Fluid-fluid levels were observed in a case of giant cavernous hemangioma on computed tomography (CT) and magnetic resonance (MR) imaging. The fluid-fluid level may be attributed to the separation of blood cells and serous fluid due to the extremely slow flow in cavernous hemangioma of the liver.

Diagnosis, Differential↗

PubMedDate not supplied

Tumor angiogenesis and dynamic CT in lung adenocarcinoma: radiologic-pathologic correlation.

PURPOSE: The purpose of this work was to evaluate the correlation of tumor angiogenesis and dynamic CT in lung adenocarcinoma. METHOD: Thirty-five consecutive patients with lung adenocarcinoma underwent dynamic chest CT. Maximum attenuation of dynamic CT was compared with microvessel densities (MVDs) and vascular endothelial growth factor (VEGF) expression by immunohistochemistry. RESULTS: The mean peak attenuation (A(PA)) of lung adenocarcinoma correlated with MVD (r = 0.689, p < 0.0001). VEGF positiveness of lung adenocarcinoma was 63%. There was a significant difference in A(PA) between VEGF-positive and -negative lung adenocarcinomas (39.9 +/- 3.9 and 24.3 +/- 2.3; p < 0.05). The mean MVDs of VEGF-positive adenocarcinomas were significantly higher than those of negative ones (82.5 +/- 5.9 and 49.2 +/- 7.1; p < 0.05). The mean A(PA) of VEGF-positive lung adenocarcinomas correlated positively with MVD (r = 0.707, p < 0.0001). CONCLUSION: The A(PA) value of dynamic CT reflects MVD in lung adenocarcinoma. The A(PA) value of dynamic CT might be an index for VEGF-related tumor angiogenesis.

Adenocarcinoma↗

PubMedDate not supplied

Dandy-Walker like malformation in a Fischer-344 rat.

A spontaneous cerebellar malformation was found in a 32-day-old male Fischer 344 rat. The cerebellar malformation was composed of a vermis defect and markedly dilated fourth ventricle. The cerebellar hemispheres were separated, with the left hemisphere being smaller than the right one. Degenerative/inflammatory lesions consisting of macrophage/lymphocyte infiltration, spheroidal calcium depositions, and astrocytic gliosis were seen adjacent to the cerebral aqueduct. Abnormally arranged hyperplastic ependymal cells were observed beneath the fourth ventricle in the medulla oblongata. The gross findings of the present case resemble those of the human Dandy-Walker malformation. While a precise mechanism remains to be elucidated, degenerative/inflammatory lesions in the present rat may be involved in the pathogenesis of this malformation.

Animals↗

PubMedDate not supplied

Long-term results of surgical treatment for invasive thymoma.

BACKGROUND: The aim of this study was to analyse the operative outcome of extensive surgery for invasive thymoma and to assess the prognostic factors for long-term survival. MATERIALS AND METHODS: Forty patients with invasive thymoma have been operated on at our institution during past the 33 years. We performed total removal of the tumour, including invaded neighboring organs. Complete resection was performed in 27 patients, incomplete resection in 4. Nine patients had unresectable thymoma. Postoperative radiotherapy was performed in 30 patients with a median dose of 48 Gy. RESULTS: The 10-year survival rate was 72% for Masaoka stage II, 47% for stage III, and 0% for stage IV. There was no postoperative mortality. Concerning the prognostic factors for long-term survival, there were no significant differences in the analysis of Masaoka staging, histological classification, association of autoimmune disease, and postradiotherapy. However, the survival rate was significantly higher for patients with complete resection than for patients with incomplete resection or biopsy only (p = 0.019). CONCLUSIONS: Whether the tumour is resected completely or not is the most important factor for long-term survival; therefore it is preferable to perform extensive surgery for invasive thymoma.

Female↗

PubMedDate not supplied

Long-term effects of distal splenorenal shunt with splenopancreatic and gastric disconnection on hypersplenism due to liver cirrhosis.

BACKGROUND/AIMS: Though the distal splenorenal shunt has been applied for gastroesophageal varices caused by liver cirrhosis, many patients develop secondary hypersplenism due to the portal hypertension following liver cirrhosis. We examined whether this operation could be effective for alleviating secondary hypersplenism for a long post-operative period. The subjects were 42 cases with gastroesophageal varices following liver cirrhosis in which we had performed distal splenorenal shunts with splenopancreatic and gastric disconnection at our institution in the period from 1983 1994 and the post-operative survival periods had been over 3 years. METHODOLOGY: White blood cell counts, platelet counts and spleen volume were measured prior to operation, 1 month after operation and during the post-operative period of 3-5 years. Quality of life and clinical symptoms were evaluated during the post-operative period of 3-5 years. RESULTS: White blood cell counts, platelet counts and spleen volume were improved respectively at 1 month and during the 3-5-year period after surgery, compared to those prior to operation. None of the clinical symptoms of hypersplenism were observed and the long-term performance status was satisfactory. CONCLUSIONS: We can conclude that the distal splenorenal shunt with splenopancreatic and gastric disconnection alleviated hypersplenism for post-operatively long periods.

