A Study of Radiological Appearances of Septic Pulmonary Embolism in Contrast Enhanced Computed Tomography Thorax

Introduction:Septic embolism, though dangerous and life threatening thenumber of cases reported are seldom. To diagnose septicembolism clinic-radiological correlation is must. Studyaimed to depict various radiological appearances of septicthromboembolism according to there frequency of occurenceand using clinical history to strengthen the suspicion of SPEin patients as SPE have grave prognosis if not detected early.Material and methods: Study was done in the GovernmentMedical College Surat including the subjects of clinicallysuspected septic pulmonary thromboembolism and studyingthe radiological pattern of their presentation during the year2018-2019.Results: In this study the most common radiologicalpresentation is feeding vessel sign seen in (90%) of patientsCT, the most common cause is liver abscess constituting (40%)of cases, the most common primary cause in the patients withcomplications and mortality is pneumonia and most commonsequelae is acute respiratory failure constituting (66%) ofmortality and most common chronic ailment association isdiabetes mellitus seen in (60%) of patients.Conclusion: Septic pulmonary embolism is life threateningbut diagnosis is difficult as there are no specific clinicalcomplaints and radiological features but for benefit of patientquick diagnosis and management must be started as it has highmortality rate. SPE should be considered in the differentialdiagnosis of patients presenting extrapulmonary infectivefocus, respiratory symptoms, and parenchymal pulmonarynodules on imaging studies of the chest.

The Efficacy of Hepatic Arterial Infusion Therapy for Advanced Hepatocellular Carcinoma according to Extrahepatic Collateral Feeding Vessels / 대한간학회지

BACKGROUND/AIMS: Despite the poor response rate of 20-30%, hepatic arterial infusion therapy (HAIT) has been often tried for advanced hepatocellular carcinoma with portal vein tumor thrombosis or ineffective response to other treatments. The factors that predict treatment response to HAIT remain unclear. This study ascertained the response rate to HAIT based on the existence of extrahepatic collateral feeding vessels or anatomical variants. METHODS: Forty one patients received repeated HAIT using an implanted drug delivery system. Of the 41 patients, 18 patients were treated with 5-FU, epirubicin and mytomycin-C; 17 patients were treated with 5-FU and cisplatin; and 6 patients were treated with 5-FU, cisplatin and leucovorin. The patients were divided into two groups according to the existence of extrahepatic collateral feeding vessels or anatomical variants. RESULTS: Of the 41 patients, 10 patients (24.4%) showed a complete response (CR) or partial response (PR). Of 41 patients, 22 patients (group A) did not have extrahepatic collateral feeding vessel or an anatomical variant, but 19 patients (group B) did. In group A, 10 patients (45.5%) had a treatment response (CR+PR). However, only one patient (5.3%) had a treatment response (CR+PR) in group B. The response rate in group A was significantly higher than that in group B (45.5 vs. 5.3%; P=0.005). The median survival of group A was significantly longer than that of group B (10.8 vs 3.4 months, P=0.031). CONCLUSIONS: Hepatic arterial infusion therapy may be useful therapeutic option for patients with advanced HCC, especially in those that do not have extrahepatic collateral feeding vessel or anatomical variant.

Thoracic Arteriovenous Malformation: Case Report

The authors experience a case of juvenile type thoracic arteriovenous malformation. It is acute onset and represent spastic paraparesis, sensory Impairment and voiding difficult. Intradural spinal arteriovenous malformation is relatively rare lesion. The authors treated with total excision of A-V malformed vessel with good results.

A Case of Giant Ependymomas of the Cauda Equina associated with Thoracic Intradural Spinal A-V Malformations

Spinal ependymomas originate in the ependymal lining and grow rather slowly which allows them to reach considerable size and length. The great majority of primary tumors of the cauda equina are ependymomas and show a rather marked predilection for the male. Histologically ependymomas are benign but merastasis and anaplasia have been reported. The basic architectural structures of the ependymoma are the ependymal rosettes and pseudo-rosettes. Intradural spinal arteriovenous malformmations are relatively rare lesions and found only at autopsy or incidentally during surgical operations before the advent of investigative procedure. Development of myelography and spinal angiography have shown that vascular malformations of the spinal cord are not rare. Male is more predominant than female. The etiology and pathophysiological mechanisms are uncertain but many authors have believed that congenital, trauma, inflammations, tumoral processes, vasculitis and abnormal posture are influenced on A-V malformations of the spinal cord. No reports have been noticed about giant ependymomas of the cauda equina combined with spinal A-V malformations. We have experienced a case of giant ependymomas of the cauda equina associated with thoracic intradural spinal A-V malformations in forty-two year-old male and reviewed the literatures.