scholarly journals Сryoablation technology for bone metastases

2021 ◽  
Vol 67 (4) ◽  
pp. 554-558
Author(s):  
Alexey Belyaev ◽  
Georgy Prokhorov ◽  
Ilya Burovik ◽  
Daria Okonechnikova
Keyword(s):  
Bone Metastases ◽  
Pelvic Ring ◽  
Pain Syndrome ◽  
The Body ◽  
Tubular Bone ◽  
Robotic Navigation ◽  
Ultrasound Monitoring ◽  
Tumor Lesion ◽  
Hollow Organ ◽  
Reusable Instruments

Puncture cryoablation of tumor lesions was performed as a part of complex palliative treatment of 32 patients with the fourth stage of the disease with bone metastases. Each patient, depending on the extent of the lesion, underwent from one to eight procedures. New domestic nitrogen equipment with reusable instruments was used. Cryoablation procedures were performed in the room for Computed Tomography (CT) using robotic navigation, as well as in the operating room under ultrasound monitoring. The indications for the procedure were severe pain syndrome, disease progression, prevention of pathological fractures, and the impossibility of performing the surgical treatment in patients with comorbidities. When performing cryoablation, the number and diameter of cryoprobes, the length of the needle and cryoprobe tip, the direction of insertion, and their mutual positioning were determined depending on the size and shape of the tumor lesion. The technique of puncture approaches and monitoring rules are described in detail. It is recommended to avoid the destruction of the pelvic ring, hip joint, to be careful in cases of tumor localization in the body and arches of the vertebrae, in the lateral parts of the sacrum, in the places where the nerve trunks adhere to the bone. The cryoablation procedure cannot be planned if the skin, the wall of a hollow organ, and the spinal cord are involved in the tumor process. There is a high risk of fracture after performing total cryoablation of metastasis if it covers more than a third of the diameter of the tubular bone.

scholarly journals Surgical Hemostasis for Severe Multisystem Pelvic Injuries

2020 ◽  
Vol 8 (4) ◽  
pp. 396-408
Author(s):  
I. V. Kazhanov ◽  
A. Y. Demko ◽  
V. A. Manukovsky ◽  
S. I. Mikityuk ◽  
V. A. Reva ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Anterior Part ◽  
Treatment Algorithm ◽  
Pelvic Trauma ◽  
Balloon Occlusion ◽  
The Body ◽  
Military Surgery ◽  
Transfusion Therapy ◽  
Homogeneous Groups ◽  
Military Medical Academy

For the treatment of patients with severe multysistem pelvic trauma accompanied by pelvic bleeding, many algorithms have been proposed that have different procedures for the use of various methods of surgical hemostasis, but none of them may guarantee the complete arrest of pelvic bleeding. The purpose of this study was to estimate clinical efficacy and developed algorithm, aimed at timely diagnosis of intrapelvic bleeding and its complete arrest with the help of different methods of surgical hemostasis in patients with severe concomitant injury of the pelvis. The article analyzes the results of treatment of 168 patients with unstable pelvic ring injuries and signs of intrapelvic bleeding, who were treated in two trauma centers of the first level in St. Petersburg: I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine and Military Surgery Clinic of S.M. Kirov Military Medical Academy in 2010-2018. The victims were divided into two statistically homogeneous groups. In the comparison group (75 people), the pelvic ring was mechanically stabilized with the Ganz C-clamp or the anterior part of the pelvis was fixed with an external fixation device (EFD), and the arrest of the ongoing pelvic bleeding was expected due to occur due to the effect of biological tamponade. In the main group (93 people), after mechanical stabilization of the pelvic ring, various methods of surgical hemostasis were used: balloon occlusion of the aorta, pelvic tamponade, angiography with embolization. The choice of method for surgical haemostasis after trauma depended on the severity of the affected condition of hemodynamic parameters, availability of life-threatening consequences of damage to other areas of the body and the efficacy of previously applied method for intrapelvic bleeding arrest. The introduction of modern diagnostic and treatment algorithm, aimed at complete hemostasis in patients with ongoing intrapelvic bleeding reduced the overall mortality rate by 1.7 times, mortality within 24 hours of admission by 2.3 times, as well as the duration and the volume of blood transfusion therapy by 3 and 1.8 times.Authors declare lack of the conflicts of interests.

