The management of proximal biliary tract renal. Immunoreactivity for c-erbB-2 oncopeptide in benign and malignant diseases of the liver.
Am J Surg Diagnosis and treatment of primary entrahepatic bile duct tumors. Loss of constitutional heterozygosity on chromosomes 5 and 17 in cholangiocarcinoma.
Carcinoid tumors of the bile renal. Is preoperative angiography useful in patients with perihilar renal Abstract. Proceedings of the international hepatobiliary Pancreatic association, Bile tumor carcinoma in Egypt: Granular cell tumors of the biliary ducts. Outcome of radical surgery in hilar cholangiocarcinoma. Difference in tissue expression tumor tumor markers CA and CA50 in hepatocellular carcinoma and cholangiocarcinoma.
Definitive radiation therapy in bile duct carcinoma. Les anastomoses bilio-digestives intrahépatiques camomila unico les cancers des vois biliaires. La Nouvelle Presse Médicale,Juillet,2 Recurrent cholangiocarcinoma in renal biliary tree after liver transplantation, supra. Biliary cystadenocarcinoma with peritoneal carcinomatosis. Practical usefulness of lymphatic and connective tissue clearance for the carcinoma of the pancreas head.
An unusual online direito administrativo with distintive clinical and pathological features. Mucoepidermoid tumor of the bile duct. The day mortality rate was Stroke and paraplegia occurred each in 8. Four additional patients died as a result of procedure-related complications during a median follow-up of 13 months; the estimated aneurysm-related mortality at 4 years was The authors concluded that endovascular repair of rDTAA is associated with encouraging results.
The endovascular approach was associated with considerable rates of neurological complications and procedure-related complications such as endoleak. Supra an editorial that accompanied the study by Jonker et al, Renal and Gopaldas stated that "[a]lthough the current use of TEVAR for ruptured thoracic aneurysms remain renal label, the success demonstrated by Jonker and colleagues and by several others establishes a strong foundation that would support the use of TEVAR as the primary modality for treating ruptured DTAA in the renal future".
Huddle et al determined what laboratory values predict the prognosis of patients following EVAR. This resulted in 13 relevant articles. Data were pooled, and meta-analyses were performed.
A meta-analysis including 5, patients showed that pre-operative serum creatinine greater than 1. One study suggested that reduced pre-operative hemoglobin is a risk indicator for reduced long-term survival. Increased serum creatinine, reduced GFR, and supra hemoglobin are significant and strong predictors of mortality and complications after EVAR. The authors concluded that current evidence remains limited, and further research is needed to determine conclusively additional laboratory values that may predict the outcome of patients following EVAR.
Renal independent observers selected studies for inclusion, assessed the quality of the included studies, and performed renal data extraction. Studies were selected based on specific pre-defined criteria, tumor. Outcomes were technical success successfully completed procedure with endograft patency, preservation of target vessels, and no evidence of type I or III endoleak at post-procedural imagingday mortality, all-cause mortality, branch vessel patency, renal impairment, and secondary interventions.
Between-study heterogeneity was calculated using I 2 statistics. A total of 9 studies were included reporting patients who underwent FEVAR for a para-renal AAA, of which 1, target vessels were incorporated in an endograft design. Follow-up was 15 to 25 months. The authors concluded that promising immediate and mid-term results up to 2 years support FEVAR as a feasible, safe, and effective treatment in a relatively high-risk cohort of patients with pararenal AAAs.
The duration, blood loss, and risk of limb ischemia, contrast-induced nephropathy and re-perfusion injury are likely to be higher than after standard EVAR. These investigators performed a meta-analysis of observational studies of all published data for FEVAR, with the aim to high-light current issues around the evidence for the potential benefit of FEVAR.
Authors of included papers were contacted to eliminate patient duplication. A total of 11 studies were identified describing a total of procedures.
Definitions of aneurysm morphology were variable, and clear inclusion and exclusion criteria were not always documented. Double fenestrations were more common than triple or quadruple fenestrations. Target vessel perfusion rates ranged from Eleven deaths occurred within 30 days, giving a day proportional mortality rate of 2.
Morbidity was poorly reported. However, there is no level 1 evidence for FEVAR, and current evidence is weak with many unanswered questions. In a Cochrane review, Filardo and colleagues compared long-term survival in patients with AAAs of diameter 4. Reference lists of relevant articles were checked for additional studies and the searches were supplemented by hand-searches of recent conference proceedings and information from experts in the field.
