A 71-year-old male suffering from an intraductal papillary tumor of the pancreas was admitted to our hospital for further investigation. Diagnostic trials, including endoscopic retrograde pancreatography, did not produce an adequate ductography because of a large amount of mucinous fluid. Therefore, we performed endoscopic ultrasonographic-guided punctured pancreatic ductography (EPPD). This procedure was safely performed without any complications. We report this initial and successful trial of EPPD.

Aged↗

PubMedDate not supplied

Ovarian fibroma of high signal intensity on T2-weighted MR image.

It has been reported that ovarian fibromas display low signal intensity on both T1- and T2-weighted magnetic resonance images. We report an ovarian fibroma exhibiting low signal intensity on a T1-weighted image and high signal intensity on a T2-weighted image. Microscopically pronounced myxomatous changes were shown in the fibroma. The signal intensity of ovarian fibromas differs with the degree of myxomatous change.

Cell Transformation, Neoplastic↗

PubMedDate not supplied

Peritoneal serous papillary carcinoma: radiological appearance.

BACKGROUND: The radiological appearance of peritoneal serous papillary carcinoma (PSPC) is described. METHODS: Three cases of PSPC were analyzed retrospectively with regard to the radiological appearance and histopathological features. RESULTS: All three patients were women, aged 44-71 years. Massive ascites and a greater omentum tumor were observed on computed tomography in all patients. Double-contrast enema performed in one patient showed irregularity on the upper aspect of the transverse colon. Radiological examinations excluded primary tumors in both gastrointestinal and genital organs in all patients. Histological diagnosis was made from the surgical specimen in two patients and from an autopsy specimen in one patient. All patients had a large omental tumor involving the transverse colon, but the ovaries were not involved or only minimally involved on the surface. Serum CA125 was markedly elevated, and immunohistochemical staining for CA125 was positive within the tumor cell cytoplasm in all three patients. CONCLUSION: PSPC cannot be diagnosed from radiological findings alone because of its similarity to metastatic peritoneal carcinomatosis and peritoneal mesothelioma. Marked elevation of serum CA125 may help with PSPC diagnosis. Response to treatment is promising, and exploratory laparotomy is thus justified when a patient shows characteristic radiological findings and high CA125 level.

Adult↗

PubMedDate not supplied

Renal cell carcinoma: preoperative assessment for enucleative surgery with angiography, CT, and MRI.

PURPOSE: Our purpose was to assess various imaging methods in detecting a pseudocapsule of renal cell carcinoma (RCC), which is critical for successful tumor enucleation. METHOD: In 42 patients with histopathologically proven RCC, images obtained at angiography (n = 42), CT (n = 30), and MRI (n = 19) were investigated retrospectively. All patients underwent treatment (enucleation: n = 15; nephrectomy: n = 27). The imaging criteria for the presence of a pseudocapsule were as follows: a surrounding radiolucent rim on angiography, a low or high density rim on CT, and a low intensity rim on MRI. All images were retrospectively reviewed by three radiologists without knowledge of the clinical and histological findings. RESULTS: Thirty-three of 42 RCCs showed a pseudocapsule on the surgical specimen. A pseudocapsule was detected in 67% of tumors (22/33) on angiography, 26% (6/23) on CT, 27% (4/15) on T1-weighted MRI, 93% (14/15) on T2-weighted MRI, 67% (8/12) on dynamic enhanced T1-weighted MRI, and 15% (2/13) on delayed enhanced T1-weighted MRI. CONCLUSION: T2-weighted MR images are superior for visualizing a pseudocapsule of RCC and for providing reliable selection criteria for tumor enucleation.

Adult↗

PubMedDate not supplied

Gallium-67 scanning in patients with malignant pleural mesothelioma.

