Interventional radiological treatment of non-colorectal liver metastases

Transcatheter treatment was performed in 81 patients with unresectable non-colorectal liver metastases. Effectiveness increased in the following order: hepatic artery infusion--arterial chemoembolization--combined, arterial and portal vein oily chemoembolization. The mean survival rates for these methods were 8.2 +/- 5.3, vs 11.7 +/- 12.9 vs 13.6 +/- 6.8 mo, and 1-year survival rates 29% vs 46% vs 65%, respectively. Chemoembolization with doxorubicin-in-oil and gelatin sponge was the most effective technique. Interventional radiological procedures were effective in neuroendocrine liver metastases. The mean survival, 1- and 3-year survival rates were as high as 34 mo, 100% and 80%, respectively, for hepatic metastases from resected malignant carcinoid tumors. Also good results were achieved after chemoembolization of metastatic ovarian carcinoma and arterial infusion for gastric carcinoma metastatic to the liver. Transcatheter treatment was ineffective in liver metastases from pancreatic carcinoma, gallbladder cancer, and unknown (and non-resected) tumors. The initial results of the use of interventional radiological procedures in non-colorectal liver metastases are promising, so following clinical trails are needed.     

Unusual presentation of choriocarcinoma

Background  

Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. The disease normally spreads to lung and brain.     

Differential expression level of cytokeratin 8 in cells of the bovine nucleus pulposus complicates the search for specific intervertebral disc cell markers

Introduction  

Development of cell therapies for repairing the intervertebral disc is limited by the lack of a source of healthy human disc cells. Stem cells, particularly mesenchymal stem cells, are seen as a potential source but differentiation strategies are limited by the lack of specific markers that can distinguish disc cells from articular chondrocytes.     

Frequent Seizures Are Associated with a Network of Gray Matter Atrophy in Temporal Lobe Epilepsy with or without Hippocampal Sclerosis

Objective

Patients with temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) have diffuse subtle gray matter (GM) atrophy detectable by MRI quantification analyses. However, it is not clear whether the etiology and seizure frequency are associated with this atrophy. We aimed to evaluate the occurrence of GM atrophy and the influence of seizure frequency in patients with TLE and either normal MRI (TLE-NL) or MRI signs of HS (TLE-HS).

Methods

We evaluated a group of 172 consecutive patients with unilateral TLE-HS or TLE-NL as defined by hippocampal volumetry and signal quantification (122 TLE-HS and 50 TLE-NL) plus a group of 82 healthy individuals. Voxel-based morphometry was performed with VBM8/SPM8 in 3T MRIs. Patients with up to three complex partial seizures and no generalized tonic-clonic seizures in the previous year were considered to have infrequent seizures. Those who did not fulfill these criteria were considered to have frequent seizures.

Results

Patients with TLE-HS had more pronounced GM atrophy, including the ipsilateral mesial temporal structures, temporal lobe, bilateral thalami and pre/post-central gyri. Patients with TLE-NL had more subtle GM atrophy, including the ipsilateral orbitofrontal cortex, bilateral thalami and pre/post-central gyri. Both TLE-HS and TLE-NL showed increased GM volume in the contralateral pons. TLE-HS patients with frequent seizures had more pronounced GM atrophy in extra-temporal regions than TLE-HS with infrequent seizures. Patients with TLE-NL and infrequent seizures had no detectable GM atrophy. In both TLE-HS and TLE-NL, the duration of epilepsy correlated with GM atrophy in extra-hippocampal regions.

Conclusion

Although a diffuse network GM atrophy occurs in both TLE-HS and TLE-NL, this is strikingly more evident in TLE-HS and in patients with frequent seizures. These findings suggest that neocortical atrophy in TLE is related to the ongoing seizures and epilepsy duration, while thalamic atrophy is more probably related to the original epileptogenic process.     

Arterial chemoembolization in the combined treatment of malignant tumors of the tongue and maxilla: preliminary results

The authors made a clinical evaluation of the efficiency of regional bolus chemotherapy and embolization as a stage of combined therapy in patients with inoperable cancer of the tongue and maxilla complicated by bleeding episodes. Carotid angiography by attempting to make chemoembolization was performed in 15 patients. The procedure could not be done in full in 2 (13%) patients due to transient vascular and neurological disorders. The remaining 13 (87%) patients had successful chemoembolization of tumor-supplying arteries with 5-fluorouracil (700 mg/m2) and methotrexate (40 mg/m2) in combination with finely cut hemostatic sponge and fragments of metallic spirals (n = 12) or regional bolus injection of a cytostatic (n = 1) without arterial occlusion. After embolization, bleeding episodes ceased in all the patients. Full (n = 1) and partial (n = 6) responses to treatment or stabilization of the process (n = 5) were noted in 12 (92%) cases, progression was only in 1 (8%) case. The study suggests that chemoembolization of the branches of the external carotid artery in patients with cancer of the tongue and maxilla contributes to the arrest of chronic tumorous bleeding and to the reduction in the risk for acute A combination of systemic multidrug therapy, radiation therapy, and chemoembolization stabilizes a tumorous process in most patients.