Risk factors associated with the progression and metastases of hindgut neuroendocrine tumors: a retrospective study.

Background: The worldwide incidence of neuroendocrine tumors (NETs) has increased remarkably, with the hindgut being the second most common site for such tumors. However, the mechanisms underlying progression and metastasis of hindgut NETs are unclear. A retrospective study was conducted to elucidate these mechanisms.

Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study.

 Magnifying narrow-band imaging (M-NBI) is useful for the accurate diagnosis of early gastric cancer (EGC). However, acquiring skill at M-NBI diagnosis takes substantial effort. An Internet-based e-learning system to teach endoscopic diagnosis of EGC using M-NBI has been developed.

Duodenal Rare Neuroendocrine Tumor: Clinicopathological Characteristics of Patients with Gangliocytic Paraganglioma.

Gangliocytic paraganglioma (GP) has been regarded as a rare benign tumor that commonly arises from the second part of the duodenum. As GP does not exhibit either prominent mitotic activity or Ki-67 immunoreactivity, it is often misdiagnosed as neuroendocrine tumor (NET) G1. However, the prognosis might be better in patients with GP than in those with NET G1.

The clinicopathological significance of angiogenesis in hindgut neuroendocrine tumors obtained via an endoscopic procedure.

Background: As the World Health Organization grading system for gastroenteropancreatic-neuroendocrine tumors (GEP-NETs) may not always correlate with tumor progression, it is imperative that other independent predictors of tumor progression be established. To identify such predictors, we conducted a retrospective histopathological study of hindgut NETs, obtained from endoscopic procedures, and used statistical analyses to evaluate predictive factors.

Methods: We first obtained clinicopathological data of cases of hindgut NETs.

Outcomes and precautions of endoscopic submucosal dissection for undifferentiated-type early gastric cancer.

Objectives: Since the development of techniques for endoscopic submucosal dissection (ESD), the indication range of endoscopic resection (ER) has been extended in early gastric cancer (EGC) treatment. For undifferentiated-type EGC, tumors with an intramucosal depth of invasion, no ulceration and a diameter of 20 mm or less were included in the expanded indications for ER in the Japanese Gastric Cancer Treatment Guidelines 2010. Nonetheless, because of difficulty in detecting lesions that meet the criteria for ER, the number of endoscopically resected cases of undifferentiated-type EGC is less than that of differentiated-type EGC.

Two-point fixed endoscopic submucosal dissection in rectal tumor (with video).

Background: Polypectomy, EMR, transanal endoscopic microsurgery, and surgery have been performed as treatments of rectal tumors. Endoscopic procedures are the least-invasive treatments for patients. Complete resection of the lesion is required to prevent its recurrence, and endoscopic submucosal dissection (ESD) has begun to be performed.

[Three cases of radiotherapy combined with S-1 and mitomycin C for anal canal squamous cell carcinomas].

We report three cases of anal canal squamous cell carcinoma treated with radiotherapy combined with S-1 and mitomycin C(MMC). During radiotherapy, MMC was administered as intravenous bolus injection at a dose of 10mg/m2 on day 1 and 29. S-1 was administered orally at a dose of 80mg/m2 on days 1-14 and 29-43.

Endoscopic submucosal dissection (two-point fixed ESD) for early esophageal cancer.

Background: We have been attempting to improve the safety, reliability and simplicity of endoscopic submucosal dissection for the treatment of early esophageal cancer and to shorten the time needed for this operation.

Methods: The present study involved nine patients with well-differentiated intramucosal early esophageal cancer over 20 mm in diameter. Two-point fixed endoscopic submucosal dissection was carried out.

[A case of infant epidural hematoma treated by continuous drainage of cephalohematoma].

A female infant was born at 36 weeks with vacuum extraction. Her weight was 2.216 g and Apgar score was 9.

Thrombosed vertebral artery aneurysm presenting with hemorrhage and bulbar compression: report of two cases.

Bulbar compression by vertebral artery (VA) aneurysm is extremely rare and only reported in a few cases. We report two cases with thrombosed VA aneurysm compressing medulla oblongata; one presented with bulbar apoplexy hemorrhage and the other with subarachnoid hemorrhage (SAH). A 61-year-old male (case 1) presented with consciousness disturbances, left hemiplegia, and subsequent respiratory arrest.

Lipomatous meningioma of the brain harboring metastatic renal-cell carcinoma: a case report.

A 70-year-old woman presented with mild left hemiparesis and intermittent global headache. Magnetic resonance imaging showed a 6 x 6 x 6-cm tumor in the right frontal lobe, and abdominal computed tomography revealed a 8 x 8 x 7-cm mass lesion in the left kidney. Magnetic resonance imaging showed that the brain tumor consisted of a central hyperintense cystic component and an outer hypointense component.

Cerebral infarction in the caudate nucleus associated with acute epidural hematoma and diffuse brain injury in a child after severe head injury.

Case Report: A 6-year-old boy was admitted to our hospital 20 min after receiving a direct impact to his head in an automobile accident. He was semi-comatose on admission and computed tomography showed acute epidural hematoma in the right supratentorial region. Three hours later, his consciousness deteriorated due to the enlargement of the hematoma.

Hydrocephalus due to cerebrospinal fluid overproduction by bilateral choroid plexus papillomas.

