A previously well 53-year-old man with fulminant myocarditis is presented. Cardiogenic shock and medically refractory low cardiac output syndrome were unsuccessfully treated using an intraaortic balloon pump. A percutaneous extracorporeal bypass system improved hemodynamics, DIC and other multiorgan injuries following acute myocarditis.

Assisted Circulation↗

PubMedDate not supplied

Transient rapid growth of uterine leiomyoma in a postmenopausal woman.

We report a case of transient rapid growth of uterine leiomyoma in a postmenopausal woman. A 58-year old woman presented with a rapidly enlarging pelvic tumor, from a 14-week to a 20-week gestational size in the one month. Transcervical needle biopsy revealed a smooth muscle tumor with 5 mitotic figures per 10 high power fields. However, surgical specimen obtained 1 month later revealed less than 1 mitotic figure per 100 high power fields. This variation may influence the final histopathological diagnosis because mitotic index is believed to be one of the most reliable histopathological parameters for differentiating between uterine leiomyoma and leiomyosarcoma.

Cell Division↗

PubMedDate not supplied

Diagnostic accuracy of needle biopsy of uterine leiomyosarcoma.

We previously reported on the efficacy of transcervical needle biopsy of a uterine muscle tumor. In this study, to examine diagnostic accuracy of our needle biopsy with small specimen size, previous slide preparations were used from 8 cases diagnosed with leiomyosarcoma and from 24 post-operative leiomyoma cases. Each tissue specimen was examined through needle biopsy-sized slit that had been randomly positioned over the slide. Three predictors: mitotic index, cytologic atypism, and tumor cell necrosis were evaluated on a 3-point scale (0, 1, or 2 points). When the diagnostic cut-off value was set to two, the sensitivity was 92.5% and the specificity was 100%.

Biopsy, Needle↗

PubMedDate not supplied

Radiation pneumonitis following multi-field radiation therapy.

The mechanisms of radiation pneumonitis have not been established. In a study on multi-field radiation therapy for lung cancer, one patient developed severe radiation pneumonitis even though the target volume was small. Radiation therapy was performed at a dose of 75 Gy in 50 fractions over five weeks. High-density areas conforming to the radiation field were observed by high-resolution CT. They were observed in the irradiated volume at doses under 20 Gy in the contralateral lung as well as in the ipsilateral lung.

Aged↗

PubMedDate not supplied

Venography under fluoroscopic monitoring by digital subtraction angiography apparatus.

We developed a new digital subtraction angiography (DSA) technique for venography of the legs. Satisfactory venograms were obtained by recording the venous images on videotape with on-line fluoroscopic monitoring followed by enhancement of the images by an image processor.

Angiography, Digital Subtraction↗

PubMedDate not supplied

Iv-DSA as a screening study before conventional transarterial angiography.

Twenty patients with hepatic mass underwent IV-DSA by loversol. (1) IV-DSA revealed useful information about whether or not intra-arterial angiography could be performed quickly and safely, because IV-DSA revealed beforehand the degree of arteriosclerotic change and presence of aneurysm of the abdominal aorta and pelvic artery. (2) IV-DSA revealed the existence of complications due to transarterial angiography in the past. (3) IV-DSA should be performed as a mapping study before conventional angiography in the future. (4) Because IV-DSA was easily influenced by misregistration artifact due to bowel gas movement in the abdomen and pelvic portion, diagnosis should be made with care. (5) There was no occurrence of early or delayed side effects due to the new nonionic contrast medium Ioversol.

Adult↗

PubMedDate not supplied

Comparison of intra-arterial digital subtraction angiography with conventional angiography after transcatheter arterial embolization for hepatic malignancy.

Twenty patients with hepatic malignancy were treated with transcatheter arterial embolization (TAE) under examination by intra-arterial digital subtraction angiography (IA-DSA) and conventional angiography (CA). Comparison of these two angiographies revealed that the time required for confirmation of the embolized portion of the artery was about four-and-a-half times shorter with IA-DSA than CA. Moreover, IA-DSA revealed the obstructed portion more readily and accurately than CA. In particular, confirmation could not be made by CA in 35% of cases because of residual Gelform sponge containing contrast medium in the artery. The visualization of residual tumor stain after TAE was 40% better on IA-DSA than CA, because of residual Gelform sponge containing contrast medium and overlapping shadow with calcified costal cartilage, excretory pyelography, and original tumor stain. However, CA was better than IA-DSA in visualizing accidental obstruction of nonobjective arteries such as the cystic artery because of the poor spatial resolution and misregistration artifacts of IA-DSA. CA was better than IA-DSA in visualizing surrounding nonembolized hepatic parenchyma because of the misregistration artifacts of IA-DSA. For effective TAE without severe complication, we concluded that TAE for HCC should be performed under a combination of IA-DSA and CA.

Adult↗

PubMedDate not supplied

Clinical evaluation of serum alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels in patients with hepatocellular carcinoma following interventional radiology.

Fourteen patients with unrespectable HCC were treated with various interventional radiology (IVR) procedures. The initial therapeutic response was determined using computed tomography (CT) findings, and determinations of serum alpha-fetoprotein (AFP) and protein induced by Vitamin K absence or antagonist-II (PIVKA-II) levels. When CT studies of the initial response to IVR were compared with changes in the serum AFP and PIVKA-II levels, the AFP level was found to correlate more closely than the PIVKA-II levels. The PIVKA-II level correlated more closely than the AFP level in cases with poor response to IVR. Both of these tumor markers should be measured in combination with the diagnostic imagings for follow-up studies of IVR.

Biomarkers↗

PubMedDate not supplied

Intra-arterial digital subtraction portography with a blood-isotonic, non-ionic, dimeric contrast medium.

Intra-arterial digital subtraction portography (IA-DSP) with a blood-isotonic, non-ionic, dimeric contrast medium was carried out in 27 patients with hepatocellular carcinoma. It was possible to obtain images of excellent or good quality of the portal vein and its bilateral main branches in all patients. The third-order branches of the portal vein in the right lobe could be identified in all patients, and images of excellent or good quality were obtained in a mean of 80.2% of patients. Images of third-order branches in the left lobe were of lower quality than those of third-order branches in the right lobe; in particular, images obtained were of poor quality for 27.3% of the medial branches of the left lobe. It was impossible to identify the caudal branches in almost all patients. The side effects of IA-DSP, pain and sensations of heat were very mild: only one patient complained of mild pain, while 18 patients (69.2%) complained of no sensations of heat whatsoever.

Aged↗