Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma (HCC). The authors present a case of CLE that occurred after the second hepat...Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma (HCC). The authors present a case of CLE that occurred after the second hepatic arterial chemoembolization for HCC, and attempt to introduce several plausible mechanisms of CLE, after reporting the clinical and radiological findings and reviewing the medical literature.展开更多
Objective: To evaluate the clinical effect of renal artery embolization with a mixture of lipiodol and polyvinyl alcohol (PVA) particles on symptomatic renal angiomyolipoma and to present the mid-term results from ...Objective: To evaluate the clinical effect of renal artery embolization with a mixture of lipiodol and polyvinyl alcohol (PVA) particles on symptomatic renal angiomyolipoma and to present the mid-term results from our single-center site. Methods: We performed a retrospective review of the seven patients who underwent embolization with a mixture of lipiodol and PVA particles to treat symptomatic renal angiomyolipoma in our center between February 2011 and December 2013. Medical records and follow-up results were reviewed and analyzed. Results: Seven patients underwent eight episodes of embolization using a mixture of lipiodol and PVA particles to treat symptomatic renal angiomyolipoma. One patient required a subsequent embolization of the right kidney 9 months after the initial embolization of the left kidney. No nephrectomy was required in any of these cases during follow-up. None had recurrence of tumor bleeding or rupture during follow-up. Decreased tumor size was achieved in six patients (85.7%) during the mid-term follow-up. Conclusions: Embolization with a mixture of lipiodol and PVA particles is an effective and safe treatment for symptomatic renal angiomyolipoma. Based on the durable mid-term results of the present study, a mixture of lipiodol and PVA particles is recommended for embolization.展开更多
AIM: The purpose of this study was to compare the diagnostic accuracy of biphasic multi-detector row helical computed tomography (MDCT), digital subtraction angiography (DSA)and Lipiodol computed tomography (CT) in de...AIM: The purpose of this study was to compare the diagnostic accuracy of biphasic multi-detector row helical computed tomography (MDCT), digital subtraction angiography (DSA)and Lipiodol computed tomography (CT) in detection of hypervascular hepatocellular carcinoma (HCC).METHODS: Twenty-eight patients with nodular HCC underwent biphasic MDCT examination: hepatic arterial phase (HAP) 25 s and portal venous phase (PVP) 70 s after injection of the contrast medium (1.5 mL/kg). They also underwent hepatic angiography and intra-arterial infusion of iodized oil. Lipiodol CT was performed 3-4 wk after infusion. MDCT images were compared with DSA and Lipiodol CT images for detection of hepatic nodules.RESULTS: The three imaging techniques had the same sensitivity in detecting nodules >20 mm in diameter. There was no significant difference in the sensitivity among HAP-MDCT, Lipiodol CT and DSA for nodules of 10-20 mm in diameter. For the nodules <10 mm in diameter, HAP-MDCT identified 47, Lipiodol CT detected 27 (X2= 11.3, P= 0.005<0.01, HAP-MDCT vs Lipiodol CT) and DSA detected 16(X2= 9.09, P= 0.005<0.01 vs Lipiodol CT and X2= 29.03,P = 0.005<0.01 vs HAP-MDCT). However, six nodules <10 mm in diameter were detected only by Lipiodol CT.CONCLUSION: MDCT and Lipiodol CT are two complementary modalities. At present, MDCT does not obviate the need for DSA and subsequent Lipiodol CT as a preoperative examination for HCC.展开更多
Pulmonary and cerebral lipiodol embolism after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma is rare. To our knowledge, only 7 cases have been reported in the literature. We present a cas...Pulmonary and cerebral lipiodol embolism after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma is rare. To our knowledge, only 7 cases have been reported in the literature. We present a case of pulmonary and cerebral lipiodol embolism, and analyzed retrospectively the imaging and clinical data of the patient and conclude the most probable mechanism of pulmonary and cerebral lipiodol embolism, which is different from that of the cases reported previously.展开更多
