1171. Endovascular treatment of aortic aneurysm by endoprosthesisMiloš Šurlan, Vladka Salapura, 2000, original scientific article Abstract: Aortic endoprosthesis are divided according to its shape, site of application,and construction material. Regarding the shape, there are tubular,unilateral and bifurcational endoprosthesis. Tubular are used mostly for treatment the thoracic aneurysm, and less for treatment of the abdominal aneurysms. For exclusion of abdominal aneurysm the bifurcational prosthesis ismostly used. Aortic endoprostheses are made of metallic support and prosthetic part. Supportive elements are made of stainless steel or nitinol, while the prosthetic part is made of dacron or PTFE. Metallic part of prosthesis attaches prosthesis to healthy part of aorta, above and below aneurysm, like sutures. It expands and gives support to the prosthesis. The procedure is precisely described for thoracic and abdominal aortic aneurysms. We describe the possible complications and the mechanism of leakage and its diagnosis. In the study are presented two cases of patients with aneurysm of thoracic aorta and one case with abdominal aorta, successfully treated in our Institution. The follow-up results after 2 years, in the patients with thoracic aortic aneurysm, and 6 months follow up in the patient with abdominalaortic aneurysm showed no signs of clinical or imaging complications.In conslusion, we were trying, on the basis of our experiences and results that have been recently published, to evaluate this method of treatment.
Published in DiRROS: 24.01.2024; Views: 247; Downloads: 66
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1172. Diagnostic imaging, indications and measurements for the treatment of aortic aneurysm by endoprosthesisMiloš Šurlan, Vladka Salapura, Tomaž Kunst, 2000, review article Abstract: Background. This paper presents imaging diagnostics of an aneurysm of the aorta, indications, common contraindications and measurements for the construction and selection of an endoprosthesis. The examination using ultrasound is the most handy and economically justifiable method for detectingan aneurysm of the aorta, for monitoring asymptomatic aneurysm as well as patients having undergone an operation or those with an endoprosthesis. Another examination to visualise the aortic aneurysm is CT with or without contrastive medium. The plan for treating an aneurysm can be made with the help of a DSA, helical CT angiography and/or MRA. DSA shows wellthe lightness of the aneurysm and the aorta, as well as the changes insideof it, large arteries close to the aneurysm and the condition of pelvic arteries for the selection of the approach. The helical CT angiography and MRAin two or three dimensional reproduction in several directions enable an accurate measurement of an aneurysm, the aorta diameter above and below the aneurysm, and the evaluation of the quality of its wall. Conclusions. The indication areas for endoprosthesis are aneurysm of the abdominal aorta and those of the descending part of thoracic aorta. The treatment with endoprosthesis as a less invasive method is indicated in patients who risk a number of complications and even mortality when treated surgically. Endoprosthesis is made of metal stent and prosthesis. The stent attaches the endoprosthesis to the unaffected part of the aorta above and below the aneurysm, it sets the stent asunder and provides support. The prosthesis is made of Dacron synthetic fabric, which has very good properties for this purpose such as small compliance, porosity, permeability and extensibility. The endoprosthesis is introduced into the aorta through a catheter system withthe help of a special guide wire. The entering point is surgically opened common femoral or iliac artery.
Published in DiRROS: 24.01.2024; Views: 284; Downloads: 74
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1173. Transjugular intrahepatic portosystemic shunt (TIPS)Miloš Šurlan, Janez Jereb, 2000, review article Abstract: Background. A clear presentation of TIPS indications and contraindications, which can be divided into absolute and relative, is given. Absolute indications are fresh and renewed bleeding of varices and inveterate ascites. Relative indications, on the other hand, are splenomegaly with hypersplenism, Budd-Chiari syndrome, liver transplantation and hepatorenal syndrome. Absolutecontraindications are severe liver dysfunction and right heart failure, while the relative ones polycystic liver degeneration, neoplasm, obstruction of the portal vein and severe local and systemic infection. Beforethe TIPS procedure, the level of dysfunction of the liver, right heart and kidneys is determined. Biochemical and blood tests, including a blood coagulation test, are made, the ammonia level in the serum is determined and possible obstructions/strictures of the portal vein are checked. A detailed description of the procedure, a care for patient and a operative monitoring are given. The success rate of the procedure is between 93% and 100% and the mortality rate within 30 days because TIPS is between 1% and 3%. The hemorrhage is stopped in 95% to 100%, the ascites is improved in 87% to 92% and the kidney function in 81%. In case of hypersplenism the thrombocytopenia is improved in 75% and leucopenia in 50% of patients. There are relatively fewcomplications during the procedure. Postoperative complications are more frequent due to stricture and obstruction of the shunt. After a two-year treatment the shunt is passable in 50% of patients. Thus, in a group of 29 patients, who were treated in the period of four years with an average monitoring period of two years, 22 patients (75,9%) are still alive and only 7died (24,1%). Six of dead patients suffered from alcoholic cirrhosis of the liver. In two cases the cause of death was not related to the TIPS and the cirrhosis of the liver. (Abstract truncated at 2000 characters).
