New possibilities in the treatment of uterine body myomas – HIFU-technology

2017 ◽  
pp. 47-51
Author(s):  
T.M. Kozarenko ◽  
◽  
I.Yu. Karacharova ◽  
V.N. Goncharenko ◽  
A.N. Klyusov ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
The Body ◽  
Uterine Myoma ◽  
Long Term Results ◽  
Clinical Material ◽  
General Effect ◽  
Non Invasive ◽  
Ultrasound Ablation ◽  
Clinically Significant

The technology of HIFU-ablation has a number of advantages in comparison with other methods of treatment of patients with uterine myoma, since it is non-invasive, organ-preserving, has no clinically significant general effect on the body, is not accompanied by a long period of rehabilitation and temporary disability. The objective: was to increase the effectiveness of treatment of women with uterine myoma by optimizing the protocols of ultrasound ablation. Patients and methods. The clinical material consisted of 90 remote ultrasound ablations for women diagnosed with «symptomatic myoma of the uterus body», which were performed at KMECC, the Center for Nuclear Medicine. The procedure was carried out on a JC apparatus (manufactured by: Chongqing Haifu (HIFU) Technology Co., Ltd., China). Results. The power during treatment was 350±70 W, the total energy was 282 487±47 650 J, the average time of insonation was 765±137 s. With dynamic observation, the regression of the volume of myoma nodes on average averaged 25±14.6% after 1 month, 33±12.9% after 3 months, and 61±17.8% after 6 months. But 4 (9,7%) patients had an unsatisfactory effect after the procedure, and the treatment was continued. All patients recorded a decrease in clinical symptoms already in the first month after the procedure. When the procedure was performed, 5 (12.2%) patients had a first-degree skin burn, 14 (34.1%) women had a short-term increase in body temperature to 37.6°C on the day of the procedure, which stabilized independently in for 3 days, in 1 (2.4%) – cystitis. The conclusion. The method is selective, does not damage surrounding tissues, thereby being safe for the endometrium, which is important for maintaining fertility. The area of fibrosis, which is formed after treatment and the regression process of the myoma node, is safe for further gestation. For the clinical evaluation of this method, its impact on the quality of life, immediate and long-term results, further accumulation and analysis of the clinical material is necessary. Key words: uterine myoma, local adenomyosis, ultrasonic ablation, HIFU-technology, treatment.

scholarly journals Immediate and Long-Term Results of the Spleen-Preserved Operations in the Surgical Treatment of Gastric Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 227-232
Author(s):  
Marina I. Rogozianskaia ◽  
Alexander Nikolayevich Redkin ◽  
Ivan Petrovich Moshurov
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Total Gastrectomy ◽  
The Body ◽  
Long Term Results ◽  
D2 Lymphadenectomy ◽  
Spleen Preserving ◽  
Cardiac Region ◽  
Clinically Significant

ntroduction. Currently, total gastrectomy with D2 lymphadenectomy is the standard surgical treatment for proximal gastric cancer at the resectable stages (I-III). The issue of advisability of splenectomy as a component of lymphadenectomy remains a controversial one, especially when the tumor is localized in the region of the body or cardiac region of the stomach.The aim of the study was to compare immediate and long-term outcomes, including the quality of life, between spleen preserving and spleen removing surgeries.Methods. The study included 363 patients with gastric cancer II-III stages, localized in the upper and/or the middle third of the stomach, who underwent surgery at the Voronezh Regional Clinical Oncology Hospital and the Voronezh Clinical Hospital of the Russian Railway-Medicine in 2015-2017. All patients were conditionally divided into 2 groups for comparative retrospective analysis. All patients of the first (experimental or spleen-preserved) group (144 patients) were performed R0 total gastrectomy with D2 lymphadenectomy, including splenic hilar nodes (№ 10,11) removal without splenectomy. Patients of the second (control or splenectomy) group (219 patients) were performed R0 total gastrectomy with D2 lymphadenectomy and prophylactic splenectomy (for splenic hilar nodes removal).Results. The average duration of the operation and the volume of blood loss did not differ in both groups. The incidence of early postoperative surgical complications was lower in the spleen-preserved group. Splenectomy was associated with more severe complications of class 4 and 5 according to the Clavien-Dindo classification. Conclusion. Parameters of the 1- and 3-year overall survival rate did not differ in both groups. The results of the GSRS questionnaire were similar in both groups, excluding reflux-esophageal symptoms scale. The reflux scale demonstrated a statistically and clinically significant advantage of spleen preservation.