AIM: To study the distribution and stability of antisense oligodeoxynucleotide (ASODN) in Walker-256 cells and their distribution in liver, lung and kidney tissues after being infused alone or mixed with lipiodol via ...AIM: To study the distribution and stability of antisense oligodeoxynucleotide (ASODN) in Walker-256 cells and their distribution in liver, lung and kidney tissues after being infused alone or mixed with lipiodol via hepatic artery in a rat liver tumor model.METHODS: 5'-Isothiocyananate (FITC)-labeled vascular endothelial growth factor (VEGF) ASODN was added into Walker-256 cell culture media. Its distribution in cells was observed by fluorescence microscope at different time points. Walker-256 carcinosarcoma was transplanted into Wistar rat liver to establish a liver cancer model. 5'-FITC-labeled VEGF ASODN mixed with (mixed group, n = 6) or without (TAI group, n = 6)ultra-fluid lipiodol was administrated via hepatic artery.Frozen samples of liver, lung and kidney tissue were taken from rats after 1, 3 and 6 d, respectively. The distribution of ASODN was observed under fluorescent microscope.RESULTS: ASODN could enter cytoplasm within 2 h and nuclei within 6 h. Accumulation of ASODN reached the peak point in nuclei at 12 h, and then disappeared gradually. No fluorescence could be seen in cells at 48 h. In vivo experiment, on d 1 and 3 the fluorescence staining in liver was stronger in mixed group than in TAI group and more fluorescence could be detected in lung and kidney in TAI group than in mixed group. On d 6, no fluorescence could be detected in TAI group, but faint fluorescence could be seen in mixed group. ASODN could be seen in cancer cells and normal hepatic cells. In mixed group, ASODN was mainly distributed in liver tumor tissues.CONCLUSION: ASODN can transfect Walker-256 cells.ASODN mixed with lipiodol infusion via hepatic artery can be used in the treatment of HCC.展开更多
Two new nitrido-188Re complexes were prepared by a modified method in high yield. These complexes were stable in vitro. The biodistribution in normal mice showed that these nitrido-188Re complexes could accumulate in ...Two new nitrido-188Re complexes were prepared by a modified method in high yield. These complexes were stable in vitro. The biodistribution in normal mice showed that these nitrido-188Re complexes could accumulate in liver and dissipate quickly from almost all organs. TAE was performed with the use of lipiodol solutions of two complexes to rabbit VX2 liver tumor models. SPECT images showed that the two lipiodol solutions could remain in tumor for about 9h (188ReN-NEPTDD/lipiodol) and 12h (188ReN-NEMMPTDD/lipiodol),respectively.展开更多
Objective The objective of this study was to explore the short-term effects and postoperative complications of ultrasound-guided percutaneous ethanol-lipiodol injection(PEI)combined with high-intensity focused ultraso...Objective The objective of this study was to explore the short-term effects and postoperative complications of ultrasound-guided percutaneous ethanol-lipiodol injection(PEI)combined with high-intensity focused ultrasound(HIFU)for the treatment of small hepatocellular carcinoma in a special or high-risk location.Methods Forty patients with small liver cancer in a special or high-risk location were randomly divided into two groups:20 patients were treated with PEI combined with HIFU(P+H group),and 20 patients were treated with HIFU alone(H group).There were no significant differences in average age,liver function,tumor location,tumor number,or tumor size between the two groups(P>0.05).Results Significant differences were observed in ablation parameters between the two groups(P<0.05).Under the same power,ablation rates of the P+H group were significantly higher than those in the H group,and postoperative complications in the P+H group were significantly lower than those in the H group(P<0.05).Conclusion The combination of PEI and HIFU has better clinical value than HIFU alone for small-cell liver cancer in special or high-risk locations.展开更多
We report a case of cerebral lipiodol embolism(CLE) after transarterial chemoembolization(TACE) for unresectable hepatic carcinoma(HCC).A 54-year-old man with unresectable HCC underwent TACE via the right hepatic arte...We report a case of cerebral lipiodol embolism(CLE) after transarterial chemoembolization(TACE) for unresectable hepatic carcinoma(HCC).A 54-year-old man with unresectable HCC underwent TACE via the right hepatic artery and right inferior phrenic artery using a mixture of 40 mg pirarubicin and 30 mL lipiodol.His level of consciousness deteriorated after TACE,and non-contrast computed tomography revealed a CLE.The cerebral conditions improved after supportive therapy.The complication might have been due to hepatic arterio-pulmonary vein shunt caused by direct invasion of the tumor.Even though CLE is an uncommon complication of TACE,we should be aware of these rare complications in patients with high risk factors.展开更多
