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Review : Fluoroscopic Management of Complications after Colorectal Stent Placement
( Jorge E Lopera ),( Miguel Angel De Gregorio ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.s1
Colorectal self-expanding metal stents have been widely used as a bridge to surgery in patients with acute malignant colonic obstruction by allowing a single- stage operation, or as a definitive palliative procedure in patients with inoperable tumors. Colonic stents are placed under either fluoroscopic or combined endoscopic and fluoroscopic guidance, with similar technical- success and complication rates. Placement of colonic stents is a very safe procedure with a low procedure-related mortality rate, but serious complications can develop and reinterventions are not uncommon. Most of the complications can be treated by minimally invasive or conservative techniques, while surgical interventions are required for most patients with perforation. (Gut Liver 2010;4(Suppl. 1):S9-18)
Lopera Alex A.,Bezzon Vinicius D. N.,Ospina Victoria,Higuita-Castro Jorge L.,Ramirez Francisco J.,Ferraz Humberto G.,Orlando Marcos T. A.,Paucar Carlos G.,Robledo Sara M.,Garcia Claudia P. 한국세라믹학회 2023 한국세라믹학회지 Vol.60 No.1
Many efforts in the tissue engineering field have been devoted to producing biomedical devices with several physico-chemical properties that could promote an increase in the quality of therapeutic treatments. Thus, 3D printing is an efficient method which facilitates manufacturing high quality products to be used as medical devices. However, high-performance materials are required for obtaining products that are able to be 3D printed to attend the biomedical concerns. In this work, fused PLA-calcium phosphate-tobramycin-based filaments with antimicrobial properties were produced. X-ray powder diffraction, Fourier transform infrared spectroscopy and thermal analysis were performed to characterize the pure compounds as well as the composite filaments, revealing that the drug is preserved into the filaments by the implemented methodology, even after the hot extrusion procedure. The filaments and the printed pieces presented great antimicrobial effect and a controlled-release profile was also observed by the drug-release assays for the filaments produced, thereby indicating this material as a promising candidate to be used for implantable medical devices in the future.
Sánchez Jorge,Sánchez Andres,Munera Marlon,Garcia Elizabeth,Lopez Juan-Felipe,Velásquez-Lopera Margarita,Cardona Ricardo 대한천식알레르기학회 2021 Allergy, Asthma & Immunology Research Vol.13 No.5
Purpose: Eosinophils are frequently found in atopic dermatitis (AD) and chronic spontaneous urticaria (CSU) that release eosinophil peroxidase (EPX) and eosinophil cationic protein (ECP). Continuous exposure to these proteins could trigger an autoimmune response which may contribute to the pathogenesis and severity of skin inflammation. In this study, we investigate the immunoglobulin E (IgE) response against eosinophil proteins in CSU and AD. Methods: We recruited patients with severe AD, severe CSU and healthy subjects to explore the presence of IgE autoantibodies and cross-reactivity against EPX, ECP and thyroid peroxidase (TPO). The potential cross-reactive epitopes among the peroxidase family were determined using in silico tools. Results: The frequencies of anti-EPX IgE (28.8%) and anti-ECP IgE (26.6%) were higher in the AD group, and anti-TPO IgE was higher in the CSU group (27.2%). In the CSU group, there was a correlation between the anti-EPX IgE and anti-TPO IgE levels (r = 0.542, P < 0.001); TPO inhibited 42% of IgE binding to EPX, while EPX inhibited 59% of IgE binding to TPO, suggesting a cross-reactivity with EPX as a primary sensitizer. There was greater inhibition when we used a pool of sera CSU and AD, TPO inhibited 52% of IgE binding to EPX, while EPX inhibited 78% of IgE binding to TPO. In silico analysis showed a possible shared epitope in the peroxidase protein family. Conclusions: IgE against eosinophil proteins may contribute to chronic inflammation in patients with AD and CSU. Cross-reactivity between EPX and TPO could explain thyroid problems in CSU patients.
Jesus Beltran-Perez,Gregory Ramsey,Jorge E. Lopera 소화기인터벤션의학회 2019 International journal of gastrointestinal interven Vol.8 No.2
This case report shows an effective esophageal stent placement via retrograde (transgastric) approach under fluoroscopic guidance in the interven-tional radiology suite. This alternative can be evaluated and offered to patients that suffer from a firm esophageal occlusion before a major proce-dure such as surgery can be considered. Thus, decreasing major surgery complications and improving the quality of life.
