Cerebellopontine angle ganglioneuroblastoma

Summary The CT, MR and histological features of a rare ganglioneuroblastoma of the cerebellopontine angle and cavernous sinus are reported.     

Tricuspid annuloplasty and right ventricular function in mitral valve disease

From 1985 to 1987, we examined relationship between the lesion of tricuspid valve and right ventricular function in 31 patients (male: 9, female: 22) with mitral valve disease. The median age at operation was 52 years (range 37-69 years). Group I consisted of 17 patients (MS: 10, MSR: 5, MR: 2) accompanied with tricuspid regurgitation (TR) and Group II 14 patients (MS: 12, MSR: 2) without TR. In all cases of Group I tricuspid annuloplasty (TAP) were performed correctly. De Vega methods were done in 12 cases and Carpentier rings were used in 5 cases. Cardiac catheterization was done before and after operation. And right ventricular volume was measured by right ventricular angiography. In both groups pulmonary capillary wedge pressure, pulmonary artery pressure and cardiac index were improved postoperatively. Pulmonary artery resistance (PAR) and total pulmonary resistance (TPR) in Group I were significantly higher before operation but there were no difference between two groups postoperatively. Right ventricular end-diastolic volume index (RVEDVI) and right ventricular end-systolic volume index (RVESVI) in Group I were significantly improved postoperatively, but in Group II these were within normal range both pre- and postoperatively. Preoperative PAR was correlated inversely with postoperative right ventricular ejection fraction (RVEF). It means that patients with severe pulmonary vascular lesion had postoperative lower right ventricular function. In both groups, RVESVI was in inverse correlation with RVEF pre- and postoperatively. In both groups, there was an inverse correlation between the per cent change of RVESVI and that of RVEF. This means that RVESVI influenced right ventricular pump function.     

Tumor necrosis factor-alpha in the placenta is not elevated in pre-eclamptic patients despite its elevation in peripheral blood

PROBLEM: Tumor necrosis factor-alpha (TNF-alpha) is present in human placental and uterine cells at the early and late stages of gestation and promotes the regulation of trophoblast growth and invasion. We evaluated whether TNF-alpha levels in the placenta and blood of pre-eclamptic women differed from those with normal pregnancies. METHOD OF STUDY: The subjects were 39 pregnant women carrying single fetuses (21 normal-pregnant and 18 pre-eclamptic patients). Their average gestational age at entry was 38-39 weeks. Peripheral blood was collected before the onset of labor and separated serum was stored at -20 degrees C. A tissue segment of the placenta was cut and frozen in liquid nitrogen immediately after delivery at -80 degrees C. The frozen placental tissue was added to phosphate-buffered saline. The tissue was fully homogenized and centrifuged. Separated supernatant was stored at -80 degrees C. TNF-alpha levels in separated serum and TNF-alpha and total protein (TP) levels in separated supernatant were measured. The presence of TNF-alpha in the placenta was evaluated by immunohistochemistry in five pre-eclamptic and five normal-pregnant patients. RESULTS: Serum TNF-alpha levels were higher in pre-eclampsia than in normal pregnancies. However, TNF-alpha/TP levels in the placenta did not differ significantly between the two groups. As for TNF-alpha immunostaining of trophoblastic cells in the placenta, it was weak in three and moderate in two of the normal pregnancies, while it was absent in two, weak in one, and moderate in two in the pre-eclampsia group. CONCLUSIONS: We demonstrated no significant increase in TNF-alpha/TP levels in the placenta in pre-eclampsia despite a significant increase in serum TNF-alpha levels. There was no strong immunostaining for TNF-alpha detected by immunohistochemistry in the pre-eclampsia group. These findings suggest that TNF-alpha in the placenta is not a key cytokine to interfere with normal trophoblast invasion into the myometrium in pre-eclampsia, and that sources other than the placenta may contribute to the elevated levels of TNF-alpha found in the circulation of pre-eclamptic patients.     

Scanning electron microscopic determination of quantitative parameters of villi in the rat jejunum

In rat jejunum, the number of epithelial cells per villus and the villus surface area were measured directly on the scanning electron micrograph. The villus height and the number of epithelial cells of the same villus were measured on the histological sections under a light microscope. Both the number of epithelial cells per villus and the villus surface area correlated well with the villus height and with the number of epithelial cells per villus sections. In the normal rat jejunum, the approximate values of the number of epithelial cells per villus surface and villus surface area may be estimated from the villus height or the number of epithelial cells per villus section.     

