[A case of alcoholic liver cirrhosis associated with portal vein thrombosis which was successfully treated by TIPS]

We reported a case of 51-year-old man with repeated bleeding from gastroesophageal varices and portal vein thrombosis which were successfully treated by transjugular intrahepatic portosystemic shunt (TIPS) and thrombolysis. We used a flexible tip puncture needle (.038") which was thought to be safer than Colapinto needle (16G).

[CT features of chronic maxillary osteomyelitis in adults]

CT findings were reviewed in four adult patients with chronic maxillary osteomyelitis (CMO) that was histologically proved. The CT features of CMO included bone destruction and soft tissue mass, predominantly in the inferior portion of the maxillary antrum (all 4 cases), thickening of the antral wall (3 cases) and abnormal soft tissue around the antrum associated with or without bony wall destruction (3 cases). CMO could not be distinguished from cancer of the maxillary antrum on CT because of the similar findings. However, abnormal soft tissue around the antrum together with an undestructed bony antral wall may be useful for differentiating the two diseases.

[CT-guided percutaneous lung biopsy using a cutting needle and an automated biopsy gun. Comparison with lung biopsy using a manual aspiration needle]

Twenty-five percutaneous lung biopsies using a 20-gauge cutting needle and automated biopsy gun (ABG) were performed under CT guidance in 25 patients with thoracic lesions. This procedure was compared with that using a 21-gauge manual aspiration needle in 36 patients (40 examinations, 37 lesions) in terms of success rate, rate of correct diagnosis, mean examination time and rate of complications. Specimens obtained from lung biopsy were graded by a histopathologist according to quality and quantity from 0 to 4 (pathological score). There were no statistically significant differences between the two procedures in terms of success rate, rate of correct diagnosis and rate of complications; only the time required was significantly different. However, sufficient biopsy material and a mean pathological score of G-II 2.8 (that of G-I was 1.9, p less than 0.05) could be obtained by the biopsy procedure using the cutting needle. The above results indicated that aspiration needle biopsy was adequate for lung biopsy, but that a cutting needle and ABG should be used when a good biopsy specimen is needed for tissue diagnosis.

[CT findings of mucin-producing pancreatic cancer--differentiation from chronic pancreatitis]

Mucin-producing pancreatic cancers (MPPC), which include mucinous adenocarcinoma, papillary adenocarcinoma and cystadenocarcinoma, are radiographically characterized by diffuse or localized dilatation of the main pancreatic duct due to excessive mucin production. Therefore, MPPC are occasionally difficult to distinguish from chronic pancreatitis on CT unless the primary pancreatic lesion is visualized. We compared five cases of MPPC with five cases of chronic pancreatitis with marked duct dilatation to determine differences in CT images between the two diseases. There was no significant difference between the two diseases in the nature of duct dilatation (size, extent, contour) or parenchymal changes (atrophy, enlargement, calcification, cystic lesion). However, dilatation of the intramural duct was characteristically observed in MPPC but not in chronic pancreatitis. Papillary masses in the pancreatic duct, when observed, were another finding specific to MPPC.

Bilateral multiple renal adenocarcinomas in a patient with acquired renal cystic disease: correlation of imaging with pathological study

The findings of computed tomography (CT), magnetic resonance imaging (MRI), and angiography were correlated with the histopathological findings in a patient with acquired renal cystic disease (ARCD) and bilateral multiple renal adenocarcinomas. Hemodialysis patients, especially with ARCD, should have a follow-up imaging study for an early detection of renal adenocarcinomas because multiple renal adenocarcinomas would arise frequently and simultaneously from ARCD.

[CT of abdominal aortic aneurysms--aneurysmal size and thickness of intra-aneurysmal thrombus as risk factors of rupture]

In order to seek for the factors to suggest a risk of rupture of abdominal aortic aneurysms (AAA), we measured the largest diameter of AAA and the thickness of intra-luminal thrombus on CT in 72 patients. The mean aneurysmal size was 64 mm in diameter in 9 patients with ruptured aneurysm and 61 mm in diameter in 63 patients with non-ruptured aneurysm respectively (p less than 0.90). The rupture of AAA was seen in 3 of 30 patients with AAA of the small size (less than 50 mm in diameter), in 3 of 16 patients with AAA of the intermediate size (51-66 mm in diameter) and in 3 of 26 patients with AAA of the large size (more than 70 mm in diameter), respectively. The mean intra-luminal thrombus was 9 mm in 9 patients with ruptured aneurysm and 19 mm in thickness in 63 patients with non-ruptured aneurysm respectively (p = 0.05). We concluded from the above results that the aneurysmal size was not important, but the thickness of intra-luminal thrombus was useful for suggestion of a risk of rupture of AAA.

