High-Risk Neuroblastoma with Metastases to Bilateral Kidneys at Diagnosis.

Renal metastasis at diagnosis with neuroblastoma is rare. We present a 14-month-old boy who was diagnosed with high-risk neuroblastoma with multiple metastases, including bilateral kidneys. He received five cycles of induction chemotherapy and high-dose chemotherapy with autologous peripheral blood stem cell transplantation.

Directional characteristics of incipient temporomandibular joint disc displacements: A magnetic resonance imaging study.

Introduction: Disc displacement (DD) is common in adolescents, but not much is understood about its cause. Assessment of the directionality of incipient DDs may provide clues about the etiology.

Methods: The sample consisted of magnetic resonance images of 143 temporomandibular joints with incipient DD from 89 preorthodontic patients (mean age, 10.

Autophagy-related IRGM polymorphism is associated with mortality of patients with severe sepsis.

Objective: Autophagy is the regulated catabolic process for recycling damaged or unnecessary organelles, which plays crucial roles in cell survival during nutrient deficiency, and innate immune defense against pathogenic microorganisms. Autophagy has been also reported to be involved in various conditions including inflammatory diseases. IRGM (human immunity-related GTPase) has an important function in eliminating Mycobacterium tuberculosis from host cells via autophagy.

Prevalence of disc displacement of various severities among young preorthodontic population: a magnetic resonance imaging study.

Purpose: There has been no study on the prevalence of disc displacement (DD) of different levels in children and adolescents with adequate sample size using magnetic resonance images (MRIs). This retrospective cross-sectional study was designed to investigate the relationship between increasing age and the prevalence of DD of various severities in a young preorthodontic population.

Materials And Methods: Of 199 preorthodontic patients aged 6 to 15 years visiting a private orthodontic office for initial examination, 153 patients with signs and symptoms of temporomandibular joint (TMJ) disorders had MRIs of their TMJs taken for further evaluation.

Usefulness of the endotoxin activity assay as a biomarker to assess the severity of endotoxemia in critically ill patients.

The aim of this study was to investigate the prevalence of endotoxemia in critically ill Japanese patients using the endotoxin activity assay, a newly developed rapid assay of endotoxin. The endotoxin levels (EA levels) in the blood of 314 patients admitted to our university hospital's intensive care unit (ICU) were measured within 24 h of admission, and its correlation with disease severity and outcome examined. In addition, the EA levels in 61 samples from healthy volunteers were measured.

A reference line on temporomandibular joint MRI.

Purpose: The aim of this study was to establish a reference line and the 12 o'clock position on sagittal MRI images of the temporomandibular joint (TMJ) for close observation of early changes in disk position.

Materials And Methods: The study included 106 joints of 53 consecutive male and female patients (mean age 13.3 years) with available MRI and limited cone-beam computed tomography (LCBCT) images, from a pool of postorthodontic patients who had finished phase I or phase II orthodontic treatment between March 2006 and March 2008 in a private orthodontic office.

Comparison of whole-body cooling and selective head cooling on changes in urinary 8-hydroxy-2-deoxyguanosine levels in patients with global brain ischemia undergoing mild hypothermia therapy.

Background: We evaluated changes in the levels of urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) in patients undergoing mild hypothermia therapy and compared 8-OHdG expressions in those receiving whole-body cooling or selective head cooling.

Material/methods: The subjects were 15 patients undergoing mild hypothermia therapy following resuscitation after cardiac arrest in our intensive care unit. We divided the patients into 2 groups receiving either whole-body cooling or selective head cooling, according to their circulatory stability.

Assessment of optimal condylar position in the coronal and axial planes with limited cone-beam computed tomography.

Purpose: No quantitative standards for the optimal position of the mandibular condyle in the glenoid fossa are yet available in the coronal and axial planes. We previously reported measurements of this position in the sagittal plane, using recently developed limited cone-beam computed tomography (LCBCT) capable of imaging the craniofacial structures with high accuracy. In this study, we assessed the optimal condylar position in the coronal and axial planes.

HMGB-1 as a useful prognostic biomarker in sepsis-induced organ failure in patients undergoing PMX-DHP.

Background: High mobility group box 1 (HMGB-1) has recently received attention as a late mediator of lipopolysaccharide-induced shock, and is thought to function as a mediator in such a disorder as multi-organ failure (MOF). In Japan, we have access to an immobilized polymyxin B fiber column using a direct hemoperfusion (PMX-DHP) for patients with septic shock to improve hemodynamics and organ dysfunction. In this study, we looked at HMGB-1 levels in each category based on the sequential organ failure assessment (SOFA) scores to further dissect its importance in specific aspects of organ failure in patients undergoing PMX-DHP.