The use of stereotaxic chemical hypophysectomy in the treatment of thalamic pain syndrome

1983 ◽  
Vol 59 (6) ◽  
pp. 1002-1006 ◽  
Author(s):  
Allan B. Levin ◽  
Lincoln F. Ramirez ◽  
Jordan Katz
Keyword(s):  
Pain Relief ◽  
Diabetes Insipidus ◽  
Pain Syndrome ◽  
Pituitary Hormones ◽  
The Body ◽  
Cerebral Stroke ◽  
Preoperative Pain ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Thalamic Pain Syndrome

✓ Three patients with neurological injuries consistent with cerebral stroke subsequently developed pain over portions of the body contralateral to the injured hemisphere. Stereotaxic chemical hypophysectomy was used in the management of this pain after other surgical procedures and medical management had failed to provide relief. Postoperatively, all patients were treated for hypopituitarism. All developed transient diabetes insipidus, and one patient developed transient right third nerve palsy. No other complications were encountered. All three patients experienced significant pain relief within 48 hours of the procedure. By the date of discharge, two of the three patients reported complete, and the third greater than 80% pain relief. At the initial follow-up visit all patients were essentially pain-free. These patients have now been followed for 58, 39 and 19 months, and remain free of their original pain. During this time the intravenous administration of naloxone has failed to reproduce the preoperative pain. Pituitary function testing 1 year or more following operation demonstrated that none of the patients had an endocrinologically complete hypophysectomy. Recovery from transient diabetes insipidus was not associated with return of the original pain. The mechanism of action of stereotaxic chemical hypophysectomy in the relief of pain related to thalamic lesions remains unknown. The observation that naloxone failed to reproduce the preoperative pain casts doubt on the theory that augmentation of endogenous opiate release is the primary mechanism. Additional observations suggest that pain relief after hypophysectomy may be more directly the result of stimulation of a hypothalamic pain-suppressing mechanism than due to the elimination of pituitary hormones.

scholarly journals NUT midline carcinoma in a young pregnant female: a case report

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sebastian Joel ◽  
Friederike Weschenfelder ◽  
Ekkehard Schleussner ◽  
Gunther O. Hofmann ◽  
Wolfram Weschenfelder
Keyword(s):  
Outpatient Clinic ◽  
Close Relation ◽  
The Body ◽  
Pregnant Female ◽  
Upper Aerodigestive Tract ◽  
Nut Midline Carcinoma ◽  
Tumor Lesion ◽  
Related Symptom ◽  
Chest X Ray ◽  
The Right

Abstract Introduction The NUT midline carcinoma is a rare tumor mostly reported in the midline of upper aerodigestive tract and mediastinum. Children as well as adolescents are affected without a gender distribution. A standard treatment is not established. So far, there exists no reported case of a pregnant female suffering from NUT midline carcinoma with musculoskeletal manifestation. Case presentation A 34-year-old woman was referred to our outpatient clinic by the general practitioner during her 31st week of pregnancy suffering from shoulder pain and dyspnea. So far, dyspnea was interpreted as a typical pregnancy-related symptom. However, a chest X-ray showed a tumor mass in the right lung in close relation to the scapula. Further examinations found metastases in different areas of the body. No pregnancy-related complications were detected by obstetric examination. After an interdisciplinary perinatal case discussion, cesarean section was directly followed by an open biopsy of the right side scapula tumor lesion. A NUT midline carcinoma was diagnosed by immunohistochemistry. Due to disseminated tumor disease in multiple non-resectable locations, a palliative systemical chemotherapy was started by the oncological outpatient clinic. Conclusion This report presents the case of the very rare NUT midline carcinoma under pregnancy which made interdisciplinary case discussions indispensable for therapy planning.

Osteoscintigraphy and SPECT/CT in the Diagnosis of Various Variants of Bone Metastases

2018 ◽  
Vol 63 (2) ◽  
pp. 41-46 ◽  
Author(s):  
А. Рыжков ◽  
A. Ryzhkov ◽  
А. Крылов ◽  
A. Krylov ◽  
А. Блудов ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Bone Tissue ◽  
Primary Diagnosis ◽  
Combined System ◽  
Metabolic Bone ◽  
Tumor Lesion ◽  
Bone Changes ◽  
Radiological Procedures ◽  
Diagnostic Capabilities ◽  
Two Stages

