scholarly journals Stent Placement For Intracranial Cysts By Combined Stereotactic/Endoscopic Surgery

2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-474-ONS-480 ◽  
Author(s):  
Ansgar Berlis ◽  
Jan Vesper ◽  
Christoph Ostertag
Keyword(s):  
Stent Placement ◽  
Clinical Symptoms ◽  
Treatment Method ◽  
Low Grade ◽  
Cystic Lesions ◽  
Internal Drainage ◽  
Computed Tomographic ◽  
Stereotactic Frame ◽  
Cyst Aspiration ◽  
New Treatment

Abstract OBJECTIVE: The treatment of space-occupying cystic lesions includes percutaneous cyst aspiration, marsupialization, percutaneous ventriculocystotomy, or Rickham catheter implantation. In some patients, the cysts tend to recur and repeated evacuations are necessary. The authors present a new treatment method with internal drainage of cysts into the ventricular system using a balloon-mounted vascular stent. METHODS: Six patients with cysts of low-grade gliomas, one with monocystic craniopharyngioma, and one with suprasellar arachnoid cyst were treated between September 2003 and May 2005. All patients were symptomatic after multiple previous treatments. Stent implantations were performed under local anesthesia in adults and under general anesthesia in children. In all patients, the stereotactic frame and computed tomographic and magnetic resonance fusion were used for an optimized approach. The treatment was performed in a compassionate manner and the patients were informed about the off-label use of the device. RESULTS: Stent placement was successful in all eight patients without procedure-related complications. Improvement of clinical symptoms was seen in seven out of eight patients. Seven out of eight cysts decreased in size within a follow-up period of up to 23 months (mean, 17 mo; median, 18 mo; range, 6-23 mo). The first patient showed recurrence of the tumor cyst 3 months after initial treatment with a Herkulink stent (5 × 18 mm), followed by retreatment with an Omnilink stent (6 × 28 mm; Guidant Corp., Santa Clara, CA). Stenting was ineffective in one patient. @@CONCLUSION:@@ Treatment of intracranial cystic lesions by internal drainage is possible with the use of stent-assisted ventriculocystostomy.

scholarly journals ERCP in Evaluating The Mode of Therapy in Pancreatic Pseudocyst

HPB Surgery ◽  
1988 ◽  
Vol 1 (1) ◽  
pp. 35-44 ◽  
Author(s):  
I. Nordback ◽  
O. Auvinen ◽  
I. Airo ◽  
J. Isolauri ◽  
O. Teerenhovi
Keyword(s):  
Pancreatic Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Main Pancreatic Duct ◽  
Pancreatic Pseudocyst ◽  
Treatment Method ◽  
Internal Drainage ◽  
Endoscopic Retrograde ◽  
External Drainage ◽  
Computed Tomographic ◽  
Pancreatic Resections

Twenty patients with ultrasonographic or computed tomographic diagnosis of pancreatic pseudocyst were referred for endoscopic retrograde cholangiopancreatography (ERCP). Two of these were found at laparotomy not to have pseudocysts and were excluded. Pancreatography was successful in 15 out of 18 cases (83%) and cholangiography in 12 out of 18 cases (67%). Three types of pseudocysts were noticed according to the communication of the pseudocyst to the main pancreatic duct and the presence of pancreatic duct stensosis. Successful treatment included two spontaneous resolutions, two internal drainages and three left pancreatic resections. In the eight percutaneous external drainages four recurrences (50%) occurred, one after closure of temporary pancreatocutaneous fistula. All the recurrences occurred in Type III pseudocysts with communication of the pseudocysts to stenotic main pancreatic duct. In these cases internal drainage would have been the preferable treatment method. We believe that by ERCP one can identify pseudocysts not suitable for external drainage.

