No abstract available.
Maxillary Sinus Neoplasms* ; Maxillary Sinus*

A retrospective study was performed on 15 patients with suprasellar germ cell tumors treated by megavoltage external beam irradiation between Feb. 1979 and Dec. 1985. Follow-up period of survivors was 30 to 91 moths. Histologic diagnosis was obtained before radiation therapy in 10 patients (9 germinomas and 1 mixed). Five patients were treated without histologic verification. In 9 patients with biopsy-proven germinomas radiation therapy was delivered to the craniospinal axis in 6, to the whole brain in 3. In 5 patients with mixed germ cell tumor or elevated tumor marker, irradiation was delievered to the craniospinal axis in 2, to the whole brain in 2, and to the primary site only in 1. Total doses ranged from 5,000 to 5,500 cgy to the promary site, 3,000 to 4,400 cgy to the whole brain, and 1,300 to 3,000 cgy to the spine. In these 14, local tumor was controlled and primary or spinal failure was not observed. One patient without elevated tumor marker was treated to the whole brain, The tumor was not controlled and he had spinal recurrence. It is proven that radiation therapy is an effective treatment for suprasellar gern cell tumors. The neuroendocrinologic presentation, tumor marker status, early response to radiation measured on CT seem to be useful means for selecting patients for radiation therapy when tissue diagnosis is not available.
Axis, Cervical Vertebra ; Brain ; Diagnosis ; Follow-Up Studies ; Germinoma ; Humans ; Moths ; Neoplasms, Germ Cell and Embryonal ; Recurrence ; Retrospective Studies ; Spine ; Survivors

A retrospective analysis was performed on 23 patients with pineal region tumors treated with radiation from 1979 through 1985 at the Department of Therapeutic Radiology, Seoul National University Hospital, Histologic confirmation was done in only one case by surgical removal, and in the remaining 22 patients, the diagnosis was based on clinical and radiological findings. The radiation volume was the primary tumor site in 1 case, whole brain in 14 cases, and the whole craniospinal axis in 8 cases. The overall 5 year survival was 71.5%. The 5 year survival was 69. 3% for whole brain treated group and 73.3% for craniospinal axis treated group. The survival for the two groups did not differ significantly. In two cases sites of recurrence were detected. One in supratentorial area, and the other in the lung. The results from this retrospective analysis and the review of other reports indicate that routine use of prophlatic spinal irradiation is not warranted in pineal region tumor, and the craniospinal irradiation is recommended in cases with high risk for subarachnoid seeding such as positive CSF cytology, surgical removal or biopsy.
Axis, Cervical Vertebra ; Biopsy ; Brain ; Craniospinal Irradiation ; Diagnosis ; Humans ; Lung ; Pinealoma* ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Seoul

A retrospective analysis was performed on 49 patients with astrocytoma of glioblastoma multiforme of brain who received postoperative radiotherapy in the period between February 1979 and December 1985. Fourteen patients had grade I astrocytoma, 11 patients grade II, 14 patients grade III, and 10 patients glioblastoma multiforme. Three year actuarial surival rates were 85.7%, 44.6% and 23.1% for grade I,II, and III astrocytomas, respectively. One and 2 year actuarial survival rates for patients with glioblastoma multiforme were 54.5% and 27.3%, respectively. Histologic grade, age, extent of operation and tumor location were revealed to be prognosticators.
Astrocytoma* ; Brain* ; Glioblastoma* ; Humans ; Radiotherapy* ; Retrospective Studies ; Survival Rate

PURPOSE: To assess the usefulness of 0.5 %-methylcellulose as oral contrast agent in spiral CT examinationsfor the evaluation of anastomotic site and remnant stomach in patients who have undergone subtotal gastrectomy dueto stomach cancer. MATERIALS AND METHODS: Twenty-seven patients who underwent subtotal gastrectomy for stomachcancer and were referred for the evaluation of anastomosis recurrence and lymph node metastasis wereprosepectively analyzed by spiral CT. They were divided into two groups: before scanning, group A patients drank0.5 %-methylcellulous 500ml as oral contrast agent, while those in group B drank diluted gastrografin 500ml. Threepatients were examined twice. Anatomic delineation of the anastomosis site was graded by two radiologists asexcellent (3), good (2), fair (1), or poor (0). To evaluate the degree of distension, maximal transverse andanterior-posterior diameter of remnant stomach and anastomotic sites were measured. RESULTS: In Group A, anatomicdelineation of the anastomotic site was very much better than in group B (mean score: 2.93 vs 1.80, p<0.05). Inaddition, the maximum diameters of remnant stomach and anastomotic site were significantly larger in group A thanin group B (transverse A-P remnant stomach and anastomosis site: 87.5 +/-14.7mm, 103.3 +/-20.1mm, 17.6 +/-2.9mm vs57.6 +/-20.1mm, 69.9 +/-3 5 . 0 m m , 10.7 +/-7 . 2 m m ) CONCLUSION: In patients who had undergone subtotalgastrectomy, the use of 0.5 %-methylcellulose as oral contrast agent for spiral CT showed excellent anatomicdelineation of the anastomotic site and distension of remnant stomach.
Contrast Media ; Diatrizoate Meglumine ; Gastrectomy* ; Gastric Stump ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms ; Tomography, Spiral Computed