Published in DiRROS: 23.01.2024; Views: 295; Downloads: 72
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1174. Defecography: a report on 35 casesBreda Jamar, Katarina Šurlan Popović, 2000, original scientific article Abstract: Purpose. To evaluate indications in the patients referred for defecography to our Institute between October 1996 and December 1999. Patients and methods. Inthis period, 35 patients (31 women and 4 men, their mean age being 56,5 and34,5 years, respectively) with defecation disorders disorders of 1 months to 17 years of duration were referred to us for defecography - 26 from proctology specialists and 9 from internal medical out-patient departments. After the rectum was filled with thick barium paste, spot shots from lateral position were made in different phases of defecation, with the patient sittingon a specially designed commode. Results. Rectocele was found in 21 cases, in 9 cases in association with rectorectal intussusception, in 3 with rectoanal intussusception and in 2 with herniation of rectal wall into ishiorectal fossa. Prolapse was found in 2 cases, and 4 rectorectal intussusception, 1 rectoanal intussusception and 3 fistulas were diagnosed. The findings were normal in only one case, while in 3 cases defectography showed functional abnormalities. In female patients, symptoms started after gynaecological operation in 11 cases and 6 cases after delivery. Eight women had to press perineum with their hand to faciliate defecation. Conclusions. Defecography proved useful in clarifying the pathology underlying patient's difficulties.
Published in DiRROS: 23.01.2024; Views: 260; Downloads: 74
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1176. Antitumor effectiveness of bleomycin on SA-1 tumor after pretreatment with vinblastineMaja Čemažar, Marija Auersperg, Gregor Serša, 2000, original scientific article Abstract: In our previous study, vinblastine (VLB) was shown to increase the plasma membrane fluidity. This effect of VLB might be exploited for better transport of drugs through the plasma membrane. The aim of the present study was to determine whether pretreatment with VLB can increase the cytotoxic effect of BLM on intraperitoneal SA-1 tumors in mice. Materials and methods. BLM and VLBwere used as single agents or in various combinations, i.e. BLM injected 24h before VLB or vice-versa, VLB injected 24 h before BLM. Cell and animal survival together with DNA histograms were the end-points used to determine the effect of these combined treatments. Results. Both drugs, either as singletreatment or in different combined therapy schedules reduced significantly the number of cells in peritoneal lavage, compared to control, saline treated animals. The combination of VLB, followed by BLM after 24 h reduced significantly the number of cells in peritoneal lavage, compared to the treatment in which BLM was followed by VLB or to the treatment with singledrugs alone. Median survival time of mice treated with VLB alone, BLM alone and combination of both drugs was significantly prolonged compared to the control untreated mice. When VLB and BLM were combined, both treatment combinations were more effective than monochemotherapies with VLB or BLM. The best results were obtained when VLB was followed by BLM after 24 h. The DNA histogram of cells treated with VLB showed a decreased number of cells in S phase and an increased number of cells with DNA values greater than in G2M compartment compared to the control untreated cells. BLM in the dosage used inthese experiments did not affect the progression of cells through cell cycle. Both combinations of VLB and BLM produced similar cell kinetic effect as VLB alone. Conclusion. (Abstract truncated at 2000 characters.)
Published in DiRROS: 23.01.2024; Views: 282; Downloads: 56
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1177. Cathepsin D and plasminogen activator inhibitor type 1 in normal, benign and alignant ovarian tissues : a preliminary reportMarina Šprem, Damir Babić, Marija Abramić, Duško Miličić, Ivan Vrhovec, Janez Škrk, Maja Osmak, 2000, original scientific article Abstract: Background. The aim of the present study was to determine the concentration ofcathepsin D (Cath D) and plasminogen activator inhibitor type 1 (PAI-1) in normal ovarian tissues, benign and malignant ovarian tumor tissues, and to asses relationship between Cath D and PAI-1 content, and some clinical and pathohistological parameters. Materials and methods. Cath D contents and PAI-1concentrations were determined (using immunoradiometric ELSA-Cath D assayand commercial IMUDIND R ELISA immunoassay, respectively) in 35 samples: 10 normal ovarii, 10 benign, 10 primary malignant and 5 metastatic ovarian tumors. Results. The concentrations of Cath D were significantly higher in malignant (32.89+-14.26 pmol/mg protein ) and metastatic (31.42+-10.24 pmol/mgprotein), than in normal (13.68+-4.03 pmol/mg protein) and benign (17.89+-13.13 pmol/mg protein) ovarian tissues. There was no statistical differences in the concentrations of PAI-1 between normal, benign, malignant and metastatic tumor specimens. The concentrations of Cath D as well as PAI-1 did not correlate to the age of patients, menopausal status, parity, GOG risk group, clinical stage or pathohistological grading. Conclusion. Concentrationsof Cath D (but not PAI-1) were significantly increased in malignant and metastatic ovarian tumor tissues when compared to normal and benign ovarian tumor samples; they were independent from pathohistological andclinical parameters.
