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Radiographics. 2003 Jan-Feb;23(1):123-34; discussion 134-6.
Major complications after radio-frequency thermal ablation of hepatic tumors: spectrum of imaging findings.
Rhim H, Yoon KH, Lee JM, Cho Y, Cho JS, Kim SH, Lee WJ, Lim HK, Nam GJ, Han SS, Kim YH, Park CM, Kim PN, Byun JY.
Department of Diagnostic Radiology, Hanyang University Hospital, 17 Haengdang-Dong, Sungdong-Ku, Seoul, Korea. rhimhanyang.ac.kr
Although radio-frequency (RF) ablation has been accepted as a promising and safe technique for treatment of unresectable hepatic tumors, investigation of its complications has been limited. According to the multicenter (1,139 patients in 11 institutions) survey data of the Korean Study Group of Radiofrequency Ablation, a spectrum of complications occurred after RF ablation of hepatic tumors. The prevalence of major complications was 2.43%. The most common complications were hepatic abscess (0.66%), peritoneal hemorrhage (0.46%), biloma (0.20%), ground pad burn (0.20%), pneumothorax (0.20%), and vasovagal reflex (0.13%). Other complications were biliary stricture, diaphragmatic injury, gastric ulcer, hemothorax, hepatic failure, hepatic infarction, renal infarction, sepsis, and transient ischemic attack. One procedure-related death (0.09%) occurred (due to peritoneal hemorrhage). Three important strategies for decreasing the rate of complications are prevention, early detection, and proper management. A physician who performs RF ablation of hepatic malignancies should be aware of the broad spectrum of major complications so that these strategies can be used. RSNA, 2003.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12533647&dopt=Abstract hemorrhage
Dent Traumatol. 2002 Aug;18(4):212-6.
Histological evaluation of changes in the temporomandibular joint after direct and indirect trauma: an experimental study.
Yucel E, Borkan U, Mollaoglu N, Erkmen E, Gunhan O.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey.
Direct or indirect trauma to the temporomandibular joint (TMJ) may cause several injuries such as fibrous adhesion, ankylosis and fracture. The aim of this study was to examine and compare the histological changes of TMJ and adjacent soft tissue after direct or indirect trauma to TMJ. In this study, a total of 35 healthy young adult guinea pigs were exposed to direct and indirect trauma to their TMJ, and histologic evaluation was done after 24 h, 7, 15 and 45 days. Hemorrhage was the most frequent complication, following that enlargement of the disc, adhesion of the disc to the condyle and fracture of the condyle were seen in both groups. There were regenerative changes in adjacent muscles of the TMJ in indirect trauma group when compared to direct trauma group. Regenerative changes were more obvious on days 15 and 45. As a result, it may be suggested that when a trauma comes to the maxillo-mandibular complex, even TMJ is indirectly affected, TMJ and its adjacent soft tissues should also be examined clinically and followed closely.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12442831&dopt=Abstract hemorrhage
Int J Gynecol Cancer. 2002 Nov-Dec;12(6):749-54.
Cisplatin-based chemotherapy regimen (DECAV) for uterine sarcomas.
Pautier P, Genestie C, Fizazi K, Morice P, Mottet C, Haie-Meder C, Le Cesne A, Lhomme C.
Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, France. pautiegr.fr
Uterine sarcomas are an extremely rare event. There is no standard therapy for cases of relapse, although chemotherapy is commonly used. We studied the use of a cisplatin-based chemotherapy regimen for uterine sarcomas with an unusually long follow-up. Thirty-nine women with a median age of 50 years (32-71) entered the study. Histologically, leiomyosarcomas (26), carcinosarcomas (8), and stromal sarcomas (5) were represented. Group 1 consisted of patients undergoing adjuvant therapy (for initial disease, eight patients; for pelvic recurrence, two patients); Group 2 consisted of patients with advanced disease (locoregional after initial local therapy, five patients; local recurrence, six patients) or metastatic disease (stage IV, four patients; recurrence, 14 patients). DECAV therapy consisted of doxorubicin 50 mg/m2 d1, dacarbazine (DTIC) 200 mg/m2/d d1-3, vindesine 2 mg/day d1-2, cisplatin 100 mg/m2 d3, and either cyclophosphamide (CPM) 200 mg/m2/d d1-3 (n = 21), or ifosfamide (IFM) 2 g/m2/d d1-3 with mesna every 4 weeks Toxicity included 18 hospital stays for cytopenia (nine patients), including 13 cases of febrile neutropenia. Twenty blood transfusions in 10 patients and 12 platelet transfusions in seven patients were required. One toxicity-related death (hemorrhage) occurred. The overall response rate was 54% (3 complete response, 11 partial response) with a median duration of 13 months (4-36). Median overall survival was 14 month overall, 45 months for Group 1 and 13 months for Group 2. We conclude that the DECAV regimen is clearly active in uterine sarcomas but is too toxic to be recommended routinely.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12445254&dopt=Abstract hemorrhage
Neurosurgery. 2002 Dec;51(6):1403-12; discussion 1412-3.
Microsurgical fenestration of the lamina terminalis reduces the incidence of shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage.
Komotar RJ, Olivi A, Rigamonti D, Tamargo RJ.