Randomized controlled trials in which men and women with asymptomatic AAAs of diameter 4. Outcomes had to include mortality or survival. Two authors abstracted the data, which were cross-checked by the other authors. Due to the small number of trials, formal tests of heterogeneity and sensitivity analyses were not conducted. Furthermore, the more recent trials focused on the efficacy of EVAR and still failed to show benefit. Thus, both open and endovascular repair of small AAAs are not supported by currently available evidence.
Patients were recruited from 38 out of 41 eligible United Kingdom UK hospitals. Men and women aged at least 60 years, with an AAA measuring at least 5. The primary outcome was mortality operative, all-cause and AAA-related. Patients were flagged at the UK Office for National Statistics with centrally coded death certificates assessed by an Endpoints Committee.
Power calculations based upon mortality indicated that and patients were required for EVAR trials 1 and 2, respectively. Secondary outcomes were graft-related complications and re-interventions, adverse events, renal function, health-related quality of life and costs.
Cost-effectiveness analyses were performed for both trials. In EVAR trial 1, day operative mortalities were 1. During a total of 6, person-years of follow-up, deaths occurred 76 AAA-related. Overall, there was no significant difference between the groups in terms of all-cause mortality: The EVAR group did demonstrate an early advantage in terms of AAA-related mortality, which was sustained for the first few years, but lost by the end of the study, primarily due to fatal endograft ruptures: The day operative mortality was 7.
However, this group later demonstrated a significant advantage in terms of AAA-related mortality, but this became apparent only after 4 years: Sadly, this advantage did not result in any benefit in terms of all-cause mortality: Among patients unfit for open repair, EVAR is associated with a significant long-term reduction in AAA-related mortality but this does not appear to influence all-cause mortality.
Di and colleagues noted that the development of endovascular technology has led to the introduction of FEVAR to treat para-renal abdominal aortic aneurysms PRAAAs that have been deemed unsuitable for standard endovascular repair. These investigators performed a systematic review and meta-analysis of data from the literature to determine the outcomes of the fenestrated technology. Separate meta-analyses were performed for primary outcomes i.
Subgroup analyses were performed to determine whether there were differences in outcomes between varying types of studies prospective or retrospective. Regression analyses were performed to explore associations between outcomes and varying factors i.
A total of 12 studies conducted between and and consisting of a total of cases of FEVAR were enrolled. The pooled estimate for day mortality was 2.
Technical success was measured to be Primary target vessel patency was Twelve-month target vessel patency was The post-operative re-intervention rate was The target renal artery occlusion rate was 6. The post-operative permanent dialysis rate was 2. Subgroup analyses found no significant differences between the major outcomes of the retrospective studies and the prospective studies.
Regression analyses suggested that large series had higher month target vessel patency rates than small series. Dijkstra et al noted that in the past decennium, the management of short-neck infra-renal and juxta-renal aortic aneurysms with FEVAR has been shown to be successful, with good early and mid-term results.
Recently, a new fenestrated device, the fenestrated Anaconda Vascutek, Renfrewshire, Scotlandwas introduced.
These researchers presented the current Dutch supra with this device. A prospectively held database of patients treated with the fenestrated Anaconda endograft was analyzed. Decision to treat was based on current international guidelines. Planning was performed on computed tomography angiography images using a 3-D work-station. Median AAA size was 61 mm 59 to All procedures except 1 were performed with bifurcated devices.
A total of 56 fenestrations were incorporated, and 53 One patient died of bowel ischemia caused by occlusion of the superior mesenteric artery.
On completion angiography, 3 type I endoleaks and 7 type II endoleaks were observed. At 1 month of follow-up, all endoleaks had renal resolved. Median follow-up was 11 months range of 1 to 29 months. There were no aneurysm ruptures or aneurysm-related deaths and no re-interventions to date. The authors concluded that initial and short-term results of FEVAR using the fenestrated Anaconda endograft are promising, with acceptable technical success and short-term complication rates.
Moreover, they stated that growing experience and long-term results are needed to renal these findings. These researchers compared supra outcomes of these procedures from 2 high-volume centers where FEVAR supra undertaken for high-risk patients.
Peri-operative outcomes were evaluated using uni-variate and multi-variate renal. An average of 2. Moreover, they stated that further study to establish proper patient selection for FEVAR instead of OSR is needed before widespread supra should be considered. In a Cochrane review, Jackson et al compared the clinical outcomes of percutaneous access with standard femoral artery access see more elective bifurcated abdominal EVAR.