Case Report: A 10-month-old boy, with congenital deafness and blindness associated with chromosomal deletion [46XY, del(13)(q32)], presented with intractable ascites 9 months after ventriculo-peritoneal shunting for congenital hydrocephalus. Revision of the ventriculo-atrial shunt resulted in shunt failure 1 month later. External ventricular drainage revealed cerebrospinal fluid (CSF) overproduction (2,000 ml/day).

A distal anterior cerebral artery aneurysm in infant: disappearance and reappearance of the aneurysm.

The incidence of intracranial aneurysms in childhood is rare, especially in infancy. Spontaneous thrombosis of a cerebral aneurysm in a child is very rare, particularly in a non-giant aneurysm. We report a case of a 1-month-old girl with a distal anterior cerebral artery aneurysm which disappeared spontaneously after subarachnoid hemorrhage and reappeared 6 months later.

[Two cases of impending herniation due to multiple traumatic acute subdural hematomas: combination of burr hole evacuation and craniotomy].

A contralateral extra-axial hematoma sometimes occurs during an operation on an acute subdural hematoma and may become fatal. Using a combined procedure of burr hole evacuation and craniotomy, we treated 2 cases of multiple traumatic acute subdural hematomas. Our policy for such cases is first to perform a burr hole evacuation for the acute subdural hematoma in the emergency room, while simultaneously preparing the operation room for a possible further operation.

[A case of vertebral artery occlusion following heading play in soccer].

A 13-year-old boy suffered from cerebeller infarction due to right vertebral artery occlusion after heading a ball during a rainy soccer game. Dissection of the vertebral artery after trivial head trauma is well known, but heading as the cause has not been reported. We speculated in this present case that excessive impact force to the young boy's neck due to the heavy rain-soaked ball might have caused right vertebral artery dissection and occlusion.

Unruptured carotid-duplicated middle cerebral artery aneurysm: case report.

We demonstrate the first case with unruptured carotid-duplicated middle cerebral artery (IC-Dup MCA) aneurysm combined with ruptured opposite carotid aneurysm. Eleven IC-Dup MCA aneurysm reported until now had all ruptured. It is noteworthy that 8 patients of the 11 were Japanese.

Growth of small unruptured intracranial aneurysm: case report.

Magnetic resonance angiography (MRA) revealed silent but rapid growth of a small unruptured intracranial aneurysm until it was surgically treated to prevent rupture. Modern neuroimaging methods such as MRA and 3-dimensional computed tomography have increased opportunity to detect small unruptured cerebral aneurysms. Strict follow up is an option for the incidentally discovered small intact aneurysms using these methods.

Single burr hole evacuation for traumatic acute subdural hematoma of the posterior fossa in the emergency room.

A 57-year-old man and a 55-year-old man presented with acute subdural hematoma of the posterior cranial fossa due to trauma. Both were comatose preoperatively. Emergent single burr hole evacuation in the posterior cranial fossa was performed in the emergency room immediately after computed tomography.

[An epithelial cyst at the frontal convexity].

We report a rare case of an epithelial cyst at the right frontal convexity. A 60-year-old woman came to our hospital suffering from dysarthria and gait disturbance. Computed tomography (CT) of the brain on admission showed a round low-density area, 6 cm in diameter, at the right frontal convexity.

Free hand aspiration for large periventricular hemorrhage. Case report.

Background: At present, there are several therapeutic options, including craniotomy and stereotactic aspiration, for large intracerebral hemorrhage perforating into the lateral ventricle. In the cases with Glasgow Coma Scale (GCS) scores under 6 with anisocoria, external ventricular drainage would be the first choice [2-4]. We have also performed anterior ventricular horn puncture in a standard manner.

[Acute epidural hematoma caused by contrecoup injury].

We report a rare case of the acute epidural hematoma caused by contrecoup injury. A 59-year-old woman came to our hospital on foot because of her head injury. She slipped on a stone and hit her occiput against the concrete floor without loss of consciousness.

Levcromakalim decreases cytoplasmic Ca2+ and vascular tone in basilar artery of SAH model dogs.

We investigated the effects of levcromakalim, a K+ channel opener, on [Ca2+]i and the contractile force of basilar arteries obtained from normal dogs and subarachnoid hemorrhage (SAH) dogs. The responsiveness to serotonin was increased more in the SAH group than in the control group. Levcromakalim decreased the resting [Ca2+]i and force more profoundly than did a Ca2+ channel blocker, nicardipine, and these effects were more prominent in the SAH group than in the control group.

Levcromakalim decreases vascular tone, cytoplasmic Ca2+ and Ca2+ sensitivity in canine basilar artery.

The involvement of large conductance Ca(2+)-activated K+ channels (BK) and ATP-sensitive K+ (KATP) channels in the regulation of canine basilar arterial tone was estimated in the presence of the agonist and blockers of these channels, by simultaneously measuring the changes in intracellular Ca2+ concentration ([Ca2+]i) with the fura-2 microfluorimetric method. In the resting condition, levcromakalim reduced [Ca2+]i and vascular tone. Levcromakalim suppressed the serotonin-induced increases in [Ca2+]i and force of contraction, the maximum effects of which were much greater than those of nicardipine.

Hirudin suppresses the invasion of inflammatory cells and the appearance of vimentin-positive astrocytes in the rat cerebral ablation model.

Hirudin is a specific and direct-acting thrombin inhibitor superior to heparin as an anticoagulant. Thrombin is a multifunctional molecule that acts as a serine protease locally generated from prothrombin during blood coagulation related to injury and/or inflammation. We previously reported that thrombin might be involved in the inflammatory response, glial reaction, and scar formation that occurred in central nervous system (CNS).