Department of Neurosurgery, Division of Cerebrovascular Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287,USA.
OBJECTIVE: Hydrocephalus requiring shunt placement is a common complication after aneurysmal subarachnoid hemorrhage (aSAH). Previous investigations suggest that fenestration of the lamina terminalis during microsurgery for aSAH may be associated with a reduced rate of shunt-dependent hydrocephalus. We report a retrospective analysis correlating fenestration of the lamina terminalis with decreased shunt-dependent hydrocephalus after aSAH. METHODS: During the past decade, 582 patients were admitted to our institution with aSAH. We compared the rate of shunting in patients operated on by a neurosurgeon ("index neurosurgeon") who routinely fenestrated the lamina terminalis (>98% of his patients) with that in patients managed by 14 other neurosurgeons who rarely fenestrated the lamina terminalis (<5% of their patients) and by 6 interventional neuroradiologists. The total cohort was subdivided into two groups on the basis of surgical approach and microsurgical access to the lamina terminalis. Group A included frontosphenotemporal craniotomies, an approach in which the lamina terminalis is accessible, and Group B included other approaches in which the lamina terminalis is not accessible. Shunting rates of the index neurosurgeon and those of the other practitioners were compared within Groups A and B. Shunting rates were compared by logistic regression and multivariable analysis. This study design isolates the effect of fenestrating the lamina terminalis on the incidence of shunt-dependent hydrocephalus. RESULTS: In Group A, the index neurosurgeon had a significantly lower rate of shunting, 2.3%, versus 12.6% for other practitioners (P = 0.011; odds ratio, 0.15). In Group B, in which the approach did not allow microsurgical fenestration of the lamina terminalis, there was no difference (P = 0.789) in the rate of shunting between the index neurosurgeon (10.0%) and other practitioners (13.2%). CONCLUSION: Fenestration of the lamina terminalis appears to be associated with a decreased incidence of shunt-dependent hydrocephalus of more than 80% after aSAH. This straightforward microsurgical maneuver should be performed whenever possible during aneurysm surgery.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12445345&dopt=Abstract hemorrhage
Neurosurgery. 2002 Dec;51(6):1457-65; discussion 1465-7.
Ischemia triggered by red blood cell products in the subarachnoid space is inhibited by nimodipine administration or moderate volume expansion/hemodilution in rats.
Dreier JP, Windmuller O, Petzold G, Lindauer U, Einhaupl KM, Dirnagl U.
Department of Neurology and Experimental Neurology, Charite Hospital, Humboldt University, Berlin, Germany. jens.dreieharite.de
OBJECTIVE: It has been proposed that delayed ischemic neurological deficits are induced by red blood cell (RBC) products after subarachnoid hemorrhage. Prophylactic treatment with the Ca2+ antagonist nimodipine or prevention of systemic volume contraction reduces the occurrence of delayed ischemic neurological deficits. To gain insight into the underlying mechanism, we studied the effects of nimodipine or volume expansion on ischemic events induced by RBC products in rats. METHODS: A cranial window was implanted in 52 rats. At the window, cerebral blood flow (measured with laser Doppler flowmetry) and the subarachnoid direct current potential were recorded; the cortical surface was superfused with artificial cerebrospinal fluid. A spreading neuronal/astroglial depolarization wave was triggered at a remote site, from which it traveled to the cranial window. RESULTS: In 16 rats, the depolarization wave triggered an ischemic event at the cranial window when artificial cerebrospinal fluid containing the RBC product hemoglobin and elevated K+ levels was superfused. In contrast, in animals receiving intravenously administered nimodipine (n = 12) or moderate volume expansion/hemodilution with hydroxyethyl starch (6% hydroxyethyl starch 200/0.5) (n = 10), the depolarization wave triggered brief initial hypoperfusion, followed by brief hyperemia, in the cortical area exposed to the RBC products. Under physiological conditions, the depolarization wave triggered brief hyperemia (n = 14). CONCLUSION: Spreading ischemia induced by RBC products is antagonized by measures known to be beneficial in the prophylaxis of delayed ischemic neurological deficits. Our findings suggest that a mechanism involving the cortical microcirculation might underlie the therapeutic effects of nimodipine and volume expansion.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12445352&dopt=Abstract hemorrhage
Hair loss alone does not pose significant health problems. In fact, there are people who opt for baldness as an alternative hair style. However, in general, however, hair loss is not considered desirable.
The most ostensive feature that distinguishes us human from chimps and other primates is the lack of bodily hair. During evolutionary process, we have lost the majority of hair. Hair is no longer a biologically essential part of our body, just
While the hair loss and resulting baldness in general have not been proven to be related to underlying health problems, there are certain correlations between hair loss and health problems. For instance, premature hair loss could suggest premature aging or nutritional and hormonal imbalance, stressful life, use of drugs that cause hair loss as a side effect, skin disease, or heart disease. The balding appearance could also impart a subdued impression of integrity in bodily health and youthfulness.
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DHEA is a natural hormone, and it is produced in our body by the adrenal glands.
DHEA has been suggested to provide numerous potential benefits. DHEA (or dehydroepiandrosterone) is converted into androgens (male hormones)
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Our bodies produce decreasing amount of DHEA as we get older.
DHEA dietary supplements are used for
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