[Changes in arterial blood flow patterns by patients' posture during hepatic arterial infusion chemotherapy assessed by 99mTc-MAA perfusion scintigraphy].

Hepatic arterial perfusion scintigraphy (HAPS) with 99mTc-macroaggregated albumin (MAA) was performed to reveal the effect of patients' posture for the arterial blood flow patterns in hepatic arterial infusion (HAI) chemotherapy. 20 patients of liver metastases with the percutaneously implanted catheter into the hepatic artery underwent HAPS following administration of 99mTc-MAA at the supine and the upright position under one week interval. 10 ml of the saline with radionuclide was injected at a rate of 1 ml per minute. Acquired two images at the different position of each patient were compared and grouped into three classes; similar, slightly different and different. Of 20 patients, 6 (30%) were judged as similar, 8 (40%) as slightly different, and 6 (30%) as different. These results suggest that the drug distribution can change by patients' posture in case of the slow rate HAI performed with continuous infusion pump.

[Intermittent hepatic arterial infusion of high-dose 5-FU for liver metastases from colorectal cancer].

A phase II study of weekly intermittent hepatic arterial infusion of high dose 5-FU for liver metastases from colorectal cancer was carried out. Thirty-two patients with unresectable liver metastases from colorectal cancer were entered in this study. Nausea (< or = grade 2) was observed in 31% of the cases, mild elevation of rGTP in 13%, biloma in 9%, and hepatic arterial occlusion in 22%. However, no major toxicity occurred. The response rate evaluated by CT-scans was 75% (4 CR + 20 PR/32), and the overall median survival was 22 months. Significant differences of median survival were observed in the extra-hepatic lesions [extrahepatic lesions: (-) 16 months vs (+) 22 months]. This regimen showed high activity without major toxicity and the reduction of pts' QOLs caused by pumps. It confirmed by a study involving a large number of cases, this regimen will become a standard regimen for unresectable liver metastases from colorectal cancer.

[Arterial redistribution to prevent hepatic arterial occlusion and gastric ulcer using hepatic arterial infusion chemotherapy with percutaneous catheterization].

Clinical usefulness of arterial redistribution using steel coils to prevent hepatic arterial occlusion and gastric ulcer was compared with the conventional method. Fifty-two patients with liver malignancies were inserted with steel coils into the common hepatic artery after percutaneous hepatic catheterization (CHA-coil) to prevent hepatic arterial occlusion. The tip of the indwelling catheter was fixed to the vascular wall, and the contact area between the catheter and blood into the liver became smaller. Fifty-nine other patients were inserted with steel coils into the right gastric artery (RGA-coil) to prevent gastric ulcer. The CHA-coil succeeded in 84% of the patients, and hepatic arterial occlusion occurred in only 4% of these patients. The RGA-coil succeeded in 88%, and gastric ulcer occurred in 2%. The rates of hepatic arterial occlusion (4%) and gastric ulcer (2%) were much decreased in comparison with 25% and 16%, respectively, in the previous cases undergoing percutaneous hepatic catheterization without such arterial redistribution. In conclusion, these procedures are highly effective to prevent complications of hepatic arterial infusion employing percutaneous hepatic catheterization and to allow continuation of arterial infusion chemotherapy for longer periods.

[Eight cases of intracranial arteriovenous malformations treated by conventional radiation therapy].

We conducted radiotherapy in 8 cases of intracranial arteriovenous malformation that had difficult embolectomy and other surgery from 1983 to October, 1988. The results in 6 cases of dural arteriovenous malformation at the cavernous sinus were "marked effect" in 4 cases, "relapse" in 1 case, and "no effect" in 1 case. One case of dural arteriovenous malformation at the sigmoid venous sinus demonstrated only slight irradiation effect. No irradiation effect was observed in 1 case of cerebral arteriovenous malformation.

[Usefulness of dual-energy digital radiography in detecting atlas and axis].

Cranial dual-energy digital radiography was applied to three patients. The anatomy of the atlas and axis was clearly recognized without utilizing the open-mouth view. We consider it a very effective technique when applied to the patient who experiences difficulty in opening the mouth, like severe traumatic or infantile patients. In addition, it is a useful examination for patients with suspected anomalies of cranio-vertebral junction.