An experimental study for tumor detection by indocyanine green with near-infrared topography

We studied tumor detection by indocyanine green (ICG) with near-infrared topography in rat experimental tumors: hepatoma AH109A and osteosarcoma POB 102. Time-intensity curves and topograms after ICG injection were obtained in tumors and surrounding normal tissues. Intensities in tumors were slowly reduced, and intensities in normal tissues were rapidly reduced, resulting in positive tumor image in topogram. It is concluded that near-infrared topography enhanced by ICG is useful for cancer detection.     

Evaluation of usefulness of bone SPECT for lumbar spondylolysis

The purpose of this study was to evaluate the usefulness of 99mTc-MDP SPECT (bone SPECT) for lumbar spondylolysis. We analyzed 11 cases with 17 lesions. All cases were compared using plain radiography, computed tomography (CT), planar bone scintigraphy (PBS), and bone SPECT. Four lesions that showed a wide defect on CT were negative on bone SPECT and may have been chronic lesions. Thirteen lesions that were positive on bone SPECT were narrow or showed no defect on CT and may have been early lesions. Two cases showed no defect on CT but were positive on bone SPECT, and one of them progressed to bilateral spondylolysis after one year. This may have been a very early lesion. Thus bone SPECT is useful for the diagnosis of lumbar spondylolysis, especially in its early stage.     

Meningiomas with brain edema: radiological characteristics on MRI and review of the literature

OBJECT: Despite their benign characteristics, meningiomas are often accompanied by perifocal brain edema. The aims of this study are to determine what kind of characteristics on magnetic resonance (MR) image are indicative of a meningioma that produces brain edema and to investigate the mechanism responsible for brain edema accompanying meningiomas. METHODS: Fifty-one patients with meningioma were examined by magnetic resonance imaging (MRI), and tumor size, tumor location, shape of tumor margin, peritumoral rim, and signal intensity of tumor on T2-weighted image (T2WI) were compared and correlated with the presence versus absence of brain edema. Surgical histopathology was also examined and correlated with the MRI findings and brain edema. RESULTS: Shape of tumor margin, peritumoral rim, and signal intensity of tumor on T2WI correlated with brain edema on multivariate analyses. CONCLUSION: Invasive pattern of brain-tumor interface and hyperintensity on T2WI were indicative factors of meningiomas producing brain edema.     

CT findings of leukemic pulmonary infiltration with pathologic correlation

The aim of this study was to demonstrate the characteristic CT findings of leukemic pulmonary infiltration based on the pathologic findings. The CT findings of 11 leukemic patients with leukemic pulmonary infiltration were compared with those of 22 leukemic patients with other diseases as a control group. Evaluated pulmonary parenchymal CT findings included thickening of bronchovascular bundles and interlobular septa, prominence of peripheral pulmonary arteries, ground-glass opacities, air-space consolidation, and nodules. The CT-pathologic correlations for leukemic infiltration were evaluated in 7 patients. Frequent parenchymal CT findings were thickening of bronchovascular bundles (81.8%), prominence of peripheral pulmonary arteries (81.8%), and non-lobular and non-segmental ground-glass opacities (90.9%). The first two findings were significantly more frequently observed in leukemic infiltration than in the control group, had good interobserver agreement, and corresponded pathologically to leukemic cell infiltration around the pulmonary arteries, bronchi, or bronchioles. Non-lobular and non-segmental ground-glass opacity corresponded to leukemic cell infiltration within alveolar spaces and septa adjacent to the pulmonary arteries or bronchi and also corresponded to hemorrhage, edema, or diffuse alveolar damage. Thickening of bronchovascular bundles and prominence of peripheral pulmonary arteries are CT findings suggestive for leukemic infiltration and correspond to peribronchovascular tumor extension.     