The findings of Gallium-67 scans in eleven patients with malignant pleural mesothelioma were reviewed and compared to those of chest CT findings. All patients had an abnormal thoracic Ga-67 accumulation. Six out of 11 showed a diffuse accumulation over the entire involved hemithorax and a localized uptake was shown in 5. A marked diffuse thickening of pleura in the absence of adequate gallium accumulation was observed in one patient. Two out of 11 had a reduction of gallium uptake after having combination chemotherapy. These results suggest that a diffusely increased uptake over the entire involved hemithorax is the most characteristic finding of Ga-67 scan in malignant pleural mesothelioma, and that Ga-67 scans may be helpful as a valuable indicator of the proper therapy. However, the superiority of Ga-67 scan to thoracic CT as a means of determining the extent of disease process could not be verified.

Aclarubicin↗

PubMedDate not supplied

A case of rheumatoid arthritis which developed after recovery from adult respiratory distress syndrome.

A 53-year-old previously healthy woman suddenly developed adult respiratory distress syndrome (ARDS) of unknown etiology. High-dose corticosteroid pulse therapy and artificial ventilation were started immediately and she dramatically responded to the treatment. However, soon after recovery from ARDS, she developed typical rheumatoid arthritis (RA). Although no apparent relationship between RA and ARDS was clear, this case is quite suggestive in the consideration of the etiology of ARDS.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Recurrent Pneumocystis carinii pneumonia with long interval showing disparate radiographic findings.

A case of recurrent Pneumocystis carinii pneumonia with a long interval between episodes and each episode showing a different radiographic appearance is reported. The radiographic finding in the initial infectious episode was bilateral, patchy, alveolar infiltrate predominantly in the upper and middle lung zones and that in the second infectious episode, six and a half years later, showed bilateral interstitial infiltrate predominantly in the middle and lower lung zones. T cell immunity expressed by mitogen-induced T cell proliferation was clearly different in the two infectious episodes. These differences in radiographic appearance could be due, at least in part, to altered immunological states between the first and second infectious episodes.

Adult↗

PubMedDate not supplied

A case of xanthinuria: a study on the metabolism of pyrazinamide and allopurinol.

A 74-year-old female was diagnosed as having xanthinuria by measurement of the uric acid level in plasma, purine bases in urine and activity of xanthine oxidase in the duodenal mucosa. The determination of the urinary excretion of purine bases in her family demonstrated a slightly increased urinary excretion of oxypurines in her younger brother, suggesting that he was a heterozygote. The pyrazinamide-loading test and allopurinol-loading test demonstrated that she could neither metabolize pyrazinoic acid into 5-hydroxypyrazinoic acid nor allopurinol into oxypurinol, although there was a slight metabolizing of prazinamide into 5-hydroxypyrazinamide. This suggested that she belonged to the subgroup which can neither metabolize pyrazinamide into 5-hydroxypyrazinamide, pyrazinoic acid into 5-hydroxypyrazinoic acid nor allopurinol into oxypurinol.

Aged↗

PubMedDate not supplied

Effects of quinolinone derivative, vesnarinone, in combination with irradiation on human lung cancer cell lines.

The quinolinone derivative, vesnarinone, is a novel inotropic agent used in the treatment of heart failure. It has also been found that vesnarinone has a potential anti-cancer activity. To evaluate the anti-cancer activity of vesnarinone in combination with irradiation, we investigated the cytostatic and cytotoxic effects on human lung cancer cell lines (PC-9 and Lu 134A) using MTT assay and isobologram analysis. We also analyzed the nuclear fragmentation of tumor cells by flow cytometric analysis. Our study demonstrated that combination of vesnarinone with irradiation had an additive inhibitory effect on both PC-9 and Lu 134A tumor cell growth. Vesnarinone could improve the sensitivity of tumor cells to irradiation and thus the dose of irradiation could be reduced to half without decreased inhibitory effect. Significant increase of the tumor cell nuclear fragmentation was observed with combination of vesnarinone and irradiation. These results indicate that vesnarinone not only directly inhibited tumor cell growth, but also improved the sensitivity to irradiation. Combination of vesnarinone with irradiation may be an efficacious protocol for lung cancer treatment. The inhibitory effect was ascribed to inducing tumor cell apoptosis.

Adenocarcinoma↗