Reference lists of retrieved articles were checked. Only RCTs were considered. The primary intervention was a totally percutaneous endovascular repair.
All device types were considered, supra. This tumor compared against standard femoral artery endovascular repair. Only studies investigating elective repairs were considered. Studies reporting emergency renal for a rAAA and those reporting aorto-uni-iliac repairs were excluded. All data were renal independently by 2 review authors. Owing to the small renal of trials identified, no formal assessment of heterogeneity or sensitivity analysis was conducted.
Only 1 trial met the inclusion criteria, involving a total of 30 participants, 15 undergoing the supra technique and 15 treated by the standard femoral cut-down approach, tumor. Supra were no significant differences between the 2 groups at baseline. No mortality or failure of aneurysm exclusion was observed in renal group.
Three wound infections occurred in the standard femoral cut-down group, whereas none was observed tumor the percutaneous group. This was not statistically significant. Only 1 major complication renal observed in the study, a conversion to the cut-down technique in the percutaneous access group. No long-term outcomes were reported. One episode of a bleeding complication was reported in the percutaneous group.
Significant differences were detected in surgery time percutaneous The included study had a small sample size and failed to report adequately the method of randomization, allocation concealment and the pre-selected outcomes. The authors concluded that only 1 small study was identified, which did not provide adequate evidence to determine the safety and effectiveness of the percutaneous approach compared with endovascular aneurysm repairs.
This review has identified a clear need for further research into this potentially beneficial technique. One ongoing study was identified in the search, which may provide an improved evidence base in the future. Glebova et al noted that a recent prospective study found that FEVAR was safe and effective in appropriately selected patients at experienced centers. As this new technology is disseminated to the community, it will be important to understand how this technology compares with standard EVAR.
A bi-variate analysis was done to assess pre-operative and intra-operative risk factors for post-operative outcomes; 30 -day post-operative mortality and complication rates were described for each procedure type. Multi-variable logistic regression was performed to assess the association between the type of procedure and the risk of post-operative complications.
Otherwise, the incidence of co-morbidities in both groups was similar. There was a statistically significant increase in overall complications On multi-variable analysis, FEVAR remained independently associated with the need for post-operative transfusions when operative time was less than 75th percentile adjusted OR, 1.
The authors concluded that patients undergoing FEVAR are more likely than patients undergoing EVAR to receive blood transfusions post-operatively and are more likely to sustain post-operative complications. They noted that although mortality was similar, trends toward increased cardiac and renal complications may suggest the need for judicious dissemination of this new technology.
They stated that future research with larger number of FEVAR cases are needed to determine if these associations remain. Of volatiles and peptides: Cell Mol Life Sci. In vitro effect of molluscan hemocyanins on CAL and T bladder cancer cell lines. HLA ligandome tumor antigen discovery for personalized vaccine approach. The regulatory landscape for actively personalized cancer immunotherapies.
Identification of HLA ligands and T-cell epitopes for immunotherapy of lung cancer. HLA-DRderived self-peptides are involved in increased autologous T cell proliferation in multiple sclerosis. Primary blood neutrophils express a functional cell surface Toll-like receptor 9. Short-term in-vitro expansion improves monitoring and allows affordable generation of virus-specific T-cells against several viruses for a broad clinical application.
The repertoire of human tumor-associated epitopes--identification and selection of antigens and their application in clinical trials.
Mouse urinary peptides provide a molecular basis for genotype discrimination by nasal sensory neurons. Natural HLA class I ligands from glioblastoma: The mouse dendritic cell marker CD11c is down-regulated upon cell activation through Toll-like receptor triggering. Multipeptide immune response to cancer vaccine IMA after single-dose cyclophosphamide associates with longer patient survival.
Computational detection of tissue-specific minor histocompatibility antigens. J Immunol Methods Exploiting the glioblastoma peptidome to discover novel tumour-associated antigens for immunotherapy. Brain Pt 4: Toll-like receptors 2 and 4 impair insulin-mediated brain activity by interleukin-6 and osteopontin and alter sleep architecture.
Identification of naturally processed hepatitis C virus-derived major histocompatibility complex class I ligands. PLoS One 7 1: Platelet-derived MHC class I confers a pseudonormal phenotype to cancer cells that subverts the antitumor reactivity of natural killer immune cells.
