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Percutaneous intraductal radiofrequency ablation for treatment of biliary stent occlusion: A preliminary result

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World Journal of Gastroenterology 2017年第10期23卷 1851-1856页

作者： Ning Xia Ju Gong Jian Lu Zhi-Jin Chen Li-Yun Zhang Zhong-Min Wang department of radiology Ruijin Hospital Luwan BranchShanghai Jiao Tong University School of Medicine department of intervention Ruijin HospitalShanghai Jiao Tong University School of Medicine

AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter. RESULTS Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5 (range: 30-243) d. One patient was lost to followup. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 +/- 65 mu mol/L and 63 +/- 29 mu mol/L, respectively. There were no related complications (haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients' stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107 (range: 12-180) d. CONCLUSION This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.

关键词： Percutaneous transhepatic cholangiography Intraductal radiofrequency Malignant obstructive jaundice

Necrotizing Pneumonia and Conservative Treatment: A Case Report and Review of the Literature

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Open Journal of Respiratory Diseases 2024年第3期14卷 69-76页

作者： Pedro Rogerio Magalhães Braga Eduarda Kipper Beck Carolina de Mello Viera Cecília Gatti Wolff Laura Gazal Passos Guilherme Bastos de Mello Luis Felipe Pilar Gomes Giacomo Farias Tramontin Taíse Rosa de Carvalho department of Internal Medicine Hospital So Lucas da PUCRS Porto Alegre Brazil School of Medicine Pontifcia Universidade Catlica do Rio Grande do Sul Porto Alegre Brazil department of radiology Hospital So Lucas da PUCRS Porto Alegre Brazil

We present a case of necrotizing pneumonia in an 87-year-old man without severe respiratory instability. Clinical suspicion arose due to the need for supplementary oxygen and persistent fever during treatment for community-acquired pneumonia. The diagnosis was confirmed by chest computed tomography. Although necrotizing pneumonia typically requires major surgical intervention upon diagnosis, we chose conservative management with antimicrobials and chest drainage alone. The patient experienced significant improvement and resolution of pneumonia with conservative management.

关键词： Respiratory Tract Infections Lung Disease Bacterial Pneumonia

Outcomes of loco-regional therapy for down-staging of hepatocellular carcinoma prior to liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2011年第2期10卷 143-150页

作者： Xian-Jie Shi, Xin Jin, Mao-Qiang Wang, Li-Xin Wei, Hui-Yi Ye, Yu-Rong Liang, Ying Luo and Jia-Hong Dongdepartment of Hepatobiliary Surgery department of intervention radiology department of Pathology and department of radiology General Hospital of PLA, Beijing 100853, China department of Hepatobiliary Surgery General Hospital of PLA Beijing 100853 China department of intervention radiology General Hospital of PLA Beijing 100853 China department of Pathology General Hospital of PLA Beijing 100853 China department of radiology General Hospital of PLA Beijing 100853 China

BACKGROUND: The number of loco-regional therapies (LRTs) for hepatocellular carcinoma (HCC) has increased dramatically during the past decade. Many patients with HCC who were beyond the Milan criteria were allowed to receive a liver transplantation (LT) once the HCC was successfully down-staged. This retrospective study aimed to analyze the outcomes of LRTs prior to LT in patients with HCC beyond the Milan criteria. METHODS: We analyzed 56 patients treated from June 2006 to March 2010: 22 met the Milan criteria (T1+T2, 39.3%), 16 had T3 tumors (28.6%), and 11 had T4a tumors (19.6%), while 7 were suspected of tumor vascular invasion (T4b, 12.5%). All patients underwent preoperative LRTs, including transcatheter arterial chemoembolization, radiofrequency ablation, percutaneous ethanol injection, liver resection, and/or microwave coagulation therapy. The number of the patients who were successfully down-staged before LT, the types of LRTs used before LT, and their outcomes after LT were recorded. RESULTS: Eleven patients had necrotic tumors (pT0, 19.6%); 6 had pT1 tumors (10.7%), 22 had pT2 tumors (39.3%), 6 had pT3 tumors (10.7%), 5 had pT4a tumors (8.9%), and 6 had pT4b tumors (10.7%). The histopathologic tumors of 39 patients (69.6%) were down-staged and met the established Milan criteria (pT0-2). Imaging-proven under-staging was present in 5 HCC patients (8.9%) who had tumors involving the intrahepatic venous system. Twenty-three patients (41.1%) had stable HCC and 10 (17.9%) died. The 1-, 3- and 4-year survival rates were 96%, 73% and 61%, respectively, with a mean survival time of 22.29±1.63 months. Six patients died of tumorrecurrence. The 1-, 3- and 4-year recurrence-free survival (RFS) rates were 88%, 75% and 66%, respectively. The 3-year RFS of patients with pT0-2 tumors was 82%, which was markedly greater than that of patients with pT3 tumors (63%, P=0.018) or pT4 tumors (17%, P=0.000). Although the 3-year RFS of patients with pT3 tumors was greater than tha