A suspension of iodized oil and anticancer agent was injected into the portal veins of 20 rats with hepatic carcinoma. Oil drops were seen in tumor cell lines,small blood vessels inside the cancer nest,the sinusoid,an...A suspension of iodized oil and anticancer agent was injected into the portal veins of 20 rats with hepatic carcinoma. Oil drops were seen in tumor cell lines,small blood vessels inside the cancer nest,the sinusoid,and the centrai veins.After injection of oil suspension through the portal vein the distal small vessels were embolized and necrotic changes of tumor cells and their subordinate normal liver cells were observed.The results obtained in this experiment provided a good anatomical and pathological basis for treating liver cancers with the portal vein embolization with chemotherapeutic agents.展开更多
Primary hepatocellular carcinoma is one of the most common and deadliest malignant tumors in the world, and most patients are diagnosed after missing the optimal treatment period. TACE (Transcatheter arterial chemoemb...Primary hepatocellular carcinoma is one of the most common and deadliest malignant tumors in the world, and most patients are diagnosed after missing the optimal treatment period. TACE (Transcatheter arterial chemoembolization) is currently the preferred treatment for advanced HCC (Hepatocellular Carcinoma), as it can induce local ischemic necrosis of the tumor while reducing the systemic side effects of drugs by embolizing the tumor-feeding arteries. Lipiodol, with its unique comprehensive properties of imaging, drug loading, and embolization, has become a key component in the process of TACE. Therefore, analyzing the deposition of lipiodol in hepatic tumor tissues after TACE can effectively evaluate the treatment efficacy. This article summarizes and analyzes the metabolism of lipiodol in tumors and the clinical application of lipiodol deposition status in predicting patient prognosis, aiming to provide clearer diagnostic and treatment strategies for clinical doctors.展开更多
BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the ...BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the tumor.Recent studies have demonstrated the feasibility of peri-tumor fiducials in enabling even more accurate delineation of target and normal tissue.The use of gold coils as fiducials in gastrointestinal tumors has been extensively studied.However,placement requires expertise and specialized endoscopic ultrasound equipment.This article reports the long-term outcomes of using a standard gastroscopy to inject liquid fiducials for the treatment of oesophageal and gastric tumors with IGRT.AIM To assess the long-term outcomes of liquid fiducial-guided IGRT in a cohort of oesophageal and gastric cancer patients.METHODS A retrospective cohort study of consecutive adults with Oesophagogastric cancers referred for liquid fiducial placement before definitive/neo-adjuvant or palliative IGRT between 2013 and 2021 at a tertiary hospital in Melbourne,Australia was conducted.Up to four liquid fiducials were inserted per patient,each injection consisting of 0.2-0.5mL of a 1:1 mixture of iodized oil(Lipiodol;Aspen Pharmacare)and n-butyl 2-cyanoacrylate(Histoacryl®;B.Braun).A 23-gauge injector(Cook Medical)was used for the injection.All procedures were performed by or under the supervision of a gastroenterologist.Liquid fiducial-based IGRT(LF-IGRT)consisted of computer-assisted direct matching of the fiducial region on cone-beam computerised tomography at the time of radiotherapy.Patients received standard-IGRT(S-IGRT)if fiducial visibility was insufficient,consisting of bone match as a surrogate for tumor position.Radiotherapy was delivered to 54Gy in 30 fractions for curative patients and up to 45Gy in 15 fractions for palliative treatments.RESULTS 52 patients were referred for liquid fiducial placement within the study period.A total of 51 patients underwent liquid fiducial implantation.Of these a total of 31 patients received radiotherapy.Among these,the median age was 77.4 years with a range between 57.5 and 88.8,and 64.5%were male.Twenty-seven out of the 31 patients were able to have LF-IGRT while four had S-IGRT.There were no complications after endoscopic implantation of liquid fiducials in our cohort.The cohort overall survival(OS)post-radiotherapy was 19 mo(range 0 to 87 mo).Whilst the progression-free survival(PFS)post-radiotherapy was 13 mo(range 0 to 74 mo).For those treated with curative intent,the median OS was 22.0 mo(range 0 to 87 mo)with a PFS median of 14.0 mo(range 0 to 74 mo).Grade 3 complication rate post-radiotherapy was 29%.CONCLUSION LF-IGRT is feasible in 87.1%of patients undergoing liquid fiducial placement through standard gastroscopy injection technique.Our cohort has an overall survival of 19 mo and PFS of 13 mo.Further studies are warranted to determine the long-term outcomes of liquid-fiducial based IGRT.展开更多