Purpose: To determine the diagnostic capabilities of body scan (BS) and SPECT/CT in the diagnosis of various variants of bone metastases (BM). Material and methods: The data of 37 patients with BM of breast cancer (20 patients), prostate cancer (7 patients) and other tumors various localization (10 patients) were analyzed. The study was carried out in two stages: first, BS was performed, 3 hours after intravenous introduction of an osteotropic radiopharmaceutical labeled with 99mTc (technephor or phosphotech), followed by SPECT/CT of the selected zone of interest. All studies were performed on a combined system Symbia T2 (Siemens) with a 2-slice low dose CT. Results: With BS the foci of the tumor lesion were identified in 33 cases, and in SPECT/CT in 37 cases. There were detected 159 BM (21 sites: 0.4–0.9, 59 sites: 1.0–1.9, 79 sited: 2.0–4.5 cm). The total detectable incidence of metastases with BS was 66.0 % (105 BM) of all metastases detected in comparison with SPECT/CT (159 BM). Detectability with BS increased with increasing size of detectable foci. Foci less than 1 cm are detected in isolated case (1 from 21 cases). Metastases measuring from 1 cm to 1.9 cm are detected only in 52.5 % of cases (31 from 59 cases). The detectability of large metastases (2 cm or more) with BS (92.4 %) approaches the SPECT/CT (100 %) – 73 from 79 cases. There were detected with BS 27 osteoblastic BM in comparison 56 BM with SPECT/CT (48.2 %). The detectability with BS of mixed BM (76.3 %) and octeolitic BM (75.4 %) showed no differences. Firstly it can be explained by a predominance of smaller osteoblastic foci, and secondly reparative processes in metastases, accompanied by reduction of the radiopharmaceutical. The correction of the conclusion of the BS was required just in 24 cases: in 8 cases, when the BS was marked overdiagnosis, 16 – underdiagnosis. However, BS does not lose its value as a screening. In one case, even if BS has been revealed metastasis, it is not yet accompanied by destruction of bone tissue. Despite such significant differences in diagnostic accuracy of BS and SPECT/CT, BS proved to be uninformative only in 2 cases: when undetected metastases without primary tumor identified, and in the case of the screening of metastasis the accumulation of the radiopharmaceutical in the bladder. In 2 other cases, the lack of accumulation of the radiopharmaceutical was determined by the reparation that can only be considered conditionally uninformative. However, SPECT/CT shows clear advantages in the visualization of bone metastases due to computed tomography, allowing to estimate the structure of bone tissue. In 9 cases even to SPECT-slices metastases were not accompanied by pathological accumulation of the radiopharmaceutical. Conclusion: SPECT/CT is a highly informative method for detecting bone metastases, the use of which allows reducing the time of examination and dose irradiation of patients due to the rejection of additional radiological procedures. In addition, SPECT/CT at the same time allows differential diagnosis of structural and metabolic bone changes, which increases both the accuracy of primary diagnosis and control of treatment.

scholarly journals ADJUVANT TREATMENT WITH BIPHOSPONATES IN COMPLEX THERAPY OF PAPILLARY THYROID CANCER BONE METASTASES

2017 ◽  
Vol 4 (3) ◽  
pp. 93-99
Author(s):  
A. D. Kaprin ◽  
A. P. Polyakov ◽  
P. O. Rumiantsev ◽  
K. S. Nizegorodova ◽  
M. V. Degtiarev ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Surgical Treatment ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Distant Metastasis ◽  
Injury Rate ◽  
Pain Syndrome ◽  
Complex Treatment ◽  
Cost Of Treatment ◽  
Skeletal Involvement

Distant metastasis of thyroid cancer are founded in 10% of all metastases. Bone metastases are founded in 23% of distant metastasis. Complications associated with metastatic skeletal involvement often lead to a deterioration in the overall condition and a decrease in the quality of life of patients. Surgical treatment, chemotherapy are less effective, provide a higher injury rate and toxicity. This is a reason of increasing of cost of treatment. Bisphosphonates are a class of drugs that prevent the loss of bone mass, which can prolong the time to releasing bone complications: bone fracture, spine column fracture with spinal medulla compression, which decrease the QoL. Surgical treatment and chemotherapy have worse outcomes, higher injury rate, toxicity and increase cost of treatment. Bisphosphonates decrease the level of pain syndrome. Bisphosphonates are used in treatment of oncological patients since 1990. First medication was Fosamax (Aledronat). Later more medications with better efficacy and more useful were synthesised. The last one was Zoledronic acid. Rezorba (zoledronic acid) was synthesised in 2006 in Russia. Rezorba has a same efficacy with other bisphosphonates, it was shown in clinical studies with groups of breast cancer and prostatic cancer. Clinical case of 67 y.o. male patient with diagnosis: Thyroid cancer IV c st pT1bN1bM1, right neck, paratraсheal, bone and lung metastasis. Complex treatment (surgery + radioiodine therapy + 5 courses of Rezorba) was presented. After 3 courses the level of pain was decreased from 3 to 1,5. After 5 courses the ECOQ score was decreased from 2 to 1 point. Inclusion of Resorba in complex treatment of patients with bone metastasis after thyroid cancer at all stages of treatment decreases the score of pain syndrome and bone tissue reparation.

