Nonalcoholic, duct-destructive, mass-forming pancreatitis in a 28-year-old man was presented with endoscopic ultrasonographic (EUS) and endoscopic retrograde cholangiopancreatographic (ERCP) findings before and after corticoid therapy. Because this disease is often mistaken for a malignant tumor, EUS combined with ERCP may provide imaging characteristics useful for differentiation from malignant tumor, for early diagnosis, and for monitoring therapeutic effects.

Adult↗

PubMedDate not supplied

A large single crystal of poly(gamma-benzyl L-glutamate).

Explore the source record for details and available documents.

Crystallography↗

PubMedDate not supplied

Dynamic computed tomography during arterial portography: the most sensitive examination for small hepatocellular carcinomas.

The efficacy of dynamic sequential CT with table incrementation during arterial portography (DSCTI-AP) in the detection of small hepatocellular carcinomas (HCC) (less than 3 cm in diameter and less than three in number) was analyzed in comparison with other imaging methods including radionuclide (RN) liver scans, ultrasound (US), CT, selective celiac angiography (SCA), and infusion hepatic angiography (IHA). The sensitivity of each study in detecting 19 cases of small HCC was as follows: RN, 16%; US, 63%; CT, 58%; SCA, 58%; IHA, 83%; and DSCTI-AP, 95%. Three of 19 cases were diagnosed only by DSCTI-AP and one case that could not be visualized by DSCTI-AP was opacified by IHA. Dynamic sequential CT with table incrementation during arterial portography was superior to IHA in visualizing small HCCs.

Adult↗

PubMedDate not supplied

Muscle pathology in polymyalgia rheumatica: histochemical and immunohistochemical study.

Immunohistochemical studies were performed on muscle biopsy specimens of polymyalgia rheumatica (PMR) to evaluate the extent of muscle and peripheral nerve involvement. The routine histochemistry revealed a mild variation of fiber size, type 2 fiber atrophy and type 2A or 2B fiber deficiency. In 63% of the PMR cases small angular fibers, pyknotic nuclear clumps or target-targetoid fibers were observed, suggesting neurogenic changes, although abnormalities were mild in degree. In immunocytochemical studies, neither major histocompatibility complex (MHC) class 1 nor class 2 products were expressed on the muscle surface membrane of PMR. But regarding intramuscular vessels, MHC class 2 products were distinctly visualized. On serial sections, combined deposits of IgG and Clq in perimysial arteries were seen in 38% of PMR. These results suggest that arteries of small caliber might be involved in immunopathological processes, causing muscle and peripheral nerve damage.

Aged↗

PubMedDate not supplied

Left hepatic trisegmentectomy for intraductal papillary cholangiocarcinoma: report of a case.

We present a rare case of intraductal papillary cholangiocarcinoma in a 69 year-old man which was treated with left hepatic trisegmentectomy. The hepatic bile ducts were dilated by intraductal masses, which had extended into the intrahepatic bile ducts without involvement of the posterior inferior segmental duct (B6). The patient underwent left hepatic trisegmentectomy with hilar duct resection. The tumors in the posterior superior segmental duct (B7) were resected and biliary reconstruction was performed with a jejunal loop. Post-operative recovery was good, and the patient survived for 7 months after surgery.

Aged↗

PubMedDate not supplied

Fluid-attenuated inversion recovery intraarterial signal: an early sign of hyperacute cerebral ischemia.