Immunotherapy and potential predictive biomarkers in the treatment of neuroendocrine neoplasia

2020 ◽  
Author(s):  
Guanghui Xu ◽  
Yuhao Wang ◽  
Hushan Zhang ◽  
Xueke She ◽  
Jianjun Yang
Keyword(s):  
Current Knowledge ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Predictive Biomarkers ◽  
The Body ◽  
Low Grade ◽  
Ablative Therapies ◽  
Cancer Types ◽  
New Treatment ◽  
Well Differentiated

Neuroendocrine neoplasias (NENs) are a heterogeneous group of rare tumors scattered throughout the body. Surgery, locoregional or ablative therapies as well as maintenance treatments are applied in well-differentiated, low-grade NENs, whereas cytotoxic chemotherapy is usually applied in high-grade neuroendocrine carcinomas. However, treatment options for patients with advanced or metastatic NENs are limited. Immunotherapy has provided new treatment approaches for many cancer types, including neuroendocrine tumors, but predictive biomarkers of immune checkpoint inhibitors (ICIs) in the treatment of NENs have not been fully reported. By reviewing the literature and international congress abstracts, we summarize the current knowledge of ICIs, potential predicative biomarkers in the treatment of NENs, implications and efficacy of ICIs as well as biomarkers for NENs of gastroenteropancreatic system, lung NENs and Merkel cell carcinoma in clinical practice.

scholarly journals LGG-23. EXCELLENT CLINICAL / RADIOLOGICAL RESPONSE TO BRAF INHIBITION IN A YOUNG CHILD WITH IN-OPERABLE SUPRA-SELLAR PILOCYTIC ASTROCYTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii370-iii371
Author(s):  
Stacy Chapman ◽  
Demitre Serletis ◽  
Colin Kazina ◽  
Mubeen Rafay ◽  
Sherry Krawitz ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Pilocytic Astrocytoma ◽  
Clinical Symptoms ◽  
Obstructive Hydrocephalus ◽  
Braf V600e Mutation ◽  
Braf V600e ◽  
Low Grade ◽  
Dramatic Improvement ◽  
Chemotherapeutic Regimen ◽  
Response To Chemotherapy

Abstract In-operable low grade gliomas (LGG) in the pediatric population continue to present a treatment dilemma. Due to the low-grade nature of these tumors, and variable response to chemotherapy / radiation, the choice of adjuvant treatment is difficult. Overall survival is directly related to the degree of surgical resection, adding complexity to these inoperable tumors. Current chemotherapeutic regimen for these inoperable tumors includes vincristine (VCR) and carboplatin (Carbo). With advancements in the molecular characterization of gliomas, the role of targeted therapy has come into question. We present a 2-year-old female with biopsy proven Pilocytic Astrocytoma (positive BRAF-V600E mutation) involving the hypothalamic/optic chiasm region. She presented with ataxic gait, bi-temporal hemianopia, obstructive hydrocephalus and central hypothyroidism, which progressed to altered consciousness, and right hemiparesis due to location/mass effect of the tumor. She was initially treated with chemotherapy (VCR/Carbo) but her tumor progressed at 6 weeks of treatment. As her tumor was positive for BRAF-V600E mutation, she was started on Dabrafenib monotherapy, resulting in dramatic improvement in her clinical symptoms (able to stand, improved vision), and a 60% reduction in tumor size at 3-months. At 6-months, follow up MRI showed slight increase in the solid portion of the tumor, with no clinical symptoms. We plan to add MEK inhibitor (Trametinib) and continue with Dabrafenib. Our experience and literature review suggests that LGG with BRAF-V600E mutations may benefit from upfront targeted therapy. Prospective clinical trials comparing the efficacy of BRAF inhibitors versus standard chemotherapy in LGG with BRAF mutations are urgently needed.

Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement

2003 ◽  
Vol 98 (5) ◽  
pp. 1045-1055 ◽  
Author(s):  
Brian K. Owler ◽  
Geoffrey Parker ◽  
G. Michael Halmagyi ◽  
Victoria G. Dunne ◽  
Verity Grinnell ◽  
...  
Keyword(s):  
Stent Placement ◽  
Pseudotumor Cerebri ◽  
Venous Sinus ◽  
Stent Insertion ◽  
Benign Intracranial Hypertension ◽  
Content Type ◽  
Venous Sinuses ◽  
Pseudotumor Cerebri Syndrome ◽  
New Treatment ◽  
Fine Print