scholarly journals Comparison of the Effect of Bicarbonate, Hyaluronidase, and Lidocaine Injection on Myofascial Pain Syndrome

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Mahshid Ghasemi ◽  
Faramarz Mosaffa ◽  
Behnam Hoseini ◽  
Faranak Behnaz
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Trapezius Muscle ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
The Body ◽  
Lidocaine Injection ◽  
Permanent Effect

Background: Myofascial pain syndrome is a chronic syndrome that occurred in a local or focal part of the body. The basis for myofascial pain syndrome is the presence of myofascial trigger point or points, producing pain in clinical examinations. Objectives: This study aimed to compare the effect of injection of bicarbonate, hyaluronidase, and lidocaine on myofascial pain syndrome. Methods: The patients were randomly allocated to three groups of bicarbonate, hyaluronidase, and lidocaine. The injection was done at two painful regions of trapezius muscle with a sonography guide for each patient. The values of visual analogue scale (VAS), pre-injection range of motion (ROM), immediately after injection, second and fourth week were measured. Results: The analysis showed that there were no significant differences between the three groups for age, gender, BMI, and height (P > 0.05). Repeated measures one-way ANOVA (week * group) 4 * 3 was used to compare the effect of bicarbonate, hyaluronidase, and lidocaine on VAS and range of motion (ROM) before injection, immediately after injection, second and fourth week. The results showed that the main effect of group and week is significant for VAS (P < 0.05). This study showed that the values of VAS were significantly different between the three groups during the fourth weeks of the study. Moreover, the patients experienced more pain decline in the hyaluronidase group during weeks before injection, after injection, second and fourth week, which indicated the permanent effect of this medication on pain decline. Conclusions: Injection of lidocaine leads to a significant reduction in pain immediately after injection; however, the decline was not permanent and disappeared in the following four weeks. But VAS reduction in hyaluronidase group more than bicarbonate and lidocaine groups.

scholarly journals X-ray densitometric indices of proximal phalanx, medial phalanx and ungular pelvic limb bones as criteria for age diagnosis of cattle in forensic veterinary expertise

2019 ◽  
Vol 10 (2) ◽  
pp. 197-202
Author(s):  
I. V. Yatsenko ◽  
S. A. Tkachuk ◽  
L. V. Busol ◽  
M. M. Bondarevsky ◽  
I. V. Zabarna ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Mathematical Model ◽  
Proximal Phalanx ◽  
The Body ◽  
Heterogeneous Structure ◽  
Tubular Bone ◽  
X Rays ◽  
X Ray ◽  
Limb Bones ◽  
Pelvic Limb