Adult↗

PubMedDate not supplied

Tumor size does not have prognostic significance in stage Ia NSCLC.

PURPOSE: We aimed to determine whether the prognosis of non-small cell lung cancer (NSCLC), with lesions 2 cm or less in diameter, was better than that of Stage Ia lung cancer having a diameter of more than 2 cm. METHODS: We reviewed 64 cases of NSCLC which were preoperatively diagnosed as TINOMO. The tumors were classified into 2 groups on the basis of a tumor diameter set at 2 cm. After comparison of background factors, we compared the prognoses of the groups and determined the prognostic factors in Stage IA NSCLC. RESULTS: No differences were observed in the survival rate between the 2 groups. Statistically significant factors for the survival period in Stage IA NSCLC were serum carcino-embryonic antigen (CEA), residual tumor condition and lymph node metastasis. Those cases where CEA was abnormal were all in Stage II or inllmore advanced stage. CONCLUSION: It is not justifiable to sub-classify Stage IA NSCLC on the basis of a tumor diameter of 2 cm. The present study revealed that the most important preoperative prognostic factor was serum CEA.

Adenocarcinoma↗

PubMedDate not supplied

Preoperative embolization of the common hepatic artery in preparation for radical pancreatectomy for pancreas body cancer.

BACKGROUND/AIMS: To assess preliminary results of preoperative embolization of the common hepatic artery in preparation for distal pancreatectomy with en bloc resection of the celiac and common hepatic arteries for carcinoma of the body of the pancreas involving these arteries. METHODOLOGY: Four patients underwent the embolization with coils 1-7 (median: 5) days before surgery. A detachable coil was used to obtain the best position of the first coil as an anchor in 3 patients. RESULTS: Immediately after embolization, collateral pathways developed from the superior mesenteric artery via the pancreatoduodenal arcades to the proper hepatic and gastroduodenal arteries in all 4 patients; however, they were relatively poor in one patient. There were no complications after embolization. The pulsation of the proper hepatic and gastroduodenal arteries was well palpable during surgery, although it had been compromised sometimes in previous cases without embolization. There were no ischemia-related complications in the 2 patients who underwent radical surgery. CONCLUSIONS: Preoperative embolization of the common hepatic artery is a safe technique and has the potential to enlarge the collateral pathways by the time of distal pancreatectomy with en bloc resection of the celiac artery and prevent postoperative fatal ischemia-related complications.

Aged↗

PubMedDate not supplied

Combined use of surface and perfusion hypothermia in intracardiac surgery in infants under one year of age.

Deep hypothermia has recently gained popularity as an adjunct to intracardiac surgery for neonates and infants. A number of Japanese investigators played a role in the development and clinical application of both simple surface-induced hypothermia and the combined use of surface and perfusion cooling. The developmental history of both methods is described in detail. At the Heart Institute of Japan, 71 infants under one year of age underwent intracardiac surgery over the past six years. There has been a notable decrease in operative mortality since the employment of circulatory arrest under deep hypothermia and limited pump-perfusion. This trend is marked in infants with ventricular septal defect and pulmonary hypertension, and in those with total anomalous pulmonary venous connection. The Landé-Edwards membrane oxygenator proved helpful in prevention of postoperative pulmonary complications.

Age Factors↗

PubMedDate not supplied

Hepatectomy for metastases from breast cancer offers the survival benefit similar to that in hepatic metastases from colorectal cancer.