Assessment of optimal condylar position with limited cone-beam computed tomography.

Introduction: There are no quantitative standards for the optimal position of the mandibular condyle in the glenoid fossa. Recently developed limited cone-beam computed tomography (LCBCT) allows measurement of this position with high accuracy.

Methods: LCBCT was used to assess 24 joints in 22 symptom-free subjects (10 male, 12 female; mean age, 18 years) who had no disc displacement as verified by magnetic resonance imaging.

Successful management by recombinant activated factor VII in a case of disseminated intravascular coagulopathy caused by obstetric hemorrhage.

Postpartum hemorrhage (PPH) is a life-threatening emergency in obstetrics. Although recombinant activated factor VII (rFVIIa) has become used for the treatment of some cases of massive hemorrhage, its applications in the field of obstetrics are still limited. We describe a case of successful treatment with rFVIIa for PPH due to placenta accreta.

Usefulness of procalcitonin serum level for the discrimination of severe sepsis from sepsis: a multicenter prospective study.

Procalcitonin serum level has been recommended as a new marker of bacterial infectious diseases. The aim of this prospective, multicenter study was to determine the clinical usefulness of procalcitonin in differentiating patients with sepsis from those with severe sepsis. Eighty-two patients were enrolled: 20 without systemic inflammatory response syndrome (SIRS), 9 with SIRS, 34 with sepsis, and 19 with severe sepsis.

Physiological response to superantigen-adsorbing hemoperfusion in toxin-concentration-controlled septic swine.

Background/aims: Superantigens are suspected of being potent initiators of gram-positive sepsis, and new therapies for superantigen elimination are required. The effects of hemoadsorption with a superantigen-adsorbing device (SAAD) were evaluated in septic swine.

Methods: Toxic shock syndrome toxin-1 (TSST-1) was infused, and blood concentration was maintained at the clinical level for 6 h.

Superantigen-induced multiple organ dysfunction in a toxin-concentration-controlled and sequential parameter-monitored swine sepsis model.

Objective: In order to examine the biological activity of low-dose and continuously infused superantigen, and to establish a superantigen-induced multiple organ dysfunction animal model, several pathophysiological parameters were sequentially monitored in a toxin-concentration-controlled pig model.

Methods: Anesthetized, mechanically ventilated and Swan-Ganz thermodilution catheter-inserted pigs were treated with toxic shock syndrome toxin-1 (TSST-1) by infusion at 2 microg/kg/h for 5 h. Monitoring was performed for both the infusion period and a subsequent 1-h post-infusion period.

Multicenter prospective study of procalcitonin as an indicator of sepsis.

The clinical significance of serum procalcitonin (PCT) for discriminating between bacterial infectious disease and nonbacterial infectious disease (such as systemic inflammatory response syndrome (SIRS)), was compared with the significance of endotoxin, beta-D: -glucan, interleukin (IL)-6, and C-reactive protein (CRP) in a multicenter prospective study. The concentrations of PCT in patients with systemic bacterial infection and those with localized bacterial infection were significantly higher than the concentrations in patients with nonbacterial infection or noninfectious diseases. In addition, PCT, endotoxin, IL-6, and CRP concentrations were significantly higher in patients with bacterial infectious disease than in those with nonbacterial infectious disease (P<0.

Clinical evaluation of PMX-DHP for hypercytokinemia caused by septic multiple organ failure.

Endotoxin-adsorbing fibers have been applied to treat septic shock patients. The limitations of endotoxin hemoadsorption therapy (PMX-DHP) and the optimal time to start PMX-DHP were examined in patients with septic multiple organ failure with hypercytokinemia (interleukin-6 = 1000 pg/mL). Subjects were separated into those who survived more than 28 days after the start of PMX-DHP therapy (S group) and those who did not (N-S group).

Change in the concentration of vitamins C and E in rat tissues by paraquat administration.

Paraquat causes lung injury by oxidative stress. After 48 h of intraperitoneal administration of paraquat (50 mg/kg of body weight) to rats, the vitamin C concentration in the lungs was significantly decreased, while lung vitamin E content was increased after 12 h. These results indicate that vitamin C directly reflected the oxidative stress in the lungs.

Colloid osmotic pressure (COP) can be a good indicator of occurrence of vasospasm following subarachnoid hemorrhage (SAH).

Background: The aim of this study was to evaluate the value of measurement of colloid osmotic pressure (COP) directly concerned with cerebral vasospasm following subarachnoid hemorrhage (SAH).

Material/methods: The subjects were 20 patients who received clipping operation within 48 hours after onset. We conducted a two weeks monitoring of COP measured directly by osmometer and evaluated serum concentrations of albumin at the same time.