关键词： hepatocellular carcinoma tumor down-staging loco-regional therapy liver transplantation

Dynamics of glutamine synthetase expression in hepatic ischemiareperfusion injury: Implications for therapeutic interventions

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World Journal of Hepatology 2024年第8期16卷 1177-1184页

作者： Zhi-Hao Huang Meng-Qi Dong Feng-Yong Liu Wei-Jie Zhou State Key Laboratory of Organ Failure Research Department of General SurgeryGuangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal TumorNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina department of interventional radiology Senior Department of OncologyFifth Medical Center of PLA General HospitalBeijing 100853China

BACKGROUND Hepatic ischemia-reperfusion injury(IRI)poses a great challenge in liver surgery and transplantation because of oxidative stress and inflammatory *** changes in glutamine synthetase(GS)expression during hepatic IRI remain *** To investigate the dynamic expression of GS during hepatic *** Following hepatic ischemia for 1 h and reperfusion,liver tissue samples were collected at 0.5,6,and 24 hours postreperfusion for fixation,embedding,*** and eosin staining and GS staining were *** GS expression rapidly decreases in hepatocytes around the central vein after IRI,reaching its lowest point at 6 hours postreperfusion,and then gradually *** GS is highly sensitive to IRI,highlighting its potential role as an indicator of liver injury states and a target for therapeutic intervention.

关键词： Hepatic ischemia-reperfusion Glutamine synthetase Central vein Liver Injury repair

Comprehensive interventions for adult cyclic vomiting syndrome complicated by superior mesenteric artery syndrome:A case report

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World Journal of Clinical Cases 2024年第29期12卷 6327-6334页

作者： Bo Liu Hui Sun Yang Liu Min-Lan Yuan Hong-Ru Zhu Wei Zhang department of Psychiatry Zigong Mental Health CenterZigong 643020Sichuan ProvinceChina department of radiology West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Mental Health Center and Psychiatric Laboratory West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Cyclic vomiting syndrome(CVS)is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea,vomiting,abdominal pain,and interspersed complete normal *** mesenteric artery(SMA)syndrome(SMAS)is a vascular condition in which the horizontal portion of the duodenum is compressed due to a reduced angle between the aorta and the *** condition presents with symptoms similar to CVS,posing challenges in distinguishing between the two and often resulting in misdiagnosis or inappropriate *** SUMMARY A 20-year-old female patient presented with recurrent episodes of vomiting and experienced a persistent fear of vomiting for the past 2 *** adopted conscious dietary restrictions,which led to severe ***,she was diagnosed with SMAS,as revealed by computed tomography *** efforts to increase the angle between the aorta and the SMA through weight gain,her vomiting did not ***,she was diagnosed with comorbidities including CVS,SMAS and anxiety *** underwent comprehensive interventions,including enteral and parenteral nutritional supplementation,administration of antiemetic and anti-anxiety agents,and participation in mindfulness-based cognitive *** patient eventually experienced a notable improvement in both body weight and clinical *** We present a rare case of CVS in an adult complicated with SMAS and propose additional treatment with nutritional support,pharmacological intervention,and psychotherapy.

关键词： Cyclic vomiting syndrome Superior mesenteric artery syndrome Anxiety disorder Nutritional supplementation Mindfulness-based cognitive therapy Case report

Removal of"ruptured"pulmonary artery infusion port catheter by pigtail catheter combined with gooseneck trap:A case report

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World Journal of Clinical Cases 2021年第29期9卷 8820-8824页

作者： Gui-Qin Chen Yang Wu Kai-Fei Zhao Rong-Shu Shi department of radiology The Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina department of intervention The Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina

BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic *** their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe *** SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary ***,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck *** When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.

关键词： Implanted intravenous infusion port Fractured catheter Gooseneck trap Pigtail catheter Pulmonary Case report

Computed tomography perfusion in liver and spleen for hepatitis B virus-related portal hypertension:A correlation study with hepatic venous pressure gradient

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World Journal of Gastroenterology 2022年第42期28卷 6068-6077页

作者： Lei Wang Yu Zhang Yi-Fan Wu Zhen-Dong Yue Zhen-Hua Fan Chun-Yan Zhang Fu-Quan Liu Jian Dong department of intervention Therapy Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China interventional radiology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China department of radiology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

