Rotational digital angiography of ulcer-like projection of pelvis

Ulcer-like projection is an angiographic sign of thrombosed aortic dissection. However, no pelvic manifestation of ulcer-like projection of aortic dissection has been reported. We report three patients in whom ulcer-like projections of the pelvic artery were revealed by rotational digital angiography using the newly developed computerized dynamic stereo-radiography apparatus.

[Hepato-biliary excretion of water-soluble iodinated contrast medium shortly after abdominal angiography]

Thirty-nine patients underwent CT examination 15 to 30 min after abdominal angiography with ioxaglate. Gallbladder opacification was observed in 15 patients in the absence of clinical evidence of renal impairment. Among them, 14 patients revealed liver cirrhosis or chronic hepatitis, and one patient showed severe fatty liver on CT. The amount of contrast medium used varied from 70 ml to 310 ml (mean 180 ml). There was no significant relationship between visualization of the gallbladder and the total dose of ioxaglate or presence of liver dysfunction, which indicated that gallbladder opacification was not a rare phenomenon on CT shortly after abdominal angiography with a normal dose of ioxaglate. Gallbladder opacification on CT examination shortly after abdominal angiography shows that the hepatobiliary tract is important in the excretion of ioxaglate.

[The case of Brazilian, Peruvian, Argentine, Bolivian, and Paraguayan labor migrants of Japanese origin in Japan]

"Over 190,700 Latin American Dekasegi Nikkeis live currently in Japan. The flow of Dekasegi, or labor migrants, [began] in 1988 and increased dramatically as from 1990 in reaction to new immigration laws in Japan and worsening of economic conditions in Latin American countries. Cultural likeness contributed to attract Nikkeis and their descent to the land of their ancestors. These Dekasegi Nikkeis, especially those coming from Peru, and to a much lesser extent some Bolivians and Paraguayans, have started forming minority ethnic communities bound by cultural networks throughout the country." (SUMMARY IN ENG)

Tuberculosis of the prostate: MR imaging

Tuberculosis of the genitourinary tract is still encountered in routine examinations. We present a case of tuberculosis of the prostate with its MR findings.

Anterior mediastinal schwannoma: a case report

The most common neoplasms of the mediastinum are those of neurogenic origin, and the majority of these arise in the posterior compartment. We report a case of benign schwannoma originating in rare location, the anterior mediastinum, and its imaging findings.

[MR angiography of the venous system of lower extremities with gadolinium-enhanced fast spoiled GRASS]

MR angiography (MRA) of the venous system of the lower extremities was carried out in 10 patients with varicose veins using the Gd-DTPA-enhanced Fast Spoiled GRASS (FSPGR) method. The quality of imaging of the popliteal vein (n = 20), calf deep vein (n = 20), varicose vein (n = 12), and femoral vein (n = 6) were assessed in terms of four categories: excellent, good, marginally adequate and nondiagnostic. Nineteen popliteal veins, seventeen calf deep veins, and nine varicose veins were judged as excellent or good. All femoral veins were evaluated as excellent. Enhanced FSPGR was useful for the preoperative evaluation of patients with varicose veins.

[Secondary porphyrinuria]

The condition that the porphyrins are excreted into the urine due to impairment of bile excretion, is called as secondary porphyrinuria. The main porphyrin is coproporphyrin, there fore the condition is called as secondary coproporphyrinuria. Secondary porphyrinuria is associated with various disorders, such as hepatobiliary diseases, hereditary hyperbilirubinemia, intoxications, blood and metabolic diseases, but the etiology of secondary porphyrinuria is unclear. Coproporphyrin is divided into two isomers, one is coproporphyrin-I type and the other is coproporphyrin-III type. In normal human urine, coproporphyrin-III type is predominant, and the ratio of coproporphyrin-I to total coproporphyrin is 10-50% (% as isomer I), while in urines of hepatobiliary diseases, the ratio is 40-60%. In Dubin-Johnson syndrome, the ratio is 80-100%. Coproporphyrinuria in hepatocellular carcinoma and alcoholic liver disease may be different from that in hepatobiliary diseases, often associated with uroporphyrinuria as well as coproporphyrinuria. Coproporphyrinuria arising in blood and metabolic diseases must be taken into account of associated liver diseases.

Aberrant right gastric vein draining directly into the quadrate lobe of the liver. A case report

Angiography and arterial angio-CT in a 21-year-old man with idiopathic portal hypertension revealed an aberrant right gastric vein communicating directly with the quadrate lobe of the liver. This is the first report of a radiologically confirmed case of an aberrant right gastric vein with a unique area of distribution in the liver parenchyma.

[Superselective local infusion therapy with tissue-plasminogen activator for acute massive pulmonary thromboembolism: preliminary clinical experience]

Three cases of acute massive pulmonary thromboembolism were treated with the superselective infusion of tissue-plasminogen activator. Superselective pulmonary angiography immediately after administration of tissue-plasminogen activator demonstrated angiographic improvement in all patients. No complications were encountered during or after the procedure. It is considered that superselective infusion of tissue-plasminogen activator can be an effective therapy for massive pulmonary thromboembolism.

