Search

A 66-year-old man was suspected of having an intestinal obstruction caused by a tumor in the small intestine after a close examination of vomiting and abdominal pain. Intestinal decompression was performed using an ileus tube, and small bowel endoscopy revealed a circumferential type 2 tumor of the ileum and a poorly differentiated adenocarcinoma on biopsy. The patient was referred to our department with a diagnosis of primary ileal cancer(cT2N1M0, cStage ⅢA). The patient underwent laparoscopic partial resection of the small intestine and lymph node dissection. Partial resection of the small intestine was performed 10 cm from the primary tumor, and lymph node dissection was performed up to the left margin of the SMV. The postoperative diagnosis was primary ileal cancer(pT3N1aM0, pStage ⅢA). The patient was administered CapeOX as adjuvant chemotherapy for 6 months. The patient has been alive since then without any recurrence. We report a case of ileal cancer that was treated with surgical therapy and postoperative adjuvant chemotherapy, with no recurrence.

In August 2022, a 59-year-old female noted a mass in her umbilicus and sought evaluation at Toyokawa City Hospital. Abdominal computed tomography(CT)scan revealed a 1.6 cm mass in the umbilical region, ascites in the pelvis, and increased absorption in the omentum. Peritoneal dissemination of the carcinoma and Sister Mary Joseph's nodule due to an unknown primary tumor were suspected because no abnormalities were detected during upper and lower gastrointestinal endoscopy. She underwent an umbilical lumpectomy and diagnostic laparoscopy to establish a definitive diagnosis. The surgical findings included numerous white nodules throughout the abdominal cavity. The umbilical mass and omental white nodules were resected. A final diagnosis of epithelial peritoneal mesothelioma was made based on the histopathologic examination. In general, peritoneal mesothelioma has a poor prognosis, and early treatment is essential; however, making a timely definitive diagnosis is difficult. Peritoneal mesothelioma should be included in the differential diagnosis for a patient with unexplained ascites and abdominal pain. Diagnostic laparoscopy and biopsy will facilitate the establishment of a definitive diagnosis.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by behavioral abnormalities such as poor social communication and stereotyped/repetitive behaviors. Functional dynamics among multiple cortical areas are associated with processing sensory information and planning and executing behavioral expressions. However, the reconfiguration of large-scale functional network dynamics during behaviors remains to be elucidated in ASD. In this review, we describe our virtual reality (VR) based real-time imaging system which allowed us to investigate wide-field cortical activity in voluntarily behaving mice. We previously generated a mouse model of ASD with chromosome 15q11-13 duplication (15q dup), one of the most frequent genomic abnormalities, and reported that 15q dup mice display ASD-like behaviors. Using this system, we examined the functional cortical network during behaviors in 15q dup mice. Pair-wise correlation of cortical area activity on a time scale of a second was calculated to represent the dynamic state of cortical functional connectivity (FC). A graph theoretical network analysis was then conducted to illustrate rapid and robust behavior-state-dependent cortical network reconfiguration. Our VR-based real-time imaging system provides invaluable information to understand FC dynamics linked to a behavioral abnormality of neuropsychiatric disorders.

Background: T4 is one of the high-risk factors, but the efficacy of adjuvant chemotherapy for T4-Stage Ⅱ colon cancer are unclear., Method: We retrospectively reviewed 211 patients with primary pStage Ⅱ colon cancer who underwent radical resection between 2004 and 2015., Results: The 5-year overall survival rate(OS)of Stage ⅡA/ⅡB/ⅡC were 90.2/83.4/ 59.2%, and the 5-year recurrence-free survival rate(RFS)were 87.3/73.3/42.8%. Multivariate analysis of OS as a high-risk factor of T4 revealed male, ly2/3, no adjuvant chemotherapy, and in RFS, male, ly2/3. However, compared the cases with or without adjuvant chemotherapy, 5-year OS was no difference. There were no cases used oxaliplatin-based adjuvant chemotherapy., Conclusion: An adjuvant chemotherapy without oxaliplatin were not enough to improve the prognoses of T4-Stage Ⅱcolon cancer, so the oxaliplatin based regimen might be recommended.

Severe hyperglycemia often occurs when acute stroke patients receive enteral tube feeding. Hyperglycemia should be managed because it adversely affects stroke outcome. However, it remains unclear how blood glucose level (BGL) changes with enteral nutrition in acute stroke patients. Our purpose was to investigate features of the blood glucose curve in acute stroke patients receiving enteral feeding. We retrospectively evaluated acute stroke patients who developed hyperglycemia during enteral tube feeding and underwent CGM in our institution. We evaluated characteristics of blood glucose curves, fasting and peak BGL, and time to peak of BGL. Six patients were analyzed. The median fasting BGL was 125.5 mg/dL and the median peak BGL was 351.5 mg/dL. The blood glucose curve showed the following characteristics following: 1) BGL elevated slowly reach the peak in 180 to 240 minutes; 2) BGL decreased slowly or very little after its peak; 3) there was a large gap between fasting and peak BGL regardless of presence of diabetes mellitus. We grouped the curves into four types by time to peak and how BGL decreased after peak. (Received August 17, 2017; Accepted February 1, 2018; Published July 1, 2018).