BACKGROUND Hepatic venous pressure gradient(HVPG)is the gold standard for diagnosis of portal hypertension(PH).However,its use can be limited because it is an invasive ***,it is necessary to explore a non-invasive method to assess *** To investigate the correlation of computed tomography(CT)perfusion of the liver with HVPG and Child-Pugh score in hepatitis B virus(HBV)-related *** Twenty-eight patients(4 female,24 male)with gastroesophageal variceal bleeding induced by HBV-related PH were recruited in our *** patients received CT perfusion of the liver before transjugular intrahepatic portosystemic stent-shunt(TIPS)*** parameters of CT perfusion of the liver,including liver blood flow(LBF),liver blood volume(LBV),hepatic artery fraction,splenic blood flow and splenic blood volume were *** was recorded during TIPS *** of liver perfusion with Child-Pugh score and HVPG were analyzed,and the receiver operating characteristic curve was *** on HVPG(>12 mmHg vs≤12 mmHg),patients were divided into moderate and severe groups,and all parameters were *** Based on HVPG,18 patients were classified into the moderate group and 10 patients were classified into the severe *** Child-Pugh score,HVPG,LBF and LBV were significantly higher in the moderate group compared to the severe group(all P<0.05).LBF and LBV were negatively associated with HVPG(r=-0.473,P<0.05 and r=-0.503,P<0.01,respectively),whereas splenic blood flow was positively associated with hepatic artery fraction(r=0.434,P<0.05).LBV was negatively correlated with Child-Pugh ***-Pugh score was not related to *** a cutoff value of 17.85 mL/min/100 g for LBV,the sensitivity and specificity of HVPG≥12 mmHg for diagnosis were 80%and 89%,*** LBV and LBF were negatively correlated with HVPG and Child-Pugh *** perfusion imaging is a potential non-invasive quantitative predictor for PH i

关键词： Hepatic venous pressure gradient Portal hypertension Computed tomography perfusion Hepatitis B Liver cirrhosis

Sinonasal teratocarcinosarcoma involving the nasal cavity,unilateral paranasal sinuses,and intracranial invasion:A case report

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World Journal of Clinical Cases 2024年第25期12卷 5784-5790页

作者： Li-Yuan Fu Mi-Yang Yang Pei-Yun Ye Zhao-Chu Wang Chu-Jie Chen Hui Li Shang-Wen Xu department of radiology 900th Hospital of Joint Logistics Support ForceFuzhou 350025Fujian ProvinceChina The First Clinical Medical College Fuzong Teaching HospitalFujian University of Traditional Chinese MedicineFuzhou 350122Fujian ProvinceChina

BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and ***,it exhibits an invasive behavior towards adjacent structures;however,in exceptional instances,it may infiltrate the intracranial *** to the tumor's rarity and lack of distinctive features on computed tomography(CT)and magnetic resonance imaging(MRI)images,SNTCS is often *** SUMMARY In this study,we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before *** and MRI scans revealed the presence of a mass in the right nasal cavity,with lesions extending to the right ethmoid sinus and right frontal ***,the patient underwent pathological examination for confirmation and received surgical intervention to excise the *** future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of *** SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses,presenting a diagnostic challenge due to its nonspecific imaging *** accurately delineates the location,morphological characteristics,size,internal structure,extent of surrounding involvement,and metabolic information of the *** aspects play a pivotal role in the precise localization and qualitative assessment of ***,a definitive diagnosis still requires a pathological biopsy.

关键词： Paranasal sinus Malignant tumor Sinonasal teratocarcinosarcoma Brain invasion Case report

The underlying molecular mechanism of intratumoral radiofrequency hyperthermia-enhanced chemotherapy of pancreatic cancer

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Journal of interventional Medicine 2022年第2期5卷 57-63页

作者： Liangcai Zhao Yiming Zhou Zhibin Bai Feng Zhang Xiaoming Yang Image-Guided Biomolecular intervention Research Section of Interventional RadiologyDepartment of RadiologyUniversity of Washington School of MedicineSeattle WAUSA School of Pharmaceutical Science Wenzhou Medical UniversityWerzhouChina

Background:To investigate the underlying molecular mechanisms of radiofrequency hyperthermia(RFH)-enhanced direct chemotherapy of pancreatic ***:Rat ductal PaCa cell line DSL-6A/C1 and orthotopic pancreatic cancers of Lewis rats were divided into four study groups with various treatments:i)phosphate-buffered saline(PBS)as a control;ii)RFH alone;iii)intratumoral chemotherapy alone(gemcitabine);and(iv)combination therapy of gemcitabine plus intratumoral RFH at 42°C for30 *** the in-vitro confirmation experiments,the viability and apoptosis of DSL-6A/C1 cells in each treatment group were evaluated using cell live/dead staining,flow cytometry,and Western *** the in vivo validation experiments,related proteins were evaluated by immunohistochemistry(IHC)staining of ***:Of the in-vitro experiments,the lowest cell viability and more apoptotic cells were shown in the group with combination therapy compared to other *** blot data showed elevated Bax/Bcl-2,Caspase-3,and HSP70 expressions in DSL cells with combination therapy,compared to other *** the in vivo experiments,IHC staining detected the significantly increased expressions of HSP70,IL-1β,TNF-ɑ,Bax,and Caspase-3 in pancreatic cancer tissues of the animal group treated by combination therapy of gemcitabine with ***:Molecular imaging-guided interventional RFH can significantly enhance the chemotherapeutic effect on pancreatic cancers via potential molecular mechanisms of up-regulating Bax/caspase-3-dependent apoptosis pathways.

关键词： Pancreatic cancer Radiofrequency Hyperthermia Chemotherapy Mechanism