Pleuropulmonary Blastoma: A Case Report

Primary pulmonary neoplasms are uncommon in children. One such tumor, pleuropulmonary blastoma (PPB), is very rare, highly aggressive and malignant, and originates from either the lungs or pleura. It contains both mesenchymal and benign epithelial elements that resemble fetal lung, and occurs mainly in children aged less than five. The clinal symptoms often suggest upper respiratory tract infection or pneumothorax, but ultrasonography and chest CT scans depict both a large mass occupying an almost entire hemithorax, and a simple lung cyst. Contrast-enhanced CT demonstrates hetergeneous attenuation and a whorled appearance.

A Study on the Activation of Supplementary Motor Area in Functional Magnetic Resonance Imaging of the Brain

PURPOSE: To evaluate the activated zone of the supplementary motor area through motor and sensorystimula-tion of both hands by fMRI. MATERIALS AND METHODS: Twenty-four healthy volunteers, ranging in age from 20to 30 years, served as sub-jects. They were divided into four groups and performed one of the four activationtasks : complex movement, fine movement, touch sensation, heat sensation. Complex movement consisted of a fingertask in which sub-jects flexed and extended all fingers repeatedly in union, without the fingers touching eachother(group I). Fine movement involved a thumb task in which subjects flexed and extended the thumb repeatedlywithout touch-ing the other fingers(group II). Touch sensation consisted of a palm task in which another personrepeatedly drew a circle on the subject 's palm (group III), and heat sensation involved of a palm task in whichsubject 's palm was touched by another person with a 40 degreeC water-bag (group IV). F-MRI was conducted on acommer-cial 1.5-T scanner equipped with echo-planar imaging. After overlapping images were obtained using aZ-s-core, and the mean/curve in the MR devices was evaluated, the activated zone of the supplementary motor RESULTS: Thirty-two of 48 images(20 of the 24 men) revealed activated zones in the supplementary motor area. Ingroup I, activation was observed in five subjects, in three of whom it was bilateral (contralateral activation).In group II, activation was observed in five subjects, in one of whom it was bilateral. In group III, activationoccurred in five subjects(bilateral in four, and contralateral in three), and In group IV, activation was alsoob-served in five ; in three of these it was bilateral. CONCLUSION: Using fMRI, and in association with motor andsensory tasks, the supplementary motor area was activated in 66.7% of healthy volunteers (32/48).

Functional MRI of Motor Speech Area Combined with Motor Stimulation during Resting Period

PURPOSE: To evaluate functional MR imaging of the motor speech area with and without motor stimulation duringthe rest period. MATERIALS AND METHODS: Nine healthy, right-handed volunteers(M:F=7:2, age:21-40years) wereincluded in this study. Brain activity was mapped using a multislice, gradient echo single shot EPI on a 1.5T MRscanner. The paradigm consisted on a series of alternating rest and activation tasks, performed six times. Each volunteer in the first study(group A) was given examples of motor stimulation during the rest period, while eachin the second study(group B) was not given examples of a rest period. Motor stimulation in group A was achieved bycontinuously flexing five fingers of the right hand. In both groups, maximum internal word generation was achievedduring the activation period. Using fMRI analysis software(Stimulate 5.0) and a cross-correlationmethod(background threshold, 200; correlation threshold, 0.3; ceiling, 1.0; floor, 0.3; minimal count, 3),functional images were analysed. After correlating the activated foci and a time-signal intensity curve, theactivated brain cortex and number of pixels were analysed and compared between the two tasks. The t-test was usedfor statistical analysis. RESULT: In all nine subjects in group A and B, activation was observed in and adjacentto the left Broca's area. The mean number of activated pixels was 31.6 in group A and 27.8 in group B, adifference which was not statistically significant(P>0.1). Activities in and adjacent to the right Broca 's areawere seen in seven of group A and four of group B. The mean number of activated pixels was 14.9 in group A and 18in group B. Eight of nine volunteers in group A showed activity in the left primary motor area with negativecorrelation to the time-signal intensity curve. The mean number of activated pixels for this group was 17.5. Inthree volonteers, activation in the right primary motor area was also observed, the mean number of activatedpixels in these cases was 10.0. CONCLUSION: During the rest period, functional MR imaging of the motor speechcenter combined with motor stimulation was more effective than that without stimulation, and simultaneouslyprovided mapping of the primary motor area.

Effectiveness of Transarterial Chemoembolization in Hepatoblastoma: A Preliminary Study

PURPOSE: To evaluate the therapeutic effectiveness and useful as well as the ness, systemic effect andeffectiveness, of preoperative TACE when used in patients with unresectable or high risk hepatoblastoma. MATERIALS AND METHODS: We retrospectively evaluated four patients with pathologically proven hepatoblastoma. One was maleand three were female, and they were aged between 8 and 27 (mean, 15) months. All underwent selective hepaticangiography and chemoembolization after superselection of tumor feeding vessels. Cisplatin 90mg/m2 (50-80mg),adriamycine 40mg/m2 (20mg) and lipiodol suspension 4cc ere used and chemotherapeutic angents. Embolization wasthen performed, gelfoam particles. TACE was repeated at intervals of 3 weeks, and after the second episode, allpatients underwent hepatic resection. To evaluate changes in the size, volume, internal texture and margin of themass, as well as the systemic toxicity of chemotherapeutic drugs, we performed contrast-enhanced CT and checkedAFP, CBC and GOT/GPT before and after TACE. RESULTS: In all patients, TACE was successfully performed and majorproblems related to the procedure and toxicity of chemotherapeutic agents used were not noted. The largestdiameter and volume of tumors were reduced by 33% (from 8.3 to 5.6cm) and 69% respectively. Tumor necrosis wasevident in all patients. Lipiodol uptake by tumors was homogenous and tumors were well distinguished from normalparenchyma. Compared to pre-TACE, serum alpha-feto-protein was reduced from 994(range:615-1690ng/ml) to 46ng/ml(42-47ng/ml)after the second TACE, and six months after surgery was in the normal range(13ng/ml;3-23ng/ml).SGOT/SGPT levels were temporally elevated after TACE but normalized within a few weeks. CONCLUSION: TACE can be auseful technique for preoperative treatment of hepatoblestomas. In tomors which are high-risk or inoperable, thetherapeutio agents involved were not shown to be toxic.