We examined the correlations between changes in serum protein fractions and the prognosis of the patients. The levels of 21 protein components of the sera of 36 patients with maxillary sinus cancer were determined by a single radial immunodiffusion method before and after radiation therapy. The patients with maxillary sinus cancer were treated with combined intra-arterial infusion of bleomycin and external irradiation of 60 Co gamma-rays, and were concurrently treated with 5-fluorouracil at 200 mg/day p.o. The levels of the same protein components were also measured in 34 normal adult as a control. All patients were observed 5 years and 12 years after radiation therapy. In patients who had survived at least 5 years after radiation therapy, the Alb, Tf, Hx, IgG and IgM levels measured before radiation therapy were elevated significantly compared with those who had died within 5 years. In those who had survived at least 5 years, the Alb, Tf, Hx, IgG, IgM, IgA and I alpha I levels measured after radiation therapy were elevated significantly compared with those who had died within 5 years, and AT III was reduced. In cases of maxillary sinus cancer following a period of 5 to 12 years after radiation therapy, multiple regression analysis was used to determine whether increased concentrations of serum protein fractions were associated with good prognosis for the original disease, alpha 2HS. IgM, HX, alpha 1AT and alpha 1X before radiation therapy were positively correlated with survival, whereas AT III, Pmg, Cp, IgA, and alpha 1AG showed negative correlations. After radiation therapy, Pmg, Hx, Cp, Cl inh and Fib were found to be positive factors of survival rate, whereas alpha 2M, alpha 2Pl, I alpha 1, IgA, alpha 1AG and C3 were negative factors.
The levels of 23 protein components of the sera of 84 patients with uterine cervical cancer undergoing radiotherapy were determined by a single radial immunodiffusion method, before radiation therapy, after whole pelvic irradiation, and after intracavitary irradiation using a remote after roading system (RALS). We examined the correlations between changes in serum protein fractions and the prognosis of the patients. The patients with uterine cervical cancer were treated with combined external irradiation of 60Co gamma-rays or 10 MV X-rays, and RALS therapy. The levels of the same protein components were also measured in 21 normal adult women as a control. All patients were observed between 4 years and 8 years after radiation therapy. In the pretreatment sera obtained from patients with uterine cervical cancer, the concentrations of prealbumin (Prealb), alpha 2HS glycoprotein (alpha 2 HS), alpha 2-plasmin inhibitor (alpha 2PI), transferrin (Tf), plasminogen (Pmg), albumin (Alb), IgM and hemopexin (Hx) were significantly lower than those normal controls. However the serum concentrations of: alpha 1-antichymotrypsin (alpha 1 X), haptoglobin (Hp), C9, fibrinogen (Fib), ceruloplasmin (Cp), alpha 1-acid glycoprotein (alpha 1AG), alpha 1-antitrypsin (alpha 1AT) and C4 were elevated. At the completion of whole pelvic irradiation and RALS therapy, the Hp, C4, and Fib levels were significantly lower than those before radiation therapy, whereas Prealb, alpha 2HS and alpha 2PI were elevated. In patients who had lived between 4 years and 8 years after radiation therapy, the Cp, alpha 1 AG, Hp and C9 levels measured before radiation therapy were reduced significantly, while Tf was elevated compared with patients who died within 4 years. In those who had lived more than 4 years, the alpha 1 AT, Hp, alpha 1X, Cp and C9 levels measured after whole pelvic irradiation were reduced significantly; while the C4 level was elevated. In cases of uterine cervical cancer followed for a period of 4 to 8 years after radiation therapy, multiple regression analysis was used to determine whether increased concentrations of serum protein fractions were associated with good prognosis for the original disease. Tf, Pmg, and alpha 1AT before radiation therapy were positively correlated with survival, whereas AT III, Cp, C1Inh, IgA, alpha 1 AG and C9 showed negative correlations. After whole pelvic irradiation,Pmg, C4 Prealb, Alb,alpha 2M and Hp were found to be positively associated with survival, whereas Tf, alpha 2PI, AT III, alpha 1 AT,C1Inh, C9 and IgA were negative factors.
The case of a 40-year-old woman with a mature cystic teratoma in the lateral ventricle is reported. An unusual mobile sediment of radiopaque material in the cyst was identified as grains of calcium carbonate. It was considered to have precipitated from the cystic fluid under specific chemical conditions.
Elective embolotherapy for recurrent hemoptysis was evaluated for its effectiveness. Forty embolotherapeutic procedures were performed in 30 patients. In the short term, complete hemostasis was achieved in 16 of 40 procedures (40%) and significant improvement in another 16 procedures (40%). Long-term, complete hemostasis was achieved in 14 of 34 procedures (41%) and significant improvement in 12 (35%). Embolotherapy was consistently more effective in patients who had no pleural abnormalities compared with those with pleural thickening. Long-term complete hemostasis was achieved in 7 of 10 procedures (70%) for the patients without pleural thickening and only 7 of 24 (29%) in patients with pleural thickening. Thus, pleural abnormalities negatively influence long-term effectiveness of embolotherapy.