Morphological parameters of biological material are extremely informative in diagnostic studies, in particular, to determine the species, sex, time of death, the term of burial. The most informative object for these tasks is the skeleton, because changes in the bones are stored for a long time, while soft tissue is subjected to rotting. Bone tissue is the most durable, but at the same time, it is very labile and reacts to all metabolic processes in the body. The object of the study was proximal phalanx, medial phalanx and ungular bone of the pelvic limb of cattle ranging in age from newborn to 12 years old. Radiography of the proximal phalanx, medial phalanx and ungular bones of the pelvic limb was performed on the Arman apparatus. The bones were subjected to X-ray in the lateromedial projection. The inner and outer sections of the tubular bone were determined. The mathematical modeling of the interaction of X-rays and the cortical layer of bones of fingers (proximal phalanx, medial phalanx and ungular) of cattle was carried out in this work. It is established that this process is described by Bouger's law. The physico-mathematical model of proximal phalanx, medial phalanx and ungular bones has been calculated, on the basis of which it was possible to calculate the X-ray densitometric indices of these bones of cattle. The age features of dynamics of X-ray densitometric indices of the proximal phalanx, medial phalanx and ungular bones were established and a method of determining the age of cattle according to this criterion was proposed. A mathematical model for the proximal phalanx, medial phalanx and ungular bones of the pelvic limbs of cattle that can be applied in X-ray densitometry uses: for the average third proximal phalanx – section of heterogeneous tubular structure modeled by a semicircle; for a medial phalanx bone – a section of a triangular shape; for the ungular bone – a heterogeneous structure, the plantar surface is inscribed in a rectangle. The process of interaction of X-rays with the bone structure of the examined pelvic limb bones can be described by Bouguer's law. The developed mathematical modeling of this interaction and the algorithm for its analysis is the basis for determining the age of cattle for X-ray densitometric indices of the proximal phalanx, medial phalanx and ungular bones of pelvic limbs. By X-ray densitometry of the proximal phalanx and medial phalanx bones of the pelvic limbs extremities one can diagnose the age of bovine animals from birth to 5 years, but according to ungular bones – from birth to 10 years. X-ray densitometry of medial phalanx and ungular bones of pelvic limbs can be used for diagnosing bovine cattle in a complex with other morphological, chemical and physical methods of investigation.

Abstract 326: Postural Orthostatic Tachycardia Syndrome and its Associated Chronic Pain Symptoms

2015 ◽  
Vol 117 (suppl_1) ◽  
Author(s):  
Chandralekha Ashangari ◽  
Amer Suleman
Keyword(s):  
Chronic Pain ◽  
Medical Records ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
The Body ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Chronic Regional Pain Syndrome ◽  
High Prevalence ◽  
Pain Symptoms ◽  
Very High

Background and Purpose: The Postural Orthostatic Tachycardia Syndrome (POTS) affects primarily young women. POTS is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. The symptoms of POTS are widespread because the autonomic nervous system plays an extensive role in regulating functions throughout the body. The aim of this study is to determine the chronic pain symptoms in Postural Orthostatic tachycardia syndrome (POTS) patients. Method: Two hundred fifty-five (255) POTS patients were randomly selected from our clinic (January 2014 to March 2015) , reviewed the medical records of 255 POTS patients for chronic pain symptoms and performed data analysis. Results: Two hundred thirty-three of the 255 (91%) patients are females (n=233, age 29.20 ± 10.32), Twenty-three of the 255 (9%) patients are males (n=23, age 29.70 ± 14.52).63% (161 of the 255) had Joint Pain/aches, 51% (131 of the 255) had Chronic headache, 40% (102 of the 255) had chest pain, 31% (80 of the 255) had Migraine, 30% (76 of the 255) had Chronic back pain,16% (42 of the 255) had Heartburn,8%(20 of the 255) had Chronic pleurisy, Rheumatoid arthritis, Muscle aches, Chronic regional pain syndrome and Hip aches. Conclusion: Our study is the first to characterize that Patients with postural orthostatic tachycardia syndrome (POTS) have a very high prevalence of chronic pain symptoms.

scholarly journals Advances in Endoscopic Photoacoustic Imaging

Photonics ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 281
Author(s):  
Yan Li ◽  
Gengxi Lu ◽  
Qifa Zhou ◽  
Zhongping Chen
Keyword(s):  
Photoacoustic Imaging ◽  
The Body ◽  
Intravascular Imaging ◽  
Target Tissue ◽  
Strong Light ◽  
Future Directions ◽  
Excitation Light ◽  
Hollow Organ ◽  
Direct Delivery ◽  
Molecular Contrast

Photoacoustic (PA) imaging is able to provide extremely high molecular contrast while maintaining the superior imaging depth of ultrasound (US) imaging. Conventional microscopic PA imaging has limited access to deeper tissue due to strong light scattering and attenuation. Endoscopic PA technology enables direct delivery of excitation light into the interior of a hollow organ or cavity of the body for functional and molecular PA imaging of target tissue. Various endoscopic PA probes have been developed for different applications, including the intravascular imaging of lipids in atherosclerotic plaque and endoscopic imaging of colon cancer. In this paper, the authors review representative probe configurations and corresponding preclinical applications. In addition, the potential challenges and future directions of endoscopic PA imaging are discussed.

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