BACKGROUND AND PURPOSE: Early detection of arterial occlusion and perfusion abnormality is necessary for effective therapy of hyperacute cerebral ischemia. We attempted to assess the utility of the fast fluid-attenuated inversion recovery (fast-FLAIR) sequence in detecting occluded arteries as high signal (referred to as intraarterial signal) and to establish the role of fast-FLAIR in detecting ischemic penumbra of hyperacute stroke within 24 hours after ictus. METHODS: We studied 60 patients with hyperacute cerebral ischemia caused by occlusion of intracranial major arteries. We compared intraarterial signal on FLAIR images with time of flight (TOF) on MR angiograms, flow voids on T2-weighted images, hyperintense lesions on diffusion-weighted images, and results of follow-up CT or MR scans. RESULTS: In 58 (96.7%) patients, FLAIR detected intraarterial signals as early as 35 minutes after stroke onset. In 48 (80.0%) patients, intraarterial signal on FLAIR images coincided with lack of TOF on MR angiograms. In 41 (74.5%) of 55 patients, the intraarterial signals of fast T2-weighted imaging depicted occlusion better than did deficient flow void on T2-weighted images. In 25 (41.7%) of 60 patients, the area of intraarterial signal distribution was larger than the hyperintense lesion measured on diffusion-weighted images. Areas of final infarction had sizes between those of intraarterial signal distribution on FLAIR images and lesions measured on diffusion-weighted images. In 35 (87.5%) of 40 patients, areas of intraarterial signal distribution were equal to regions of abnormal perfusion. CONCLUSION: Intraarterial signal on FLAIR images is an early sign of occlusion of major arteries. FLAIR combined with diffusion-weighted imaging can be helpful to predict an area at risk for infarction (ischemic penumbra). FLAIR plays an important role for determining whether a patient should undergo perfusion study.

Acute Disease↗

PubMedDate not supplied

Numerical aberrations of chromosome 17 detected by FISH with DNA-specific probe in oral tumors.

Numerical aberrations of chromosomes were investigated in oral tumors by using fluorescence in situ hybridization (F1SH) with 4 chromosome centromere-specific DNA probes. The hybridization signals of the centromere sequence were easily detected and counted within interphase nuclei as well as metaphase chromosomes. The number of hybridized signals for chromosome 17 significantly increased in oral malignant tumors compared to benign tumors, which had two spots as well as normal lymphocytes. Cell lines derived from oral squamous cell carcinoma also showed numerical aberrations of chromosomes 1, 4 and 11, in addition to chromosome 17. These findings suggested that numerical aberrations of chromosomes occur during the development of malignant tumors of the oral cavity.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Hepatic granuloma with progressive calcification: CT appearance.

Calcification in the liver is uncommon but not rare in clinical practice, and may be caused by many pathological conditions. We report a patient with hepatic mass on abdominal sonogram and CT scan. The mass was shown as a hypoechoic lesion on abdominal sonogram and as a well-marginated hypodense mass on pre- and postcontrast CT. Inflammatory granuloma was diagnosed by pathological examination following percutaneous needle biopsy. A follow-up precontrast CT scan was performed 22 months after the initial examination, and the hepatic granuloma could be the cause of hepatic parenchymal calcification.

Adult↗

PubMedDate not supplied

MR angiography of ruptured aneurysms in acute subarachnoid hemorrhage.

PURPOSE: To determine the efficacy of high-resolution MR angiography for the prospective diagnosis of ruptured aneurysms in acute subarachnoid hemorrhage. METHODS: We used 3-D time-of-flight MR angiography with a large image matrix (193 x 512 frequency-encoding steps), magnetization transfer saturation, and a variable flip-angle excitation (tilted optimized nonsaturating excitation [TONE]) to study 28 patients with acute subarachnoid hemorrhage. The MR angiograms were compared with intraarterial digital subtraction angiographic (IA-DSA) images. RESULTS: Thirty-five (90%) of 39 aneurysms were detected prospectively with MR angiography. At least one aneurysm was identified with MR angiography in 25 (96%) of 26 patients with aneurysms proved by IA-DSA. Although four aneurysms were missed prospectively, three of these were detected retrospectively with MR angiography. Six aneurysms (18%) of those evident on MR angiograms were 3 mm or less in diameter. In one patient, additional targeted maximum intensity projections were greatly helpful for the ensuing IA-DSA by determining the optimial projection angle by which to depict a ruptured aneurysm that neither routine MR angiography nor routine IA-DSA detected. CONCLUSION: High-resolution MR angiography may be a useful diagnostic technique for detecting ruptured aneurysms, even in patients with acute subarachnoid hemorrhage. Initial MR angiography offers valuable and reliable information on ruptured aneurysms in acute subarachnoid hemorrhage, allowing the optimization of projection angles at conventional angiography.

Adolescent↗