Locally Advanced Squamous Cell Carcinoma of the Uterine Cervix: MR Evaluation of Effect of Combined Biologic (13-cis-Retinoic Acid plus Interferon alpha-2a) and Radiation Therapy

PURPOSE: To evaluate the effectiveness of MR imaging in assessing the response of carcinomas of the uterinecervix to the combined therapy of interferon alpha-2a, 13-cis-retinoic acid and radiation. MATERIALS AND METHODS: Thirteen patients with untreated, locally advanced squamous cell cervical carcinoma were treated for eight weeks with 13-cis-retinoic acid plus interferon alpha-2a and radiotherapy. Axial and sagittal T1-weighted spin echo and fast spin echo MR images were obtained before and after treatment, using a 1.5-T MR scanner. MR images were correlated with biopsy findings. In each patient, pre- and post-treatment images were prospectively analyzed andcompared. RESULTS: In all patients, tumor volume could be calculated by three dimensional measurement on MR images. Initial response to the combined therapy was complete in eight patients, partial in four and progressivein one. Evidence of tumor recurrence was noted in two patients during the follow-up period. MR images correlated well with biopsy findings. CONCLUSION: MR imaging is useful in the evaluation of tumor response to the combined biologic and radiation therapy, which can be an effective first-line therapy against locally advanced squamouscell carcinoma of the cervix.

CT findings of exophytic hepatocellular carcinoma

We retrospectively evaluated the characteristic computed tomographic (CT) findings in nine patients with exohepatic hepatocellular carcinoma(HCC) pathologically prove by surgery(n=2) or percutaneous needle biopsy(n=7). The CT findings of exohepatic HCC were correlated with clinical findings and compared with those of usual HCC Lesions were in the left lobe lobe(n=7) and right lobe(n=2) of the liver. All lesions showed a well-marginated hypodense mass with capsular enhancement on enhanced CT scan. The patterns of capsular enhancement were complete in five and partial in four cases. The portal vein thrombosis was seen only in one case. There was no difference between exohepatic HCC and usual HCC in clinical findings such as increased α-fetoprotein(α-FP), positive Hepatitis B surface antigen(HBsAg), and underlying liver cirrhosis. In conclusion, the CT findings of exohepatic HCC were a well-defined hypodense mass with complete or partial capsular enhancement and these findings may be useful in differentiation from the tumors of adjacent organs.

Percutaneous biliary drainage in acute suppurative cholangitis with biliary sepsis

Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as a result of partial or complete obstruction of the bile duct, and may manifest clinically severe from of disease, rapidly deterioration to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying causes were 12 benign diseases(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis (n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients improvement of general condition and failed in three patients. The procedures were preterminated due to the patient's condition in two and biliary-porto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggests that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.

Computed tomography of stomach cancer: water as an oral contrast agent

No abstract available.

Dyke-Davidoff-Masson Syndrome Associated with Occlusion of Internal Carotid Artery

No abstract available.

Radiological evaluation of tuberculous spondylitis with computed tomography

Spinal tuberculosis is curable disease, and early diagnosis is mandatory for early treatment. We reviewedconventional radiographies and CT from Histopathologically confirmed 30 cases of spinal tuberculosis, and comparedthese findings with radiologic findings from 2 cases of pyogenic spondylitis and 4 cases of meastasis. The resultswere as follows: 1. The frequnet site of involvement were thoracolumbar juntion and low lumbar vertebrae, and themost frequent type is multisegmented subligamentous type (93.3%). 2. CT was not of great use in the diferentaldiagnosis of the tuberculosis. Dominant CT findings of tuberculous spondylitis were anterior vertebral bodydestruction, paravertebral soft-tissue mass and thick walled abscess formation occasionally containingcalcification and disc space narrowing, in the setting of an indolent or relatively benign course. 3. CT is thebest modality for imaging the extent and anatomy of the destructive process, the degree of canal encroachment, andthe change of adjacent vital structure. So CT was particularily useful in pre-operative planing of debridement andstabilization surgery. 4. The most common causes of neurologic manifestations in tuberculous spondylitis were thecompression of spinal cord by sequestrated bony fragments and disc material, granulation tissue or abscess in thespinal canal.

Ultrasonography of hydronephrosis and renal masses

We have analyzed utrasonographic finding of 55 cases of hydronephrosis and 34 cases of renal maasses. The results are as follows; 1. 55 cases of hydronephrosis revealed renal enlargement in 55 cases, separation of central echo complex in 27 cases, multiple anechoic areas radiating from the center in 25 cases and dilated renalpelvis in 24 cases. 2. Among the renal masses in 34 cases, simple renal cyst were 15 cases, polycystic kidney in 8 cases, hypernephroma in 8 cases, Wilms' tmor in 2 cases and angiomyolipoma in 1 case. 3. Simple renal cystrevealed single in 14 cases (93%) and well defined anechoic mass with posterior enhancement in all cases. 4. Polycystic kidney revealed bilateral irregular shaped renal enlargement and multiple anechoic cysts throughout the kidney. 2 cases (25%) involved liver. 5. 6 cases (75%) of hypernephroma revealed ill defined modarately echogenicmass without posterior enhancement. 6. All cases of Wilms' tumor revealed well defined large mixed echogenic massin right kidney. 7. Angiomyolipoma revealed bilateral dense echogenic mass with large hemorrhagic cyst in rightkidney. 8. The ultrasonography is useful noninvasive diagnostic modality of evaluation of renal masses and hydronephrosis.