Jesus Beltran-Perez,Gregory Ramsey,Jorge E. Lopera 소화기인터벤션의학회 2019 Gastrointestinal Intervention Vol.8 No.2
This case report shows an effective esophageal stent placement via retrograde (transgastric) approach under fluoroscopic guidance in the interven-tional radiology suite. This alternative can be evaluated and offered to patients that suffer from a firm esophageal occlusion before a major proce-dure such as surgery can be considered. Thus, decreasing major surgery complications and improving the quality of life.
Partha Mandal,Barrett P. O’Donnell,Eric Reuben Smith,Osamah Al-Bayati,Adam Khalil,Serena Jen,Mario Vela,Jorge Lopera 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.1
Background: This study investigated the incidence and clinical outcomes of portal and hepatic vein thrombosis (VT) on imaging after transjugular intrahepatic portosystemic shunt (TIPS). Methods: A retrospective review of records at a single liver transplant center between 2010 and 2018 revealed 423 patients who underwent TIPS. Contrast-enhanced computed tomography and magnetic resonance images within 1 year post-TIPS were available for 138 patients and compared to assess the imaging findings of VT and liver infarction. The associations of VT with overall survival, patient characteristics, stent size, pre- and post- TIPS Model for End-Stage Liver Disease (MELD) scores, and post-TIPS hepatic encephalopathy at 90 days were analyzed. Results: The prevalence of VT on imaging within 1 year was 63.0% (n = 87). VT within the right portal vein was more common: 41 cases were in the right portal vein, 25 in the posterior portal vein, and two in the anterior right portal vein. Ten patients had VT in the left portal vein. Four had VT in the main portal vein (MPV), and one had shunt thrombosis extending into the superior mesenteric vein. Hepatic VT was seen in the right hepatic vein in 17 patients and in the middle hepatic vein in six patients. VT was associated with liver infarction (n = 9, P = 0.018). There was no relationship between VT and sex, age, cirrhosis etiology, indication for TIPS, stent size, or hepatic encephalopathy at 90 days. VT in the MPV had poorer survival (P < 0.001). Older age (P = 0.028) and higher pre-TIPS MELD score (P = 0.049) were poor prognostic factors. VT was not treated. Conclusion: Portal and hepatic VTs were common imaging findings after TIPS without worsened clinical outcomes unless VT involved the MPV. VT may cause liver infarction, but infarcts were not independently associated with poorer survival.
Partha Mandal,Barrett P. O’Donnell,Eric Reuben Smith,Osamah Al-Bayati,Adam Khalil,Serena Jen,Mario Vela,Jorge Lopera 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.1
Background: This study investigated the incidence and clinical outcomes of portal and hepatic vein thrombosis (VT) on imaging after transjugular intrahepatic portosystemic shunt (TIPS). Methods: A retrospective review of records at a single liver transplant center between 2010 and 2018 revealed 423 patients who underwent TIPS. Contrast-enhanced computed tomography and magnetic resonance images within 1 year post-TIPS were available for 138 patients and compared to assess the imaging findings of VT and liver infarction. The associations of VT with overall survival, patient characteristics, stent size, pre- and post- TIPS Model for End-Stage Liver Disease (MELD) scores, and post-TIPS hepatic encephalopathy at 90 days were analyzed. Results: The prevalence of VT on imaging within 1 year was 63.0% (n = 87). VT within the right portal vein was more common: 41 cases were in the right portal vein, 25 in the posterior portal vein, and two in the anterior right portal vein. Ten patients had VT in the left portal vein. Four had VT in the main portal vein (MPV), and one had shunt thrombosis extending into the superior mesenteric vein. Hepatic VT was seen in the right hepatic vein in 17 patients and in the middle hepatic vein in six patients. VT was associated with liver infarction (n = 9, P = 0.018). There was no relationship between VT and sex, age, cirrhosis etiology, indication for TIPS, stent size, or hepatic encephalopathy at 90 days. VT in the MPV had poorer survival (P < 0.001). Older age (P = 0.028) and higher pre-TIPS MELD score (P = 0.049) were poor prognostic factors. VT was not treated. Conclusion: Portal and hepatic VTs were common imaging findings after TIPS without worsened clinical outcomes unless VT involved the MPV. VT may cause liver infarction, but infarcts were not independently associated with poorer survival.