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Acta Gastroenterol Belg. 2002 Jan-Mar;65(1):6-11.
Duodenal ulcer hemorrhage treated by embolization: results in 28 patients.

De Wispelaere JF, De Ronde T, Trigaux JP, de Canniere L, De Geeter T.

Department of Radiology, Cliniques Universitaires UCL de Mont-Godinne, B-5530 Yvoir, Belgium.

BACKGROUND: To assess the effectiveness and prospects of transcatheter gastroduodenal artery embolization in the control of massive duodenal bleeding and to relate our experience. METHODS OF STUDY: The study is based on the retrospective analysis of 165 patients with endoscopically detected bleeding duodenal ulcer who presented between 1991-1998. 28 patients were considered eligible for endovascular treatment either at initial presentation or following hemorrhage recurrence after endoscopic therapy. RESULTS: Technical failure was noted in 3 cases, thereafter treated by surgery. In the other 25 patients, embolization was performed: bleeding recurrence occurred in 7 cases. Four were treated only endoscopically. One was reembolized and the last two were treated by surgery. In 6 cases, a coaxial technique was used (guiding catheter in 2 and 3F microcatheter in 4). No complication related to the catheterization was observed. CONCLUSION: Transcatheter embolization of the gastroduodenal artery appears to be an efficient procedure even in the absence of active bleeding at the time of the procedure. Failure and recurrence rates can be reduced by using a coaxial technique in the uneasy cases. Embolization seems to have a low recurrence rate and a very low complication rate.


Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12014319&dopt=Abstract hemorrhage



Med J Malaysia. 2001 Dec;56(4):460-2.
Vaginal hysterectomy for the large uterus.

Teoh TG.

Johor Specialist Hospital, Jalan Abdul Samad, Bahru.

Vaginal hysterectomy for the large uterus is seldom performed in Malaysia. The traditional operation is abdominal hysterectomy. This is a personal series of vaginal hysterectomies for enlarged uterus of more than 12 weeks size (>280g) carried out in a private hospital between 1/1/97 to 30/9/2000. A total of 40 cases were done with the weights of the uterus ranging from 290g to 790g. The mean weight of the uterus was 434g. The average operating time was 92.1 min. The complications were minimal with 2 cases of blood transfusion for intra-operative hemorrhage, 1 case of fever and 1 case of bladder perforation. This series demonstrates feasibility and safety of the operation. The excellent recovery due to the absence of an abdominal scar should be a strong incentive for specialists to learn the skill.


Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12014766&dopt=Abstract hemorrhage



Zhonghua Xue Ye Xue Za Zhi. 2002 Mar;23(3):151-2.
[Study of radiation synovectomy using (188)Re-Sulfide in hemophilic arthritis]

[Article in Chinese]

Li P, Chen G, Zhang L, Jiang X, Wang X, Sun Z, Zhang H.

Department of Nuclear Medicine of Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.

OBJECTIVE: To study the effectiveness of radiation synovectomy with (188)Re-sulfide. METHODS: Twenty rabbit models of joint synovitis were injected intra-articularly with different doses of (188)Re-sulfide from 7.4 to 37.0 MBq. By pathological examination, the effects of (188)Re-sulfide on synovium and cartilage were evaluated. Clinically, 10 joints of 7 cases of hemophilic arthritis with (188)Re-sulfide radiation synovectomy were performed. MRI was taken before and after the synovectomy to evaluate the treatment effects. RESULTS: In rabbit models, when (188)Re-sulfide dose larger than 14.8 MBq, the radiation effect on synovitis was remarkable, including thinning the thickened synovium and reducing the inflammatory cells. When radio-activity dose increased to 37.0 MBq, pathological damage was noted in cartilage. Clinical trial demonstrated that radiation synovectomy by (188)Re-sulfide could reduce the frequencies of intra-articular hemorrhage. MRI showed that edema and villi reduced. CONCLUSIONS: Radiation synovectomy using (188)Re-sulfide is effective on synovitis in hemophilic arthritis.


Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12015070&dopt=Abstract hemorrhage



Neurosurgery. 2003 Feb;52(2):364-8; discussion 368-9.
Far posterior subtemporal approach to the dorsolateral brainstem and tentorial ring: technique and clinical experience.

Smith ER, Chapman PH, Ogilvy CS.

Cerebrovascular Surgery, Neurosurgical Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

OBJECTIVE: Surgical access to the posterolateral mesencephalon or tentorial ring can be problematic, depending on the angle of the tentorium and associated venous structures. A far posterior subtemporal approach was developed that uses the wide opening of the tentorium and the option of supratentorial retraction of the cerebellum to provide an excellent angle of approach to this region. Details of this technique and a series of eight patients with lesions treated by this approach are presented. METHODS: Seven cavernous malformations and one dural arteriovenous malformation were approached in eight patients. In this far posterior subtemporal approach, a horseshoe incision is centered slightly behind the ear, with the caudal extent of the craniotomy defined by the temporal fossa floor. The entry of the vein of Labbe into transverse sinus is identified intradurally. If the vein enters anteriorly in the exposure, it is mobilized. Retractors are then placed, and the tentorium is visualized and opened laterally, avoiding the trochlear nerve. A thin, tapered retractor can be used to retract the cerebellum posterolaterally away from the brainstem. RESULTS: This approach was used to treat eight patients, and their lesions were successfully resected. Seven patients experienced good outcomes, and one patient, who presented with Hunt-Hess Grade IV subarachnoid hemorrhage from a dural arteriovenous malformation, experienced a fair outcome. CONCLUSION: The far posterior subtemporal approach is effective for approaching carefully selected lesions of the posterolateral mesencephalon and tentorial ring.


Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12535365&dopt=Abstract hemorrhage



Neurol Med Chir (Tokyo). 2002 Nov;42(11):491-5.
Spontaneous resolution of nontraumatic bilateral intracranial vertebral artery dissections.

Fukunaga A, Tabuse M, Naritaka H, Nakamura T, Akiyama T.

Department of Neurosurgery, Saiseikai Kanagawaken Hospital, Yokohama, Japan. fukunagc.itc.keio.ac.jp

A 49-year-old man presented with nontraumatic bilateral intracranial vertebral artery dissections without subarachnoid hemorrhage manifesting as Wallenberg's syndrome on the right. Magnetic resonance imaging revealed an infarct in the right dorsolateral aspect of the medulla oblongata. Antiplatelet therapy was administered. Vertebral angiography performed on the 9th hospital day (Day 9) revealed pearl and string sign in the right vertebral artery and narrowing of the left vertebral artery. Second angiography performed on Day 25 showed no change, but third angiography performed on Day 74 revealed spontaneous resolution of the bilateral vertebral artery dissections. Magnetic resonance angiography performed on Day 250 showed no evidence of dissection. However, magnetic resonance imaging revealed a small infarct in the splenium of the corpus callosum. Spontaneous resolution of stenotic dissections of the bilateral vertebral arteries is extremely unusual. Serial cerebral angiography and magnetic resonance angiography are very important for monitoring the time course of changes in patients with vertebral artery dissections.


Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12472213&dopt=Abstract hemorrhage








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