Perfusion scintigraphy has proved to be an essential part for the diagnosis of pulmonary thromboembolism. The wedge shaped perfusion defect extending to lung base is a highly probable finding of pulmonary embolism. Occasionally, great perfusion defects could be presented as a false positive finding under the circumstance of nonthromboembolic origin, such as neoplastic compression or invasion of pulmonary artery. We report an unusual case of massive perfusion defect resulting from pulmonary arterial compression by bronchogenic carcinoma. A 71-year-old man visited our hospital because of productive cough and was diagnosed as bronchogenic carcinoma. The perfusion scintigraphy showed unilateral total defect of lung, not accompanied by any clinical evidence of thromboembolism. A contrast enhanced computed tomogram showed heterogeneous mass shadow in left hilum, abutting to the descending aorta and compressing left main pulmonary artery. These findings suggested a nonembolic mechanism of perfusion defects which were produced by the neoplastic compression of pulmonary artery.
Aged ; Aorta, Thoracic ; Carcinoma, Bronchogenic* ; Cough ; Diagnosis ; Humans ; Lung* ; Perfusion Imaging ; Perfusion* ; Pulmonary Artery ; Pulmonary Embolism ; Thromboembolism

PURPOSE: Periportal low attenuation, defined as a low attenuation rim around the portal vein and its branches which is seen on contrast material-enhanced CT scans, has been described in a variety of conditions. We tried to document that lymphatic obstruction is one of the major cause of periportal low attenuation. METHODS AND MATERIALS: We retrospectively analyzed 57 cases of periportal low attenuation on abdominal CT scans and also reviewed the surgical records in 32 cases. Lymph node enlargement in the hepatoduodenal ligament which is a main lymphatic channel from the liver were analyzed and calculated the ratio of the transeverse diameter between the inferior vena cava and the aorta at the level of right adrenal gland. After complete surgical interruption of the lymphatic drainage from the liver in a dog, follow up CT scans were obtained and correlated with pathologic findings. RESULTS: Fifty patients(88%) had underlying disease which could cause impairment of lymphatic drainage. Periportal low attenuation was identified in several clinical conditions, including surgical lymph node dissection, lymphadenopathy in the hepatoduodenal ligament, blunt trauma. In animal model, CT scan showed prominent periportal low attenuation at 5 days after surgery. Histologic examination revealed numerous dilated lymphatic vessels and a marked lymphedema in the connective tissues surrounding the portal vein and its major branches. CONCLUSION: One of the major.cuase of periportal low attenuation was impaired lymphatic drainage and periportal low attenuation corresponding to the numerous dilated lymphatic vessels and a marked lymphedema in the connective tissues surrounding the portal vein and its major branches.
Adrenal Glands ; Animals ; Aorta ; Connective Tissue ; Dogs ; Drainage ; Follow-Up Studies ; Ligaments ; Liver ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Diseases ; Lymphatic Vessels ; Lymphedema ; Models, Animal ; Portal Vein ; Retrospective Studies ; Tomography, X-Ray Computed ; Vena Cava, Inferior

CNS prophylaxis with 18 or 24 Gy cranial irradiation plus intrathecal methotrexate was given to 134 childhood acute lymphoblastic leukemia patients who had got bone marrow remission(M1) after remission induction chemotherapy from August 1979 to December 1986. The rate of initial total CNS relapse was 14.2%(19/134), the rate of isolated CNS relapse was 5.2%(7/134), and the rate of CNS relapse concomittantly combined with bone marrow relapse or testicular relapse was 9%(12/134). Male sex or older age was accociated with higher CNS relapes and the initial peripheral leukocyte count over 50,000/ul had higher relapse rate. Relapse with radiation dose of 18 Gy was somewhat lower than that with 24 Gy. Within 4 years after CNS prophylaxis occurred 89% of the total CNS relapses, 100% of the isolated CNS relapses, and 83% of the combined CNS relapses. Adjusted to exposed cases to risk of CNS relapse, the total CNS relapse rate was 11.9% during maintenance chemotherapy and 4.9% after maintenance chemotherapy.
Bone Marrow ; Child* ; Cranial Irradiation* ; Drug Therapy ; Humans ; Leukocyte Count ; Maintenance Chemotherapy ; Male ; Methotrexate ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Remission Induction

Inverted papilloma of the urinary tract is a rare finding, and it is almost benign in its histologic morphology and clinical behavior. Despite several published reports, the prognostic significance and potential clinical behavior of this malady remains unclear. The most commonly associated clinical symptoms are hematuria and obstruction of the urinary tract. Most inverted papillomas of urinary tract occur in the bladder and only rarely in the ureter, renal pelvis and urethra. We report here on one case of inverted papilloma in the prostatic urethra. This was diagnosed by transrectal ultrasonography and confirmed by its histology.
Hematuria ; Kidney Pelvis ; Papilloma, Inverted* ; Ultrasonography ; Ureter ; Urethra* ; Urinary Bladder ; Urinary Tract

Hematogenous metastasis to skeletal muscle from urothelial carcinoma is extremely rare and metastatic disease to skeletal muscle tends to be found in people with advanced-stage neoplasm. We report in this paper a case of left sartorius muscle metastasis from urothelial cell carcinoma. A left nephroureterectomy with bladder cuff excision was performed and revealed a high-grade papillary transitional cell carcinoma (TCC) of the pelvis. And 6 month later, recurrent bladder cancer was found regular cystoscopy and then treated with transurethral resection of the bladder. After 6 times resection of bladder, an invasion into the bladder muscle layer was found. We recommended additional radical cystectomy to prevent the disease from advancing. However, the patient refused additional surgery. 6 month later, the patient complained of left thigh pain, so ultrasonography-guided biopsy of the nodular mass lesion in the left sartorius muscle was performed. The pathological analysis of the biopsy specimen revealed poorly differentiated metastatic urothelial carcinoma.
Biopsy ; Carcinoma, Transitional Cell ; Cystectomy ; Cystoscopy ; Humans ; Muscle, Skeletal ; Muscles ; Neoplasm Metastasis ; Pelvis ; Thigh ; Urinary Bladder ; Urinary Bladder Neoplasms