Published in DiRROS: 23.01.2024; Views: 268; Downloads: 83
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1178. A paraungual tumor? - No, just tungiasisRastko Golouh, Marko Špiler, 2000, professional article Abstract: Background. Tunga penetrans is a burrowing flea that is prevalent in Central and South America, the Caribbean, tropical Africa, India and Pakistan. Tungiasis results from cutaneous infestation by gravid female flea, Tunga penetrans. Case report. We report a case of tungiasis in a male who had been on a tourist expedition to Bolivia and Peru. The condition had manifested as aparaungual infiltration of a toe, that was clinically suspicious for tumor. Conclusions. Microscopic examination of the lesion and travel history led to the diagnosis of tungiasis. This is the first case report of Tunga penetrans infestation in Slovenia.
Published in DiRROS: 23.01.2024; Views: 278; Downloads: 68
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1179. Combined modality treatment with organ preservation in invasive bladder cancerTanja Čufer, 2000, original scientific article Abstract: Background. The standard treatment for muscle-invasive bladder cancer is stillradical cystectomy. However despite mutilating surgery half of the patients eventually develop metastatic disease and subsequently die of the disease. In view of these problems, a bladder-sparing approach using multi-modality treatment with transurethral resection (TUR), irradiation and chemotherapy has been tested in this disease. So far, the results published byfive groups, showed that the survival rates of patients treated by multi-modality therapy with a bladder sparing approach, based on the response to initial TUR and chemotherapy or chemoradiotherapy, are comparable to cystectomy series, while also offering a 60% to 70% chance of maintaining a functioning bladder. The probability of survival with bladder preserved was found to be around 40% at 5-years. The best predictor of successful multi-modality treatment with bladder preservation seems to be a complete response to initial therapy and a close cystoscopic surveillance is obligatoryto allow for cystectomy at earliest opportunity, if necessary. Conclusions. Multimodality treatment with selective bladder preservation offers a chance for long term cure and survival equal to radical cystectomy inmuscle invasive bladder cancer, while also offering a chance of maintaining a normally functioning bladder. It is expected, that the identification of biological factors with a predictive value for successful chemoradiation will allow for a better selection of patients who could benefit from this treatmentin future.
Published in DiRROS: 23.01.2024; Views: 256; Downloads: 69
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1180. Influence of hydralazine on interstitial fluid pressure in experimental tumors - a preliminary study : Vpliv hydralazina na tlak medcelične tekočine v poskusnih tumorjihBlaž Podobnik, Damijan Miklavčič, 2000, original scientific article Abstract: Background. Interstitial fluid pressure (IFP) has been recognised as the most important obstacle in macromolecular drug delivery to solid tumors. Our interest was to reduce differentialy tumor IFP with respect to IFP in surrounding and normal tissues in order to increase drug delivery to tumors aswell to increase tumor blood flow and potentialy tumor tissue oxygenation. In this preliminary study we used hydralazine, a longacting arterial vasodilator. Materials and methods. Measurements of interstitial fluid pressure were performed in vivo on CBA mice bearing SAF tumors using wick-in-needle technigue. Altogether eleven measurements were obtained on different animals with tumors of different size. Results. IFP in tumors after hydralazine administration was significantly lower than initial values in corresponding tumors. On average tumor IFP decreased for 33 % from initial value. On the contrary, no change in IFP in normal tissue was observed after hydralazine administration. Also, after injection of physiological saline instead of hydralazine there was no change in IFP neither in tumors nor in muscle. The results of our preliminary study on the effect of hydralazine on IFP in SAF tumor model is in accordance to previously reported studies. The decrease in tumor IFP was only observed in tumors, but not in muscle and surrounding subcutis. Conclusion. Hydralazine is a vasodilator which is capable of decreasing tumor IFP, reproducibly and with favorably long lasting dynamics.
Keywords: sarcoma, experimental drug therapy, hydralazine, extracellular space, interstitial fluid pressure, manometry
Published in DiRROS: 23.01.2024; Views: 295; Downloads: 80
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