No abstract available.
Blood Glucose* ; Carcinoma, Hepatocellular* ; Humans

Scintigraphic localization of therapeutic gelatin emboli were evaluated during and after transcatheterarterial embolization (TAE) in nine patients. Focal uptakes in the spleen suggesting adverse embolism were notedin three of 7 patients with hepatic neoplasms. Two of which were confiremd by CT. Scintiscan of the patient withdural arteriovenous malformation obtained during TAE demonstrated adverse pulmonary embolism, which dictatedchange in procedure. Scintiscan during TAE showed no advers deposition of the injected emboli in the patients withhemangioma of the back, who was safely treated by TAE. Scintigraphic study during or after TAE using radiolabeledgelatin particle with 99mTc seemed to be a useful modality for early detection of adverse embolism and forprevention of serious complications.
Arteriovenous Malformations ; Embolism ; Gelatin ; Humans ; Liver Neoplasms ; Pulmonary Embolism ; Spleen

No abstract available.
Thoracic Wall* ; Thorax*

Twenty cases of hepatocelluar carcinoma were examined by selective celiac and superior mesentericarteriography. Obstruction of the main portal vein due to tumor thrombus was revealed in 7 cases and 3 of thesecases had carvenous transformation of the protal vein(CTPV). The authors intended in this study to evaluate CTPVgroup and non-CTPV group clinically and radiologically. The results obtained are as follows; 1. The duration ofillness was shorter in CTPV group than non-CTPV group. 2. There was no significant difference in tumor sizebetween two groups, and main portion of tumor was located in the right lobe in both groups. 3. Arterioportal shuntwas present in 2 of 4 cases in non-CTPV group, but was no present at all in CTPV group. 4. Hepatofugal collateralsof portal vein were developed in all but one in both groups. 5. There was no significant difference in bloodchemistry between two groups. 6. CTPV may play an important role maintain the hepatic blood flow.
Carcinoma, Hepatocellular ; Portal Vein ; Thrombosis

PURPOSE: To evaluate effectiveness of oblique approach under biplane fluoroscopic guidance in transthoracic fine needle aspiration biopsy. MATERIALS AND METHODS: Fourteen consecutive patients underwent transthoracic fine needle aspiration biopsy for subcarinal lesions. Subcarina was the only accessible biopsy site in 13 patients. Subcarinal biopsy was performed to determine the presence of metastasis in an enlarged subcarinal lymph node in the remaining one patient. Before biopsy, we evaluated the size and location of the lesion on preliminary plain chest X-ray film and CT scan. Under dual projection fluoroscopic guidence, biopsy was performed through right posterior intercostal space with the patient prone by using oblique approach. On 15 degree LAO projection the needle was directed to the area anterior to the spine and advanced to the line extending through the posterior wall of the main bronchus. RESULTS: Cytologic diagnosis was made in 12 out of 14 patients(accuracy 85.7%). The final diagnosis consisted of 5 squamous cell carcinoma, 5 small cell carcinoma, 1 adenocarcinoma and 1 adenosquamous carcinoma. Pneumothorax developed in 2 patients(14%) and was managed by chest tube drainage. Mild hemoptysis was observed in 2. CONCLUSION: Transthoracic fine needle aspiration biopsy using oblique approach under biplane fluoroscopic guidance is a relatively safe and sensitive method for the histologic diagnosis of subcarinal lesion.
Adenocarcinoma ; Biopsy* ; Biopsy, Fine-Needle* ; Bronchi ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chest Tubes ; Diagnosis ; Drainage ; Hemoptysis ; Humans ; Lymph Nodes ; Needles ; Neoplasm Metastasis ; Pneumothorax ; Spine ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