OBJECTIVE To explore the MR characteristics following lipiodol retention in rabbit liver and to evaluate the sensitivity of CT (CT value 〉400 HU) and MR in displaying the hepatic degeneration and necrosis following...OBJECTIVE To explore the MR characteristics following lipiodol retention in rabbit liver and to evaluate the sensitivity of CT (CT value 〉400 HU) and MR in displaying the hepatic degeneration and necrosis following embolization. METHODS Thirty-two rabbits were randomly divided into 3 groups. In the control group (n=8), 2 ml of normal saline was injected into the right branch of the portal vein. In the first experimental group(n= 12), 4 ml of lipiodol emulsion was injected into the main portal vein. In the second experimental group (n= 12), 2 ml of lipiodol emulsion was injected into the right branch of the portal vein. CT and MR images were obtained before and after surgery in each group. The histopathologic condition was determined for all liver tissue specimens. RESULTS In the control group, CT and MR did not show any significant changes in the livers after surgery. After the operations in the experimental groups, the regional CT attenuation was 601±101 HU in the largest slice, which had no abnormal signals on T1Wl and T2Wl. In the first group, histologic examinations showed there were concentrated lipiodol droplets around the portal areas. In the second group, serious degeneration and necrosis in the right hepatic lobe occurred in 9 rabbits. T1Wl displayed homogenous or non-homogenous low signals and T2Wl mainly displayed a high signal. However, these pathologic changes did not appear on CT scanning due to high attenuation of the lipiodol. CONCLUSION There were no remarkable hepatic changes on MR in rabbits following good retention of the formulated lipiodol emulsion mixture of lipiodol and urografin(CT value 〉 400 HU). MR displayed serious degeneration and necrosis of the liver following embolization.展开更多
Internal radiotherapy with hepatic artery injection(HAI)and B-ultrasound guidedpuncture injection(BGPI)of 131I-lipiodol was observed in 20 patients with liver cancer.The radinuclide images showed that 131I-lipiodol ac...Internal radiotherapy with hepatic artery injection(HAI)and B-ultrasound guidedpuncture injection(BGPI)of 131I-lipiodol was observed in 20 patients with liver cancer.The radinuclide images showed that 131I-lipiodol accumulated in tumor mainly.The radioactivity of tumor/liverratio(T/L)in HAI and BGPI was 3.87±2.77 and 9.15±3.41 resistively. The effective half-lifeof,131I-lipiodol in tumor was(4.5±1.92)anys and(6.22±0.61) days. The radioactivity of lung was(13.19±3.01)% and(5.19±2.28)% espectively.These results suggest that the 131I-lipiodol biodistribution in BGPI is better than that in HAI.Clinical results showed that ABP levels dropped rapidlyin 64.3% of patients with peltive AFP.A shrinkage in tumor size was observed in 66.7% of patients.Besides transient fever,elevated bilirubin and SGPT,no any toxicity and adverse reaction wasobserved.展开更多
Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of con...Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.展开更多
Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our cont...Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.展开更多
BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip...BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.展开更多
Congenital unilateral lower lip palsy(CULLP),or congenital hypoplasia of the depressor anguli oris muscle,also known as asymmetric crying facies,is a rare condition that results in asymmetry of the lower lip during sm...Congenital unilateral lower lip palsy(CULLP),or congenital hypoplasia of the depressor anguli oris muscle,also known as asymmetric crying facies,is a rare condition that results in asymmetry of the lower lip during smiling,laughing,and crying.Although the etiology is unknown,weakness of the depressor labii inferioris(DLI)muscle is implicated as a contributing factor.Currently,no well-established treatment options are available.This case report describes an 18-year-old male patient diagnosed with CULLP.Physical examination revealed a symmetric face at rest,but asymmetry when smiling and opening the mouth.Following the administration of lidocaine into the affected DLI muscle,the patient’s smile and lower lip symmetry were immediately restored without any adverse effects.Subsequently,administration of botulinum toxin for neuromodulation of the DLI muscle led to a significant improvement in symmetry and oral function within 2 weeks,which was sustained at 1 month and 3 months post-treatment.No adverse effects were reported,and both patients and families expressed high satisfaction with the outcomes.This case highlights the potential use of neuromodulation as a minimally invasive and effective treatment for CULLP.展开更多
