Clostridial sepsis following hepatic arterial infusion chemotherapy.

Three patients with clostridial sepsis during or following hepatic arterial infusions for the regional chemotherapy of hepatic metastatic tumors are described. In all patients abdominal roentgenograms revealed lucencies in the right upper quadrant consistent with gas-containing hepatic abscesses at the time of clinically apparent sepsis and positive blood cultures. The occurrence of three such cases in one year and the low incidence of clostridial infections in non-catheterized oncology patients at our institution suggest that clostridial infection is a previously unrecognized complication of hepatic arterial infusion chemotherapy.

Lung metastases in cervical and endometrial carcinoma.

Carcinoma of the cervix or endometrium was evaluated in 1,021 patients at the Joint Center for Radiation Therapy, Boston, between July 1968 and December 1977. The patients were retrospectively evaluated for the presence of lung metastases, appearing initially or during their disease course. On chest radiography, 42 patients were found to have metastases.

Gas-forming intrahepatic abscess: a possible complication of arterial infusion chemotherapy.

Three cases of intrahepatic gas-forming abscesses are presented with liver metastases and indwelling hepatic artery catheters for drug infusion. This may represent a further complication of intrahepatic arterial drug infusion. Possible etiologies along with future prospects for this form of therapy are discussed.

Ultrasonic appearance of the falciform ligament.

In transverse liver scans an echogenic focus was commonly encountered at the junction of the right and left hepatic lobes. This finding was variable in prominence, but could be identified in 22 of 25 patients with otherwise normal livers in whom it was specifically sought. Correlation of ultrasound and CT examinations indicate that these echoes represent the falciform ligament.

Intra-arterial radionuclide infusion: a new technique to assess chemotherapy perfusion patterns.

A mechanical infusion pump was used to introduce 99mTc-sulfur colloid at a rate of 1 ml/minute into the hepatic arteries of six patients. The radiotracer distribution patterns were compared to those obtained with "bolus" radionuclide angiography and those seen with standard contrast angiography. In all cases, the slow flow rate radionuclide studies evidenced dramatic differences from the patterns obtained with rapid flow rate injections.

Evaluation of renal transplants with ultrasound.

Ultrasound scanning is useful in evaluating renal transplants: it is atraumatic, independent of renal function, and well suited for analyzing such common complications as lymphocele, abscess, hydronephrosis, and hematoma. When there is uncertainty as to the nature of a paranephric mass, ultrasonically guided percutaneous aspiration is definitive. Ultrasound can also detect the acute increase in renal volume associated with rejection and may prove to be a valuable adjunct in the early diagnosis of this problem.

Percutaneous aspiration biopsy of the pancreas under ultrasonic guidance.

Fine-needle aspiration biopsy for cytologic diagnosis was performed on seven patients suspected of having pancreatic tumors. A 23-gauge biopsy needle was accurately placed in the suspicious lesion under ultrasonic guidance. Six patients had tumors; of these, five had a definite cytologic diagnosis, and the sixth was suspicious of tumor.

Xerographic applications in neuroradiology. A comparison with conventional film imaging.

The capacity of electrostatic imaging for edge enhancement and wide latitude recording can improve visualization in neuroradiologic studies using low differential absorption contrast agents. Gas myelography and pneumoencephalography show the most satisfactory improvement in visualization. Tomography combined with xerography enhances definition further, but with gas myelography, especially in the thoracic region, plain xeroradiographic definition is frequently diagnostic.