Efficacy of contrast-enhanced MR imaging in cardiomyopathy: an experimental study using Bio14.6 hamsters

RATIONALE AND OBJECTIVES: Myocardial fibrosis was evaluated with magnetic resonance (MR) imaging in Bio14.6 hamsters. MATERIALS AND METHODS: Gated gradient-echo T1-weighted images and spin-echo images with gadopentetate dimeglumine enhancement (0.2 mmol/kg) were obtained. RESULTS: Myocardial enhancement persisted for 13 minutes after administration of gadopentetate dimeglumine, and myocardial signal intensity peaked at 13 minutes on gradient-echo T1-weighted images. The enhanced areas were greater in Bio14.6 hamsters at 25-42 weeks than at 10 weeks. Pathologic data revealed enhancement with inflammation at 10 weeks and fibrosis with vessel proliferation at 25-42 weeks. Pathologic fibrotic change was greater at 32-42 weeks than at 10 weeks. The myocardium of 42-week-old Bio14.6 hamsters showed remarkable contrast enhancement, which continued for 13 minutes. There was no correlation between gadolinium enhancement and pathologic findings in the evaluation of myocardial degeneration and fibrosis. CONCLUSION: Gadolinium-enhanced MR imaging was useful for estimating myocardial fibrotic changes with vessel proliferation and myocardial damage.     

An autopsy case of human skeletal remains with a numerical variation in thoraco-lumbar vertebrae

Unidentified skeletal remains with almost every part of a single body were found in a closed shed; it wore a jacket, pants and underwears. It was brought to Hamamatsu University School of Medicine for autopsy. We estimated the victim to be male, 50-65 years old, 164-168cm high and at 5-10 years after death. The cause of his death was not clear. During the careful examination, we noticed that there was an extra vertebra (vertebra X), at the thoraco-lumbar region. The vertebra X was located between T12 and L1, and showed intermediate properties of T12 and L1. The presence of numerical variations in the thoraco-lumbar vertebrae should be more well-known for forensic scientists; the knowledge seems very important for the judgment whether the remains are of a single or multiple individuals.     

Is D2 lymph node dissection necessary for early gastric cancer?

Background The objective of this study was to clarify a survival benefit of D2 lymphadenectomy in patients with early gastric carcinoma (GC). Methods A retrospective study was conducted to examine the incidence of metastasis to level 2 lymph nodes, the causes of postoperative death, and the mode of recurrence in 1041 patients who head early GC and underwent D2 lymphadenectomy with curative intent. Results Postoperative mortality occurred in 129 (12,4%) of 1041 patients, 6 patients (.6%) died of surgical complications 108 (10.2%) died of diseases other than cancer, and 16 (1.5%) died of recurrence. Hematogenous metastasis was the major mode of recurrence (56.3% of recurrences). The incidence of metastasis to level 2 nodes was 2.5% (26 of 1041 patients, 18 of whom were alive). Thus, the estimated survival benefit of radical lymphadenectomy for patients with early GC was calculated to be 1.7% (18 of 1041 patients). Conclusions D2 lymphadenectomy in patients with early GC had little survival benefit because (1) metastasis to level 2 nodes was rare, (2) most causes of death were not related to the tumor, and (3) more than half the recurrences were hematogenous. Use of radical lymphadenectomy for early GC should be limited.     

Henoch-Schönlein purpura with hypocomplementemia in children

BACKGROUND: The clinical course and prognosis of Henoch-Schonlein purpura (HSP) associated with hypocomplementemia are not clear. METHODS: The clinical findings of 10 children with HSP and hypocomplementemia were studied. RESULTS: Purpuric rash in all patients, abdominal pain in five, and arthralgia in nine were noted. The findings in HSP were not different from others with HSP. In eight patients, infection preceded hypocomplementemia. Serum levels of CH50, C3 or C4 were depressed variously. Complement levels returned to normal within 5 weeks in all patients. Antistreptolysin-O (ASO) titer was elevated in all patients and nephritis occurred in eight patients. Six patients had generalized edema and hypertension. Macroscopic hematuria occurred in two patients and heavy proteinuria in five patients. One patient was diagnosed as having poststreptococcal acute glomerulonephritis (PSAGN) combined with HSP nephritis according to renal biopsy findings. In three of eight patients with nephritis, abnormal urinary findings continued for more than 1 year. CONCLUSIONS: Hypocomplementemia in children with HSP was transient and was not related to severity of HSP. Incidences of elevated ASO titer and nephritis were high. The nephritis resembled PSAGN during the acute stage and long-term clinical courses varied. These findings suggest PSAGN may be associated with HSP nephritis.