Teratogenicity of Aino virus in the chick embryo.

Aino virus (JaNAr 28 strain), a possible agent of a congenital anomaly of calves, was inoculated into the yolk sac of chick embryos at a dose of 10(2), 10(3), 10(4) or 10(5) TCID50 0.2 ml-1 at four, six or eight days of incubation. At 21 days of incubation all the unhatched embryos or hatched chickens in the experimental and control groups were sacrificed for pathological examination. The incidence of hydranencephaly, cerebellar hypoplasia or agenesis and arthrogryposis or scoliosis was highest (85 per cent in the chicks inoculated with 10(3) TCID50 0.2 ml-1 at eight days of incubation. The lesions were very similar to those found in congenital abnormalities in calves suspected of a natural infection with Aino virus.

99Tcm tetrofosmin uptake in mediastinal tumours.

We present our experience in visualizing mediastinal tumours using 99Tcm tetrofosmin. Three patients with thymic tumours and two patients with a mediastinal tumour (seminoma and small cell carcinoma) were found to have anterior mediastinal masses on chest radiographs, and subsequently underwent computed tomography and magnetic resonance imaging. In addition, the patients underwent single photon emission computed tomography (SPECT) with 99Tcm tetrofosmin and 201Tl. Intense uptake was seen on early 99Tcm tetrofosmin images in three patients with thymoma, invasive thymoma and mediastinal tumour (small cell carcinoma). In the remaining two patients with thymic carcinoma and mediastinal seminoma, there was intense 99Tcm tetrofosmin uptake on early images which reduced on delayed images. 201Tl uptake was intense on both early and delayed images. These findings suggest that different 99Tcm tetrofosmin uptake in early and delayed imaging may offer new information on these mediastinal tumours.

Hydranencephaly, cerebellar hypoplasia, and myopathy in chick embryos infected with aino virus.

Pathogenesis of Aino virus (AIV), a suspected causative agent of congenital abnormalities of calves, has not yet been established by experimental infection of dams. To investigate the pathogenesis, 10(3) median tissue culture infective doses per 0.2 ml of AIV strain JaNAr 28 was inoculated into the yolk sac of 8-day-old chick embryos. At 4, 7, 10, and 13 days post-inoculation (PI) 20 eggs were opened and macro- and microscopic studies combined with virus recovery and immunohistochemical detection of the virus antigen were performed. At 7 to 13 days PI chick embryos manifested marked hydranencephaly, cerebellar hypoplasia, arthrogryposis, and scoliosis, with the highest incidences of 86.7%, 73.3%, 80.0%, and 20.0%, respectively. At 4 days PI the viral antigen was found in nerve cells, gitter cells in mild necrotic foci of the central nervous system (CNS), degenerative myotubules, and macrophages in the interstitium, which was associated with the early phase of AIV-induced encephalitis and polymyositis, with occasional accompanying hemorrhage and clumping of myotubular fragments. From 7 to 10 days PI, AIV antigen increased markedly in the liquefactive necrosis and in both degenerative and normal-looking myotubules in conjunction with developing hydranencephaly and arthrogryposis. The encephalitis and myositis had a tendency to mitigate by 10 days PI, coincident with a slight decrease in amount of AIV antigen. At 13 days PI there was almost no detectable AIV antigen in CNS and skeletal muscles, probably due to depletion of cells having affinity to AIV.

99mTc tetrofosmin uptake in lung cancer. A case report.

This case report describes a 71-year-old man with a lung tumor in the posterior inferior segment of the right lung, detected on a screening chest radiograph. The patient underwent myocardial imaging with 99mTc tetrofosmin and 201Tl, using single photon emission CT (SPECT), and the tumor showed intense focal uptake of the radiotracer. This observation supports the recent suggestion that 99mTc tetrofosmin may be useful for oncologic imaging of lung carcinoma, and further studies may be warranted.

[Visual analysis of hepatic function by a scoring system using 99mTc-GSA].

To establish a simple hepatic function test, a five-point scoring system using 99mTc-galactosyl-human serum albumin (GSA) was applied to seventy-six patients with or suspected with hepatic dysfunction. Dynamic data at rest were obtained immediately and 30 minutes after intravenous bolus injection of 99mTc-GSA (185 MBq). Regions of interest (ROIs) were superimposed over the images of the liver and the entire heart. A visual analysis using a image taken 5 to 6 minutes after radiotracer injection was performed by the three observers blinded to the clinical information to assess their agreement or disagreement on the grading score. kappa-Test was used to evaluate the goodness of agreement. Three pairs in the first reading showed excellent interobserver agreement (0.92 mean kappa-value). Three pairs in the first and second reading also showed excellent intraobserver agreement (0.89 mean kappa-value). Data were also analyzed for correlations with heart/liver count ratio, ICG R15, LHL15, Alb, TB, PT, HPT and ZTT. There were good correlations between visual grading score and ICG R15 (Rs = 0.619, p < 0.0001) and between grading score and heart/liver count ratio (Rs = 0.866, p < 0.0001). Grading score was also correlated with LHL15, Alb, TB, PT, HPT and ZTT (Rs = -0.770; -0.580; 0.593; -0.544; -0.622; 0.518, p < 0.0001 for each). There was a significant difference between heart/liver count ratio and LHL15 in the Grade 4 and Grade 5 groups. In conclusion, the present data suggest that a five-point scoring system based on visual analysis using 99mTc-GSA uptake is a useful indicator for hepatic dysfunction in a clinical setting.