Object. Pseudotumor cerebri, or benign intracranial hypertension, is a condition of raised intracranial pressure in the absence of a mass lesion or cerebral edema. It is characterized by headache and visual deterioration that may culminate in blindness. Pseudotumor cerebri is caused by venous sinus obstruction in an unknown percentage of cases. The purpose of this study was to investigate the role of cerebral venous sinus disease in pseudotumor cerebri and the potential of endoluminal venous sinus stent placement as a new treatment. Methods. Nine consecutive patients in whom diagnoses of pseudotumor cerebri had been made underwent examination with direct retrograde cerebral venography (DRCV) and manometry to characterize the morphological features and venous pressures in their cerebral venous sinuses. The cerebrospinal fluid (CSF) pressure was measured simultaneously in two patients. If patients had an amenable lesion they were treated using an endoluminal venous sinus stent. Five patients demonstrated morphological obstruction of the venous transverse sinuses (TSs). All lesions were associated with a distinct pressure gradient and raised proximal venous sinus pressures. Four patients underwent stent insertion in the venous sinuses and reported that their headaches improved immediately after the procedure and remained so at 6 months. Vision was improved in three patients, whereas it remained poor in one despite normalized CSF pressures. Conclusions. Patients with pseudotumor cerebri should be evaluated with DRCV and manometry because venous TS obstruction is probably more common than is currently appreciated. In patients with a lesion of the venous sinuses, treatment with an endoluminal venous sinus stent is a viable alternative for amenable lesions.

scholarly journals Pulp Revascularization of Immature Permanent Teeth: A Review of the Literature and a Proposal of a New Clinical Protocol

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Mélanie Namour ◽  
Stephanie Theys
Keyword(s):  
Treatment Method ◽  
Permanent Teeth ◽  
Clinical Protocol ◽  
Therapeutic Success ◽  
Immature Teeth ◽  
Triple Antibiotic Paste ◽  
New Treatment ◽  
Near Future ◽  
Pulp Revascularization ◽  
Stimulation Of

Tissue engineering is a growing field. In the near future, it will probably be possible to generate a complete vital tooth from a single stem cell. Pulp revascularization is dependent on the ability of residual pulp and apical and periodontal stem cells to differentiate. These cells have the ability to generate a highly vascularized and a conjunctive rich living tissue. This one is able to colonize the available pulp space. Revascularization is a new treatment method for immature necrotic permanent teeth. Up to now, apexification procedures were applied for these teeth, using calcium dihydroxide or MTA to produce an artificial apical barrier. However, the pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth. Two pulp revascularization techniques are used in the literature, one using calcium dihydroxide and the second using a triple antibiotic paste. Based on these two different pulp revascularization protocols, which obtain the desired therapeutic success, the literature will be reviewed and analyzed according to the relevance of their choice of materials. Based on the literature, we propose a new relevant protocol and a new mixture of antibiotics.

Pancreatic Cysts: Pathologic Classification, Differential Diagnosis, and Clinical Implications

2009 ◽  
Vol 133 (3) ◽  
pp. 423-438 ◽  
Author(s):  
Olca Basturk ◽  
Ipek Coban ◽  
N. Volkan Adsay
Keyword(s):  
Differential Diagnosis ◽  
Malignant Potential ◽  
Common Finding ◽  
Pancreatic Cysts ◽  
Pancreatic Ducts ◽  
Low Grade ◽  
Cystic Lesions ◽  
Dismal Prognosis ◽  
Cystic Tumors ◽  
Pathologic Classification

Abstract Context.—Cystic lesions of the pancreas are being recognized with increasing frequency and have become a more common finding in clinical practice because of the widespread use of advanced imaging modalities and the sharp drop in the mortality rate of pancreatic surgery. Consequently, in the past 2 decades, the nature of many cystic tumors in this organ has been better characterized, and significant developments have taken place in the classification and in our understanding of pancreatic cystic lesions. Objective.—To provide an overview of the current concepts in classification, differential diagnosis, and clinical/biologic behavior of pancreatic cystic tumors. Data Sources.—The authors' personal experience, based on institutional and consultation materials, combined with an analysis of the literature. Conclusions.—In contrast to solid tumors, most of which are invasive ductal adenocarcinomas with dismal prognosis, cystic lesions of the pancreas are often either benign or low-grade indolent neoplasia. However, those that are mucinous, namely, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, constitute an important category because they have well-established malignant potential, representing an adenoma-carcinoma sequence. Those that are nonmucinous such as serous tumors, congenital cysts, lymphoepithelial cysts, and squamoid cyst of pancreatic ducts have no malignant potential. Only rare nonmucinous cystic tumors that occur as a result of degenerative/necrotic changes in otherwise solid neoplasia, such as cystic ductal adenocarcinomas, cystic pancreatic endocrine neoplasia, and solid-pseudopapillary neoplasm, are also malignant and have variable degrees of aggressiveness.

