[Whole body irradiation by high energy electrons for mycosis fungoides].
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Biomedical subjects
Publications and source records attributed to Y Wakuta.
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The use of liver and hepatobiliary scintigraphy for evaluation of the hepatobiliary system in patients with hepatic disease is now widespread. In the present case, the usefulness of liver and hepatobiliary scintigraphy for the diagnosis of liver malformation is described.
Organ volume was experimentally and clinically determined using single photon emission computed tomography (SPECT). In organ phantom filling with 99mTcO4-, the error was less than 3.3% in the volume over 400 ml but 11% at 200 ml. In 28 cases of patient, liver and spleen volume were measured by SPECT and X-CT. Good correlation was founded between SPECT volume and X-CT volume (r = 0.99, n = 49), although SPECT volume were 16% higher than X-CT volume (y = 1.16 x + 11.6, x: X-CT volume, y: SPECT volume).
Two cases of cerebral aneurysm combined with polycystic kidneys (PCKs) were presented. Case 1, a 24-year-old hypertensive male, was referred to our clinic owing to sudden onset of severe headache at August 20, 1982. Neurological findings on admission were stuporous, right vitreous hemorrhage (so-called Terson's syndrome), and hypertension. CT scans showed subarachnoid hemorrhage, and right MCA bifurcation aneurysm with marked vasospasms by cerebral angiography was revealed. Intentional delayed operation with V-P shunt was performed. He discharged with mild left upper limb paresis, and visual impairment on the right. Bilateral PCKs were confirmed by postoperative DIP and CT scan. Case 2, a 51-year-old female, who suddenly complained of severe headache, was referred to our department 3 days after subarachnoid hemorrhage. One year previously, she had been pointed out PCKs. Neurological findings on admission at February 29, 1980, were drowsy, left third cranial nerve palsy, and hypertension. Cerebral angiography showed multiple aneurysms (bilateral IC-PC & A-com). Neck clipping (1-IC-PC & A-com) and coating (r-IC-PC) were performed at the next day of admission, and V-P shunt operation was followed about 8 weeks after first operation. About 2 weeks after discharge, she suddenly became loss of consciousness and expired. Autopsy revealed intracerebral hemorrhage in left basal ganglia and thalamus. Both kidneys were PCKs of Potter type 3 and cysts of the liver were also noted. In young hypertensive patients with cerebral aneurysms, it should be in mind whether PCKs may be combined or not, and cerebral angiography in PCKs were reasonable to find out harbored cerebral aneurysm.(ABSTRACT TRUNCATED AT 250 WORDS)
A case of multiple intracranial anomalies was reported. They consisted of fenestration of the middle cerebral artery (MCA), persistent primitive trigeminal artery and four intracranial aneurysms. The patient, 45-year-old male, had an attack of subarachnoid hemorrhage on July 15, 1982. He was transferred and admitted to our Dept. of Neurosurgery on July 27. On admission neurological examinations revealed retinal hemorrhage, bilateral papilledema and abducens nerve paresis on the left. Cerebral angiography demonstrated multiple aneurysms, one in the left vertebral artery, one in the left MCA, one in the right IC-PC junction and one in the fenestrated right MCA and persistent primitive trigeminal artery. Computed tomography (CT) demonstrated high density areas in the basal cistern and bilateral sylvian fissures, and cavum septi pellucidi and cavum Vergae as well. Surgical intervention was done and all aneurysms were clipped or coated successfully. The aneurysm in the fenestrated right MCA had originated from the proximal end of the fenestration of the MCA. The cavum septi pellucidi and cavum Vergae were asymptomatic. The postoperative course was uneventful. The authors discussed the pathogenesis and clinical meanings of fenestration of the MCA and persistent primitive trigeminal artery, and inferred that the genetic abnormality at the stage of development of cerebral vessels could play one part of the formation of intracranial aneurysms, because of the fact that the cerebrovascular anomalies showed high incidence of coexistence of intracranial aneurysms.
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Serum ferritin levels were studied in 264 patients who were consisted of 153 patients with various malignant neoplasms and 111 patients with various benign diseases. Positive rate of serum ferritin in all patients with malignant neoplasms was 35%. Hepatomas and pulmonary cancer showed relatively high positive rate, respectively 65% and 42%. In patients with benign diseases, hepatic diseases showed the high positive rate (52%) and the other benign diseases was low positive rate (11%). The relationship between serum ferritin and alpha-feto-protein in patients with hepatomas and other liver diseases was low. And the relationship between serum ferritin and CEA (carcinoembryonic antigen) in patients with malignant neoplasms of gastrointestinal tract was also low. It seemed that the measurement of serum ferritin levels will be of low value in the differentiation of the patients with malignant neoplasms.
We report our experience with radiation therapy in 2 patients with anaplastic esophageal cancer with extensive distant metastases. Radiotherapy was given to the primary esophageal lesions and in both patients the tumors completely disappeared after irradiation with 2000 to 3000 rads. However, the metastatic lesions of the bone and liver did not respond despite the administration of BLM + PT -207 + BEMP in one case and METVFC + FT -207 in the other. Both patients died 4 and 5 months, respectively, after beginning the treatment. Effective chemotherapy of metastases needs to be developed because the primary lesions of anaplastic esophageal cancer are highly sensitive to radiation therapy.
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One hundred and ten patients with persistent vegetative state, were followed up for a period of five years from 1973 to 1978. Seventy-three per cent of the patients died during the period while about 10% of them recovered partially from the vegetative state. Among the recovered patients, only three became able to communicate, but two of these are not independent for their daily activites. Reactivity and clinical symptoms of 30 survivors were examined, but no great changes occurred during the last two years of the study.
Persistent vegetative state after severe brain damage was studied epidemiologically in 110 cases from 1973 to 1976. The causes of brain damage were varied. More than one-third of the cases were due to trauma, and about one-fifth were the result of vascular accidents. Three year observation revealed that 65% of the patients died during this period. Mean survival time for dead patients was 38 months. Reactivity, clinical signs, EEG findings, methods of management, and results of various trials of treatment were investigated in connection with the patient's prognosis.
The authors present a case report of the successful removal of an epidermoid tumor of the temporal horn of the lateral ventricle. The tumor was confined to the ventricular cavity and was not adherent or connected to the choroid plexus. Spilling of tumor material during surgery was presumed to have contributed to the development of a postoperative acute hydrocephalus, either by obstructing the cerebospinal fluid pathways or by causing an aseptic meningitis in conjunction with cholesterol in the ventricular fluid in the postoperative period.
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The differentiation of pancreatic abnormalities remains a problem. We analyzed the sensitivity and specificity of computed tomography (CT) in the diagnosis of pancreatic disease, using six radiologists who had less than six months' training in CT (resident level: inexperienced) and six who had more than 12 months' training (staff level: experienced) in order to clarify the difficulty with CT in the qualitative diagnosis of pancreatic cancer. We reviewed retrospectively 100 cases: 28 cases of pancreatic cancer, 15 of chronic pancreatitis, three of acute pancreatitis, 12 of neoplastic disease that involved the pancreas, and 42 normal subjects. The average sensitivity and specificity of CT in the diagnosis of pancreatic disease were 81.3% and 84.4%, respectively, for the experienced radiologists and 64.0% and 82.1%, respectively, for the inexperienced radiologists. The averages for pancreatic cancer were 65.3% and 87.8% for the experienced radiologists and 60.7% and 87.3% for the inexperienced radiologists. We conclude that the ability to detect pancreatic abnormalities improves with training and experience, but diagnosis of pancreatic cancer does not improve after a certain level of expertise.