Proliferation and teratogenicity of Aino virus in chick embryos.

Aino virus (AIV; JaNAr 28 strain) 10(3) TCID50/0.2 ml was inoculated in the yolk sac of 8-day-old chick embryos. Recovery and titration of the virus from various organs including the central nervous system (CNS) and skeletal muscle were performed at 2, 4, 7, 10 and 13 days after inoculation (PI). AIV was systematically disseminated and proliferated even 2 days PI. The titers of the recovered virus from the CNS and from skeletal muscle was the highest at 4 days PI and declined with time, whereas hydranencephaly, arthrogryposis and cerebellar hypoplasia developed at 7 days PI and gradually progressed until 13 days PI.

[MR diagnosis for metastasis or non-metastasis of mediastinal and hilar lymph nodes in cases of primary lung cancer: detectability, signal intensity, and MR-pathologic correlation].

The detectability and signal intensity on MR imaging of mediastinal and hilar lymph nodes were studied in cases of lung cancer. Additionally, short inversion time inversion recovery (STIR) images and pathologic findings were compared. In the detection of resected metastatic mediastinal and hilar lymph nodes (n = 146), the STIR image (82%) was superior to the T1-weighted image (71%) and the T2-weighted image (60%). On STIR imaging, 212 (60%) of 412 resected non-metastatic mediastinal nodes and 38 (33%) of 116 resected non-metastatic hilar lymph nodes were detected. Characteristics of signal intensities of metastatic nodes were mainly low on T1-weighted images, high on T2-weighted images, and very high on STIR images. The rate of these characteristics of signal intensity of metastatic nodes was 59%. However, the rate of very high signal intensity of metastatic nodes on STIR imaging was 81%. Pathologically, lymph nodes with high or very high signal intensities on STIR images were metastatic, reactive and hyperplastic, or non-metastatic. Lymph nodes with slightly high signal intensity or high intensity with a low focus on STIR images were anthracotic, anthrasilicotic, caseous necrotic, calcified, or fibrotic. Thus, when the signal intensity of a lymph node was decreased on the STIR image, there was no definite evidence of metastasis excluding micro-metastasis or coagulation necrosis of a metastatic tumor. We conclude that the signal characteristics on STIR imaging are useful for distinguishing between macro-metastatic and non-metastatic lymph nodes when enlarged nodes are detected by various other types of medical imaging.

Transcatheter hepatic arterial chemoembolization using epirubicin-lipiodol: experimental and pharmacological evaluation.

The experimental and pharmacological characteristics of various formulations of an anticancer agent (epirubicin, EPI) and lipiodol were evaluated in vitro and in vivo. Three forms of EPI-lipiodol, i.e., an oil-in-water type of emulsion (O/W type), a water-in-oil type of emulsion (W/O type), and a suspension (S type), were prepared and investigated for their stability. An O/W-type emulsion using a stock solution of Iopamidol as the solvent for EPI was the most stable form in the stationary state in vitro. In 16 patients with malignant liver tumors (14 hepatocellular carcinomas and 2 liver metastases), the three forms of EPI-lipiodol were injected into the proper hepatic artery. The plasma EPI level was monitored periodically and analyzed pharmacokinetically. No significant difference in the pharmacokinetics of EPI was detected among the O/W, W/O, and S types.

[Bronchial atresia of additive anomalous bronchus].

A case of bronchial atresia of additive anomalous bronchus in right middle lobe was reported. A mass and emphysematous lung were found on the chest roentgenogram. CT, and MRI, and it is not difficult to diagnose.

[Diagnosis of acute gastrointestinal bleeding using scintigraphy with 99mTc-labeled red blood cells].

To evaluate the usefulness and clinical significance of scintigraphy using 99mTc-RBC in urgent abdominal bleeding, we performed abdominal bleeding scintigraphy in 20 patients with melena. These patients were admitted to the critical care center. Nine of 20 patients showed positive images with bleeding scintigraphy. Five of 20 patients were referred because of small intestinal bleeding. Four of these 5 patients revealed positive images. Seven of 9 patients who had positive image and four of 11 patients who were negative had open-surgery performed. While angiography was done in 8 patients, only 3 of the 8 patients were proven to have bleeding. These 3 patients also revealed positive images by bleeding scintigraphy. This technique facilitates the screening of bleeding in the ileum, where endoscopic techniques may prove difficult to detect the site of bleeding. We emphasize that abdominal scintigraphy should be performed on patients with G.I. bleeding since this is a more accurate examination than angiography.

