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We evaluated the efficacy of the lipiodol-transcatheter arterial embolization (L-TAE) technique for hepatocellular carcinoma (HCC) performed using a left brachial approach. A total of 64 procedures were performed using the brachial route in 53 patients with HCC between 1989 and 1996 using a 4-French catheter and these patients were retrospectively studied. The technical success rate was 95.3%. The overall complication rate was 31.3%: fever of over 38.0 degrees C lasting longer than three days (18.8%), transient neurologic complications (4.7%), and pancreatitis (1.6%). Complications such as lumbago, back pain, and dissection of the celiac artery or its branches, which frequently complicated femoral approaches, were avoided. These data indicate that L-TAE using the left brachial approach may be a safe and effective alternative to the transfemoral approach in patients with HCC. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the impact of age on the relationship between obstructive sleep apnea syndrome (OSAS), nocturia, and other lower urinary tract symptoms (LUTSs)., Methods: This was a secondary analysis study based on data derived from a previously conducted prospective observational cohort study on OSAS and nocturia. We analyzed 90 subjects who were suspected of having OSAS. Prior to polysomnography, we assessed International Prostate Symptom Score-Quality of Life scores, Overactive Bladder Symptom Scores, and International Consultation on Incontinence Modular Questionnaire-Nocturia Quality of Life scores to evaluate LUTSs. Nocturnal urine volume, night-time frequency, and night-time urine electrolyte content were measured during polysomnography. Patients were divided into groups according to age and OSAS severity determined using apnea-hypopnea index (AHI) scores. Young patients were those aged <65 years and elderly patients, ≥65 years. A multiple linear regression with multiple imputations was performed to examine the association of night-time frequency with demographic, polysomnographic, and clinical characteristics., Results: In young patients, night-time frequency was significantly associated with nocturnal urine volume, AHI score, and total IPSS. However, night-time frequency in elderly subjects was not associated with demographic and polysomnographic characteristics. In order to compare the severity of OSAS, night-time frequency and urinary sodium content significantly increased only in young patients (P = .007 and .004, respectively)., Conclusion: OSAS is a strong candidate of causative factor for nocturia in younger individuals. When a younger patient complains nocturia without any urological disorders, OSAS should be kept in mind as a potential cause of nocturia., (Copyright © 2020 Elsevier Inc. All rights reserved.)

A 25-year-old woman received oral salazosulfapyridine, 4 g/day, for treatment of ulcerative colitis. At 10 days later, she presented with fever and respiratory symptoms. Based on physical, laboratory and radiological findings, bacterial pneumonia and non-cardiogenic pulmonary oedema was suspected. Salazosulfapyridine was immediately halted and antibiotic therapy started. Two days later, her symptoms and abnormal findings had improved rapidly. Bacteriological studies were negative. Salazosulfapyridine-induced non-cardiogenic pulmonary oedema was diagnosed. Non-cardiogenic pulmonary oedema should be considered as one of several salazosulfapyridine- induced pulmonary diseases in patients who are receiving salazosulfapyridine and who develop respiratory symptoms and an abnormal CXR.

To determine the usefulness of the H1 system, we applied it to 14 patients with acute leukemia and 19 patients with myelodysplastic syndrome (MDS). We revealed interesting cytogram patterns in several patients with acute leukemia, ALL (L2), ALL (L3), and AML (M7). In the basophil and lobularity cytogram, their blast cells were clustered mainly in the blast box. However, a small cluster appeared in the basophil area and was expressed as pseudo-basophilia of 4.4%, 9.6%, and 21%, respectively. We speculated that not only normal basophils but also some type of leukemic blasts could be resistant to rupture of the cell membrane induced by a surfuctant at a low pH. Characteristics of H1 cytogram and histogram pattern have hardly been reported in patients with MDS. From the analysis of H1 pattern of 19 cases, we found that the (1) the values of RDW and HDW were high in comparison to those for aplastic anemia and normal controls and (2) the MPXI (mean peroxidase activity index) was significantly low at the time of diagnosis. MPXI had declined at the terminal stage in cases of death with bone marrow failure. These characteristics were concluded to be useful in clinicopathological diagnosis using the H1 automatic hematological system.

Myelodysplastic syndrome (MDS) combined with monoclonal gammopathy or multiple myeloma has rarely been reported. In this article, two siblings, a brother and his sister who showed simultaneous occurrence of MDS and monoclonal gammopathy are reported. The first case, a 73-year-old male, was admitted to our hospital in November, 1987. Analysis of peripheral blood revealed pancytopenia without blast cells. Bone marrow was hypocellular with 14.9% of myeloblasts and 2.8% of plasma cells characterized by 2 to 4 nuclei. Serum IgA level was 635 mg/dl and serum immunoelectrophoresis revealed a monoclonal IgA lambda band. The second case, a 70-year-old female, younger sister of the first case, was admitted to our hospital in January, 1988. Bone marrow was normocellular with 23% of peroxidase-negative myeloblasts and 12.8% of atypical plasma cells. Serum IgG level was 1,901 mg/dl with monoclonal IgG kappa band. Hematological findings have remained unchanged for 12 months. The first case was regarded as hypoplastic MDS with monoclonal gammopathy and the second case was MDS with smoldering myeloma. These cases were very similar with in respect to age, time of onset, clinical course, hematological findings and especially, association with M-protein. There are no reports concerning the familial incidence of MDS with M-protein. These findings supported the hypothesis that an initial event selects a clone of stem cells which retain the capability to differentiate into mature myeloid and lymphoid cells, in these cases B-cells.