Successful operation for hepatic tumor extending to the inferior vena cava (IVC) depends heavily on accurate preoperative imaging. We investigate the diagnostic value of intracaval endovascular ultrasonography (US) in the diagnosis of invasion to the IVC. A retrospective study of 26 consecutive patients of hepatic tumor with possible invasion of the IVC was performed using conventional imaging techniques from the right femoral vein with an 8-French, 20-MHz intravascular US. Nineteen of 26 cases were operated on and 15 cases were resected, including three cases of combined resection of the IVC. The sonographic criterion for IVC invasion was obliteration of a single echogenic layer of the IVC wall or intracaval tumor mass. The results of intracaval endovascular US were compared with those of CT and cavography. Vascular invasion was obtained in seven of 26 cases. Vascular invasion was confirmed by pathologic examination of five resected specimens, including two autopsy and two operative findings. The sensitivity, specificity, and overall accuracy of intracaval endovascular US for the diagnosis of the IVC invasion were 100%, 94.7%, and 96.1%, respectively. The values were 85.7%, 63.2%, and 69.2% for CT and 71.4%, 68.4%, and 69.2% for cavography, respectively. The intracaval endovascular US clearly visualized the IVC and established the presence and extent of tumor invasion. Intracaval endovascular US is a useful technique that can precisely evaluate the IVC for possible hepatic tumor invasion, especially when presence or extent of vascular invasion is not definitely established by conventional imaging techniques.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Esophageal squamous cell carcinoma: pathology and prognosis.

Between 1985 and 1992 a total of 403 patients with resected thoracic esophageal squamous cell carcinoma were evaluated histopathologically, and various pathologic findings related to survival were examined. Concerning depth of tumor invasion, 8 (2%) cases were pTis, 110 (27%) were pT1, 48 (12%) were pT2, 202 (50%) were pT3, and 35 (9%) were pT4. Lymphatic invasion was detected in 299 cases (74%), blood vessel invasion in 200 cases (49%), intramural metastasis in 45 (11%), and lymph node metastasis in 232 (58%). In pT1 carcinoma cases, 4% of mucosal carcinomas and 30% of submucosal carcinomas had lymph node metastasis. Tumors with deeper invasion had a higher incidence of lymph node metastasis: 74% of pT3 carcinomas and 83% of pT4 carcinomas. The sites of lymph node metastasis were divided into mediastinal, cervical, and abdominal fields; and rates of lymph node metastasis were 49%, 14%, and 41%, respectively. In all resected cases, the operative mortality rate was 3.2%, and the overall 5-year survival rate was 44.8%. The 5-year survival rate of patients with curative resection (R0 and R1) was 49.5%, whereas patients with palliative resection (R2) did not survive more than 3 years. There was no significant difference in survival relative to tumor location. In curatively resected cases, the significant prognostic factors by multivariate analysis were pT category, vascular invasion, lymph node metastasis, and intramural metastasis. Prognosis of lymph node-positive cases did not depend on the positive node site. Patients with only one positive node had a better prognosis, and those with six or more positive nodes had a poor prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Efficacy of gastric blood supply redistribution by transarterial embolization: preoperative procedure to prevent postoperative anastomotic leaks following esophagoplasty for esophageal carcinoma.

PURPOSE: The aim of this study was to evaluate the effect of preoperative redistribution of gastric blood supply on the prevention of anastomotic leakage following surgical reconstruction of the esophagus. METHODS: In 37 patients with esophageal carcinoma, transarterial embolization (TAE) of the left gastric, right gastric, and splenic arteries was preoperatively performed with coils so that gastric blood supply was dependent only on the right gastroepiploic artery. RESULTS: In 34 of 37 patients, preoperative redistribution was successfully performed. The gastric tissue blood flow (TBF) of a gastric tube was higher than in 12 nonredistributed patients. Reduction in the gastric TBF during preparation of a gastric tube was 27.5% in successful patients, in contrast to 68.9% in 12 nonredistributed patients (p < 0.005). CONCLUSION: Preoperative redistribution by TAE reduced the drop in gastric TBF during preparation of a gastric tube and helped prevent postoperative anastomotic leakage in esophageal reconstruction.

Adult↗

PubMedDate not supplied

Antiretroviral activities of anthraquinones and their inhibitory effects on reverse transcriptase.

Alizarin complexone (AC), alizarin Red S (ARS) and various other anthraquinones were evaluated for their inhibitory effects on Rous-associated virus 2 reverse transcriptase (RAV-2 RT). Some 1,2-dihydroxyanthraquinones were active against this enzyme and AC was the most potent inhibitor among these compounds [50% inhibitory concentration (IC50): 3.8 micrograms/ml]. AC slightly inhibited Rous sarcoma virus RT (RSV RT) and human immunodeficiency virus type 1 RT (HIV-1 RT) (IC50: 100 micrograms/ml and 45 micrograms/ml, respectively). However, AC efficiently inhibited focus formation by Rous sarcoma virus (RSV) and cytopathogenicity of human immunodeficiency virus type 1 (HIV-1). Simultaneous administration of AC with RSV to newborn chickens also delayed tumor induction by RSV.

Animals↗

PubMedDate not supplied

Independent double reading system. Application of digital image management database.

The most important role in a radiologist's work is communicating his findings to the attending physician. This is difficult when the radiologic examinations are performed with portable X-ray units because the attending physician wishes to read the images as soon as possible. To resolve this problem, we have developed an independent double reading system. The hardware consists of a magnetic card reader, a display station, a personal computer and a mouse, all linked with the digital image database and a communication network between HIS and RIS. We also present the software of this system and evaluate the results of the implementation to establish the accuracy of the technique. It was concluded that this system could expand the contribution of the radiologist to portable radiographic examinations and to improve the quality of the RIS database.

Computer Systems↗

PubMedDate not supplied

Restriction enzyme analysis of mitochondrial DNA of Acanthamoeba strains isolated from corneal lesions.

Although Acanthamoeba keratitis has been recognized as one of the important infectious diseases of the cornea, especially in contact lens wearers in recent years, its taxonomy has not been well established. We carried out mitochondrial DNA (mtDNA) analysis of the Acanthamoeba organisms isolated from corneal lesions in four eyes of three patients who had suffered from keratitis. The mtDNA was analyzed by restriction fragment length polymorphism (RFLP) using restriction enzymes Bg/II and EcoRI. The RFLP analyses revealed that the DNA phenotypes of the Acanthamoeba organisms were identical to those of the Ma strain in two patients and to the Castellani strain in one patient.

Acanthamoeba↗