[Stent placement without thrombolysis in chronic iliac arterial occlusion: preliminary clinical evaluation]

Intra-arterial stent placement without thrombolytic therapy was performed in four patients with chronic iliac arterial occlusion. The length of angiographically observed occluded lesions ranged from 2.0 cm to 14.0 cm (mean: 5.1 cm). The implanted stents included four Wall stents, two Strecker stents and one Palmaz stent. The mean ankle-arm index before and after stenting improved from 0.48 to 0.77, while the mean pressure gradient improved from 82.5 mmHg to 3.0 mmHg. Symptoms were eliminated in all patients after the procedure. No major complications were encountered during the procedure. Primary stent implantation in chronic iliac occlusions is useful to avoid bypass surgery.

[Three-dimensional imaging of portal and hepatic veins using helical CT with intravenous injection of contrast medium]

The authors developed a simple new method for obtaining three-dimensional helical CT images that simultaneously depict both the portal and hepatic veins. One hundred ml of contrast medium was injected intravenously, and helical CT was carried out. Three-dimensional venous images were successfully displayed with rotational movement on the CRT monitor. The new method provided high-quality images in which the anatomical relationship between the portal and hepatic venous systems could be clearly visualized. This information was useful in helping angiographers to successfully perform transjugular intrahepatic portosystemic shunt and will be of great value for the presurgical planning of hepatic resection.

Gallbladder visualization on CT shortly after angiography with ioxaglate

Thirty-five patients underwent CT examination 15 to 30 min after abdominal angiography with ioxaglate. The gallbladder was visualized in 12 patients in the absence of clinical evidence of renal impairment. Gallbladder opacification on CT examinations shortly after angiography shows that the hepatobiliary tract is important in the excretion of ioxaglate.

[A case of cutaneous and brain metastasis of gastric carcinoma, treated effectively by chemotherapy with CDDP, MMC, etoposide and 5'-DFUR]

A case of cutaneous and brain metastasis of gastric carcinoma, treated effectively by chemotherapy, is reported. The patient was a 67-year-old female. She underwent total gastrectomy for advanced gastric carcinoma with direct invasion to liver. Six months later, she was admitted with headache and multiple skin nodules on the trunk. CT showed two round tumor shadows on the left side of brain, and a skin biopsy specimen revealed poorly differentiated adenocarcinoma. Chemotherapy with 10mg of CDDP, 2mg of MMC, 150mg of etoposide and 300mg/day of 5'-DFUR was performed. After the third course of chemotherapy, cutaneous and brain metastasis disappeared. Although the patient died of pulmonary metastasis 24 weeks after, cutaneous and brain metastasis disappeared 12 weeks.

Risk of hepatocellular carcinoma in patients with cirrhosis in Japan. Analysis of infectious hepatitis viruses

BACKGROUND

The development of hepatocellular carcinoma (HCC) is associated closely with cirrhosis. In the present study, the cumulative risk of HCC in patients with cirrhosis was investigated.

METHODS

A total of 401 patients were registered from April 1977 and followed for a mean of 4.4 years. Of 401 patients, 255 (64%) were tested for hepatitis B surface antigen (HBsAg) and antibody (anti-) to the hepatitis C virus (HCV); 87 (34%) patients were positive for HBsAg but were negative for anti-HCV (hepatitis B virus [HBV] group), 126 (49%) were negative for HBsAg but were positive for anti-HCV (HCV group), 10 (4%) were positive for both and 32 (13%) were negative for both (non-B non-C group).

RESULTS

By the end of March 1993, HCC was diagnosed in 127 (31.6%) patients. The cumulative risk of HCC in the HCV group was slightly higher than that in HBV group (P = 0.3, 5-year risk: 36.9 versus 21.2%). In contrast, the rate was significantly lower in the non-B non-C group than in the HBV or HCV groups (P < 0.05 and P < 0.01, respectively, 5 year risk: 12.4%).

CONCLUSIONS

These results suggest that not only HBV infection but also HCV infection increase the risk for HCC in patients with cirrhosis.

Risk of hepatocellular carcinoma in patients with cirrhosis in Japan. Analysis of infectious hepatitis viruses

BACKGROUND

The development of hepatocellular carcinoma (HCC) is associated closely with cirrhosis. In the present study, the cumulative risk of HCC in patients with cirrhosis was investigated.

METHODS

A total of 401 patients were registered from April 1977 and followed for a mean of 4.4 years. Of 401 patients, 255 (64%) were tested for hepatitis B surface antigen (HBsAg) and antibody (anti-) to the hepatitis C virus (HCV); 87 (34%) patients were positive for HBsAg but were negative for anti-HCV (hepatitis B virus [HBV] group), 126 (49%) were negative for HBsAg but were positive for anti-HCV (HCV group), 10 (4%) were positive for both and 32 (13%) were negative for both (non-B non-C group).

RESULTS

By the end of March 1993, HCC was diagnosed in 127 (31.6%) patients. The cumulative risk of HCC in the HCV group was slightly higher than that in HBV group (P = 0.3, 5-year risk: 36.9 versus 21.2%). In contrast, the rate was significantly lower in the non-B non-C group than in the HBV or HCV groups (P < 0.05 and P < 0.01, respectively, 5 year risk: 12.4%).

CONCLUSIONS

These results suggest that not only HBV infection but also HCV infection increase the risk for HCC in patients with cirrhosis.