We have developed a rapid analysis method for determination of histamine using ultra-performance liquid chromatography and fluorescamine derivatization. Histamine was extracted from foods with trichloroacetic acid after homogenization. The supernatant obtained by centrifugation was filtered and derivatized without solid-phase extraction. The mobile phase was 10 mM phosphate-acetonitrile (75 : 25) without ion-pairing. Recovery tests of histamine from fishes, seasoning and fish products gave acceptable recovery (95.8-117.7%). This method should be useful for rapid evaluation of food poisoning outbreaks.

A 78-year-old man was admitted to our hospital because of sudden right hemiparesis and dysarthria. His cranial MRI showed an area of hyperintensity in left pons on DWI and MRA revealed dilated, elongated and tortuous intracranial artery. We diagnosed as acute phase ischemic stroke and intracranial arterial dolichoectasia (IADE). Intravenous infusion of rt-PA was performed 157 minutes after the onset of symptoms, and his hemiparesis improved. However, he subsequently suffered from cerebral infarction 4 times in 6 months, and we treated him twice with thrombolytic therapy. Although thrombolytic therapy was effective in the short term and antithrombotic therapy was continued, he had bilateral hemiplegia and severe dysphagia because of repeated cerebral infarctions. Hence basilar artery was dilated with intramural hemorrhage over 6 months, and we discontinued antithrombolytic therapy. It is possible that antithrombolytic therapy affects enlargement of IADE. Antithrombolytic therapy for IADE should be done carefully.

A 53-year-old male with a past medical history of hypertension and bipolar disorder gradually developed gait disturbance and cognitive dysfunction over half a year. His cranial MRI showed an area of hyperintensity in the right occipital lobe on T2 weighted images and the surface of the lesion was enhanced along the sulci. We diagnosed his condition as amyloid-β-related angiitis (ABRA) based on brain biopsy. Repeated, frequent seizures resistant to several antiepileptic drugs (AEDs) occurred after the operation. Steroid therapy was effective and the symptoms, including the intractable seizures and MRI abnormalities dramatically improved. In contrast to the common wild type ε3/ε3 ApoE genotype, a majority of ABRA patients have ε4/ε4. However, in this case the rare ε4/ε2 type was detected. The ε4 allele is considered to promote Aβ deposition on the vessel wall, and ε2 is speculated to trigger vessel ruptures or vascular inflammation. Although seizure is not a common complication of brain biopsy, it occurred repeatedly and responded poorly to AEDs in this case. Surgical stress in this patient with ε2 probably induced the uncontrolled seizures. ApoE genotype may be an effective and low-invasive marker in case of suspected ABRA and in predicting the risks of the complication from brain biopsy.

The present case is the first report of a systemic lupus erythematosus patient which has been induced Parkinsonism with the administration of tacrolimus (TAC). A 50-year-old woman was diagnosed as lupus nephritis on September 2003. The patient had been prescribed initially 40 mg/day of prednisolone, then cyclosporine was added on May 2005. One year later, she developed severe headache, so cyclosporine was stopped, and she was prescribed tacrolimus on February 2007. However her severe headache had been disappeared, she experienced rigidity and tremor around September 2007. The Dopamine-transporter-imaging examination reavealed that she had Parkinson's disease. The gene analysis on the genetic background showed her case was the sporadic type? Parkinson's disease. Washing out of Tacrolimus, her Parkinsonism was partially improved. This fact suggested that her Parkinsonism was drug-induced type Parkinsonism. In lupus nephritis patients who have been treated with TAC, a very careful observation should be considered because neurological disorders inducing Parkinsonism may occur.

A 21-year-old woman developed immune thrombocytopenia (ITP), subclinical Graves disease and peripheral neuropathy without typical chronic graft-versus-host disease (GVHD) 5 years following an allogeneic bone marrow transplantation from an HLA-identical sibling. She received high-dose intravenous immunoglobulin (IVIG) and prednisolone (PSL), which resulted in transient recovery of platelet numbers and muscle weakness. A combination of cyclosporine and PSL induced a durable response against not only the thrombocytopenia but also her high levels of thyroid stimulating antibody (TSAb), muscle weakness and sensory abnormality. The level of thyroglobulin in the donor, who had not developed Graves disease, was also elevated, indicating that late onset-subclinical Graves disease was caused by donor lymphocytes that were autoreactive to the thyroid glands.

The efficacy and safety of granulocyte transfusions were evaluated in two acute lymphoblastic leukemia patients for the control of severe infections (cervical cellulitis, sepsis) prior to hematopoietic stem cell transplantation. One patient received 6 transfusions and the other 2 transfusions. The donors were given subcutaneous granulocyte-colony stimulating factor plus oral dexamethasone/betamethasone 12 hours before the scheduled collection. Granulocytes were obtained by standard leukapheresis procedures utilizing hydroxyethyl starch with processing of 7 liters of blood. The yield was 3.2-10.7 x 10(10) (0.7-2.1 x 10(9)/kg of recipient) granulocytes. Post-transfusion increases of peripheral blood neutrophil counts in the following morning were 300 to approximately 6,900/ml. Infections resolved and successful engraftment was obtained in both patients after the transplants. No severe adverse reactions were observed. These findings suggest that granulocyte transfusions are useful for control of severe infections prior to allogeneic hematopoietic stem cell transplantation.

