explore the feasibility and efficacy of residual aneurysmal sac (RAS) embolization with the expandable hydrogel embolic device (EHED) in prevention of endoleaks in a surgically created and endoluminally treated abdominal aortic aneurysm (AAA).

Methods: In eight dogs, an AAA was created by means of side-to-side anastomosis between the infrarenal abdominal aorta and inferior vena cava (IVC) with ligation of the IVC above and below the anastomotic end, followed by deployment of an endograft with holes. The RAS was then embolized with the EHED.

Transcatheter arterial embolization for hemorrhage caused by injury of the hepatic artery.

Background: The aims of the study were to compare (i) the effects of transcatheter arterial embolization on initial hemostasis and the control of rebleeding in the treatment of hemorrhage due to hepatic artery injury; and (ii) the outcomes of embolization by different locations.

Methods: Subjects were 32 patients with suspected hepatic artery injury who were transferred to Chi-Mei Foundation Medical Center for hepatic angiography and embolization. The causes of arterial injury included liver trauma (n = 15) and iatrogenic injury (n = 17).

A flexible stent with small intestinal submucosa covering for direct intrahepatic portocaval shunt: experimental pilot study in swine.

The suitability of the flexible sandwich Zilver stent-graft (SZSG) with a biologically active tissue layer (small intestinal submucosa) for creation of the intravascular ultrasound (IVUS)-guided direct intrahepatic portocaval shunt (DIPS) was explored in six young swine in a search for a flexible system to replace the rigid polytetrafluoroethylene (PTFE) stent originally used by this group with limited success. The portal vein was punctured from the inferior vena cava through the caudate lobe of the liver using IVUS guidance. After balloon dilation of the puncture tract, DIPS was successfully created in all animals with use of an SZSG 9 mm in diameter and 6 cm or 8 cm long.

Large diverticulum and volvulus of the small bowel in adults.

The purpose of this study was to evaluate the relationship of large diverticulum (>3 cm) and volvulus of the small bowel (SB) in adults. A computer search of the medical records between January 1995 and December 2002 revealed 94 surgically proved cases of small bowel volvulus in adults. We reviewed the surgical records and recorded any specific condition found during laparotomy.