To study the efficacy of lip moisturizing cosmetics and explore the methods for evaluating their efficacy.The claimed efficacy and number of claimed efficacy of 44 lip moisturizing cosmetics were investigated,and a co...To study the efficacy of lip moisturizing cosmetics and explore the methods for evaluating their efficacy.The claimed efficacy and number of claimed efficacy of 44 lip moisturizing cosmetics were investigated,and a combination of in vitro and human testing was used to evaluate the efficacy of the lip moisturizing cosmetics.The efficacy claims of lip cosmetics mainly included 4 categories of moisturizing,repairing,soothing and anti-wrinkle,with 79.55%of the products claiming 3~4 categories of efficacy.In the in vitro test,the cell morphology of the skin damage model improved and the secretion of pro-inflammatory factors decreased significantly.In the human trial,the water content,skin softness and brightness L value of the cuticle of the lips increased significantly in 31 subjects,and the transepidermal water loss,redness a value,and the area and volume of lip wrinkles decreased significantly;the dryness of the lip skin and the uniformity of the skin texture improved significantly.The dryness of lip skin and the uniformity of skin texture were significantly improved.The results show that the moisture content of the stratum corneum can be used to evaluate the moisturizing efficacy of lip products.The transepidermal water loss,skin color,skin softness and expert assessment can be used to evaluate the repairing efficacy.The observation of cell morphology of skin damage models and the detection of pro-inflammatory factor content can be used to evaluate the soothing efficacy.The area and volume of lip wrinkles can be used to evaluate the anti-wrinkle efficacy of products.展开更多
文摘Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma (HCC). The authors present a case of CLE that occurred after the second hepatic arterial chemoembolization for HCC, and attempt to introduce several plausible mechanisms of CLE, after reporting the clinical and radiological findings and reviewing the medical literature.
文摘Objective: To evaluate the clinical effect of renal artery embolization with a mixture of lipiodol and polyvinyl alcohol (PVA) particles on symptomatic renal angiomyolipoma and to present the mid-term results from our single-center site. Methods: We performed a retrospective review of the seven patients who underwent embolization with a mixture of lipiodol and PVA particles to treat symptomatic renal angiomyolipoma in our center between February 2011 and December 2013. Medical records and follow-up results were reviewed and analyzed. Results: Seven patients underwent eight episodes of embolization using a mixture of lipiodol and PVA particles to treat symptomatic renal angiomyolipoma. One patient required a subsequent embolization of the right kidney 9 months after the initial embolization of the left kidney. No nephrectomy was required in any of these cases during follow-up. None had recurrence of tumor bleeding or rupture during follow-up. Decreased tumor size was achieved in six patients (85.7%) during the mid-term follow-up. Conclusions: Embolization with a mixture of lipiodol and PVA particles is an effective and safe treatment for symptomatic renal angiomyolipoma. Based on the durable mid-term results of the present study, a mixture of lipiodol and PVA particles is recommended for embolization.
基金Supported by the Medical Science Research Fund of Sichuan Province,No. 200054
文摘AIM: The purpose of this study was to compare the diagnostic accuracy of biphasic multi-detector row helical computed tomography (MDCT), digital subtraction angiography (DSA)and Lipiodol computed tomography (CT) in detection of hypervascular hepatocellular carcinoma (HCC).METHODS: Twenty-eight patients with nodular HCC underwent biphasic MDCT examination: hepatic arterial phase (HAP) 25 s and portal venous phase (PVP) 70 s after injection of the contrast medium (1.5 mL/kg). They also underwent hepatic angiography and intra-arterial infusion of iodized oil. Lipiodol CT was performed 3-4 wk after infusion. MDCT images were compared with DSA and Lipiodol CT images for detection of hepatic nodules.RESULTS: The three imaging techniques had the same sensitivity in detecting nodules >20 mm in diameter. There was no significant difference in the sensitivity among HAP-MDCT, Lipiodol CT and DSA for nodules of 10-20 mm in diameter. For the nodules <10 mm in diameter, HAP-MDCT identified 47, Lipiodol CT detected 27 (X2= 11.3, P= 0.005<0.01, HAP-MDCT vs Lipiodol CT) and DSA detected 16(X2= 9.09, P= 0.005<0.01 vs Lipiodol CT and X2= 29.03,P = 0.005<0.01 vs HAP-MDCT). However, six nodules <10 mm in diameter were detected only by Lipiodol CT.CONCLUSION: MDCT and Lipiodol CT are two complementary modalities. At present, MDCT does not obviate the need for DSA and subsequent Lipiodol CT as a preoperative examination for HCC.