PURPOSE: To determine which prognostic factors contribute to long-term survival after transcatheter arterialchemoembolization(TACE) of hepatocellular carcinoma. MATERIALS AND METHODS: In 100 patients who expired withinone year and 84 who survived or have survived for more than 3 years after TACE, prognostic factors wereretrospectively evaluated. TACE was accomplished by hepatic arterial infusion of a suspension of Lipiodol andanticancer drugs(Mitomycin-C and Adriamycin), either alone or followed by gelfoam embolization. Fisher 's exacttest of probability was used to determine which prognostic factors were statistically significant. RESULTS:Statistically significant prognostic factors were as follows: Child classification(p<0.01), alpha-fetopro-teinvalue(p<0.05), type of tumor(p<0.01), portal vein status(p<0.01), and vascularity of the tumor(p<0.05). HBsAg,tumor size, and method of chemoembolization were not statistically significant(p>0.05). CONCLUSION: The prognosisof patients with hepatocellular carcinoma treated by TACE was affected favorably by good liver function(Childclassification A), low alphafetoprotein value, nodular or massive-type tumor, patent main and first-order portalvein, and hypervascular tumor.
Carcinoma, Hepatocellular* ; Child ; Ethiodized Oil ; Gelatin Sponge, Absorbable ; Humans ; Liver ; Portal Vein ; Survivors*

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

Forty five patients with inferior vena cava (IVC) thrombosis were studied with the use of ultrasonography (US) and computed tomography (CT). Thirty seven cases were cased by tumor extension and the primary neoplasms were hepatocellular Ca. (26cases), renal cell Ca. (6 cases), Wilms' tumor (1 case), IVC leiomyosarcoma (1 case) and retroperitoneal metastatic tumor (3 cases). Non-tumor thrombus were 8 cases which included 5 cases of Budd-Chiari syndrome and 3 cases of thrombophlebitis. US and CT both were good for the diagnosis of IVC thrombosis. Cranial extension was better demonstrated by US whereas CT yielded better delineation of the lower extension. Even though, differentiation of tumor non-tumor thrombi by the echogenecity and density of the thrombus was not possible, the finkdings of adjacent tumor mass, complete obstructive thrombus within dilated lumen with bulging wall, and nontapered acute margin of thrombus made the possibility of tumor thrombus more likely.
Budd-Chiari Syndrome ; Diagnosis ; Humans ; Leiomyosarcoma ; Thrombophlebitis ; Thrombosis* ; Ultrasonography ; Vena Cava, Inferior* ; Wilms Tumor

To evaluate the influence of intraoperative irradiation on the healing of jejunal anastomosis, an experimentalstudy was undertaken using a total of 150 rats. The bursting pressure of the normal jejunum was obtained in groupI. Group II was subjected to resection and anastomosis, and group III was irradiated on the anastomosed jejunumwith a single dose of 1,000 rads. Healing process was evaluated by measuring bursting pressure of the anastomosedjejunum on each postoperative day from 2nd to 14th, and on 21 th day. Bursting pressure was tested by inflatingthe loop of gut with water, and bursting sites were observed. The resuls obtained are summarized as follows; 1.The bursting pressure of the anastomosed jejunum retained normal strength by the 7th postoperative day in thenonirradiated group, whereas by the 11th postoperative day in the irradiated group. 2. Irradiation caused delay inthe healing of anastomosis of the jejunum until the 10th postoperative day; but after then, there was nosignificant difference in bursting pressure between both groups. 3. In the jejunal segments with normal strength,bursting occurred exclusively at the non-anastomotic site in both groups; Bursting started along the mesentericborder in the non-irradiated group, whereas rupture usually occurred on the antimesenteric border in theirradiated group. in the jejunal segments with subnormal strength, bursting usually started on the mesentericborder of the anastomotic site in both groups. The results indicate that intraoperative irradiation with a singledose of 1,000 rads causes no harmful effect on the healing of anastomosis of the jejunum in rats. Therefore, thisstudy suggests the possibility of more effective clinical application of intraoperative irradiation.
Animals ; Intestine, Small ; Jejunum ; Rats ; Rupture ; Water