Magnetic resonance imaging of 28 patients with radiological and/or histopathologically proved ossification of the ligamentum flavum (OLF) was reviewed. The locations of OLF were cervical (n = 4), thoracic (n = 22), and lumbar (n = 2). On T1- and T2-weighted images, OLF demonstrated low signal intensity. Areas of high or intermediate signal intensity within the OLF on T1-weighted images were observed in three cases and were interpreted to be due to fat infiltration. In six cases, high intensity areas in the spinal cord caused by compressing OLF were demonstrated on T2-weighted images. Gadolinium-diethylenetriamine pentaacetic acid, which was used in four cases, showed cord enhancement at the level of compression by OLF in three cases.
The magnetic resonance imaging (MRI) features of sponges retained postsurgically in three patients are described. MRI depicted these as well-defined round masses, which were of low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. We scrutinized these masses on T2-weighted images. MRI revealed the low-signal-intensity structures to have wavy, striped, and/or spotted appearances, which raised the suspicion that they might be retained surgical sponges within mass lesions.
Right anterior caudocranial oblique (RACCO) projections were evaluated for transarterial portography with digital subtraction angiography. For RACCO projection, the image intensifier was tilted 25° caudally and 30° to the patient's right with the patient in the supine position. The abnormal findings imaged in 20 patients were analyzed by types of abnormalities and their locations in the portal venous systems by comparing RACCO and PA projections. The RACCO view was superior to the PA projection for demonstrating either encasements or tumor thrombi in relatively proximal segments of the portal venous branches. Two encasement lesions and a tumor thrombus were imaged only on the RACCO projection. However, the RACCO projection had no definite advantage over the PA view for showing encasements or tumor thrombi in the distal segmental branches. The RACCO projection was superior to the PA view for demonstrating defects in the hepatograms of some hepatic segments (S5 and S8). We concluded that the RACCO view is extremely useful and is indicated for angiographic work-ups of hepatic or biliary lesions when abnormalities are suspected in proximal portal venous branches.
Chronic pancreatitis is known to cause vascular disorders including pseudoaneurysm of peripancreatic arteries. Although the incidence of pseudoaneurysms due to pancreatitis detected by angiography has been reported as high as 10% in western literature, they are still considered rare in Japan. We reported two cases of pseudoaneurysm caused by chronic pancreatitis, one in splenic artery and the other in gastroduodenal artery, successfully treated by embolization. The embolizations were performed by occluding proximal splenic artery for splenic arterial aneurysm and gastroduodenal artery distal and proximal to the orifice for the aneurysm of gastroduodenal artery with stainless steel coils. Since the surgical therapy has high mortality rate, we consider transcatheter embolization is the treatment of choice for pseudoaneurysms caused by chronic pancreatitis.
The right caudocranial oblique (RACCO) view which is obtained by tilting the image intensifier 25 degrees caudally and 30 degrees to the right while the patients lie in supine position is proposed for improved depiction of the portal venous system. Transarterial portography with digital subtraction angiography was performed in the RACCO and posteroanterior (PA) views in 32 patients. Comparison of the two views revealed that the RACCO view was superior to the PA view of the left main branch in 25 patients (78%) and of the right posterior lobe branch in 24 (75%) patients. Visibility of more distal portal branches, however, did not always improve by RACCO view. RACCO view will be useful for the evaluation of portal systems of primary and secondary hepatic neoplasms as a special view following portogram in PA projection when more detailed information is necessary on proximal portal branches.
To analyze the CT findings of OPLL quantitatively, stenotic rate (thickness of OPLL/A-P diameter of the spinal canal) and occupying rate (area occupied by OPLL/area of spinal canal) were correlated with severity of the myelopathy. The cervical vertebrae were most frequently involved (88.9%). The shapes of OPPL on lateral plain radiography were various but there were slightly more continuous and mixed types than segmented or protrusion types in this series. When the occupying rate exceeded 20%, myelopathy tended to appear. And when the stenotic rate became over 30%, myelopathy tended to appear. There was statistically significant tendency that the higher the stenotic rate or patient had. Therefore we concluded the stenotic rate and occupying rate were useful indicators to evaluate the severity of OPLL.
Uptake of Tc-99m Hexamethylpropylene-amine Oxine (HM-PAO) was seen in bone metastases from carcinoma of the lung. The uptake was prominent when compared to Tc-99m MDP, 1-123 IMP, and Ga-67citrate. Brain imaging with Tc-99m HM-PAO and N-isopropyl-p-[l-123] iodoamphetamine (IMP) is now frequently performed. Uptake of these agents has been reported in brain tumors and melanomas. In this report, uptake of Tc-99m HM-PAO in a metastatic lesion in bone is discussed.