BACKGROUND/AIMS: There have been no reports comparing surgical results of hepatectomy for metastases between breast cancer origin and colorectal cancer origin. The aim of the present study was to compare the both and to clarify the survival benefit brought by hepatectomy for metastases from breast cancer. METHODOLOGY: Between 1990 and 1999, 6 patients with hepatic metastases from breast cancer and 94 patients with those from colorectal cancer underwent hepatectomy with curative intent. All patients in the breast-cancer-origin group received adjuvant chemotherapy following hepatectomy, however, fewer patients (55% of the 94 patients) did in the colorectal-cancer-origin group (P = 0.034). RESULTS: Morbidity and mortality rates after hepatectomy in patients with hepatic metastases from breast cancer were 0% and 0%, respectively, and those in patients with metastases from colorectal cancer were 12% and 1%, respectively. Postoperative survival curves in the both groups were similar. Three- and five-year survival rates in the breast-cancer-origin group were 60% and 40%, respectively, and those in the colorectal-cancer-origin group were 54% and 42%, respectively. CONCLUSIONS: When appropriate adjuvant chemotherapy is performed, hepatectomy for metastases from breast cancer offers the survival benefit similar to that in hepatic metastases from colorectal cancer.

Adult↗

PubMedDate not supplied

Endocrine cell carcinoma of the gallbladder with anomalous pancreaticobiliary ductal junction.

We experienced a case of endocrine cell carcinoma of the gallbladder with anomalous pancreaticobiliary ductal junction. It is well known that anomalous pancreaticobiliary ductal junction has potentiality to cause gallbladder cancer and that most of the cases are papillary adenocarcinoma or well-differentiated adenocarcinoma. The direct relationship between endocrine cell carcinoma of the gallbladder and anomalous pancreaticobiliary ductal junction has not been elucidated.

Biliary Tract↗

PubMedDate not supplied

True carcinosarcoma of the esophagus with osteosarcoma.

We experienced a case of true carcinosarcoma of the esophagus with osteosarcoma. Computed tomography scan revealed calcification of the tumor. Immunohistochemically, vimentin staining was positive, and osteoid formation was found in the sarcomatous portion. It was clear that the lesion contained osteosarcoma of mesenchymal origin, and thus we diagnosed it as true carcinosarcoma.

Aged↗

PubMedDate not supplied

Biliary cystadenocarcinoma with superficial spread to the extrahepatic bile duct.

We report a case of biliary cystadenocarcinoma of the liver with superficial spread to the extrahepatic bile duct. Preoperative endoscopic retrograde cholangiography revealed communication between a 4.5-cm cyst in segment 4 of the liver and the bile duct. From the findings obtained by peroral cholangioscopy and intraoperative cholangioscopy, the granular mucosa in the bile duct was diagnosed as superficially spreading cancer. The right posterior segmental bile duct and the right anterior segmental bile duct were resected at the point where the spread of cancer was no longer traceable and left lobectomy plus caudate lobectomy was carried out. This achieved radical resection, leaving the resected margin of the bile duct free from cancer. Histopathologically, well-differentiated papillary adenocarcinoma was found on the inner surface of the cyst, and the cancer had superficially spread from the cyst to the extrahepatic bile duct via the 2.5-mm diameter communication between the cyst and bile duct. The cancer was limited only to the mucosal layer all over the lesion. When performing radical surgery for biliary cystadenocarcinoma, it is recommended that cholangioscopy be performed to examine whether the cancer has superficial spread to the extrahepatic bile duct or not. Bile duct resection should be carried out, depending on the extent of the superficial spread, so that the resected margin of the bile duct is free from cancer.

Adult↗

PubMedDate not supplied

Repeat hepatectomy for recurrent hepatic metastases from colorectal cancer.

BACKGROUND/AIMS: Resection of liver metastases from colorectal cancer is accepted as a safe, and curative treatment. Furthermore, repeat hepatectomy has been indicated for hepatic recurrence after initial hepatectomy to achieve long-term survival or cure. The present study is a retrospective review of our results using repeat hepatectomy for colorectal liver metastases to identify outcomes and prognostic factors associated with long-term survival. METHODOLOGY: Ninety-four patients underwent an initial hepatectomy for colorectal metastases between 1990 and 1995. Thirty patients had hepatic recurrence after the initial hepatectomy. Eleven patients underwent repeat hepatectomy for isolated hepatic recurrence. RESULTS: The operative mortality was 0%. The overall 5-year survival rate after detection of second liver metastases of 11 patients was 45.5%. The distribution of first liver metastases and disease-free interval between the first and second hepatectomy demonstrated significance in relation to survival after repeat hepatectomy (P = 0.0303 and 0.0338). CONCLUSIONS: Repeat hepatectomy for recurrent liver metastases from colorectal cancer was the most effective treatment to improve survival time for selected patients. In patients with isolated second liver metastasis, unilateral spread of first liver metastases, and a disease-free interval between the first and second hepatectomies of more than 12 months, long-term survival or cure can be expected after repeat hepatectomy.

Colorectal Neoplasms↗