Radiologic study of spontaneous pneumothorax

The authors reviewed serial chest films of 113 patients of spontaneous pneumothorax which were treated byclosed tube thoracotomy during the period from May, 1979 till July, 1982 in CNUH. The resuls are as follows; 1.Male was more frequently affected than female, and the sex ratio was 3.5:1. 2. 71.1 per cent of patients were over31 years of age. 3. Of the 113 cases, 51.3 per cent were on the right, 48.7 per cent on the left. 4. The mostcommon underlying pulmonary disease was pulmonary tuberculosis(39.8), the next was belb or bullar (17.7%), and thelast was pneumonia(8.8%). 5. Pneumothorax was the most common type in pulmonary tuberculosis(66.7%), andpyopneumothorax in pneumonia(80.0%). 6. Among 103 cases in complete re-expansion of collapsed lung after closedthe thoracotomy, 39.5 per cent was expanded completely within 1 week in presence of visceral and/or parietalpleural thickening, and 86.2 per cent in none of it. According to the degree of pneumothorax, the more severedegree of pneumothorax, the more delay in re-expansion times. 7. Most common chest finding after re-expansion ofcollapsed lung was pleural thickening(51.4%).

Congenital anomalies of the ribs

Conegenital anomalies of the ribs are common but rarely result in shadow which might be mistaken forpathological lesions. Careful inspection of the bony parts, which should be a routine, will usually be sufficientto avoid mistakes. Authors reviewed 6,921(5,865 male, 1,056 female) chest P-A films in adult (older than 16years), and radiolographic findings of congenital anomalies of the ribs were analized. The result were as follows;1. Congenital anomalies of the ribs were present in 193 patients. The incidence of congenital anomalies of theribs were 2.7% in male, 3.3% in female. 2. Among the 193 cases of congenital rib anomalies, 7 cases(0.1%) ofcervical ribs, 31 cases (0.4%) of underdeveloped ribs, 81 cases (1.2%) of anterior bifurcation, 34 cases (0.5%) ofbroadned ribs, 19 cases (0.3) of complete fusion and 21 cases (0.3%) of pseudathrosis were included. 3. 11.4% ofthe cases were bilateral, and right to left was 4:3 in unilateral involvement. 4. The location of the ribanomalies were as follows; (1) Underdeveloped ribs; 1st rib 31 case (79.5%), 2nd rib 3 cases(7.7%), 4th rib 3cases(7.7%), 5th rib 2 cases(5.1%). (2) Anterior bifurcation; 3rd rib 37 cases. 4th rib 29 cases, 5th rib 12cases, 6th rib 6cases, 2nd rib 2 cases. (3) Broadened ribs; 3rd 17 cases, 4th rib 15 cases, 5th rib 4 cases, 2ndrib 1 case. (4) Complete fusion; 1st-2nd rib 13 cases (68.4%), 5-6th ribs 4 cases (21.0%), 4-5th ribs 1case(5.3%), 6-7 ribs 1case(5.3%). The fusion occur in the posterior portion of 1st-2nd and 4-5th ribs,and in theposterior portion of 5-6th and 6-7ribs. (5) Pseudarthrosis; 1st-2nd and 2nd-3rd ribs, and in the posterior portionof 3-4th, 4-5 and 5-6th ribs. 5. In the cases of anterior bifurcation, the rib bifurcates almost in its anterior2.1-5.0 cm and most common in 3.1-4.0cm. 6. The characteristic radiographic findings in anterior bifurcation wereas follow;

Radiologic study on measurement of lumbosacral angle in backache patients

The radiologic findings of lumbosacral spine and measurement of lumbosacral angle were analysed in 238 with backache and 102 without backache which were visited at Chungnam National University from March 1980 to July 1981.The measurement of lumbosacral angle was based on a method of Fergson. The results obtained were as follows; 1. The age group of 18 to 29 years was most common in backache group and the male was affected more frequently than the female with the ratio of 1.9 to 1. 2. In patients with backache, the overall mean lumbosacral angles were 44.2±2.6 degrees in male and 35.8±2.0 degrees in female. In patients without backache, in control group, the overall mean lumbosacral angles were 32.6±0.7 degrees in male and 33.4±1.4degrees in female. 3. In control group, difference of means between male and female was about 1degrees in patients with backache, the overall mean lumbosacral angles were increased about 12degrees in male and 2degrees in female than control group. In patients with and without backache, no significant difference of lumbosacral angle between the 4 age groups was present. 4. In backache group, increased lordosis was more common and increased lumbosacral angle than the decreased lordosis. 5. In backache group, lumbosacral angle of abnormal radiologic findings in lumbosacral spine was significantly increased than control group. 6. In patients with backache, radiologic findings and its lumboscral angles were alumbosacral anomaly 56 cases (23.5%): 46.9 degrees, increased lumbar lordosis 46 cases (19.2%): 48.1 degrees, osteoarthritis 44 cases(18.5%) : 40.8 degrees, decreased lumbar lordosis 30 cases (12.6%): 29.9 degrees, in order, And these radiologic findings were similar with many other authors.

Changes of affected kidney in patient with ureteral stones

The intravenous pyelograms of 126 cases of ureteral stones were analized for study on changes in size,renocortical idex(RCI) and function of the affected kidney. The following results were obtained. 1. The size ofaffected kidney was increased in 45% of cases and decreased in 40% of cases. 2. The affected kidney showed anelevated RCI value as compared to the normal side. The mean value of RCI of the affected kidneys was 0.44 andnormal kidneys was 0.35. 3. The cases of upper ureteral stones most frequently showed urinary stasis. Theincidence of urinary stasis: hydronephrosis 61%, hydroureter 48%, nonvisualization 10%, and combinedhydronephrosis and hydroureter in 54% of the all cases.