Contemporary Treatment for Central Serous Chorioretinopathy

2021 ◽  
Author(s):  
Mitova D
Keyword(s):  
Subretinal Fluid ◽  
Functional Results ◽  
Clinical Results ◽  
Long Term Results ◽  
Nanosecond Laser ◽  
Success Rates ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Short And Long Term

Aim: To study the short-and long-term results of 2RT nanosecond laser treatment for CSC. To compare clinical results with those with AntiVEGF. Methods: Nanosecond laser (2RT, Ellex) was used. Patients were followed by BCVA, FAF, OCT, Angio-OCT. Results: 90% of the patient treated with 2RT had improvement of visual acuity and contrast sensitivity. 19 % [1] patients showed no improvement. 81% of the 2RT treated patients had total resorbtion of subretinal fluid against 60% treated with AntiVEGF. Functional results correlated with the atrophy of RPE in the macula. 46% (19 patients) had resolution on the first month, 23% [2]-on the third and 12% [3]-on the sixth month. The time of resolution shows no relation to the baseline pigment epithelial atrophy. Four patients presented with a recurrency of the disease in the follow-up period. 19% [1] were non responders. 60% of AntiVEGF treated eyes were responders and 40% were non responders. Those who responded to treatment needed between 3 and 10 injections. Conclusion: 2 RT is a non-invasive treatment modality with no adverse effects and high success rates.

scholarly journals Heart valve injury due to radiation therapy

Kardiologiia ◽  
2019 ◽  
Vol 59 (2S) ◽  
pp. 56-68
Author(s):  
M. G. Poltavskaya ◽  
E. I. Emelina ◽  
Yu. V. Avdeev ◽  
G. E. Gendlin ◽  
G. N. Paramonova
Keyword(s):  
Radiation Therapy ◽  
Heart Valves ◽  
Single Photon ◽  
Stress Test ◽  
Gas Analysis ◽  
Long Term Results ◽  
Cardiovascular Pathology ◽  
Results Of Treatment ◽  
Clinically Significant

Relevance.Radiation therapy (RT) plays an important role in oncology, improving the immediate and long-term results of treatment of a number of tumors. One of the most significant complications of RT are lesions of the heart valves.Objective.To study the variants of valve damage that occur in patients who received radiation therapy for cancer.Patients and methods.A group of patients who, during the period from 1978 to 2002, underwent chemo-radiation therapy (CRT) for Hodgkin's lymphoma (LH) of 2–4 stages with damage to the intrathoracic lymph nodes: 71 patients, 60 of whom did not go to the cardiologist and were invited to be examined, 11 were hospitalized due to clinically significant cardiovascular pathology (CHF, myocardial infarction, angina pectoris, valvular defect, AV block). The study methods included: standard clinical and laboratory examination, spirometry, 24‑hour ECG monitoring, echocardiography, in some patients single-photon myocardial emission tomoscintigraphy (SPECT), and CT scan of the chest organs. In 60 patients, a stress test on an ECG-controlled treadmill was performed, in 18 patients – a maximum stress test on a treadmill with a gas analysis – ergospirometry.Results and discussion. Valve pathology was detected in 49.3 % of cases, most often (in 46.5 %) mitral regurgitation (MR) occurred, primarily due to MR of the 1 st degree, which had no clinical significance. Pathology of the aortic valve (12.7 % of patients) was represented mainly by mild regurgitation (11.3 %). Aortic stenosis was diagnosed in 4.2 % of patients. In the studied cohort of patients, predominantly non-severe valve lesions were detected. In addition, examples of patients with clinically significant valve valvular lesions are presented.