Cancer Res 72 2: Int J Cancer 1: Int J Cancer 7: Generation, selection and preclinical characterization of an Fc-optimized FLT3 antibody for the treatment of myeloid leukemia. Elevated serum levels of heat shock protein 70 can be detected after radiofrequency ablation. Cell Stress Chaperones 16 5: More than just tumor destruction: Nucleosome-induced neutrophil activation occurs independently of TLR9 and endosomal acidification: Implications for systemic lupus erythematosus.
Phagocytosis of dying tumor cells by human peritoneal mesothelial cells. Analysis of tumor antigen-specific T cells and antibodies in cancer patients treated with radiofrequency ablation. Immune evasion by Yersinia enterocolitica: CD ligand mediates opposite effects in human and mouse NK cells and impairs NK cell reactivity against human acute myeloid leukemia cells. Higher HLA class I expression in renal cell carcinoma than in autologous tissue.
Simultaneous infiltration of polyfunctional effector and suppressor T cells into renal cell carcinomas. Neurological symptoms in patients with biopsy proven celiac disease. Naturally presented peptides on major histocompatibility complex I and II molecules eluted from central nervous system of multiple sclerosis patients.
Insulin-mediated cortical activity in the slow frequency rang eis diminished in obese mice and promotes physical inactivity. NKp80 defines and stimulates a reactive subset of CD8 T cells. Inhibitors of indoleamine-2,3-dioxygenase for cancer therapy: They also summarized the clinical experience with ETTF, mainly in 2 indications: This combination resulted in an excellent median OS of This is an important finding because it can be assumed that in the same patient the higher tumor control within the tumor-treating fields TTFields area was a specific effect of TTFields.
Electric Tumor Treatment Fields
The side supra of ETTF were minimal and in general consisted of skin reaction to the electrodes. The authors said that there are are a number of ways in which ETTF could be further evaluated, for example, in combination with chemotherapy, as a maintenance treatment, or as a salvage prontuario nr if radiotherapy or surgery is not possible. The authors concluded that while more clinical data are clearly needed, tumor de supra renal, Tumor is an emerging renal promising novel treatment concept Pless and Weinberg, Disruption of cancer cell replication by alternating electric fields.
Alternating electric fields arrest cell proliferation in animal tumor models and human brain tumors. Chemotherapeutic treatment efficacy and sensitivity are increased by adjuvant alternating electric fields TTFields. Stupp R, Weller M. A prospective, randomized, open-label, phase III clinical trial of NovoTTFieldsA versus best standard of care chemotherapy in patients with recurrent glioblastoma.
Subgroup and quality of life analyses of the phase III clinical trial of NovoTTFieldsA versus best standard chemotherapy for recurrent glioblastoma. Pless M, Weinberg U. Concept, evidence and future. Expert Opin Investig Drugs. Summary of safety and effectiveness data SSED. FDA; April 8, Accessed November 18, FDA approves new medical device for form of brain cancer. FDA; April 15, Adult brain tumors treatment PDQ.
Central nervous system cancers. NovoTTFA versus physician's choice chemotherapy in recurrent glioblastoma: A randomised phase III trial of a novel treatment modality. Electric fields for the treatment of glioblastoma. Novocure; issued March 3, A new frontier in cancer therapy.
Ann N Y Acad Sci. Vymazal J, Wong ET. Response patterns of recurrent glioblastomas treated with tumor treating fields TTFields.
Endovascular Repair of Aortic Aneurysms
Alternating electric fields tumor treating fields therapy renal improve chemotherapy treatment efficacy in non-small cell lung cancer both in vitro and in supra. World J Surg Oncol. Elzinga G, Wong ET. Resolution of cystic enhancement to add-on tumor treating electric fields for recurrent link after incomplete response to bevacizumab.
Characterization and management of dermatologic adverse events with the NovoTTFA System, a novel anti-mitotic electric field device for the treatment of recurrent glioblastoma. Mitotic disruption and reduced clonogenicity of pancreatic cancer cells in vitro and in vivo by tumor treating fields. A roundtable discussion on the clinical challenges and options for the treatment of glioblastoma: Introducing a novel modality, TTFields. NHIC; August 1, Tumor treating field therapy in combination with bevacizumab for the treatment of recurrent glioblastoma.
FDA approves expanded indication for medical device to treat a form of brain cancer. Accessed October 6, FDA; October 5,