Ruptured abdominal aortic aneurysm: factors influencing operative mortality.

Of fifty-eight consecutive patients surgically treated for aneurysm of the abdominal aorta, twenty were emergency cases following the rupture. Associated diseases were found in 85 per cent of patients; hypertension being the most common. Fifty per cent of patients were in shock on admission. The duration between rupture and operation was three hrs to two weeks with the average of 115.5 hrs. In six patients, the diagnosis of abdominal aortic aneurysm was known for over six months. The operative mortality rate in case of ruptured abdominal aortic aneurysm was 45 per cent. The most important determinants of survival were the incidence of shock on admission, the incidence of associated disease, the known duration of the aneurysm, and the time interval from rupture to admission. The intraoperative factors most influencing survival were the type of rupture, intraoperative hypotension, and total blood loss. Comparison of the mortality rate in elective surgery of abdominal aortic aneurysms (5.3 per cent) with that in ruptured aneurysms (45.0 per cent) suggests the necessity for early elective operations whenever abdominal aortic aneurysms are diagnosed.

[Acute and chronic experimental tricuspid valvular stenosis in dogs].

Acute and chronic experimental tricuspid valve stenosis was produced in 20 dogs. Clinical and hemodynamic alterations that resulted from severe anatomic tricuspid valve narrowing were surprisingly mild. In the acute stenosis studies, the normal tricuspid valve area of 8.2 +/- 0.3 sq cm was narrowed to less than 1.0 +/- 0.1 sq cm with a resulting right auricle-right ventricle diastolic gradient of 3.7 +/- 0.7 mm Hg. In chronic studies, a decrease in tricuspid valve area from 7.6 sq cm to 1.6 +/- 0.3 sq cm produced a diastolic gradient of 1.8 +/- 0.2 mm Hg. After 60 days, overt signs of right-sided failure (pleural effusions and ascites) were absent, and histological evidence of passive congestion (liver and spleen) was not recognized. The splanchnic vascular beds appear to act as excellent buffers against increases in right-sided cardiac pressure. We conclude that isolated narrowing of the tricuspid valve must be very severe to cause notable clinical and hemodynamic changes.

[A comparative study of experimental models for cardiac preservation through orthotopic transplantation].

Various kinds of models for canine heart preservation were evaluated through orthotopic transplantation. Following warm ischemic (WIT) and preservation times (PT), donor hearts were orthotopically transplanted to recipients and observed for 2 hours. The study was divided into four groups. A heart-lung preparation (Group A) was preserved by coronary perfusion with diluted blood for an hour following 15-minute WIT in A-1 (n = 33), and 2 hours following 30-minute WIT in A-2 (n = 19). Following 30-minute WIT, the heart (Group B) was preserved for an hour by coronary perfusion with diluted blood in B-1 (n = 20), a modified Krebs solution in B-2 (n = 14), and a EL-solution in B-2 (n = 14). Following 30-minute WIT, the heart (Group C) was preserved for 2 hours by a Langendorff's model with coronary perfusion using perfluorochemical in C-1 (n = 5) and Hydroxyethyl starch in C-2 (n = 1). In Group D, electromechanical arrest of the heart and coronary vascular washout were performed in D-1 (n = 8) with K+ cardioplegia, D-2 (n = 8) with K+-verapamil cardioplegia, and D-3 (n = 5) with Collins M-verapamil cardioplegia. The heart was then removed and suspended in the same solution. The graft was preserved at 4 degrees C for 6 hours in D-1 and D-2, and 24 hours in D-3. Fourty-eight % in A-1 and 26% in A-2 were successfully transplanted.(ABSTRACT TRUNCATED AT 250 WORDS)

Cystic partially differentiated nephroblastoma and multilocular cyst of the kidney. Report of two cases of so-called multilocular cyst of the kidney.

Two cases of so-called multilocular cyst of the kidney are presented. Although both cases satisfied all of the criteria which characterize the multilocular cyst of the kidney, one had cystic lesions and neoplastic lesions (nephroblastoma-like lesions) and the other had only cystic lesions and was complicated with hamartoma. We prefer the term "cystic partially differentiated nephroblastoma" as the diagnostic term for the former and "multilocular cyst of the kidney" for the latter. A study of 40 reported cases of multilocular cystic lesions of the kidney revealed that cases having only cystic lesions were distributed in all ages from 4.5 months to 71 years and that cases having neoplastic lesions were seen in infants from 4 months to 2 years.