scholarly journals Long-term results of large-calibre expanded polytetrafluoroethylene-valved conduits with bulging sinuses

2020 ◽  
Vol 58 (6) ◽  
pp. 1274-1280
Author(s):  
Shuhei Fujita ◽  
Masaaki Yamagishi ◽  
Takako Miyazaki ◽  
Yoshinobu Maeda ◽  
Keiichi Itatani ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
The Body ◽  
Long Term Results ◽  
Pulmonary Insufficiency ◽  
Long Term Outcomes ◽  
Expanded Polytetrafluoroethylene

Abstract OBJECTIVES In Japan, homograft and bovine jugular vein are available in very limited institutions for the reconstruction of the right ventricular outflow tract, and handmade expanded polytetrafluoroethylene (ePTFE)-valved conduits have been widely used instead. This study aimed to clarify the long-term outcomes and the durability of the ePTFE-valved conduits purely by narrowing down to those with large sizes to eliminate the influence of the body growth. METHODS Between January 2002 and December 2015, patients who underwent right ventricular outflow tract reconstruction in 34 Japanese institutions using ePTFE-valved conduits with a diameter of ≥18 mm were included. All the valved conduits were made in the authors’ institution and delivered to each participating institution. RESULTS Overall, 502 patients were included. Early mortality was 1.4% and not related to conduit failure. The overall survival rate was 98.2% at 5 years and 96.6% at 10 years. Freedom from conduit explantation was 99.5% at 5 years and 89.0% at 10 years. Three patients (0.13 per 100 patient-years) developed infective endocarditis of the conduit, and only 1 patient required conduit removal. Pulmonary insufficiency was mild or less in 480 (96%) patients, and conduit stenosis was mild or less in 436 (88%) patients at the latest follow-up. CONCLUSIONS By narrowing the analyses down to only ePTFE conduits with a large size, satisfactory long-term outcomes of these conduits with a fan-shaped valve and bulging sinuses were shown. These conduits would be among the optimal choices for right ventricular outflow tract reconstruction.

scholarly journals Percutaneous Closure of PFO in Patients with Reduced Oxygen Saturation at Rest and during Exercise: Short- and Long-Term Results

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Céline De Cuyper ◽  
Tristan Pauwels ◽  
Eric Derom ◽  
Michel De Pauw ◽  
Daniël De Wolf ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Clinical Symptoms ◽  
Systemic Circulation ◽  
Percutaneous Closure ◽  
Long Term Results ◽  
Sf 36 ◽  
Short And Long Term

Background. A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dyspnea. Due to a right-to-left shunt, desaturated blood enters the systemic circulation in a subset of patients resulting in dyspnea and a subsequent reduction in quality of life (QoL). Percutaneous closure of PFO is the treatment of choice. Objectives. This retrospective multicentre study evaluates short- and long-term results of percutaneous closure of PFO in patients with dyspnea and/or reduced oxygen saturation. Methods. Patients with respiratory symptoms were selected from databases containing all patients percutaneously closed between January 2000 and September 2018. Improvement in dyspnea, oxygenation, and QoL was investigated using pre- and postprocedural lung function parameters and two postprocedural questionnaires (SF-36 and PFSDQ-M). Results. The average follow-up period was 36 [12–43] months, ranging from 0 months to 14 years. Percutaneous closure was successful in 15 of the 16 patients. All patients reported subjective improvement in dyspnea immediately after device deployment, consistent with their improvement in oxygen saturation (from 90 ± 6% to 94 [92–97%] on room air and in upright position) (p<0.05). Both questionnaires also indicated an improvement of dyspnea and QoL after closure. The two early and two late deaths were unrelated to the procedure. Conclusion. PFO-related dyspnea and/or hypoxemia can be treated successfully with a percutaneous intervention with long-lasting benefits on oxygen saturation, dyspnea, and QoL.