Carbon-13 and proton magnetic resonance studies of poly(N-vinylcarbazole) in solution

Spin-lattice relaxation times T₁ of individual carbons and protons were measured by the partially relaxed Fourier transform (PRFT) method for poly(N-vinylcarbazole) in solution. The ¹³C-T₁ value of the methylene carbon is about one-half of that of the methine carbon, and the carbazolyl CH carbons have T₁ values close to that of the skeletal CH carbons. The effective correlation time for the skeletal carbon is estimated as ca. 0,95 ns on the basis of the measured T₁ and ¹³C-¹H nuclear Overhauser effect (NOE) factor. Moreover, the ¹³C normal Fourier transformation (NFT) spectrum and proton T₁ indicate strong steric interactions between the pendant carbazolyl groups in the polymer. The results demonstrate that the polymer in solution has a rigid local structure with hindered internal rotation of the bulky side-chain groups.     

Usefulness of CT-angiography for superselective intra-arterial chemotherapy for advanced head and neck cancers

Eighteen N3 cases, fourteen skullbase invasion cases and twenty-six cases of paranasal sinus cancer with orbital invasion were treated by superselective intra-arterial chemotherapy using CDDP and sodium thiosulfate to preserve the organs and to improve poor prognosis. In these patients, 100-150 mg/m2 of CDDP was administered weekly to each feeding artery of the tumor superselectively at 5 mg/m. CT-arteriography (CTA) was used to diagnosis all feeding arteries of advanced cancers before infusing CDDP. Twenty-three of 26 cases with orbital invasion were treated with preservation of the eyeball. In three cases with extirpation of the eyeball CTA was not used in the treatment, and CDDP was infused into only the maxillary artery excluding the transverse facial artery. In skullbase invasion cases, the number of complete responses (CR) was 8/14, and that of partial responses (PR) was 6/14. Feeding arteries originating from the external carotid artery were found in 10 of all 14 cases by CTA, and four cases in which blood supply was from both carotid arteries were all anterior skullbase invasion cases. Ten cases with superselective intra-arterial chemotherapy originating from only the external carotid artery were significantly better responders than four cases originating from both carotid arteries. In N3 cases, feeding arteries were found in more than three arteries by CTA and the overall survival rate was 55%, calculated by the Kaplan-Meier method. CTA is a very efficient method for diagnosing all feeding arteries of advanced cancers in the superselective intra-arterial chemotherapy.     

Surgical treatment of the aortic aneurysm

For 93 cases of thoracic and 118 cases of abdominal aneurysms, the over-all operative mortality rate was 24.7 per cent and 9.3 per cent, respectively. Although the over-all operative mortality rate for 37 patients with aneurysms of the ascending aorta or aortic arch had been 40.5 per cent, recent advances in surgical technique led to a higher survival rate so that since 1975 no death occurred among 14 consecutive surgery cases. Cardiopulmonary bypass with or without selective perfusion of the carotid arteries or temporary external bypass procedures were employed in these 14 cases. The over-all operative mortality rate for 56 patients with aneurysms of the descending thoracic aorta was 14.3 per cent. Temporary external bypass procedures were employed in 49 cases. The operative mortality rate for 99 patients with unruptured abdominal aneurysms was five per cent, and that for 19 patients with ruptured aneurysms was 31.5 per cent.     

A case report of epithelioid hemangioendothelioma metastasizing to the tonsil

Epithelioid hemangioendothelioma is an extremely rare, difficult-to-diagnose vascular tumor mainly originating from the lung or liver. Primary tumors in the head and neck are very rare. A 40-year-old man admitted for right throat pain had been found in biopsy elsewhere to have squamous cell carcinoma. Based on a diagnosis of mesopharyngeal cancer, he underwent radical surgery, reporting cough, sputum, and hemosputum postoperatively. Epithelioid hemangioendothelioma was first diagnosed histopathologically from a biopsy of scalp tumors. Lung specimens at open biopsy 4 years earlier showed the same histological features indicating he had had epithelioid hemangioendothelioma lesion since that time. We assumed this epithelioid hemangioendothelioma had originated in the lung and metastasized to the right tonsil. These tumors are typically progressive and aggressive, and this patient had a poor prognosis. We discuss tumor features and review them clinically and histologically.