Preoperative arterial embolization of large liver hemangiomas

PURPOSEWe aimed to investigate the efficacy and safety of preoperative selective intra-arterial embolization (PSIAE) in the surgical treatment of large liver hemangiomas.METHODSData of 22 patients who underwent resection of large liver hemangiomas were retrospectively analyzed. PSIAE was performed in cases having a high risk of severe blood loss during surgery (n=11), while it was not applied in cases with a low risk of blood loss (n=11).RESULTSA total of 19 enucleations and six anatomic resections were performed. Operative time, intraoperative bleeding amount, Pringle period, and blood transfusion were comparable between the two groups (P > 0.05, for all). The perioperative serum aspartate transaminase level was not different between groups (P = 1.000). Perioperative total bilirubin levels were significantly increased in the PSIAE group (P = 0.041). Postoperative hospital stay was longer in the PSIAE group. Surgical complications were comparable between groups (P = 0.476).CONCLUSIONPatients who underwent PSIAE due to a high risk of severe blood loss during resection of large liver hemangiomas had comparable operative success as patients with a low risk of blood loss who were operated without PSIAE. Hence, PSIAE can be used for the control of intraoperative blood loss, especially in surgically difficult cases

Les Actes du XXIVe Congrès international d'histoire de la médecine : Acta Congressus internationalis XXIV Historiae Artis Medicinae, 25-31 Augusti 1974, Budapestini

Julien Pierre. Les Actes du XXIVe Congrès international d'histoire de la médecine : Acta Congressus internationalis XXIV Historiae Artis Medicinae, 25-31 Augusti 1974, Budapestini. In: Revue d'histoire de la pharmacie, 66ᵉ année, n°236, 1978. pp. 61-62

Effect of cerebrospinal fluid leakage on wound healing in flap surgery: Histological evaluation

The aim of this study was to find out the effect of CSF leakage on wound healing after flap surgery. Sixteen male Wistar rats were used. The superiorly based rectangular dorsal skin flap 3 x 3 cm was elevated at the interscapular region. Through this opening, paraspinal muscle dissection and three-level bilateral laminectomy were done. Finally, a dura defect with a diameter of 3-4 mm was created. In the control group, laminectomy was performed as in the study group but the dura was left intact. Persistent CSF leakage was confirmed using isotope cisternography. At the end of 2-week study period, there was no necrosis, infection, or dehiscence of the flap in either group. On necroscopy, cyst formation over the dura defect was detected in 4 animals of the study group. Another gross finding in this group was intensive vascularization of the undersurface of the flap and wound bed. With HE staining, the tissue sections from the study group revealed new vessel formation with small diameter, increase in the reactional mesenchymal tissue, granulation tissue, degeneration of the striated muscle fibers, dystrophic calcifications, fat necrosis, and coagulation necrosis (ischemic necrosis). In the control group, there was only minimal lymphocytic invasion of the subdermal plane. In this study, we have shown that CSF leakage itself has effects on wound healing in the absence of known causative factors. Copyright © 2004 S. Karger AG, Basel

Fokal Lazer Fotokoagülasyon ile Tedavi Edilmiş Diyabetik Makula Ödeminde İntravitreal Bevacizumab

Amaç: Çalışmamızda, daha önce fokal lazer fotokoagülasyon (FLF) ile tedavi edilen, ancak bu tedaviye yanıt vermeyen veya kısmen yanıt veren hastalarda görme keskinliği ve makula kalınlığına intravitreal bevacizumab (IVB) tedavisinin etkinliğini analiz etmek amaçlanmıştır. Gereç ve Yöntemler: Diyabetik maküla ödemi (DMÖ) tanısıyla daha önce FLF tedavisi uygulanan, klinik olarak anlamlı makula ödemi (KAMÖ) tanısı alan, ya da >=250 um santral makula kalınlığı (SMK) bulunan ve sonrasında IVB ile tedavi edilmiş 32 hastanın 40 gözünün medikal kayıtları geriye dönük olarak incelendi. Bir yıllık takip süresince ortalama en iyi düzeltilmiş görme keskinliği (EİDGK) ve SMK'daki değişim değerlendirildi.Bulgular: Tedavi öncesi ve sonrası SMK sırasıyla 403,64 ± 118,34 ?m ve 319,39 ± 99,57 ?m olarak ölçüldü. SMK başlangıçla kıyaslandığıunda son kontrolde anlamlı olarak azalmıştı (p = 0.0001). Tedavi öncesi ve sonrası Log MAR değerleri sırasıyla 0.45 (aralık 0,20-0,95) ve 0.50 (aralık 0,30-1,00) idi. Bu değerler arasındaki fark anlamlı değildi (p> 0.05). Sonuç: Bu çalışma, eğer tedavi FLP ile başlatılır ve bunu IVB ile takip eder ise, fonsiyonel fayda gözlenemese bile iyi anatomik sonuçlar elde edilebileceğini düşündürmektedir. Anti-vasküler endotelyal büyüme faktörü (VEBF) tedavisi, diyabetik maküla ödeminde ilk tedavi olmalı ya da daha önce FLF tedavisi gören hastalarda en azından daha iyi anatomik sonuçlar elde etmek için hemen başlanmalıdır.Objective: Our study aimed to analyze the effi cacy of intravitreal bevacizumab (IVB) therapy on visual acuity and macular thickness in patients previously treated by focal laser photocoagulation (FLP) and who did not respond or only partially responded to this treatment. Materials and Methods: Medical records comprising 40 eyes of 32 patients treated with IVB who previously underwent FLP due to diabetic macular edema (DME) but diagnosed as clinically signifi cant macular edema (CSME), or those with >=250 ?mcentral macular thickness (CMT) were analyzed retrospectively. Outcome measures were the change in mean best corrected visual acuity (BCVA) and CMT during the one year follow-up period.Results: Mean CMT were 403.64 ± 118.34 ?m and 319.39 ± 99.57 ?m before and after treatment, respectively. CMT was signifi cantly reduced at the last follow-up visit (p = 0.0001) compared to the baseline. Pre-treatment and post-treatment Log MAR values were 0.45 (range 0.20-0.95) and 0.50 (range 0.30-1.00) before and after treatment. The difference was not signifi cant (p> 0.05). Conclusion: This study suggests that if the treatment is initiated as prompt FLP and is followed by IVB therapy, good anatomic results may be obtained however; functional benefi t may not be observed. Anti-vascular endothelial growth factor (VEGF) therapy should be the fi rst treatment in diabetic macular edema or be initiated immediately in patients who had FLP treatment before in order to have at least better anatomic results