scholarly journals Gold Extraction from Cyanidation Tailing Using Microwave Chlorination Roasting Method

Metals ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. 1025 ◽  
Author(s):  
Fei Zhu ◽  
Libo Zhang ◽  
Haoyu Li ◽  
Shaohua Yin ◽  
Sivasankar Koppala ◽  
...  
Keyword(s):  
Microwave Field ◽  
High Efficiency ◽  
Chloride Concentration ◽  
Treatment Method ◽  
Gold Extraction ◽  
Microwave Roasting ◽  
Gold Mines ◽  
Chlorination Roasting ◽  
New Treatment ◽  
Gold Industry

At present, gold mines are increasingly scarce in the world. The yield of cyanidation tailing (CT) of refractory gold ores with a grade of 10 g/T is huge; however, the effective capitalization of the cyanidation tailing is a significant problem in the gold industry. In this work, a new treatment method, a microwave-roasting process developed. The effect of roasting temperature, calcium chloride concentration, holding time and mineral size on the recovery of Au researched under conventional and microwave conditions. It found that, under the same processing conditions, the Au recovery in the microwave field is much higher than that of conventional conditions. The preliminary reinforcing role of the microwave discussed in the recovery of gold. This might be because of the microwave absorption ability of CaCl2 is much better, heated quickly and the reactions intensified among CaCl2, O2, and H2O. As a result, the extraction of gold in CT drastically increased in the microwave field, and the microwave roasting technology shows the characteristics of environmental protection in terms of low energy consumption and high efficiency.

scholarly journals Study of the sensitivity and specificity of smell and taste disorders as a predictive factor of SARS-CoV-2 infection among primary care healthcare professionals

BJGP Open ◽  
2022 ◽  
pp. BJGPO.2021.0141
Author(s):  
Anna Ruiz-Comellas ◽  
Pere Roura Poch ◽  
Glòria Sauch Valmaña ◽  
Víctor Guadalupe-Fernández ◽  
Jacobo Mendioroz Peña ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Symptoms ◽  
Strong Predictor ◽  
Area Under The Curve ◽  
Low Grade ◽  
Predictive Values ◽  
Standard Value ◽  
Taste Disorders ◽  
Smell Disorders ◽  
Taste And Smell

Backgroundamong the manifestations of COVID-19 are Taste and Smell Disorders (TSDs).AimThe aim of the study is to evaluate the sensitivity and specificity of TSDs and other associated symptoms to estimate predictive values for determining SARS-CoV-2 infection.Design and settingRetrospective observational study.Methodsa study of the sensitivity and specificity of TSDs has been carried out using the Polymerase Chain Reaction (PCR) test for the diagnosis of SARS-CoV-2 as the Gold Standard value. Logistic regressions adjusted for age and sex were performed to identify additional symptoms that might be associated with COVID-19.Resultsthe results are based on 226 healthcare workers with clinical symptoms suggestive of COVID-19, 116 with positive PCR and 111 with negative PCR. TSDs had an OR of 12.43 (CI 0.95 6.33–26.19), sensitivity 60.34% and specificity 89.09%. In the logistic regression model, the association of TSD, fever or low-grade fever, shivering, dyspnoea, arthralgia and myalgia obtained an area under the curve of 85.7% (CI 0.95: 80.7 % - 90.7 %), sensitivity 82.8 %, specificity 80% and positive predictive values 81.4% and negative 81.5%.ConclusionsTSDs are a strong predictor of COVID-19. The association of TSD, fever, low-grade fever or shivering, dyspnoea, arthralgia and myalgia correctly predicts 85.7% of the results of the COVID-19 test.

Sign in / Sign up

Export Citation Format

Share Document