基金Supported by Medical Scientific Research Foundation of Zhejiang Province, No. 2008A082, China
文摘Pulmonary and cerebral lipiodol embolism after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma is rare. To our knowledge, only 7 cases have been reported in the literature. We present a case of pulmonary and cerebral lipiodol embolism, and analyzed retrospectively the imaging and clinical data of the patient and conclude the most probable mechanism of pulmonary and cerebral lipiodol embolism, which is different from that of the cases reported previously.
文摘AIM: To study the distribution and stability of antisense oligodeoxynucleotide (ASODN) in Walker-256 cells and their distribution in liver, lung and kidney tissues after being infused alone or mixed with lipiodol via hepatic artery in a rat liver tumor model.METHODS: 5'-Isothiocyananate (FITC)-labeled vascular endothelial growth factor (VEGF) ASODN was added into Walker-256 cell culture media. Its distribution in cells was observed by fluorescence microscope at different time points. Walker-256 carcinosarcoma was transplanted into Wistar rat liver to establish a liver cancer model. 5'-FITC-labeled VEGF ASODN mixed with (mixed group, n = 6) or without (TAI group, n = 6)ultra-fluid lipiodol was administrated via hepatic artery.Frozen samples of liver, lung and kidney tissue were taken from rats after 1, 3 and 6 d, respectively. The distribution of ASODN was observed under fluorescent microscope.RESULTS: ASODN could enter cytoplasm within 2 h and nuclei within 6 h. Accumulation of ASODN reached the peak point in nuclei at 12 h, and then disappeared gradually. No fluorescence could be seen in cells at 48 h. In vivo experiment, on d 1 and 3 the fluorescence staining in liver was stronger in mixed group than in TAI group and more fluorescence could be detected in lung and kidney in TAI group than in mixed group. On d 6, no fluorescence could be detected in TAI group, but faint fluorescence could be seen in mixed group. ASODN could be seen in cancer cells and normal hepatic cells. In mixed group, ASODN was mainly distributed in liver tumor tissues.CONCLUSION: ASODN can transfect Walker-256 cells.ASODN mixed with lipiodol infusion via hepatic artery can be used in the treatment of HCC.
基金grants from Science & Technology Development Foundation of CAEP (2007A02004)
文摘Two new nitrido-188Re complexes were prepared by a modified method in high yield. These complexes were stable in vitro. The biodistribution in normal mice showed that these nitrido-188Re complexes could accumulate in liver and dissipate quickly from almost all organs. TAE was performed with the use of lipiodol solutions of two complexes to rabbit VX2 liver tumor models. SPECT images showed that the two lipiodol solutions could remain in tumor for about 9h (188ReN-NEPTDD/lipiodol) and 12h (188ReN-NEMMPTDD/lipiodol),respectively.
基金Supported by the research grant from Dalian Health and Family Planning Commission of China(No.1611020).
文摘Objective The objective of this study was to explore the short-term effects and postoperative complications of ultrasound-guided percutaneous ethanol-lipiodol injection(PEI)combined with high-intensity focused ultrasound(HIFU)for the treatment of small hepatocellular carcinoma in a special or high-risk location.Methods Forty patients with small liver cancer in a special or high-risk location were randomly divided into two groups:20 patients were treated with PEI combined with HIFU(P+H group),and 20 patients were treated with HIFU alone(H group).There were no significant differences in average age,liver function,tumor location,tumor number,or tumor size between the two groups(P>0.05).Results Significant differences were observed in ablation parameters between the two groups(P<0.05).Under the same power,ablation rates of the P+H group were significantly higher than those in the H group,and postoperative complications in the P+H group were significantly lower than those in the H group(P<0.05).Conclusion The combination of PEI and HIFU has better clinical value than HIFU alone for small-cell liver cancer in special or high-risk locations.
文摘We report a case of cerebral lipiodol embolism(CLE) after transarterial chemoembolization(TACE) for unresectable hepatic carcinoma(HCC).A 54-year-old man with unresectable HCC underwent TACE via the right hepatic artery and right inferior phrenic artery using a mixture of 40 mg pirarubicin and 30 mL lipiodol.His level of consciousness deteriorated after TACE,and non-contrast computed tomography revealed a CLE.The cerebral conditions improved after supportive therapy.The complication might have been due to hepatic arterio-pulmonary vein shunt caused by direct invasion of the tumor.Even though CLE is an uncommon complication of TACE,we should be aware of these rare complications in patients with high risk factors.
