Search

Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disease accompanied by mutations in CSF3R. Here, we present a patient with CNL who developed to acute myeloid leukemia (AML) at the same time that a t(4;12)(q12;p13) translocation appeared. The uniqueness of this cytogenetic abnormality led us to delineate the molecular aberrations relevant for clonal evolution. While the CSF3R mutation was present throughout the course of the disease, the SETBP1 mutation was newly acquired at the AML transformation. The present case suggests that careful monitoring of t(4;12)(q12;p13) and SETBP1 is crucial to predict AML evolution in CNL patients.

Background: Various technologies to provide long-term care have been developed in the last decade due to the shortage of caregivers in Japan. However, care technologies are not widely used in long-term care, and the reasons for the lack of acceptance of care technologies are poorly understood. Objectives: To identify the factors associated with the acceptance of care technologies designed to assist with activities of daily living (i.e., bathing, dressing, toileting, transferring, and eating) among middle-aged and older adults in Japan. Design and Methods: A cross-sectional survey was conducted in August 2020. The target population was middle-aged and older adults (i.e., 40–79 years) in Japan. We used an online questionnaire platform of a research company to target people throughout Japan, and measured the acceptance of care technologies to support the performance of each of five activities of daily living. Multivariable logistic regression models were fitted to identify the associated factors using the bivariate variable “willingness to use care technologies for activities of daily living” as the dependent variable. Results: A total of 3261 eligible respondents were included in the analysis. The factors positively associated with the acceptance of care technologies for transferring, which had the highest level of acceptance, were female sex (adjusted odds ratio=1.25, 95% CI: 1.04–1.52), university or higher education level (1.73, 1.41–2.12), an annual income of 39000 to 58999 USD (1.47, 1.08–2.01) or greater than 99,000 USD (1.88, 1.21–2.94), experience as an informal caregiver (1.25, 1.02–1.54), the use of social networking services a few times per year (1.40, 1.11–1.78) or nearly every day (1.47, 1.19–1.82), and willingness to live in a nursing home when care is needed (1.29, 1.05–1.60). In contrast, aged 70–79 years was negatively associated with the acceptance of care technologies for transferring (0.70, 0.52–0.93). Conclusion: Female sex, university or higher education level, an annual income greater than 99,000 USD, the use of social networking services a few times per year or more often, and willingness to live in a nursing home when care is needed were positively associated with the acceptance of care technologies for multiple activities of daily living. Given that many of the respondents will need care in 5–10 years, the acceptance of care technologies among those who need care will increase. Therefore, governments and developers of care technologies could consider the potential needs of this population group.

Background: Hypoglossal schwannoma is a rare benign tumor that comprises about 5% of all intracranial schwannoma. Surgical management for hypoglossal schwannoma is still evolving along with our understanding of neuroanatomy and surgical equipment improvement, especially endoscopy. The far lateral transcondylar approach is commonly used for hypoglossal schwannomas. This traditional approach requires great effort and is considered a lengthy procedure. The use of endoscopy gives an additional advantage to microscopic surgery in managing this tumor, making surgery less complicated and faster. Combining the microscope and endoscope is an effective way to operate in small corridors. Case: In a stepwise fashion, we present a case of a 53-year-old female with hypoglossal schwannoma, which was successfully resected using a retrosigmoid transcondylar approach with endoscopic assistance. Conclusion: A retrosigmoid transcondylar approach with endoscopic assistance is an excellent option in surgical management for hypoglossal schwannoma. Both microscopic and endoscopic approaches will be gaining more usefulness in managing skull base tumors and should be used collaboratively.

A preliminary report is presented of 12 patients with dorsal fracture-dislocations of the proximal interphalangeal joint with a central depressed fragment treated by volar buttress plating, with good results. Key words: bone plates, finger joint, fracture dislocation, fracture fixation, open fracture reduction

Purpose: To investigate the correlation between changes in carpal alignment, particularly capitate position, and functional outcomes after open reduction internal fixation with a volar locking plate to treat unstable distal radius fractures. Methods: A total of 63 patients (mean age, 59 years) underwent volar locking plate fixation with a single type of plate within 1 week after injury. Radiocapitate distance (RCD), defined as the relative position of the capitate to the radius, was measured using standardized lateral-view radiographs of the uninjured and postoperative wrists. The correlation between the change in RCD and functional outcomes was analyzed statistically, including the range of motion of the wrist and grip strength. Results: The mean value of RCD for the uninjured wrists was 1.4 mm. There was no correlation with age and sex or laterality. The mean value of RCD for the postoperative wrists was –1.2 mm. Decreases in flexion and extension angle of the wrist and grip strength were 18°, 9°, and 6 kg, respectively. The decrease in RCD was weakly correlated with the decreases in flexion angle of the wrist and grip strength. Conclusions: Anatomical recovery of carpal alignment was not routinely achieved with the use of a single type of plate. Dorsal displacement of the capitate was correlated with functional outcomes. Radiocapitate distance should be further evaluated as a parameter for use in distal radius fracture treatment. Type of study/level of evidence: Therapeutic IV. Key words: Carpal alignment, Distal radius fracture, Locking plate fixation, Osteosynthesis, Wrist

A 91-year-old woman was admitted with persistent pyrexia, anorexia and weight loss. A chest radiograph showed multiple circular masses of various sizes. Chest computed tomography revealed multiple pleural tumors without any lung lesion. The ultrasound-guided biopsy specimens demonstrated diffusely-proliferated tumor cells with clear or vacuolated cytoplasm, which were positive for CD10, PAX8, vimentin and CAM5.2, but were negative for mesothelial cell markers such as HBME-1 and thrombomodulin. These findings indicated metastatic clear cell carcinoma of the kidney, and a solitary renal tumor was observed on abdominal computed tomography. It has been reported that pleural metastases constituted 12% of patients with progressive renal cell carcinoma, and most of the pleural metastases occurred secondary to lung metastasis. This was a rare case of renal cell carcinoma with an unusual chest image via an intriguing metastatic pathway, which was limited to pleura. Keywords: Pleural metastasis, Transcutaneous biopsy, Renal cell carcinoma, Computed tomography

Two patients with granulomatous lung lesions thought to be related to Crohn's disease (CD) are reported. Patient 1 was a 43-year-old man who was diagnosed with CD at age 11 years. He developed a fever in the 38 °C, and a chest X-ray and CT scan showed infiltrates with air bronchograms in the right upper lobe and left lingular segment. Transbronchial lung biopsy (TBLB) revealed granulomatous lesions. Patient 2 was a 76-year-old woman who was diagnosed with CD at age 44 years. Chest CT showed infiltrates and nodular shadows in both lung fields. Video-assisted thoracoscopic surgery (VATS) in June 2012 revealed granulomatous lesions. Tuberculosis, fungal infections, drug-induced lung disorder, and sarcoidosis were ruled out as a cause of the granulomatous lesions in both patients. The aetiology was thought to be CD.