Lymphoepithelioma-like carcinoma of the lung was diagnosed in a 39-year-old Chinese woman. In situ hybridization of Epstein Barr virus-encoded small nuclear RNA 1 (EBER 1) detected strong EBER 1 signals in the nuclei of tumor cell specimens from the patient. After polymerase chain reaction (PCR) amplification, electrophoresis identified the IR-1 region in this tumor as a positive sharp band, closely resembling Raji cells (Burkitt's cell line). The uniform and intense presence of EBER 1 in the tumor nuclei and the PCR products of EBV DNA in the tumor demonstrated that a high copy number of EB virus genome existed in the tumor, and indicated involvement of the EB virus in the pathogenesis of lymphoepithelioma-like carcinoma of the lung.

The single dose toxicity studies of montirelin hydrate (NS-3), a new drug for the treatment of disturbance of consciousness, were conducted in Slc:ddY mice, Slc:SD rats, and beagle dogs of both sexes. The drug was administered intravenously (i.v.) to mice, rats and dogs, and intramuscularly (i.m.) to mice and rats. The animals were observed for 14 days after administration. LD50 values were more than 500 mg/kg and 200 mg/kg in mice and rats, respectively, by the i.v. route, and more than 20 mg/kg in both animal species by the i.m. route. In dogs, the minimum lethal dose was more than 200 mg/kg by the i.v. route. Mice that received more than 125 mg/kg by the i.v. route showed tremor and a decrease in locomotor activity during administration and for 30 min thereafter. Mice that received more than 5 mg/kg by the i.m. route showed tremor 5 min after administration and for 2 hr thereafter. Rats that received more than 50 mg/kg by the i.v. route showed tremor, and those that received 200 mg/kg by the same route showed a decrease in locomotor activity and ataxic gait, during and immediately after administration. Rats that received more than 5 mg/kg by the i.m. route showed tremor, and those that received 20 mg/kg by the same route showed salivation 5 min after administration and for 30 min thereafter. Dogs that received more than 12.5 mg/kg by the i.v. route revealed excitement, biting, vocalization, mydriasis, salivation, urination, defecation, licking chops, vomiting, increase in heart rate, panting, hyperthermia, tremor and conjunctival injection during administration and for 6 hr thereafter. The body weight, food consumption and water consumption, and pathological findings showed no changes attributable to the dosing of montirelin hydrate in any animal.

Nineteen hematological and serum biochemical values were analyzed for 91 healthy cats of both sexes (aged 1 to 48 months) that were bred and reared in our laboratory. Age-related changes were found for many parameters. Red blood cell counts (RBC), hemoglobin (Hb), hematocrit (Ht), Mean corpuscular constants, GPT, total protein (TP) and albumin (ALB) initially were low but increased then stabilized. White blood cell counts (WBC), alkaline phosphatase (ALP), inorganic phosphorus (Pi), total bilirubin (TBil), total cholesterol (TC), glucose (GLU), and triglyceride (TG) initially were high, but decreased then stabilized. No age-related changes were found for GOT, blood urea nitrogen, or calcium. Of the parameters that changed with age, the mean corpuscular constants, GPT, GLU, and TG became stabilized during the first 3 to 4 months of life, but others (RBC, Hb, Ht, TP, ALB) became stabilized after 9 to 11 months, during which period body weight reached a plateau. Some parameters (WBC, ALP, TG, Pi) showed change up to 18 months of age. These results suggest that cats 9 to 11 months old can be regarded as adults; but for some parameters, cats aged 18 months, or older, are better regarded as adults. Sex-related differences in the values for mean corpuscular volume, mean corpuscular hemoglobin, and WBC that were found after 11 months of age were higher in females. ALB was higher in males.

The present study was performed to clarify the regeneration and splenic changes following hepatectomy. The processes were compared between the three classes (L greater than 50%, 30 less than M less than 50%, S less than 30%) categorized by the resection rate (%) calculated by CT scan in the 26 cirrhotics (LC) and 22 non-cirrhotics (N). Hepato-splenic volumes were serially measured by CT scan. The regenerative speed (cm3/day) of the remaining liver were significantly higher in the N group than LC and in the larger resection class. Liver functions tended to return to the initial levels behind the time of restoration of the liver volumes. The delay was partially caused by the posttransfusion hepatitis (PTH), which developed more frequently with an increase of fresh frozen plasma transfusion given. The changing pattern of splenic size was strongly regulated by the massiveness of hepatectomy. Newly developed posthepatectomy esophageal variceal ruptures were endoscopically determined in the 10% of the 129 late deaths after hepatectomies for hepatomas (1973-1987) with or without recurrences and its occurrence was found to be enhanced in the massive resection in the LC group ended with the poor regeneration of the liver and persistent postoperative splenic enlargement.