文摘A suspension of iodized oil and anticancer agent was injected into the portal veins of 20 rats with hepatic carcinoma. Oil drops were seen in tumor cell lines,small blood vessels inside the cancer nest,the sinusoid,and the centrai veins.After injection of oil suspension through the portal vein the distal small vessels were embolized and necrotic changes of tumor cells and their subordinate normal liver cells were observed.The results obtained in this experiment provided a good anatomical and pathological basis for treating liver cancers with the portal vein embolization with chemotherapeutic agents.
文摘Primary hepatocellular carcinoma is one of the most common and deadliest malignant tumors in the world, and most patients are diagnosed after missing the optimal treatment period. TACE (Transcatheter arterial chemoembolization) is currently the preferred treatment for advanced HCC (Hepatocellular Carcinoma), as it can induce local ischemic necrosis of the tumor while reducing the systemic side effects of drugs by embolizing the tumor-feeding arteries. Lipiodol, with its unique comprehensive properties of imaging, drug loading, and embolization, has become a key component in the process of TACE. Therefore, analyzing the deposition of lipiodol in hepatic tumor tissues after TACE can effectively evaluate the treatment efficacy. This article summarizes and analyzes the metabolism of lipiodol in tumors and the clinical application of lipiodol deposition status in predicting patient prognosis, aiming to provide clearer diagnostic and treatment strategies for clinical doctors.
文摘BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the tumor.Recent studies have demonstrated the feasibility of peri-tumor fiducials in enabling even more accurate delineation of target and normal tissue.The use of gold coils as fiducials in gastrointestinal tumors has been extensively studied.However,placement requires expertise and specialized endoscopic ultrasound equipment.This article reports the long-term outcomes of using a standard gastroscopy to inject liquid fiducials for the treatment of oesophageal and gastric tumors with IGRT.AIM To assess the long-term outcomes of liquid fiducial-guided IGRT in a cohort of oesophageal and gastric cancer patients.METHODS A retrospective cohort study of consecutive adults with Oesophagogastric cancers referred for liquid fiducial placement before definitive/neo-adjuvant or palliative IGRT between 2013 and 2021 at a tertiary hospital in Melbourne,Australia was conducted.Up to four liquid fiducials were inserted per patient,each injection consisting of 0.2-0.5mL of a 1:1 mixture of iodized oil(Lipiodol;Aspen Pharmacare)and n-butyl 2-cyanoacrylate(Histoacryl®;B.Braun).A 23-gauge injector(Cook Medical)was used for the injection.All procedures were performed by or under the supervision of a gastroenterologist.Liquid fiducial-based IGRT(LF-IGRT)consisted of computer-assisted direct matching of the fiducial region on cone-beam computerised tomography at the time of radiotherapy.Patients received standard-IGRT(S-IGRT)if fiducial visibility was insufficient,consisting of bone match as a surrogate for tumor position.Radiotherapy was delivered to 54Gy in 30 fractions for curative patients and up to 45Gy in 15 fractions for palliative treatments.RESULTS 52 patients were referred for liquid fiducial placement within the study period.A total of 51 patients underwent liquid fiducial implantation.Of these a total of 31 patients received radiotherapy.Among these,the median age was 77.4 years with a range between 57.5 and 88.8,and 64.5%were male.Twenty-seven out of the 31 patients were able to have LF-IGRT while four had S-IGRT.There were no complications after endoscopic implantation of liquid fiducials in our cohort.The cohort overall survival(OS)post-radiotherapy was 19 mo(range 0 to 87 mo).Whilst the progression-free survival(PFS)post-radiotherapy was 13 mo(range 0 to 74 mo).For those treated with curative intent,the median OS was 22.0 mo(range 0 to 87 mo)with a PFS median of 14.0 mo(range 0 to 74 mo).Grade 3 complication rate post-radiotherapy was 29%.CONCLUSION LF-IGRT is feasible in 87.1%of patients undergoing liquid fiducial placement through standard gastroscopy injection technique.Our cohort has an overall survival of 19 mo and PFS of 13 mo.Further studies are warranted to determine the long-term outcomes of liquid-fiducial based IGRT.