Evaluation of acute renal failure with magnetic resonance imaging using gradient-echo and Gd-DTPA

Detection of acute renal failure (ARF) using fast-scan magnetic resonance imaging (MRI) with Gd-DTPA was studied in a dog model. ARF was produced in five dogs by infusion of norepinephrine (0.75 micrograms/kg/min) into the renal arteries for 40 minutes. MRI was performed 1 hour later and compared with baseline (pre-ARF) MRI. There was no significant difference in the ratios of signal intensity-vs.-time curves from 0 to 35 seconds after injection of Gd-DTPA. However, a difference between the outer and inner medulla was significant in the time period of 5 to 20 minutes after Gd-DTPA injection. These later signal intensity differences by fast-scan (gradient-echo) technique may be useful in the evaluation of ARF.

A renal cell carcinoma extending into the renal pelvis simulating transitional cell carcinoma

A case of renal cell carcinoma with unusual extension is reported, in which the radiographic findings have a close resemblance to those of transitional cell carcinoma of the renal pelvis. We emphasize that it is occasionally difficult to draw a distinction between transitional cell carcinoma with renal invasion and renal cell carcinoma with renal pelvic extension even by computed tomography (CT) and angiography.

[New oral contrast material for gastrointestinal MR examination--green tea mixed with sodium alginate]

We found incidentally the stomach filled with the material of high signal intensity on T1 weighted images. The material was a mixture of green tea and sodium alginate (drug for peptic ulcer). We proved that T1 and T2 were significantly shortened by the mixture in the experimental study. This was successfully used for the patients.

Radiographic findings and hypotensive reactions in excretory urography

The radiographic findings and the hypotension patterns were reviewed in 19 patients having hypotensive reactions in routine excretory urography using ionic contrast medium. The lowest systolic blood pressure was above 80 mmHg in 10 patients while below 80 mmHg in remaining 9 patients. The urogram was unremarkable as long as the systolic blood pressure was preserved above 80 mmHg. In 2 patients, whose systolic blood pressure decreased quickly beyond 80 mmHg immediately after injection of contrast medium, the pyelogram was faint or non-visualized. On the other hand, in 4 patients, whose systolic blood pressure decreased beyond 80 mmHg in several minutes after injection of contrast medium and remained under 80 mmHg for more than 20 minutes, the nephrogram was dense and the pyelogram was faint or non-visualized. Although systolic blood pressure decreased beyond 80 mmHg, the urogram was unremarkable in 3 patients. This was due to the delayed hypotension or the short duration of hypotension.

Non-seminomatous testicular tumors: effect of lesion side on CT detection of lymph node metastasis

Abdominal CT examinations of 40 patients with non-seminomatous testicular tumors were reviewed with previous knowledge of the side of the testicular primary. Metastatic nodes, between 1.5 cm and 2.0 cm in diameter were overlooked more frequently in patients with right than in those with left testicular primaries, because mildly enlarged aorto-caval or para-caval nodes (which are the most frequent site of metastasis from a right testicular lesion) were more difficult to detect than enlarged left para-aortic lymph nodes. Efforts to delineate the aorto-caval region on CT examinations of patients with right-sided lesions must be increased in order to reduce a surprisingly high false negative rate.

Hemiazygos continuation of a left inferior vena cava: CT appearance

The CT appearance of hemiazygos continuation of a left-sided inferior vena cava is presented along with discussion of associated anomalies.

Computed tomography of retroperitoneal cystic lymphangiomas

The CT features of retroperitoneal lymphangiomas are unilocular or multilocular cysts in the retroperitoneum and slightly and uniformly thickened wall that enhances following contrast medium administration. Three cases are reported.

Enzyme immunoassay of blasticidin S with high sensitivity: a new and convenient method for preparation of immunogenic (hapten-protein) conjugates

An antibody against blasticidin S (BLS), an antibiotic effective for blast disease of rice, has been produced in rabbits immunized with a blasticidin S-protein conjugate prepared by a novel and convenient procedure devised to couple BLS to bovine serum albumin (BSA) after sodium borohydride reduction of its disulfide bonds, using N-(m-maleimidobenzoyloxy)succinimide (MBS) as a cross-linker. BLS-MBS-BSA conjugate contained about 16 BLS per BSA molecule. Enzyme labeling of BLS with beta-D-galactosidase was performed by utilizing another cross-linker, N-(gamma-maleimidobutyryloxy)succinimide by means of a convenient labeling method which we introduced last year. A double antibody enzyme immunoassay of BLS which could determine as little as 100 pg per tube of BLS was developed using labeled BLS and anti-BLS antiserum. Various commonly used drugs were found to have little reactivity in this immunoassay, indicating that the anti-BLS produced is highly specific. The titer of the anti-BLS was excellent and 10,000,000-fold diluted solution could bind with the enzyme labeled BLS.