scholarly journals Medium- and long-term results of high tibial osteotomy in patients with primary and secondary knee osteoarthritis with varus deformity

2019 ◽  
Vol 13 (2) ◽  
pp. 38-46
Author(s):  
V. E. Byalik ◽  
S. A. Makarov ◽  
L. I. Alekseeva ◽  
E. I. Byalik
Keyword(s):  
Knee Osteoarthritis ◽  
High Tibial Osteotomy ◽  
The Body ◽  
Long Term Results ◽  
Tibial Osteotomy ◽  
Female Ratio ◽  
Knee Oa ◽  
Functional Scores ◽  
The Mean

The most common operation for knee osteoarthritis (OA) is total knee arthroplasty (TKA); however, the latter is associated with the development of severe complications. This was the reason for the revival of the interest of orthopedic traumatologists in high tibial osteotomy (HTO), the essence of which is to transfer the load away from the affected medial part of the knee joint (KJ) to the intact lateral one.Objective: to evaluate the medium- and long-term results of open-wedge (OW) HTO in primary and secondary I–III stage knee OA.Patients and methods. The Laboratory of Orthopedic Rheumatology and Rehabilitation, V.A. Nasonova Research Institute of Rheumatology, performed 10 OW HTOs in 9 patients in 2005 to 2009 and 21 more OW HTOs in 19 patients in 2014 to 2018 (a total of 31 operations). The male/female ratio was 2.5:1. The mean age of the patients was 57.6±12.5 years; the body mass index (BMI) was 28.5±3.6 kg/m2 ; the correction angle was 11.7±2.5°. Preoperative planning was performed using the Miniaci method; the X-ray stage of knee OA was evaluated according to the Kellgren–Lawrence classification. OW HTO was carried out. For assessment of its results, the investigators determined the degree of pain using a visual analogue scale (VAS) and the KJ status by the Knee Society Score (KSS) scale. The results were assessed at one (n=31), 3.5±0.6 (n=28), and 8.5±1.3 (n=10) years.Results and discussion. There was a tendency to worsen surgical results over time. The mean VAS values for pain at 1, 3.5, and 8.5 years were as follows: 9.8±10.3; 21.2±16.2 and 38±15.5 mm, respectively. In the same periods, the KSS functional scores were 83.6±14.8, 85.2±12.6, and 80.5±14.2; the objective scores were 80.7±8.5, 75.2±12.7, and 67.8±16.3. There was a strong correlation between the severity of pain and the functional and objective KSS scores (-0.78, -0.81 years, and -0.91 at 1, 3.5, and 8.5 years, respectively; p<0.05). At 3.5±0.6 years, the survival rate after OW HTO was 96.6%. None of the patients examined at 8.5±1.3 years after OW HTO needed TKA. The surgical result was studied in 2 patients at 14 years; one patient underwent TKA, the other refused surgical intervention, the result was satisfactory.Conclusion. OW HTO has limited indications for use. However, in patients who are allowed to undergo this operation, pain syndrome can be relieved, by maintaining and/or improving KJ function; in most cases, TKA can be delayed for more than 10 years. 

Long-term results of osteoplastic fixation of the spine in tuberculous spondylitis

1935 ◽  
Vol 31 (11-12) ◽  
pp. 1274-1279
Author(s):  
M. O. Friedland
Keyword(s):  
The Body ◽  
Long Term Results ◽  
Tuberculous Spondylitis ◽  
Surgical Measures ◽  
Tuberculous Lesion ◽  
Infectious Focus ◽  
Biological Reaction

Osteoplastic fixation of the spine with its tuberculous lesion is an operation aimed at accelerating the localization of the infectious focus in the vertebrae with the help of surgical measures designed to ankylosing the arch of the spine. This is the very process that is the natural biological reaction of the body in this disease. The operation activates it.

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