文摘OBJECTIVE To explore the MR characteristics following lipiodol retention in rabbit liver and to evaluate the sensitivity of CT (CT value 〉400 HU) and MR in displaying the hepatic degeneration and necrosis following embolization. METHODS Thirty-two rabbits were randomly divided into 3 groups. In the control group (n=8), 2 ml of normal saline was injected into the right branch of the portal vein. In the first experimental group(n= 12), 4 ml of lipiodol emulsion was injected into the main portal vein. In the second experimental group (n= 12), 2 ml of lipiodol emulsion was injected into the right branch of the portal vein. CT and MR images were obtained before and after surgery in each group. The histopathologic condition was determined for all liver tissue specimens. RESULTS In the control group, CT and MR did not show any significant changes in the livers after surgery. After the operations in the experimental groups, the regional CT attenuation was 601±101 HU in the largest slice, which had no abnormal signals on T1Wl and T2Wl. In the first group, histologic examinations showed there were concentrated lipiodol droplets around the portal areas. In the second group, serious degeneration and necrosis in the right hepatic lobe occurred in 9 rabbits. T1Wl displayed homogenous or non-homogenous low signals and T2Wl mainly displayed a high signal. However, these pathologic changes did not appear on CT scanning due to high attenuation of the lipiodol. CONCLUSION There were no remarkable hepatic changes on MR in rabbits following good retention of the formulated lipiodol emulsion mixture of lipiodol and urografin(CT value 〉 400 HU). MR displayed serious degeneration and necrosis of the liver following embolization.
文摘Internal radiotherapy with hepatic artery injection(HAI)and B-ultrasound guidedpuncture injection(BGPI)of 131I-lipiodol was observed in 20 patients with liver cancer.The radinuclide images showed that 131I-lipiodol accumulated in tumor mainly.The radioactivity of tumor/liverratio(T/L)in HAI and BGPI was 3.87±2.77 and 9.15±3.41 resistively. The effective half-lifeof,131I-lipiodol in tumor was(4.5±1.92)anys and(6.22±0.61) days. The radioactivity of lung was(13.19±3.01)% and(5.19±2.28)% espectively.These results suggest that the 131I-lipiodol biodistribution in BGPI is better than that in HAI.Clinical results showed that ABP levels dropped rapidlyin 64.3% of patients with peltive AFP.A shrinkage in tumor size was observed in 66.7% of patients.Besides transient fever,elevated bilirubin and SGPT,no any toxicity and adverse reaction wasobserved.
文摘Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.
文摘Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.
文摘BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.
文摘Congenital unilateral lower lip palsy(CULLP),or congenital hypoplasia of the depressor anguli oris muscle,also known as asymmetric crying facies,is a rare condition that results in asymmetry of the lower lip during smiling,laughing,and crying.Although the etiology is unknown,weakness of the depressor labii inferioris(DLI)muscle is implicated as a contributing factor.Currently,no well-established treatment options are available.This case report describes an 18-year-old male patient diagnosed with CULLP.Physical examination revealed a symmetric face at rest,but asymmetry when smiling and opening the mouth.Following the administration of lidocaine into the affected DLI muscle,the patient’s smile and lower lip symmetry were immediately restored without any adverse effects.Subsequently,administration of botulinum toxin for neuromodulation of the DLI muscle led to a significant improvement in symmetry and oral function within 2 weeks,which was sustained at 1 month and 3 months post-treatment.No adverse effects were reported,and both patients and families expressed high satisfaction with the outcomes.This case highlights the potential use of neuromodulation as a minimally invasive and effective treatment for CULLP.
文摘To study the efficacy of lip moisturizing cosmetics and explore the methods for evaluating their efficacy.The claimed efficacy and number of claimed efficacy of 44 lip moisturizing cosmetics were investigated,and a combination of in vitro and human testing was used to evaluate the efficacy of the lip moisturizing cosmetics.The efficacy claims of lip cosmetics mainly included 4 categories of moisturizing,repairing,soothing and anti-wrinkle,with 79.55%of the products claiming 3~4 categories of efficacy.In the in vitro test,the cell morphology of the skin damage model improved and the secretion of pro-inflammatory factors decreased significantly.In the human trial,the water content,skin softness and brightness L value of the cuticle of the lips increased significantly in 31 subjects,and the transepidermal water loss,redness a value,and the area and volume of lip wrinkles decreased significantly;the dryness of the lip skin and the uniformity of the skin texture improved significantly.The dryness of lip skin and the uniformity of skin texture were significantly improved.The results show that the moisture content of the stratum corneum can be used to evaluate the moisturizing efficacy of lip products.The transepidermal water loss,skin color,skin softness and expert assessment can be used to evaluate the repairing efficacy.The observation of cell morphology of skin damage models and the detection of pro-inflammatory factor content can be used to evaluate the soothing efficacy.The area and volume of lip wrinkles can be used to evaluate the anti-wrinkle efficacy of products.